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Sample records for stringent future treatment

  1. Water treatments of the future

    International Nuclear Information System (INIS)

    Poon, John; Moore Kenneth

    2011-01-01

    This article discusses and reviews nine water technologies. They are solar desalination, synthetic aquaporin membranes, microbial fuel cell and desalination, forward osmosis, resource recovery and brine managment, 'Smart' water grids, micropollutant treatment, the Cities of the Future program and high retention membrane bioreactors.

  2. The future of uveitis treatment.

    Science.gov (United States)

    Lin, Phoebe; Suhler, Eric B; Rosenbaum, James T

    2014-01-01

    Uveitis is a heterogeneous collection of diseases with polygenic and environmental influences. This heterogeneity presents challenges in trial design and selection of end points. Despite the multitude of causes, therapeutics targeting common inflammatory pathways are effective in treating diverse forms of uveitis. These treatments, including corticosteroids and immunomodulatory agents, although often effective, can have untoward side effects, limiting their utility. The search for drugs with equal or improved efficacy that are safe is therefore paramount. A mechanism-based approach is most likely to yield the future breakthroughs in the treatment of uveitis. We review the literature and provide examples of the nuances of immune regulation and dysregulation that can be targeted for therapeutic benefit. As our understanding of the causes of uveitis grows we will learn how to better apply antibodies designed to block interaction between inflammatory cytokines and their receptors. T-lymphocyte activation can be targeted by blocking co-stimulatory pathways or inhibiting major histocompatibility complex protein interactions. Furthermore, intracellular downstream molecules from cytokine or other pathways can be inhibited using small molecule inhibitors, which have the benefit of being orally bioavailable. An emerging field is the lipid-mediated inflammatory and regulatory pathways. Alternatively, anti-inflammatory cytokines can be provided by administering recombinant protein, and intracellular "brakes" of inflammatory pathways can be introduced potentially by gene therapy. Novel approaches of delivering a therapeutic substance include, but are not limited to, the use of small interfering RNA, viral and nonviral gene therapy, and microparticle or viscous gel sustained-release drug-delivery platforms. Copyright © 2014. Published by Elsevier Inc.

  3. Pediatric uveitis: new and future treatments

    Science.gov (United States)

    Mehta, Preema J.; Alexander, Janet L.; Sen, H. Nida

    2017-01-01

    Purpose of review Pediatric uveitis is relatively uncommon, accounting for only 5–10% of all patients with uveitis. However, owing to high prevalence of complications and devastating outcomes, its lifetime burden can be significant. Recent findings Immunomodulatory therapy has been associated with better outcomes in noninfectious pediatric uveitis. However, effective treatments are limited by medication-related complications, including multiorgan toxicities and systemic side effects. Summary We review the current therapies available to treat pediatric uveitis, discuss novel and future therapies, and provide clinical recommendations utilizing these new agents. The consideration for treatment regimens in noninfectious pediatric uveitis is multifactorial. Understanding past, present, and future technology will aid in treatment of a complex and refractory disease. PMID:23872814

  4. Future-proof radioactive waste treatment technologies for nuclear power plants

    Energy Technology Data Exchange (ETDEWEB)

    Buettner, Klaus; Braehler, Georg [NUKEM Technologies Engineering Services GmbH, Alzenau (Germany)

    2014-08-15

    In order to select the optimal treatment method for radioactive waste three options can be considered. First, to treat the radioactive waste only to allow long term interim storage until the waste acceptance criteria are defined and the disposal sites are operable. Second, to select treatment methods just in compliance with the current state of discussion with the regard to the above. Third, taking also the future development in the field of waste acceptance criteria and disposal into account. When developing waste treatment systems for Nuclear Power Plants NUKEM Technologies follows the following targets, minimisation of the amount of radioactive waste, maximisation of free release material, volume reduction, avoidance of unwanted materials in the waste package, as well as efficient waste treatment solutions (low investment, high volume reduction). With its technologies produced waste packages fulfil the most stringent waste acceptance criteria.

  5. Narcolepsy: current treatment options and future approaches

    Directory of Open Access Journals (Sweden)

    Michel Billiard

    2008-06-01

    Full Text Available Michel BilliardDepartment of Neurology, Gui de Chauliac Hospital, Montpellier, FranceAbstract: The management of narcolepsy is presently at a turning point. Three main avenues are considered in this review: 1 Two tendencies characterize the conventional treatment of narcolepsy. Modafinil has replaced methylphenidate and amphetamine as the first-line treatment of excessive daytime sleepiness (EDS and sleep attacks, based on randomized, double blind, placebo-controlled clinical trials of modafinil, but on no direct comparison of modafinil versus traditional stimulants. For cataplexy, sleep paralysis, and hypnagogic hallucinations, new antidepressants tend to replace tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs in spite of a lack of randomized, double blind, placebo-controlled clinical trials of these compounds; 2 The conventional treatment of narcolepsy is now challenged by sodium oxybate, the sodium salt of gammahydroxybutyrate, based on a series of randomized, double-blind, placebo-controlled clinical trials and a long-term open label study. This treatment has a fairly good efficacy and is active on all symptoms of narcolepsy. Careful titration up to an adequate level is essential both to obtain positive results and avoid adverse effects; 3 A series of new treatments are currently being tested, either in animal models or in humans, They include novel stimulant and anticataplectic drugs, endocrine therapy, and, more attractively, totally new approaches based on the present state of knowledge of the pathophysiology of narcolepsy with cataplexy, hypocretine-based therapies, and immunotherapy.Keywords: narcolepsy, treatment, conventional drugs, modafinil, sodium oxybate, future treatments

  6. Current and future treatment options in osteoporosis.

    LENUS (Irish Health Repository)

    Brewer, Linda

    2012-02-01

    PURPOSE: The incidence of osteoporosis-related fractures will increase substantially over the coming decades as the population ages globally. This has important economic and public health implications, contributing substantially to morbidity and excess mortality in this population. METHODS: When prescribing for older patients the effectiveness profile of drugs needs to be balanced against their tolerability in individual patients. RESULTS: Currently we have good anti-fracture data to support the use of many available anti-resorptive and anabolic drugs including bisphosphonates, strontium ranelate and recombinant human parathyroid hormone. We also have evidence to demonstrate the importance of calcium and vitamin D repletion in these patients. However, in recent years our understanding of normal bone physiology and the mechanisms underlying the development of osteoporosis has significantly advanced and this has led to the development of new therapies. Novel agents, particularly denosumab, but also inhibitors of cathepsin K and anabolic agents that act on Wnt signalling, will increase the therapeutic options for clinicians in the coming years. CONCLUSION: This review discusses the evidence supporting the use of currently available treatment options for osteoporosis and potential future advances in drug therapy. Particular consideration should be given when prescribing for certain older patients who have issues with compliance or tolerance and also in those with co-morbidities or levels of frailty that may restrict the choice of therapy. Understanding the evidence for the benefit and possible harm of osteoporosis treatments is critical to appropriate management of this patient population.

  7. Strategies of temozolomide in future glioblastoma treatment

    Directory of Open Access Journals (Sweden)

    Lee CY

    2017-01-01

    Full Text Available Chooi Yeng Lee School of Pharmacy, Monash University Malaysia, Selangor, Malaysia Abstract: Glioblastoma multiforme (GBM may be one of the most challenging brain tumors to treat, as patients generally do not live more than 2 years. This review aimed to give a timely review of potential future treatments for GBM by looking at the latest strategies, involving mainly the use of temozolomide (TMZ. Although these studies were carried out either in vitro or in rodents, the findings collectively suggested that we are moving toward developing a more efficacious therapy for GBM patients. Nanoparticles preparation was, by far, the most extensively studied strategy for targeted brain delivery. Therefore, the first section of this review presents a treatment strategy using TMZ-loaded nanocarriers, which encompassed nanoparticles, nanoliposomes, and nanosponges. Besides nanocarriers, new complexes that were formed between TMZ and another chemical agent or molecule have shown increased cytotoxicity and antitumor activity. Another approach was by reducing GBM cell resistance to TMZ, and this was achieved either through the suppression of metabolic change occurring in the cells, inhibition of the DNA repair protein, or up-regulation of the protein that mediates autophagy. Finally, the review collates a list of substances that have demonstrated the ability to suppress tumor cell growth. Keywords: cellular resistance, glioblastoma multiforme, nanoparticles, targeted delivery, temozolomide

  8. Circuitry linking the Csr and stringent response global regulatory systems.

    Science.gov (United States)

    Edwards, Adrianne N; Patterson-Fortin, Laura M; Vakulskas, Christopher A; Mercante, Jeffrey W; Potrykus, Katarzyna; Vinella, Daniel; Camacho, Martha I; Fields, Joshua A; Thompson, Stuart A; Georgellis, Dimitris; Cashel, Michael; Babitzke, Paul; Romeo, Tony

    2011-06-01

    CsrA protein regulates important cellular processes by binding to target mRNAs and altering their translation and/or stability. In Escherichia coli, CsrA binds to sRNAs, CsrB and CsrC, which sequester CsrA and antagonize its activity. Here, mRNAs for relA, spoT and dksA of the stringent response system were found among 721 different transcripts that copurified with CsrA. Many of the transcripts that copurified with CsrA were previously determined to respond to ppGpp and/or DksA. We examined multiple regulatory interactions between the Csr and stringent response systems. Most importantly, DksA and ppGpp robustly activated csrB/C transcription (10-fold), while they modestly activated csrA expression. We propose that CsrA-mediated regulation is relieved during the stringent response. Gel shift assays confirmed high affinity binding of CsrA to relA mRNA leader and weaker interactions with dksA and spoT. Reporter fusions, qRT-PCR and immunoblotting showed that CsrA repressed relA expression, and (p)ppGpp accumulation during stringent response was enhanced in a csrA mutant. CsrA had modest to negligible effects on dksA and spoT expression. Transcription of dksA was negatively autoregulated via a feedback loop that tended to mask CsrA effects. We propose that the Csr system fine-tunes the stringent response and discuss biological implications of the composite circuitry. © Published 2011. This article is a US Government work and is in the public domain in the USA.

  9. Present and Future: Pharmacologic Treatment of Obesity

    Directory of Open Access Journals (Sweden)

    Mariela Glandt

    2011-01-01

    Full Text Available Obesity now presents one of the biggest health problems of our times. Diet and exercise are best for both prevention and treatment; unfortunately, both require much discipline and are difficult to maintain. Medications offer a possible adjunct, but their effect is modest, they are limited by side effects, and the weight loss lasts only as long as the drug is being taken, since as soon as treatment is stopped, the weight is regained. Sibutramine, a sympathomimetic medication which was available for long-term treatment, is the most recent of the drugs to be withdrawn from the market due to side effects; in this case it was an increased risk of cardiovascular events. This paper reviews those medications which are available for treatment of obesity, including many of those recently taken off the market. It also discusses some of the newer treatments that are currently being investigated.

  10. Narcolepsy: current treatment options and future approaches

    Science.gov (United States)

    Billiard, Michel

    2008-01-01

    The management of narcolepsy is presently at a turning point. Three main avenues are considered in this review: 1) Two tendencies characterize the conventional treatment of narcolepsy. Modafinil has replaced methylphenidate and amphetamine as the first-line treatment of excessive daytime sleepiness (EDS) and sleep attacks, based on randomized, double blind, placebo-controlled clinical trials of modafinil, but on no direct comparison of modafinil versus traditional stimulants. For cataplexy, sleep paralysis, and hypnagogic hallucinations, new antidepressants tend to replace tricyclic antidepressants and selective serotonin reuptake inhibitors (SSRIs) in spite of a lack of randomized, double blind, placebo-controlled clinical trials of these compounds; 2) The conventional treatment of narcolepsy is now challenged by sodium oxybate, the sodium salt of gammahydroxybutyrate, based on a series of randomized, double-blind, placebo-controlled clinical trials and a long-term open label study. This treatment has a fairly good efficacy and is active on all symptoms of narcolepsy. Careful titration up to an adequate level is essential both to obtain positive results and avoid adverse effects; 3) A series of new treatments are currently being tested, either in animal models or in humans, They include novel stimulant and anticataplectic drugs, endocrine therapy, and, more attractively, totally new approaches based on the present state of knowledge of the pathophysiology of narcolepsy with cataplexy, hypocretine-based therapies, and immunotherapy. PMID:18830438

  11. Is ionizing radiation regulated more stringently than chemical carcinogens

    International Nuclear Information System (INIS)

    Travis, C.C.; Pack, S.R.; Hattemer-Frey, H.A.

    1989-01-01

    It is widely believed that United States government agencies regulate exposure to ionizing radiation more stringently than exposure to chemical carcinogens. It is difficult to verify this perception, however, because chemical carcinogens and ionizing radiation are regulated using vastly different strategies. Chemical carcinogens are generally regulated individually. Regulators consider the risk of exposure to one chemical rather than the cumulative radiation exposure from all sources. Moreover, standards for chemical carcinogens are generally set in terms of quantities released or resultant environmental concentrations, while standards for ionizing radiation are set in terms of dose to the human body. Since chemicals and ionizing radiation cannot be compared on the basis of equal dose to the exposed individual, standards regulating chemicals and ionizing radiation cannot be compared directly. It is feasible, however, to compare the two sets of standards on the basis of equal risk to the exposed individual, assuming that standards for chemicals and ionizing radiation are equivalent if estimated risk levels are equitable. This paper compares risk levels associated with current standards for ionizing radiation and chemical carcinogens. The authors do not attempt to determine whether either type of risk is regulated too stringently or not stringently enough but endeavor only to ascertain if ionizing radiation is actually regulated more strictly than chemical carcinogens

  12. Current and future treatment options for acne.

    NARCIS (Netherlands)

    Kerkhof, P.C.M. van de; Kleinpenning, M.M.; Jong, E.M.G.J. de; Gerritsen, M.J.P.; Dooren-Greebe, R.J. van; Alkemade, J.A.C.

    2006-01-01

    Acne is a frequent skin disease with abnormalities in the process of keratinization, sebaceous gland functioning and inflammation. In this review, our understanding of the pathogenesis of acne has been updated. An overview of efficacy and side effects of available anti-acne treatments is presented.

  13. The future of tic disorder treatment.

    Science.gov (United States)

    Bennett, Shannon M; Keller, Alex E; Walkup, John T

    2013-11-01

    Competing theories on the etiology and treatment of chronic tic disorders and Tourette syndrome have long made the search for efficacious intervention more challenging for patients and families seeking to reduce functional impairment related to tic symptoms. These symptoms were historically posited to be either psychological in origin, leading to the long tradition of psychoanalytic psychotherapy for tics, or biological in nature, particularly since the advent of successful treatments using neuroleptic medications. Current thinking about the phenomenology of tic disorders comes from growing empirical evidence as well as advances in neuroscience and genetics research and reveals a biological vulnerability that is exacerbated by physiological arousal related to environmental or interpersonal stress. This manuscript summarizes the evolution of this knowledge base and describes current best-practice recommendations for patients, families, and clinicians. © 2013 New York Academy of Sciences.

  14. Nanobots The Future Of Medical Treatments

    Directory of Open Access Journals (Sweden)

    Somanna M B

    2015-08-01

    Full Text Available Abstract Nanobots will help bridge the technological gaps between physics chemistry and biology on the nano-scale. This will lead to many innovative approaches which will result in new methods and products for both technological and medical-pharmaceutical applications. In this report the following questions are addressed How a nanobot works and how nanobots can contribute to medical technology. Advancement in technology is essential for the treatment of many problems such as implants related to bones and membranes. Furthermore nanobots are good candidates for these complex treatments with their size being very small. Nanobots are also considered and some are already in use as drug delivery systems and contrast agents. It is argued that coated nanobots functionalized with target molecules are interacting with external devices offering real prospective for medical applications.

  15. Future prospects for treatment of hemoglobinopathies.

    OpenAIRE

    Stamatoyannopoulos, J A

    1992-01-01

    Strategies for the treatment of sickle cell anemia and beta-thalassemia are founded on the knowledge that these disorders result from structural or functional defects in an adult gene for which an intact fetal counterpart exists. During the past decade, several pharmacologic agents have been investigated for their potential to ameliorate sickle cell anemia and beta-thalassemia by increasing the synthesis of fetal hemoglobin in adults. Progress in understanding globin gene regulation is now be...

  16. Achondroplasia: pathogenesis and implications for future treatment.

    Science.gov (United States)

    Laederich, Melanie B; Horton, William A

    2010-08-01

    Although the genetic defect underlying achondroplasia has been known for over a decade, no effective therapies to stimulate bone growth have emerged. Here we review the recent literature and summarize the molecular mechanisms underlying disease pathology and examine their potential as therapeutic targets. Currently used preclinical models are discussed in the context of recent advances with a special focus on C-type natriuretic peptide. Research on the mutation in Fibroblast Growth Factor Receptor 3 (FGFR3) that causes achondroplasia suggests that disease results from increased signal transduction from the mutant receptor. Thus, current therapeutic strategies have focused on reducing signals emanating from FGFR3. First-generation therapies directly targeting FGFR3, such as kinase inhibitors and neutralizing antibodies, designed for targeting FGFR3 in cancer, are still in the preclinical phase and have yet to translate into the management of achondroplasia. Counteracting signal transduction pathways downstream of FGFR3 holds promise with the discovery that administration of C-type natriuretic peptide to achondroplastic mice ameliorates their clinical phenotype. However, more research into long-term effectiveness and safety of this strategy is needed. Direct targeting of therapeutic agents to growth plate cartilage may enhance efficacy and minimize side effects of these and future therapies. Current research into the pathogenesis of achondroplasia has expanded our understanding of the mechanisms of FGFR3-induced disease and has increased the number of approaches that we may use to potentially correct it. Further research is needed to validate these approaches in preclinical models of achondroplasia.

  17. Treatment of hemophilia in the near future.

    Science.gov (United States)

    Peyvandi, Flora; Garagiola, Isabella

    2015-11-01

    Advancements and debacles have characterized hemophilia treatment over the past 50 years. The 1970s saw the availability of plasma-derived concentrates making prophylaxis and home therapy possible. This optimistic perception changed extremely in the early 1980s, when most people with hemophilia were infected with HIV and hepatitis viruses. Then, also in the 1980s, the rapid progress in molecular biology led to the development of recombinant therapeutic products. This important advancement was a huge technological leap fresh off from the earlier 1980s disaster. Now in the 21st century, the newer bioengineering drugs open a new hopeful phase for the management of hemophilia. The current efforts are concentrated on producing novel coagulation factors with prolonged bioavailability, increased potency, and resistance to inactivation and potentially reduced immunogenicity; this phase of evolution is improving very quickly. 2014 is the year of marketing approval by the Food and Drug Administration of the first bioengineered FVIII and FIX long-acting drugs, using Fc-fusion strategy. This represents the first significant advance in the hemophilia therapy that dramatically transforms patient management by substantially reducing the frequency of injections, improving compliance, and simplifying prophylaxis and, in turn, refining the quality of life of hemophilia patients, offering them a nearly normal life expectancy, particularly to newborns with hemophilia B. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  18. Technology and the Future of Mental Health Treatment

    Science.gov (United States)

    ... Health Intervention Technology? Join a Study Learn More Technology and the Future of Mental Health Treatment Introduction ... What is NIMH’s Role in Mental Health Intervention Technology? Between FY2009 and FY2015, NIMH awarded 404 grants ...

  19. Future prospects of antiarrhythmic treatment based on experimental studies

    NARCIS (Netherlands)

    Janse, M. J.

    1995-01-01

    Based on recent experimental studies, a number of speculations about future developments are made regarding the treatment of atrial fibrillation, the problem of proarrhythmia in patients with heart failure, and the treatment of ventricular tachycardia developing during the first 6 weeks following

  20. Current approaches and future directions in the treatment of leprosy

    Directory of Open Access Journals (Sweden)

    Worobec SM

    2012-08-01

    Full Text Available Sophie M WorobecDepartment of Dermatology, College of Medicine, University of Illinois at Chicago, Chicago, Illinois, USAAbstract: This review surveys current treatments and future treatment trends in leprosy from a clinical perspective. The World Health Organization provides a multidrug treatment regimen that targets the Mycobacterium leprae bacillus which causes leprosy. Several investigational drugs are available for the treatment of drug-resistant M. leprae. Future directions in leprosy treatment will focus on: the molecular signaling mechanism M. leprae uses to avoid triggering an immune response; prospective studies of the side effects experienced during multiple-drug therapy; recognition of relapse rates post-completion of designated treatments; combating multidrug resistance; vaccine development; development of new diagnostic tests; and the implications of the recent discovery of a genetically distinct leprosy-causing bacillus, Mycobacterium lepromatosis.Keywords: epidemiology, leprosy, Hansen’s disease, multidrug resistance, multidrug therapy

  1. Flight Hardware Packaging Design for Stringent EMC Radiated Emission Requirements

    Science.gov (United States)

    Lortz, Charlene L.; Huang, Chi-Chien N.; Ravich, Joshua A.; Steiner, Carl N.

    2013-01-01

    This packaging design approach can help heritage hardware meet a flight project's stringent EMC radiated emissions requirement. The approach requires only minor modifications to a hardware's chassis and mainly concentrates on its connector interfaces. The solution is to raise the surface area where the connector is mounted by a few millimeters using a pedestal, and then wrapping with conductive tape from the cable backshell down to the surface-mounted connector. This design approach has been applied to JPL flight project subsystems. The EMC radiated emissions requirements for flight projects can vary from benign to mission critical. If the project's EMC requirements are stringent, the best approach to meet EMC requirements would be to design an EMC control program for the project early on and implement EMC design techniques starting with the circuit board layout. This is the ideal scenario for hardware that is built from scratch. Implementation of EMC radiated emissions mitigation techniques can mature as the design progresses, with minimal impact to the design cycle. The real challenge exists for hardware that is planned to be flown following a built-to-print approach, in which heritage hardware from a past project with a different set of requirements is expected to perform satisfactorily for a new project. With acceptance of heritage, the design would already be established (circuit board layout and components have already been pre-determined), and hence any radiated emissions mitigation techniques would only be applicable at the packaging level. The key is to take a heritage design with its known radiated emissions spectrum and repackage, or modify its chassis design so that it would have a better chance of meeting the new project s radiated emissions requirements.

  2. Comparison of urine iodine/creatinine ratio between patients following stringent and less stringent low iodine diet for radioiodine remnant ablation of thyroid cancer

    International Nuclear Information System (INIS)

    Roh, Jee Ho; Kim, Byung Il; Ha, Ji Su; Chang, Sei Joong; Shin, Hye Young; Choi, Joon Hyuk; Kim, Do Min; Kim, Chong Soon

    2006-01-01

    A low iodine diet (LID) for 1 ∼ 2 weeks is recommended for patients who undergoing radioiodine remnant ablation. However, the LID educations for patients are different among centers because there is no concrete recommendation for protocol of LID. In this investigation, we compared two representative types of LID protocols performed in several centers in Korea using urine iodine to creatinine tatio (urine I/Cr). From 2006, April to June, patients referred to our center for radioiodine remnant ablation of thyroid cancer from several local hospitals which had different LID protocols were included. We divided into two groups, stringent LID for 1 week and less stringent LID for 2 weeks, then measured their urine I/Cr ratio with spot urine when patients were admitted to the hospital. Total 27 patients were included in this investigation (M:F = 1:26; 13 in one-week stringent LID; 14 in two-week less stringent LID). Average of urine I/Cr ratio was 127.87 ± 78.52 μ g/g in stringent LID for 1 week, and 289.75 ± 188.24 μ g/g in less stringent LID for 2 weeks. It was significantly lower in stringent LID for 1 week group (ρ = 0.008). The number of patients whose urine I/Cr ratios were below 100 μ g/g was 6 of 13 in stringent LID for 1 week group, and 3 of 14 in less stringent LID for 2 weeks group. Stringent LID for 1 week resulted in better urinary I/Cr ratio in our investigation compared with the other protocol. However it still resulted in plenty of inadequate range of I/Cr ratio, so more stringent protocol such as stringent LID for 2 weeks is expected more desirable

  3. Treatment for primary hypothyroidism: current approaches and future possibilities

    Science.gov (United States)

    Chakera, Ali J; Pearce, Simon HS; Vaidya, Bijay

    2012-01-01

    Primary hypothyroidism is the most common endocrine disease. Although the diagnosis and treatment of hypothyroidism is often considered simple, there are large numbers of people with this condition who are suboptimally treated. Even in those people with hypothyroidism who are biochemically euthyroid on levothyroxine replacement there is a significant proportion who report poorer quality of life. This review explores the historical and current treatment options for hypothyroidism, reasons for and potential solutions to suboptimal treatment, and future possibilities in the treatment of hypothyroidism. PMID:22291465

  4. Alzheimer’s Disease: Background, Current and Future Treatments

    OpenAIRE

    Evelyn Chou

    2014-01-01

    Alzheimer’s disease is a currently incurable neurodegenerative disorder, and its treatment has posed a big challenge. Proposed causes of Alzheimer’s disease include the cholinergic, amyloid and tau hypothesis. Current therapeutic treatments have been aimed at dealing with neurotransmitter imbalance. These include cholinesterase inhibitors and N-methyl D-aspartate receptor antagonists. However, current therapeutics have been unable to halt its progression. The future of Alzheimer’s disease tre...

  5. [Treatment of posterior noninfectious uveitis : Current situation and future developments].

    Science.gov (United States)

    Pleyer, U; Pohlmann, D; Stübiger, N

    2016-05-01

    Treatment of autoimmune diseases has undergone significant changes and developments in recent years. New classes of active substances, in particular biologics and small molecules have resulted in previously unknown success in the treatment of many diseases. In particular patients suffering from autoimmune rheumatic or dermatological diseases have benefited. For autoimmune uveitis there are numerous reports indicating excellent therapeutic and preventive effects; however, statutory approval for therapy in adults is still pending. This article outlines recent advances and future therapeutic options for the treatment of posterior segment noninfectious uveitis.

  6. Poor Response to Periodontal Treatment May Predict Future Cardiovascular Disease.

    Science.gov (United States)

    Holmlund, A; Lampa, E; Lind, L

    2017-07-01

    Periodontal disease has been associated with cardiovascular disease (CVD), but whether the response to the treatment of periodontal disease affects this association has not been investigated in any large prospective study. Periodontal data obtained at baseline and 1 y after treatment were available in 5,297 individuals with remaining teeth who were treated at a specialized clinic for periodontal disease. Poor response to treatment was defined as having >10% sites with probing pocket depth >4 mm deep and bleeding on probing at ≥20% of the sites 1 y after active treatment. Fatal/nonfatal incidence rate of CVD (composite end point of myocardial infarction, stroke, and heart failure) was obtained from the Swedish cause-of-death and hospital discharge registers. Poisson regression analysis was performed to analyze future risk of CVD. During a median follow-up of 16.8 y (89,719 person-years at risk), those individuals who did not respond well to treatment (13.8% of the sample) had an increased incidence of CVD ( n = 870) when compared with responders (23.6 vs. 15.3%, P 4 mm, and number of teeth, the incidence rate ratio for CVD among poor responders was 1.28 (95% CI, 1.07 to 1.53; P = 0.007) as opposed to good responders. The incidence rate ratio among poor responders increased to 1.39 (95% CI, 1.13 to 1.73; P = 0.002) for those with the most remaining teeth. Individuals who did not respond well to periodontal treatment had an increased risk for future CVD, indicating that successful periodontal treatment might influence progression of subclinical CVD.

  7. The future for electrocoagulation as a localised water treatment technology.

    Science.gov (United States)

    Holt, Peter K; Barton, Geoffrey W; Mitchell, Cynthia A

    2005-04-01

    Electrocoagulation is an electrochemical method of treating polluted water whereby sacrificial anodes corrode to release active coagulant precursors (usually aluminium or iron cations) into solution. Accompanying electrolytic reactions evolve gas (usually as hydrogen bubbles) at the cathode. Electrocoagulation has a long history as a water treatment technology having been employed to remove a wide range of pollutants. However electrocoagulation has never become accepted as a 'mainstream' water treatment technology. The lack of a systematic approach to electrocoagulation reactor design/operation and the issue of electrode reliability (particularly passivation of the electrodes over time) have limited its implementation. However recent technical improvements combined with a growing need for small-scale decentralised water treatment facilities have led to a re-evaluation of electrocoagulation. Starting with a review of electrocoagulation reactor design/operation, this article examines and identifies a conceptual framework for electrocoagulation that focuses on the interactions between electrochemistry, coagulation and flotation. In addition detailed experimental data are provided from a batch reactor system removing suspended solids together with a mathematical analysis based on the 'white water' model for the dissolved air flotation process. Current density is identified as the key operational parameter influencing which pollutant removal mechanism dominates. The conclusion is drawn that electrocoagulation has a future as a decentralised water treatment technology. A conceptual framework is presented for future research directed towards a more mechanistic understanding of the process.

  8. Palmoplantar Psoriasis and Palmoplantar Pustulosis: Current Treatment and Future Prospects.

    Science.gov (United States)

    Raposo, Inês; Torres, Tiago

    2016-08-01

    Palmoplantar psoriasis and palmoplantar pustulosis are chronic skin diseases with a large impact on patient quality of life. They are frequently refractory to treatment, being generally described as a therapeutic challenge. This article aims to review the definitions of palmoplantar psoriasis and palmoplantar pustulosis, highlighting the similarities and differences in terms of epidemiology, clinical presentation, genetics, histopathology, and pathogenesis, as well as treatment options for both entities. Classical management of mild to moderate palmoplantar pustulosis and palmoplantar psoriasis relies on use of potent topical corticosteroids, phototherapy, and/or acitretin. Nevertheless, these drugs have proven to be insufficient in long-term control of extensive disease. Biologic therapy-namely, anti-interleukin-17 agents and phosphodiesterase type 4 inhibitors-has recently shown promising results in the treatment of palmoplantar psoriasis. Knowledge of the pathophysiologic pathways of both entities is of utmost importance and may, in the future, allow development of molecularly targeted therapeutics.

  9. Temperature impacts on economic growth warrant stringent mitigation policy

    Science.gov (United States)

    Moore, Frances C.; Diaz, Delavane B.

    2015-02-01

    Integrated assessment models compare the costs of greenhouse gas mitigation with damages from climate change to evaluate the social welfare implications of climate policy proposals and inform optimal emissions reduction trajectories. However, these models have been criticized for lacking a strong empirical basis for their damage functions, which do little to alter assumptions of sustained gross domestic product (GDP) growth, even under extreme temperature scenarios. We implement empirical estimates of temperature effects on GDP growth rates in the DICE model through two pathways, total factor productivity growth and capital depreciation. This damage specification, even under optimistic adaptation assumptions, substantially slows GDP growth in poor regions but has more modest effects in rich countries. Optimal climate policy in this model stabilizes global temperature change below 2 °C by eliminating emissions in the near future and implies a social cost of carbon several times larger than previous estimates. A sensitivity analysis shows that the magnitude of climate change impacts on economic growth, the rate of adaptation, and the dynamic interaction between damages and GDP are three critical uncertainties requiring further research. In particular, optimal mitigation rates are much lower if countries become less sensitive to climate change impacts as they develop, making this a major source of uncertainty and an important subject for future research.

  10. Stringent Mitigation Policy Implied By Temperature Impacts on Economic Growth

    Science.gov (United States)

    Moore, F.; Turner, D.

    2014-12-01

    Integrated assessment models (IAMs) compare the costs of greenhouse gas mitigation with damages from climate change in order to evaluate the social welfare implications of climate policy proposals and inform optimal emissions reduction trajectories. However, these models have been criticized for lacking a strong empirical basis for their damage functions, which do little to alter assumptions of sustained GDP growth, even under extreme temperature scenarios. We implement empirical estimates of temperature effects on GDP growth-rates in the Dynamic Integrated Climate and Economy (DICE) model via two pathways, total factor productivity (TFP) growth and capital depreciation. Even under optimistic adaptation assumptions, this damage specification implies that optimal climate policy involves the elimination of emissions in the near future, the stabilization of global temperature change below 2°C, and a social cost of carbon (SCC) an order of magnitude larger than previous estimates. A sensitivity analysis shows that the magnitude of growth effects, the rate of adaptation, and the dynamic interaction between damages from warming and GDP are three critical uncertainties and an important focus for future research.

  11. Present and future treatment possibilities in macular degeneration

    Science.gov (United States)

    Fisher, E.; Wegner, A.; Pfeiler, T.; Mertz, M.

    2005-11-01

    Purpose: To discuss present and future treatment possibilities in different types of choroidal neovascularisation. Methods: Presented are angiographic- and OCT-findings in patients with macular degeneration of different origin. Choroidal neovascularisations, which are not likely to respond positively to established procedures like thermal laser coagulation or photodynamic therapy will be discussed. Results and conclusions: Present study-guidelines and new methods of pharmacological intervention are analysed in different patterns of macular degeneration. Conventional laser coagulation in the treatment of classic, extrafoveal CNV and photodynamic therapy of predominantly classic subfoveal CNV still represent a gold standard. There are new recommendations, loosening the tight criteria of the TAP and VIP-guidelines, which cover, for instance, wider visual acuity ranges and the treatment of juxtafoveally located choroidal neovascularisations. Positive findings in literature confirm the role of PDT in pathologic myopia and other non-AMD CNV. Studies about surgical procedures, like macula- or RPE-translocation after surgical removal or thermal laser destruction of the CNV are in progress and are expected to show promising results. Phase II/III studies will soon point out the effect of anti-VEGF agents. The application of intravitreal (triamcinolone) or peribulbar (anecortave acetat) steroids could be useful. The combination with surgical or laser techniques could bring further benefit to the patient.

  12. [Present status and future of hypnotic drug treatment for insomnia].

    Science.gov (United States)

    Uchiyama, Makoto; Konno, Michiko

    2012-07-01

    Pharmacological treatments of insomnia have become safer since the first benzodiazepine receptor agonist (BzRA) hypnotic was introduced in the 1960's. Though BzRAs could hardly cause a fatal condition even in cases of overdosing, they had inherited the arguments on addiction and withdrawal from the prior studies of barbiturate hypnotics that indicated they are strongly addictive. In the 2000s, it was repeatedly demonstrated that insomnia as well as sleep deprivation underlie the development and deterioration of comorbid diseases such as hypertension, cardiovascular diseases, diabetes and depression, and that the proper use of hypnotic drugs is unlikely to cause tolerance, addiction nor rebound phenomena, but likely to be associated with improvement of QOL. Thus, the 2005's consensus report on chronic insomnia by NIH has recommended general physicians to facilitate insomnia treatment to prevent the development of physical and/or mental disorders. The author reviewed in this article the efficacy and side effects of BzRA hypnotics, a hypnotic drug therapy combined with cognitive and behavioral interventions, uses of melatonin receptor agonist in general and sleep medicine practices, and future utilization of newly-developed orexin antagonists for insomnia treatment.

  13. The future of pharmacogenetics in the treatment of heart failure.

    Science.gov (United States)

    Anwar, Mohamed Subhan; Iskandar, Muhammad Zaid; Parry, Helen M; Doney, Alex S; Palmer, Colin N; Lang, Chim C

    2015-11-01

    Heart failure is a common disease with high levels of morbidity and mortality. Current treatment comprises β-blockers, ACE inhibitors, aldosterone antagonists and diuretics. Variation in clinical response seen in patients begs the question of whether there is a pharmacogenetic component yet to be identified. To date, the genes most studied involve the β-1, β-2, α-2 adrenergic receptors and the renin-angiotensin-aldosterone pathway, mainly focusing on SNPs. However results have been inconsistent. Genome-wide association studies and next-generation sequencing are seen as alternative approaches to discovering genetic variations influencing drug response. Hopefully future research will lay the foundations for genotype-led drug management in these patients with the ultimate aim of improving their clinical outcome.

  14. Traumatic brain injury: future assessment tools and treatment prospects

    Directory of Open Access Journals (Sweden)

    Steven R Flanagan

    2008-10-01

    Full Text Available Steven R Flanagan1, Joshua B Cantor2, Teresa A Ashman21New York University School of Medicine, The Rusk Institute of Rehabilitation, New York, NY, USA; 2Department of Rehabilitation Medicine, Mount Sinai School of Medicine, New York, NY, USAAbstract: Traumatic brain injury (TBI is widespread and leads to death and disability in millions of individuals around the world each year. Overall incidence and prevalence of TBI are likely to increase in absolute terms in the future. Tackling the problem of treating TBI successfully will require improvements in the understanding of normal cerebral anatomy, physiology, and function throughout the lifespan, as well as the pathological and recuperative responses that result from trauma. New treatment approaches and combinations will need to be targeted to the heterogeneous needs of TBI populations. This article explores and evaluates the research evidence in areas that will likely lead to a reduction in TBI-related morbidity and improved outcomes. These include emerging assessment instruments and techniques in areas of structural/chemical and functional neuroimaging and neuropsychology, advances in the realms of cell-based therapies and genetics, promising cognitive rehabilitation techniques including cognitive remediation and the use of electronic technologies including assistive devices and virtual reality, and the emerging field of complementary and alternative medicine.Keywords: traumatic brain injury, assessments, treatments

  15. Synthetic Peptides to Target Stringent Response-Controlled Virulence in a Pseudomonas aeruginosa Murine Cutaneous Infection Model

    Directory of Open Access Journals (Sweden)

    Daniel Pletzer

    2017-09-01

    Full Text Available Microorganisms continuously monitor their surroundings and adaptively respond to environmental cues. One way to cope with various stress-related situations is through the activation of the stringent stress response pathway. In Pseudomonas aeruginosa this pathway is controlled and coordinated by the activity of the RelA and SpoT enzymes that metabolize the small nucleotide secondary messenger molecule (pppGpp. Intracellular ppGpp concentrations are crucial in mediating adaptive responses and virulence. Targeting this cellular stress response has recently been the focus of an alternative approach to fight antibiotic resistant bacteria. Here, we examined the role of the stringent response in the virulence of P. aeruginosa PAO1 and the Liverpool epidemic strain LESB58. A ΔrelA/ΔspoT double mutant showed decreased cytotoxicity toward human epithelial cells, exhibited reduced hemolytic activity, and caused down-regulation of the expression of the alkaline protease aprA gene in stringent response mutants grown on blood agar plates. Promoter fusions of relA or spoT to a bioluminescence reporter gene revealed that both genes were expressed during the formation of cutaneous abscesses in mice. Intriguingly, virulence was attenuated in vivo by the ΔrelA/ΔspoT double mutant, but not the relA mutant nor the ΔrelA/ΔspoT complemented with either gene. Treatment of a cutaneous P. aeruginosa PAO1 infection with anti-biofilm peptides increased animal welfare, decreased dermonecrotic lesion sizes, and reduced bacterial numbers recovered from abscesses, resembling the phenotype of the ΔrelA/ΔspoT infection. It was previously demonstrated by our lab that ppGpp could be targeted by synthetic peptides; here we demonstrated that spoT promoter activity was suppressed during cutaneous abscess formation by treatment with peptides DJK-5 and 1018, and that a peptide-treated relA complemented stringent response double mutant strain exhibited reduced peptide

  16. HAART in HIV/AIDS Treatments: Future Trends.

    Science.gov (United States)

    Lu, Da-Yong; Wu, Hong-Ying; Yarla, Nagendra Sastry; Xu, Bin; Ding, Jian; Lu, Ting-Ren

    2018-01-01

    AIDS (acquired immune deficient syndrome) is a deadly human viral infectious disease caused by HIV (human immune-deficient virus) infection. Almost every AIDS patient losses his/her life before mid 1990s. AIDS was once the 1st disease killer in US (1993). After one decade hard work, antiviral drug cocktails-high active anti-retroviral therapy (HAART) have been invented for almost all HIV infection treatments. Due to the invention of HAART, 80-90% HIV/AIDS patients still effectively response to HAART for deadly AIDS episode controls and life saving. Yet, this type of HIV therapeutics is incurable. HIV/AIDS patients need to take HAART medications regularly and even life-long. To counteract this therapeutic drawback, more revolutionary efforts (different angles of therapeutic modes/attempts) are urgently needed. In this article, the major progresses and drawbacks of HIV/AIDS chemotherapy (HAART) to HIV/AIDS patients have been discussed. Future trends (updating pathogenesis study, next generations of drug developments, new drug target discovery, different scientific disciplinary and so on) are highlighted. Copyright© Bentham Science Publishers; For any queries, please email at epub@benthamscience.org.

  17. Treatment strategies for inherited optic neuropathies: past, present and future

    Science.gov (United States)

    Yu-Wai-Man, P; Votruba, M; Moore, A T; Chinnery, P F

    2014-01-01

    Bilateral visual loss secondary to inherited optic neuropathies is an important cause of registrable blindness among children and young adults. The two prototypal disorders seen in clinical practice are Leber hereditary optic neuropathy (LHON) and autosomal dominant optic atrophy (DOA). About 90% of LHON cases are due to one of three mitochondrial DNA (mtDNA) point mutations: m.3460G>A, m.11778G>A, and m.14484T>C, which affect critical complex I subunits of the mitochondrial respiratory chain. The majority of patients with DOA harbour pathogenic mutations within OPA1, a nuclear gene that codes for a multifunctional inner mitochondrial membrane protein. Despite their contrasting genetic basis, LHON and DOA share overlapping pathological and clinical features that serve to highlight the striking tissue-specific vulnerability of the retinal ganglion cell (RGC) layer to disturbed mitochondrial function. In addition to severe visual loss secondary to progressive optic nerve degeneration, a subgroup of patients will also develop a more aggressive syndromic phenotype marked by significant neurological deficits. The management of LHON and DOA remains largely supportive, but major advances in our understanding of the mechanisms underpinning RGC loss in these two disorders are paving the way for novel forms of treatment aimed at halting or reversing visual deterioration at different stages of the disease process. In addition to neuroprotective strategies for rescuing RGCs from irreversible cell death, innovative in vitro fertilisation techniques are providing the tantalising prospect of preventing the germline transmission of pathogenic mtDNA mutations, eradicating in so doing the risk of disease in future generations. PMID:24603424

  18. Treatment strategies for inherited optic neuropathies: past, present and future.

    Science.gov (United States)

    Yu-Wai-Man, P; Votruba, M; Moore, A T; Chinnery, P F

    2014-05-01

    Bilateral visual loss secondary to inherited optic neuropathies is an important cause of registrable blindness among children and young adults. The two prototypal disorders seen in clinical practice are Leber hereditary optic neuropathy (LHON) and autosomal dominant optic atrophy (DOA). About 90% of LHON cases are due to one of three mitochondrial DNA (mtDNA) point mutations: m.3460G>A, m.11778G>A, and m.14484T>C, which affect critical complex I subunits of the mitochondrial respiratory chain. The majority of patients with DOA harbour pathogenic mutations within OPA1, a nuclear gene that codes for a multifunctional inner mitochondrial membrane protein. Despite their contrasting genetic basis, LHON and DOA share overlapping pathological and clinical features that serve to highlight the striking tissue-specific vulnerability of the retinal ganglion cell (RGC) layer to disturbed mitochondrial function. In addition to severe visual loss secondary to progressive optic nerve degeneration, a subgroup of patients will also develop a more aggressive syndromic phenotype marked by significant neurological deficits. The management of LHON and DOA remains largely supportive, but major advances in our understanding of the mechanisms underpinning RGC loss in these two disorders are paving the way for novel forms of treatment aimed at halting or reversing visual deterioration at different stages of the disease process. In addition to neuroprotective strategies for rescuing RGCs from irreversible cell death, innovative in vitro fertilisation techniques are providing the tantalising prospect of preventing the germline transmission of pathogenic mtDNA mutations, eradicating in so doing the risk of disease in future generations.

  19. Cobalt-60 in the treatment of cancer-future scenario

    International Nuclear Information System (INIS)

    Sastri, K.V.S.; Patil, B.N.; Kohli, A.K.

    2009-01-01

    Treatment of cancer using radiation is established method. Cobalt-60 is the workhorse of cancer treatment from the beginning. Later linear accelerators with more accessories were developed and are now used for the advanced treatments like IMRT, IGRT etc. Gammaknife, Gyroknife and supergamma machines using 60 Co have also taken roots for the treatment of cancer. The use of 60 Co in the treatment of cancer is expected to continue for some more time to come. (author)

  20. Polycystic Ovary Syndrome: Update on Treatment Options and Treatment Considerations for the Future

    Directory of Open Access Journals (Sweden)

    Kristen A. Farrell-Turner

    2011-01-01

    Full Text Available Polycystic ovary syndrome is an endocrine disorder characterized by insulin resistance, hyperandrogenemia, obesity, and inflammation, and is the most common cause of infertility. Women with PCOS are at higher risk than non-PCOS women for diabetes, cardiovascular disease, endometrial cancer, and psychiatric disorders. Because many abnormalities present in PCOS and symptoms vary considerably among PCOS women, treatment is guided by presentation and does not consist of simply one modality. Often, however, one type of medication can ameliorate more than one abnormality in PCOS. This review summarizes current research on several treatment modalities for PCOS, including drugs that are fairly well-established as efficacious and other agents that may prove efficacious in the future, with particular emphasis on the benefits and barriers of lifestyle change.

  1. Present and Future Developments in Radiotherapy Treatment Units.

    Science.gov (United States)

    Boyer

    1995-04-01

    Technical advances in the design of medical accelerators are making possible the exploration of new treatment techniques. Technology currently available to the radiation oncologist allows the use of internal and dynamic wedges. Multileaf collimators can be used for static treatment ports, and dynamic field shaping and beam modulation using multileaf collimators has been shown to be feasible. Computer interfaces are necessary to transfer the complex treatment sequences that are possible with these devices. Such network interfaces also provide for more efficient conventional treatments. New machines such as X-band linear accelerators and advanced proton accelerators are being developed for applications such as boron neutron capture therapy and proton conformal therapy.

  2. Treatment of Hodgkin lymphoma: the past, present, and future

    DEFF Research Database (Denmark)

    Evens, A.M.; Hutchings, M.; Diehl, V.

    2008-01-01

    signaling pathways involved in HL. Continued translational research is needed to improve the long-term survival and to lessen the toxicities associated with therapy. Furthermore, continued clinical-trial involvement by oncologists and patients is imperative to further advance the field of HL Udgivelsesdato......Significant advances in the biology and treatment of Hodgkin lymphoma (HL) have been accomplished over the past decades. In a landmark study, DeVita and colleagues showed that half of patients with advanced-stage HL experienced long-term disease-free survival following treatment with a four......-drug chemotherapy regimen. Subsequent reports and randomized clinical trials conducted over the past 40 years have defined prognostic categories and refined the treatment options for patients with early-stage and advanced-stage HL. New treatment concepts and regimens have continued to increase the cure rate of HL...

  3. The future of thermal waste treatment; Zukunft der thermischen Restabfallbehandlung

    Energy Technology Data Exchange (ETDEWEB)

    Wiemer, K.; Kern, M. (eds.); Tappen, I.; Weber-Wied, R. (comps.)

    2001-07-01

    Contents: State of the art of energy-efficient thermal waste treatment processes and practical examples; Regional and economic aspects; Licensing problems of thermal waste treatment plants. [German] Der vorliegende Tagungsband zum 2. Stassfurter Abfall- und Energieforum beschreibt den aktuellen Stand energieeffizienter thermischer Abfallbehandlungsmethoden an praktischen Beispielen und stellt den Bezug dieser Massnahmen zum raeumlich-wirtschaftlichen Umfeld dar. Darueber hinaus werden vergaberechtliche Fragen im Zusammenhang mit der europaweiten Ausschreibungspflicht fuer die Errichtung thermischer Abfallbehandlungsanlagen aufgezeigt und eroertert. (orig.)

  4. Treatment of Cannabis Use Disorder: Current Science and Future Outlook

    Science.gov (United States)

    Sherman, Brian J.; McRae-Clark, Aimee L.

    2016-01-01

    Cannabis is the most commonly used illicit substance in the United States. Rates of cannabis use and cannabis use disorder have increased in the past decade, paralleling changes in the legal and political climate favoring legalization. Almost 20 million people aged 12 years or older report past-month cannabis use, and 8 million report daily or near-daily use. Concurrently, the perception that cannabis use poses a significant risk of negative consequences has decreased. Contrary to this perception, heavy cannabis use is associated with cognitive impairment, increased risk for psychotic disorders and other mental health problems, lower education attainment, and unemployment. Clinical trials of various treatments for cannabis use disorder have likewise increased, focusing primarily on psychotherapy treatments, specifically, motivational enhancement therapy, cognitive behavioral therapy, and contingency management. Their findings suggest that a combination of these three modalities produces the best abstinence outcomes, although abstinence rates remain modest and decline after treatment. More recently, pharmacotherapy trials have been conducted as adjunctive interventions to psychosocial treatment. N-acetylcysteine and gabapentin are two of the most promising medications, although no pharmacologic treatment has emerged as clearly efficacious. In this review, we provide a detailed summary of clinical trials that evaluated psychotherapy and pharmacotherapy for treating cannabis use disorder and discuss emerging areas of clinical research and cannabis-specific barriers to treatment. PMID:27027272

  5. Electricity versus hydrogen for passenger cars under stringent climate change control

    NARCIS (Netherlands)

    Rösler, H.; van der Zwaan, B.; Keppo, I.; Bruggink, J.

    2014-01-01

    In this article we analyze how passenger car transportation in Europe may change this century under permanent high oil prices and stringent climate control policy. We focus on electricity and hydrogen as principal candidate energy carriers, because these two options are increasingly believed to

  6. Structural characterization of the stringent response related exopolyphosphatase/guanosine pentaphosphate phosphohydrolase protein family

    DEFF Research Database (Denmark)

    Kristensen, Ole; Laurberg, Martin; Liljas, Anders

    2004-01-01

    Exopolyphosphatase/guanosine pentaphosphate phosphohydrolase (PPX/GPPA) enzymes play central roles in the bacterial stringent response induced by starvation. The high-resolution crystal structure of the putative Aquifex aeolicus PPX/GPPA phosphatase from the actin-like ATPase domain superfamily has...

  7. Present and future prospects of external radiation cancer treatment

    International Nuclear Information System (INIS)

    Valuckas, K. P.; Aleknavicius, E.; Grybauskas, M.

    2004-01-01

    Radiotherapy is the most applicable method in the treatment of cancer patients. Rapid advances in radiotherapy and imaging techniques allow improvement in definition of target margins, volumes, and organs at risk. Conformal radiotherapy using multileaf collimator was introduced towards the end of the 1980s. Further improvements in dose distribution were possible through intensity modulation radiation therapy based on the use of computer-controlled multileaf collimators for creating the desired dose variation inside a radiation field. The dose of definite radiotherapy is limited by dose tolerance of organs or tissues at risk near the target. In the last 50 years radiotherapy modalities achieved rapid developments, particularly in field of treatment planning and dose distribution. The main goal of that development is to apply definite radiotherapy dose to target and minimize normal tissue irradiation, leaving the patient free of treatment related morbidity. (author)

  8. Treatment of Functional Gastrointestinal Disorders in Children and Future Challenges

    Directory of Open Access Journals (Sweden)

    K Eftekhari

    2014-04-01

    Full Text Available Functional gastrointestinal disorders (FGIDs are a common problem in children. These disorders in children are classified into the following categories according to the ROME III classification: Functional Dyspepsia, Irritable bowel syndrome (IBS, Abdominal Migraines, Childhood Functional abdominal pain (FAP, Childhood functional abdominal pain syndrome and functional constipation. FGIDs are diagnosed based on history and normal physical examination provided that there is no evidence of underlying disease such as anatomical abnormalities, infectious, inflammatory and malignancies. This group of poorly defined diseases represent a huge treatment challenge to the specialist, because, until now there is no therapy that has been effective in improving the symptoms. FGIDs also cause deep family problems as the disease interrupts their routine and positive response to treatment is rarely seen. On the other hand there is no objective document of the disease neither endoscopic, radiologic nor pathologic. Therapeutic strategies of FGIDs are: education and parent's assurance, detection and modifying physical and psychological stress, dietary intervention, pharmacological treatment, psychotherapy and other complementary medical treatments. Some foods may trigger the illness such as coffee, fatty foods and spicy foods, therefore they should be avoided. Lactose-free diet cannot improve symptoms of FGIDs, except in children with lactose intolerance. The beneficial effect of fiber supplement in children with FGIDs remains unknown but it has been useful in adults with IBS. Probiotics have potential efficacy in treating IBS but the efficacy in children with FGIDs remains uncertain and needs to be further studied. In patients with severe symptoms, pharmacological agents can be effective. These drugs include Antacids, Prokinetics, Anticholinergic, Tricyclic antidepressants (TCAS and Serotonergic agents (Agonists and anti agonists. Psychotherapy in FAP and IBS is

  9. Surgical Treatment for Chronic Pancreatitis: Past, Present, and Future

    Directory of Open Access Journals (Sweden)

    Stephanie Plagemann

    2017-01-01

    Full Text Available The pancreas was one of the last explored organs in the human body. The first surgical experiences were made before fully understanding the function of the gland. Surgical procedures remained less successful until the discovery of insulin, blood groups, and finally the possibility of blood donation. Throughout the centuries, the surgical approach went from radical resections to minimal resections or only drainage of the gland in comparison to an adequate resection combined with drainage procedures. Today, the well-known and standardized procedures are considered as safe due to the high experience of operating surgeons, the centering of pancreatic surgery in specialized centers, and optimized perioperative treatment. Although surgical procedures have become safer and more efficient than ever, the overall perioperative morbidity after pancreatic surgery remains high and management of postoperative complications stagnates. Current research focuses on the prevention of complications, optimizing the patient’s general condition preoperatively and finding the appropriate timing for surgical treatment.

  10. Future directions in the treatment of HIV-HBV coinfection.

    Science.gov (United States)

    Iser, David M; Lewin, Sharon R

    2009-07-01

    Liver disease is a major cause of mortality in individuals with HIV-HBV coinfection. The pathogenesis of liver disease in this setting is unknown, but is likely to involve drug toxicity, infection of hepatic cells with both HIV and HBV, and an altered immune response to HBV. The availability of therapeutic agents that target both HIV and HBV replication enable dual viral suppression, and assessment of chronic hepatitis B is important prior to commencement of antiretroviral therapy. Greater importance is now placed on HBV DNA levels and staging of liver fibrosis, either by liver biopsy or noninvasive measurement, such as transient elastography, since significant liver fibrosis may exist in the presence of normal liver function tests. Earlier treatment of both HIV and HBV is now generally advocated and treatment is usually lifelong.

  11. Future directions in the treatment of HIV–HBV coinfection

    Science.gov (United States)

    Iser, David M; Lewin, Sharon R

    2009-01-01

    Liver disease is a major cause of mortality in individuals with HIV–HBV coinfection. The pathogenesis of liver disease in this setting is unknown, but is likely to involve drug toxicity, infection of hepatic cells with both HIV and HBV, and an altered immune response to HBV. The availability of therapeutic agents that target both HIV and HBV replication enable dual viral suppression, and assessment of chronic hepatitis B is important prior to commencement of antiretroviral therapy. Greater importance is now placed on HBV DNA levels and staging of liver fibrosis, either by liver biopsy or noninvasive measurement, such as transient elastography, since significant liver fibrosis may exist in the presence of normal liver function tests. Earlier treatment of both HIV and HBV is now generally advocated and treatment is usually lifelong. PMID:20161405

  12. Angina pectoris: current therapy and future treatment options.

    Science.gov (United States)

    Parikh, Raj; Kadowitz, Philip J

    2014-02-01

    Angina pectoris is the consequence of an inequality between the demand and supply of blood to the heart. Angina manifests itself as chest pain or discomfort and is a common complaint of patients in the hospital and in the clinic. There are, in fact, roughly half a million new cases of angina per year. Chest pain, while having many etiologies, is generally considered to be most lethal when related to a cardiac cause. In this review, the authors outline the current medical and surgical therapies that are used in the management of angina. Highlights of the various clinical trials that have assisted in the investigation of these therapies are summarized also. Then, the authors provide a focused review of the novel therapy options for angina that are currently being explored. From new medical treatments to revised surgical techniques to the discovery of stem cell therapy, many innovative options are being investigated for the treatment of angina.

  13. Current and future medical treatments for patients with acromegaly.

    Science.gov (United States)

    Maffezzoni, Filippo; Formenti, Anna Maria; Mazziotti, Gherardo; Frara, Stefano; Giustina, Andrea

    2016-08-01

    Acromegaly is a relatively rare condition of growth hormone (GH) excess associated with significant morbidity and, when left untreated, high mortality. Therapy for acromegaly is targeted at decreasing GH and insulin-like growth hormone 1 levels, ameliorating patients' symptoms and decreasing any local compressive effects of the pituitary adenoma. The therapeutic options for acromegaly include surgery, medical therapies (such as dopamine agonists, somatostatin receptor ligands and the GH receptor antagonist pegvisomant) and radiotherapy. However, despite all these treatments option, approximately 50% of patients are not adequately controlled. In this paper, the authors discuss: 1) efficacy and safety of current medical therapy 2) the efficacy and safety of the new multireceptor-targeted somatostatin ligand pasireotide 3) medical treatments currently under clinical investigation (oral octreotide, ITF2984, ATL1103), and 4) preliminary data on the use of new injectable and transdermal/transmucosal formulations of octreotide. This expert opinion supports the need for new therapeutic agents and modalities for patients with acromegaly.

  14. Treatment for primary hypothyroidism: current approaches and future possibilities

    OpenAIRE

    Chakera, Ali J; Pearce, Simon HS; Vaidya, Bijay

    2011-01-01

    Ali J Chakera1, Simon HS Pearce2, Bijay Vaidya11Department of Endocrinology, Royal Devon and Exeter Hospital and Peninsula Medical School, Exeter, 2Endocrine Unit, Royal Victoria Infirmary and Newcastle University, Newcastle upon Tyne, UKAbstract: Primary hypothyroidism is the most common endocrine disease. Although the diagnosis and treatment of hypothyroidism is often considered simple, there are large numbers of people with this condition who are suboptimally treated. Even in those people ...

  15. Osteogenesis imperfecta: from diagnosis and multidisciplinary treatment to future perspectives.

    Science.gov (United States)

    Bregou Bourgeois, Aline; Aubry-Rozier, Bérengère; Bonafé, Luisa; Laurent-Applegate, Lee; Pioletti, Dominique P; Zambelli, Pierre-Yves

    2016-01-01

    Osteogenesis imperfecta is an inherited connective tissue disorder with wide phenotypic and molecular heterogeneity. A common issue associated with the molecular abnormality is a disturbance in bone matrix synthesis and homeostasis inducing bone fragility. In very early life, this can lead to multiple fractures and progressive bone deformities, including long bone bowing and scoliosis. Multidisciplinary management improves quality of life for patients with osteogenesis imperfecta. It consists of physical therapy, medical treatment and orthopaedic surgery as necessary. Medical treatment consists of bone-remodelling drug therapy. Bisphosphonates are widely used in the treatment of moderate to severe osteogenesis imperfecta, from infancy to adulthood. Other more recent drug therapies include teriparatide and denosumab. All these therapies target the symptoms and have effects on the mechanical properties of bone due to modification of bone remodelling, therefore influencing skeletal outcome and orthopaedic surgery. Innovative therapies, such as progenitor and mesenchymal stem cell transplantation, targeting the specific altered pathway rather than the symptoms, are in the process of development.

  16. The immediate future for the medical treatment of atrial fibrillation

    DEFF Research Database (Denmark)

    Pedersen, Ole Dyg; Brendorp, Bente; Køber, Lars

    2002-01-01

    ) the rhythm causes loss of atrioventricular synchrony, which reduces diastolic filling and may lead to heart failure; and iii) atrial contraction is lost leading to stagnant blood that again may lead to atrial thrombi and peripheral embolism. Thus, the treatment of atrial fibrillation is focused...... on the maintenance of sinus rhythm, rate control and prevention of embolism. For the maintenance of sinus rhythm, all drugs under current development are potassium channel blockers; the so-called class III anti-arrhythmic drugs. Those which have been further investigated appear to be valuable for maintenance...

  17. Nasal continuous positive airway pressure treatment: current realities and future.

    Science.gov (United States)

    Berthon-Jones, M; Lawrence, S; Sullivan, C E; Grunstein, R

    1996-11-01

    Nasal continuous positive airway pressure (CPAP) is a highly effective treatment for obstructive sleep apnea syndrome. The apnea/hypopnea index (AHI) is reduced 10-fold, but the patient dropout rate is up to 30%, and usage is typically 20/hour were recruited, with written informed consent. Subjects slept for a diagnostic night, followed by a treatment night, in the laboratory, using the AutoSet system with full polysomnographic monitoring of respiratory and sleep variables. Arousals were scored using ASDA criteria. Hypopneas were scored when there was a 50% reduction in ventilation for > 10 seconds, associated with a 4% drop in oxygen saturation. For comparison, the ASDA arousal index in 16 normal subjects (without nasal CPAP) is provided. Results are given as mean +/- standard error of the mean. AHI was reduced from 55 +/- 3 to 1.5 +/- 0.35 events/hour (p < 0.0001). The arousal index was reduced from 65 +/- 3 to 18 +/- 2 events/hour (p < 0.0001), identical to the value in the 16 healthy normal subjects. There was a 158% +/- 21% increase in slow-wave sleep (p = 0.01) and a 186% +/- 27% increase in rapid eye movement sleep (p = 0.013). The AutoSet self-adjusting nasal CPAP system adequately treats obstructive sleep apnea syndrome on the first night under laboratory conditions.

  18. Osteoarthritis: detection, pathophysiology, and current/future treatment strategies.

    Science.gov (United States)

    Sovani, Sujata; Grogan, Shawn P

    2013-01-01

    Osteoarthritis (OA) is a disease of the joint, and age is the major risk factor for its development. Clinical manifestation of OA includes joint pain, stiffness, and loss of mobility. Currently, no pharmacological treatments are available to treat this specific joint disease; only symptom-modifying drugs are available. Improvement in imaging technology, identification of biomarkers, and increased understanding of the molecular basis of OA will aid in detecting the early stages of disease. Yet the development of interventional strategies remains elusive and will be critical for effective prevention of OA-associated joint destruction. The potential of cell-based therapies may be applicable in improving joint function in mild to more advanced cases of OA. Ongoing studies to understand the basis of this disease will eventually lead to prevention and treatment strategies and will also be a key in reducing the social and economic burden of this disease. Nurses are advised to provide an integrative approach of disease assessment and management in OA patients' care with a focus on education and implementation. Knowledge and understanding of OA and how this affects the individual patient form the basis for such an integrative approach to all-round patient care and disease management.

  19. Endoradiotherapy in cancer treatment--basic concepts and future trends.

    Science.gov (United States)

    Zoller, Frederic; Eisenhut, Michael; Haberkorn, Uwe; Mier, Walter

    2009-12-25

    Endoradiotherapy represents an alternative therapeutic method in cancer treatment with advantageous features compared to chemotherapy and radiation therapy. Intelligent dose delivery concepts using small drugs, peptides or antibodies as radionuclide carriers enable the verification of a selective accumulation in the tumour lesion and to reduce radiation toxicity for the peripheral organs. The development of endoradiotherapeutic agents, especially chelator-conjugated biomolecules, for example ibritumomab tiuxetan or DOTATOC, gains importance due to the stable complexation of versatile radiometals, such as (90)Y or (177)Lu. The rational design of novel target binding sides and their grafting into a drug scaffold is a highly promising strategy, which may promote further implication in endoradiotherapy. This review highlights the basic concepts of endoradiotherapy and discusses the potential of targeted therapy and the properties of energy-rich particles emitted by radionuclides for tumour therapy.

  20. [Laparoscopic Kasai portoenterostom: present and future of biliary atresia treatment].

    Science.gov (United States)

    Ayuso, L; Vila-Carbó, J J; Lluna, J; Hernández, E; Marco, A

    2008-01-01

    Kasai's operation has proved its value in surgical treatment of biliary atresia (BA). Its laparoscopic approach is a new challenge for pediatric surgeons, with all the potential advantages of minimally invasive surgery. The aim of the present study has been to report our experience in laparoscopic management of five patients with biliary atresia. The average of age of five patients with biliary atresia, three boys and two girls was 58 days (range 40-64). Pre and postoperative management included antibiotic prophylaxis and choleretic treatment. Laparoscopic procedure was accomplished using one umbilical 10-mm trocar and two additional 5-mm trocars. We carried out the same technique in all the patients except in one of them with a total situs inversus and who compelled us to modify the original procedure. All five patients underwent a laparoscopic procedure, conversion was not necessary. The mean surgical time was 3 hours and 40 minutes (range: 5:30 y 3:10). There were not intra operative complications and all of them had a satisfactory recovery, except for the patient with situs inversus, who suffered a small bowel volvulus 9 days after the operation, leading us to perform an extensive bowel resection. All the patients, except this one, showed signs of adequate bile flow, with disappearance of clinical cholestasis. Biochemistry test became normal. Besides the certain advantages compared with conventional surgical procedures (lower surgical damage, diminished post-operative recovery), laparoscopic management of BA, allows a better exposure of the porta hepatis without hepatic mobilization so it shows similar or better preliminary results than conventional techniques. The advantages of laparoscopic portoenterostomy are yet to be proved whenever liver transplantation is indicated.

  1. Ivabradine: Current and Future Treatment of Heart Failure.

    Science.gov (United States)

    Thorup, Lene; Simonsen, Ulf; Grimm, Daniela; Hedegaard, Elise R

    2017-08-01

    In heart failure (HF), the heart cannot pump blood efficiently and is therefore unable to meet the body's demands of oxygen, and/or there is increased end-diastolic pressure. Current treatments for HF with reduced ejection fraction (HFrEF) include angiotensin-converting enzyme (ACE) inhibitors, angiotension receptor type 1 (AT 1 ) antagonists, β-adrenoceptor antagonists, aldosterone receptor antagonists, diuretics, digoxin and a combination drug with AT 1 receptor antagonist and neprilysin inhibitor. In HF, the risk of readmission for hospital and mortality is markedly higher with a heart rate (HR) above 70 bpm. Here, we review the evidence regarding the use of ivabradine for lowering HR in HF. Ivabradine is a blocker of an I funny current (I(f)) channel and causes rate-dependent inhibition of the pacemaker activity in the sinoatrial node. In clinical trials of HFrEF, treatment with ivabradine seems to improve clinical outcome, for example improved ejection fraction (EF) and less readmission for hospital, but the effect appears most pronounced in patients with HRs above 70 bpm, while the effect on cardiovascular death appears less consistent. The adverse effects of ivabradine include bradycardia, atrial fibrillation and visual disturbances, but ivabradine avoids the negative inotrope effects observed with β-adrenoceptor antagonists. In conclusion, in patients with stable HFrEF with EF<35% and HR above 70 bpm, ivabradine improves the outcome and might be a first choice of therapy, if beta-adrenoceptor antagonists are not tolerated. Further studies must show whether that can be extended to HF patients with preserved EF. © 2017 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  2. Treatment and trade or organic manures in the future

    International Nuclear Information System (INIS)

    Verkuyten, J.C.A.M.

    1997-01-01

    The manure market is dominated by both low prices and low quality. This current market does not favour the sustainable use of manures, nor does it favour innovation. First step in improving both manure quality and manure utilisation is optimizing the manure supply chain. A powerful instrument for this optimizing forms ''certification of the links within the chain''. The successful marketing of the derivates requires technological and organisational innovation. A powerful instrument in successful marketing is ''certification''. Through certification of the supply chain, as well as certification of the products, upgrading of the products is possible, leading to economical viable investments in waste treatment. Product certification leads furthermore to the possibility of positioning the products. A positive positioning of the products, differentiating it from ''waste'', is essential for the desired investments by market parties. In this paper new ideas and developments on the Dutch manure market are presented. A new technology (v. Aspert plant), including the marketing concept as the derivates produced are presented. A profile on a manure brokerage organisation (MBO) and, on last year founded, European Manure association (EMA) are added. (au)

  3. Treatment of Nonalcoholic Steatohepatitis in Adults: Present and Future

    Directory of Open Access Journals (Sweden)

    S. Gitto

    2015-01-01

    Full Text Available Nonalcoholic steatohepatitis has become one of the most common liver-related health problems. This condition has been linked to an unhealthy diet and weight gain, but it can also be observed in nonobese people. The standard of care is represented by the lifestyle intervention. However, because this approach has several limitations, such as a lack of compliance, the use of many drugs has been proposed. The first-line pharmacological choices are vitamin E and pioglitazone, both showing a positive effect on transaminases, fat accumulation, and inflammation. Nevertheless, vitamin E has no proven effect on fibrosis and on long-term morbidity and mortality and pioglitazone has a negative impact on weight. Other drugs have been studied such as metformin, ursodeoxycholic acid, statins, pentoxiphylline, and orlistat with only partially positive results. Among the emerging treatments, telmisartan is particularly interesting as it seems to have an impact on insulin resistance, liver steatosis, inflammation, and fibrosis. However, the pathogenesis of steatohepatitis is highly complex and is determined by different parallel hits; indeed, the association of different drugs that act on various levels has been suggested. In conclusion, lifestyle intervention should be optimised and the associations of different drugs should be tested in large studies with long-term outcomes.

  4. Are bio-absorbable stents the future of SFA treatment?

    Science.gov (United States)

    Peeters, P; Keirse, K; Verbist, J; Deloose, K; Bosiers, M

    2010-02-01

    Several limitations inherent to the implantation of a metallic device, such as the occurrence of in-stent re-stenosis, in an arterial lumen intuitively explain the interest for developing bio-absorbable stents. Two main types of bio-absorbable stents currently exist: polymer stents and metallic stents. To date, no studies with bio-absorbable stents have been conducted in the superficial femoral artery (SFA). Because of their strut thickness and lack of radial force, polymer stents are no good candidates for endovascular use. Absorbable metal stents (AMS) do have the potential to perform well for artery treatment, although current evidence from in-human coronary and infrapopliteal studies yield unsatisfactory results. Drastic technological improvements are mandatory before AMS can be considered for every day practice. Yet, it is our belief that further development of other metal and non-metal bio-absorbable stents, with or without drug-coating, may lead to the creation of the ultimate SFA stent.

  5. Treatment and trade or organic manures in the future

    Energy Technology Data Exchange (ETDEWEB)

    Verkuyten, J C.A.M. [European Manure Association, EMA, Deventer (Netherlands)

    1997-08-01

    The manure market is dominated by both low prices and low quality. This current market does not favour the sustainable use of manures, nor does it favour innovation. First step in improving both manure quality and manure utilisation is optimizing the manure supply chain. A powerful instrument for this optimizing forms `certification of the links within the chain`. The successful marketing of the derivates requires technological and organisational innovation. A powerful instrument in successful marketing is `certification`. Through certification of the supply chain, as well as certification of the products, upgrading of the products is possible, leading to economical viable investments in waste treatment. Product certification leads furthermore to the possibility of positioning the products. A positive positioning of the products, differentiating it from `waste`, is essential for the desired investments by market parties. In this paper new ideas and developments on the Dutch manure market are presented. A new technology (v. Aspert plant), including the marketing concept as the derivates produced are presented. A profile on a manure brokerage organisation (MBO) and, on last year founded, European Manure association (EMA) are added. (au)

  6. The future of surgery in the treatment of breast cancer.

    Science.gov (United States)

    Wood, William C

    2003-12-01

    The role of surgery cannot be discussed independently, but in relationship to the other modalities of treatment. Sentinel lymph node mapping and biopsy has revolutionized the role of surgery in axillary staging. Techniques of sentinel node mapping, the timing relative to chemotherapy, possible contraindications, and the necessity of completion axillary dissection are all under active investigation. The next few years will see continued changes in this important technique. Techniques of localizing clinically occult tumors are numerous and under study. These are not yet at the level of Phase III comparative trials. Induction chemotherapy has long been standard care for women with locally advanced breast cancer. It has not become standard care for Stage I or II breast cancers that meet criteria for adjuvant therapy. The ability to significantly downsize 80% of breast cancers is reason enough to make it usual practice for women who are certain to receive chemotherapy, if only for the cosmetic advantage that would accrue. Much has been made of the use of thermal ablation of small breast cancers by small probes introduced by skin puncture. In initial trials the lesions were excised after being heated or frozen. Current studies are leaving the destroyed tissue in place and following for evidence of control or recurrence. The value of this approach in terms of cosmesis is unproven, and the timing of its introduction when small tumors are being evaluated for margins and genetic markers, make it difficult to imagine broad acceptance. Finally, the role of prophylactic surgery for women at increased risk remains a difficult equation, compounded of alternatives such as chemoprevention, availability and effectiveness of surveillance techniques, and the level of fear and anxiety of the patient.

  7. The History and Future of Treatment of Hypothyroidism

    Science.gov (United States)

    McAninch, Elizabeth A.; Bianco, Antonio C.

    2016-01-01

    Thyroid hormone replacement has been used for more than a century to treat hypothyroidism. Natural thyroid preparations (thyroid extract, desiccated thyroid, or thyroglobulin), which contain both thyroxine (T4) and triiodothyronine (T3), were the first pharmacologic treatments available and dominated the market for the better part of the 20th century. Dosages were adjusted to resolve symptoms and to normalize the basal metabolic rate and/or serum protein-bound iodine level, but thyrotoxic adverse effects were not uncommon. Two major developments in the 1970s led to a transition in clinical practice: 1) The development of the serum thyroid-stimulating hormone (TSH) radioimmunoassay led to the discovery that many patients were overtreated, resulting in a dramatic reduction in thyroid hormone replacement dosage, and 2) the identification of peripheral deiodinase-mediated T4-to-T3 conversion provided a physiologic means to justify l-thyroxine monotherapy, obviating concerns about inconsistencies with desiccated thyroid. Thereafter, l-thyroxine mono-therapy at doses to normalize the serum TSH became the standard of care. Since then, a subgroup of thyroid hormone–treated patients with residual symptoms of hypothyroidism despite normalization of the serum TSH has been identified. This has brought into question the inability of l-thyroxine monotherapy to universally normalize serum T3 levels. New research suggests mechanisms for the inadequacies of l-thyroxine monotherapy and highlights the possible role for personalized medicine based on deiodinase polymorphisms. Understanding the historical events that affected clinical practice trends provides invaluable insight into formulation of an approach to help all patients achieve clinical and biochemical euthyroidism. PMID:26747302

  8. Advanced therapies for the treatment of hemophilia: future perspectives.

    Science.gov (United States)

    Liras, Antonio; Segovia, Cristina; Gabán, Aline S

    2012-12-13

    Monogenic diseases are ideal candidates for treatment by the emerging advanced therapies, which are capable of correcting alterations in protein expression that result from genetic mutation. In hemophilia A and B such alterations affect the activity of coagulation factors VIII and IX, respectively, and are responsible for the development of the disease. Advanced therapies may involve the replacement of a deficient gene by a healthy gene so that it generates a certain functional, structural or transport protein (gene therapy); the incorporation of a full array of healthy genes and proteins through perfusion or transplantation of healthy cells (cell therapy); or tissue transplantation and formation of healthy organs (tissue engineering). For their part, induced pluripotent stem cells have recently been shown to also play a significant role in the fields of cell therapy and tissue engineering. Hemophilia is optimally suited for advanced therapies owing to the fact that, as a monogenic condition, it does not require very high expression levels of a coagulation factor to reach moderate disease status. As a result, significant progress has been possible with respect to these kinds of strategies, especially in the fields of gene therapy (by using viral and non-viral vectors) and cell therapy (by means of several types of target cells). Thus, although still considered a rare disorder, hemophilia is now recognized as a condition amenable to gene therapy, which can be administered in the form of lentiviral and adeno-associated vectors applied to adult stem cells, autologous fibroblasts, platelets and hematopoietic stem cells; by means of non-viral vectors; or through the repair of mutations by chimeric oligonucleotides. In hemophilia, cell therapy approaches have been based mainly on transplantation of healthy cells (adult stem cells or induced pluripotent cell-derived progenitor cells) in order to restore alterations in coagulation factor expression.

  9. Orphan Toxin OrtT (YdcX) of Escherichia coli Reduces Growth during the Stringent Response

    Science.gov (United States)

    2015-01-29

    antimicrobials trimethoprim and sulfamethoxazole; these antimicrobials induce the stringent response by inhibiting tetrahydrofolate synthesis...in the presence of both antimicrobials trimethoprim and sulfamethoxazole; these antimicrobials induce the stringent response by inhibiting...level [20]. Toxins 2015, 7 301 Despite these difficulties in determining physiological roles, TA systems are clearly phage inhibition systems

  10. Couples with non-obstructive azoospermia are interested in future treatments with artificial gametes

    NARCIS (Netherlands)

    Hendriks, S.; Hessel, M.; Mochtar, M. H.; Meissner, A.; van der Veen, F.; Repping, S.; Dancet, E. A. F.

    2016-01-01

    Would couples diagnosed with non-obstructive azoospermia (NOA) consider two future treatments with artificial gametes (AGs) as alternatives for testicular sperm extraction followed by ICSI (TESE-ICSI)? Most couples with NOA (89%) would opt for treatment with AGs before attempting TESE-ICSI and/or

  11. The Stringent Response Induced by Phosphate Limitation Promotes Purine Salvage in Agrobacterium fabrum.

    Science.gov (United States)

    Sivapragasam, Smitha; Deochand, Dinesh K; Meariman, Jacob K; Grove, Anne

    2017-10-31

    Agrobacterium fabrum induces tumor growth in susceptible plant species. The upregulation of virulence genes that occurs when the bacterium senses plant-derived compounds is enhanced by acidic pH and limiting inorganic phosphate. Nutrient starvation may also trigger the stringent response, and purine salvage is among the pathways expected to be favored under such conditions. We show here that phosphate limitation induces the stringent response, as evidenced by production of (p)ppGpp, and that the xdhCSML operon encoding the purine salvage enzyme xanthine dehydrogenase is upregulated ∼15-fold. The xdhCSML operon is under control of the TetR family transcription factor XdhR; direct binding of ppGpp to XdhR attenuates DNA binding, and the enhanced xdhCSML expression correlates with increased cellular levels of (p)ppGpp. Xanthine dehydrogenase may also divert purines away from salvage pathways to form urate, the ligand for the transcription factor PecS, which in the plant pathogen Dickeya dadantii is a key regulator of virulence gene expression. However, urate levels remain low under conditions that produce increased levels of xdhCSML expression, and neither acidic pH nor limiting phosphate results in induction of genes under control of PecS. Instead, expression of such genes is induced only by externally supplemented urate. Taken together, our data indicate that purine salvage is favored during the stringent response induced by phosphate starvation, suggesting that control of this pathway may constitute a novel approach to modulating virulence. Because bacterial purine catabolism appears to be unaffected, as evidenced by the absence of urate accumulation, we further propose that the PecS regulon is induced by only host-derived urate.

  12. Stringent or nonstringent complete remission and prognosis in acute myeloid leukemia

    DEFF Research Database (Denmark)

    Øvlisen, Andreas K; Oest, Anders; Bendtsen, Mette D

    2018-01-01

    Stringent complete remission (sCR) of acute myeloid leukemia is defined as normal hematopoiesis after therapy. Less sCR, including non-sCR, was introduced as insufficient blood platelet, neutrophil, or erythrocyte recovery. These latter characteristics were defined retrospectively as postremission...... transfusion dependency and were suggested to be of prognostic value. In the present report, we evaluated the prognostic impact of achieving sCR and non-sCR in the Danish National Acute Leukaemia Registry, including 769 patients registered with classical CR (ie,

  13. Augmenting the Genetic Toolbox for Sulfolobus islandicus with a Stringent Positive Selectable Marker for Agmatine Prototrophy

    Science.gov (United States)

    Cooper, Tara E.; Krause, David J.

    2013-01-01

    Sulfolobus species have become the model organisms for studying the unique biology of the crenarchaeal division of the archaeal domain. In particular, Sulfolobus islandicus provides a powerful opportunity to explore natural variation via experimental functional genomics. To support these efforts, we further expanded genetic tools for S. islandicus by developing a stringent positive selection for agmatine prototrophs in strains in which the argD gene, encoding arginine decarboxylase, has been deleted. Strains with deletions in argD were shown to be auxotrophic for agmatine even in nutrient-rich medium, but growth could be restored by either supplementation of exogenous agmatine or reintroduction of a functional copy of the argD gene from S. solfataricus P2 into the ΔargD host. Using this stringent selection, a robust targeted gene knockout system was established via an improved next generation of the MID (marker insertion and unmarked target gene deletion) method. Application of this novel system was validated by targeted knockout of the upsEF genes involved in UV-inducible cell aggregation formation. PMID:23835176

  14. Ten Year Study of the Stringently Defined Otitis Prone Child in Rochester, NY

    Science.gov (United States)

    Pichichero, Michael E.

    2016-01-01

    This review summarizes a prospective, longitudinal 10-year study in Rochester NY with virtually every clinically diagnosed acute otitis media (AOM) confirmed by bacterial culture of middle ear fluid. Children experiencing 3 episodes within 6 months or 4 episodes in 12 months were considered stringently-defined otitis prone (sOP). We found stringent diagnosis compared with clinical diagnosis reduced the frequency of children meeting the OP definition from 27% to 6% resulting in 14.8% and 2.4% receiving tympanostomy tubes, respectively. Significantly more often RSV infection led to AOM in sOP than non-otitis prone (NOP) children that correlated with diminished total RSV-specific serum IgG. sOP children produced low levels of antibody to Streptococcus pneumoniae and Haemophilus influenzae candidate vaccine protein antigens and to routine pediatric vaccines. sOP children generated significantly fewer memory B cells, functional and memory T cells to otopathogens following NP colonization and AOM than NOP children and they had defects in antigen presenting cells. PMID:27273691

  15. Futures

    DEFF Research Database (Denmark)

    Pedersen, Michael Haldrup

    2017-01-01

    Currently both design thinking and critical social science experience an increased interest in speculating in alternative future scenarios. This interest is not least related to the challenges issues of global sustainability present for politics, ethics and design. This paper explores the potenti......Currently both design thinking and critical social science experience an increased interest in speculating in alternative future scenarios. This interest is not least related to the challenges issues of global sustainability present for politics, ethics and design. This paper explores...... the potentials of speculative thinking in relation to design and social and cultural studies, arguing that both offer valuable insights for creating a speculative space for new emergent criticalities challenging current assumptions of the relations between power and design. It does so by tracing out discussions...... of ‘futurity’ and ‘futuring’ in design as well as social and cultural studies. Firstly, by discussing futurist and speculative approaches in design thinking; secondly by engaging with ideas of scenario thinking and utopianism in current social and cultural studies; and thirdly by showing how the articulation...

  16. ENGINEERING STUDY FOR THE 200 AREA EFFLUENT TREATMENT FACILITY (ETF) SECONDARY WASTE TREATMENT OF PROJECTED FUTURE WASTE FEEDS

    International Nuclear Information System (INIS)

    LUECK, K.J.

    2004-01-01

    This report documents an engineering study conducted to evaluate alternatives for treating secondary waste in the secondary treatment train (STT) of the Hanford Site 200 Area Effluent Treatment Facility (ETF). The study evaluates ETF STT treatment alternatives and recommends preferred alternatives for meeting the projected future missions of the ETF. The preferred alternative(s) will process projected future ETF influents to produce a solid waste acceptable for final disposal on the Hanford Site. The main text of this report summarizes the ETF past and projected operations, lists the assumptions about projected operations that provide the basis for the engineering evaluation, and summarizes the evaluation process. The evaluation process includes identification of available modifications to the current ETF process, screens those modifications for technical viability, evaluates the technically viable alternatives, and provides conclusions and recommendations based on that evaluation

  17. Stringent limits on the ionized mass loss from A and F dwarfs

    International Nuclear Information System (INIS)

    Brown, A.; Veale, A.; Judge, P.; Bookbinder, J.A.; Hubeny, I.

    1990-01-01

    Following the suggestion of Willson et al. (1987) that A- and F-type main-sequence stars might undergo significant mass loss due to pulsationally driven winds, upper limits to the ionized mass loss from A and F dwarfs have been obtained using VLA observations. These stringent upper limits show that the level of ionized mass loss would have at most only a small effect on stellar evolution. Radiative-equilibrium atmospheric and wind models for early A dwarfs indicate that it is highly likely that a wind flowing from such stars would be significantly ionized. In addition, late A and early F dwarfs exhibit chromospheric emission indicative of significant nonradiative heating. The present mass-loss limits are thus representative of the total mass-loss rates for these stars. It is concluded that A and F dwarfs are not losing sufficient mass to cause A dwarfs to evolve into G dwarfs. 24 refs

  18. Future Directions in Etiologic, Prevention, and Treatment Research for Eating Disorders

    Science.gov (United States)

    Stice, Eric; South, Kelsey; Shaw, Heather

    2012-01-01

    Significant advances have occurred regarding the understanding of etiologic processes that give rise to eating disorders and the design and evaluation of efficacious prevention programs and treatment interventions. Herein we offer suggestions regarding potentially fruitful directions for future research in these areas. We suggest it would be…

  19. Considering treatment of male genital schistosomiasis as a tool for future HIV prevention

    DEFF Research Database (Denmark)

    Stecher, Chalotte Willemann; Kallestrup, Per; Kjetland, Eyrun Floerecke

    2015-01-01

    OBJECTIVES: Male genital schistosomiasis (MGS) is a neglected manifestation of Schistosoma haematobium infection with ignored implications on reproductive health and a differential diagnosis to sexually transmitted infections in endemic regions. MGS may have associations with HIV transmission...... and acquisition, and treatment could be a neglected chance of HIV prevention. This review summarizes current knowledge on epidemiology, clinical manifestations, diagnosis and treatment of MGS as a hypothesized risk factor for HIV transmission. Future research areas of global interest are suggested. METHODS: Pub...... association between MGS and HIV are urgently needed. Furthermore, field diagnostic tools should be developed and future mass treatment programs should include adults to reduce morbidity and prevent HIV acquisition. SYSTEMATIC REVIEW REGISTRATION NUMBER: CRD42015016252....

  20. [Novel current and future therapy options for treatment of dry eye disease].

    Science.gov (United States)

    Messmer, E M

    2018-02-01

    Dry eye disease was redefined by the dry eye workshop (DEWS II) in May 2017. According to the new definition "dry eye is a multifactorial disease of the ocular surface characterized by a loss of homeostasis of the tear film and accompanied by ocular symptoms". The current definition encompasses etiological factors, such as instability and hyperosmolarity of the tear film, ocular surface inflammation and damage as well as a new aspect compared to the former definition, neurosensory abnormalities. Recent and future therapeutic options for dry eye focus on treatment of the aforementioned pathogenetic events. New tear substitutes, medications and devices to stimulate tear production, innovative anti-inflammatory treatment, medications to influence corneal innervation and new methods for treatment of Meibomian gland dysfunction are already available or will be available in the near future.

  1. Polycystic Ovary Syndrome: Update on Treatment Options and Treatment Considerations for the Future

    OpenAIRE

    Kristen A. Farrell-Turner

    2011-01-01

    Polycystic ovary syndrome is an endocrine disorder characterized by insulin resistance, hyperandrogenemia, obesity, and inflammation, and is the most common cause of infertility. Women with PCOS are at higher risk than non-PCOS women for diabetes, cardiovascular disease, endometrial cancer, and psychiatric disorders. Because many abnormalities present in PCOS and symptoms vary considerably among PCOS women, treatment is guided by presentation and does not consist of simply one modality. Often...

  2. Air Quality and Health Benefits of China's Recent Stringent Environmental Policy

    Science.gov (United States)

    Zheng, Y.; Xue, T.; Zhang, Q.; Geng, G.; He, K.

    2016-12-01

    Aggressive emission control measures were taken by China's central and local governments after the promulgation of the "Air Pollution Prevention and Control Action Plan" in 2013. We evaluated the air quality and health benefits of this ever most stringent air pollution control policy during 2013-2015 by utilizing a two-stage data fusion model and newly-developed cause-specific integrated exposure-response functions (IER) developed for the Global Burden of Disease (GBD). The two-stage data fusion model predicts spatiotemporal continuous PM2.5 (particulate matter with aerodynamic diameter less than 2.5 µm) concentrations by integrating satellite-derived aerosol optical depth (AOD) measurements, PM2.5 concentrations from measurement and air quality model, and other ancillary information. During the years of analysis, PM2.5 concentration dropped significantly on national average and over heavily polluted regions as identified by Mann-Kendall analysis. The national PM2.5-attributable mortality decreased by 72.8 (95% CI: 59.4, 85.2) thousand (6%) from 1.23 (95% CI: 1.06, 1.39) million in 2013 to 1.15 (95% CI: 0.98, 1.31) million in 2015 due to considerable reduction (i.e. 18%) of population-weighted PM2.5 from 61.4 to 50.5 µg/m3. Meteorological variations between 2013 and 2015 were estimated to raise the PM2.5 levels by 0.24 µg/m3 and national mortality by 2.1 (95% CI: 1.6, 2.6) thousand through sensitivity tests, which implies the dominant role of anthropogenic impacts on PM2.5 abatement and attributable mortality reduction. Our study affirms the effectiveness of China's recent air quality policy, however, due to the possible supralinear shape of C-R functions, health benefits induced by air quality improvement in these years are limited. We therefore appeal for continuous implementation of current policies and further stringent measures from both air quality improvement and public health protection perspectives.

  3. Treatment Options for Severe Obesity in the Pediatric Population: Current Limitations and Future Opportunities.

    Science.gov (United States)

    Ryder, Justin R; Fox, Claudia K; Kelly, Aaron S

    2018-06-01

    Severe obesity is the only obesity classification increasing in prevalence among children and adolescents. Treatment options that produce meaningful and sustained weight loss and comorbidity resolution are urgently needed. The purpose of this review is to provide a brief overview of the current treatment options for pediatric severe obesity and offer suggestions regarding future opportunities for accelerating the development and evaluation of innovative treatment strategies. At present, there are three treatment options for youth with severe obesity: lifestyle modification therapy, pharmacotherapy, and bariatric surgery. Lifestyle modification therapy can be useful for improving many chronic disease risk factors and comorbid conditions but often fails to achieve clinically meaningful and sustainable weight loss. Pharmacotherapy holds promise as an effective adjunctive treatment but remains in the primordial stages of development in the pediatric population. Bariatric surgery provides robust weight loss and risk factor/comorbidity improvements but is accompanied by higher risks and lower uptake compared to lifestyle modification therapy and pharmacotherapy. New areas worth pursuing include combination pharmacotherapy, device therapy, identification of predictors of response aimed at precision treatment, and interventions in the postbariatric surgical setting to improve long-term outcomes. Treating pediatric severe obesity effectively and safely is extremely challenging. Some progress has been made, but substantially more effort and innovation are needed in the future to combat this serious and ongoing medical and public health issue. © 2018 The Obesity Society.

  4. Improving Treatment Adherence in Bipolar Disorder: A Review of Current Psychosocial Treatment Efficacy and Recommendations for Future Treatment Development

    Science.gov (United States)

    Gaudiano, Brandon A.; Weinstock, Lauren M.; Miller, Ivan W.

    2008-01-01

    Treatment adherence is a frequent problem in bipolar disorder, with research showing that more than 60% of bipolar patients are at least partially nonadherent to medications. Treatment nonadherence is consistently predictive of a number of negative outcomes in bipolar samples, and the discontinuation of mood stabilizers places these patients at…

  5. Ribosome•RelA structures reveal the mechanism of stringent response activation

    Science.gov (United States)

    Loveland, Anna B; Bah, Eugene; Madireddy, Rohini; Zhang, Ying; Brilot, Axel F; Grigorieff, Nikolaus; Korostelev, Andrei A

    2016-01-01

    Stringent response is a conserved bacterial stress response underlying virulence and antibiotic resistance. RelA/SpoT-homolog proteins synthesize transcriptional modulators (p)ppGpp, allowing bacteria to adapt to stress. RelA is activated during amino-acid starvation, when cognate deacyl-tRNA binds to the ribosomal A (aminoacyl-tRNA) site. We report four cryo-EM structures of E. coli RelA bound to the 70S ribosome, in the absence and presence of deacyl-tRNA accommodating in the 30S A site. The boomerang-shaped RelA with a wingspan of more than 100 Å wraps around the A/R (30S A-site/RelA-bound) tRNA. The CCA end of the A/R tRNA pins the central TGS domain against the 30S subunit, presenting the (p)ppGpp-synthetase domain near the 30S spur. The ribosome and A/R tRNA are captured in three conformations, revealing hitherto elusive states of tRNA engagement with the ribosomal decoding center. Decoding-center rearrangements are coupled with the step-wise 30S-subunit 'closure', providing insights into the dynamics of high-fidelity tRNA decoding. DOI: http://dx.doi.org/10.7554/eLife.17029.001 PMID:27434674

  6. Does dishonesty really invite third-party punishment? Results of a more stringent test.

    Science.gov (United States)

    Konishi, Naoki; Ohtsubo, Yohsuke

    2015-05-01

    Many experiments have demonstrated that people are willing to incur cost to punish norm violators even when they are not directly harmed by the violation. Such altruistic third-party punishment is often considered an evolutionary underpinning of large-scale human cooperation. However, some scholars argue that previously demonstrated altruistic third-party punishment against fairness-norm violations may be an experimental artefact. For example, envy-driven retaliatory behaviour (i.e. spite) towards better-off unfair game players may be misidentified as altruistic punishment. Indeed, a recent experiment demonstrated that participants ceased to inflict third-party punishment against an unfair player once a series of key methodological problems were systematically controlled for. Noticing that a previous finding regarding apparently altruistic third-party punishment against honesty-norm violations may have been subject to methodological issues, we used a different and what we consider to be a more sound design to evaluate these findings. Third-party punishment against dishonest players withstood this more stringent test. © 2015 The Author(s) Published by the Royal Society. All rights reserved.

  7. Present and future etiological treatment of bacterial pneumonia 3. The antibacterial drugs under development

    Directory of Open Access Journals (Sweden)

    A.A. Abaturov

    2017-08-01

    Full Text Available The rapid spread of antibiotic-resistant bacterial strains necessitates the development of new antibacterial agents and a review of the guidelines for etiological treatment of bacterial infections, including pneumonia. Currently, new antibacterial agents are being developed that disrupt the biosynthesis of peptidoglycan, teichoic and lipoteichoic acids, and also block the attachment of virulent factors to the bacterial wall. New molecules of old classes of antibiotics and representatives of new classes of antibiotics with their targets (lipid II and III, teichoic and lipoteichoic acids, alanine racemase, and sortase A will become practical tools in clinical practice in the very near future. The goals and mechanisms of action of new antibacterial compounds predetermine their clinical prospects in future strategies for the treatment of infectious bacterial diseases.

  8. Treatment of Hypogonadism: Current and Future Therapies [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Arthi Thirumalai

    2017-01-01

    Full Text Available The treatment of hypogonadism in men is of great interest to both patients and providers. There are a number of testosterone formulations currently available and several additional formulations under development. In addition, there are some lesser-used alternative therapies for the management of male hypogonadism, which may have advantages for certain patient groups. The future of hypogonadism therapy may lie in the development of selective androgen receptor modulators that allow the benefits of androgens whilst minimizing unwanted side effects.

  9. Treatment of Hypogonadism: Current and Future Therapies [version 1; referees: 2 approved

    OpenAIRE

    Arthi Thirumalai; Kathryn E. Berkseth; John K. Amory

    2017-01-01

    The treatment of hypogonadism in men is of great interest to both patients and providers. There are a number of testosterone formulations currently available and several additional formulations under development. In addition, there are some lesser-used alternative therapies for the management of male hypogonadism, which may have advantages for certain patient groups. The future of hypogonadism therapy may lie in the development of selective androgen receptor modulators that allow the benefits...

  10. Dose escalation with 3D conformal treatment: five year outcomes, treatment optimization, and future directions

    International Nuclear Information System (INIS)

    Hanks, Gerald E.; Hanlon, Alexandra L. M.S.; Schultheiss, Timothy E.; Pinover, Wayne H.; Movsas, Benjamin; Epstein, Barry E.; Hunt, Margie

    1998-01-01

    Purpose: To report the 5-year outcomes of dose escalation with 3D conformal treatment (3DCRT) of prostate cancer. Methods and Materials: Two hundred thirty-two consecutive patients were treated with 3DCRT alone between 6/89 and 10/92 with ICRU reporting point dose that increased from 63 to 79 Gy. The median follow-up was 60 months, and any patient free of clinical or biochemical evidence of disease was termed bNED. Biochemical failure was defined as prostate-specific antigen (PSA) rising on two consecutive recordings and exceeding 1.5 ng/ml. Morbidity was reported by the Radiation Therapy Oncology Group (RTOG) scale, the Late Effects Normal Tissue (LENT) scale, and a Fox Chase modification of the latter (FC-LENT). All patients were treated with a four-field technique with a 1 cm clinical target volume (CTV) to planning target volume (PTV) margin to the prostate or prostate boost; the CTV and gross tumor volume (GTV) were the same. Actuarial rates of outcome were calculated by Kaplan-Meier and cumulative incidence methods and compared using the log rank and Gray's test statistic, respectively. Cox regression models were used to establish prognostic factors predictive of the various measures of outcome. Five-year Kaplan-Meier bNED rates were utilized by dose group to estimate logit response models for bNED and late morbidity. Results: PSA 10 ng/ml based on 5-year bNED results. No dose response was observed for patients with pretreatment PSA 10 ng/ml strongly suggests that clinical trials employing radiation should investigate the use of 3DCRT and prostate doses of 76-80 Gy

  11. Couples with non-obstructive azoospermia are interested in future treatments with artificial gametes.

    Science.gov (United States)

    Hendriks, S; Hessel, M; Mochtar, M H; Meissner, A; van der Veen, F; Repping, S; Dancet, E A F

    2016-08-01

    Would couples diagnosed with non-obstructive azoospermia (NOA) consider two future treatments with artificial gametes (AGs) as alternatives for testicular sperm extraction followed by ICSI (TESE-ICSI)? Most couples with NOA (89%) would opt for treatment with AGs before attempting TESE-ICSI and/or after failed TESE-ICSI. Couples with NOA who undergo TESE-ICSI have a 25% chance of conceiving a child. Two future treatments that are being developed are 'ICSI with artificial sperm formed from somatic cells' (ICSI with AGs) and 'natural conception after autotransplantation of in vitro proliferated spermatogonial stem cells' (natural conception with AGs). It is unknown what treatment preferences patients have. A cross-sectional survey conducted in 2012-2013, addressing all 921 couples diagnosed with NOA and treated with TESE-ICSI in Dutch fertility clinics between 2007 and 2012. The coded questionnaires were sent by mail and followed up with two reminders. We developed the questionnaire based on a literature review and previous qualitative interviews, and included treatment preference and the valuation of nine treatment characteristics. We assessed reliability of the questionnaires and calculated mean importance scores (MISs: 0-10) of each treatment characteristic. We assessed which patient and treatment characteristics were associated with a couple's hypothetical treatment preference using binominal regression. The vast majority (89%) of the 494 responding couples (response rate: 54%) would potentially opt for AGs as a first and/or a last resort treatment option. More specifically, as a first treatment couples were likely (67%) to prefer natural conception with AGs over TESE-ICSI and less likely to prefer ICSI with AGs over TESE-ICSI (34%). After failed TESE-ICSI, the majority of couples (75%) would want to attempt ICSI with AGs as a last resort option. The most important characteristics of treatment were safety for children (MIS: 8.2), pregnancy rates (MIS: 7.7) and

  12. Stringent DDI-based prediction of H. sapiens-M. tuberculosis H37Rv protein-protein interactions.

    Science.gov (United States)

    Zhou, Hufeng; Rezaei, Javad; Hugo, Willy; Gao, Shangzhi; Jin, Jingjing; Fan, Mengyuan; Yong, Chern-Han; Wozniak, Michal; Wong, Limsoon

    2013-01-01

    H. sapiens-M. tuberculosis H37Rv protein-protein interaction (PPI) data are very important information to illuminate the infection mechanism of M. tuberculosis H37Rv. But current H. sapiens-M. tuberculosis H37Rv PPI data are very scarce. This seriously limits the study of the interaction between this important pathogen and its host H. sapiens. Computational prediction of H. sapiens-M. tuberculosis H37Rv PPIs is an important strategy to fill in the gap. Domain-domain interaction (DDI) based prediction is one of the frequently used computational approaches in predicting both intra-species and inter-species PPIs. However, the performance of DDI-based host-pathogen PPI prediction has been rather limited. We develop a stringent DDI-based prediction approach with emphasis on (i) differences between the specific domain sequences on annotated regions of proteins under the same domain ID and (ii) calculation of the interaction strength of predicted PPIs based on the interacting residues in their interaction interfaces. We compare our stringent DDI-based approach to a conventional DDI-based approach for predicting PPIs based on gold standard intra-species PPIs and coherent informative Gene Ontology terms assessment. The assessment results show that our stringent DDI-based approach achieves much better performance in predicting PPIs than the conventional approach. Using our stringent DDI-based approach, we have predicted a small set of reliable H. sapiens-M. tuberculosis H37Rv PPIs which could be very useful for a variety of related studies. We also analyze the H. sapiens-M. tuberculosis H37Rv PPIs predicted by our stringent DDI-based approach using cellular compartment distribution analysis, functional category enrichment analysis and pathway enrichment analysis. The analyses support the validity of our prediction result. Also, based on an analysis of the H. sapiens-M. tuberculosis H37Rv PPI network predicted by our stringent DDI-based approach, we have discovered some

  13. Current knowledge and trends in age-related macular degeneration: today's and future treatments.

    Science.gov (United States)

    Velez-Montoya, Raul; Oliver, Scott C N; Olson, Jeffrey L; Fine, Stuart L; Mandava, Naresh; Quiroz-Mercado, Hugo

    2013-09-01

    To address the most dynamic and current issues concerning today's treatment options and promising research efforts regarding treatment for age-related macular degeneration. This review is aimed to serve as a practical reference for more in-depth reviews on the subject. An online review of the database PubMed and Ovid were performed, searching for the key words age-related macular degeneration, AMD, VEGF, treatment, PDT, steroids, bevacizumab, ranibizumab, VEGF-trap, radiation, combined therapy, as well as their compound phrases. The search was limited to articles published since 1985. All returned articles were carefully screened, and their references were manually reviewed for additional relevant data. The web page www.clinicaltrials.gov was also accessed in search of relevant research trials. A total of 363 articles were reviewed, including 64 additional articles extracted from the references. At the end, only 160 references were included in this review. Treatment for age-related macular degeneration is a very dynamic research field. While current treatments are mainly aimed at blocking vascular endothelial growth factor, future treatments seek to prevent vision loss because of scarring. Promising efforts have been made to address the dry form of the disease, which has lacked effective treatment.

  14. The rapidly evolving centromere-specific histone has stringent functional requirements in Arabidopsis thaliana.

    Science.gov (United States)

    Ravi, Maruthachalam; Kwong, Pak N; Menorca, Ron M G; Valencia, Joel T; Ramahi, Joseph S; Stewart, Jodi L; Tran, Robert K; Sundaresan, Venkatesan; Comai, Luca; Chan, Simon W-L

    2010-10-01

    Centromeres control chromosome inheritance in eukaryotes, yet their DNA structure and primary sequence are hypervariable. Most animals and plants have megabases of tandem repeats at their centromeres, unlike yeast with unique centromere sequences. Centromere function requires the centromere-specific histone CENH3 (CENP-A in human), which replaces histone H3 in centromeric nucleosomes. CENH3 evolves rapidly, particularly in its N-terminal tail domain. A portion of the CENH3 histone-fold domain, the CENP-A targeting domain (CATD), has been previously shown to confer kinetochore localization and centromere function when swapped into human H3. Furthermore, CENP-A in human cells can be functionally replaced by CENH3 from distantly related organisms including Saccharomyces cerevisiae. We have used cenh3-1 (a null mutant in Arabidopsis thaliana) to replace endogenous CENH3 with GFP-tagged variants. A H3.3 tail domain-CENH3 histone-fold domain chimera rescued viability of cenh3-1, but CENH3's lacking a tail domain were nonfunctional. In contrast to human results, H3 containing the A. thaliana CATD cannot complement cenh3-1. GFP-CENH3 from the sister species A. arenosa functionally replaces A. thaliana CENH3. GFP-CENH3 from the close relative Brassica rapa was targeted to centromeres, but did not complement cenh3-1, indicating that kinetochore localization and centromere function can be uncoupled. We conclude that CENH3 function in A. thaliana, an organism with large tandem repeat centromeres, has stringent requirements for functional complementation in mitosis.

  15. Combining Pharmacological and Psychological Treatments for Binge Eating Disorder: Current Status, Limitations, and Future Directions.

    Science.gov (United States)

    Grilo, Carlos M; Reas, Deborah L; Mitchell, James E

    2016-06-01

    Binge eating disorder (BED) is characterized by recurrent binge eating and marked distress about binge eating without the extreme compensatory behaviors for weight control that characterize other eating disorders. BED is prevalent, associated strongly with obesity, and is associated with heightened levels of psychological, psychiatric, and medical concerns. This article provides an overview of randomized controlled treatments for combined psychological and pharmacological treatment of BED to inform current clinical practice and future treatment research. In contrast to the prevalence and significance of BED, to date, limited research has been performed on combining psychological and pharmacological treatments for BED to enhance outcomes. Our review here found that combining certain medications with cognitive behavioral therapy (CBT) or behavioral weight loss (BWL) interventions produces superior outcomes to pharmacotherapy only but does not substantially improve outcomes achieved with CBT/BWL only. One medication (orlistat) has improved weight losses with CBT/BWL albeit minimally, and only one medication (topiramate) has enhanced reductions achieved with CBT in both binge eating and weight. Implications for future research are discussed.

  16. Nonthionamide Drugs for the Treatment of Hyperthyroidism: From Present to Future

    Directory of Open Access Journals (Sweden)

    Nattakarn Suwansaksri

    2018-01-01

    Full Text Available Hyperthyroidism is a common endocrine disease. Although thionamide antithyroid drugs are the cornerstone of hyperthyroidism treatment, some patients cannot tolerate this drug class because of its serious side effects including agranulocytosis, hepatotoxicity, and vasculitis. Therefore, nonthionamide antithyroid drugs (NTADs still have an important role in controlling hyperthyroidism in clinical practice. Furthermore, some situations such as thyroid storm or preoperative preparation require a rapid decrease in thyroid hormone by combination treatment with multiple classes of antithyroid drugs. NTADs include iodine-containing compounds, lithium carbonate, perchlorate, glucocorticoid, and cholestyramine. In this narrative review, we summarize the mechanisms of action, indications, dosages, and side effects of currently used NTADs for the treatment of hyperthyroidism. In addition, we also describe the state-of-the-art in future drugs under development including rituximab, small-molecule ligands (SMLs, and monoclonal antibodies with a thyroid-stimulating hormone receptor (TSHR antagonist effect.

  17. The estimated future disease burden of hepatitis C virus in the Netherlands with different treatment paradigms.

    Science.gov (United States)

    Willemse, S B; Razavi-Shearer, D; Zuure, F R; Veldhuijzen, I K; Croes, E A; van der Meer, A J; van Santen, D K; de Vree, J M; de Knegt, R J; Zaaijer, H L; Reesink, H W; Prins, M; Razavi, H

    2015-11-01

    Prevalence of hepatitis C virus (HCV) infection in the Netherlands is low (anti-HCV prevalence 0.22%). All-oral treatment with direct-acting antivirals (DAAs) is tolerable and effective but expensive. Our analysis projected the future HCV-related disease burden in the Netherlands by applying different treatment scenarios. Using a modelling approach, the size of the HCV-viraemic population in the Netherlands in 2014 was estimated using available data and expert consensus. The base scenario (based on the current Dutch situation) and different treatment scenarios (with increased efficacy, treatment uptake, and diagnoses) were modelled and the future HCV disease burden was predicted for each scenario. The estimated number of individuals with viraemic HCV infection in the Netherlands in 2014 was 19,200 (prevalence 0.12%). By 2030, this number is projected to decrease by 4 5% in the base scenario and by 85% if the number of treated patients increases. Furthermore, the number of individuals with hepatocellular carcinoma and liver-related deaths is estimated to decrease by 19% and 27%, respectively, in the base scenario, but may both be further decreased by 68% when focusing on treatment of HCV patients with a fibrosis stage of ≥ F2. A substantial reduction in HCV-related disease burden is possible with increases in treatment uptake as the efficacy of current therapies is high. Further reduction of HCV-related disease burden may be achieved through increases in diagnosis and preventative measures. These results might inform the further development of effective disease management strategies in the Netherlands.

  18. Stem Cells as New Agents for the Treatment of Infertility: Current and Future Perspectives and Challenges

    Directory of Open Access Journals (Sweden)

    Vladislav Volarevic

    2014-01-01

    Full Text Available Stem cells are undifferentiated cells that are present in the embryonic, fetal, and adult stages of life and give rise to differentiated cells that make up the building blocks of tissue and organs. Due to their unlimited source and high differentiation potential, stem cells are considered as potentially new therapeutic agents for the treatment of infertility. Stem cells could be stimulated in vitro to develop various numbers of specialized cells including male and female gametes suggesting their potential use in reproductive medicine. During past few years a considerable progress in the derivation of male germ cells from pluripotent stem cells has been made. In addition, stem cell-based strategies for ovarian regeneration and oocyte production have been proposed as future clinical therapies for treating infertility in women. In this review, we summarized current knowledge and present future perspectives and challenges regarding the use of stem cells in reproductive medicine.

  19. Digital Technologies in the Treatment of Anxiety: Recent Innovations and Future Directions.

    Science.gov (United States)

    Firth, Joseph; Torous, John; Carney, Rebekah; Newby, Jill; Cosco, Theodore D; Christensen, Helen; Sarris, Jerome

    2018-05-19

    This review aims to provide a comprehensive overview of the efficacy, limitations, and future of e-health treatments for anxiety. Within this, we provide detail on "first-generation" e-health approaches, such as computerized therapies. Additionally, we assess the emergence and early efficacy of newer methods of treatment delivery, including smartphone apps and virtual reality interventions, discussing the potential and pitfalls for each. There is now substantial clinical research demonstrating the efficacy of internet-delivered cognitive behavioral therapy in the treatment of anxiety. However, the ability of these interventions for engaging patients in "real-world" settings is unclear. Recently, smartphone apps for anxiety have presented a more popular and ubiquitous method of intervention delivery, although the evidence base supporting these newer approaches drastically falls behind the extensive marketing and commercialization efforts currently driving their development. Meanwhile, the increasing availability of novel technologies, such as "virtual reality" (VR), introduces further potential of e-health treatments for generalized anxiety and anxiety-related disorders such as phobias and obsessive compulsive disorder, while also creating additional challenges for research. Although still in its infancy, e-health research is already presenting several promising avenues for delivering effective and scalable treatments for anxiety. Nonetheless, several important steps must be taken in order for academic research to keep pace with continued technological advances.

  20. Advance statements for borderline personality disorder: a qualitative study of future crisis treatment preferences.

    Science.gov (United States)

    Borschmann, Rohan; Trevillion, Kylee; Henderson, R Claire; Rose, Diana; Szmukler, George; Moran, Paul

    2014-06-01

    Little is known about the crisis treatment preferences of people with borderline personality disorder. Clinicians may also question service users' ability to make considered decisions about their treatment when in crisis. Therefore, this qualitative study aimed to investigate crisis treatment preferences of a sample of community-dwelling adults with borderline personality disorder. Participants were 41 adults with borderline personality disorder who had created joint crisis plans during a randomized controlled trial. Data from all 41 joint crisis plans were analyzed iteratively via a thematic analysis framework. Participants gave clear statements in their crisis plans relating to the desire to recover from the crisis and to improve their social functioning. Key themes included the desire to be treated with dignity and respect and to receive emotional and practical support from clinicians. Many participants spoke of the importance of connecting with others during periods of crisis, but several reported a clear desire to be left alone during a future crisis. Other themes concerned preferences for specific treatment refusals during crises, including particular types of psychotropic medication and involuntary treatment. The variation of participants' preferences underscores the importance of developing individually tailored crisis plans for people with borderline personality disorder. The need to be treated with dignity and respect and to be given autonomy in decision making--also identified in global surveys of people with severe mental illness--is important to people with borderline personality disorder. Key messages for clinicians, service users, and policy makers, in addition to staff training issues, are discussed.

  1. Bariatric Surgery as Potential Treatment for Nonalcoholic Fatty Liver Disease: A Future Treatment by Choice or by Chance?

    Directory of Open Access Journals (Sweden)

    Shuja Hafeez

    2013-01-01

    Full Text Available Morbid obesity is strongly associated with nonalcoholic fatty liver disease (NAFLD which is one of the most common causes of chronic liver disease worldwide. The current best treatment of NAFLD and NASH is weight reduction through life style modifications, antiobesity medication, and bariatric surgery. Importantly, bariatric surgery is the best alternative option for weight reduction if lifestyle modifications and pharmacological therapy have not yielded long-term success. Bariatric surgery is an effective treatment option for individuals who are grossly obese and associated with marked decrease in obesity-related morbidity and mortality. The most common performed bariatric surgery is Roux-en-Y gastric bypass (RYGB. The current evidence suggests that bariatric surgery in these patients will decrease the grade of steatosis, hepatic inflammation, and fibrosis. NAFLD per se is not an indication for bariatric surgery. Further research is urgently needed to determine (i the benefit of bariatric surgery in NAFLD patients at high risk of developing liver cirrhosis (ii the role of bariatric surgery in modulation of complications of NAFLD like diabetes and cardiovascular disease. The outcomes of the future research will determine whether bariatric surgery will be one of the recommended choice for treatment of the most progressive type of NAFLD.

  2. [Diagnosis and Treatment of Peptic Ulcer Disease: Present and Future Perspective].

    Science.gov (United States)

    Kim, Byung Wook

    2016-06-25

    Peptic ulcer disease is one of the most commonly encountered diseases in gastroenterology clinics. After the discovery of Helicobacter pylori by Warren and Marshall, it has been identified as the most important cause of peptic ulcer. Eradication of H. pylori markedly reduces the post-treatment recurrence rate of peptic ulcer. However, as human populations age, the incidence of cardiovascular and musculoskeletal diseases increases and consequent use of aspirin and non-steroidal anti-in-flammatory drugs increases. Thus causes and presenting patterns of peptic ulcer have changed. In this review, I describe new diagnostic and therapeutic strategies for peptic ulcer disease and explore future perspectives.

  3. Surgery and Multimodal treatments in pancreatic cancer. A review on the basis of future multimodal treatment concepts

    International Nuclear Information System (INIS)

    Link, K.H.; Leder, G; Formentini, A.; Fortnagel, G.; Kornmann, M.; Schatz, M.; Beger, H.G.

    1999-01-01

    The literature on the indications and results of adjuvant/neoadjuvant therapies in pancreatic cancer was reviewed to provide a solid base for current recommendations and future developments. A special view was concentrated on the biology of the disease in the spontaneous course, after surgery and during/after various palliative and adjuvant/neoadjuvant treatment modalities, to characterize the disease for an optimally targeted treatment in conjunction with surgical removal of the tumor. The results of systemic and regional chemotherapy and radiotherapy either alone or in combination, before, during, and after surgery, were critically analyzed with respect to the oncological possibilities and pitfalls of each treatment method. In two randomized trials, one testing postoperative radio chemotherapy (GITSG), and one postoperative chemotherapy (Bakkevold), the adjuvant treatment, achieved a significant prolongation of the median survival time. The 5- and 10-year survival rates were improved in the GITSG study. The EORTC-GITCCG trial could not confirm the benefit of adjuvant radiochemotherapy. This study had a different design than the GITSG trial. Several historical control studies supported the beneficial effect of postoperative radio chemotherapy. In three historical control trials using regional chemotherapy, one with intraoperative radiotherapy, the survival times were improved vs. surgery alone. Intraoperative or postoperative radiotherapy as single modalities might reduce local relapses, but a survival advantage is still debated. Preoperative neoadjuvant radio chemotherapy has several advantages, and does not seem to increase the postoperative morbidity. Several trials have confirmed the feasibility of this concept, but no survival advantage has yet been proven. Systemic and regional chemotherapy is able to down stage primarily nonresectable pancreatic cancers. (K.H.). 111 refs

  4. Direct-to-physician and direct-to-consumer advertising: Time to have stringent regulations.

    Science.gov (United States)

    Kannan, S; Gowri, S; Tyagi, V; Kohli, S; Jain, R; Kapil, P; Bhardwaj, A

    2015-01-01

    the opinion regarding DTCA, 69.9% physicians had a patient discussing DTCA that was clinically inappropriate. One hundred (64.5%) out of 155 physicians opined that DTCA encourage patients to attend physicians regarding preventive healthcare. On the contrary, 82/155 (52.9%) physicians felt that DTCA would damage the same. Similarly, 69 out of the total 100 patients felt that drug advertisements aid them to have better discussions with their treating physicians. Surprisingly, a large majority (91/100) were of the opinion that only safe drugs are allowed to be advertised. To conclude, from the findings of this study both the physicians and patients should be cautious and not overzealous while dealing with drug advertisements or promotional literature. More stringent scrutiny and issue of WLs or blacklisting of indulging pharmaceutical companies are mandatory by the regulatory agency to contain the same.

  5. Current adjuvant treatment modalities for gastric cancer: From history to the future

    Science.gov (United States)

    Kilic, Leyla; Ordu, Cetin; Yildiz, Ibrahim; Sen, Fatma; Keskin, Serkan; Ciftci, Rumeysa; Pilanci, Kezban Nur

    2016-01-01

    The discrepancy between the surgical technique and the type of adjuvant chemotherapy used in clinical trials and patient outcomes in terms of overall survival rates has led to the generation of different adjuvant treatment protocols in distinct parts of the world. The adjuvant treatment recommendation is generally chemoradiotherapy in the United States, perioperative chemotherapy in the United Kingdom and parts of Europe, and chemotherapy in Asia. These options mainly rely on the United States Intergroup-0116, United Kingdom British Medical Research Council Adjuvant Gastric Infusional Chemotherapy, and the Asian Adjuvant Chemotherapy Trial of S-1 for Gastric Cancer and Capecitabine and Oxaliplatin Adjuvant Study in Stomach Cancer trials. However, the benefits were evident for only certain patients, which were not very homogeneous regarding the type of surgery, chemotherapy regimens, and stage of disease. Whether the dissimilarities in survival are attributable to surgical technique or intrinsic biological differences is a subject of debate. Regardless of the extent of surgery, multimodal therapy may offer modest survival advantage at least for diseases with lymph node involvement. Moreover, in the era of individualized treatment for most of the other cancer types, identification of special subgroups comprising those who will derive more or no benefit from adjuvant therapy merits further investigation. The aim of this review is to reveal the historical evolution and future reflections of adjuvant treatment modalities for resected gastric cancer patients. PMID:27190583

  6. Therapeutic Effects of Traditional Chinese Medicine on Spinal Cord Injury: A Promising Supplementary Treatment in Future

    Directory of Open Access Journals (Sweden)

    Qian Zhang

    2016-01-01

    Full Text Available Objective. Spinal cord injury (SCI is a devastating neurological disorder caused by trauma. Pathophysiological events occurring after SCI include acute, subacute, and chronic phases, while complex mechanisms are comprised. As an abundant source of natural drugs, Traditional Chinese Medicine (TCM attracts much attention in SCI treatment recently. Hence, this review provides an overview of pathophysiology of SCI and TCM application in its therapy. Methods. Information was collected from articles published in peer-reviewed journals via electronic search (PubMed, SciFinder, Google Scholar, Web of Science, and CNKI, as well as from master’s dissertations, doctoral dissertations, and Chinese Pharmacopoeia. Results. Both active ingredients and herbs could exert prevention and treatment against SCI, which is linked to antioxidant, anti-inflammatory, neuroprotective, or antiapoptosis effects. The detailed information of six active natural ingredients (i.e., curcumin, resveratrol, epigallocatechin gallate, ligustrazine, quercitrin, and puerarin and five commonly used herbs (i.e., Danshen, Ginkgo, Ginseng, Notoginseng, and Astragali Radix was elucidated and summarized. Conclusions. As an important supplementary treatment, TCM may provide benefits in repair of injured spinal cord. With a general consensus that future clinical approaches will be diversified and a combination of multiple strategies, TCM is likely to attract greater attention in SCI treatment.

  7. Thyroid hormone analogs for the treatment of dyslipidemia: past, present, and future.

    Science.gov (United States)

    Delitala, Alessandro P; Delitala, Giuseppe; Sioni, Paolo; Fanciulli, Giuseppe

    2017-11-01

    Treatment of dyslipidemia is a major burden for public health. Thyroid hormone regulates lipid metabolism by binding the thyroid hormone receptor (TR), but the use of thyroid hormone to treat dyslipidemia is not indicated due to its deleterious effects on heart, bone, and muscle. Thyroid hormone analogs have been conceived to selectively activate TR in the liver, thus reducing potential side-effects. The authors searched the PubMed database to review TR and the action of thyromimetics in vitro and in animal models. Then, all double-blind, placebo controlled trials that analyzed the use of thyroid hormone analog for the treatment of dyslipidemia in humans were included. Finally, the ongoing research on the use of TR agonists was searched, searching the US National Institutes of Health Registry and the WHO International Clinical Trial Registry Platform (ICTRP). Thyromimetics were tested in humans for the treatment of dyslipidemia, as a single therapeutic agent or as an add-on therapy to the traditional lipid-lowering drugs. In most trials, thyromimetics lowered total cholesterol, low-density lipoprotein cholesterol, and triglycerides, but their use has been associated with adverse side-effects, both in pre-clinical studies and in humans. The use of thyromimetics for the treatment of dyslipidemia is not presently recommended. Future possible clinical applications might include their use to promote weight reduction. Thyromimetics might also represent an interesting alternative, both for the treatment of non-alcoholic steatohepatitis, and type 2 diabetes due to their positive effects on insulin sensitivity. Finally, additional experimental and clinical studies are needed for a better comprehension of the effect(s) of a long-term therapy.

  8. Sustainable Treatment of Aquaculture Effluents—What Can We Learn from the Past for the Future?

    Directory of Open Access Journals (Sweden)

    Ariel E. Turcios

    2014-02-01

    Full Text Available Many aquaculture systems generate high amounts of wastewater containing compounds such as suspended solids, total nitrogen and total phosphorus. Today, aquaculture is imperative because fish demand is increasing. However, the load of waste is directly proportional to the fish production. Therefore, it is necessary to develop more intensive fish culture with efficient systems for wastewater treatment. A number of physical, chemical and biological methods used in conventional wastewater treatment have been applied in aquaculture systems. Constructed wetlands technology is becoming more and more important in recirculating aquaculture systems (RAS because wetlands have proven to be well-established and a cost-effective method for treating wastewater. This review gives an overview about possibilities to avoid the pollution of water resources; it focuses initially on the use of systems combining aquaculture and plants with a historical review of aquaculture and the treatment of its effluents. It discusses the present state, taking into account the load of pollutants in wastewater such as nitrates and phosphates, and finishes with recommendations to prevent or at least reduce the pollution of water resources in the future.

  9. A review of treatment strategies for hydrofluoric acid burns: current status and future prospects.

    Science.gov (United States)

    Wang, Xingang; Zhang, Yuanhai; Ni, Liangfang; You, Chuangang; Ye, Chunjiang; Jiang, Ruiming; Liu, Liping; Liu, Jia; Han, Chunmao

    2014-12-01

    Hydrofluoric acid (HF), a dangerous inorganic acid, can cause severe corrosive effects and systemic toxicity. HF enters the human body via where it contacts, such as skin and mucosa, alimentary and respiratory tracts, and ocular surfaces. In the recent years, the incidence of HF burn has tended to increase over time. The injury mechanism of HF is associated primarily with the massive absorption of HF and the release of hydrogen ions. Correct diagnosis and timely treatment are especially important for HF burns. The critical procedure to treat HF burn is to prevent on-going HF absorption, and block the progressive destruction caused by fluoride ions. Due to the distinct characteristics of HF burns, the topical treatment, as well as systemic support, has been emphasised. Whereas, management of patients with HF burns remains a great challenge in some situations. To date, there has been no widely accepted protocol for the rescue of HF burns, partly due to the diversity of HF burns. This paper overviews the current status and problems of treatment strategies for HF burns, for the purpose of promoting the future researches and improvement. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  10. Hospital treatment as a foal does not adversely affect future sales performance in Thoroughbred horses.

    Science.gov (United States)

    Corley, K T T; Corley, M M B

    2012-02-01

    Many Thoroughbred foals are intended to be sold at public auction. The impact of disease conditions necessitating hospital treatment as a foal on future sales performance is unknown. To determine whether Thoroughbred horses that were treated in a hospital before age 125 days and presented to public auction sell for a different mean price than controls. Foals aged horses that were presented to the same sale immediately before and immediately after the subject. Results were controlled for the sale at which the animal presented and the sex of the subject and controls. Sixty-three subjects were presented to public auction: 19 at the foal sales, 39 at the yearling sales and 5 at the 2-year-old sales. Forty-five subjects were sold. There was no difference in the mean sales price (subjects Euros 38,207; controls Euros 35,026) or percentage of animals sold (subjects 71.4%; controls 66.4%) between subjects and controls. If Thoroughbred horses are presented for public auction following hospital treatment as a foal, there is no impact on sales outcome. This information may help commercial breeders of Thoroughbred foals make informed decisions about treatment of their foals.

  11. Induction of a stringent metabolic response in intracellular stages of Leishmania mexicana leads to increased dependence on mitochondrial metabolism.

    Directory of Open Access Journals (Sweden)

    Eleanor C Saunders

    2014-01-01

    Full Text Available Leishmania parasites alternate between extracellular promastigote stages in the insect vector and an obligate intracellular amastigote stage that proliferates within the phagolysosomal compartment of macrophages in the mammalian host. Most enzymes involved in Leishmania central carbon metabolism are constitutively expressed and stage-specific changes in energy metabolism remain poorly defined. Using (13C-stable isotope resolved metabolomics and (2H2O labelling, we show that amastigote differentiation is associated with reduction in growth rate and induction of a distinct stringent metabolic state. This state is characterized by a global decrease in the uptake and utilization of glucose and amino acids, a reduced secretion of organic acids and increased fatty acid β-oxidation. Isotopomer analysis showed that catabolism of hexose and fatty acids provide C4 dicarboxylic acids (succinate/malate and acetyl-CoA for the synthesis of glutamate via a compartmentalized mitochondrial tricarboxylic acid (TCA cycle. In vitro cultivated and intracellular amastigotes are acutely sensitive to inhibitors of mitochondrial aconitase and glutamine synthetase, indicating that these anabolic pathways are essential for intracellular growth and virulence. Lesion-derived amastigotes exhibit a similar metabolism to in vitro differentiated amastigotes, indicating that this stringent response is coupled to differentiation signals rather than exogenous nutrient levels. Induction of a stringent metabolic response may facilitate amastigote survival in a nutrient-poor intracellular niche and underlie the increased dependence of this stage on hexose and mitochondrial metabolism.

  12. REVIEW ARTICLE:Future of Lead Chelation – Distribution and Treatment

    Directory of Open Access Journals (Sweden)

    Venkatesh Thuppil

    2012-01-01

    Full Text Available Lead is the major environmental toxin resulting in the ill health and deleterious effect on almost all organs in the human body in a slow and effective manner. The best treatment for lead poisoning is chelation therapy which is next only to prevention. The authors describe the disruption of homeostasis of the human body by lead in various tissues like blood, bones, liver, kidneys and brain; and the ability of lead to enter the cell using calcium channels and calcium receptors like Ca++ dependant K+ ion channels, transient receptor potential channels, T-tubules, calmodulin receptors, inositol trisphosphate receptors and ryanodine receptors. We report a few novel chelating agents like ionophores, decadentate ligands, picolinate ligands, octadentate ligand, allicin, thiamine, that show good potential for being used in chelation therapy. Future of leadpoisoning is a challenge to all and it needs to be meticulously studies to have an economic and health approach.

  13. Software to support planning for future waste treatment, storage, transport, and disposal requirements

    International Nuclear Information System (INIS)

    Holter, G.M.; Shay, M.R.; Stiles, D.L.

    1990-04-01

    Planning for adequate and appropriate treatment, storage, transport and disposal of wastes to be generated or received in the future is a complex but critical task that can be significantly enhanced by the development and use of appropriate software. This paper describes a software system that has been developed at Pacific Northwest Laboratory to aid in such planning. The basic needs for such a system are outlined, and the approach adopted in developing the software is described. The individual components of the system, and their integration into a unified system, are discussed. Typical analytical applications of this type of software are summarized. Conclusions concerning the development of such software systems and the necessary supporting data are then presented. 2 figs

  14. Stringent homology-based prediction of H. sapiens-M. tuberculosis H37Rv protein-protein interactions.

    Science.gov (United States)

    Zhou, Hufeng; Gao, Shangzhi; Nguyen, Nam Ninh; Fan, Mengyuan; Jin, Jingjing; Liu, Bing; Zhao, Liang; Xiong, Geng; Tan, Min; Li, Shijun; Wong, Limsoon

    2014-04-08

    H. sapiens-M. tuberculosis H37Rv protein-protein interaction (PPI) data are essential for understanding the infection mechanism of the formidable pathogen M. tuberculosis H37Rv. Computational prediction is an important strategy to fill the gap in experimental H. sapiens-M. tuberculosis H37Rv PPI data. Homology-based prediction is frequently used in predicting both intra-species and inter-species PPIs. However, some limitations are not properly resolved in several published works that predict eukaryote-prokaryote inter-species PPIs using intra-species template PPIs. We develop a stringent homology-based prediction approach by taking into account (i) differences between eukaryotic and prokaryotic proteins and (ii) differences between inter-species and intra-species PPI interfaces. We compare our stringent homology-based approach to a conventional homology-based approach for predicting host-pathogen PPIs, based on cellular compartment distribution analysis, disease gene list enrichment analysis, pathway enrichment analysis and functional category enrichment analysis. These analyses support the validity of our prediction result, and clearly show that our approach has better performance in predicting H. sapiens-M. tuberculosis H37Rv PPIs. Using our stringent homology-based approach, we have predicted a set of highly plausible H. sapiens-M. tuberculosis H37Rv PPIs which might be useful for many of related studies. Based on our analysis of the H. sapiens-M. tuberculosis H37Rv PPI network predicted by our stringent homology-based approach, we have discovered several interesting properties which are reported here for the first time. We find that both host proteins and pathogen proteins involved in the host-pathogen PPIs tend to be hubs in their own intra-species PPI network. Also, both host and pathogen proteins involved in host-pathogen PPIs tend to have longer primary sequence, tend to have more domains, tend to be more hydrophilic, etc. And the protein domains from both

  15. Direct-Acting Antivirals for the Treatment of Chronic Hepatitis C: Open Issues and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Hee Bok Chae

    2013-01-01

    Full Text Available Currently, two direct-acting antivirals (DAAs show well-established efficacy against hepatitis C virus (HCV, namely, first-wave protease inhibitors telaprevir and boceprevir. Most clinical trials have examined DAAs in combination with standard of care (SOC regimens. Future therapeutic drugs were divided into three categories. They are second-wave protease inhibitors, second-generation protease inhibitors, and polymerase inhibitors. Second-wave protease inhibitors are more improved form and can be administered once a day. Oral drug combinations can be favored because interferon (IFN not only has to be given as intradermal injection, but also can cause several serious side effects. Combination of drugs with different mechanisms shows a good sustained virological response (SVR. But several mutations are associated with viral resistance to DAAs. Therefore, genotypic resistance data may provide insights into strategies aimed at maximizing SVR rates and minimizing resistance. Combined drug regimens are necessary to prevent the emergence of drug-resistant HCV. Many promising DAA candidates have been identified. Of these, a triple regimen containing sofosbuvir shows promise, and treatment with daclatasvir plus asunaprevir yields a high SVR rate (95%. Oral drug combinations will be standard of care in the near future.

  16. Manual Therapy: The Historical, Current, and Future Role in the Treatment of Pain

    Directory of Open Access Journals (Sweden)

    A. Russell Smith

    2007-01-01

    Full Text Available Manual therapy has been an approach in the management of patients with various disorders dating back to ancient times and continues to play a significant role in current health care. The future role of manual therapy in health care is an important area of research. This paper reviews the history of manual therapy, examines the current literature related to the use of manual techniques (including manipulation, massage, and nerve manipulation, and discusses future research topics. The literature related to manual therapy has historically been anecdotal and theoretical, and current research tends to have a generic approach with broad definitions of manual therapy and inconsistencies in the classification of specific disorders. Systematic reviews of various types of manual therapy have differed on their conclusions regarding the effectiveness of this treatment modality. The current demand in health care for evidence-based practice necessitates a movement towards more specificity in the research of the effectiveness of manual therapy, with emphasis on specific patient signs and symptoms and specific manual techniques that result in effective care.

  17. Manual Therapy: The Historical, Current, and Future Role in the Treatment of Pain

    Science.gov (United States)

    Smith, A. Russell

    2007-01-01

    Manual therapy has been an approach in the management of patients with various disorders dating back to ancient times and continues to play a significant role in current health care. The future role of manual therapy in health care is an important area of research. This paper reviews the history of manual therapy, examines the current literature related to the use of manual techniques (including manipulation, massage, and nerve manipulation), and discusses future research topics. The literature related to manual therapy has historically been anecdotal and theoretical, and current research tends to have a generic approach with broad definitions of manual therapy and inconsistencies in the classification of specific disorders. Systematic reviews of various types of manual therapy have differed on their conclusions regarding the effectiveness of this treatment modality. The current demand in health care for evidence-based practice necessitates a movement towards more specificity in the research of the effectiveness of manual therapy, with emphasis on specific patient signs and symptoms and specific manual techniques that result in effective care. PMID:17334604

  18. Gene x environment interactions in conduct disorder: Implications for future treatments.

    Science.gov (United States)

    Holz, Nathalie E; Zohsel, Katrin; Laucht, Manfred; Banaschewski, Tobias; Hohmann, Sarah; Brandeis, Daniel

    2016-08-18

    Conduct disorder (CD) causes high financial and social costs, not only in affected families but across society, with only moderately effective treatments so far. There is consensus that CD is likely caused by the convergence of many different factors, including genetic and adverse environmental factors. There is ample evidence of gene-environment interactions in the etiology of CD on a behavioral level regarding genetically sensitive designs and candidate gene-driven approaches, most prominently and consistently represented by MAOA. However, conclusive indications of causal GxE patterns are largely lacking. Inconsistent findings, lack of replication and methodological limitations remain a major challenge. Likewise, research addressing the identification of affected brain pathways which reflect plausible biological mechanisms underlying GxE is still very sparse. Future research will have to take multilevel approaches into account, which combine genetic, environmental, epigenetic, personality, neural and hormone perspectives. A better understanding of relevant GxE patterns in the etiology of CD might enable researchers to design customized treatment options (e.g. biofeedback interventions) for specific subgroups of patients. Copyright © 2016 Elsevier Ltd. All rights reserved.

  19. Treatment of Thrombotic Antiphospholipid Syndrome: The Rationale of Current Management-An Insight into Future Approaches.

    Science.gov (United States)

    Chighizola, Cecilia Beatrice; Ubiali, Tania; Meroni, Pier Luigi

    2015-01-01

    Vascular thrombosis and pregnancy morbidity represent the clinical manifestations of antiphospholipid syndrome (APS), which is serologically characterized by the persistent positivity of antiphospholipid antibodies (aPL). Antiplatelet and anticoagulant agents currently provide the mainstay of APS treatment. However, the debate is still open: controversies involve the intensity and the duration of anticoagulation and the treatment of stroke and refractory cases. Unfortunately, the literature cannot provide definite answers to these controversial issues as it is flawed by many limitations, mainly due to the recruitment of patients not fulfilling laboratory and clinical criteria for APS. The recommended therapeutic management of different aPL-related clinical manifestations is hereby presented, with a critical appraisal of the evidence supporting such approaches. Cutting edge therapeutic strategies are also discussed, presenting the pioneer reports about the efficacy of novel pharmacological agents in APS. Thanks to a better understanding of aPL pathogenic mechanisms, new therapeutic targets will soon be explored. Much work is still to be done to unravel the most controversial issues about APS management: future studies are warranted to define the optimal management according to aPL risk profile and to assess the impact of a strict control of cardiovascular risk factors on disease control.

  20. Targeted Therapy of FLT3 in Treatment of AML—Current Status and Future Directions

    Directory of Open Access Journals (Sweden)

    Caroline Benedicte Nitter Engen

    2014-12-01

    Full Text Available Internal tandem duplications (ITDs of the gene encoding the Fms-Like Tyrosine kinase-3 (FLT3 receptor are present in approximately 25% of patients with acute myeloid leukemia (AML. The mutation is associated with poor prognosis, and the aberrant protein product has been hypothesized as an attractive therapeutic target. Various tyrosine kinase inhibitors (TKIs have been developed targeting FLT3, but in spite of initial optimism the first generation TKIs tested in clinical studies generally induce only partial and transient hematological responses. The limited treatment efficacy generally observed may be explained by numerous factors; extensively pretreated and high risk cohorts, suboptimal pharmacodynamic and pharmacokinetic properties of the compounds, acquired TKI resistance, or the possible fact that inhibition of mutated FLT3 alone is not sufficient to avoid disease progression. The second-generation agent quizartinb is showing promising outcomes and seems better tolerated and with less toxic effects than traditional chemotherapeutic agents. Therefore, new generations of TKIs might be feasible for use in combination therapy or in a salvage setting in selected patients. Here, we sum up experiences so far, and we discuss the future outlook of targeting dysregulated FLT3 signaling in the treatment of AML.

  1. Treatment of Thrombotic Antiphospholipid Syndrome: The Rationale of Current Management—An Insight into Future Approaches

    Science.gov (United States)

    Ubiali, Tania; Meroni, Pier Luigi

    2015-01-01

    Vascular thrombosis and pregnancy morbidity represent the clinical manifestations of antiphospholipid syndrome (APS), which is serologically characterized by the persistent positivity of antiphospholipid antibodies (aPL). Antiplatelet and anticoagulant agents currently provide the mainstay of APS treatment. However, the debate is still open: controversies involve the intensity and the duration of anticoagulation and the treatment of stroke and refractory cases. Unfortunately, the literature cannot provide definite answers to these controversial issues as it is flawed by many limitations, mainly due to the recruitment of patients not fulfilling laboratory and clinical criteria for APS. The recommended therapeutic management of different aPL-related clinical manifestations is hereby presented, with a critical appraisal of the evidence supporting such approaches. Cutting edge therapeutic strategies are also discussed, presenting the pioneer reports about the efficacy of novel pharmacological agents in APS. Thanks to a better understanding of aPL pathogenic mechanisms, new therapeutic targets will soon be explored. Much work is still to be done to unravel the most controversial issues about APS management: future studies are warranted to define the optimal management according to aPL risk profile and to assess the impact of a strict control of cardiovascular risk factors on disease control. PMID:26075289

  2. Waste management from reprocessing: a stringent regulatory requirements for high quality conditioned residues

    International Nuclear Information System (INIS)

    Bordier, J. C.; Greneche, D.; Devezeaux, J. G.; Dalcorso, J.

    2000-01-01

    Nuclear waste production and management in France is governed by safety requirements imposed to all operators. French nuclear safety relies on two basic principles: · Responsibility of the nuclear operator, which expands to waste generated, · Safety basic objectives issued by national Safety Authority. For a long time the regulatory framework for waste production and management has been satisfactorily applied and has benefited to each actor of the process. LLW/MLW and HLW nuclear waste are currently conditioned in safe matrices or packages either likely to be disposed in surface repositories or designed with the intention to be disposed underground according to their radioactive content. France is looking into the case of VLLW and has already carried out a design for future disposal, the design being in the pipe. Other types of waste (i. e. radium bearing waste, graphite, and tritium content waste) are also considered in the whole framework of French waste management. (author)

  3. Current and future funding sources for specialty mental health and substance abuse treatment providers.

    Science.gov (United States)

    Levit, Katharine R; Stranges, Elizabeth; Coffey, Rosanna M; Kassed, Cheryl; Mark, Tami L; Buck, Jeffrey A; Vandivort-Warren, Rita

    2013-06-01

    Goals were to describe funding for specialty behavioral health providers in 1986 and 2005 and examine how the recession, parity law, and Affordable Care Act (ACA) may affect future funding. Numerous public data sets and actuarial methods were used to estimate spending for services from specialty behavioral health providers (general hospital specialty units; specialty hospitals; psychiatrists; other behavioral health professionals; and specialty mental health and substance abuse treatment centers). Between 1986 and 2005, hospitals-which had received the largest share of behavioral health spending-declined in importance, and spending shares trended away from specialty hospitals that were largely funded by state and local governments. Hospitals' share of funding from private insurance decreased from 25% in 1986 to 12% in 2005, and the Medicaid share increased from 11% to 23%. Office-based specialty providers continued to be largely dependent on private insurance and out-of-pocket payments, with psychiatrists receiving increased Medicaid funding. Specialty centers received increased funding shares from Medicaid (from 11% to 29%), and shares from other state and local government sources fell (from 64% to 46%). With ACA's full implementation, spending on behavioral health will likely increase under private insurance and Medicaid. Parity in private plans will also push a larger share of payments for office-based professionals from out-of-pocket payments to private insurance. As ACA provides insurance for formerly uninsured individuals, funding by state behavioral health authorities of center-based treatment will likely refocus on recovery and support services. Federal Medicaid rules will increase in importance as more people needing behavioral health treatment become covered.

  4. Does metformin treatment during pregnancy modify future metabolic profile in women with PCOS?

    Science.gov (United States)

    Underdal, Maria Othelie; Stridsklev, Solhild; Oppen, Ingrid Hennum; Høgetveit, Kristin; Andersen, Marianne Skovsager; Vanky, Eszter

    2018-04-05

    Worldwide, metformin is prescribed in an attempt to improve pregnancy outcome in PCOS. Metformin may also benefit future health by modulating the increased metabolic stress during pregnancy. To investigate if metformin during pregnancy modified future metabolic health in women with PCOS. Follow-up study of a randomized controlled trial, which compared metformin to placebo in women with PCOS. Mean follow-up period was 8 years (5-11). Three university hospitals, seven local hospitals, and one gynecological specialist practice. Women with PCOS according to Rotterdam criteria, all former participants in the PregMet study. Metformin 2000 mg daily or placebo from 1st trimester to delivery in the original study. No intervention in the present follow-up study. Main outcome measure was weight-gain in the follow-up period. Weight, body mass index, waist and hip circumferences and blood pressure were registered. Body composition was assessed by bioelectrical impedance analysis, and fasting lipids, glucose and insulin were analysed. 131 out of 239 (55%) invited women participated in the follow-up. Weight gain was similar in women given metformin (2.1±10.5) and women given placebo (1.8±11.2) at 7.7 years follow-up after pregnancy (p-value=0.834). No difference was found between those treated with metformin and placebo during pregnancy in BMI, waist/hip ratio, blood pressure, body composition, lipids, glucose and insulin levels or prevalence of metabolic syndrome at follow-up. Metformin treatment during pregnancy did not influence the metabolic profile in women with PCOS at 7.7 years of follow-up.

  5. Recent progress in the biology of multiple myeloma and future directions in the treatment.

    Science.gov (United States)

    Pico, J L; Castagna, L; Bourhis, J H

    1998-04-01

    A great amount of scientific information, accumulated over recent years on the biology of Multiple Myeloma (MM), has fuelled speculation about the origin of malignant plasma cells, about a purported critical role played by the bone marrow stroma, and further still, on cytokine interactions and in particular that of IL-6 and its relationship with the immune system. Among the growth factors secreted by stroma cells, IL-6 is a potent stimulator of myeloma cells in vitro but does not induce a malignant phenotype in normal plasma cells. Many efforts have been produced to identify the stem cell in MM and probably memory B lymphocytes are the best candidates. The demonstration of a Graft vs Myeloma effect in the allogeneic setting strongly supports the immunotherapy in MM. Recent data also suggest that a virus (Kaposi-associated herpes virus, HHV-8) may be significantly associated with the development of MM. In parallel, progress has been achieved in the treatment of this incurable disease with well defined prognostic factors, more efficient supportive care and its corollary, improved quality of life and dose-intensified chemo-radiotherapy followed by autologous hematopoietic stem cell support. Improving the quality of grafts with the selection of CD34 positive cells is another approach aimed at reducing plasma cell contamination without impairing haematological recovery. An EBMT randomized study assessing the role of CD34 selection has been initiated by our group Increasingly efficient first-line therapy, better quality autografts and improved post-remission treatment with, for example, anti-idiopathic vaccination are the most promising future directions.

  6. The role of stents in the treatment of congenital heart disease: Current status and future perspectives

    International Nuclear Information System (INIS)

    Peters, Bjoern; Ewert, Peter; Berger, Felix

    2009-01-01

    Intravascular or intracardiac stenoses occur in many forms of congenital heart disease (CHD). Therefore, the implantation of stents has become an accepted interventional procedure for stenotic lesions in pediatric cardiology. Furthermore, stents are know to be used to exclude vessel aneurysm or to ensure patency of existing or newly created intracardiac communications. With the further refinement of the first generation of devices, a variety of “modern” stents with different design characteristics have evolved. Despite the tremendous technical improvement over the last 20 years, the “ideal stent” has not yet been developed. Therefore, the pediatric interventionalist has to decide which stent is suitable for each lesion. On this basis, currently available stents are discussed in regard to their advantages and disadvantages for common application in CHD. New concepts and designs developed to overcome some of the existing problems, like the failure of adaptation to somatic growth, are presented. Thus, in the future, biodegradable or growth stents might replace the currently used generation of stents. This might truly lead to widening indications for the use of stents in the treatment of CHD

  7. Combination therapies for the treatment of HER2-positive breast cancer: current and future prospects.

    Science.gov (United States)

    Brandão, Mariana; Pondé, Noam F; Poggio, Francesca; Kotecki, Nuria; Salis, Mauren; Lambertini, Matteo; de Azambuja, Evandro

    2018-05-24

    HER2-positive disease is an aggressive subtype of breast cancer that has been revolutionized by anti-HER2 directed therapies. Multiple drugs have been developed and are currently in clinical use, including trastuzumab, lapatinib, pertuzumab, T-DM1, and neratinib, alone or combined in 'dual HER2-blockade' regimens. Areas covered: A comprehensive literature review was performed regarding the current state and the future of combination regimens containing anti-HER2 agents, focusing on their efficacy, toxicity, and cost-effectiveness. Expert commentary: The combination of trastuzumab/pertuzumab is approved in all disease settings, while trastuzumab/neratinib is approved in the adjuvant setting and trastuzumab/lapatinib in metastatic disease. Meanwhile, as breast cancer biology and resistance mechanisms become clearer, combinations with drugs like PI3K/Akt/mTOR inhibitors, CDK4/6 inhibitors, anti-PD(L)1 antibodies, endocrine therapy, and new anti-HER2 agents (panHER and HER2 tyrosine kinase inhibitors, bispecific antibodies, anti-HER3 antibodies, and antibody-drug conjugates) are being extensively tested in clinical trials. More specific strategies for the 'triple-positive' (estrogen receptor-positive/HER2-positive) disease are also being explored. However, there is an urgent need for the development of predictive biomarkers for a better tailoring of anti-HER2 directed therapy. This is the only way to further improve clinical outcomes and quality of life and to decrease costs and toxicities of unnecessary treatments.

  8. City-specific vehicle emission control strategies to achieve stringent emission reduction targets in China's Yangtze River Delta region.

    Science.gov (United States)

    Zhang, Shaojun; Wu, Ye; Zhao, Bin; Wu, Xiaomeng; Shu, Jiawei; Hao, Jiming

    2017-01-01

    The Yangtze River Delta (YRD) region is one of the most prosperous and densely populated regions in China and is facing tremendous pressure to mitigate vehicle emissions and improve air quality. Our assessment has revealed that mitigating vehicle emissions of NOx would be more difficult than reducing the emissions of other major vehicular pollutants (e.g., CO, HC and PM 2.5 ) in the YRD region. Even in Shanghai, where the emission control implemented are more stringent than in Jiangsu and Zhejiang, we observed little to no reduction in NOx emissions from 2000 to 2010. Emission-reduction targets for HC, NOx and PM 2.5 are determined using a response surface modeling tool for better air quality. We design city-specific emission control strategies for three vehicle-populated cities in the YRD region: Shanghai and Nanjing and Wuxi in Jiangsu. Our results indicate that even if stringent emission control consisting of the Euro 6/VI standards, the limitation of vehicle population and usage, and the scrappage of older vehicles is applied, Nanjing and Wuxi will not be able to meet the NOx emissions target by 2020. Therefore, additional control measures are proposed for Nanjing and Wuxi to further mitigate NOx emissions from heavy-duty diesel vehicles. Copyright © 2016. Published by Elsevier B.V.

  9. Stringent tests of constrained Minimal Flavor Violation through ΔF=2 transitions

    International Nuclear Information System (INIS)

    Buras, Andrzej J.; Girrbach, Jennifer

    2013-01-01

    New Physics contributions to ΔF=2 transitions in the simplest extensions of the Standard Model (SM), the models with constrained Minimal Flavor Violation (CMFV), are parametrized by a single variable S(v), the value of the real box diagram function that in CMFV is bounded from below by its SM value S 0 (x t ). With already very precise experimental values of ε K , ΔM d , ΔM s and precise values of the CP-asymmetry S ψK S and of B K entering the evaluation of ε K , the future of CMFV in the ΔF = 2 sector depends crucially on the values of vertical stroke V cb vertical stroke, vertical stroke V ub vertical stroke, γ, F B s √(B B s ) and F B d √(B B d ). The ratio ξ of the latter two non-perturbative parameters, already rather precisely determined from lattice calculations, allows then together with ΔM s / ΔM d and S ψK S to determine the range of the angle γ in the unitarity triangle independently of the value of S(v). Imposing in addition the constraints from vertical stroke ε K vertical stroke and ΔM d allows to determine the favorite CMFV values of vertical stroke V cb vertical stroke, vertical stroke V ub vertical stroke, F B s √(B B s ) and F B d √(B B d ) as functions of S(v) and γ. The vertical stroke V cb vertical stroke 4 dependence of ε K allows to determine vertical stroke V cb vertical stroke for a given S(v) and γ with a higher precision than it is presently possible using tree-level decays. The same applies to vertical stroke V ub vertical stroke, vertical stroke V td vertical stroke and vertical stroke V ts vertical stroke that are automatically determined as functions of S(v) and γ. We derive correlations between F B s √(B B s ) and F B d √(B B d ), vertical stroke V cb vertical stroke, vertical stroke V ub vertical stroke and γ that should be tested in the coming years. Typically F B s √(B B s ) and F B d √(B B d ) have to be lower than their present lattice values, while vertical stroke V cb vertical stroke has to

  10. Stringent tests of constrained Minimal Flavor Violation through {Delta}F=2 transitions

    Energy Technology Data Exchange (ETDEWEB)

    Buras, Andrzej J. [TUM-IAS, Garching (Germany); Girrbach, Jennifer [TUM, Physik Department, Garching (Germany)

    2013-09-15

    New Physics contributions to {Delta}F=2 transitions in the simplest extensions of the Standard Model (SM), the models with constrained Minimal Flavor Violation (CMFV), are parametrized by a single variable S(v), the value of the real box diagram function that in CMFV is bounded from below by its SM value S{sub 0}(x{sub t}). With already very precise experimental values of {epsilon}{sub K}, {Delta}M{sub d}, {Delta}M{sub s} and precise values of the CP-asymmetry S{sub {psi}K{sub S}} and of B{sub K} entering the evaluation of {epsilon}{sub K}, the future of CMFV in the {Delta}F = 2 sector depends crucially on the values of vertical stroke V{sub cb} vertical stroke, vertical stroke V{sub ub} vertical stroke, {gamma}, F{sub B{sub s}} {radical}(B{sub B{sub s}}) and F{sub B{sub d}} {radical}(B{sub B{sub d}}). The ratio {xi} of the latter two non-perturbative parameters, already rather precisely determined from lattice calculations, allows then together with {Delta}M{sub s} / {Delta}M{sub d} and S{sub {psi}K{sub S}} to determine the range of the angle {gamma} in the unitarity triangle independently of the value of S(v). Imposing in addition the constraints from vertical stroke {epsilon}{sub K} vertical stroke and {Delta}M{sub d} allows to determine the favorite CMFV values of vertical stroke V{sub cb} vertical stroke, vertical stroke V{sub ub} vertical stroke, F{sub B{sub s}} {radical}(B{sub B{sub s}}) and F{sub B{sub d}} {radical}(B{sub B{sub d}}) as functions of S(v) and {gamma}. The vertical stroke V{sub cb} vertical stroke {sup 4} dependence of {epsilon}{sub K} allows to determine vertical stroke V{sub cb} vertical stroke for a given S(v) and {gamma} with a higher precision than it is presently possible using tree-level decays. The same applies to vertical stroke V{sub ub} vertical stroke, vertical stroke V{sub td} vertical stroke and vertical stroke V{sub ts} vertical stroke that are automatically determined as functions of S(v) and {gamma}. We derive correlations

  11. Transplantation of retinal pigment epithelial cells - a possible future treatment for age-related macular degeneration

    DEFF Research Database (Denmark)

    Wiencke, Anne Katrine

    2001-01-01

    ophthalmology, age-related macular degeneration, transplantation, retinal pigment epithelial cells, treatment......ophthalmology, age-related macular degeneration, transplantation, retinal pigment epithelial cells, treatment...

  12. Transplantation of retinal pigment epithelial cells - a possible future treatment for age-related macular degeneration

    DEFF Research Database (Denmark)

    Wiencke, Anne Katrine

    2001-01-01

    ophthalmology, age-related macular degeneration, retinal pigment epithelial cells, transplantation, treatment......ophthalmology, age-related macular degeneration, retinal pigment epithelial cells, transplantation, treatment...

  13. Bench to Bedside: Future Therapies For Treatment Of Anemia In Patients With Chronic Kidney Disease

    Directory of Open Access Journals (Sweden)

    KM Murali

    2017-10-01

    anemia have been or are being developed and tested in clinical trials. Some of these have the potential to become realistic treatment options in the near future.

  14. The implementation of modern digital technology in x-ray medical diagnosis in Republic of Moldova - a stringent necessity

    International Nuclear Information System (INIS)

    Rosca, Andrei

    2011-01-01

    The study includes analyses of current technical state of radiodiagnostic equipment from the Public Medico-Sanitary Institution of Ministry of Health of Republic of Moldova (IMSP MS RM). The traditional radiodiagnostic apparatuses were morally and physically outrun at 96,6% (in regional MSPI - 93,5%), inclusive the dental one - 92,0% (in raional MSPI - 97,2%), X-Ray exam -100%, mobile - 84,1% etc. The exploitation of the traditional radiodiagnostic apparatuses with high degree of physical and moral wear essentially diminished the quality of profile investigation, creates premises for diagnostic error perpetrating, increase the collective ionizing irradiation of population etc. In recent years the subvention of MSPI HM RM with digital radiodiagnostic equipment was started. This process is very hard unfold because of grave socio-economic crises in Republic of Moldova. Despite these obstacles the subvention of MSPI HM RM with digital equipment represents a stringent necessity and a time request.

  15. Insulated hsp70B' promoter: stringent heat-inducible activity in replication-deficient, but not replication-competent adenoviruses.

    Science.gov (United States)

    Rohmer, Stanimira; Mainka, Astrid; Knippertz, Ilka; Hesse, Andrea; Nettelbeck, Dirk M

    2008-04-01

    Key to the realization of gene therapy is the development of efficient and targeted gene transfer vectors. Therapeutic gene transfer by replication-deficient or more recently by conditionally replication-competent/oncolytic adenoviruses has shown much promise. For specific applications, however, it will be advantageous to provide vectors that allow for external control of gene expression. The efficient cellular heat shock system in combination with available technology for focused and controlled hyperthermia suggests heat-regulated transcription control as a promising tool for this purpose. We investigated the feasibility of a short fragment of the human hsp70B' promoter, with and without upstream insulator elements, for the regulation of transgene expression by replication-deficient or oncolytic adenoviruses. Two novel adenoviral vectors with an insulated hsp70B' promoter were developed and showed stringent heat-inducible gene expression with induction ratios up to 8000-fold. In contrast, regulation of gene expression from the hsp70B' promoter without insulation was suboptimal. In replication-competent/oncolytic adenoviruses regulation of the hsp70B' promoter was lost specifically during late replication in permissive cells and could not be restored by the insulators. We developed novel adenovirus gene transfer vectors that feature improved and stringent regulation of transgene expression from the hsp70B' promoter using promoter insulation. These vectors have potential for gene therapy applications that benefit from external modulation of therapeutic gene expression or for combination therapy with hyperthermia. Furthermore, our study reveals that vector replication can deregulate inserted cellular promoters, an observation which is of relevance for the development of replication-competent/oncolytic gene transfer vectors. (c) 2008 John Wiley & Sons, Ltd.

  16. Nuclear controls are stringent

    International Nuclear Information System (INIS)

    Sonnekus, D.

    1983-01-01

    The peace-time application of nuclear power in South Africa, the organisations concerned and certain provisions laid down by the Act on Nuclear Energy, aimed at safeguarding the general public, are discussed

  17. How to Create Evidence for the Integration of Local and Locoregional Treatments in Future Oncological Treatment Concepts?

    OpenAIRE

    Lordick, Florian; Ricke, Jens; Mohnike, Konrad; Hacker, Ulrich

    2014-01-01

    Summary Background While local treatment using more innovative technologies is increasingly applied in contemporary treatment of advanced cancer, its impact on outcomes is not well understood. Methods We reviewed the literature using PubMed and major oncology congress websites, and report here about the understanding of oligometastatic disease, about the role of primary tumor resection in metastatic disease, and about the value of cytoreduction and tumor ablation. Results The Achilless' heel ...

  18. [Current status and future prospect of internal medicine treatment for advanced esophageal cancer].

    Science.gov (United States)

    Wang, F; Fan, Q X

    2016-09-23

    Esophageal cancer (EC) is one of common malignant tumors, and the incidence and mortality of EC in China rank the first place in the world. Because of the occult onset, the early atypical symptoms, and the lack of effective early diagnostic methods, most of patients are diagnosed at an advanced stage of the disease and lost the chance of surgery. Comprehensive treatment including palliative medical treatment, molecular targeted therapy, immunotherapy and so on is appropriate for these patients. How to choose the chemotherapy regimen and formulate reasonable treatment plan has become a hot spot in clinical research. Molecular targeted drugs have become a new developmental direction in cancer treatment because of their high specificity and antitumor activity, but the effects on esophageal cancer remain controversial. With the development of immune check point blockade treatment, breakthrough has been made in tumor immunotherapy, which has become an important means in cancer comprehensive treatment and shown a good prospect of treatment.

  19. Future challenges and treatment of Staphylococcus aureus bacteremia with emphasis on MRSA

    DEFF Research Database (Denmark)

    Rasmussen, Rasmus V; Fowler, Vance G; Skov, Robert

    2011-01-01

    . Compounding this problem is the growing prevalence of methicillin-resistant S. aureus (MRSA) and the dwindling efficacy of vancomycin, long the treatment of choice for this pathogen. Despite the recent availability of several new antibiotics for S. aureus, new strategies for treatment and prevention...

  20. Quantifying Health Utilities in Patients Undergoing Stereotactic Body Radiation Treatment for Liver Metastases for Use in Future Economic Evaluations.

    Science.gov (United States)

    Warren, B; Munoz-Schuffenegger, P; Chan, K K W; Chu, W; Helou, J; Erler, D; Chung, H

    2017-09-01

    Stereotactic body radiation therapy (SBRT) is increasingly used as an option for those with liver metastases. In order to facilitate future economic impact of health technologies, health utility scores may be used. The EuroQOL-5D-3L (EQ-5D) preference-based healthy utility instrument was used to evaluate the impact of treatment with SBRT on health utility scores. Between August 2013 and October 2014, 31 patients treated with 3-5 fractions of SBRT for liver metastases were enrolled in this study. The EQ-5D instrument was administered at baseline, during and up to 6 months post-SBRT. Mean EQ-5D score at baseline was 0.857, which remained stable across the entire study time period. Transient increases in difficulties with mobility (9.7% reported at baseline to 16.1% on the last day of treatment) and usual activities (3.2% reported at baseline to 34.5% on day two) were found during the course of treatment; these returned to baseline levels subsequently. The mean visual analogue score at baseline was 65.8 and remained unchanged throughout treatment and follow-up. The stability of health utility scores and problems reported by patients undergoing treatment indicate that SBRT for liver metastases does not impart a significant adverse effect on quality of life. These results may be used for future economic evaluation of SBRT. Copyright © 2017 The Royal College of Radiologists. Published by Elsevier Ltd. All rights reserved.

  1. Brachytherapy for head and neck cancer. Treatment results and future prospect

    International Nuclear Information System (INIS)

    Shibuya, Hitoshi; Yoshimura, Ro-ichi; Miura, Masahiko; Ayukawa, Fumio; Watanabe, Hiroshi

    2005-01-01

    Following the increasing desire of many patients to keep the form and function of speech and swallowing, interstitial brachytherapy has become the main treatment for head and neck cancer. In addition, aged and physically handicapped patients who are refused general anesthesia have come to be referred to our clinic to receive less invasive and curative treatment. In the field of brachytherapy for head and neck cancers, less complicated and more superior treatment results have been achieved following the introduction of spacers, computer dosimetry and so on. As a result of these efforts, treatment results have come to fulfill the desire of patients and their families. During the past 43 years from 1962 to 2005, we have treated over 2, 100 patients of head and neck cancer including 850 with stage I·II oral tongue carcinoma by brachytherapy and acquired a lot of important and precious data including the treatment results, multiple primary cancers as well as radiation-induced cancers. (author)

  2. Pathophysiology and Nonsurgical Treatment of Chronic Subdural Hematoma: From Past to Present to Future.

    Science.gov (United States)

    Holl, Dana C; Volovici, Victor; Dirven, Clemens M F; Peul, Wilco C; van Kooten, Fop; Jellema, Korné; van der Gaag, Niels A; Miah, Ishita P; Kho, Kuan H; den Hertog, Heleen M; Lingsma, Hester F; Dammers, Ruben

    2018-05-14

    Chronic subdural hematoma (CSDH) is one of the more frequent pathologic entities in daily neurosurgical practice. Historically, CSDH was considered progressive recurrent bleeding with a traumatic cause. However, recent evidence has suggested a complex intertwined pathway of inflammation, angiogenesis, local coagulopathy, recurrent microbleeds, and exudates. The aim of the present review is to collect existing data on pathophysiology of CSDH to direct further research questions aiming to optimize treatment for the individual patient. We performed a thorough literature search in PubMed, Ovid, EMBASE, CINAHL, and Google scholar, focusing on any aspect of the pathophysiology and nonsurgical treatment of CSDH. After a (minor) traumatic event, the dural border cell layer tears, which leads to the extravasation of cerebrospinal fluid and blood in the subdural space. A cascade of inflammation, impaired coagulation, fibrinolysis, and angiogenesis is set in motion. The most commonly used treatment is surgical drainage. However, because of the pathophysiologic mechanisms, the mortality and high morbidity associated with surgical drainage, drug therapy (dexamethasone, atorvastatin, tranexamic acid, or angiotensin-converting enzyme inhibitors) might be a beneficial alternative in many patients with CSDH. Based on pathophysiologic mechanisms, animal experiments, and small patient studies, medical treatment may play a role in the treatment of CSDH. There is a lack of level I evidence in the nonsurgical treatment of CSDH. Therefore, randomized controlled trials, currently lacking, are needed to assess which treatment is most effective in each individual patient. Copyright © 2018 The Author(s). Published by Elsevier Inc. All rights reserved.

  3. Critical analysis of the stringent complete response in multiple myeloma: contribution of sFLC and bone marrow clonality.

    Science.gov (United States)

    Martínez-López, Joaquín; Paiva, Bruno; López-Anglada, Lucía; Mateos, María-Victoria; Cedena, Teresa; Vidríales, María-Belén; Sáez-Gómez, María Auxiliadora; Contreras, Teresa; Oriol, Albert; Rapado, Inmaculada; Teruel, Ana-Isabel; Cordón, Lourdes; Blanchard, María Jesús; Bengoechea, Enrique; Palomera, Luis; de Arriba, Felipe; Cueto-Felgueroso, Cecilia; Orfao, Alberto; Bladé, Joan; San Miguel, Jesús F; Lahuerta, Juan José

    2015-08-13

    Stringent complete response (sCR) criteria are used in multiple myeloma as a deeper response category compared with CR, but prospective validation is lacking, it is not always clear how evaluation of clonality is performed, and is it not known what the relative clinical influence is of the serum free light chain ratio (sFLCr) and bone marrow (BM) clonality to define more sCR. To clarify this controversy, we focused on 94 patients that reached CR, of which 69 (73%) also fulfilled the sCR criteria. Patients with sCR displayed slightly longer time to progression (median, 62 vs 53 months, respectively; P = .31). On analyzing this contribution to the prognosis of sFLCr or clonality, it was found that the sFLCr does not identify patients in CR at distinct risk; by contrast, low-sensitive multiparametric flow cytometry (MFC) immunophenotyping (2 colors), which is equivalent to immunohistochemistry, identifies a small number of patients (5 cases) with high residual tumor burden and dismal outcome; nevertheless, using traditional 4-color MFC, persistent clonal BM disease was detectable in 36% of patients, who, compared with minimal residual disease-negative cases, had a significantly inferior outcome. These results show that the current definition of sCR should be revised. © 2015 by The American Society of Hematology.

  4. Are Dutch residents ready for a more stringent policy to enhance the energy performance of their homes?

    International Nuclear Information System (INIS)

    Middelkoop, Manon van; Vringer, Kees; Visser, Hans

    2017-01-01

    Investments in the energy performance of houses offer good prospects for reducing energy consumption and CO_2 emissions. However, people are not easily convinced of the need to take measures to improve the energy performance of their houses, even when financial benefits outweigh the costs. This article analyses the factors that influence the decision for improving the energy performance of existing homes, including policy instruments. Subsequently, the article provides policy suggestions on how to stimulate energy performance improvements. Both owners and tenants (50–70%) support government policy on energy performance improvements to existing homes. Nevertheless, people also have strong feelings of autonomy regarding their homes. Our results underline the importance of well-informed and competent decision-makers. Introducing the use of Energy Performance Certificates (EPCs) into the tax system for energy and residential buildings might therefore be an effective way to increase the interest of owners in the EPC, improve the use and effect of this informative instrument, and make the first step towards bridging the tension between autonomy and more stringent instruments.

  5. Treatment of Pulmonary Sequestrations by Means of Endovascular Embolization: Future or Fashion?

    Directory of Open Access Journals (Sweden)

    Jeroen Diks

    2011-01-01

    Full Text Available Bronchopulmonary sequestration is a rare malformation of the lower respiratory tract. Several methods of treatment have been described since the first publication. We present two cases of female adult patients with bronchopulmonary sequestration. In the first patient an unsuccessful attempt to treat the bronchopulmonary sequestration by means of arterial embolization is described. She was subsequently treated by means of surgical resection, which was the primary treatment for the second patient. Although endovascular techniques are becoming promising, in our opinion surgical resection remains the unique treatment for bronchopulmonary sequestration.

  6. From genetics and epigenetics to the future of precision treatment for obesity.

    Science.gov (United States)

    Sun, Xulong; Li, Pengzhou; Yang, Xiangwu; Li, Weizheng; Qiu, Xianjie; Zhu, Shaihong

    2017-11-01

    Obesity has become a major global health problem, epitomized by excess accumulation of body fat resulting from an imbalance between energy intake and expenditure. The treatments for obesity range from modified nutrition and additional physical activity, to drugs or surgery. But the curative effect of each method seems to vary between individuals. With progress in the genetics and epigenetics of obesity, personalization of the clinical management of obesity may be at our doorstep. This review presents an overview of our current understanding of the genetics and epigenetics of obesity and how these findings influence responses to treatments. As bariatric surgery is the most effective long-term treatment for morbid obesity, we pay special attention to the association between genetic factors and clinical outcomes of bariatric surgery. Finally, we discuss the prospects for precision obesity treatment.

  7. Does metformin treatment during pregnancy modify future metabolic profile in women with PCOS?

    DEFF Research Database (Denmark)

    Underdal, Maria Othelie; Stridsklev, Solhild; Oppen, Ingrid Hennum

    2018-01-01

    with PCOS. Design: Follow-up study of a randomized controlled trial, which compared metformin to placebo in women with PCOS. Mean follow-up period was 8 years (5-11). Setting: Three university hospitals, seven local hospitals, and one gynecological specialist practice. Participants: Women with PCOS......Context: Worldwide, metformin is prescribed in an attempt to improve pregnancy outcome in PCOS. Metformin may also benefit future health by modulating the increased metabolic stress during pregnancy. Objective: To investigate if metformin during pregnancy modified future metabolic health in women......-up period. Weight, body mass index, waist and hip circumferences and blood pressure were registered. Body composition was assessed by bioelectrical impedance analysis, and fasting lipids, glucose and insulin were analysed. Results: 131 out of 239 (55%) invited women participated in the follow-up. Weight...

  8. Radiation treatment compliance in the indigenous population: the pilot of Northern Territory experience and future directions

    International Nuclear Information System (INIS)

    Le, Hien; Carruthers, Scott; Penniment, Michael; Roos, Daniel; Sullivan, Thomas; Baxi, Siddhartha

    2013-01-01

    There is a perception that Indigenous patients are less likely to attend radiotherapy treatment. This study sought to determine if a difference in radiotherapy treatment compliance rates exists between Indigenous and non-Indigenous patients. Secondly, we aimed to ascertain which patient, disease and treatment factors affect compliance in Indigenous patients. All patients treated with radiotherapy at the Alan Walker Cancer Care Centre between March and October 2010 were analysed. Data regarding compliance rates (defined as those who chose and completed the recommended course of treatment), patient, disease and treatment factors were collected, and chi-squared and Fisher's exact tests were applied. A total of 41 courses were delivered to Indigenous patients and 224 courses delivered to non-Indigenous patients in this period. There was no difference in compliance between Indigenous and non-Indigenous patients (83% vs. 81%, P=0.75). Of the factors assessed, it was found that there was an association between toxicity grade and compliance (P=0.048). From this cohort, we cannot support the perception that Indigenous patients have overall poorer compliance with recommended radiation treatment courses. In this study, the only factor which correlated significantly with compliance was toxicity grade. It is felt that a number of factors, which negatively impact on compliance, can potentially be counteracted by a culturally sensitive model of care.

  9. New drugs for the treatment of tuberculosis: needs, challenges, promise, and prospects for the future.

    Science.gov (United States)

    Lienhardt, Christian; Raviglione, Mario; Spigelman, Mel; Hafner, Richard; Jaramillo, Ernesto; Hoelscher, Michael; Zumla, Alimuddin; Gheuens, Jan

    2012-05-15

    For the first time in 40 years, a portfolio of promising new compounds for the treatment of tuberculosis is on the horizon. The introduction of new drugs in combination treatment for all forms of tuberculosis raises several issues related to patients' access to novel treatments, programmatic feasibility, cost effectiveness, and implications for monitoring and surveillance, particularly with regard to the development of drug resistance. Particular attention should be given to the identification of optimal drug combination(s) for the treatment of all forms of tuberculosis, particularly in high-risk and vulnerable groups, such as human immunodeficiency virus-coinfected persons and children, and to the rational use of new drugs. Addressing these issues adequately requires the establishment of clear guidelines to assist countries in the development of policies for the proper use of tuberculosis drugs in a way that guarantees access to best treatments for all those in need and avoids inappropriate use of new drugs. After a description of these various challenges, we present activities that will be carried out by the World Health Organization in collaboration with key stakeholders for the development of policy guidelines for optimal treatment of tuberculosis.

  10. HIV Treatment as Prevention: Modelling the Cost of Antiretroviral Treatment—State of the Art and Future Directions

    Science.gov (United States)

    Meyer-Rath, Gesine; Over, Mead

    2012-01-01

    Policy discussions about the feasibility of massively scaling up antiretroviral therapy (ART) to reduce HIV transmission and incidence hinge on accurately projecting the cost of such scale-up in comparison to the benefits from reduced HIV incidence and mortality. We review the available literature on modelled estimates of the cost of providing ART to different populations around the world, and suggest alternative methods of characterising cost when modelling several decades into the future. In past economic analyses of ART provision, costs were often assumed to vary by disease stage and treatment regimen, but for treatment as prevention, in particular, most analyses assume a uniform cost per patient. This approach disregards variables that can affect unit cost, such as differences in factor prices (i.e., the prices of supplies and services) and the scale and scope of operations (i.e., the sizes and types of facilities providing ART). We discuss several of these variables, and then present a worked example of a flexible cost function used to determine the effect of scale on the cost of a proposed scale-up of treatment as prevention in South Africa. Adjusting previously estimated costs of universal testing and treatment in South Africa for diseconomies of small scale, i.e., more patients being treated in smaller facilities, adds 42% to the expected future cost of the intervention. PMID:22802731

  11. Pediatric Thermal Burns and Treatment: A Review of Progress and Future Prospects

    Directory of Open Access Journals (Sweden)

    Elton Mathias

    2017-12-01

    Full Text Available Burn injuries are a devastating critical care problem. In children, burns continue to be a major epidemiologic problem around the globe resulting in significant morbidity and death. Apparently, treating these burn injuries in children and adults remains similar, but there are significant physiological and psychological differences. The dermal layer of the skin is generally thinner in neonates, infants, and children than in adults. Enhanced evaporative loss and need for isotonic fluids increases the risk of hypothermia in the pediatric population. The pain management of the children with major burns challenges the skills of the personnel of every unit. Managing these wounds requires intensive therapeutic treatment for multi-organ dysfunction, and surgical treatment to prevent sepsis and other complications that further delay wound closure. Alternatives to the practice of donor site harvest and autografting for the treatment of severe burns and other complex skin defects are urgently needed for both adult and pediatric populations. This review article focuses on thermal burn pathophysiology and pain management and provides an overview of currently approved products used for the treatment of pediatric burn wounds. A new promising approach has been presented as a first-line therapy in the treatment of burns to reduce surgical autografting in pediatric patients.

  12. Mindfulness Meditation Training for Attention-Deficit/Hyperactivity Disorder in Adulthood: Current Empirical Support, Treatment Overview, and Future Directions

    Science.gov (United States)

    Mitchell, John T.; Zylowska, Lidia; Kollins, Scott H.

    2015-01-01

    Research examining nonpharmacological interventions for adults diagnosed with attention-deficit/hyperactivity disorder (ADHD) has expanded in recent years and provides patients with more treatment options. Mindfulness-based training is an example of an intervention that is gaining promising preliminary empirical support and is increasingly administered in clinical settings. The aim of this review is to provide a rationale for the application of mindfulness to individuals diagnosed with ADHD, describe the current state of the empirical basis for mindfulness training in ADHD, and summarize a treatment approach specific to adults diagnosed with ADHD: the Mindful Awareness Practices (MAPs) for ADHD Program. Two case study examples are provided to demonstrate relevant clinical issues for practitioners interested in this approach. Directions for future research, including mindfulness meditation as a standalone treatment and as a complementary approach to cognitive-behavioral therapy, are provided. PMID:25908900

  13. When idols look into the future: fair treatment modulates the affective forecasting error in talent show candidates.

    Science.gov (United States)

    Feys, Marjolein; Anseel, Frederik

    2015-03-01

    People's affective forecasts are often inaccurate because they tend to overestimate how they will feel after an event. As life decisions are often based on affective forecasts, it is crucial to find ways to manage forecasting errors. We examined the impact of a fair treatment on forecasting errors in candidates in a Belgian reality TV talent show. We found that perceptions of fair treatment increased the forecasting error for losers (a negative audition decision) but decreased it for winners (a positive audition decision). For winners, this effect was even more pronounced when candidates were highly invested in their self-view as a future pop idol whereas for losers, the effect was more pronounced when importance was low. The results in this study point to a potential paradox between maximizing happiness and decreasing forecasting errors. A fair treatment increased the forecasting error for losers, but actually made them happier. © 2014 The British Psychological Society.

  14. Novel agents in the treatment of multiple myeloma: a review about the future

    Directory of Open Access Journals (Sweden)

    Leonard Naymagon

    2016-06-01

    Full Text Available Abstract Multiple myeloma (MM is a disease that affects plasma cells and can lead to devastating clinical features such as anemia, lytic bone lesions, hypercalcemia, and renal disease. An enhanced understanding of MM disease mechanisms has led to new more targeted treatments. There is now a plethora of treatments available for MM. In this review article, our aim is to discuss many of the novel agents that are being studied or have recently been approved for the treatment of MM. These agents include the following: immunomodulators (pomalidomide, proteasome inhibitors (carfilzomib, marizomib, ixazomib, oprozomib, alkylating agents (bendamustine, AKT inhibitors (afuresertib, BTK inhibitors (ibrutinib, CDK inhibitors (dinaciclib, histone deacetylase inhibitors (panobinostat, rocilinostat, vorinostat, IL-6 inhibitors (siltuximab, kinesin spindle protein inhibitors (filanesib, monoclonal antibodies (daratumumab, elotuzumab, indatuximab, SAR650984, and phosphoinositide 3-kinase (PI3K inhibitors.

  15. Treatment of impulse control disorders in Parkinson's disease: Practical considerations and future directions.

    Science.gov (United States)

    Ramirez-Zamora, Adolfo; Gee, Lucy; Boyd, James; Biller, José

    2016-01-01

    Impulse control disorders (ICDs) including compulsive gambling, buying, sexual behaviors, and eating occur relatively frequently in Parkinson disease (PD) with at least one ICD identified in 14% of PD patients in a large, multicenter, observational study. ICDs behaviors range widely in severity but can lead to catastrophic consequences, including financial ruin, divorce, loss of employment, and increased health risks. The main risk factor for ICDs in PD is the use of Dopamine agonists (DAs) and discontinuation of the offending agent is considered first line treatment. However, many patients do not tolerate this intervention as consequence of increased motor and psychiatric disability or appearance of DA withdrawal syndrome. In this article, we review current management strategies and emerging new interventions for treatment of ICDs in PD. Pharmacological treatment should be individualized based on patient's unique neuropsychiatric profile, social support, medical comorbidities, tolerability and motor symptoms.

  16. The present and future disease burden of hepatitis C virus (HCV) infection with today's treatment paradigm

    DEFF Research Database (Denmark)

    Razavi, H; Waked, I; Sarrazin, C

    2014-01-01

    The disease burden of hepatitis C virus (HCV) is expected to increase as the infected population ages. A modelling approach was used to estimate the total number of viremic infections, diagnosed, treated and new infections in 2013. In addition, the model was used to estimate the change in the total...... number of HCV infections, the disease progression and mortality in 2013-2030. Finally, expert panel consensus was used to capture current treatment practices in each country. Using today's treatment paradigm, the total number of HCV infections is projected to decline or remain flat in all countries...

  17. Stringent constraints on the dark matter annihilation cross section from subhalo searches with the Fermi Gamma-Ray Space Telescope

    Energy Technology Data Exchange (ETDEWEB)

    Berlin, Asher; Hooper, Dan

    2014-01-01

    The dark matter halo of the Milky Way is predicted to contain a very large number of smaller subhalos. As a result of the dark matter annihilations taking place within such objects, the most nearby and massive subhalos could appear as point-like or spatially extended gamma-ray sources, without observable counterparts at other wavelengths. In this paper, we use the results of the Aquarius simulation to predict the distribution of nearby subhalos, and compare this to the characteristics of the unidentified gamma-ray sources observed by the Fermi Gamma-Ray Space Telescope. Focusing on the brightest high latitude sources, we use this comparison to derive limits on the dark matter annihilation cross section. For dark matter particles lighter than ~200 GeV, the resulting limits are the strongest obtained to date, being modestly more stringent than those derived from observations of dwarf galaxies or the Galactic Center. We also derive independent limits based on the lack of unidentified gamma-ray sources with discernible spatial extension, but these limits are a factor of ~2-10 weaker than those based on point-like subhalos. Lastly, we note that four of the ten brightest high-latitude sources exhibit a similar spectral shape, consistent with 30-60 GeV dark matter particles annihilating to b quarks with an annihilation cross section on the order of sigma v ~ (5-10) x 10^-27 cm^3/s, or 8-10 GeV dark matter particles annihilating to taus with sigma v ~ (2.0-2.5) x 10^-27 cm^3/s.

  18. DIAGNOSIS AND TREATMENT OF ADHD DURING ADOLESCENCE IN THE PRIMARY CARE SETTING: REVIEW AND FUTURE DIRECTIONS

    Science.gov (United States)

    Brahmbhatt, Khyati; Hilty, Donald M.; Hah, Mina; Han, Jaesu; Angkustsiri, Kathy; Schweitzer, Julie

    2017-01-01

    Introduction Attention deficit hyperactivity disorder (ADHD) is a chronic neurodevelopmental disorder with a worldwide prevalence of about 5% in school age children. Objective The goal of this review is to assist primary care providers (PCPs) in diagnosing and treating ADHD in adolescents. Methods PubMed, PsychInfo and Science Citation Index databases were searched from March 1990–2015 with the key words: attention deficit hyperactivity disorder, primary care/pediatrics and children/adolescents, abstracts addressing diagnosis and/or treatment with 105 citations identified including supplementary treatment guidelines/books. Results Adolescent ADHD presents with significant disturbances in attention, academic performance and family relationships with unique issues associated with this developmental period. Diagnostic challenges include the variable symptom presentation during adolescence, complex differential diagnosis and limited training and time for PCPs to conduct thorough evaluations. The evidence-base for treatments in adolescence in comparison to those in children or adults with ADHD is relatively weak. Providers should be cognizant of prevention, early identification and treatment of conditions associated with ADHD that emerge during adolescence as substance use disorders. Conclusions Adolescent ADHD management for the PCP is complex, requires further research, and perhaps new primary care-psychiatric models, to assist in determining the optimal care for patients at this critical period. PMID:27209327

  19. Future wastewater solutions: removal of pharmaceuticals in conventional wastewater treatment plants

    DEFF Research Database (Denmark)

    Jensen, Thomas

    Residues of pharmaceuticals, personal care products and industrial chemicals find their way into the environment mainly through incomplete removal in the conventional urban wastewater treatment plants (WWTPs) and appear as micro-pollutants at pg L-1 to μg L-1 concentrations. WWTPs were designed...

  20. Future strategies in the diagnosis, staging and treatment of bladder cancer.

    NARCIS (Netherlands)

    Heijden, A.G. van der; Witjes, J.A.

    2003-01-01

    PURPOSE OF REVIEW: In this review new modalities in the diagnosis, staging and treatment of superficial and invasive bladder cancer are reviewed. RECENT FINDINGS: Urinary markers still cannot replace cystoscopy in diagnosing bladder cancer. However, DNA micro-array has shown promise for diagnosis.

  1. Clinical Pharmacology of Current and Future Drugs for the Acute Treatment of Migraine

    DEFF Research Database (Denmark)

    Tfelt-Hansen, Peer

    2012-01-01

    Migraine is a common disorder with a female prevalence of 17% and a male prevalence of 9%. Migraine is most often disabling and the patients need treatment of the attacks. The introduction of triptans has been a revolution for many migraine patients but only a minority of patients use these speci...

  2. Silvicultural treatments enhance growth rates of future crop trees in a tropical dry forest

    NARCIS (Netherlands)

    Villegas, Z.; Peña-Claros, M.; Mostacedo, B.; Alarcón, A.; Licona, J.C.; Leaño, C.; Pariona, W.; Choque, U.

    2009-01-01

    Silvicultural treatments are often needed in selectively logged tropical forest to enhance the growth rates of many commercial tree species and, consequently, for recovering a larger proportion of the initial volume harvested over the next cutting cycle. The available data in the literature suggest,

  3. Status of industrial scale radiation treatment of wastewater and its future. Proceedings of a consultants meeting

    International Nuclear Information System (INIS)

    2004-09-01

    Providing access to clean water resources is one of the most important objectives of the UN's Millennium Project. Contamination of surface water is a big problem for many, mostly developing countries. The main sources of liquid polluted effluents are municipalities and industry. Effective, mostly biological wastewater technologies for wastewater purification are available nowadays. However, they cannot be applied to solve all existing problems. Destruction of non-biodegradable organic compounds is one problem and biological contamination (caused by viruses, bacteria, parasites, etc.) of sludge is another. Methods of their purification are sought. Ionizing radiation (gamma or X rays, electron beams) is a very effective form of energy, which can destroy organic or biological contaminants. The IAEA promotes and supports research on radiation treatment of liquid effluents. The Coordinated Research Project (CRP) on Remediation of Polluted Waters and Wastewater by Radiation Processing aims to establish optimal treatment methodologies to disinfect and decontaminate actual samples of drinking water and wastewater by using ionizing radiation. Quite a few technical cooperation (TC) projects concerning radiation treatment of wastewater and sludge are under development. In the frame of one of such TC projects pilot plant for electron beam treatment of textile dyeing complex wastewater was constructed in the Republic of Korea. To discuss developments achieved under these projects and results of the pilot plant operation, the IAEA organized a consultants meeting in Daejon, Republic of Korea, 13-16 October 2003. These proceedings will be of value to research groups working in the field of radiation technology development. Developing Member States with radiation technology programmes will benefit from research in this area. The meeting dealt with advanced radiation processing of wastewater and its technical and economical aspects. It informed about high power accelerators ELV-12

  4. French Health Technology Assessment of Antineoplastic Drugs Indicated in the Treatment of Solid Tumours: Perspective for Future Trends.

    Science.gov (United States)

    Chouaid, Christos; Borget, Isabelle; Braun, Eric; Bazil, Marie-Laure; Schaetz, Dominique; Rémuzat, Cécile; Toumi, Mondher

    2016-08-01

    France is one of the European countries that spend the most on oncology drugs. To keep pharmaceutical expenditure under control, Health Authorities highly scrutinize market access of costly medicines. To assess current and future trends in French health technology assessment (HTA) of antineoplastic drugs indicated in the treatment of solid tumours. A review of the SMR and ASMR drivers of the Transparency Committee (CT) opinions issued for antineoplastic drugs indicated in the treatment of solid tumours and approved between 2009 and 2014 was performed to assess current trends in French health technology assessment (HTA), complemented by an expert board consultation to capture the critical issues on the future of antineoplastic drugs HTA. Thirty-one drugs indicated for the treatment of solid tumours were identified (77 % targeted therapies). Initial CT assessments were available for 26 drugs. Four key items in the CT assessment were identified: 1) Clinical trial methodology; 2) Acceptance of progression-free survival (PFS) as a valuable endpoint; 3) Transferability of clinical trials in clinical practice; 4) Unpredictability of CT decisions. Experts raised the important development of personalised medicines in oncology and key challenges for oncology products to generate information expected from HTA perspective. The French system remains committed to its values and philosophy (access of all innovations for everybody) which are threatened by the increasing launch of innovative therapies and budget constraint. Both HTA decision framework evolution and revision of the current pricing process should be considered in France to cope with these new challenges.

  5. Molecular and cellular biology of cerebral arteriovenous malformations: a review of current concepts and future trends in treatment.

    Science.gov (United States)

    Rangel-Castilla, Leonardo; Russin, Jonathan J; Martinez-Del-Campo, Eduardo; Soriano-Baron, Hector; Spetzler, Robert F; Nakaji, Peter

    2014-09-01

    Arteriovenous malformations (AVMs) are classically described as congenital static lesions. However, in addition to rupturing, AVMs can undergo growth, remodeling, and regression. These phenomena are directly related to cellular, molecular, and physiological processes. Understanding these relationships is essential to direct future diagnostic and therapeutic strategies. The authors performed a search of the contemporary literature to review current information regarding the molecular and cellular biology of AVMs and how this biology will impact their potential future management. A PubMed search was performed using the key words "genetic," "molecular," "brain," "cerebral," "arteriovenous," "malformation," "rupture," "management," "embolization," and "radiosurgery." Only English-language papers were considered. The reference lists of all papers selected for full-text assessment were reviewed. Current concepts in genetic polymorphisms, growth factors, angiopoietins, apoptosis, endothelial cells, pathophysiology, clinical syndromes, medical treatment (including tetracycline and microRNA-18a), radiation therapy, endovascular embolization, and surgical treatment as they apply to AVMs are discussed. Understanding the complex cellular biology, physiology, hemodynamics, and flow-related phenomena of AVMs is critical for defining and predicting their behavior, developing novel drug treatments, and improving endovascular and surgical therapies.

  6. HIV Risks, Testing, and Treatment in the Former Soviet Union: Challenges and Future Directions in Research and Methodology.

    Science.gov (United States)

    Saadat, Victoria M

    2015-01-01

    The dissolution of the USSR resulted in independence for constituent republics but left them battling an unstable economic environment and healthcare. Increases in injection drug use, prostitution, and migration were all widespread responses to this transition and have contributed to the emergence of an HIV epidemic in the countries of former Soviet Union. Researchers have begun to identify the risks of HIV infection as well as the barriers to HIV testing and treatment in the former Soviet Union. Significant methodological challenges have arisen and need to be addressed. The objective of this review is to determine common threads in HIV research in the former Soviet Union and provide useful recommendations for future research studies. In this systematic review of the literature, Pubmed was searched for English-language studies using the key search terms "HIV", "AIDS", "human immunodeficiency virus", "acquired immune deficiency syndrome", "Central Asia", "Kazakhstan", "Kyrgyzstan", "Uzbekistan", "Tajikistan", "Turkmenistan", "Russia", "Ukraine", "Armenia", "Azerbaijan", and "Georgia". Studies were evaluated against eligibility criteria for inclusion. Thirty-nine studies were identified across the two main topic areas of HIV risk and barriers to testing and treatment, themes subsequently referred to as "risk" and "barriers". Study design was predominantly cross-sectional. The most frequently used sampling methods were peer-to-peer and non-probabilistic sampling. The most frequently reported risks were condom misuse, risky intercourse, and unsafe practices among injection drug users. Common barriers to testing included that testing was inconvenient, and that results would not remain confidential. Frequent barriers to treatment were based on a distrust in the treatment system. The findings of this review reveal methodological limitations that span the existing studies. Small sample size, cross-sectional design, and non-probabilistic sampling methods were frequently

  7. The promise of ketamine for treatment-resistant depression: current evidence and future directions

    Science.gov (United States)

    DeWilde, Kaitlin E.; Levitch, Cara F.; Murrough, James W.; Mathew, Sanjay J.; Iosifescu, Dan V.

    2014-01-01

    Major depressive disorder (MDD) is one of the most disabling diseases worldwide and is a significant public health threat. Current treatments for MDD primarily consist of monoamine-targeting agents and have limited efficacy. However, the glutamate neurotransmitter system has recently come into focus as a promising alternative for novel antidepressant treatments. We review the current data on the glutamate NMDA receptor antagonist ketamine, which has been shown in clinical trials to act as a rapid antidepressant in MDD. We also examine ketamine efficacy on dimensions of psychopathology, including anhedonia, cognition, and suicidality, consistent with the NIMH Research Domain Criteria (RDoC) initiative. Other aspects of ketamine reviewed in this paper include safety and efficacy, different administration methods, and the risks of misuse of ketamine outside of medical settings. Finally, we conclude with a discussion of other glutamatergic agents other than ketamine currently being tested as novel antidepressants. PMID:25649308

  8. Oxcarbazepine: Drug of the future in the treatment of trigeminal neuralgia

    Directory of Open Access Journals (Sweden)

    Revant H Chole

    2011-01-01

    Full Text Available Background: The aim of the study was to estimate the efficacy of oxcarbazepine in trigeminal neuralgia. Oxcarbazepine is a novel antiepilepfic drug, and its effect on trigeminal neuralgia has not been studied extensively previously. Materials and methods: Fifty-three patients with trigeminal neuralgia (34 men and 19 women took a mean dose of 600 mg of oxcarbazepine for a period of three weeks. Pain intensity was measured by using visual analog scale. Results: Of the 53 patients, 42 (79% were completely or well controlled by OXC, and nine (17% partially but acceptably controlled. Treatment with OXC was therefore satisfactory initially in 51 (96% of the patients. In seven of these patients, mild transient side effects occurred but did not necessitate cessation of treatment Conclusion: OXC appears to be an effective substitute for carbamazepine in those patients intolerant of this agent, or experiencing significant side effects.

  9. Aspirin-exacerbated respiratory disease: Prevalence, diagnosis, treatment, and considerations for the future

    Science.gov (United States)

    Stoner, Ashley N.; Borish, Larry

    2016-01-01

    Aspirin-exacerbated respiratory disease (AERD) is a late onset condition characterized by the Samter triad (aspirin sensitivity [as well as sensitivity to any nonselective cyclooxygenase inhibitor], nasal polyps, asthma) and additional features, including eosinophilic chronic rhinosinusitis, hypereosinophilia, anosmia, frequent absence of atopy, and, intolerance to ingestion of red wine and other alcoholic beverages. The diagnosis is rare, and, because of this, it is also often missed by physicians. However, it is highly overexpressed in patients with severe asthma (and severe chronic rhinosinusitis with nasal polyps), which makes its recognition essential. For this review, we considered mechanisms involved in the pathogenesis of this disease and discussed the clinical symptoms of AERD. We also discussed the role of aspirin desensitization in the treatment of AERD. Also, we considered medications (e.g, leukotriene modifiers) and surgical interventions that have a role in the treatment of AERD. PMID:28124651

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

    Science.gov (United States)

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

    2018-03-01

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

  11. From genetics and epigenetics to the future of precision treatment for obesity

    OpenAIRE

    Sun, Xulong; Li, Pengzhou; Yang, Xiangwu; Li, Weizheng; Qiu, Xianjie; Zhu, Shaihong

    2017-01-01

    Abstract Obesity has become a major global health problem, epitomized by excess accumulation of body fat resulting from an imbalance between energy intake and expenditure. The treatments for obesity range from modified nutrition and additional physical activity, to drugs or surgery. But the curative effect of each method seems to vary between individuals. With progress in the genetics and epigenetics of obesity, personalization of the clinical management of obesity may be at our doorstep. Thi...

  12. BTEX compounds in water - future trends and directions for water treatment

    OpenAIRE

    Fayemiwo, OM; Daramola, MO; Moothi, K

    2017-01-01

    BTEX (benzene, toluene, ethylbenzene, and xylene) compounds are common water resource and potable water pollutants that are often left undetected and untreated by municipal treatment systems in spite of the negative repercussions associated with their ingestion. The US EPA has classified these pollutants as priority pollutant, yet they are persistently present in a variety of water resources. In this review paper, we highlight the sources and reported concentrations of BTEX compounds in water...

  13. Proposals for future activities agreed upon at the seminar on wastewater treatment in urban areas

    International Nuclear Information System (INIS)

    1987-01-01

    The programme of the seminar was divided into three different sections: - Sewerage systems, - Discharge of industrial wastewater to municipal sewerage systems, - Reduction of nitrogen. For each subject the participants of the seminar agreed upon the following proposal for future activities: Sewerage systems: a) Combined sewer overflows (CSO). Brief state-of-the-art reports should be compiled by the Contracting Parties. The reports should provide information on: - extent of combined sewers (in % of sewered area), - design practices including flow equalization, - rates of inflow/infiltration, - pollution due to CSO, - current research, - trends. A compilation of these reports may hopefully lead to the derivation of suitable effluent standards, which may be expressed as frequencies, total volumes or total amount of pollution load. The effluent standards may be expressed as monthly to yearly values

  14. Treatment facilities, human resource development, and future prospect of particle beam therapy

    International Nuclear Information System (INIS)

    Tamaki, Tomoaki; Nakano, Takashi

    2015-01-01

    The number of particle beam therapy facilities is increasing globally. Among the countries practicing particle beam therapy, Japan is one of the leading countries in the field with four operating carbon-ion therapy facilities and ten operating proton therapy facilities. With the increasing number of particle beam therapy facilities, the human resource development is becoming extremely important, and there has been many such efforts including the Gunma University Program for Cultivating Global Leaders in Heavy Ion Therapeutics and Engineering, which aimed to educate and train the radiation oncologists, medical physicists, accelerator engineers, and radiation biologists to become global leaders in the field of particle beam therapy. In the future, the benefit and effectiveness of particle beam therapy should be discussed and elucidated objectively in a framework of comprehensive cancer care. (author)

  15. Future waste treatment and energy systems – examples of joint scenarios

    DEFF Research Database (Denmark)

    Münster, Marie; Finnveden, G.; Wenzel, H.

    2013-01-01

    of scenarios is recommended, too, in order to adapt to the methods and tools of different disciplines, such as developing predictive scenarios with general equilibrium tools and analysing explorative scenarios with energy system analysis tools. Furthermore, as marginals identified in differing future......Development and use of scenarios for large interdisciplinary projects is a complicated task. This article provides practical examples of how it has been carried out in two projects addressing waste management and energy issues respectively. Based on experiences from the two projects......, recommendations are made for an approach concerning development of scenarios in projects dealing with both waste management and energy issues. Recommendations are given to develop and use overall scenarios for the project and leave room for sub-scenarios in parts of the project. Combining different types...

  16. CDK4/6 inhibitor PD0332991 in glioblastoma treatment: does it have a future?

    Directory of Open Access Journals (Sweden)

    Lisette eSchroder

    2015-11-01

    Full Text Available Glioblastoma is aggressive, highly infiltrating, and the most frequent malignant form of brain cancer. With a median survival time of only 14.6 months, when treated with the standard of care, it is essential to find new therapeutic options. A specific CDK4/6 inhibitor, PD0332991, obtained accelerated approval from the Food and Drug Administration for the treatment of patients with advanced estrogen receptor-positive and HER2-negative breast cancer. Common alterations in the cyclin D1-Cyclin Dependent Kinase 4/6-Retinoblastoma 1 pathway in glioblastoma make PD0332991 also an interesting drug for the treatment of glioblastoma. Promising results in in vitro studies, where patient derived glioblastoma cell lines showed sensitivity to PD0332991, gave motive to start in vivo studies. Outcomes of these studies have been contrasting in terms of PD0332991 efficacy within the brain: more research is necessary to conclude whether CDK4/6 inhibitor can be beneficial in the treatment of glioblastoma.

  17. Therapeutic Potential of Curcumin in Treatment of Pancreatic Cancer: Current Status and Future Perspectives.

    Science.gov (United States)

    Hosseini, Mina; Hassanian, Seyed Mahdi; Mohammadzadeh, Elham; ShahidSales, Soodabeh; Maftouh, Mina; Fayazbakhsh, Hasan; Khazaei, Majid; Avan, Amir

    2017-07-01

    Pancreatic cancer is among the leading cause of deaths due to cancer with extremely poor prognosis. Gemcitabine is being used in the treatment of patient with pancreatic ductal adenocarcinoma (PDAC), although, the response rate is bellow 12%. A recent phase III trial revealed that FOLFIRINOX could be an option for the treatment of metastatic PDAC patients, although it is associated with increased toxicity. Therefore, identification of novel agents that either improves gemcitabine activity, within novel combinatorial approaches, or with a better efficacy than gemcitabine is warranted. The antitumor activity of curcumin in several tumors, including prostate, breast and colorectal cancers have investigated. A recent phase II trial explored the effects of curcumin in advanced pancreatic cancer patient. They found that oral curcumin was well tolerated. Another trial showed the activity of 8,000 mg of curcumin in combination with gemcitabine in patients with advanced pancreatic cancer. This review summarizes the current knowledge about possible molecular mechanisms of curcumin in PDAC with particular emphasis on preclinical/clinical studies in pancreatic cancer treatment. J. Cell. Biochem. 118: 1634-1638, 2017. © 2017 Wiley Periodicals, Inc. © 2017 Wiley Periodicals, Inc.

  18. N-acetylcysteine in the treatment of psychiatric disorders: current status and future prospects.

    Science.gov (United States)

    Minarini, Alessandro; Ferrari, Silvia; Galletti, Martina; Giambalvo, Nina; Perrone, Daniela; Rioli, Giulia; Galeazzi, Gian Maria

    2017-03-01

    N-acetylcysteine (NAC) is widely known for its role as a mucolytic and as an antidote to paracetamol overdose. There is increasing interest in the use of NAC in the treatment of several psychiatric disorders. The rationale for the administration of NAC in psychiatric conditions is based on its role as a precursor to the antioxidant glutathione, and its action as a modulating agent of glutamatergic, dopaminergic, neurotropic and inflammatory pathways. Areas covered: This study reviews the available data regarding the use of NAC in different psychiatric disorders including substance use disorders, autism, obsessive-compulsive spectrum disorders, schizophrenia, depression, bipolar disorder. Promising results were found in trials testing the use of NAC, mainly as an add-on treatment, in cannabis use disorder in young people, depression in bipolar disorder, negative symptoms in schizophrenia, and excoriation (skin-picking) disorder. Despite initial optimism, recent findings regarding NAC efficacy in autism have been disappointing. Expert opinion: These preliminary positive results require further confirmation in larger samples and with longer follow-ups. Given its high tolerability and wide availability, NAC represents an important target to investigate in the field of new adjunctive treatments for psychiatric conditions.

  19. Bariatric surgery and nonalcoholic fatty liver disease: current and potential future treatments

    Directory of Open Access Journals (Sweden)

    Akira eSasaki

    2014-10-01

    Full Text Available Nonalcoholic fatty liver disease (NAFLD and nonalcoholic steatohepatitis (NASH are increasingly common cause of chronic liver disease worldwide. The diagnosis of NASH is challenging as most affected patients are symptom-free and the role of routine screening is not clearly established. Most patients with severe obesity who undergo bariatric surgery have NAFLD, which is associated insulin resistance, type 2 diabetes mellitus (T2DM, hypertension, and obesity-related dyslipidemia. The effective treatment for NAFLD is weight reduction through lifestyle modifications, antiobesity medication, or bariatric surgery. Among these treatments, bariatric surgery is the most reliable method for achieving substantial, sustained weight loss. This procedure is safe when performed by a skilled surgeon, and the benefits include reduced weight, improved quality of life, decreased obesity-related comorbidities, and increased life expectancy. Further research is urgently needed to determine the best use of bariatric surgery with NAFLD patients at high risk of developing liver cirrhosis and its role in modulating complications of NAFLD, such as T2DM and cardiovascular disease. The current evidence suggests that bariatric surgery for patients with severe obesity decreases the grade of steatosis, hepatic inflammation, and fibrosis. However, further long-term studies are required to confirm the true effects before recommending bariatric surgery as a potential treatment for nonalcoholic steatohepatitis.

  20. Islet cell transplantation for the treatment of type 1 diabetes: recent advances and future challenges

    Directory of Open Access Journals (Sweden)

    Bruni A

    2014-06-01

    Full Text Available Anthony Bruni, Boris Gala-Lopez, Andrew R Pepper, Nasser S Abualhassan, AM James Shapiro Clinical Islet Transplant Program and Department of Surgery, University of Alberta, Edmonton, AB, Canada Abstract: Islet transplantation is a well-established therapeutic treatment for a subset of patients with complicated type I diabetes mellitus. Prior to the Edmonton Protocol, only 9% of the 267 islet transplant recipients since 1999 were insulin independent for >1 year. In 2000, the Edmonton group reported the achievement of insulin independence in seven consecutive patients, which in a collaborative team effort propagated expansion of clinical islet transplantation centers worldwide in an effort to ameliorate the consequences of this disease. To date, clinical islet transplantation has established improved success with insulin independence rates up to 5 years post-transplant with minimal complications. In spite of marked clinical success, donor availability and selection, engraftment, and side effects of immunosuppression remain as existing obstacles to be addressed to further improve this therapy. Clinical trials to improve engraftment, the availability of insulin-producing cell sources, as well as alternative transplant sites are currently under investigation to expand treatment. With ongoing experimental and clinical studies, islet transplantation continues to be an exciting and attractive therapy to treat type I diabetes mellitus with the prospect of shifting from a treatment for some to a cure for all. Keywords: islet transplantation, type I diabetes mellitus, Edmonton Protocol, engraftment, immunosuppression

  1. Islet cell transplantation for the treatment of type 1 diabetes: recent advances and future challenges

    Science.gov (United States)

    Bruni, Anthony; Gala-Lopez, Boris; Pepper, Andrew R; Abualhassan, Nasser S; Shapiro, AM James

    2014-01-01

    Islet transplantation is a well-established therapeutic treatment for a subset of patients with complicated type I diabetes mellitus. Prior to the Edmonton Protocol, only 9% of the 267 islet transplant recipients since 1999 were insulin independent for >1 year. In 2000, the Edmonton group reported the achievement of insulin independence in seven consecutive patients, which in a collaborative team effort propagated expansion of clinical islet transplantation centers worldwide in an effort to ameliorate the consequences of this disease. To date, clinical islet transplantation has established improved success with insulin independence rates up to 5 years post-transplant with minimal complications. In spite of marked clinical success, donor availability and selection, engraftment, and side effects of immunosuppression remain as existing obstacles to be addressed to further improve this therapy. Clinical trials to improve engraftment, the availability of insulin-producing cell sources, as well as alternative transplant sites are currently under investigation to expand treatment. With ongoing experimental and clinical studies, islet transplantation continues to be an exciting and attractive therapy to treat type I diabetes mellitus with the prospect of shifting from a treatment for some to a cure for all. PMID:25018643

  2. Introduction of Microbial Biopolymers in Soil Treatment for Future Environmentally-Friendly and Sustainable Geotechnical Engineering

    Directory of Open Access Journals (Sweden)

    Ilhan Chang

    2016-03-01

    Full Text Available Soil treatment and improvement is commonly performed in the field of geotechnical engineering. Methods and materials to achieve this such as soil stabilization and mixing with cementitious binders have been utilized in engineered soil applications since the beginning of human civilization. Demand for environment-friendly and sustainable alternatives is currently rising. Since cement, the most commonly applied and effective soil treatment material, is responsible for heavy greenhouse gas emissions, alternatives such as geosynthetics, chemical polymers, geopolymers, microbial induction, and biopolymers are being actively studied. This study provides an overall review of the recent applications of biopolymers in geotechnical engineering. Biopolymers are microbially induced polymers that are high-tensile, innocuous, and eco-friendly. Soil–biopolymer interactions and related soil strengthening mechanisms are discussed in the context of recent experimental and microscopic studies. In addition, the economic feasibility of biopolymer implementation in the field is analyzed in comparison to ordinary cement, from environmental perspectives. Findings from this study demonstrate that biopolymers have strong potential to replace cement as a soil treatment material within the context of environment-friendly construction and development. Moreover, continuing research is suggested to ensure performance in terms of practical implementation, reliability, and durability of in situ biopolymer applications for geotechnical engineering purposes.

  3. Management of menopause-associated vasomotor symptoms: Current treatment options, challenges and future directions

    Directory of Open Access Journals (Sweden)

    Deirdre R Pachman

    2010-05-01

    Full Text Available Deirdre R Pachman1, Jason M Jones1, Charles L Loprinzi21Internal Medicine, Mayo Clinic, Rochester, MN, USA; 2Medical Oncology, Mayo Clinic, Rochester, MN, USAAbstract: Hot flashes are one of the most common and distressing symptoms associated with menopause, occurring in more than 75% of postmenopausal women. They are especially problematic in breast cancer patients since some breast cancer therapies can induce hot flashes. For mild hot flashes, it is proposed that behavioral modifications are the first step in management. Hormonal therapies, including estrogens and progestogens, are the most well known effective agents in relieving hot flashes; however, the safety of these agents is controversial. There is an increasing amount of literature on nonhormonal agents for the treatment of hot flashes. The most promising data regard newer antidepressant agents such as venlafaxine, which reduces hot flashes by about 60%. Gabapentin is another nonhormonal agent that is effective in reducing hot flashes. While many complimentary therapies, including phytoestrogens, black cohosh, and dehydroepiandrosterone, have been explored for the treatment of hot flashes; none can be recommended at this time. Furthermore, there is a lack of strong evidence to support exercise, yoga, or relaxation for the treatment of hot flashes. Paced respirations and hypnosis appear to be promising enough to warrant further investigation. Another promising nonpharmacological therapy, currently under investigation, involves a stellate ganglion block.Keywords: vasomotor symptoms, hot flashes, menopause, therapy

  4. Guest Editorial : New European Union plant health regime: A more stringent regulation that could impact trade from developing countries in the near future

    OpenAIRE

    Schiffers, Bruno

    2017-01-01

    The new "Plant Health Law" provides more comprehensive and clearer rules for the prevention of entry into, and spread within, the EU territory of pests injurious to plant health but this regulation also includes regulating pests on the basis of pre-established criteria for risk assesment and prioritising of pests with the most serious consequences. Peer reviewed

  5. FLU AS PROBLEM COMMON TO ALL MANKIND. FUTURE DIRECTIONS FOR PREVENTION AND TREATMENT OF INFLUENZA

    Directory of Open Access Journals (Sweden)

    Korovaeva I.V

    2014-06-01

    Full Text Available This article discusses the flu, as one of the most common infectious diseases affecting humanity throughout its history. The data on the structure of A influenza virus and its variability is given historical background for most famous of the pandemics, which inflicted irreparable damage to the population of the Earth, are shown the basic stages of the study for influenza virus. Are considered the types of variability of the A virus influenza, its ability to overcome interspecies barriers that form the basis of pathogen escape from the immune response. The article shows the promising areas of modern prevention and treatment of this disease

  6. Evolution of checkpoint inhibitors for the treatment of metastatic gastric cancers: Current status and future perspectives.

    Science.gov (United States)

    Taieb, Julien; Moehler, Markus; Boku, Narikazu; Ajani, Jaffer A; Yañez Ruiz, Eduardo; Ryu, Min-Hee; Guenther, Silke; Chand, Vikram; Bang, Yung-Jue

    2018-05-01

    Standard treatment options for patients with advanced gastric or gastroesophageal junction cancer (GC/GEJC) are associated with limited efficacy and some toxicity. Recently, immunotherapy with antibodies that inhibit the programmed death 1 (PD-1)/programmed death ligand 1 (PD-L1) interaction has emerged as a new treatment option. This manuscript reviews early-phase and late-phase trials of immunotherapy in advanced GC/GEJC. Searches for studies of immunotherapy in GC/GEJC were performed using PubMed, ClinicalTrials.gov, and abstract databases for select annual congresses. Findings were interpreted based on expert opinion. Monotherapy with anti-PD-1/PD-L1 antibodies, including pembrolizumab, nivolumab, avelumab, durvalumab, and atezolizumab, has shown interesting objective response rates (ORRs; 7-26%) across varying GC/GEJC populations, with ORRs potentially higher in PD-L1 + vs PD-L1 - tumors. Safety profiles compare favorably with chemotherapy, with grade ≥3 treatment-related adverse events occurring in 5-17%. Based on a large phase 2 study, pembrolizumab was approved in the United States for third-line treatment of patients with PD-L1 + GC/GEJC. In a phase 3 trial, third-line or later nivolumab increased overall survival vs placebo in an Asian population, leading to regulatory approval in Japan, although other completed phase 3 trials did not show superiority for pembrolizumab or avelumab monotherapy vs chemotherapy. Other trials in advanced GC/GEJC are assessing various anti-PD-1/PD-L1-based strategies, including administration in first-line and later-line settings and as combination (with chemotherapy or agents targeting other immune checkpoint proteins, eg, CTLA-4, LAG-3, and IDO) or switch-maintenance regimens. Anti-PD-1/PD-L1 antibodies have shown encouraging clinical activity in advanced GC/GEJC. Results from ongoing phase 3 trials are needed to further evaluate the potential roles of these agents within the continuum of care. Copyright

  7. Impact of treatment strategy and physical performance on future knee-related self-efficacy in individuals with ACL injury

    DEFF Research Database (Denmark)

    Flosadottir, Vala; Frobell, Richard; Roos, Ewa M

    2018-01-01

    BACKGROUND: In people with anterior cruciate ligament (ACL) injury, high self-efficacy facilitates recovery, indicated by improved muscle function, reduced knee symptoms and increased physical activity. Impact of treatment on future self-efficacy is however not well investigated. The aims...... of the study were to 1) investigate knee-related self-efficacy 6 years after acute ACL injury in patients treated with exercise therapy alone or in combination with either early or the option of delayed ACL reconstruction (ACLR), and 2) to investigate associations between single-leg physical performance...... at various time points after ACL injury and knee self-efficacy at 6 years after injury. METHODS: Participants (n = 121) originated from the KANON-study (ISRCTN84752559), a treatment RCT including active adults with acute ACL injury treated with structured exercise therapy combined with early or the option...

  8. Mobile Phones in Research and Treatment: Ethical Guidelines and Future Directions

    Science.gov (United States)

    Liddle, Jacki; Hall, Wayne; Chenery, Helen

    2015-01-01

    Mobile phones and other remote monitoring devices, collectively referred to as "mHealth," promise to transform the treatment of a range of conditions, including movement disorders, such as Parkinson’s disease. In this viewpoint paper, we use Parkinson’s disease as an example, although most considerations discussed below are valid for a wide variety of conditions. The ability to easily collect vast arrays of personal data over long periods will give clinicians and researchers unique insights into disease treatment and progression. These capabilities also pose new ethical challenges that health care professionals will need to manage if this promise is to be realized with minimal risk of harm. These challenges include privacy protection when anonymity is not always possible, minimization of third-party uses of mHealth data, informing patients of complex risks when obtaining consent, managing data in ways that maximize benefit while minimizing the potential for disclosure to third parties, careful communication of clinically relevant information gleaned via mHealth technologies, and rigorous evaluation and regulation of mHealth products before widespread use. Given the complex array of symptoms and differences in comfort and literacy with technology, it is likely that these solutions will need to be individualized. It is therefore critical that developers of mHealth apps engage with patients throughout the development process to ensure that the technology meets their needs. These challenges will be best met through early and ongoing engagement with patients and other relevant stakeholders. PMID:26474545

  9. Role of ribavirin in HCV treatment response: now and in the future.

    Science.gov (United States)

    Jain, Mamta K; Zoellner, Cindy

    2010-03-01

    Ribavirin is a broad spectrum antiviral agent that is used with pegylated IFN (Peg-IFN) for HCV treatment. Ribavirin does not significantly reduce HCV viral load when used alone but increases rates of sustained virologic response (SVR) when combined with Peg-IFN. HCV genotype 1 infected patients require higher doses of ribavirin administered for a longer duration of time versus HCV genotypes 2 and 3 patients who respond effectively to Peg-IFN with lower doses of ribavirin and shorter duration of therapy. Higher serum concentrations of ribavirin are associated with higher response rates but also higher rates of hemolytic anemia which is a dose limiting side effect. Alternatives to current therapy are under clinical evaluation. Systematic literature review of ribavirin use in HCV patients from 1995 to 2009 was conducted. To review the efficacy and safety of ribavirin in current HCV treatment and in new therapies in Phase III clinical trials. Ribavirin is a drug which is essential to produce higher SVR rates both with Peg-IFN and HCV protease inhibitors currently in Phase III clinical trials. Thus, ribavirin is and will remain an important drug to achieving higher SVR rates in HCV infected persons.

  10. Neprilysin inhibition: a brief review of past pharmacological strategies for heart failure treatment and future directions

    Science.gov (United States)

    Howell, Erik H.; Cameron, Scott J.

    2016-01-01

    Heart failure (HF) is a manifestation of aberrant vascular responses and remains a public health concern with a worldwide prevalence of around 23 million and a 5-year mortality numerically equivalent to many cancers. Over the last two decades, mortality from HF reached a plateau with current pharmaceutical agents and mechanical cardiac support. In the last several years, various “novel” pharmaceutical agents have been tested in clinical trials and ultimately met with disappointment, showing only incremental benefit in the treatment of HF. Designing a HF drug with enhanced efficacy over existing agents seemed like a Sisyphean task. Yet again, pharmaceutical chemists have demonstrated their prowess in lateral thinking by developing a vasoactive agent which is a co-crystallized compound of valsartan and sacubitril in a one-to-one molar ratio; the former molecule belongs to a family of agents that are the current standard of care for HF and the latter molecule is a novel agent which inhibits neprilysin — a neutral endopeptidase found in human plasma which alters neurohumoral responses. In July of 2015, a drug which is a combination of valsartan and sacubitril was formally licensed by the United States Food and Drug Administration for the treatment of HF. This review describes the evolution of HF medications focusing on rational drug design with the first HF medication, the beta adrenergic receptor antagonist. We then discuss the biochemical and physiological properties of sacubitril/valsartan which likely lead to its dramatic ability to ameliorate HF mortality. PMID:27665860

  11. Pancreatic Neuroendocrine Neoplasms: Basic Biology, Current Treatment Strategies and Prospects for the Future

    Directory of Open Access Journals (Sweden)

    Akihiro Ohmoto

    2017-01-01

    Full Text Available Pancreatic neuroendocrine neoplasms (pNENs are rare tumors accounting for only 1%–2% of all pancreatic tumors. pNENs are pathologically heterogeneous and are categorized into three groups (neuroendocrine tumor: NET G1, NET G2; and neuroendocrine carcinoma: NEC on the basis of the Ki-67 proliferation index and the mitotic count according to the 2010 World Health Organization (WHO classification of gastroenteropancreatic NENs. NEC in this classification includes both histologically well-differentiated and poorly differentiated subtypes, and modification of the WHO 2010 classification is under discussion based on genetic and clinical data. Genomic analysis has revealed NETs G1/G2 have genetic alterations in chromatin remodeling genes such as MEN1, DAXX and ATRX, whereas NECs have an inactivation of TP53 and RB1, and these data suggest that different treatment approaches would be required for NET G1/G2 and NEC. While there are promising molecular targeted drugs, such as everolimus or sunitinib, for advanced NET G1/G2, treatment stratification based on appropriate predictive and prognostic biomarkers is becoming an important issue. The clinical outcome of NEC is still dismal, and a more detailed understanding of the genetic background together with preclinical studies to develop new agents, including those already under investigation for small cell lung cancer (SCLC, will be needed to improve the prognosis.

  12. STEM CELLS IN THE TREATMENT OF URINARY STRESS INCONTINENCE – A VISION OF FUTURE?

    Directory of Open Access Journals (Sweden)

    Adolf Lukanović

    2018-02-01

    Full Text Available Background. For one third of all women urinary incontinence is a health problem. Different strategies of treatment have been used, namely surgical, medical and physiotherapy. To this armamentarium a new method – adult stem cells therapy – has been added. Methods. The source of adult autologues multipotent stem cells consists of muscle-derived stem cells, adipose-derived stem cells and mesenchymed bone marrow cells. In facilities for stem cells with processing and in the presence of specific inducing factors, muscle derived stem cells can be differentiated to striated or smooth muscles. Clinical work is based on animal models that with immunohistochemical analysis demonstrated new skeletal-muscle fiber formation at the site of injection of stem cells. In stress urinary incontinence (SUI autologues bioptic material is obtained by using a musle needle biopsy device. From the biopsy speciment with dissociation muscle-derived stem cells are isolated and injected under local anaesthesia in the middle urethra and/or external urethral sphincter. Initial results of SUI treatment with adult muscle-derived stem cells suggest that perspectives of this method are encouraging. Conclusions. Stem cell therapy is promising to become minimally invasive method for reconstruction of the muscles and connective tissue of urethra and external urethral sphincter.

  13. Non-melanoma skin cancer: new and future synthetic drug treatments.

    Science.gov (United States)

    Amaral, Teresa; Garbe, Claus

    2017-05-01

    Non-melanoma skin cancers (NMSC) mainly comprise two different entities: basal cell carcinoma (BCC) and squamous cell carcinoma (SCC); beneath these two entities, Merkel cell carcinoma, adnexal tumors, dermatofibrosarcoma protuberans, angiosarcoma, and cutaneous lymphoma belong to NMSC. These rare skin tumors are not the topic of this review. BCC and SCC are the most common cancers diagnosed in humans. The preferred treatment is surgery, which in most cases is curative. Although a high recurrence rate is seen, these cancers rarely metastasize. Therefore, systemic treatments were not a priority for these patients. It is long known that the abnormal activation of Hedgehog and epidermal growth factor receptor pathways were involved in BCC and SCC. In the last decade, metastatic disease became an important area of research, mostly because new therapies that targeted components of these two pathways became available. Areas covered: Here we cover the available therapeutic options for patients diagnosed with BCC and SCC, focus on systemic and targeted therapies. Expert opinion: BCC and SCC are common cancers, with good prognosis. More than the metastatic disease, advanced local disease and recurrent disease pose clinicians a great challenge. Albeit there are promising results with targeted therapies, resistance development has already been described.

  14. Future of external beam irradiation as initial treatment of rectal cancer

    Energy Technology Data Exchange (ETDEWEB)

    Papillon, J.

    1987-06-01

    The authors' protocol consists of a split-course regimen with a short course of cobalt-60 arc rotation (3000 c/Gy in 12 days). After 2 months rest, the second stage treatment depends upon the pressure of residual disease and the tumour site. It consists of either radical surgery (82 cases) or conservative treatment by intracavitary irradiation in the event of a favourable initial response or in the case of poor risk patients (73 cases). In the radiotherapy-surgical group, the subsequent operative specimens were tumour free in 17% of cases and assigned to Dukes' A category in 32% of cases. Of 91 patients with T/sub 2/ or T/sub 3/ tumour involving the lower third of the rectum (followed up for more than 3 years) 72(84%) had no recurrence. Thirty-three of these patients (46%) underwent a colostomy while 39 (54%) has normal anal function. These results demonstrate the major place that a properly planned external beam irradiation can have in the curative management of cancers of the low rectum.

  15. Treatment options and patient perspectives in the management of fibromyalgia: future trends

    Directory of Open Access Journals (Sweden)

    Kim Lawson

    2008-11-01

    Full Text Available Kim LawsonBiomedical Research Centre, Sheffield Hallam University, Faculty of Health and Wellbeing, Sheffield, UKAbstract: Fibromyalgia (FM is a common, complex, and difficult to treat chronic widespread pain disorder, which usually requires a multidisciplinary approach using both pharmacological and non-pharmacological (education and exercise interventions. It is a condition of heightened generalized sensitization to sensory input presenting as a complex of symptoms including pain, sleep dysfunction, and fatigue, where the pathophysiology could include dysfunction of the central nervous system pain modulatory systems, dysfunction of the neuroendocrine system, and dysautonomia. A cyclic model of the pathophysiological processes is compatible with the interrelationship of primary symptoms and the array of postulated triggers associated with FM. Many of the molecular targets of current and emerging drugs used to treat FM have been focused to the management of discrete symptoms rather than the condition. Recently, drugs (eg, pregabalin, duloxetine, milnacipran, sodium oxybate have been identified that demonstrate a multidimensional efficacy in this condition. Although the complexity of FM suggests that monotherapy, non-pharmacological or pharmacological, will not adequately address the condition, the outcomes from recent clinical trials are providing important clues for treatment guidelines, improved diagnosis, and condition-focused therapies.Keywords: fibromyalgia, pain, sleep dysfunction, fatigue, exercise, pharmacological treatments

  16. Treatment of photon radiation in kinematics fits at future e{sup +}e{sup -} colliders

    Energy Technology Data Exchange (ETDEWEB)

    Beckmann, M.; List, J. [Deutsches Elektronen-Synchrotron (DESY), Hamburg (Germany); List, B. [Hamburg Univ. (Germany). Inst. fuer Experimentalphysik

    2010-05-15

    Kinematic fitting, where constraints such as energy and momentum conservation are imposed on measured four-vectors of jets and leptons, is an important tool to improve the resolution in high-energy physics experiments. At future e{sup +}e{sup -} colliders, photon radiation parallel to the beam carrying away large amounts of energy and momentum will become a challenge for kinematic fitting. A photon with longitudinal momentum p{sub z,{gamma}} ({eta}) is introduced, which is parametrized such that {eta} follows a normal distribution. In the fit, {eta} is treated as having a measured value of zero, which corresponds to p{sub z,{gamma}}, = 0. As a result, fits with constraints on energy and momentum conservation converge well even in the presence of a highly energetic photon, while the resolution of fits without such a photon is retained. A fully simulated and reconstructed e{sup +}e{sup -}{yields}q anti qq anti q event sample at {radical}(s)=500 GeV is used to investigate the performance of this method under realistic conditions, as expected at the International Linear Collider. (orig.)

  17. Treatment of photon radiation in kinematics fits at future e+e- colliders

    International Nuclear Information System (INIS)

    Beckmann, M.; List, J.; List, B.

    2010-05-01

    Kinematic fitting, where constraints such as energy and momentum conservation are imposed on measured four-vectors of jets and leptons, is an important tool to improve the resolution in high-energy physics experiments. At future e + e - colliders, photon radiation parallel to the beam carrying away large amounts of energy and momentum will become a challenge for kinematic fitting. A photon with longitudinal momentum p z,γ (η) is introduced, which is parametrized such that η follows a normal distribution. In the fit, η is treated as having a measured value of zero, which corresponds to p z,γ , = 0. As a result, fits with constraints on energy and momentum conservation converge well even in the presence of a highly energetic photon, while the resolution of fits without such a photon is retained. A fully simulated and reconstructed e + e - →q anti qq anti q event sample at √(s)=500 GeV is used to investigate the performance of this method under realistic conditions, as expected at the International Linear Collider. (orig.)

  18. Future waste treatment and energy systems – examples of joint scenarios

    International Nuclear Information System (INIS)

    Münster, M.; Finnveden, G.; Wenzel, H.

    2013-01-01

    Highlights: • Approach for use of scenarios dealing with both waste management and energy issues. • Overall scenarios for the common project and sub-scenarios in parts of the project. • Combining different types of scenarios to the tools of different disciplines. • Use of explorative external scenarios based on marginals for consequential LCA. - Abstract: Development and use of scenarios for large interdisciplinary projects is a complicated task. This article provides practical examples of how it has been carried out in two projects addressing waste management and energy issues respectively. Based on experiences from the two projects, recommendations are made for an approach concerning development of scenarios in projects dealing with both waste management and energy issues. Recommendations are given to develop and use overall scenarios for the project and leave room for sub-scenarios in parts of the project. Combining different types of scenarios is recommended, too, in order to adapt to the methods and tools of different disciplines, such as developing predictive scenarios with general equilibrium tools and analysing explorative scenarios with energy system analysis tools. Furthermore, as marginals identified in differing future background systems determine the outcomes of consequential life cycle assessments (LCAs), it is considered advisable to develop and use explorative external scenarios based on possible marginals as a framework for consequential LCAs. This approach is illustrated using an on-going Danish research project

  19. Nanomedicine applied to translational oncology: A future perspective on cancer treatment.

    Science.gov (United States)

    Bregoli, Lisa; Movia, Dania; Gavigan-Imedio, James D; Lysaght, Joanne; Reynolds, John; Prina-Mello, Adriele

    2016-01-01

    The high global incidence of cancer is associated with high rates of mortality and morbidity worldwide. By taking advantage of the properties of matter at the nanoscale, nanomedicine promises to develop innovative drugs with greater efficacy and less side effects than standard therapies. Here, we discuss both clinically available anti-cancer nanomedicines and those en route to future clinical application. The properties, therapeutic value, advantages and limitations of these nanomedicine products are highlighted, with a focus on their increased performance versus conventional molecular anticancer therapies. The main regulatory challenges toward the translation of innovative, clinically effective nanotherapeutics are discussed, with a view to improving current approaches to the clinical management of cancer. Ultimately, it becomes clear that the critical steps for clinical translation of nanotherapeutics require further interdisciplinary and international effort, where the whole stakeholder community is involved from bench to bedside. From the Clinical Editor: Cancer is a leading cause of mortality worldwide and finding a cure remains the holy-grail for many researchers and clinicians. The advance in nanotechnology has enabled novel strategies to develop in terms of cancer diagnosis and therapy. In this concise review article, the authors described current capabilities in this field and outlined comparisons with existing drugs. The difficulties in bringing new drugs to the clinics were also discussed. Copyright © 2015 Elsevier Inc. All rights reserved.

  20. Pharmacogenetics and pharmacogenomics in psoriasis treatment: current challenges and future prospects.

    Science.gov (United States)

    Sutherland, Alison; Power, Rebecca J; Rahman, Proton; O'Rielly, Darren D

    2016-08-01

    Topical, systemic, oral disease modifying, and biologic agents are part of the armamentarium to manage psoriatic disease. The choice of therapy depends upon disease severity, relevant co-morbidities and patient preference. There is great variability in patient response with these agents, and there is still no clear method of selecting the preferred therapeutic agent for efficacy or lack of adverse events. This article will review the pharmacogenetic and pharmacogenomic targets that are currently known with respect to psoriasis vulgaris, and the most frequent co-morbidity of psoriasis, psoriatic arthritis. Presently, no clinically actionable biomarker exists for any therapeutic agent used to treat psoriasis or psoriatic arthritis. The lack of validated outcome measures and conflicting results of open-label studies conducted may be attributed to a multitude of issues that confound discovery. Consequently, studies have been underpowered to identify genes or genetic variants worth translating to clinical practice. In order to achieve a pharmacogenetic/pharmacogenomic signature, improvements in study design of future investigations are required, including carefully designed prospective studies. It is imperative to combine known clinical, serological, and molecular markers with consistent outcomes and an adequate health economic evaluation before they can be adopted widely in clinical practice.

  1. Inhaled tyrosine kinase inhibitors for pulmonary hypertension: a possible future treatment

    Directory of Open Access Journals (Sweden)

    Pitsiou G

    2014-10-01

    Full Text Available Georgia Pitsiou,1 Paul Zarogoulidis,1 Dimitris Petridis,2 Ioannis Kioumis,1 Sofia Lampaki,1 John Organtzis,1 Konstantinos Porpodis,1 Antonis Papaiwannou,1 Theodora Tsiouda,3 Wolfgang Hohenforst-Schmidt,4 Stylianos Kakolyris,5 Konstantinos Syrigos,6 Haidong Huang,7 Qiang Li,7 J Francis Turner,8 Konstantinos Zarogoulidis1 1Pulmonary Department, G Papanikolaou General Hospital, Aristotle University of Thessaloniki, 2Department of Food Technology, School of Food Technology and Nutrition, Alexander Technological Educational Institute, 3Internal Medicine Department, Thegenio Anticancer Hospital, Thessaloniki, Greece; 4II Medical Department, Coburg Regional Hospital, Coburg, Germany; 5Oncology Department, Sotiria Hospital of Chest Diseases, University of Athens, Athens, 6Oncology Department, University General Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece; 7Department of Respiratory Diseases, Changhai Hospital/First Affiliated Hospital of the Second Military Medical University, Shanghai, People’s Republic of China; 8Division of Interventional Pulmonology and Medical Oncology, Cancer Treatment Centers of America, Western Regional Medical Center, Goodyear, AZ, USA Abstract: Pulmonary hypertension is a disease with severe consequences for the human body. There are several diseases and situations that induce pulmonary hypertension and are usually underdiagnosed. Treatments include conventional medical therapies and oral, inhaled, intravenous, and subcutaneous options. Depending on its severity, heart or lung transplant may also be an option. A possible novel treatment could be tyrosine kinase inhibitors. We conducted experiments with three jet nebulizers and three ultrasound nebulizers with erlotinib, gefitinib, and imatinib. Different residual cup designs and residual cup loadings were used in order to identify the best combination to produce droplets of less than 5 µm in mass median aerodynamic diameter. We

  2. Evaluating 5 years' NIMART mentoring in South Africa's HIV treatment programme: Successes, challenges and future needs.

    Science.gov (United States)

    Jones, M; Cameron, D

    2017-09-22

    Task shifting has enabled South Africa (SA) to rapidly expand its HIV treatment programme. This has been achieved by training and mentoring primary-care nurses in nurse initiation and management of antiretroviral therapy (NIMART). Five years into its clinical mentoring programme, the Foundation for Professional Development conducted an evaluation that identified improved knowledge, attitudes and confidence perceived by nurses who received NIMART mentoring. Low completion rates for the Department of Health (DoH) NIMART training process were identified and therefore targeted mentoring was introduced; this increased the percentage of primary nurses eligible for DoH certificates of clinical competence in NIMART from 12%, adding a further 30%. There remain a large number of primary nurses who require mentoring in order to complete the NIMART process. For those who have completed the process, there remains a need for ongoing mentoring as SA's HIV programme evolves, complex cases emerge and primary care undergoes change.

  3. Alternative Argets Within the Endocannabinoid System for Future Treatment of Gastrointestinal Diseases

    Directory of Open Access Journals (Sweden)

    Rudolf Schicho

    2011-01-01

    Full Text Available Many beneficial effects of herbal and synthetic cannabinoids on gut motility and inflammation have been demonstrated, suggesting a vast potential for these compounds in the treatment of gastrointestinal disorders. These effects are based on the so-called ‘endocannabinoid system’ (ECS, a cooperating network of molecules that regulate the metabolism of the body’s own and of exogenously administered cannabinoids. The ECS in the gastrointestinal tract quickly responds to homeostatic disturbances by de novo synthesis of its components to maintain homeostasis, thereby offering many potential targets for pharmacological intervention. Of major therapeutic interest are nonpsychoactive cannabinoids or compounds that do not directly target cannabinoid receptors but still possess cannabinoid-like properties. Drugs that inhibit endocannabinoid degradation and raise the level of endocannabinoids are becoming increasingly promising alternative therapeutic tools to manipulate the ECS.

  4. Sub-Zero Celsius treatment: a promising option for future martensitic stainless steels

    DEFF Research Database (Denmark)

    Villa, Matteo; Christiansen, Thomas Lundin; Somers, Marcel A. J.

    2016-01-01

    A series of samples of (in wt.%) 11.5Cr-0.67C martensiticstainless steel grade were austenitized in Argon for 1 hour attemperatures ranging from 1010°C to 1190°C. Additionally, aseries of samples of (in wt.%) 15.0Cr-5.8Ni-1.0Mo-0.03C (EN1.4418) martensitic stainless steel grade were solution...... and Vickers micro-hardness indentation.Complementary electron back-scatter diffraction was appliedfor determining the phase fractions of austenite and martensite.Data shows that sub-zero Celsius treatment yields anadditional hardening response when austenite is retained in thematerial. The relevance...

  5. Substitutes for Bear Bile for the Treatment of Liver Diseases: Research Progress and Future Perspective

    Science.gov (United States)

    Li, Sha; Tan, Hor Yue; Wang, Ning; Hong, Ming; Li, Lei; Cheung, Fan; Feng, Yibin

    2016-01-01

    Bear bile has been a well-known Chinese medicine for thousands of years. Because of the endangered species protection, the concept on substitutes for bear bile was proposed decades ago. Based on their chemical composition and pharmacologic actions, artificial bear bile, bile from other animals, synthetic compounds, and medicinal plants may be the promising candidates to replace bear bile for the similar therapeutic purpose. Accumulating research evidence has indicated that these potential substitutes for bear bile have displayed the same therapeutic effects as bear bile. However, stopping the use of bear bile is a challenging task. In this review, we extensively searched PubMed and CNKI for literatures, focusing on comparative studies between bear bile and its substitutes for the treatment of liver diseases. Recent research progress in potential substitutes for bear bile in the last decade is summarized, and a strategy for the use of substitutes for bear bile is discussed carefully. PMID:27087822

  6. Patient-centered care in cancer treatment programs: the future of integrative oncology through psychoeducation.

    Science.gov (United States)

    Garchinski, Christina M; DiBiase, Ann-Marie; Wong, Raimond K; Sagar, Stephen M

    2014-12-01

    The reciprocal relationship between the mind and body has been a neglected process for improving the psychosocial care of cancer patients. Emotions form an important link between the mind and body. They play a fundamental role in the cognitive functions of decision-making and symptom control. Recognizing this relationship is important for integrative oncology. We define psychoeducation as the teaching of self-evaluation and self-regulation of the mind-body process. A gap exists between research evidence and implementation into clinical practice. The patients' search for self-empowerment through the pursuit of complementary therapies may be a surrogate for inadequate psychoeducation. Integrative oncology programs should implement psychoeducation that helps patients to improve both emotional and cognitive intelligence, enabling them to better negotiate cancer treatment systems.

  7. Serotonin's Complex Role in Alcoholism: Implications for Treatment and Future Research.

    Science.gov (United States)

    Marcinkiewcz, Catherine A; Lowery-Gionta, Emily G; Kash, Thomas L

    2016-06-01

    Current pharmacological treatments for alcohol dependence have focused on reducing alcohol consumption, but to date there are few treatments that also address the negative affective symptoms during acute and protracted alcohol withdrawal which are often exacerbated in people with comorbid anxiety and depression. Selective serotonin reuptake inhibitors (SSRIs) are sometimes prescribed to ameliorate these symptoms but can exacerbate anxiety and cravings in a select group of patients. In this critical review, we discuss recent literature describing an association between alcohol dependence, the SERT linked polymorphic region (5-HTTLPR), and pharmacological response to SSRIs. Given the heterogeneity in responsiveness to serotonergic drugs across the spectrum of alcoholic subtypes, we assess the contribution of specific 5-HT circuits to discrete endophenotypes of alcohol dependence. 5-HT circuits play a distinctive role in reward, stress, and executive function which may account for the variation in response to serotonergic drugs. New optogenetic and chemogenetic methods for dissecting 5-HT circuits in alcohol dependence may provide clues leading to more effective pharmacotherapies. Although our current understanding of the role of 5-HT systems in alcohol dependence is incomplete, there is some evidence to suggest that 5-HT3 receptor antagonists are effective in people with the L/L genotype of the 5-HTTLPR polymorphism while SSRIs may be more beneficial to people with the S/L or S/S genotype. Studies that assess the impact of serotonin transporter polymorphisms on 5-HT circuit function and the subsequent development of alcohol use disorders will be an important step forward in treating alcohol dependence. Copyright © 2016 by the Research Society on Alcoholism.

  8. Customizing monoclonal antibodies for the treatment of methamphetamine abuse: current and future applications.

    Science.gov (United States)

    Peterson, Eric C; Gentry, W Brooks; Owens, S Michael

    2014-01-01

    Monoclonal antibody-based medications designed to bind (+)-methamphetamine (METH) with high affinity are among the newest approaches to the treatment of METH abuse and the associated medical complications. The potential clinical indications for these medications include treatment of overdose, reduction of drug dependence, and protection of vulnerable populations from METH-related complications. Research designed to discover and conduct preclinical and clinical testing of these antibodies suggests a scientific vision for how intact monoclonal antibody (mAb) (singular and plural) or small antigen-binding fragments of mAb could be engineered to optimize the proteins for specific therapeutic applications. In this review, we discuss keys to success in this development process including choosing predictors of specificity, efficacy, duration of action, and safety of the medications in disease models of acute and chronic drug abuse. We consider important aspects of METH-like hapten design and how hapten structural features influence specificity and affinity, with an example of a high-resolution X-ray crystal structure of a high-affinity antibody to demonstrate this structural relationship. Additionally, several prototype anti-METH mAb forms such as antigen-binding fragments and single-chain variable fragments are under development. Unique, customizable aspects of these fragments are presented with specific possible clinical indications. Finally, we discuss clinical trial progress of the first in kind anti-METH mAb, for which METH is the disease target instead of vulnerable central nervous system networks of receptors, binding sites, and neuronal connections. © 2014 Elsevier Inc. All rights reserved.

  9. Coatings and surface treatments for enhanced performance suspensions for future gravitational wave detectors

    Science.gov (United States)

    Birney, R.; Cumming, A. V.; Campsie, P.; Gibson, D.; Hammond, G. D.; Hough, J.; Martin, I. W.; Reid, S.; Rowan, S.; Song, S.; Talbot, C.; Vine, D.; Wallace, G.

    2017-12-01

    Further improvements in the low frequency sensitivity of gravitational wave detectors are important for increasing the observable population of astrophysical sources, such as intermediate mass compact black hole binary systems. Improvements in the lower stage mirror and suspension systems will set challenging targets for the required thermal noise performance of the cantilever blade springs, which provide vertical softness and, thus, isolation to the mirror suspension stack. This is required due to the coupling between the vertical and horizontal axes due to the curvature of the Earth. This can be achieved through use of high mechanical Q materials, which are compatible with cryogenic cooling, such as crystalline silicon. However, such materials are brittle, posing further challenges for assembly/jointing and, more generally, for long-term robustness. Here, we report on experimental studies of the breaking strength of silicon at room temperature, via both tensile and 4-point flexural testing; and on the effects of various surface treatments and coatings on durability and strength. Single- and multi-layer DLC (diamond-like carbon) coatings, together with magnetron-sputtered silica and thermally-grown silica, are investigated, as are the effects of substrate preparation and argon plasma pre-treatment. Application of single- or multi-layer DLC coatings can significantly improve the failure stress of silicon flexures, in addition to improved robustness for handling (assessed through abrasion tests). Improvements of up to 80% in tensile strength, a twofold increase in flexural strength, in addition to a 6.4 times reduction in the vertical thermal noise contribution of the suspension stack at 10 Hz are reported (compared to current Advanced LIGO design). The use of silicon blade springs would also significantly reduce potential ‘crackling noise’ associated with the underlying discrete events associated with plastic deformation in loaded flexures.

  10. Patient-tailored modulation of the immune system may revolutionize future lung cancer treatment

    International Nuclear Information System (INIS)

    Heuvers, Marlies E; Aerts, Joachim G; Cornelissen, Robin; Groen, Harry; Hoogsteden, Henk C; Hegmans, Joost P

    2012-01-01

    Cancer research has devoted most of its energy over the past decades on unraveling the control mechanisms within tumor cells that govern its behavior. From this we know that the onset of cancer is the result of cumulative genetic mutations and epigenetic alterations in tumor cells leading to an unregulated cell cycle, unlimited replicative potential and the possibility for tissue invasion and metastasis. Until recently it was often thought that tumors are more or less undetected or tolerated by the patient’s immune system causing the neoplastic cells to divide and spread without resistance. However, it is without any doubt that the tumor environment contains a wide variety of recruited host immune cells. These tumor infiltrating immune cells influence anti-tumor responses in opposing ways and emerges as a critical regulator of tumor growth. Here we provide a summary of the relevant immunological cell types and their complex and dynamic roles within an established tumor microenvironment. For this, we focus on both the systemic compartment as well as the local presence within the tumor microenvironment of late-stage non-small cell lung cancer (NSCLC), admitting that this multifaceted cellular composition will be different from earlier stages of the disease, between NSCLC patients. Understanding the paradoxical role that the immune system plays in cancer and increasing options for their modulation may alter the odds in favor of a more effective anti-tumor immune response. We predict that the future standard of care of lung cancer will involve patient-tailor-made combination therapies that associate (traditional) chemotherapeutic drugs and biologicals with immune modulating agents and in this way complement the therapeutic armamentarium for this disease

  11. Patient-tailored modulation of the immune system may revolutionize future lung cancer treatment

    Directory of Open Access Journals (Sweden)

    Heuvers Marlies E

    2012-12-01

    Full Text Available Abstract Cancer research has devoted most of its energy over the past decades on unraveling the control mechanisms within tumor cells that govern its behavior. From this we know that the onset of cancer is the result of cumulative genetic mutations and epigenetic alterations in tumor cells leading to an unregulated cell cycle, unlimited replicative potential and the possibility for tissue invasion and metastasis. Until recently it was often thought that tumors are more or less undetected or tolerated by the patient’s immune system causing the neoplastic cells to divide and spread without resistance. However, it is without any doubt that the tumor environment contains a wide variety of recruited host immune cells. These tumor infiltrating immune cells influence anti-tumor responses in opposing ways and emerges as a critical regulator of tumor growth. Here we provide a summary of the relevant immunological cell types and their complex and dynamic roles within an established tumor microenvironment. For this, we focus on both the systemic compartment as well as the local presence within the tumor microenvironment of late-stage non-small cell lung cancer (NSCLC, admitting that this multifaceted cellular composition will be different from earlier stages of the disease, between NSCLC patients. Understanding the paradoxical role that the immune system plays in cancer and increasing options for their modulation may alter the odds in favor of a more effective anti-tumor immune response. We predict that the future standard of care of lung cancer will involve patient-tailor-made combination therapies that associate (traditional chemotherapeutic drugs and biologicals with immune modulating agents and in this way complement the therapeutic armamentarium for this disease.

  12. Future of liver disease in the era of direct acting antivirals for the treatment of hepatitis C

    Institute of Scientific and Technical Information of China (English)

    Francesca Romana Ponziani; Francesca Mangiola; Cecilia Binda; Maria Assunta Zocco; Massimo Siciliano; Antonio Grieco; Gian Lodovico Rapaccini; Maurizio Pompili; Antonio Gasbarrini

    2017-01-01

    Hepatitis C virus(HCV) infection has been a global health problem for decades, due to the high number of infected people and to the lack of effective and welltolerated therapies. In the last 3 years, the approval of new direct acting antivirals characterized by high rates of virological clearance and excellent tolerability has dramatically improved HCV infection curability, especially for patients with advanced liver disease and for liver transplant recipients. Long-term data about the impact of the new direct acting antivirals on liver fibrosis and liver disease-related outcomes are not yet available, due to their recent introduction. However, previously published data deriving from the use of pegylatedinterferon and ribavirin lead to hypothesizing that we are going to observe, in the future, a reduction in mortality and in the incidence of hepatocellular carcinoma, as well as a regression of fibrosis for people previously affected by hepatitis C. In the liver transplant setting, clinical improvement has already been described after treatment with the new direct acting antivirals, which has often led to patients delisting. In the future, this may hopefully reduce the gap between liver organ request and availability, probably expanding liver transplant indications to other clinical conditions. Therefore, these new drugs are going to change the natural history of HCV-related liver disease and the epidemiology of HCV infection worldwide. However, the global consequences will depend on treatment accessibility and on the number of countries that could afford the use of the new direct acting antivirals.

  13. Actual and future strategies in interdisciplinary treatment of medulloblastomas, supratentorial PNET and intracranial germ cell tumors in childhood

    International Nuclear Information System (INIS)

    Kortmann, R.D.; Timmermann, B.; Bamberg, M.; Kuehl, J.; Calaminus, G.; Goebel, U.; Dieckmann, K.; Wurm, R.; Soerensen, N.; Urban, C.

    2001-01-01

    Methods: Systemic irradiation of neuroaxis is an essential part in the management of medulloblastoma, stPNET and intracranial germ cell tumors. The introduction of quality assurance programs in radiooncology assures a precise radiotherapy of target volumes and is a prerequisite to improve survival. Results: Hyperfractionated radiotherapy has the potential of increasing dose to tumor more safely without increasing the risk for late adverse effects. Pilot studies revealed excellent tumor control in medulloblastoma with acceptable acute toxicity and a long-term survival of up to 96%. In medulloblastoma stereotactic radiation techniques reveal an acceptable toxicity and promising results in tumor control in recurrent disease or as primary treatment. They are now part of future treatment protocols in case of persisting residual tumor. Radiotherapy alone in pure germinoma is continuously yielding high cure rates. In secreting germ cell tumors cisplatin containing chemotherapies in conjunction with radiotherapy achieve a long-term survival rate of 80% today. Especially in high risk medulloblastoma and secreting germ cell tumors chemotherapies are playing an increasingly important role in the interdisciplinary management. It can be expected that future developments of chemotherapeutic protocols and the introduction of new cytostatic substances will further improve the therapeutic outcome. (orig.) [de

  14. The future role of personalized medicine in the treatment of glioblastoma multiforme

    Directory of Open Access Journals (Sweden)

    Jing Li

    2010-08-01

    Full Text Available Jing Li1,2, Chunhui Di1,2, Austin K Mattox1,2, Linda Wu1,2, D Cory Adamson1,2,3,41Preston Robert Tisch Brain Tumor Center, Duke Medical Center, Durham, North Carolina, USA; 2Department of Surgery (Neurosurgery, Duke Medical Center, Durham, North Carolina, USA; 3Department of Neurobiology, Duke Medical Center, Durham, North Carolina, USA; 4Neurosurgery Section, Durham VA Medical Center, Durham, North Carolina, USAAbstract: Glioblastoma multiforme (GBM remains one of the most malignant primary central nervous system tumors. Personalized therapeutic approaches have not become standard of care for GBM, but science is fast approaching this goal. GBM’s heterogeneous genomic landscape and resistance to radiotherapy and chemotherapy make this tumor one of the most challenging to treat. Recent advances in genome-wide studies and genetic profiling show that there is unlikely to be a single genetic or cellular event that can be effectively targeted in all patients. Instead, future therapies will likely require personalization for each patient’s tumor genotype or proteomic profile. Over the past year, many investigations specifically focused simultaneously on strategies to target oncogenic pathways, angiogenesis, tumor immunology, epigenomic events, glioma stem cells (GSCs, and the highly migratory glioma cell population. Combination therapy targeting multiple pathways is becoming a fast growing area of research, and many studies put special attention on small molecule inhibitors. Because GBM is a highly vascular tumor, therapy that directs monoclonal antibodies or small molecule tyrosine kinase inhibitors toward angiogenic factors is also an area of focus for the development of new therapies. Passive, active, and adoptive immunotherapies have been explored by many studies recently, and epigenetic regulation of gene expression with microRNAs is also becoming an important area of study. GSCs can be useful targets to stop tumor recurrence and

  15. Current and future strategy for breast cancer treatment at Nagasaki University Hospital

    International Nuclear Information System (INIS)

    Morishita, Mariko; Hayashi, Tomayoshi; Maeda, Shigeto

    2005-01-01

    Breast cancer has emerged as the most frequent malignant neoplasm among Japanese women in recent years, raising awareness in society of the issue of breast cancer, including good screening and therapies. In fact, the establishment of breast cancer screening program with mammography in the United States and Western Europe has contributed to improve the diagnosis of breast cancer at early stage, and proper management, including various options of evidence-based treatment has not only reduced mortality but also enhanced patients' quality of life. However, the mortality rate due to breast cancer in Japan has continued to increase, and the number of patients is also increasing rapidly. It is therefore very urgent to develop a good system of breast care in all medical facilities as well as the provision of a national scheme in Japan. In this report, we review the situations of breast surgery at Nagasaki University Hospital from 1975 to 2004 and current management practices for breast disease, and evaluate the possibility of establishing a better system for breast care at our hospital, which could then act as a core medical institute in Nagasaki. (author)

  16. The Future of Bronchopulmonary Dysplasia: Emerging Pathophysiological Concepts and Potential New Avenues of Treatment

    Directory of Open Access Journals (Sweden)

    Jennifer J. P. Collins

    2017-05-01

    Full Text Available Yearly more than 15 million babies are born premature (<37 weeks gestational age, accounting for more than 1 in 10 births worldwide. Lung injury caused by maternal chorioamnionitis or preeclampsia, postnatal ventilation, hyperoxia, or inflammation can lead to the development of bronchopulmonary dysplasia (BPD, one of the most common adverse outcomes in these preterm neonates. BPD patients have an arrest in alveolar and microvascular development and more frequently develop asthma and early-onset emphysema as they age. Understanding how the alveoli develop, and repair, and regenerate after injury is critical for the development of therapies, as unfortunately there is still no cure for BPD. In this review, we aim to provide an overview of emerging new concepts in the understanding of perinatal lung development and injury from a molecular and cellular point of view and how this is paving the way for new therapeutic options to prevent or treat BPD, as well as a reflection on current treatment procedures.

  17. Treatment-resistant Lennox-Gastaut syndrome: therapeutic trends, challenges and future directions

    Directory of Open Access Journals (Sweden)

    Ostendorf AP

    2017-04-01

    Full Text Available Adam P Ostendorf,1 Yu-Tze Ng2 1Department of Pediatrics, Neurology Section, Nationwide Children’s Hospital, The Ohio State University, Columbus, OH, 2Department of Pediatrics, Baylor College of Medicine, The Children’s Hospital of San Antonio, San Antonio, TX, USA Abstract: Lennox-Gastaut syndrome is a severe, childhood-onset electroclinical syndrome comprised of multiple seizure types, intellectual and behavioral disturbances and characteristic findings on electroencephalogram of slow spike and wave complexes and paroxysmal fast frequency activity. Profound morbidity often accompanies a common and severe seizure type, the drop attack. Seizures often remain refractory, or initial treatment efficacy fades. Few individuals are seizure free despite the development of multiple generations of antiseizure medications over decades and high-level evidence on several choices. Approved medications such as lamotrigine, topiramate, rufinamide, felbamate and clobazam have demonstrated efficacy in reducing seizure burden. Cannabidiol has emerged as a promising investigational therapy with vast social interest yet lacks a standard, approved formulation. Palliative surgical procedures, such as vagal nerve stimulation and corpus callosotomy may provide reduction in total seizures and drop attacks. Emerging evidence suggests that complete callosotomy provides greater improvement in seizures without additional side effects. Etiologies such as dysplasia or hypothalamic hamartoma may be amenable for focal resection and thus offer potential to reverse this devastating epileptic encephalopathy. Keywords: Lennox-Gastaut syndrome, epilepsy, epilepsy surgery, cannabidiol, epileptic encephalopathy

  18. Current and future applications of protons in medical imaging and treatment

    Energy Technology Data Exchange (ETDEWEB)

    Schulte, Reinhard W. [Loma Linda University Medical Center, CA (United States). Dept. of Radiation Medicine

    2011-07-01

    Protons have a more than 50-year history of applications in medical therapy and more recently also in imaging. Therapy with protons became possible after proton accelerators capable of accelerating protons to energies higher than 150 MeV had been built during the 1940s in a few places around the world. Proton radiography experiments started at the Harvard Cyclotron in the early 1960s. Physicist Allan Cormack, who shared the Nobel Prize for laying the foundation of computed tomography together with Sir Godfrey Hounsfield in 1979, suggested that protons can be used for tomographic imaging for the first time in 1963. Proton CT requires a rotating proton gantry, which did not become available until 1991, at our institution. The interest in proton CT has been renewed due to the fact that exact proton treatment planning is only possible with accurate knowledge of the relative proton stopping power distribution (with respect to water) of the patient, which is best derived by using protons for imaging. Early attempts to do proton CT were hampered by the lack of high-resolution particle trackers, fast data acquisition electronics, and sufficient computing power. Also, efficient proton CT reconstruction algorithms had to be developed that can handle reconstruction based on a large number of proton histories, taking into account the non-straight probabilistic paths of multiply scattered protons. Most of these challenges have been or are about to be solved with the help of high-energy and particle physicists, computer science engineers, and applied mathematicians. In this talk, I will give an update on the development of proton CT for applications in proton therapy. This is an update from a talk I gave at the Annual Brazilian Physics Meeting in 2001, when I first suggested that physicists should contribute to the development of modern proton CT. Brazilian physicists have provided many valuable ideas and discussions for this exciting development. (author)

  19. Concurrent chemoradiotherapy in the treatment of small-cell lung cancer: current results and future prospects

    International Nuclear Information System (INIS)

    Reboul, F.; Vincent, P.; Brewer, Y.; Chauvet, B.; Taulelle, M.

    1995-01-01

    The prognosis of small cell carcinoma of the lung is reportedly poor, even in limited disease. However, new modalities of combined chemotherapy and radiotherapy may actually result in improved survival in these patients. First-line chemotherapy regimens with cisplatin and etoposide are effective and allow early and concurrent administration of thoracic radiotherapy, without overwhelming toxicity. Radiosensitizing properties of cisplatin and etoposide have been demonstrated, and concurrent delivery of radiotherapy results in a high complete response rate on the primary tumor, and improved long-term local control, which is a prerequisite for cure. In addition, a reduction of the irradiated volume, restricted to the macroscopic tumor, appears feasible without compromising local control and results in a reduced long-term complication rate of the combined treatment. Acute toxicities of these concurrent regiments are mainly hematological and esophageal, but are reversible and without late effect in the majority of the patients. The potential benefit of a twice-daily over standard once-daily irradiation has not been conclusively demonstrated in recent trials. However, these trials have demonstrated excellent outcome after short duration chemotherapy (four courses) with early concurrent radiotherapy (45 Gy), resulting in a 40 % survival at 2 years, which appears substantially higher than that obtained with the sequential or alternating regimens. The benefit of prophylactic cranial irradiation has also been confirmed in a large trial in terms of reduction of brain relapses, but with only marginal benefit upon survival. Further improvement of the prognosis of these patients may result form an early intensification of chemotherapy with the support of hematopoietic growth factors and from a dose escalation of radiotherapy with the support of three dimensional computerized dosimetry. (authors). 53 refs., 1 tab

  20. Current and future applications of protons in medical imaging and treatment

    International Nuclear Information System (INIS)

    Schulte, Reinhard W.

    2011-01-01

    Protons have a more than 50-year history of applications in medical therapy and more recently also in imaging. Therapy with protons became possible after proton accelerators capable of accelerating protons to energies higher than 150 MeV had been built during the 1940s in a few places around the world. Proton radiography experiments started at the Harvard Cyclotron in the early 1960s. Physicist Allan Cormack, who shared the Nobel Prize for laying the foundation of computed tomography together with Sir Godfrey Hounsfield in 1979, suggested that protons can be used for tomographic imaging for the first time in 1963. Proton CT requires a rotating proton gantry, which did not become available until 1991, at our institution. The interest in proton CT has been renewed due to the fact that exact proton treatment planning is only possible with accurate knowledge of the relative proton stopping power distribution (with respect to water) of the patient, which is best derived by using protons for imaging. Early attempts to do proton CT were hampered by the lack of high-resolution particle trackers, fast data acquisition electronics, and sufficient computing power. Also, efficient proton CT reconstruction algorithms had to be developed that can handle reconstruction based on a large number of proton histories, taking into account the non-straight probabilistic paths of multiply scattered protons. Most of these challenges have been or are about to be solved with the help of high-energy and particle physicists, computer science engineers, and applied mathematicians. In this talk, I will give an update on the development of proton CT for applications in proton therapy. This is an update from a talk I gave at the Annual Brazilian Physics Meeting in 2001, when I first suggested that physicists should contribute to the development of modern proton CT. Brazilian physicists have provided many valuable ideas and discussions for this exciting development. (author)

  1. HIV Risks, Testing, and Treatment in the Former Soviet Union: Challenges and Future Directions in Research and Methodology

    Directory of Open Access Journals (Sweden)

    Victoria M. Saadat

    2016-01-01

    Full Text Available Background. The dissolution of the USSR resulted in independence for constituent republics but left them battling an unstable economic environment and healthcare. Increases in injection drug use, prostitution, and migration were all widespread responses to this transition and have contributed to the emergence of an HIV epidemic in the countries of former Soviet Union. Researchers have begun to identify the risks of HIV infection as well as the barriers to HIV testing and treatment in the former Soviet Union. Significant methodological challenges have arisen and need to be addressed. The objective of this review is to determine common threads in HIV research in the former Soviet Union and provide useful recommendations for future research studies.Methods. In this systematic review of the literature, Pubmed was searched for English-language studies using the key search terms “HIV”, “AIDS”, “human immunodeficiency virus”, “acquired immune deficiency syndrome”, “Central Asia”, “Kazakhstan”, “Kyrgyzstan”, “Uzbekistan”, “Tajikistan”, “Turkmenistan”, “Russia”, “Ukraine”, “Armenia”, “Azerbaijan”, and “Georgia”. Studies were evaluated against eligibility criteria for inclusion.Results. Thirty-nine studies were identified across the two main topic areas of HIV risk and barriers to testing and treatment, themes subsequently referred to as “risk” and “barriers”. Study design was predominantly cross-sectional. The most frequently used sampling methods were peer-to-peer and non-probabilistic sampling. The most frequently reported risks were condom misuse, risky intercourse, and unsafe practices among injection drug users.  Common barriers to testing included that testing was inconvenient, and that results would not remain confidential.  Frequent barriers to treatment were based on a distrust in the treatment system. Conclusion. The findings of this review reveal methodological limitations

  2. Waste management experience during all the life cycle of treatment facilities from commissioning till decommissioning. Today's situation and future trends

    International Nuclear Information System (INIS)

    Decobert, Guy; Devezeaux de Lavergne, Jean-Guy; Maurin, Matthieu

    2005-01-01

    Over time, the concepts of waste management have deeply evolved. In the case of the earlier generation of treatment plants, on-line conditioning was generally not implemented. In several cases, the strategy was clearly set as promoting storage of 'interim' raw waste, and implementing long-run R and D programs for future conditioning. Thus, one of the main objectives of the last generation of plants was to implement on-line conditioning of all waste, i.e. including waste issued from the used fuel and also those issued from plant operation (technological waste and effluent treatment waste). These strategic issues are naturally part of the core of the design of every new plant, as part of the operating performance. The enormous amount of experience collected from previous generations of plants, and managed by AREVA, allows us to go one step further. Indeed, our target is to rely on a comprehensive vision of waste management best practices, from the plant design through its decommissioning. This will allow AREVA to think about the next plant generation when encompassing the whole life cycle of the plant, including its different steps: Conception and building, Operation, Decommissioning. The first part of the paper will go back to waste management lessons and achievements in the design-construction phase and the operating phases of past and present treatment plants. From the past till today's generation, a factor of reduction of 50 for the volume of HLW-ILW type of waste was achieved leading to a ratio of 0.0012 m 3 /GWhe for a burn-up of 45 000 MWd/t! With regards to the development of the next generation of reactors and associated back-end, future improvements appear still possible in waste volume reduction. The second part of the paper will focus on decommissioning, which is likely to generate significant amount of waste, whose removal, handling, sorting, measurement, treatment and conditioning represent a substantial part of the cost of the program. Starting from

  3. Spine radiosurgery for the local treatment of spine metastases: Intensity-modulated radiotherapy, image guidance, clinical aspects and future directions

    International Nuclear Information System (INIS)

    Moraes, Fabio Ynoe de; Neves-Junior, Wellington Furtado Pimenta; Hanna, Samir Abdallah; Carvalho, Heloisa de Andrade; Laufer, Ilya

    2016-01-01

    Many cancer patients will develop spinal metastases. Local control is important for preventing neurologic compromise and to relieve pain. Stereotactic body radiotherapy or spinal radiosurgery is a new radiation therapy technique for spinal metastasis that can deliver a high dose of radiation to a tumor while minimizing the radiation delivered to healthy, neighboring tissues. This treatment is based on intensity-modulated radiotherapy, image guidance and rigid immobilization. Spinal radiosurgery is an increasingly utilized treatment method that improves local control and pain relief after delivering ablative doses of radiation. Here, we present a review highlighting the use of spinal radiosurgery for the treatment of metastatic tumors of the spine. The data used in the review were collected from both published studies and ongoing trials. We found that spinal radiosurgery is safe and provides excellent tumor control (up to 94% local control) and pain relief (up to 96%), independent of histology. Extensive data regarding clinical outcomes are available; however, this information has primarily been generated from retrospective and non randomized prospective series. Currently, two randomized trials are enrolling patients to study clinical applications of fractionation schedules spinal Radiosurgery. Additionally, a phase I clinical trial is being conducted to assess the safety of concurrent stereotactic body radiotherapy and ipilimumab for spinal metastases. Clinical trials to refine clinical indications and dose fractionation are ongoing. The concomitant use of targeted agents may produce better outcomes in the future. (author)

  4. Spine radiosurgery for the local treatment of spine metastases: Intensity-modulated radiotherapy, image guidance, clinical aspects and future directions

    Energy Technology Data Exchange (ETDEWEB)

    Moraes, Fabio Ynoe de; Neves-Junior, Wellington Furtado Pimenta; Hanna, Samir Abdallah; Carvalho, Heloisa de Andrade [Hospital Sirio-Libanes, Sao Paulo, SP (Brazil). Departamento de Radioterapia; Taunk, Neil Kanth; Yamada, Yoshiya [Memorial Sloan Kettering Cancer Center, Department of Radiation Oncology, New York, NY (United States); Laufer, Ilya, E-mail: fymoraes@gmail.com [Memorial Sloan Kettering Cancer Center, Department of Neurosurgery, New York, NY (United States)

    2016-02-15

    Many cancer patients will develop spinal metastases. Local control is important for preventing neurologic compromise and to relieve pain. Stereotactic body radiotherapy or spinal radiosurgery is a new radiation therapy technique for spinal metastasis that can deliver a high dose of radiation to a tumor while minimizing the radiation delivered to healthy, neighboring tissues. This treatment is based on intensity-modulated radiotherapy, image guidance and rigid immobilization. Spinal radiosurgery is an increasingly utilized treatment method that improves local control and pain relief after delivering ablative doses of radiation. Here, we present a review highlighting the use of spinal radiosurgery for the treatment of metastatic tumors of the spine. The data used in the review were collected from both published studies and ongoing trials. We found that spinal radiosurgery is safe and provides excellent tumor control (up to 94% local control) and pain relief (up to 96%), independent of histology. Extensive data regarding clinical outcomes are available; however, this information has primarily been generated from retrospective and non randomized prospective series. Currently, two randomized trials are enrolling patients to study clinical applications of fractionation schedules spinal Radiosurgery. Additionally, a phase I clinical trial is being conducted to assess the safety of concurrent stereotactic body radiotherapy and ipilimumab for spinal metastases. Clinical trials to refine clinical indications and dose fractionation are ongoing. The concomitant use of targeted agents may produce better outcomes in the future. (author)

  5. From assistive to enhancing technology: should the treatment-enhancement distinction apply to future assistive and augmenting technologies?

    Science.gov (United States)

    Minerva, Francesca; Giubilini, Alberto

    2018-04-01

    The treatment-enhancement distinction is often used to delineate acceptable and unacceptable medical interventions. It is likely that future assistive and augmenting technologies will also soon develop to a level that they might be considered to provide users, in particular those with disabilities, with abilities that go beyond natural human limits, and become in effect an enhancing technology. In this paper, we describe how this process might take place, and discuss the moral implications of such developments. We argue that such developments are morally acceptable and indeed desirable. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2018. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  6. The opinion of Iranian students about the society's perception on using surrogacy as an infertility treatment in the future community.

    Science.gov (United States)

    Salehi, Kobra; Shakour, Mahsa; Pashaei Sabet, Fatemeh; Alizadeh, Shiva

    2015-03-01

    Surrogacy is one of the challengeable treatments for infertility; therefore, it seems necessary to learn the attitutude of people toward it, especially the opinion of those who are working in infertility treatment. Students studying midwifery, medicine, psychology and law are involved in this process to various degrees. The aim of this study was to investigate the students' opinions about the perception of the society on using surrogacy. This study was a descriptive cross-sectional survey. The sample of this study included 200 students of the Isfahan University and Isfahan University of Medical Sciences from the following courses: Midwifery, Medicine, Psychology and Law. Since the number of students in different discipline was not equal, we therefore used quota sampling. The data collection instrument was a researcher-made questionnaire. The questionnaire included questions on their knowledge, attitude and surrogacy acceptance in the future in Iran. The students of the medical course were mostly in the category "strongly agree" and "agree" with surrogacy (43 students which constitute 79.6%), then, midwifery students (15 students which constitute 78.9%) and finally, the students of other courses agreed less with this method. According to chi-square test, there was no significant difference between attitudes of students (P=0.08). Individuals mostly assert their acceptance of this method through "increasing tendency to this method in the future" (77.1%). Students in this study had a positive attitude toward surrogacy and they accepted it as a norm; despite this, it is essential to make some changes within cultures to improve the situation. Copyright © 2014 Elsevier B.V. All rights reserved.

  7. Whole-Genome Microarray and Gene Deletion Studies Reveal Regulation of the Polyhydroxyalkanoate Production Cycle by the Stringent Response in Ralstonia eutropha H16

    Energy Technology Data Exchange (ETDEWEB)

    Brigham, CJ; Speth, DR; Rha, C; Sinskey, AJ

    2012-10-22

    Poly(3-hydroxybutyrate) (PHB) production and mobilization in Ralstonia eutropha are well studied, but in only a few instances has PHB production been explored in relation to other cellular processes. We examined the global gene expression of wild-type R. eutropha throughout the PHB cycle: growth on fructose, PHB production using fructose following ammonium depletion, and PHB utilization in the absence of exogenous carbon after ammonium was resupplied. Our results confirm or lend support to previously reported results regarding the expression of PHB-related genes and enzymes. Additionally, genes for many different cellular processes, such as DNA replication, cell division, and translation, are selectively repressed during PHB production. In contrast, the expression levels of genes under the control of the alternative sigma factor sigma(54) increase sharply during PHB production and are repressed again during PHB utilization. Global gene regulation during PHB production is strongly reminiscent of the gene expression pattern observed during the stringent response in other species. Furthermore, a ppGpp synthase deletion mutant did not show an accumulation of PHB, and the chemical induction of the stringent response with DL-norvaline caused an increased accumulation of PHB in the presence of ammonium. These results indicate that the stringent response is required for PHB accumulation in R. eutropha, helping to elucidate a thus-far-unknown physiological basis for this process.

  8. Current Treatment Limitations in Age-Related Macular Degeneration and Future Approaches Based on Cell Therapy and Tissue Engineering

    Science.gov (United States)

    Fernández-Robredo, P.; Sancho, A.; Johnen, S.; Recalde, S.; Gama, N.; Thumann, G.; Groll, J.; García-Layana, A.

    2014-01-01

    Age-related macular degeneration (AMD) is the leading cause of blindness in the Western world. With an ageing population, it is anticipated that the number of AMD cases will increase dramatically, making a solution to this debilitating disease an urgent requirement for the socioeconomic future of the European Union and worldwide. The present paper reviews the limitations of the current therapies as well as the socioeconomic impact of the AMD. There is currently no cure available for AMD, and even palliative treatments are rare. Treatment options show several side effects, are of high cost, and only treat the consequence, not the cause of the pathology. For that reason, many options involving cell therapy mainly based on retinal and iris pigment epithelium cells as well as stem cells are being tested. Moreover, tissue engineering strategies to design and manufacture scaffolds to mimic Bruch's membrane are very diverse and under investigation. Both alternative therapies are aimed to prevent and/or cure AMD and are reviewed herein. PMID:24672707

  9. Dual Regulation of Bacillus subtilis kinB Gene Encoding a Sporulation Trigger by SinR through Transcription Repression and Positive Stringent Transcription Control.

    Science.gov (United States)

    Fujita, Yasutaro; Ogura, Mitsuo; Nii, Satomi; Hirooka, Kazutake

    2017-01-01

    It is known that transcription of kinB encoding a trigger for Bacillus subtilis sporulation is under repression by SinR, a master repressor of biofilm formation, and under positive stringent transcription control depending on the adenine species at the transcription initiation nucleotide (nt). Deletion and base substitution analyses of the kinB promoter (P kinB ) region using lacZ fusions indicated that either a 5-nt deletion (Δ5, nt -61/-57, +1 is the transcription initiation nt) or the substitution of G at nt -45 with A (G-45A) relieved kinB repression. Thus, we found a pair of SinR-binding consensus sequences (GTTCTYT; Y is T or C) in an inverted orientation (SinR-1) between nt -57/-42, which is most likely a SinR-binding site for kinB repression. This relief from SinR repression likely requires SinI, an antagonist of SinR. Surprisingly, we found that SinR is essential for positive stringent transcription control of P kinB . Electrophoretic mobility shift assay (EMSA) analysis indicated that SinR bound not only to SinR-1 but also to SinR-2 (nt -29/-8) consisting of another pair of SinR consensus sequences in a tandem repeat arrangement; the two sequences partially overlap the '-35' and '-10' regions of P kinB . Introduction of base substitutions (T-27C C-26T) in the upstream consensus sequence of SinR-2 affected positive stringent transcription control of P kinB , suggesting that SinR binding to SinR-2 likely causes this positive control. EMSA also implied that RNA polymerase and SinR are possibly bound together to SinR-2 to form a transcription initiation complex for kinB transcription. Thus, it was suggested in this work that derepression of kinB from SinR repression by SinI induced by Spo0A∼P and occurrence of SinR-dependent positive stringent transcription control of kinB might induce effective sporulation cooperatively, implying an intimate interplay by stringent response, sporulation, and biofilm formation.

  10. Risk assessment analysis of the future technical unit dedicated to the evaluation and treatment of motor disabilities.

    Science.gov (United States)

    Grelier, S; Thetio, M; Quentin, V; Achache, V; Sanchez, N; Leroux, V; Durand, E; Pequignot, R

    2011-03-01

    The National Hospital of Saint Maurice (HNSM) for Physical Medicine and Rehabilitation aims at strengthening its position as a pivot rehabilitation and physical therapy center. The opening in 2011 of a new unit for the evaluation and treatment of motor disabilities meets this objective. This project includes several parts: clinical, financial, architectural, organizational, applied clinical research as well as dealing with medical equipments and information system. This study focuses on the risk assessment of this future technical unit. This study was conducted by a group of professionals working for the hospital. It started with the design of a functional model to better comprehend the system to be analyzed. Risk assessment consists in confronting this functional model to a list of dangers in order to determine the vulnerable areas of the system. Then the team designed some scenarios to identify the causes, securities barriers and consequences in order to rank the risks. The analysis targeted various dangers, e.g. political, strategic, financial, economical, marketing, clinical and operational. The team identified more than 70 risky scenarios. For 75% of them the criticality level was deemed initially tolerable and under control or unacceptable. The implementation of an action plan for reducing the level of risks before opening this technical unit brought the system down to an acceptable level at 66%. A year prior to opening this technical unit for the evaluation and treatment of motor disabilities, conducting this preliminary risk assessment, with its exhaustive and rigorous methodology, enabled the concerned professionals to work together around an action plan for reducing the risks. 2011 Elsevier Masson SAS. All rights reserved.

  11. Immunotherapy targeting α-synuclein, with relevance for future treatment of Parkinson's disease and other Lewy body disorders.

    Science.gov (United States)

    Lindström, Veronica; Ihse, Elisabet; Fagerqvist, Therese; Bergström, Joakim; Nordström, Eva; Möller, Christer; Lannfelt, Lars; Ingelsson, Martin

    2014-01-01

    Immunotherapy targeting α-synuclein has evolved as a potential therapeutic strategy for neurodegenerative diseases, such as Parkinson's disease, and initial studies on cellular and animal models have shown promising results. α-synuclein vaccination of transgenic mice reduced the number of brain inclusions, whereas passive immunization studies demonstrated that antibodies against the C-terminus of α-synuclein can pass the blood-brain barrier and affect the pathology. In addition, preliminary evidence suggests that transgenic mice treated with an antibody directed against α-synuclein oligomers/protofibrils resulted in reduced levels of such species in the CNS. The underlying mechanisms of immunotherapy are not yet fully understood, but may include antibody-mediated clearance of pre-existing aggregates, prevention of protein propagation between cells and microglia-dependent protein clearance. Thus, immunotherapy targeting α-synuclein holds promise, but needs to be further developed as a future disease-modifying treatment in Parkinson's disease and other α-synucleinopathies.

  12. Present and future of targeted molecular imaging and therapy (theranostics) as a personalized pathway to diagnosis and treatment

    International Nuclear Information System (INIS)

    Baum, Richard P.

    2014-01-01

    of radioactivity given over a longer period of time (Bad Berka Concept using sequential (DUO) PRRT) results in excellent therapeutic responses, By this approach, severe hematological and/or renal toxicity can be avoided and quality of life/clinical symptoms can be significantly improved. The concept of THERANOSTICS has now been translated to other malignancies as well (e.g. prostate cancer using PSMA as ligand and 68 Ga/ 177 Lu as diagnostic/therapeutic pair) and current state and future perspectives of this fascinating approach - which enables personalized treatment of malignant neoplasms - will be discussed. (author)

  13. The national drug abuse treatment clinical trials network data share project: website design, usage, challenges, and future directions.

    Science.gov (United States)

    Shmueli-Blumberg, Dikla; Hu, Lian; Allen, Colleen; Frasketi, Michael; Wu, Li-Tzy; Vanveldhuisen, Paul

    2013-01-01

    There are many benefits of data sharing, including the promotion of new research from effective use of existing data, replication of findings through re-analysis of pooled data files, meta-analysis using individual patient data, and reinforcement of open scientific inquiry. A randomized controlled trial is considered as the 'gold standard' for establishing treatment effectiveness, but clinical trial research is very costly, and sharing data is an opportunity to expand the investment of the clinical trial beyond its original goals at minimal costs. We describe the goals, developments, and usage of the Data Share website (http://www.ctndatashare.org) for the National Drug Abuse Treatment Clinical Trials Network (CTN) in the United States, including lessons learned, limitations, and major revisions, and considerations for future directions to improve data sharing. Data management and programming procedures were conducted to produce uniform and Health Insurance Portability and Accountability Act (HIPAA)-compliant de-identified research data files from the completed trials of the CTN for archiving, managing, and sharing on the Data Share website. Since its inception in 2006 and through October 2012, nearly 1700 downloads from 27 clinical trials have been accessed from the Data Share website, with the use increasing over the years. Individuals from 31 countries have downloaded data from the website, and there have been at least 13 publications derived from analyzing data through the public Data Share website. Minimal control over data requests and usage has resulted in little information and lack of control regarding how the data from the website are used. Lack of uniformity in data elements collected across CTN trials has limited cross-study analyses. The Data Share website offers researchers easy access to de-identified data files with the goal to promote additional research and identify new findings from completed CTN studies. To maximize the utility of the website

  14. Role of Omega-3 Fatty Acids in the Etiology, Treatment, and Prevention of Depression: Current Status and Future Directions

    Science.gov (United States)

    McNamara, Robert K.

    2016-01-01

    Over the past three decades a body of translational evidence has implicated dietary deficiency in long-chain omega-3 (LCn-3) fatty acids, including eicosapenaenoic acid (EPA) and docosahexaenoic acid (DHA), in the pathophysiology and etiology of major depressive disorder (MDD). Cross-national and cross-sectional data suggest that greater habitual intake of preformed EPA+DHA is associated with reduced risk for developing depressive symptoms and syndromal MDD. Erythrocyte EPA and DHA composition is highly correlated with habitual fish or fish oil intake, and case-control studies have consistently observed lower erythrocyte EPA and/or DHA levels in patients with MDD. Low erythrocyte EPA+DHA composition may also be associated with increased risk for suicide and cardiovascular disease, two primary causes of excess premature mortality in MDD. While controversial, dietary EPA+DHA supplementation may have antidepressant properties and may augment the therapeutic efficacy of antidepressant medications. Neuroimaging and rodent neurodevelopmental studies further suggest that low LCn-3 fatty acid intake or biostatus can recapitulate central pathophysiological features associated with MDD. Prospective findings suggest that low LCn-3 fatty acid biostatus increases risk for depressive symptoms in part by augmenting pro-inflammatory responsivity. When taken collectively, these translational findings provide a strong empirical foundation in support of dietary LCn-3 fatty acid deficiency as a modifiable risk factor for MDD. This review provides an overview of this translational evidence and then discusses future directions including strategies to translate this evidence into routine clinical screening and treatment algorithms. PMID:27766299

  15. Achieving stringent climate targets. An analysis of the role of transport and variable renewable energies using energy-economy-climate models

    Energy Technology Data Exchange (ETDEWEB)

    Pietzcker, Robert Carl

    2014-07-01

    Anthropogenic climate change is threatening the welfare of mankind. Accordingly, policy makers have repeatedly stated the goal of slowing climate change and limiting the increase of global mean temperature to less than 2 C above pre-industrial times (the so-called ''two degree target''). Stabilizing the temperature requires drastic reductions of greenhouse gas (GHG) emissions to nearly zero. As the global system of energy supply currently relies on fossil fuels, reducing GHG emissions can only be achieved through a full-scale transformation of the energy system. This thesis investigates the economic requirements and implications of different scenarios that achieve stringent climate mitigation targets. It starts with the analysis of characteristic decarbonization patterns and identifies two particularly relevant aspects of mitigation scenarios: deployment of variable renewable energies (VRE) and decarbonization of the transport sector. After investigating these fields in detail, we turned towards one of the most relevant questions for policy makers and analyzed the trade-off between the stringency of a climate target and its economic requirements and implications. All analyses are based on the improvement, application, comparison, and discussion of large-scale IAMs. The novel ''mitigation share'' metric allowed us to identify the relevance of specific technology groups for mitigation and to improve our understanding of the decarbonization patterns of different energy subsectors. It turned out that the power sector is decarbonized first and reaches lowest emissions, while the transport sector is slowest to decarbonize. For the power sector, non-biomass renewable energies contribute most to emission reductions, while the transport sector strongly relies on liquid fuels and therefore requires biomass in combination with carbon capture and sequestration (CCS) to reduce emissions. An in-depth investigation of the solar power

  16. Behavioral Treatment of Drooling: A Methodological Critique of the Literature With Clinical Guidelines and Suggestions for Future Research

    NARCIS (Netherlands)

    Burg, J.J.W. van der; Didden, H.C.M.; Jongerius, P.H.; Rotteveel, J.J.

    2007-01-01

    Many children with mental retardation and developmental disabilities suffer from the consequences of chronic drooling. Behavioral treatment for drooling should be considered before other, more intrusive treatments such as medication and surgery are implemented. However, empirical studies on

  17. Behavioral treatment of drooling: a methodological critique of the literature with clinical guidelines and suggestions for future research.

    NARCIS (Netherlands)

    Burg, J.J.W. van der; Didden, R.; Jongerius, P.H.; Rotteveel, J.J.

    2007-01-01

    Many children with mental retardation and developmental disabilities suffer from the consequences of chronic drooling. Behavioral treatment for drooling should be considered before other, more intrusive treatments such as medication and surgery are implemented. However, empirical studies on

  18. Antimicrobial treatment of infective endocarditis caused by viridans streptococci highly susceptible to penicillin: historic overview and future considerations

    NARCIS (Netherlands)

    Verhagen, D. W. M.; Vedder, A. C.; Speelman, P.; van der Meer, J. T. M.

    2006-01-01

    In this article we present the path that led to current concepts regarding antimicrobial treatment of endocarditis caused by viridans streptococci highly susceptible to penicillin. Early treatment trials indicate that some patients with subacute endocarditis can be cured with shorter treatment

  19. The development of a gender identity psychosocial clinic: treatment issues, logistical considerations, interdisciplinary cooperation, and future initiatives.

    Science.gov (United States)

    Leibowitz, Scott F; Spack, Norman P

    2011-10-01

    Few interdisciplinary treatment programs that tend to the needs of youth with gender nonconforming behaviors, expressions, and identities exist in academic medical centers with formal residency training programs. Despite this, the literature provides evidence that these youth have higher rates of poor psychosocial adjustment and suicide attempts. This article explores the logistical considerations involved in developing a specialized interdisciplinary service to these gender minority youth in accordance with the existing treatment guidelines.Demographic data will be presented and treatment issues will be explored. The impact that a specialized interdisciplinary treatment program has on clinical expansion, research development, education and training, and community outreach initiatives is discussed.

  20. Processes of Change in Cognitive-Behavioural Treatment of Obsessive-Compulsive Disorder : Current Status and Some Future Directions

    NARCIS (Netherlands)

    Polman, Annemiek; Bouman, Theo K.; van Hout, Wiljo J. P. J.; de Jong, Peter J.; den Boer, Johan A.

    2010-01-01

    The present paper discusses theoretical and methodological issues involved in the processes of change in cognitive-behavioural treatment (CBT) of obsessive-compulsive disorder (OCD). Treatment outcome studies showed that CBT is effective in reducing obsessive-compulsive symptoms. However, why and

  1. Behavioral Treatment of Drooling: A Methodological Critique of the Literature with Clinical Guidelines and Suggestions for Future Research

    Science.gov (United States)

    Van der Burg, Jan J. W.; Didden, Robert; Jongerius, Peter H.; Rotteveel, Jan J.

    2007-01-01

    Many children with mental retardation and developmental disabilities suffer from the consequences of chronic drooling. Behavioral treatment for drooling should be considered before other, more intrusive treatments such as medication and surgery are implemented. However, empirical studies on behavioral procedures are scarce. This article reviews 19…

  2. Cascade of Refusal-What Does It Mean for the Future of Treatment as Prevention in Sub-Saharan Africa?

    Science.gov (United States)

    Katz, Ingrid T; Bangsberg, David R

    2016-04-01

    Recent recommendations by the World Health Organization support treatment for all people living with HIV (PLWH) globally to be initiated at the point of testing. While there has been marked success in efforts to identify and expand treatment for PLWH throughout sub-Saharan Africa, the goal of universal treatment may prove challenging to achieve. The pre-ART phase of the care cascade from HIV testing to HIV treatment initiation includes several social and structural barriers. One such barrier is antiretroviral therapy (ART) treatment refusal, a phenomenon in which HIV-infected individuals choose not to start treatment upon learning their ART eligibility. Our goal is to provide further understanding of why treatment-eligible adults may choose to present for HIV testing but not initiate ART when indicated. In this article, we will discuss factors driving pre-ART loss and present a framework for understanding the impact of decision-making on early losses in the care cascade, with a focus on ART refusal.

  3. What Virtual Reality Research in Addictions Can Tell Us about the Future of Obesity Assessment and Treatment

    OpenAIRE

    Bordnick, Patrick S; Carter, Brian L; Traylor, Amy C

    2011-01-01

    Virtual reality (VR), a system of human–computer interaction that allows researchers and clinicians to immerse people in virtual worlds, is gaining considerable traction as a research, education, and treatment tool. Virtual reality has been used successfully to treat anxiety disorders such as fear of flying and post-traumatic stress disorder, as an aid in stroke rehabilitation, and as a behavior modification aid in the treatment of attention deficit disorder. Virtual reality has also been emp...

  4. Implementation and evaluation of treatments for children and adolescents with conduct problems: Findings, challenges, and future directions.

    Science.gov (United States)

    Kazdin, Alan E

    2018-01-01

    The intervention work of our clinical-research team has focused on the treatment of children and young adolescents referred for Conduct Disorder or Oppositional Defiant Disorder. We have evaluated two interventions: parent management training (PMT) and cognitive problem-solving skills training in several randomized controlled clinical trials. Our findings have indicated the treatments, alone or in combination, produce reliable and significant reductions in oppositional, aggressive, and antisocial behaviour and increases in prosocial behaviour among children. Parent dysfunction (depression, multiple symptom domains) and stress decline and family relations improve as well. Apart from outcome studies, we have studied the therapeutic alliance, factors that influence dropping out and retaining cases, and variations of treatment delivery (e.g., computer based, reduced therapist contact). The article considers challenges in conducting controlled trials in clinic settings (e.g., recruiting cases, maintaining treatment integrity, securing funding) and activities related to implementation that are not easily covered within the confines of research articles. The article ends with a discussion of one of the treatments (PMT) and the broad role it can play in treatment, prevention, and help with many parenting challenges of everyday life.

  5. Special report: workshop on 4D-treatment planning in actively scanned particle therapy--recommendations, technical challenges, and future research directions.

    Science.gov (United States)

    Knopf, Antje; Bert, Christoph; Heath, Emily; Nill, Simeon; Kraus, Kim; Richter, Daniel; Hug, Eugen; Pedroni, Eros; Safai, Sairos; Albertini, Francesca; Zenklusen, Silvan; Boye, Dirk; Söhn, Matthias; Soukup, Martin; Sobotta, Benjamin; Lomax, Antony

    2010-09-01

    This article reports on a 4D-treatment planning workshop (4DTPW), held on 7-8 December 2009 at the Paul Scherrer Institut (PSI) in Villigen, Switzerland. The participants were all members of institutions actively involved in particle therapy delivery and research. The purpose of the 4DTPW was to discuss current approaches, challenges, and future research directions in 4D-treatment planning in the context of actively scanned particle radiotherapy. Key aspects were addressed in plenary sessions, in which leaders of the field summarized the state-of-the-art. Each plenary session was followed by an extensive discussion. As a result, this article presents a summary of recommendations for the treatment of mobile targets (intrafractional changes) with actively scanned particles and a list of requirements to elaborate and apply these guidelines clinically.

  6. A review of lysergic acid diethylamide (LSD) in the treatment of addictions: historical perspectives and future prospects.

    Science.gov (United States)

    Liester, Mitchell B

    2014-01-01

    Lysergic acid diethylamide (LSD) is a semisynthetic compound with strong psychoactive properties. Chemically related to serotonin, LSD was initially hypothesized to produce a psychosislike state. Later, LSD was reported to have benefits in the treatment of addictions. However, widespread indiscriminate use and reports of adverse affects resulted in the classification of LSD as an illicit drug with no accepted medical use. This article reviews LSD's storied history from its discovery, to its use as a research tool, followed by its widespread association with the counterculture movement of the 1960s, and finally to its rebirth as a medicine with potential benefits in the treatment of addictions. LSD's pharmacology, phenomenology, effects at neurotransmitter receptors, and effects on patterns of gene expression are reviewed. Based upon a review of the literature, it is concluded that further research into LSD's potential as a treatment for addictions is warranted.

  7. Design of future municipal wastewater treatment plants: A mathematical approach to manage complexity and identify optimal solutions

    DEFF Research Database (Denmark)

    Bozkurt, Hande; Quaglia, Alberto; Gernaey, Krist

    The increasing number of alternative wastewater treatment (WWT) technologies and stricter effluent requirements imposed by regulations make the early stage decision making for WWTP layout design, which is currently based on expert decisions and previous experiences, much harder. This paper...... therefore proposes a new approach based on mathematical programming to manage the complexity of the problem and generate/identify novel and optimal WWTP layouts for municipal/domestic wastewater treatment. Towards this end, after developing a database consisting of primary, secondary and tertiary WWT...... solved to obtain the optimal WWT network and the optimal wastewater and sludge flow through the network. The tool is evaluated on a case study, which was chosen as the Benchmark Simulation Model no.1 (BSM1) and many retrofitting options for obtaining a cost-effective treatment were investigated...

  8. State of the art of drug treatment of schizophrenia and the future position of the novel/atypical antipsychotics.

    Science.gov (United States)

    Möller, H J

    2000-10-01

    Neuroleptic medication is the most important part of the treatment regimen for schizophrenic patients. The efficacy of neuroleptics in the acute and long-term treatment of schizophrenia is very well proven and the effect size is comparatively high. After more than 40 years of clinical practice with the classical neuroleptics, several more or less generally accepted rules for the management of drug treatment in schizophrenia have been established. The paper aims to describe these standards, discussing, among other things, developments which have appeared in the last 10 to 20 years, e.g. the tendency to a lower daily dose during acute treatment and the tendency to alternative strategies during long-term treatment. The paper especially also takes into consideration the benefits of the novel/atypical antipsychotics as compared to the classical neuroleptics, which will change the current treatment standards under several aspects--a change which is already ongoing. The novel/atypical antipsychotics will be much better accepted by patients, thus leading to increased compliance, will be associated with a better quality of life and will possibly change the long-term outcome of schizophrenic patients in a very important manner. It should be considered that the so-called novel/atypical neuroleptics do not constitute a homogeneous group but are a group of individual drugs, each with their own advantages and disadvantages. As was the situation with the classical neuroleptics, the physician also has to choose the most adequate drug under consideration of the risk/benefit profile of each drug in relation to the disposition of the individual patient.

  9. New strategies for the treatment of Parkinson's disease hold considerable promise for future management of neurodegenerative disorders

    DEFF Research Database (Denmark)

    Bjarkam, Carsten Reidies; Sørensen, Jens Christian; Sunde, Niels Å

    2001-01-01

    or more. Parkinson's disease ischaracterized by a massive loss of dopaminergicneurons in the substantia nigra, leading tosevere functional disturbance of the neuronalcircuitry in the basal ganglia. A thoroughdescription of basal ganglia circuitry inhealth and disease is presented. We describehow...... the functional disturbances seen inParkinson's disease may be corrected atspecific sites in this circuitry by medicaltreatment or, in advanced stages of Parkinson'sdisease, by neurosurgical methods. The latterinclude lesional surgery, neuraltransplantation and deep brain stimulation,together with future...... in otherneurodegenerative diseases are discussed, withspecial emphasis on deep brain stimulation....

  10. Radiotherapy in the curative treatment of breast cancer: current status and future trends. An opinion sample of radiation oncologists active in breast cancer research

    International Nuclear Information System (INIS)

    Kurtz, J.M.

    1994-01-01

    A questionnaire regarding the current practice of breast cancer radiotherapy and possible future trends in this field was filled out by 13 radiation oncologists active in breast cancer research. In the opinion of this small group, radiotherapy is presently included in the initial treatment of the large majority of early breast cancers, particularly in the framework of breast-conserving therapy, which is currently used in >50% of these patients. Indications for post-mastectomy irradiation vary greatly among respondents, as do attitudes toward the potentially negative aspects of adjuvant radiotherapy. Most respondents feel that their future practices will be significantly influenced by an increase in screen-detected cancers, the aging of the population, the increasing influence of medical oncologists, participation in clinical trials, and increased patient participation in treatment decisions. An increase is foreseen in the use of breast-conserving approaches, radiotherapy, and systemic therapies, and a decrease in the use of both total mastectomy and axillary dissection. Most respondents feel that there will be a modest decrease in the percentage of conservatively operated patients receiving radiotherapy. A future role is seen for neo-adjuvant chemotherapy, at least in well-defined subgroups, increasing the number of patients offered breast-conserving approaches. Most respondents expect that irradiation of lymph nodal areas will gain new credibility and be used more often. No majority opinion could be elicited regarding ways of improving the therapeutic ratio in breast cancer radiotherapy. (author)

  11. Can cardiovascular magnetic resonance prompt early cardiovascular/rheumatic treatment in autoimmune rheumatic diseases? Current practice and future perspectives.

    Science.gov (United States)

    Mavrogeni, Sophie I; Sfikakis, Petros P; Dimitroulas, Theodoros; Koutsogeorgopoulou, Loukia; Katsifis, Gikas; Markousis-Mavrogenis, George; Kolovou, Genovefa; Kitas, George D

    2018-06-01

    Life expectancy in autoimmune rheumatic diseases (ARDs) remains lower compared to the general population, due to various comoborbidities. Cardiovascular disease (CVD) represents the main contributor to premature mortality. Conventional and biologic disease-modifying antirheumatic drugs (DMARDs) have considerably improved long-term outcomes in ARDs not only by suppressing systemic inflammation but also by lowering CVD burden. Regarding atherosclerotic disease prevention, EULAR has recommended tight disease control accompanied by regular assessment of traditional CVD risk factors and lifestyle changes. However, this approach, although rational and evidence-based, does not account for important issues such as myocardial inflammation and the long asymptomatic period that usually proceeds clinical manifestations of CVD disease in ARDs before or after the diagnosis of systemic disease. Cardiovascular magnetic resonance (CMR) can offer reliable, reproducible and operator independent information regarding myocardial inflammation, ischemia and fibrosis. Some studies suggest a role for CMR in the risk stratification of ARDs and demonstrate that oedema/fibrosis visualisation with CMR may have the potential to inform cardiac and rheumatic treatment modification in ARDs with or without abnormal routine cardiac evaluation. In this review, we discuss how CMR findings could influence anti-rheumatic treatment decisions targeting optimal control of both systemic and myocardial inflammation irrespective of clinical manifestations of cardiac disease. CMR can provide a different approach that is very promising for risk stratification and treatment modification; however, further studies are needed before the inclusion of CMR in the routine evaluation and treatment of patients with ARDs.

  12. Evolving landscape of human epidermal growth factor receptor 2-positive breast cancer treatment and the future of biosimilars.

    Science.gov (United States)

    Jackisch, Christian; Lammers, Philip; Jacobs, Ira

    2017-04-01

    Human epidermal growth factor receptor 2-positive (HER2+) breast cancer comprises approximately 15%-20% of all breast cancers and is associated with a poor prognosis. The introduction of anti-HER2 therapy has significantly improved clinical outcomes for patients with HER2+ breast cancer, and multiple HER2-directed agents (ie, trastuzumab, pertuzumab, lapatinib, and ado-trastuzumab emtansine [T-DM1]) are approved for clinical use in various settings. The treatment landscape for patients with HER2+ breast cancer is continuing to evolve. While novel agents and therapeutic strategies are emerging, biologic therapies, particularly trastuzumab, are likely to remain a mainstay of treatment. However, access issues create barriers to the use of biologics, and there is evidence for underuse of trastuzumab worldwide. A biosimilar is a biologic product that is highly similar to a licensed biologic in terms of product safety and effectiveness. Biosimilars of trastuzumab are in development and may soon become available. The introduction of biosimilars may improve access to anti-HER2 therapies by providing additional treatment options and lower-cost alternatives. Because HER2-targeted drugs may be administered for extended periods of time and in combination with other systemic therapies, biosimilars have the potential to result in significant savings for healthcare systems. Herein we review current and emerging treatment options for, and discuss the possible role of biosimilars in, treating patients with HER2+ breast cancer. Copyright © 2017 Authors, Pfizer Inc. Published by Elsevier Ltd.. All rights reserved.

  13. What virtual reality research in addictions can tell us about the future of obesity assessment and treatment.

    Science.gov (United States)

    Bordnick, Patrick S; Carter, Brian L; Traylor, Amy C

    2011-03-01

    Virtual reality (VR), a system of human-computer interaction that allows researchers and clinicians to immerse people in virtual worlds, is gaining considerable traction as a research, education, and treatment tool. Virtual reality has been used successfully to treat anxiety disorders such as fear of flying and post-traumatic stress disorder, as an aid in stroke rehabilitation, and as a behavior modification aid in the treatment of attention deficit disorder. Virtual reality has also been employed in research on addictive disorders. Given the strong evidence that drug-dependent people are highly prone to use and relapse in the presence of environmental stimuli associated with drug use, VR is an ideal platform from which to study this relationship. Research using VR has shown that drug-dependent people react with strong craving to specific cues (e.g., cigarette packs, liquor bottles) as well as environments or settings (e.g., bar, party) associated with drug use. Virtual reality has also been used to enhance learning and generalization of relapse prevention skills in smokers by reinforcing these skills in lifelike environments. Obesity researchers and treatment professionals, building on the lessons learned from VR research in substance abuse, have the opportunity to adapt these methods for investigating their own research and treatment questions. Virtual reality is ideally suited to investigate the link between food cues and environmental settings with eating behaviors and self-report of hunger. In addition, VR can be used as a treatment tool for enhancing behavior modification goals to support healthy eating habits by reinforcing these goals in life-like situations. © 2011 Diabetes Technology Society.

  14. The Brown-Vialetto-Van Laere and Fazio Londe syndrome revisited: natural history, genetics, treatment and future perspectives

    Directory of Open Access Journals (Sweden)

    Bosch Annet M

    2012-10-01

    Full Text Available Abstract The Brown-Vialetto-Van Laere syndrome is a rare neurological disorder which may present at all ages with sensorineural deafness, bulbar palsy and respiratory compromise. Fazio-Londe syndrome is considered to be the same disease entity. Recently it was demonstrated that in some patients the disease is caused by mutations in the SLC52A3 gene which encodes the intestinal (hRFT2 riboflavin transporter. In these patients riboflavin deficiency is the cause of the BVVL/FL syndrome and supplementation of riboflavin proved a life saving treatment. Mutations in the SLC52A2 gene and the SLC52A1 (GPR172B gene, coding for human riboflavin transporters hRFT3 and hRFT1 have been associated with the BVVL syndrome as well. We performed a review of the literature, with emphasis on the natural history and the effects of treatment in these patients. A total of 35 publications were traced reporting on the clinical presentation of 74 patients who presented before age 18. The most prevalent symptoms were bulbar palsy, hearing loss, facial weakness and respiratory compromise. Death was reported in 28 of the 61 untreated patients, with a very low survival in patients presenting before age 4. All 13 patients who were treated with riboflavin survived, with a strong clinical improvement after days to months of treatment in eight patients. Three patients demonstrated a stable clinical course and treatment was stopped early in two patients. Abnormalities in plasma flavin levels and/or plasma acylcarnitine profiles were observed in some but not in all patients, and also patients with normal plasma flavin levels and acylcarnitine profiles demonstrated a striking clinical improvement on riboflavin supplementation. It is now clear that proper diagnosis requires mutation analysis of all three transporter genes and treatment should be started immediately without first awaiting results of molecular analysis. Clinical improvement may be rapid or gradual over a period of

  15. What Virtual Reality Research in Addictions Can Tell Us about the Future of Obesity Assessment and Treatment

    Science.gov (United States)

    Bordnick, Patrick S; Carter, Brian L; Traylor, Amy C

    2011-01-01

    Virtual reality (VR), a system of human–computer interaction that allows researchers and clinicians to immerse people in virtual worlds, is gaining considerable traction as a research, education, and treatment tool. Virtual reality has been used successfully to treat anxiety disorders such as fear of flying and post-traumatic stress disorder, as an aid in stroke rehabilitation, and as a behavior modification aid in the treatment of attention deficit disorder. Virtual reality has also been employed in research on addictive disorders. Given the strong evidence that drug-dependent people are highly prone to use and relapse in the presence of environmental stimuli associated with drug use, VR is an ideal platform from which to study this relationship. Research using VR has shown that drug-dependent people react with strong craving to specific cues (e.g., cigarette packs, liquor bottles) as well as environments or settings (e.g., bar, party) associated with drug use. Virtual reality has also been used to enhance learning and generalization of relapse prevention skills in smokers by reinforcing these skills in lifelike environments. Obesity researchers and treatment professionals, building on the lessons learned from VR research in substance abuse, have the opportunity to adapt these methods for investigating their own research and treatment questions. Virtual reality is ideally suited to investigate the link between food cues and environmental settings with eating behaviors and self-report of hunger. In addition, VR can be used as a treatment tool for enhancing behavior modification goals to support healthy eating habits by reinforcing these goals in life–like situations. PMID:21527092

  16. Risk as feelings in the effect of patient outcomes on physicians' future treatment decisions: a randomized trial and manipulation validation.

    Science.gov (United States)

    Hemmerich, Joshua A; Elstein, Arthur S; Schwarze, Margaret L; Moliski, Elizabeth Ghini; Dale, William

    2012-07-01

    The present study tested predictions derived from the Risk as Feelings hypothesis about the effects of prior patients' negative treatment outcomes on physicians' subsequent treatment decisions. Two experiments at The University of Chicago, U.S.A., utilized a computer simulation of an abdominal aortic aneurysm (AAA) patient with enhanced realism to present participants with one of three experimental conditions: AAA rupture causing a watchful waiting death (WWD), perioperative death (PD), or a successful operation (SO), as well as the statistical treatment guidelines for AAA. Experiment 1 tested effects of these simulated outcomes on (n = 76) laboratory participants' (university student sample) self-reported emotions, and their ratings of valence and arousal of the AAA rupture simulation and other emotion-inducing picture stimuli. Experiment 2 tested two hypotheses: 1) that experiencing a patient WWD in the practice trial's experimental condition would lead physicians to choose surgery earlier, and 2) experiencing a patient PD would lead physicians to choose surgery later with the next patient. Experiment 2 presented (n = 132) physicians (surgeons and geriatricians) with the same experimental manipulation and a second simulated AAA patient. Physicians then chose to either go to surgery or continue watchful waiting. The results of Experiment 1 demonstrated that the WWD experimental condition significantly increased anxiety, and was rated similarly to other negative and arousing pictures. The results of Experiment 2 demonstrated that, after controlling for demographics, baseline anxiety, intolerance for uncertainty, risk attitudes, and the influence of simulation characteristics, the WWD experimental condition significantly expedited decisions to choose surgery for the next patient. The results support the Risk as Feelings hypothesis on physicians' treatment decisions in a realistic AAA patient computer simulation. Bad outcomes affected emotions and decisions, even

  17. EFFICACIOUS PSYCHOLOGICAL TREATMENTS FOR REDUCING FATIGUE IN CANCER SURVIVORS: THE STATE OF THE QUESTION AND FUTURE PROSPECTS

    Directory of Open Access Journals (Sweden)

    Francisco García Torres

    2015-09-01

    Full Text Available Cancer remains a major health problem worldwide. Due to the efficacy of the treatments and the improvements in healthcare systems, however, the number of cancer survivors has increased significantly over the years. Fatigue is one of the consequences of cancer that appears most frequently, causing significant changes in the lives of survivors. Different psychological treatments have been used to reduce fatigue in this patient group. Cognitive-behavioural techniques and mindfulness therapies are the ones that have the most data supporting their effectiveness, ahead of psycho-educational type interventions. The majority of studies, however, have been conducted with breast cancer survivors, and it would be desirable to test the effectiveness of these techniques with a greater variability of cancer types.

  18. Current state and future of photodynamic therapy for the treatment of head and neck squamous cell carcinoma

    Directory of Open Access Journals (Sweden)

    Christina Mimikos

    2016-06-01

    Full Text Available Photodynamic therapy has shown promise in the treatment of early head and neck squamous cell carcinoma (SCC. In photodynamic therapy (PDT, a light sensitive drug (photosensitizer and visible light cause cancer cell death by the creation of singlet oxygen and free radicals, inciting an immune response, and vascular collapse. In this paper, we review several studies that demonstrate the effectiveness of PDT in the treatment of early stage SCC of the head and neck, with some showing a similar response rate to surgery. Two cases are presented to illustrate the effectiveness of PDT. Then, new advances are discussed including the discovery of STAT3 crosslinking as a potential biomarker for PDT response and interstitial PDT for locally advanced cancers. Keywords: Photodynamic therapy, PDT, Squamous cell carcinoma, Head and neck cancer

  19. Present and future of the Image Guided Radiotherapy (I.G.R.T.) and its applications in lung cancer treatment

    International Nuclear Information System (INIS)

    Lefkopoulos, D.; Ferreira, I.; Isambert, A.; Le Pechoux, C.; Mornex, F.

    2007-01-01

    These last years, the new irradiation techniques as the conformal 3D radiotherapy and the IMRT are strongly correlated with the technological developments in radiotherapy. The rigorous definition of the target volume and the organs at risk required by these irradiation techniques, imposed the development of various image guided patient positioning and target tracking techniques. The availability of these imaging systems inside the treatment room has lead to the exploration of performing real-time adaptive radiation therapy. In this paper we present the different image guided radiotherapy (IGRT) techniques and the adaptive radiotherapy (ART) approaches. IGRT developments are focused in the following areas: 1) biological imaging for better definition of tumor volume; 2) 4D imaging for modeling the intra-fraction organ motion; 3) on-board imaging system or imaging devices registered to the treatment machines for inter-fraction patient localization; and 4) treatment planning and delivery schemes incorporating the information derived from the new imaging techniques. As this paper is included in the 'Cancer Radiotherapie' special volume dedicated to the lung cancers, in the description of the different IGRT techniques we try to present the lung tumors applications when this is possible. (author)

  20. Anti-IgE treatment, airway inflammation and remodelling in severe allergic asthma: current knowledge and future perspectives

    Directory of Open Access Journals (Sweden)

    Konstantinos Samitas

    2015-12-01

    Full Text Available Asthma is a disorder of the airways involving various inflammatory cells and mediators and characterised by bronchial hyperresponsiveness, chronic inflammation and structural alterations in the airways, also known as remodelling. IgE is an important mediator of allergic reactions and has a central role in allergic asthma pathophysiology, as it is implicated in both the early and late phase allergic response. Moreover, clinical and mechanistic evidence has lately emerged, implicating IgE in the development of airway remodelling. The use of monoclonal antibodies targeting IgE, such as omalizumab, has proven very effective in improving respiratory symptoms and quality of life, while reducing asthma exacerbations, emergency room visits and the use of systemic corticosteroids in allergic severe asthma. These effects are believed to be mainly mediated by omalizumab's inhibitory effect on the initiation and further propagation of the allergic inflammation cascade. However, there is evidence to suggest that anti-IgE treatment remains effective long after it has been discontinued. In part, these findings could be attributed to the possible ameliorating effects of anti-IgE treatment on airway remodelling. In this review, we discuss recent findings supporting the notion that anti-IgE treatment modulates the complex immune responses that manifest clinically as asthma and ameliorates airway remodelling changes often observed in allergic severe asthma phenotypes.

  1. Haematopoietic stem cell transplantation as first-line treatment in myeloma: a global perspective of current concepts and future possibilities

    Directory of Open Access Journals (Sweden)

    Catriona Elizabeth Mactier

    2012-10-01

    Full Text Available Stem cell transplantation forms an integral part of the treatment for multiple myeloma. This paper reviews the current role of transplantation and the progress that has been made in order to optimize the success of this therapy. Effective induction chemotherapy is important and a combination regimen incorporating the novel agent bortezomib is now favorable. Adequate induction is a crucial adjunct to stem cell transplantation and in some cases may potentially postpone the need for transplant. Different conditioning agents prior to transplantation have been explored: high-dose melphalan is most commonly used and bortezomib is a promising additional agent. There is no well-defined superior transplantation protocol but single or tandem autologous stem cell transplantations are those most commonly used, with allogeneic transplantation only used in clinical trials. The appropriate timing of transplantation in the treatment plan is a matter of debate. Consolidation and maintenance chemotherapies, particularly thalidomide and bortezomib, aim to improve and prolong disease response to transplantation and delay recurrence. Prognostic factors for the outcome of stem cell transplant in myeloma have been highlighted. Despite good responses to chemotherapy and transplantation, the problem of disease recurrence persists. Thus, there is still much room for improvement. Treatments which harness the graft-versus-myeloma effect may offer a potential cure for this disease. Trials of novel agents are underway, including targeted therapies for specific antigens such as vaccines and monoclonal antibodies.

  2. Adherence to treatment in male batterers against their intimate partners in a community setting: State of the art and future challenges

    Directory of Open Access Journals (Sweden)

    Enrique Echeburúa

    2013-08-01

    Full Text Available This paper addresses the difficulties inherent in providing mental health treatment for men who commit acts of violence against their intimate partners. The effectiveness of available treatment programs for men who batter, both in the international literature and in Spain, is analyzed. In all studies the dropout rates in the treatment of men involved in intimate partner violence are very high. Different studies have pointed to multiple psychological and social causes to explain the poor adherence to treatment in men who batter. The main predictors of poor adherence to therapy are described. Therefore, motivational enhancement strategies are being developed to strengthen subjects' commitment to change by helping them to identify their goals for recovery and to determine ways to reach these goals. Finally, some suggestions are discussed about how to successfully deal with these issues. It is necessary to implement strategies to improve motivation for treatment. Implications of this study for clinical practice, policy decisions, and future research in this field are commented upon.

  3. Defining the Value of Future Research to Identify the Preferred Treatment of Meniscal Tear in the Presence of Knee Osteoarthritis.

    Directory of Open Access Journals (Sweden)

    Elena Losina

    Full Text Available Arthroscopic partial meniscectomy (APM is extensively used to relieve pain in patients with symptomatic meniscal tear (MT and knee osteoarthritis (OA. Recent studies have failed to show the superiority of APM compared to other treatments. We aim to examine whether existing evidence is sufficient to reject use of APM as a cost-effective treatment for MT+OA.We built a patient-level microsimulation using Monte Carlo methods and evaluated three strategies: Physical therapy ('PT' alone; PT followed by APM if subjects continued to experience pain ('Delayed APM'; and 'Immediate APM'. Our subject population was US adults with symptomatic MT and knee OA over a 10 year time horizon. We assessed treatment outcomes using societal costs, quality-adjusted life years (QALYs, and calculated incremental cost-effectiveness ratios (ICERs, incorporating productivity costs as a sensitivity analysis. We also conducted a value-of-information analysis using probabilistic sensitivity analyses.Calculated ICERs were estimated to be $12,900/QALY for Delayed APM as compared to PT and $103,200/QALY for Immediate APM as compared to Delayed APM. In sensitivity analyses, inclusion of time costs made Delayed APM cost-saving as compared to PT. Improving efficacy of Delayed APM led to higher incremental costs and lower incremental effectiveness of Immediate APM in comparison to Delayed APM. Probabilistic sensitivity analyses indicated that PT had 3.0% probability of being cost-effective at a willingness-to-pay (WTP threshold of $50,000/QALY. Delayed APM was cost effective 57.7% of the time at WTP = $50,000/QALY and 50.2% at WTP = $100,000/QALY. The probability of Immediate APM being cost-effective did not exceed 50% unless WTP exceeded $103,000/QALY.We conclude that current cost-effectiveness evidence does not support unqualified rejection of either Immediate or Delayed APM for the treatment of MT+OA. The amount to which society would be willing to pay for additional information

  4. Non-invasive brain stimulation for the treatment of brain diseases in childhood and adolescence: state of the art, current limits and future challenges

    Directory of Open Access Journals (Sweden)

    Carmelo Mario Vicario

    2013-11-01

    Full Text Available In the last decades interest in application of non-invasive brain stimulation for enhancing neural functions is growing continuously. However, the use of such techniques in pediatric populations remains rather limited and mainly confined to the treatment of severe neurological and psychiatric diseases. In this article we provide a complete review of non-invasive brain stimulation studies conducted in pediatric populations. We also provide a brief discussion about the current limitations and future directions in a field of research still very young and full of issues to be explored.

  5. Impact of applying the more stringent validation criteria of the revised European Society of Hypertension International Protocol 2010 on earlier validation studies.

    Science.gov (United States)

    Stergiou, George S; Karpettas, Nikos; Atkins, Neil; O'Brien, Eoin

    2011-04-01

    Since 2002 when the European Society of Hypertension International Protocol (ESH-IP) was published it has become the preferred protocol for validating blood pressure monitors worldwide. In 2010, a revised version of the ESH-IP with more stringent criteria was published. This study assesses the impact of applying the revised ESH-IP criteria. A systematic literature review of ESH-IP studies reported between 2002 and 2010 was conducted. The impact of applying the ESH-IP 2010 criteria retrospectively on the data reported in these studies was investigated. The performance of the oscillometric devices in the last decade was also investigated on the basis of the ESH-IP criteria. Among 119 published studies, 112 with sufficient data were analyzed. According to ESH-IP 2002, the test device failed in 19 studies, whereas by applying the ESH-IP 2010 criteria in 28 additional studies increased the failure rate from 17 to 42%. Of these 28 studies, in 20 (71%) the test device failed at part 1 (accuracy per measurement) and in 22 (79%) at part 2 (accuracy per subject). Most of the failures involved the '5 mmHg or less' criterion. In the last decade there has been a consistent trend toward improved performance of oscillometric devices assessed on the basis of the ESH-IP criteria. This retrospective analysis shows that the stricter revised ESH-IP 2010 criteria will noticeably increase the failure rate of devices being validated. Oscillometric devices are becoming more accurate, and the revised ESH-IP by acknowledging this trend will allow more accurate devices to enter the market.

  6. Trends in treatment of ruptured abdominal aortic aneurysm: impact of endovascular repair and implications for future care.

    Science.gov (United States)

    Park, Brian D; Azefor, Nchang; Huang, Chun-Chih; Ricotta, John J

    2013-04-01

    Our aim was to determine national trends in treatment of ruptured abdominal aortic aneurysm (RAAA), with specific emphasis on open surgical repair (OSR) and endovascular aneurysm repair (EVAR) and its impact on mortality and complications. Data from the Nationwide Inpatient Sample (NIS) from 2005 to 2009 were queried to identify patients older than 59 years with RAAA. Three groups were studied: nonoperative (NO), EVAR, and OSR. Chi-square analysis was used to determine the relationship between treatment type and patient demographics, clinical characteristics, and hospital type. The impact of EVAR compared with OSR on mortality and overall complications was examined using logistic regression analysis. We identified 21,206 patients with RAAA from 2005 to 2009, of which 16,558 (78.1%) underwent operative repair and 21.8% received no operative treatment. In the operative group, 12,761 (77.1%) underwent OSR and 3,796 (22.9%) underwent EVAR. Endovascular aneurysm repair was more common in teaching hospitals (29.1% vs 15.2%, p < .0001) and in urban versus rural settings. Nonoperative approach was twice as common in rural versus urban hospitals. Reduced mortality was seen in patients transferred from another institutions (31.2% vs 39.4%, p = 0.014). Logistic regression analysis demonstrated a benefit of EVAR on both complication rate (OR = 0.492; CI, 0.380-0.636) and mortality (OR=0.535; CI, 0.395-0.724). Endovascular aneurysm repair use is increasing for RAAA and is more common in urban teaching hospitals while NO therapy is more common in rural hospitals. Endovascular aneurysm repair is associated with reduced mortality and complications across all age groups. Efforts to reduce mortality from RAAA should concentrate on reducing NO and OSR in patients who are suitable for EVAR. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  7. Back to the future: extended dialysis for treatment of acute kidney injury in the intensive care unit.

    Science.gov (United States)

    Kielstein, Jan T; Schiffer, Mario; Hafer, Carsten

    2010-01-01

    On September 11, 1945, Maria Schafstaat was the first patient who successfully underwent a dialysis treatment for acute kidney injury (AKI). The ingenious design of the first dialysis machine, made of cellophane tubing wrapped around a cylinder that rotated in a bath of fluid, together with the brave determination to treat patients with AKI, enabled the Dutch physician W.J. Kolff to save the life of the 67-year-old woman. By treating her for 690 minutes (i.e., 11.5 hours) with a blood flow rate of 116 ml/min, Kolff also set the coordinates of a renal replacement therapy that has enjoyed an unsurpassed renaissance over the last decade for treatment of severely ill patients with AKI in the intensive care unit (ICU). Prolonged dialysis time with low flow rates - these days, called extended dialysis (ED) - combines several advantages of both intermittent and continuous techniques, which makes it an ideal treatment method for ICU patients with AKI. This review summarizes our knowledge of this method, which is increasingly used in many centers worldwide. We reflect on prospective controlled studies in critically ill patients that have documented that small-solute clearance with ED is comparable with that of intermittent hemodialysis and continuous venovenous hemofiltration, as well as on studies showing that patients' cardiovascular stability during ED is similar to that with continuous renal replacement therapy. Furthermore, we report on logistic and economic advantages of this method. We share our view on how extended dialysis offers ample opportunity for a collaborative interaction between nephrologists and intensivists as the nephrology staff, enabling optimal treatment of complex critically ill patients by using the skill and knowledge of 2 indispensable specialties in the ICU. Lastly, we address the problem of ED intensity, which does not seem to have an impact on survival at higher doses, a finding that might be caused by the fact that we still adhere to dosing

  8. Current and future strategies in radiotherapy of childhood low-grade glioma of the brain. Part I. Treatment modalities of radiation therapy

    International Nuclear Information System (INIS)

    Kortmann, R.D.; Timmermann, B.; Plasswilm, L.; Paulsen, F.; Jeremic, B.; Kay, S.; Bamberg, M.; Taylor, R.E.; Scarzello, G.; Gnekow, A.K.; Dieckmann, K.

    2003-01-01

    Background: Treatment of childhood low-grade gliomas is a challenging issue owing to their low incidence and the lack of consensus about ''optimal'' treatment approach. Material and Methods: Reports in the literature spanning 60 years of radiation therapy, including orthovoltage, megavoltage and recently modern high-precision treatments, were reviewed with respect to visual function, survival, prognostic factors, dose prescriptions, target volumes, and treatment techniques. Based on these experiences, future strategies in the management of childhood low-grade glioma are presented. Results: Evaluation of published reports is difficult because of inconsistencies in data presentation, relatively short follow-up in some series and failure to present findings and results in a comparable way. Even with the shortcomings of the reports available in the literature, primarily concerning indications, age at treatment, dose response, timing and use of ''optimal'' treatment fields, radiation therapy continues to play an important role in the management of these tumors achieving long-term survival rates up to 80% or more. Particularly in gliomas of the visual pathway, high local tumor control and improved or stable function is achieved in approximately 90% of cases. Data on dose-response relationships recommend dose prescriptions between 45 and 54 Gy with standard fractionation. There is consensus now to employ radiation therapy in older children in case of progressive disease only, regardless of tumor location and histologic subtype. In younger children, the role of radiotherapy is unclear. Recent advances in treatment techniques, such as 3-D treatment planning and various ''high-precision'' treatments achieved promising initial outcome, however with limited patient numbers and short follow-ups. Conclusions: Radiation therapy is an effective treatment modality in children with low-grade glioma regarding tumor control and improvement and/or preservation of neurologic function or

  9. Treatment options for high-risk T1 bladder cancer. Status quo and future perspectives of radiochemotherapy

    International Nuclear Information System (INIS)

    Weiss, C.; Roedel, C.; Ott, O.J.; Wittlinger, M.; Fietkau, R.; Sauer, R.; Krause, S.F.

    2008-01-01

    Purpose: to review the standards and new developments in diagnosis and management of high-risk T1 bladder cancer with emphasis on the role of radiotherapy (RT) and radiochemotherapy (RCT). Material and methods: a systematic review of the literature on developments in diagnosis and management of high-risk T1 bladder cancer was performed. Results: first transurethral resection (TUR), as radical as safely possible, supported by fluorescence cystoscopy, shows higher detection and decreased recurrence rates. An immediate single postoperative instillation with a chemotherapeutic drug reduces the relative risk of recurrence by 40%. A second TUR is recommended to assess residual tumor. For adjuvant intravesical therapy, bacille Calmette-Guerin (BCG) demonstrated the highest efficacy. Early cystectomy should be reserved for selected patients. A recent phase III trial comparing RT versus conservative treatment in T1 G3 tumors could not show any advantage for RT. Data from Erlangen, Germany, using combined RCT in 80% of the patients, compare favorably with most of the contemporary BCG series. Conclusion: results of intravesical therapy are still unsatisfying and early cystectomy is associated with morbidity and mortality. RT alone proved not superior to other conservative treatment strategies. However, data on RCT are promising and demonstrate an alternative to intravesical therapy and radical cystectomy. (orig.)

  10. Incremental Innovation and Progress in Advanced Squamous Cell Lung Cancer: Current Status and Future Impact of Treatment.

    Science.gov (United States)

    Langer, Corey J; Obasaju, Coleman; Bunn, Paul; Bonomi, Philip; Gandara, David; Hirsch, Fred R; Kim, Edward S; Natale, Ronald B; Novello, Silvia; Paz-Ares, Luis; Pérol, Maurice; Reck, Martin; Ramalingam, Suresh S; Reynolds, Craig H; Socinski, Mark A; Spigel, David R; Wakelee, Heather; Mayo, Carlos; Thatcher, Nick

    2016-12-01

    Squamous cell lung cancer (sqCLC) is an aggressive form of cancer that poses many therapeutic challenges. Patients tend to be older, present at a later stage, and have a high incidence of comorbidities, which can compromise treatment delivery and exacerbate toxicity. In addition, certain agents routinely available for nonsquamous cell histologic subtypes, such as bevacizumab and pemetrexed, are contraindicated or lack efficacy in sqCLC. Therapeutic progress has been much slower for advanced sqCLC, with median survival times of approximately 9 to 11 months in most studies. Herein, we discuss the current therapeutic landscape for patients with sqCLC versus with nonsquamous NSCLC. Current evidence indicates that new targeted treatments, notably monoclonal antibodies such as ramucirumab and necitumumab, and immunotherapies such as nivolumab and pembrolizumab can provide survival prolongation, although the benefits are still relatively modest. These incremental improvements, all realized since 2012, in aggregate, will very likely have a clinically meaningful impact for patients with sqCLC. We also discuss recent genomic studies of sqCLC that have identified potentially actionable molecular targets, as well as the relevant targeted agents in clinical development. Finally, we discuss the magnitude of survival benefit and the risk-to-benefit ratio that would prove clinically meaningful in this underserved patient population with unmet needs. Copyright © 2016 International Association for the Study of Lung Cancer. Published by Elsevier Inc. All rights reserved.

  11. Prevention and treatment of demineralisation during fixed appliance therapy: a review of current methods and future applications.

    Science.gov (United States)

    Chambers, C; Stewart, S; Su, B; Sandy, J; Ireland, A

    2013-11-01

    Orthodontic treatment, like all aspects of dentistry, exposes the clinician to the risk of malpractice and litigation. Demineralisation of tooth enamel is still one of the main complications of orthodontic treatment and it is essential patients are made aware of this risk during the consent process. There are a variety of fluoride delivery systems (mouthrinse, varnish, bonding system, and elastics), which can be used to prevent white spot lesion (WSL) formation. Glass-ionomer bonding cements (GIC) have also been shown to reduce WSL formation and have the benefit of not relying on patient compliance. However, these materials have not found widespread acceptance, possibly due to handling characteristics. A number of new technologies, principally fillers and coatings, have recently become available with potential antimicrobial and antibiofilm properties. Coatings can be applied to brackets and wires, which prevent bacterial adhesion. However, the longevity of these coatings is questionable. There are a number of methods available aimed at reducing the incidence of WSL, but they all have limitations. Capitalising on technological advances will enable the production of tailor made orthodontic brackets and adhesive systems, which provide long-term protection against WSL without relying on patient compliance.

  12. A systematic review of treatment response rates in Pakistani hepatitis C virus patients; current prospects and future challenges

    Science.gov (United States)

    Ali, Muhammad; Afzal, Samia; Zia, Asad; Hassan, Ahmed; Khalil, Ali Talha; Ovais, Muhammad; Shinwari, Zabta Khan; Idrees, Muhammad

    2016-01-01

    Abstract Background: The estimated hepatitis C virus (HCV) carriers are approximately 10 million in Pakistan which usually progresses to chronic hepatitis, with rare cases of spontaneous viral eradication. The present article reviews the treatment status of HCV infection in Pakistani population and various factors associated with the treatment response rates. Methods: Literature on anti-HCV therapy was searched in PubMed, Google Scholar and PakMediNet. Thirty three different studies representing different geographic regions of Pakistan published from 2002 to 2016 were included in the present review. Weighted mean, standard error estimates (SE) and standard deviation (SD) were determined for each population group. Results: Mean value for sustained virological response (SVR) for standard IFN plus ribavirin (RBV) combination therapy was 68.38% ± 14.13% (range 33.8%–87.10%; SE 3.08) and pegylated-IFN plus RBV combination therapy 64.38% ± 8.68% (range 55.0%–76.00%; SE 3.88). The lowest value for SVR has been reported to be 24.3% (for genotype 1; administering INF-α 2b 3MU 3 times/week and RBV 1000–1200 mg/day for 48 weeks) while highest of 87.5% (genotype 3a; INF-α 2a 3MU 3 times/week and RBV 1000–1200 mg/day for 24 weeks). The mean value for rapid virological response (RVR) was found to be 48.18% ± 29.20% (SE 9.73). As PEG-interferon and direct acting antivirals (DAAs) are relatively expensive, interferon-alfa (IFN-α) and RBV combination therapy have been used widely to treat HCV infected patients in Pakistan for the last one and half decade. On average, 2.45% of the patients discontinued treatment due to severe side effects. Conclusion: We encourage further studies on understanding host and viral factors associated with specific focus on harder to treat viral variants (relapsers and nonresponders). These variants are currently rising in the country. PMID:27977575

  13. Impact of treatment strategy and physical performance on future knee-related self-efficacy in individuals with ACL injury

    DEFF Research Database (Denmark)

    Flosadottir, Vala; Frobell, Richard; Roos, Ewa M

    2018-01-01

    of the study were to 1) investigate knee-related self-efficacy 6 years after acute ACL injury in patients treated with exercise therapy alone or in combination with either early or the option of delayed ACL reconstruction (ACLR), and 2) to investigate associations between single-leg physical performance...... at various time points after ACL injury and knee self-efficacy at 6 years after injury. METHODS: Participants (n = 121) originated from the KANON-study (ISRCTN84752559), a treatment RCT including active adults with acute ACL injury treated with structured exercise therapy combined with early or the option...... of delayed ACLR. In this ancillary study, participants with knee self-efficacy data at 6 years (n = 89) were analyzed as treated; exercise therapy alone (n = 20), exercise therapy plus early ACLR (n = 46), and exercise therapy plus delayed ACLR (n = 23). The participants performed physical performance tests...

  14. Nanomedicine for treatment of diabetes in an aging population: state-of-the-art and future developments.

    Science.gov (United States)

    Krol, Silke; Ellis-Behnke, Rutledge; Marchetti, Piero

    2012-09-01

    Nowadays diabetes, especially type 2 diabetes (which is strongly related to the Western diet and life-style), has developed worldwide into an epidemic disease. Nanomedicine aims to provide novel tools for diagnosis, therapy and point-of-care management of patients. Several nanotechnological approaches were developed to improve life quality for patients with insulin-dependent diabetes. They facilitate blood glucose management by non-invasive glucose measurement as well as insulin administration mainly by delivering the fragile protein as protected and targeted formulation via nasal or oral route. In the present review the oral or nasal insulin delivery by polymeric nanoparticles is discussed with focus on physiological change either related to the disease, diabetes or age-related metabolic variations influencing insulin release and bioavailability. One critical point is that new generations of targeted nanoparticle based drugs are developed and optimized for certain metabolic conditions. These conditions may change with age or disease. The influence of age-related factors such as immaturity in very young age, metabolic and physiologic changes in old age or insufficient animal models are still under-investigated not only in nanomedicine but also generally in pharmacology. Summarizing it can be noted that the bioavailability of insulin administered via routes others than subcutaneously is comparably low (max. 60%). Moreover factors like changed gut permeability as described for diabetes type 1 or other metabolic peculiarities such as insulin resistance in case of type 2 diabetes also play a role in affecting the development of novel nanoparticulated drug preparations and can be responsible for unsuccessful translation of promising animal results into human therapy. In future insulin nanoparticle development for diabetes must consider not only requirements imposed by the drug but also metabolic changes inflicted by disease or by age. Moreover new approaches are

  15. The gut microbiome as a target for prevention and treatment of hyperglycaemia in type 2 diabetes: from current human evidence to future possibilities.

    Science.gov (United States)

    Brunkwall, Louise; Orho-Melander, Marju

    2017-06-01

    The totality of microbial genomes in the gut exceeds the size of the human genome, having around 500-fold more genes that importantly complement our coding potential. Microbial genes are essential for key metabolic processes, such as the breakdown of indigestible dietary fibres to short-chain fatty acids, biosynthesis of amino acids and vitamins, and production of neurotransmitters and hormones. During the last decade, evidence has accumulated to support a role for gut microbiota (analysed from faecal samples) in glycaemic control and type 2 diabetes. Mechanistic studies in mice support a causal role for gut microbiota in metabolic diseases, although human data favouring causality is insufficient. As it may be challenging to sort the human evidence from the large number of animal studies in the field, there is a need to provide a review of human studies. Thus, the aim of this review is to cover the current and future possibilities and challenges of using the gut microbiota, with its capacity to be modified, in the development of preventive and treatment strategies for hyperglycaemia and type 2 diabetes in humans. We discuss what is known about the composition and functionality of human gut microbiota in type 2 diabetes and summarise recent evidence of current treatment strategies that involve, or are based on, modification of gut microbiota (diet, probiotics, metformin and bariatric surgery). We go on to review some potential future gut-based glucose-lowering approaches involving microbiota, including the development of personalised nutrition and probiotic approaches, identification of therapeutic components of probiotics, targeted delivery of propionate in the proximal colon, targeted delivery of metformin in the lower gut, faecal microbiota transplantation, and the incorporation of genetically modified bacteria that express therapeutic factors into microbiota. Finally, future avenues and challenges for understanding the interplay between human nutrition, genetics

  16. Rapamycin combined with anti-CD45RB mAb and IL-10 or with G-CSF induces tolerance in a stringent mouse model of islet transplantation.

    Directory of Open Access Journals (Sweden)

    Nicola Gagliani

    Full Text Available BACKGROUND: A large pool of preexisting alloreactive effector T cells can cause allogeneic graft rejection following transplantation. However, it is possible to induce transplant tolerance by altering the balance between effector and regulatory T (Treg cells. Among the various Treg-cell types, Foxp3(+Treg and IL-10-producing T regulatory type 1 (Tr1 cells have frequently been associated with tolerance following transplantation in both mice and humans. Previously, we demonstrated that rapamycin+IL-10 promotes Tr1-cell-associated tolerance in Balb/c mice transplanted with C57BL/6 pancreatic islets. However, this same treatment was unsuccessful in C57BL/6 mice transplanted with Balb/c islets (classified as a stringent transplant model. We accordingly designed a protocol that would be effective in the latter transplant model by simultaneously depleting effector T cells and fostering production of Treg cells. We additionally developed and tested a clinically translatable protocol that used no depleting agent. METHODOLOGY/PRINCIPAL FINDINGS: Diabetic C57BL/6 mice were transplanted with Balb/c pancreatic islets. Recipient mice transiently treated with anti-CD45RB mAb+rapamycin+IL-10 developed antigen-specific tolerance. During treatment, Foxp3(+Treg cells were momentarily enriched in the blood, followed by accumulation in the graft and draining lymph node, whereas CD4(+IL-10(+IL-4(- T (i.e., Tr1 cells localized in the spleen. In long-term tolerant mice, only CD4(+IL-10(+IL-4(- T cells remained enriched in the spleen and IL-10 was key in the maintenance of tolerance. Alternatively, recipient mice were treated with two compounds routinely used in the clinic (namely, rapamycin and G-CSF; this drug combination promoted tolerance associated with CD4(+IL-10(+IL-4(- T cells. CONCLUSIONS/SIGNIFICANCE: The anti-CD45RB mAb+rapamycin+IL-10 combined protocol promotes a state of tolerance that is IL-10 dependent. Moreover, the combination of rapamycin+G-CSF induces

  17. Exploring patients' treatment journeys following randomisation in mental health trials to improve future trial conduct: a synthesis of multiple qualitative data sets.

    Science.gov (United States)

    Turner, Katrina M; Percival, John; Kessler, David; Donovan, Jenny

    2017-06-15

    The way in which pragmatic trials are designed suggests that there are differences between the experiences of participants randomised to usual care and intervention arms. These potential differences relate not only to which treatment participants receive but also how they access and engage with their allocated treatment. Such differences could affect trial results. The aim of this study was to assess whether such differences exist and, if they do, to consider their implications for the design of future trials. Interview transcripts were sampled from data sets gathered during three qualitative studies, all of which had been nested within large, primary care depression trials. Each study had explored trial participants' views and experiences of treatments received following randomisation. Transcripts from 37 participants were purposefully sampled, 20 of which were from interviews held with individuals allocated to receive usual GP care. Data were analysed thematically. There was evidence of differences between trial arms across all three data sets. Intervention participants were willing and able to engage with the treatment to which they had been allocated. Randomisation had led to them embarking upon a clear treatment pathway and receiving care in a context where they felt comfortable discussing their mental health and had sufficient time to do so. Intervention participants also had continuity with and confidence in the practitioners they saw. A few usual-care participants talked about having continuity with and confidence in their GPs. However, most of the usual-care participants reported a reluctance to consult GPs about mental health, difficulties in securing treatment appointments, and little or no changes in care following randomisation. Additionally, most reported a lack of continuity of care and a lack confidence in the treatment available to them. There are important differences between usual-care and intervention arms that go beyond treatment received, and

  18. Glucagon-like peptide-1 receptor agonists in the treatment of type 2 diabetes: Past, present, and future

    Directory of Open Access Journals (Sweden)

    Sanjay Kalra

    2016-01-01

    Full Text Available Glucagon-like peptide-1 (GLP-1–based therapy improves glycaemic control through multiple mechanisms, with a low risk of hypoglycaemia and the additional benefit of clinically relevant weight loss. Since Starling and Bayliss first proposed the existence of intestinal secretions that stimulate the pancreas, tremendous progress has been made in the area of incretins. As a number of GLP-1 receptor agonists (GLP-1 RAs continue to become available, physicians will soon face the challenge of selecting the right option customized to their patient's needs. The following discussion, derived from an extensive literature search using the PubMed database, applying the terms incretin, GLP-1, exenatide, liraglutide, albiglutide, dulaglutide, lixisenatide, semaglutide, and taspoglutide, provides a comprehensive review of existing and upcoming molecules in the GLP-1 RA class in terms of their structure, pharmacological profiles, efficacy, safety, and convenience. Search Methodology: A literature search was conducted using the PubMed database, applying the terms incretin, GLP-1, exenatide, liraglutide, albiglutide, dulaglutide, lixisenatide, semaglutide, and taspoglutide. Relevant articles were those that discussed structural, pharmacokinetic and pharmacodynamic differences, classification, long-acting and short-acting GLP-1 RAs, phase 3 trials, and expert opinions. Additional targeted searches were conducted on diabetes treatment guidelines and reviews on safety, as well as the American Diabetes Association/European Society for Study of Diabetes (ADA/EASD statement on pancreatic safety.

  19. Endpoint design for future renal denervation trials - Novel implications for a new definition of treatment response to renal denervation.

    Science.gov (United States)

    Lambert, Thomas; Nahler, Alexander; Rohla, Miklos; Reiter, Christian; Grund, Michael; Kammler, Jürgen; Blessberger, Hermann; Kypta, Alexander; Kellermair, Jörg; Schwarz, Stefan; Starnawski, Jennifer A; Lichtenauer, Michael; Weiss, Thomas W; Huber, Kurt; Steinwender, Clemens

    2016-10-01

    Defining an adequate endpoint for renal denervation trials represents a major challenge. A high inter-individual and intra-individual variability of blood pressure levels as well as a partial or total non-adherence on antihypertensive drugs hamper treatment evaluations after renal denervation. Blood pressure measurements at a single point in time as used as primary endpoint in most clinical trials on renal denervation, might not be sufficient to discriminate between patients who do or do not respond to renal denervation. We compared the traditional responder classification (defined as systolic 24-hour blood pressure reduction of -5mmHg six months after renal denervation) with a novel definition of an ideal respondership (based on a 24h blood pressure reduction at no point in time, one, or all follow-up timepoints). We were able to re-classify almost a quarter of patients. Blood pressure variability was substantial in patients traditionally defined as responders. On the other hand, our novel classification of an ideal respondership seems to be clinically superior in discriminating sustained from pseudo-response to renal denervation. Based on our observations, we recommend that the traditional response classification should be reconsidered and possibly strengthened by using a composite endpoint of 24h-BP reductions at different follow-up-visits. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  20. Beyond conventional antibiotics for the future treatment of methicillin-resistant Staphylococcus aureus infections: two novel alternatives.

    LENUS (Irish Health Repository)

    Fitzgerald-Hughes, Deirdre

    2012-08-01

    The majority of antibiotics currently used to treat methicillin-resistant Staphylococus aureus (MRSA) infections target bacterial cell wall synthesis or protein synthesis. Only daptomycin has a novel mode of action. Reliance on limited targets for MRSA chemotherapy, has contributed to antimicrobial resistance. Two alternative approaches to the treatment of S. aureus infection, particularly those caused by MRSA, that have alternative mechanisms of action and that address the challenge of antimicrobial resistance are cationic host defence peptides and agents that target S. aureus virulence. Cationic host defence peptides have multiple mechanisms of action and are less likely than conventional agents to select resistant mutants. They are amenable to modifications that improve their stability, effectiveness and selectivity. Some cationic defence peptides such as bactenecin, mucroporin and imcroporin have potent in vitro bactericidal activity against MRSA. Antipathogenic agents also have potential to limit the pathogenesis of S aureus. These are generally small molecules that inhibit virulence targets in S. aureus without killing the bacterium and therefore have limited capacity to promote resistance development. Potential antipathogenic targets include the sortase enzyme system, the accessory gene regulator (agr) and the carotenoid biosynthetic pathway. Inhibitors of these targets have been identified and these may have potential for further development.

  1. Patient-centered communication of community treatment assistants in Tanzania predicts coverage of future mass drug administration for trachoma.

    Science.gov (United States)

    Jenson, Alexander; Roter, Debra L; Mkocha, Harran; Munoz, Beatriz; West, Sheila

    2018-06-01

    Prevention of Trachoma, the leading cause of infectious blindness, requires community treatment assistants (CTAs) to perform mass drug administration (MDA) of azithromycin. Previous research has shown that female CTAs have higher MDA coverage, but no studies have focused on the content of conversation. We hypothesize that female CTAs had more patient-centered communication and higher MDA coverage. In 2011, CTAs from 23 distribution sites undergoing MDA as part of the Partnership for Rapid Elimination of Trachoma were selected. CTA - villager interactions were audio recorded. Audio was analyzed using an adaptation of the Roter Interaction Analysis System. The outcome of interest was the proportion of adults receiving MDA in 2011 who returned in 2012. 58 CTAs and 3122 interactions were included. Sites with female CTAs had significantly higher patient-centeredness ratio (0.548 vs 0.400) when compared to sites with male CTAs. Sites with more patient-centered interactions had higher proportion of patients return (p = 0.009). Female CTAs had higher proportion of patient-centered communication. Patient centered communication was associated with higher rates of return for MDA. Greater patient-centered connection with health care providers affects participation in public health efforts, even when those providers are lay health workers. Copyright © 2018 Elsevier B.V. All rights reserved.

  2. Outlet of products of biological treatment- what will be the future problems and opportunities?; Avsaettning av energiprodukter fraan biologisk behandling - vilka fraagestaellningar kommer att bli aktuella?

    Energy Technology Data Exchange (ETDEWEB)

    Hellstroem, Hanna

    2010-01-15

    Biological treatment and related products is a topical subject, which increases year after year, not only in Sweden but all over the world. In this phase of expansion, it is interesting to find out what subjects could become relevant for products from this treatment method in the future. The following products are incorporated in the concept 'energy products' from biological treatment: sludge from sewage treatment plants, digestate from waste digestion plants, biogas, ethanol, and products from biorefinery. Questions regarding the process of these products are not included in this project. The purpose is to bring forward a catalogue of ideas of current and future topics in the field of biological treatment. The goal is to identify development projects which could be of interest for upcoming programs at Waste Refinery. Issues and project proposals for each product have been identified by the writer's network, and in discussions tabled at a workshop arranged by Waste Refinery in the autumn of 2009. At the present time, almost all digestate is sold, but there are problems. Though the plants have found an outlet for their products, they do not receive adequate return on them. Moreover, a lot of water is being transported. Many stakeholders within Waste Refinery, as well as external stakeholders, have requested a project on refining of digestate. Other topical issues regarding digestate are how new, non-food substrates and additives affect the quality of the digestate. Sewage treatment plants have to pay large amounts of money for the disposal of sludge. If Waste Refinery can include sewage sludge in their range of work, there will be several synergies between sludge and digestate. Matters, that need to be solved in the near future, are how to best achieve hygienisation of sewage sludge in order to guarantee salmonella-free sludge. As for biogas, the demand will be determined by factors such as the access of raw material, whether it becomes a vehicle fuel

  3. Ultrasound and MRI of nerves for monitoring disease activity and treatment effects in chronic dysimmune neuropathies - Current concepts and future directions.

    Science.gov (United States)

    Décard, Bernhard F; Pham, Mirko; Grimm, Alexander

    2018-01-01

    New imaging modalities like high-resolution-ultrasound (HRUS) and MR-Neurography (MRN) are increasingly used for the evaluation of the peripheral nervous system. The increasing knowledge on morphological changes observed in different neuropathies has led to a better understanding of underlying pathophysiological processes. The diagnosis of acquired chronic dysimmune neuropathies (CDN) like chronic inflammatory demyelinating polyneuropathy (CIDP), Lewis-Sumner Syndrome (LSS) or multifocal motor neuropathy (MMN) can be challenging. The current diagnostic criteria and outcome parameters are mainly based on clinical and electrophysiological parameters. Especially in CDN cases with atypical presentation or during early disease stages, the diagnostic accuracy is low and standardized protocols for the evaluation of disease activity and treatment response are lacking. The establishment of combined diagnostic criteria for CDN including imaging modalities could help to improve the diagnostic accuracy, allow a better differentiation of subtypes and facilitate the follow-up of disease course. The appropriate selection of eligible patients and sensitive monitoring of treatment response is mandatory future in treatment trials. In this article, we briefly summarize the clinical presentations and pathophysiological concepts of different CDN like CIDP, LSS and MMN. Furthermore, this review focuses on the diagnostic value of HRUS/MRN and its potential role for the monitoring of disease activity. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  4. Ethnopharmacological Survey of Plants Used in the Traditional Treatment of Gastrointestinal Pain, Inflammation and Diarrhea in Africa: Future Perspectives for Integration into Modern Medicine

    Directory of Open Access Journals (Sweden)

    Onesmo B. Balemba

    2013-03-01

    Full Text Available There is a growing need to find the most appropriate and effective treatment options for a variety of painful syndromes, including conditions affecting the gastrointestinal tract, for treating both veterinary and human patients. The most successful regimen may come through integrated therapies including combining current and novel western drugs with acupuncture and botanical therapies or their derivatives. There is an extensive history and use of plants in African traditional medicine. In this review, we have highlighted botanical remedies used for treatment of pain, diarrheas and inflammation in traditional veterinary and human health care in Africa. These preparations are promising sources of new compounds comprised of flavonoids, bioflavanones, xanthones, terpenoids, sterols and glycosides as well as compound formulas and supplements for future use in multimodal treatment approaches to chronic pain, gastrointestinal disorders and inflammation. The advancement of plant therapies and their derivative compounds will require the identification and validation of compounds having specific anti-nociceptive neuromodulatory and/or anti-inflammatory effects. In particular, there is need for the identification of the presence of compounds that affect purinergic, GABA, glutamate, TRP, opioid and cannabinoid receptors, serotonergic and chloride channel systems through bioactivity-guided, high-throughput screening and biotesting. This will create new frontiers for obtaining novel compounds and herbal supplements to relieve pain and gastrointestinal disorders, and suppress inflammation.

  5. Online measuring devices at sewage treatment plants - state of the art and future market potential; On-Line-Messtechnik auf Klaeranlagen - Aktueller Stand und Marktpotential fuer die Zukunft

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, P [Inst. fuer Siedlungswasserbau, Wasserguete- und Abfallwirtschaft der Univ. Stuttgart, Abt. Abwassertechnik (Germany); Schlegel, S [Emschergenossenschaft, Essen (Germany)

    1998-12-31

    By means of a survey commissioned by ATV/GFA, the purposes of use and spheres of use as well as the operating experience with online measuring devices for the determination of ammonium, oxidized nitrogen compounds and orthophosphate were established and evaluated. In addition, data were acquired with the aid of other units for the continuous recording of chemical and physical parameters of sewage treatment. Finally, the future market potentials and development pospects of online measuring devices were evaluated. (orig.) [Deutsch] Anhand einer im Auftrag der ATV/GFA durchgefuehrten Umfrage wurden Einsatzzweck, Einsatzbereiche und Betriebserfahrungen von On-line-Messgeraeten zur Bestimmung von Ammonium, oxidierten Stickstoffverbindungen und Orthophosphat dargestellt und bewertet. Zusaetzlich wurden auch Daten von anderen Geraeteeinheiten zur kontinuierlichen Erfassung von chemischen und physikalischen Parametern bei der Abwasserreinigung erhoben. Anschliessend wurde das zukuenftige Marktpotential und die Entwicklungsmoeglichkeiten bei der On-line-Messtechnik bewertet. (orig.)

  6. Online measuring devices at sewage treatment plants - state of the art and future market potential; On-Line-Messtechnik auf Klaeranlagen - Aktueller Stand und Marktpotential fuer die Zukunft

    Energy Technology Data Exchange (ETDEWEB)

    Baumann, P. [Inst. fuer Siedlungswasserbau, Wasserguete- und Abfallwirtschaft der Univ. Stuttgart, Abt. Abwassertechnik (Germany); Schlegel, S. [Emschergenossenschaft, Essen (Germany)

    1997-12-31

    By means of a survey commissioned by ATV/GFA, the purposes of use and spheres of use as well as the operating experience with online measuring devices for the determination of ammonium, oxidized nitrogen compounds and orthophosphate were established and evaluated. In addition, data were acquired with the aid of other units for the continuous recording of chemical and physical parameters of sewage treatment. Finally, the future market potentials and development pospects of online measuring devices were evaluated. (orig.) [Deutsch] Anhand einer im Auftrag der ATV/GFA durchgefuehrten Umfrage wurden Einsatzzweck, Einsatzbereiche und Betriebserfahrungen von On-line-Messgeraeten zur Bestimmung von Ammonium, oxidierten Stickstoffverbindungen und Orthophosphat dargestellt und bewertet. Zusaetzlich wurden auch Daten von anderen Geraeteeinheiten zur kontinuierlichen Erfassung von chemischen und physikalischen Parametern bei der Abwasserreinigung erhoben. Anschliessend wurde das zukuenftige Marktpotential und die Entwicklungsmoeglichkeiten bei der On-line-Messtechnik bewertet. (orig.)

  7. Current state of the art, multimodality research and future visions for the treatment of patients with prostate cancer: consensus results from "Challenges and Chances in Prostate Cancer Research Meeting 2013".

    Science.gov (United States)

    Combs, Stephanie E; Debus, Jürgen; Feick, Günter; Hadaschik, Boris; Hohenfellner, Markus; Schüle, Roland; Zacharias, Jens-Peter; Schwardt, Malte

    2014-11-04

    A brainstorming and consensus meeting organized by the German Cancer Aid focused on modern treatment of prostate cancer and promising innovative techniques and research areas. Besides optimization of screening algorithms, molecular-based stratification and individually tailored treatment regimens will be the future of multimodal prostate cancer management. Effective interdisciplinary structures, including biobanking and data collection mechanisms are the basis for such developments.

  8. Preoperative Y-90 microsphere selective internal radiation treatment for tumor downsizing and future liver remnant recruitment: a novel approach to improving the safety of major hepatic resections.

    Science.gov (United States)

    Gulec, Seza A; Pennington, Kenneth; Hall, Michael; Fong, Yuman

    2009-01-08

    Extended liver resections are being performed more liberally than ever. The extent of resection of liver metastases, however, is restricted by the volume of the future liver remnant (FLR). An intervention that would both accomplish tumor control and induce compensatory hypertrophy, with good patient tolerability, could improve clinical outcomes. A 53-year-old woman with a history of cervical cancer presented with a large liver mass. Subsequent biopsy indicated poorly differentiated carcinoma with necrosis suggestive of squamous cell origin. A decision was made to proceed with pre-operative chemotherapy and Y-90 microsphere SIRT with the intent to obtain systemic control over the disease, downsize the hepatic lesion, and improve the FLR. A surgical exploration was performed six months after the first SIRT (three months after the second). There was no extrahepatic disease. The tumor was found to be significantly decreased in size with central and peripheral scarring. The left lobe was satisfactorily hypertrophied. A formal right hepatic lobectomy was performed with macroscopic negative margins. Selective internal radiation treatment (SIRT) with yttrium-90 (Y-90) microspheres has emerged as an effective liver-directed therapy with a favorable therapeutic ratio. We present this case report to suggest that the portal vein radiation dose can be substantially increased with the intent of inducing portal/periportal fibrosis. Such a therapeutic manipulation in lobar Y-90 microsphere treatment could accomplish the end points of PVE with avoidance of the concern regarding tumor progression.

  9. Sewage treatment of the future

    DEFF Research Database (Denmark)

    Jensen, Ole Jesper; Nielsen, Susanne Balslev

    1997-01-01

    A methodology for creating a dialog between very different actors e.g. technicians, politicians and users.......A methodology for creating a dialog between very different actors e.g. technicians, politicians and users....

  10. The Future of HIV Treatment

    Science.gov (United States)

    Hirsch, Martin S.; Kuritzkes, Daniel R.

    2012-01-01

    Antiretroviral therapy has transformed the management of HIV-infected individuals over the past quarter century. However, important challenges remain. These include attempts to eradicate HIV from reservoirs within the body, thereby eliminating the need for lifetime therapy. In addition, improvements in drug development, clinical trial, and regulatory pathways are necessary to expeditiously evaluate novel therapeutic regimens and strategies. Antiretroviral drug scarcity remains a major problem in underserved populations worldwide, and partnerships among pharmaceutical companies, academic investigators, and both governmental and nongovernmental agencies are necessary to improve access to these lifesaving regimens. PMID:22772389

  11. Energy futures

    International Nuclear Information System (INIS)

    Treat, J.E.

    1990-01-01

    This book provides fifteen of the futures industry's leading authorities with broader background in both theory and practice of energy futures trading in this updated text. The authors review the history of the futures market and the fundamentals of trading, hedging, and technical analysis; then they update you with the newest trends in energy futures trading - natural gas futures, options, regulations, and new information services. The appendices outline examples of possible contracts and their construction

  12. Current and future strategies in radiotherapy of childhood low-grade glioma of the brain. Part II. Treatment-related late toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Kortmann, R.D.; Timmermann, B.; Plasswilm, L.; Paulsen, F.; Jeremic, B.; Kay, S.; Bamberg, M. [Dept. of Radiooncology, Univ. of Tuebingen (Germany); Taylor, R.E. [Radiotherapy Dept., Cookridge Hospital, Leeds (United Kingdom); Scarzello, G. [Dept. of Radiotherapy, Padua General Hospital (Italy); Gnekow, A.K. [Children' s Hospital Augsburg (Germany); Dieckmann, K. [Dept. of Radiooncology, General Hospital Vienna (Austria)

    2003-09-01

    such as neurocognitive and endocrinological outcome are needed in order to clarify the impact of radiation therapy on the risk of late sequelae. Presently, the strategy to postpone radiotherapy in the younger children, especially with NF, is justified to reduce the risk of late effects. These information and the contribution of tumor, surgery and chemotherapy will help to define the role of radiation therapy in the future management of childhood low-grade glioma and whether the use of highly sophisticated and expensive treatment techniques is justifiable. The recently initiated prospective study of the APRO (Pediatric Radiooncology Working Party) on documentation of dose prescription to organs at risk and the network of the GPOH to explore late effects as well as the forthcoming prospective SIOP/GPOH (International Society of Pediatric Oncology/German Society of Pediatric Oncology and Hematology) LGG 2003 trial are addressing these issues. (orig.)

  13. Current and future strategies in radiotherapy of childhood low-grade glioma of the brain. Part II. Treatment-related late toxicity

    International Nuclear Information System (INIS)

    Kortmann, R.D.; Timmermann, B.; Plasswilm, L.; Paulsen, F.; Jeremic, B.; Kay, S.; Bamberg, M.; Taylor, R.E.; Scarzello, G.; Gnekow, A.K.; Dieckmann, K.

    2003-01-01

    such as neurocognitive and endocrinological outcome are needed in order to clarify the impact of radiation therapy on the risk of late sequelae. Presently, the strategy to postpone radiotherapy in the younger children, especially with NF, is justified to reduce the risk of late effects. These information and the contribution of tumor, surgery and chemotherapy will help to define the role of radiation therapy in the future management of childhood low-grade glioma and whether the use of highly sophisticated and expensive treatment techniques is justifiable. The recently initiated prospective study of the APRO (Pediatric Radiooncology Working Party) on documentation of dose prescription to organs at risk and the network of the GPOH to explore late effects as well as the forthcoming prospective SIOP/GPOH (International Society of Pediatric Oncology/German Society of Pediatric Oncology and Hematology) LGG 2003 trial are addressing these issues. (orig.)

  14. Assuring Potato Tuber Quality during Storage: A Future Perspective

    Directory of Open Access Journals (Sweden)

    M. C. Alamar

    2017-11-01

    Full Text Available Potatoes represent an important staple food crop across the planet. Yet, to maintain tuber quality and extend availability, there is a necessity to store tubers for long periods often using industrial-scale facilities. In this context, preserving potato quality is pivotal for the seed, fresh and processing sectors. The industry has always innovated and invested in improved post-harvest storage. However, the pace of technological change has and will continue to increase. For instance, more stringent legislation and changing consumer attitudes have driven renewed interest in creating alternative or complementary post-harvest treatments to traditional chemically reliant sprout suppression and disease control. Herein, the current knowledge on biochemical factors governing dormancy, the use of chlorpropham (CIPC as well as existing and chemical alternatives, and the effects of pre- and post-harvest factors to assure potato tuber quality is reviewed. Additionally, the role of genomics as a future approach to potato quality improvement is discussed. Critically, and through a more industry targeted research, a better mechanistic understanding of how the pre-harvest environment influences tuber quality and the factors which govern dormancy transition should lead to a paradigm shift in how sustainable storage can be achieved.

  15. Futuring for Future Ready Librarians

    Science.gov (United States)

    Figueroa, Miguel A.

    2018-01-01

    Futurists and foresight professionals offer several guiding principles for thinking about the future. These principles can help people to think about the future and become more powerful players in shaping the preferred futures they want for themselves and their communities. The principles also fit in well as strategies to support the Future Ready…

  16. Environmental Life Cycle Assessment and Cost Analysis of Bath, NY Wastewater Treatment Plant: Potential Upgrade Implications

    Science.gov (United States)

    Many communities across the U.S. are required to upgrade wastewater treatment plants (WWTP) to meet increasingly stringent nutrient effluent standards. However, increased capital, energy and chemical requirements of upgrades create potential trade-offs between eutrophication pot...

  17. Reducing handover latency in future IP-based wireless networks: Fast Proxy Mobile IPv6

    NARCIS (Netherlands)

    Heijenk, Geert; Bargh, Mortaza S.; Laganier, Julien; Prasad, Anand R.

    2008-01-01

    Current IP-level mobility protocols have difficulties meeting the stringent handover delay requirements of future wireless networks. At the same time they do not give sufficient control to the network to control the handover process. This paper presents an extension to Proxy Mobile IP, which is the

  18. Selenium: environmental significance, pollution, and biological treatment technologies.

    Science.gov (United States)

    Tan, Lea Chua; Nancharaiah, Yarlagadda V; van Hullebusch, Eric D; Lens, Piet N L

    2016-01-01

    Selenium is an essential trace element needed for all living organisms. Despite its essentiality, selenium is a potential toxic element to natural ecosystems due to its bioaccumulation potential. Though selenium is found naturally in the earth's crust, especially in carbonate rocks and volcanic and sedimentary soils, about 40% of the selenium emissions to atmospheric and aquatic environments are caused by various industrial activities such as mining-related operations. In recent years, advances in water quality and pollution monitoring have shown that selenium is a contaminant of potential environmental concern. This has practical implications on industry to achieve the stringent selenium regulatory discharge limit of 5μgSeL(-1) for selenium containing wastewaters set by the United States Environmental Protection Agency. Over the last few decades, various technologies have been developed for the treatment of selenium-containing wastewaters. Biological selenium reduction has emerged as the leading technology for removing selenium from wastewaters since it offers a cheaper alternative compared to physico-chemical treatments and is suitable for treating dilute and variable selenium-laden wastewaters. Moreover, biological treatment has the advantage of forming elemental selenium nanospheres which exhibit unique optical and spectral properties for various industrial applications, i.e. medical, electrical, and manufacturing processes. However, despite the advances in biotechnology employing selenium reduction, there are still several challenges, particularly in achieving stringent discharge limits, the long-term stability of biogenic selenium and predicting the fate of bioreduced selenium in the environment. This review highlights the significance of selenium in the environment, health, and industry and biotechnological advances made in the treatment of selenium contaminated wastewaters. The challenges and future perspectives are overviewed considering recent

  19. Assessment of wastewater treatment facility compliance with decreasing ammonia discharge limits using a regression tree model.

    Science.gov (United States)

    Suchetana, Bihu; Rajagopalan, Balaji; Silverstein, JoAnn

    2017-11-15

    A regression tree-based diagnostic approach is developed to evaluate factors affecting US wastewater treatment plant compliance with ammonia discharge permit limits using Discharge Monthly Report (DMR) data from a sample of 106 municipal treatment plants for the period of 2004-2008. Predictor variables used to fit the regression tree are selected using random forests, and consist of the previous month's effluent ammonia, influent flow rates and plant capacity utilization. The tree models are first used to evaluate compliance with existing ammonia discharge standards at each facility and then applied assuming more stringent discharge limits, under consideration in many states. The model predicts that the ability to meet both current and future limits depends primarily on the previous month's treatment performance. With more stringent discharge limits predicted ammonia concentration relative to the discharge limit, increases. In-sample validation shows that the regression trees can provide a median classification accuracy of >70%. The regression tree model is validated using ammonia discharge data from an operating wastewater treatment plant and is able to accurately predict the observed ammonia discharge category approximately 80% of the time, indicating that the regression tree model can be applied to predict compliance for individual treatment plants providing practical guidance for utilities and regulators with an interest in controlling ammonia discharges. The proposed methodology is also used to demonstrate how to delineate reliable sources of demand and supply in a point source-to-point source nutrient credit trading scheme, as well as how planners and decision makers can set reasonable discharge limits in future. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Future accelerators (?)

    Energy Technology Data Exchange (ETDEWEB)

    John Womersley

    2003-08-21

    I describe the future accelerator facilities that are currently foreseen for electroweak scale physics, neutrino physics, and nuclear structure. I will explore the physics justification for these machines, and suggest how the case for future accelerators can be made.

  1. Autologous chondrocyte implantation for cartilage injury treatment in Chiang Mai University Hospital: a case report.

    Science.gov (United States)

    Wongtriratanachai, Prasit; Pruksakorn, Dumnoensun; Pothacharoen, Peraphan; Nimkingratana, Puwapong; Pattamapaspong, Nuttaya; Phornphutkul, Chanakarn; Setsitthakun, Sasiwariya; Fongsatitkul, Ladda; Phrompaet, Sureeporn

    2013-11-01

    Autologous chondrocyte implantation (ACI) has become one of the standard procedures for articular cartilage defect treatment. This technique provides a promising result. However the procedural process requires an approach of several steps from multidisciplinary teams. Although the success of this procedure has been reported from Srinakharinvirot University since 2007, the application of ACI is still limited in Thailand due to the complexity of processes and stringent quality control. This report is to present the first case of the cartilage defect treatment using the first generation-ACI under Chiang Mai University's (CMU) own facility and Ethics Committee. This paper also reviews the process of biotechnology procedures, patient selection, surgical, and rehabilitation techniques. The success of the first case is an important milestone for the further development of the CMU Human Translational Research Laboratory in near future.

  2. Treatment

    Directory of Open Access Journals (Sweden)

    Safaa M. Raghab

    2013-08-01

    The main goal of this study is to utilize a natural low cost material “as an accelerator additive to enhance the chemical treatment process using Alum coagulant and the accelerator substances were Perlite and Bentonite. The performance of the chemical treatment was enhanced using the accelerator substances with 90 mg/l Alum as a constant dose. Perlite gave better performance than the Bentonite effluent. The removal ratio for conductivity, turbidity, BOD and COD for Perlite was 86.7%, 87.4%, 89.9% and 92.8% respectively, and for Bentonite was 83.5%, 85.0%, 86.5% and 85.0% respectively at the same concentration of 40 mg/l for each.

  3. Fuel and vehicle technology choices for passenger vehicles in achieving stringent CO2 targets: connections between transportation and other energy sectors.

    Science.gov (United States)

    Grahn, M; Azar, C; Williander, M I; Anderson, J E; Mueller, S A; Wallington, T J

    2009-05-01

    The regionalized Global Energy Transition (GET-R 6.0) model has been modified to include a detailed description of light-duty vehicle options and used to investigate the potential impact of carbon capture and storage (CCS) and concentrating solar power (CSP) on cost-effective fuel/vehicle technologies in a carbon-constrained world. Total CO2 emissions were constrained to achieve stabilization at 400-550 ppm, by 2100, at lowesttotal system cost The dominantfuel/vehicle technologies varied significantly depending on CO2 constraint future cost of vehicle technologies, and availability of CCS and CSP. For many cases, no one technology dominated on a global scale. CCS provides relatively inexpensive low-CO2 electricity and heatwhich prolongs the use of traditional ICEVs. CSP displaces fossil fuel derived electricity, prolongs the use of traditional ICEVs, and promotes electrification of passenger vehicles. In all cases considered, CCS and CSP availability had a major impact on the lowest cost fuel/vehicle technologies, and alternative fuels are needed in response to expected dwindling oil and natural gas supply potential by the end of the century.

  4. The g-factor of the electron bound in {sup 28}Si{sup 13+}. The most stringent test of bound-state quantum electrodynamics

    Energy Technology Data Exchange (ETDEWEB)

    Sturm, Sven

    2012-09-06

    This thesis describes the ultra-precise determination of the g-factor of the electron bound to hydrogenlike {sup 28}Si{sup 13+}. The experiment is based on the simultaneous determination of the cyclotron- and Larmor frequency of a single ion, which is stored in a triple Penning-trap setup. The continuous Stern-Gerlach effect is used to couple the spin of the bound electron to the motional frequencies of the ion via a magnetic bottle, which allows the non-destructive determination of the spin state. To this end, a highly sensitive, cryogenic detection system was developed, which allowed the direct, non-destructive detection of the eigenfrequencies with the required precision. The development of a novel, phase sensitive detection technique finally allowed the determination of the g-factor with a relative accuracy of 4 . 10{sup -11}, which was previously inconceivable. The comparison of the hereby determined value with the value predicted by quantumelectrodynamics (QED) allows the verification of the validity of this fundamental theory under the extreme conditions of the strong binding potential of a highly charged ion. The exact agreement of theory and experiment is an impressive demonstration of the exactness of QED. The experimental possibilities created in this work will allow in the near future not only further tests of theory, but also the determination of the mass of the electron with a precision that exceeds the current literature value by more than an order of magnitude.

  5. The g-factor of the electron bound in 28Si13+. The most stringent test of bound-state quantum electrodynamics

    International Nuclear Information System (INIS)

    Sturm, Sven

    2012-01-01

    This thesis describes the ultra-precise determination of the g-factor of the electron bound to hydrogenlike 28 Si 13+ . The experiment is based on the simultaneous determination of the cyclotron- and Larmor frequency of a single ion, which is stored in a triple Penning-trap setup. The continuous Stern-Gerlach effect is used to couple the spin of the bound electron to the motional frequencies of the ion via a magnetic bottle, which allows the non-destructive determination of the spin state. To this end, a highly sensitive, cryogenic detection system was developed, which allowed the direct, non-destructive detection of the eigenfrequencies with the required precision. The development of a novel, phase sensitive detection technique finally allowed the determination of the g-factor with a relative accuracy of 4 . 10 -11 , which was previously inconceivable. The comparison of the hereby determined value with the value predicted by quantumelectrodynamics (QED) allows the verification of the validity of this fundamental theory under the extreme conditions of the strong binding potential of a highly charged ion. The exact agreement of theory and experiment is an impressive demonstration of the exactness of QED. The experimental possibilities created in this work will allow in the near future not only further tests of theory, but also the determination of the mass of the electron with a precision that exceeds the current literature value by more than an order of magnitude.

  6. Assessing the Long-Term Impact of Treating Hepatitis C Virus (HCV-Infected People Who Inject Drugs in the UK and the Relationship between Treatment Uptake and Efficacy on Future Infections.

    Directory of Open Access Journals (Sweden)

    Hayley Bennett

    Full Text Available The prevalence of the hepatitis C virus (HCV remains high amongst people who inject drugs (PWID and accounts for the majority of newly acquired infections. This study aims to quantify the value of treatment amongst PWID with more efficacious treatments and at increased uptake rates, with respect to the avoidance of future infections and subsequent long-term complications of HCV.A dynamic HCV transmission and disease progression model was developed, incorporating acute and chronic infection and their long-term complications (decompensated cirrhosis, cancer, liver transplant and mortality, with the potential for HCV transmission to other PWID prior to successful treatment. The model was populated with prevalence and therapy data from a UK setting. Scenarios of current standard of care (SoC treatment efficacy and uptake were compared to anticipated sustained virologic response (SVR rates of 90-100% and increased uptake over varied horizons.SoC led to modest reductions in prevalence; >5% after 200 years. New treatments achieving 90% SVR could reduce prevalence below 5% within 60 years at current uptake rates or within 5 years if all patients are treated. Amongst 4,240 PWID, chronic HCV infections avoided as a result of increasing treatment uptake over the period 2015-2027 ranged from 20-580 and 34-912 with SoC and 90% SVR rates respectively. The reduction in downstream HCV infections due to increasing treatment uptake resulted in an approximate discounted gain of 300 life-years (from avoiding reduced life expectancy from HCV infection and a gain of 1,700 QALYs (from avoiding the disutility of HCV infection and related complications, with a projected £5.4 million cost saving.While improved SVR profiles led to reductions in modelled prevalence, increased treatment uptake was the key driver of future infections avoided. Increased treatment among PWID with new more efficacious therapies could significantly change the future dynamics, cost and health

  7. Future Textiles

    DEFF Research Database (Denmark)

    Hansen, Anne-Louise Degn; Jensen, Hanne Troels Fusvad; Hansen, Martin

    2011-01-01

    Magasinet Future Textiles samler resultaterne fra projektet Future Textiles, der markedsfører området intelligente tekstiler. I magasinet kan man læse om trends, drivkræfter, udfordringer samt få ideer til nye produkter inden for intelligente tekstiler. Områder som bæredygtighed og kundetilpasning...

  8. Futures Brokerages Face uncertain Future

    Institute of Scientific and Technical Information of China (English)

    WANG PEI

    2006-01-01

    @@ 2005 was a quiet year for China's futures market.After four new trading products, including cotton, fuel oil and corn, were launched on the market in 2004, the development of the market seemed to stagnate. The trade value of the futures market totaled 13.4 trillion yuan (US$ 1.67 trillion) in 2005, down 8.5 percent year-on-year. Although the decrease is quite small and the trade value was still the second highest in the market's history, the majority of futures brokerage firms were running in the red. In some areas, up to 80 percent of futures companies made losses.

  9. Sustainable Futures

    Science.gov (United States)

    Sustainable Futures is a voluntary program that encourages industry to use predictive models to screen new chemicals early in the development process and offers incentives to companies subject to TSCA section 5.

  10. Stroke and TIA survivors’ cognitive beliefs and affective responses regarding treatment and future stroke risk differentially predict medication adherence and categorised stroke risk

    OpenAIRE

    Phillips, L. Alison; Diefenbach, Michael A.; Abrams, Jessica; Horowitz, Carol R.

    2014-01-01

    Cognitive beliefs and affective responses to illness and treatment are known to independently predict health behaviours. The purpose of the current study is to assess the relative importance of four psychological domains – specifically, affective illness, cognitive illness, affective treatment and cognitive treatment – for predicting stroke and transient ischemic attack (TIA) survivors’ adherence to stroke prevention medications as well as their objective, categorised stroke risk. We assessed...

  11. The future

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    Particle accelerator development must rank as one of the major scientific achievements of the twentieth century. Progress in computing methods, engineering design techniques and advances in material science have all contributed to today's highly-developed, precision technology where small versatile machines are used for a wide range of applications. The accelerator community has opportunities to expand the range of applications in industry and medicine, particularly by increasing beam intensities. In some cases, the required 'technology-step' improvements can be achieved by employing existing materials and present day techniques. In the competitive commercial world of radiopharmaceuticals, the trend is to employ higher intensity accelerators for lower-cost production of isotopes and to operate these machines under increasingly more stringent radiological controls. Several accelerator manufacturers are developing higher current machines in the range 500 to 1000 microamps, demanding production targets better suited to handling heat production. One company, IBA in Belgium, has already supplied 2 mA, 18 MeV positive-ion cyclotrons with internal targetry for the commercial production of a new therapeutic isotope, palladium-103, for cancer brachytherapy. In Canada, EBCO Industries together with TRIUMF have announced the development of 1000 microamp extraction from their existing 30 MeV cyclotron. The isotope production industry is a major opportunity for accelerator technology. Historically, material-testing reactors have always provided low-cost isotopes to the industry and to medical companies; however many of these reactors are reaching the end of their lives and are not being replaced. Diminishing research in nuclear power generation and fuel testing, combined with the dilemma on waste disposal, has made fission-based reactors less attractive. High intensity accelerators with appropriate targetry could be constructed to produce the necessary neutron

  12. Future perspectives

    International Nuclear Information System (INIS)

    Anon.

    1987-01-01

    International involvement in particle physics is what the International Committee for Future Accelerators (ICFA) is all about. At the latest Future Perspectives meeting at Brookhaven from 5-10 October (after a keynote speech by doyen Viktor Weisskopf, who regretted the emergence of 'a nationalistic trend'), ICFA reviewed progress and examined its commitments in the light of the evolving world particle physics scene. Particular aims were to review worldwide accelerator achievements and plans, to survey the work of the four panels, and to discuss ICFA's special role in future cooperation in accelerator construction and use, and in research and development work for both accelerators and for detectors

  13. Future Contingents

    DEFF Research Database (Denmark)

    Øhrstrøm, Peter; Hasle., Per F. V.

    2015-01-01

    contingent statements. The problem of future contingents is interwoven with a number of issues in theology, philosophy, logic, semantics of natural language, computer science, and applied mathematics. The theological issue of how to reconcile the assumption of God's foreknowledge with the freedom and moral...... accountability of human beings has been a main impetus to the discussion and a major inspiration to the development of various logical models of time and future contingents. This theological issue is connected with the general philosophical question of determinism versus indeterminism. Within logic, the relation...... about the future. Finally, it should be mentioned that temporal logic has found a remarkable application in computer science and applied mathematics. In the late 1970s the first computer scientists realised the relevance of temporal logic for the purposes of computer science (see Hasle and Øhrstrøm 2004)....

  14. Future Contingents

    DEFF Research Database (Denmark)

    Øhrstrøm, Peter; Hasle., Per F. V.

    2011-01-01

    contingent statements. The problem of future contingents is interwoven with a number of issues in theology, philosophy, logic, semantics of natural language, computer science, and applied mathematics. The theological issue of how to reconcile the assumption of God's foreknowledge with the freedom and moral...... accountability of human beings has been a main impetus to the discussion and a major inspiration to the development of various logical models of time and future contingents. This theological issue is connected with the general philosophical question of determinism versus indeterminism. Within logic, the relation...... about the future. Finally, it should be mentioned that temporal logic has found a remarkable application in computer science and applied mathematics. In the late 1970s the first computer scientists realised the relevance of temporal logic for the purposes of computer science (see Hasle and Øhrstrøm 2004)....

  15. Future Savvy

    DEFF Research Database (Denmark)

    Gordon, Adam

    There's no shortage of predictions available to organizations looking to anticipate and profit from future events or trends. Apparently helpful forecasts are ubiquitous in everyday communications such as newspapers and business magazines, and in specialized sources such as government and think......-tank forecasts, consultant reports, and stock-market guides. These resources are crucial, but they are also of very mixed quality. How can decision-makers know which predictions to take seriously, which to be wary of, and which to throw out entirely? Future Savvy provides analytical filters to judging predictive...... systematic "forecast filtering" to reveal strengths and weakness in the predictions they face. Future Savvy empowers both business and policy/government decision-makers to use forecasts wisely and so improve their judgment in anticipating opportunities, avoiding threats, and managing uncertainty....

  16. An innovative treatment concept for future drinking water production : Fluidized ion exchange – ultrafiltration – nanofiltration – granular activated carbon filtration

    NARCIS (Netherlands)

    Li, S.; Heijman, S.G.J.; Verberk, J.Q.J.C.; Van Dijk, J.C.

    2009-01-01

    A new treatment concept for drinking water production from surface water has been investigated on a pilot scale. The treatment concept consists of fluidized ion exchange (FIEX), ultrafiltration (UF), nanofiltration (NF), and granular activated carbon filtration (GAC). The FIEX process removed

  17. Energy Futures

    DEFF Research Database (Denmark)

    Davies, Sarah Rachael; Selin, Cynthia

    2012-01-01

    foresight and public and stakeholder engagement are used to reflect on?and direct?the impacts of new technology. In this essay we draw on our experience of anticipatory governance, in the shape of the ?NanoFutures? project on energy futures, to present a reflexive analysis of engagement and deliberation. We...... draw out five tensions of the practice of deliberation on energy technologies. Through tracing the lineages of these dilemmas, we discuss some of the implications of these tensions for the practice of civic engagement and deliberation in a set of questions for this community of practitioner-scholars....

  18. Iraq's future

    International Nuclear Information System (INIS)

    Henderson, S.

    1998-01-01

    The large oil reserves of Iraq make it an important player in the long-term political energy world. This article briefly reviews the oil industry''s development and current status in Iraq and discusses the planned oil and gas field development. Finally there is a political discussion regarding the future of Iraq in terms of religion, race and neighbouring countries. (UK)

  19. Bitcoin futures

    DEFF Research Database (Denmark)

    Brøgger, Søren Bundgaard

    2018-01-01

    Med introduktionen af et futures-marked er Bitcoin-eksponering blevet tilgængelig for en bredere gruppe af investorer, som hidtil ikke har kunnet eller villet tilgå det underliggende marked for Bitcoin. Artiklen finder, at kontrakterne umiddelbart favoriserer spekulanter på bekostning af hedgers og...

  20. Upgrading of the STP Uithoorn: treatment of nutrient rich wastewater from horticulture.

    Science.gov (United States)

    Piekema, P; Neef, R

    2005-01-01

    The STP Uithoorn will be upgraded to accommodate the treatment of wastewater from a growing population and to meet more stringent nutrient discharge limits in 2006. In 2003 a system choice and preliminary design was made for the upgrading. A special feature is the nutrient rich wastewater flow from the rapidly developing horticulture in the area. Since the future loads from horticulture are highly uncertain, flexibility of the STP after upgrading is an important issue. A three stage system was selected: improved physical-chemical primary treatment, secondary treatment by activated sludge, and tertiary treatment by denitrifying filters. In this way an important part of the existing infrastructure can be reused, and flexibility is assured by constructing the tertiary treatment in modules and by providing a wide range of operational control possibilities. In this paper the process of system choice and selection of type of tertiary treatment are described, as well as the optimisation of the existing treatment. In order to determine the feasibility of allowing a high loading rate on the existing secondary clarifiers, a two-dimensional hydraulic model of the clarification process was used.

  1. Robot Futures

    DEFF Research Database (Denmark)

    Christoffersen, Anja; Grindsted Nielsen, Sally; Jochum, Elizabeth Ann

    Robots are increasingly used in health care settings, e.g., as homecare assistants and personal companions. One challenge for personal robots in the home is acceptance. We describe an innovative approach to influencing the acceptance of care robots using theatrical performance. Live performance...... is a useful testbed for developing and evaluating what makes robots expressive; it is also a useful platform for designing robot behaviors and dialogue that result in believable characters. Therefore theatre is a valuable testbed for studying human-robot interaction (HRI). We investigate how audiences...... perceive social robots interacting with humans in a future care scenario through a scripted performance. We discuss our methods and initial findings, and outline future work....

  2. Future directions

    International Nuclear Information System (INIS)

    Lutz, R.J. Jr.

    2004-01-01

    Topics presented concerning the future developments in risk analysis are: safety goals, US severe accident policy, code developments, research programs, analyses and operation action, linking with the deterministic analyses. Principle consideration in risk is defined as protection of both general population, and nearby residents. The principal goal should be consistent with risk of other man-caused activities, the cost benefit after minimum safety levels are achieved, and proportional to benefits to be gained

  3. Stroke and TIA survivors’ cognitive beliefs and affective responses regarding treatment and future stroke risk differentially predict medication adherence and categorised stroke risk

    Science.gov (United States)

    Phillips, L. Alison; Diefenbach, Michael A.; Abrams, Jessica; Horowitz, Carol R.

    2014-01-01

    Cognitive beliefs and affective responses to illness and treatment are known to independently predict health behaviours. The purpose of the current study is to assess the relative importance of four psychological domains – specifically, affective illness, cognitive illness, affective treatment and cognitive treatment – for predicting stroke and transient ischemic attack (TIA) survivors’ adherence to stroke prevention medications as well as their objective, categorised stroke risk. We assessed these domains among stroke/TIA survivors (n = 600), and conducted correlation and regression analyses with concurrent and prospective outcomes to determine the relative importance of each cognitive and affective domain for adherence and stroke risk. As hypothesised, patients’ affective treatment responses explained the greatest unique variance in baseline and six-month adherence reports (8 and 5%, respectively, of the variance in adherence, compared to 1–3% explained by other domains). Counter to hypotheses, patients’ cognitive illness beliefs explained the greatest unique variance in baseline and six-month objective categorised stroke risk (3 and 2%, respectively, compared to 0–1% explained by other domains). Results indicate that domain type (i.e. cognitive and affective) and domain referent (illness and treatment) may be differentially important for providers to assess when treating patients for stroke/TIA. More research is required to further distinguish between these domains and their relative importance for stroke prevention. PMID:25220292

  4. Stroke and TIA survivors' cognitive beliefs and affective responses regarding treatment and future stroke risk differentially predict medication adherence and categorised stroke risk.

    Science.gov (United States)

    Phillips, L Alison; Diefenbach, Michael A; Abrams, Jessica; Horowitz, Carol R

    2015-01-01

    Cognitive beliefs and affective responses to illness and treatment are known to independently predict health behaviours. The purpose of the current study is to assess the relative importance of four psychological domains - specifically, affective illness, cognitive illness, affective treatment and cognitive treatment - for predicting stroke and transient ischemic attack (TIA) survivors' adherence to stroke prevention medications as well as their objective, categorised stroke risk. We assessed these domains among stroke/TIA survivors (n = 600), and conducted correlation and regression analyses with concurrent and prospective outcomes to determine the relative importance of each cognitive and affective domain for adherence and stroke risk. As hypothesised, patients' affective treatment responses explained the greatest unique variance in baseline and six-month adherence reports (8 and 5%, respectively, of the variance in adherence, compared to 1-3% explained by other domains). Counter to hypotheses, patients' cognitive illness beliefs explained the greatest unique variance in baseline and six-month objective categorised stroke risk (3 and 2%, respectively, compared to 0-1% explained by other domains). Results indicate that domain type (i.e. cognitive and affective) and domain referent (illness and treatment) may be differentially important for providers to assess when treating patients for stroke/TIA. More research is required to further distinguish between these domains and their relative importance for stroke prevention.

  5. The Use of Precision Medicine to Manage Obstructive Sleep Apnea Treatment in Patients with Resistant Hypertension: Current Evidence and Future Directions.

    Science.gov (United States)

    Sapiña, Esther; Torres, Gerard; Barbé, Ferran; Sánchez-de-la-Torre, Manuel

    2018-06-08

    The significant prevalence of resistant hypertension (RH) and the high cardiovascular risk of the population of patients with RH have indicated the necessity to identify its main causes. Among these, obstructive sleep apnea (OSA) is considered the most well-established cause. In recent years, several studies have shown a beneficial effect of continuous positive airway pressure (CPAP) treatment on blood pressure (BP), but this effect exhibits great variability. The diagnosis and management of OSA in patients with RH suggest a clinical option for a phenotype of patients for whom therapeutic strategies are limited to pharmaceutical therapy and renal denervation. However, the great variability in the CPAP response has increased the necessity to develop instruments to identify patients who could benefit from a treatment that reduces BP. Application of precision medicine to these patients should be considered as a first-line intervention to avoid the prescription of ineffective treatments and excessive consumption of pharmacological drugs that do not ameliorate the cardiovascular risk.

  6. The Future of Opioid Agonist Therapies in Ukraine: A Qualitative Assessment of Multilevel Barriers and Ways Forward to Promote Retention in Treatment.

    Science.gov (United States)

    Bojko, Martha J; Mazhnaya, Alyona; Marcus, Ruthanne; Makarenko, Iuliia; Islam, Zahedul; Filippovych, Sergey; Dvoriak, Sergii; Altice, Frederick L

    2016-07-01

    Opioid agonist therapies (OAT) to treat opioid addiction in people who inject drugs (PWID) began in Ukraine in 2004. Scale-up of OAT, however, has been hampered by both low enrollment and high attrition. To better understand the factors influencing OAT retention among PWID in Ukraine, qualitative data from 199 PWIDs were collected during 25 focus groups conducted in five Ukrainian cities from February to April 2013. The experiences of PWID who were currently or previously on OAT or currently trying to access OAT were analyzed to identify entry and retention barriers encountered. Transcribed data were analyzed using a grounded theory approach. Individual beliefs about OAT, particularly misaligned treatment goals between clients and providers, influenced PWID's treatment seeking behaviors. Multiple programmatic and structural issues, including inconvenient hours and treatment site locations, complicated dosing regimens, inflexible medication dispensing guidelines, and mistreatment by clinic and medical staff also strongly influenced OAT retention. Findings suggest the need for both programmatic and policy-level structural changes such as revising legal regulations covering OAT dispensing, formalizing prescription dosing policies and making OAT more available through other sites, including primary care settings as a way to improve treatment retention. Quality improvement interventions that target treatment settings could also be deployed to overcome healthcare delivery barriers. Additional patient education and medical professional development around establishing realistic treatment goals as well as community awareness campaigns that address the myths and fears associated with OAT can be leveraged to overcome individual, family and community-level barriers. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. A Discussion on the Concept of Water Resources from the Perspective of the Most Stringent Water Management System%最严格水资源管理制度视野下水资源概念探讨

    Institute of Scientific and Technical Information of China (English)

    胡德胜

    2015-01-01

    In order to solve the increasingly serious water problems and solve this major bottleneck in China’s sustainable economic and so-cial development,China has decided to establish and implement the most stringent water management system. In order to refine and imple-ment this system,it is necessary to clarify the basic term of“water resources”with its definition and extension according to legal theory. By comparing and analyzing different understandings and/or legal definitions of“water resources”,at home and abroad,from different disci-plines,and from different legal systems in different countries,based on the perspective of the most stringent water management system,the scope of“water resources”should be legitimately delimited in a way of considering the substance of water itself as well as its relevant roles and functions comprehensively,and therefore:(i)in terms of quantity,“water resources”should be limited to freshwater in principle,only surface water and groundwater should be calculated,and atmospheric water,soil water and green water should be excluded;(ii)the man-agement of water quality and self-purification capacity should be emphasized;(iii)the objects of the most stringent water management sys-tem should include hydraulic power resources,water transport resources and those carrier of water resources,such as river/waterway,lake, wetland,reservoir/dam,pond,spring,well,glacier,etc.%为了解决日益严峻的水问题,我国决定建立并正在实施最严格水资源管理制度。为了细化和便于实施最严格水资源管理制度,需要对“水资源”这一基础术语的内涵和外延有一个符合法学理论的界定。通过比较和分析国内外、不同学科、不同国家法律对于水资源的不同认识、理解或者法律界定,基于最严格水资源管理制度的视野,需要综合考虑水物质及与其有关的各种作用和功能,对水资源的范围予以合理界定:在数量方面限

  8. Well bore Flow Treatment Used to Predict Radioactive Brine Releases to the Surface from Future Drilling Penetrations into the Waste Isolation Pilot Plant (WIPP), New Mexico, USA

    International Nuclear Information System (INIS)

    Brien, D.G.O.; Stoelzel, D.M.; Hadgu, T.

    1999-01-01

    The Waste Isolation Pilot Plant (WIPP) is the U.S. Department of Energy's (DOE) mined geologic repository in southeastern New Mexico, USA.This site is designed for the permanent burial of transuranic radioactive waste generated by defense related activities.The waste produces gases when exposed to brine. This gas generation may result in increased pressures over time. Therefore, a future driller that unknowingly penetrates through the site may experience a blowout. This paper describes the methodology used to predict the resultant volumes of contaminated brine released

  9. Current and future constraints on neutrino physics from cosmology

    International Nuclear Information System (INIS)

    Hannestad, S.; Hamann, J.; Wong, Y.Y.Y.

    2014-01-01

    In recent years precision cosmology has become an increasingly powerful probe of particle physics. Perhaps the prime example of this is the very stringent cosmological upper bound on the neutrino mass. However, other aspects of neutrino physics, such as their decoupling history and possible non-standard interactions, can be probed using observations of cosmic structure. Here, I review the current status of cosmological bounds on neutrino properties and discuss the potential of future observations, for example by the recently approved EUCLID mission, to precisely measure neutrino properties. (authors)

  10. Opioid Addiction: Social Problems Associated and Implications of Both Current and Possible Future Treatments, including Polymeric Therapeutics for Giving Up the Habit of Opioid Consumption.

    Science.gov (United States)

    Benéitez, M Cristina; Gil-Alegre, M Esther

    2017-01-01

    Detoxification programmes seek to implement the most secure and compassionate ways of withdrawing from opiates so that the inevitable withdrawal symptoms and other complications are minimized. Once detoxification has been achieved, the next stage is to enable the patient to overcome his or her drug addiction by ensuring consumption is permanently and completely abandoned, only after which can the subject be regarded as fully recovered. A systematic search on the common databases of relevant papers published until 2016 inclusive. Our study of the available oral treatments for opioid dependence has revealed that no current treatment can actually claim to be fully effective. These treatments require daily oral administration and, consequently, regular visits to dispensaries, which in most cases results in a lack of patient compliance, which causes fluctuations in drug plasma levels. We then reviewed alternative treatments in the available scientific literature on polymeric sustained release formulations. Research has been done not only on release systems for detoxification but also on release systems for giving up the habit of taking opioids. These efforts have obtained the recent authorization of polymeric systems for use in patients that could help them to reduce their craving for drugs.

  11. Special report : Workshop on 4D-treatment planning in actively scanned particle therapy-Recommendations, technical challenges, and future research directions

    NARCIS (Netherlands)

    Knopf, Antje; Bert, Christoph; Heath, Emily; Nill, Simeon; Kraus, Kim; Richter, Daniel; Hug, Eugen B.; Pedroni, Eros; Safai, Sairos; Albertini, Francesca; Zenklusen, Silvan; Boye, Dirk; Söhn, Matthias; Soukup, Martin; Sobotta, Benjamin; Lomax, Antony

    This article reports on a 4D-treatment planning workshop (4DTPW), held on 7-8 December 2009 at the Paul Scherrer Institut (PSI) in Villigen, Switzerland. The participants were all members of institutions actively involved in particle therapy delivery and research. The purpose of the 4DTPW was to

  12. Medical treatment methods, medical indication claims and patentability: A quest into the rationale of the exclusion and patentability in the context of the future of personalised medicine

    NARCIS (Netherlands)

    Bostyn, S.J.R.

    2016-01-01

    This contribution discusses the thorny issue of the rationale of the exclusion from patentability of medical treatment methods and the patentability of medical indications. This quest is the consequence of our earlier findings that medical indication patents present a real life risk for many players

  13. Opioid Addiction: Social Problems Associated and Implications of Both Current and Possible Future Treatments, including Polymeric Therapeutics for Giving Up the Habit of Opioid Consumption

    Directory of Open Access Journals (Sweden)

    M. Cristina Benéitez

    2017-01-01

    Full Text Available Background. Detoxification programmes seek to implement the most secure and compassionate ways of withdrawing from opiates so that the inevitable withdrawal symptoms and other complications are minimized. Once detoxification has been achieved, the next stage is to enable the patient to overcome his or her drug addiction by ensuring consumption is permanently and completely abandoned, only after which can the subject be regarded as fully recovered. Methods. A systematic search on the common databases of relevant papers published until 2016 inclusive. Results and Conclusion. Our study of the available oral treatments for opioid dependence has revealed that no current treatment can actually claim to be fully effective. These treatments require daily oral administration and, consequently, regular visits to dispensaries, which in most cases results in a lack of patient compliance, which causes fluctuations in drug plasma levels. We then reviewed alternative treatments in the available scientific literature on polymeric sustained release formulations. Research has been done not only on release systems for detoxification but also on release systems for giving up the habit of taking opioids. These efforts have obtained the recent authorization of polymeric systems for use in patients that could help them to reduce their craving for drugs.

  14. Future land use plan

    International Nuclear Information System (INIS)

    1995-01-01

    The US Department of Energy's (DOE) changing mission, coupled with the need to apply appropriate cleanup standards for current and future environmental restoration, prompted the need for a process to determine preferred Future Land Uses for DOE-owned sites. DOE began the ''Future Land Use'' initiative in 1994 to ensure that its cleanup efforts reflect the surrounding communities' interests in future land use. This plan presents the results of a study of stakeholder-preferred future land uses for the Brookhaven National Laboratory (BNL), located in central Long Island, New York. The plan gives the Laboratory's view of its future development over the next 20 years, as well as land uses preferred by the community were BNL ever to cease operations as a national laboratory (the post-BNL scenario). The plan provides an overview of the physical features of the site including its history, topography, geology/hydrogeology, biological inventory, floodplains, wetlands, climate, and atmosphere. Utility systems and current environmental operations are described including waste management, waste water treatment, hazardous waste management, refuse disposal and ground water management. To complement the physical descriptions of the site, demographics are discussed, including overviews of the surrounding areas, laboratory population, and economic and non-economic impacts

  15. Future land use plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1995-08-31

    The US Department of Energy`s (DOE) changing mission, coupled with the need to apply appropriate cleanup standards for current and future environmental restoration, prompted the need for a process to determine preferred Future Land Uses for DOE-owned sites. DOE began the ``Future Land Use`` initiative in 1994 to ensure that its cleanup efforts reflect the surrounding communities` interests in future land use. This plan presents the results of a study of stakeholder-preferred future land uses for the Brookhaven National Laboratory (BNL), located in central Long Island, New York. The plan gives the Laboratory`s view of its future development over the next 20 years, as well as land uses preferred by the community were BNL ever to cease operations as a national laboratory (the post-BNL scenario). The plan provides an overview of the physical features of the site including its history, topography, geology/hydrogeology, biological inventory, floodplains, wetlands, climate, and atmosphere. Utility systems and current environmental operations are described including waste management, waste water treatment, hazardous waste management, refuse disposal and ground water management. To complement the physical descriptions of the site, demographics are discussed, including overviews of the surrounding areas, laboratory population, and economic and non-economic impacts.

  16. Hope for the Future But Fear the Risk of Stigma: Ethiopian Family Caregivers' Lived Experience of Caring for Their HIV Positive Child Two Years After Starting Antiretroviral Treatment.

    Science.gov (United States)

    Biru, Mulatu; Lunqvist, Pia; Molla, Mitikie; Jerene, Degu; Hallström, Inger

    2017-12-08

    Family caregivers are believed to be the primary source of support for HIV-affected children. There is limited evidence about practices of support for caregivers, to strengthen them and to enhance the welfare of HIV positive children, especially in African settings. Our aim was therefore to illuminate caregivers' lived experiences of caring for a child in Ethiopia 2 years after the child was enrolled in antiretroviral therapy. Qualitative interviews with 18 family caregivers of 18 children were performed and analyzed using an inductive design with a hermeneutic phenomenological approach. The family caregivers' lived experience was shown in two main themes comprising "lifelong medication gives hope for the future" and "support challenged by the fear of stigma." The family caregivers experienced hope and dreams for the future as they saw their child as healthy and they had regained normality in life after the child's diagnosis. The caregivers still feared the disclosure of the child's diagnosis, which gave rise to conflicts with the child, the family, and society. Good quality support from the healthcare staff lightened their burdens. Further studies are recommended on the strategies of stigma reduction and developing need-specific modalities to support caregivers in the community.

  17. Future climate

    International Nuclear Information System (INIS)

    La Croce, A.

    1991-01-01

    According to George Woodwell, founder of the Woods Hole Research Center, due the combustion of fossil fuels, deforestation and accelerated respiration, the net annual increase of carbon, in the form of carbon dioxide, to the 750 billion tonnes already present in the earth's atmosphere, is in the order of 3 to 5 billion tonnes. Around the world, scientists, investigating the probable effects of this increase on the earth's future climate, are now formulating coupled air and ocean current models which take account of water temperature and salinity dependent carbon dioxide exchange mechanisms acting between the atmosphere and deep layers of ocean waters

  18. Future development

    International Nuclear Information System (INIS)

    Zavitz, J.; Hetherington, C.

    1997-01-01

    Issues regarding future development by oil and gas companies in Canada's Arctic and the Beaufort Sea were discussed. It was suggested in the Berger report that Northern development should be under the control of the people whose lives and economy are being changed. Aboriginal people are now much more sophisticated politically, and have a better understanding of what is involved. Most of them would like the financial benefits from development, but the development would have to be on their terms. Most people involved with Arctic oil exploration feel that there is enough oil in the Arctic to warrant production. (Reserves in the Beaufort Sea are estimated at two billion barrels of good quality oil). If development were to continue, there exist two methods of transportation to move the oil to market. Gulf, Imperial Oil and Panarctic favour the use of pipelines, whereas Dome Petroleum Ltd. favours the use of ice-breaking tankers. In each case the favored option seems to depend upon the location of the company's leases, the capital and operating costs, and the potential environmental impacts. Undoubtedly, any future development will be guided by the scientific information and technical expertise of oil industry pioneers of the 1960s and the 1970s, and the wisdom gained from the experiences of the many participants whose views and insights are recorded in this book

  19. Biosimilar Monoclonal Antibodies for Inflammatory Bowel Disease: Current Comfort and Future Prospects.

    Science.gov (United States)

    Gecse, Krisztina B; Lakatos, Péter L

    2016-10-01

    Biosimilars are biologic medicines that enter the market after a patent for an original reference product expires. The European Medicines Agency (EMA) developed a stringent legislation process for biosimilar monoclonal antibodies, whereby similarity to the reference medicinal product in terms of quality characteristics, biological activity, clinical safety and efficacy must be demonstrated. Biosimilar infliximab CT-P13 was the first biosimilar monoclonal antibody to receive EMA marketing authorization, and further biosimilar molecules are being developed. The phase I and III clinical trials were conducted in ankylosing spondylitis and rheumatoid arthritis, and the use of CT-P13 in inflammatory bowel disease (IBD) was extrapolated on the results of these trials. Medical professionals were initially concerned about the reversed engineering process, the novel legal framework and the lack of clinical data in IBD. Emerging real-world data have confirmed the similarities between CT-P13 and the reference product in terms of efficacy, safety and immunogenicity in IBD. The cost reduction represented by biosimilars promotes industry competition and improves treatment access with sustained quality of care. This article reviews the existing and emerging clinical data for CT-P13 and a future perspective on biosimilar use in IBD.

  20. An innovative treatment concept for future drinking water production: fluidized ion exchange – ultrafiltration – nanofiltration – granular activated carbon filtration

    Directory of Open Access Journals (Sweden)

    J. C. van Dijk

    2009-08-01

    Full Text Available A new treatment concept for drinking water production from surface water has been investigated on a pilot scale. The treatment concept consists of fluidized ion exchange (FIEX, ultrafiltration (UF, nanofiltration (NF, and granular activated carbon filtration (GAC. The FIEX process removed calcium and other divalent cations; the UF membrane removed particles and micro-organisms; and the NF membrane and GAC removed natural organic matter (NOM and micro-pollutants. This study focused on the prevention of fouling of the UF and scaling of the NF and investigated the overall removal of micro-pollutants by the treatment concept. The results of the experiments showed that in 14 days of continuous operation at a flux of 65 l/h m2 the UF performance was stable with the FIEX pre-treated feed water without the aid of a coagulant. The scaling of the NF was also not observed even at 97% recovery. Different micro-pollutants were spiked in the NF feed water and their concentrations in the effluent of NF and GAC were measured. The combination of NF and GAC removed most of the micro-pollutants successfully, except for the very polar substances with a molecular weight lower than 100 Daltons.

  1. Contabilización de Contratos de Futuros, Opciones, Forwards y Swaps (Accounting treatment for future, options, forwards and swap contracts

    Directory of Open Access Journals (Sweden)

    Vernor Mesén Figueroa

    2012-12-01

    Full Text Available Un entorno cada vez más dinámico y evolutivo ha dado paso al surgimiento y, por ende, al uso cada vez más frecuente de instrumentos financieros cuya flexibilidad y capacidad de ajuste a las condiciones de mercado permitan a las personas y empresas lograr sus objetivos de operación, inversión y financiamiento. En el contexto antes descrito, los contratos de futuros, opciones, forwards y swaps representan mecanismos cuyas características operativas permiten a sus tenedores el logro de objetivos alternativos tales como la cobertura eficaz de diferentes tipos de riesgos o la obtención de ganancias o pérdidas derivadas de la especulación. El presente artículo pretende reseñar, en forma breve, los mecanismos de operación de los contratos de futuros, opciones, forwards y swaps, para luego enfatizar en los criterios de contabilización que toda entidad o intermediario financiero debe seguir para reconocer los efectos que dichos tipos de contratos tienen sobre su posición financiera, resultados de operación y flujos de efectivo.   ABSTRACT A rapidly changing and evolving environment has given rise and increased the use of financial tools whose flexibility and adjusting capabilities to variable market conditions allow individuals and companies to achieve their operating, investment and financial goals. Within this framework, contracts for futures, options, forwards and swaps provide mechanisms with operating characteristics that allow their tenants to achieve alternative objectives such as the effective coverage of different risks or the attaining of profits or losses as a result of speculation. This article attempts to resume the operating mechanisms of futures, options, forwards and swap contracts and then concentrates into the accounting criteria that must be followed by financial intermediaries or entities to recognize the effects such contracts have on their financial position, operational results and cash flow.

  2. Personalized telehealth in the future

    DEFF Research Database (Denmark)

    Dinesen, B.; Nonnecke, B.; Lindeman, David

    2016-01-01

    of telehealth services and benefits, presents fundamental principles that must be addressed to advance the status quo, and provides a framework for current and future research initiatives within telehealth for personalized care, treatment, and prevention. A broad, multinational research agenda can provide...... research agenda for future telehealth applications within chronic disease management....

  3. Long-term efficacy of current thyroid prophylaxis and future perspectives on thyroid protection during 131I-metaiodobenzylguanidine treatment in children with neuroblastoma

    International Nuclear Information System (INIS)

    Clement, S.C.; Rijn, R.R. van; Eck-Smit, B.L.F. van; Trotsenburg, A.S.P. van; Caron, H.N.; Tytgat, G.A.M.; Santen, H.M. van

    2015-01-01

    Treatment with 131 I-MIBG is associated with significant thyroid damage. This study was undertaken to investigate the long-term efficacy of current thyroid prophylaxis, to explore the relationship between thyroid dysfunction and thyroid volume after exposure to 131 I-MIBG and to evaluate the possible negative effects of 131 I - on the parathyroid glands. Of 81 long-term surviving patients with neuroblastoma treated with 131 I-MIBG during the period 1999-2012, 24 were finally evaluated. Patients received thyroxine (T4), methimazole and potassium iodide as thyroid protection. In all patients (para)thyroid function was evaluated and ultrasound investigation of the (para)thyroid gland(s) was performed. Thyroid dysfunction was defined as a plasma thyrotropin concentration >5.0 mU/L (thyrotropin elevation, TE) or as the use of T4 at the time of follow-up. Hyperparathyroidism was defined as a serum calcium concentration above the age-related reference range in combination with an inappropriately high parathyroid hormone level. At a median follow-up of 9.0 years after 131 I-MIBG treatment, thyroid disorders were seen in 12 patients (50 %; 9 with TE, 5 with a thyroid nodule and 1 patient was subsequently diagnosed with differentiated thyroid carcinoma). No significant risk factors for the occurrence of thyroid damage could be identified. In 14 of 21 patients (67 %) in whom thyroid volume could be determined, the volume was considered small (<-2SD) for age and gender. Patients treated with T4 at the time of follow-up had significantly smaller thyroid volumes for age than patients without T4 treatment (p = 0.014). None of the patients was diagnosed with hyperparathyroidism. Thyroid protection during treatment with 131 I-MIBG needs attention and must be further improved, as thyroid disorders are still frequently seen despite current thyroid prophylaxis. Reduced thyroid volume in neuroblastoma survivors may be related to previous 131 I-MIBG therapy or current T4 treatment. No

  4. Long-term efficacy of current thyroid prophylaxis and future perspectives on thyroid protection during {sup 131}I-metaiodobenzylguanidine treatment in children with neuroblastoma

    Energy Technology Data Exchange (ETDEWEB)

    Clement, S.C. [University of Amsterdam, Department of Pediatric Endocrinology, Emma Children' s Hospital, Academic Medical Center, PO box 22660, Amsterdam (Netherlands); University of Amsterdam, Department of Pediatric Oncology, Emma Children' s Hospital, Academic Medical Center, Amsterdam (Netherlands); Rijn, R.R. van [University of Amsterdam, Department of Radiology, Emma Children' s Hospital, Academic Medical Center, Amsterdam (Netherlands); Eck-Smit, B.L.F. van [University of Amsterdam, Department of Nuclear Medicine, Academic Medical Center, Amsterdam (Netherlands); Trotsenburg, A.S.P. van [University of Amsterdam, Department of Pediatric Endocrinology, Emma Children' s Hospital, Academic Medical Center, PO box 22660, Amsterdam (Netherlands); Caron, H.N.; Tytgat, G.A.M. [University of Amsterdam, Department of Pediatric Oncology, Emma Children' s Hospital, Academic Medical Center, Amsterdam (Netherlands); Santen, H.M. van [Wilhelmina Children' s Hospital, University Medical Center Utrecht, Department of Pediatric Endocrinology, Utrecht (Netherlands)

    2015-04-01

    Treatment with {sup 131}I-MIBG is associated with significant thyroid damage. This study was undertaken to investigate the long-term efficacy of current thyroid prophylaxis, to explore the relationship between thyroid dysfunction and thyroid volume after exposure to {sup 131}I-MIBG and to evaluate the possible negative effects of {sup 131}I{sup -} on the parathyroid glands. Of 81 long-term surviving patients with neuroblastoma treated with {sup 131}I-MIBG during the period 1999-2012, 24 were finally evaluated. Patients received thyroxine (T4), methimazole and potassium iodide as thyroid protection. In all patients (para)thyroid function was evaluated and ultrasound investigation of the (para)thyroid gland(s) was performed. Thyroid dysfunction was defined as a plasma thyrotropin concentration >5.0 mU/L (thyrotropin elevation, TE) or as the use of T4 at the time of follow-up. Hyperparathyroidism was defined as a serum calcium concentration above the age-related reference range in combination with an inappropriately high parathyroid hormone level. At a median follow-up of 9.0 years after {sup 131}I-MIBG treatment, thyroid disorders were seen in 12 patients (50 %; 9 with TE, 5 with a thyroid nodule and 1 patient was subsequently diagnosed with differentiated thyroid carcinoma). No significant risk factors for the occurrence of thyroid damage could be identified. In 14 of 21 patients (67 %) in whom thyroid volume could be determined, the volume was considered small (<-2SD) for age and gender. Patients treated with T4 at the time of follow-up had significantly smaller thyroid volumes for age than patients without T4 treatment (p = 0.014). None of the patients was diagnosed with hyperparathyroidism. Thyroid protection during treatment with {sup 131}I-MIBG needs attention and must be further improved, as thyroid disorders are still frequently seen despite current thyroid prophylaxis. Reduced thyroid volume in neuroblastoma survivors may be related to previous {sup 131}I

  5. Future Talks,

    Directory of Open Access Journals (Sweden)

    Catherine Defeyt

    2010-11-01

    Full Text Available La conservation des matériaux modernes et les difficultés qui la caractérisent étaient l’objet du colloque international Future Talks, organisé par Die Neue Sammlung, The International Design Museum, les 22 et 23 octobre 2009 à Munich. Conservateurs-restaurateurs spécialisés, représentants des  institutions muséales les plus prestigieuses d’Europe et d’outre-Atlantique ainsi que chercheurs en sciences appliquées y ont présenté leurs travaux et recherches. En matière de design, d’art moderne e...

  6. Perspective on the future

    International Nuclear Information System (INIS)

    Warren, B.C.

    1990-01-01

    To anticipate future developments in the area of low-level radioactive waste (LLRW) management, an understanding of the following questions is necessary: what are the current regulatory policies, and What is the view toward proposed changes that affect the treatment of disposal of LLRW? The problem preventing resolution is proponents for change versus proponents for maintaining tradition. The paper discusses the author's anticipations for crises to develop prior to a decision-making mode

  7. Biologic Treatments for Sports Injuries II Think Tank-Current Concepts, Future Research, and Barriers to Advancement, Part 1: Biologics Overview, Ligament Injury, Tendinopathy.

    Science.gov (United States)

    LaPrade, Robert F; Geeslin, Andrew G; Murray, Iain R; Musahl, Volker; Zlotnicki, Jason P; Petrigliano, Frank; Mann, Barton J

    2016-12-01

    Biologic therapies, including stem cells, platelet-rich plasma, growth factors, and other biologically active adjuncts, have recently received increased attention in the basic science and clinical literature. At the 2015 AOSSM Biologics II Think Tank held in Colorado Springs, Colorado, a group of orthopaedic surgeons, basic scientists, veterinarians, and other investigators gathered to review the state of the science for biologics and barriers to implementation of biologics for the treatment of sports medicine injuries. This series of current concepts reviews reports the summary of the scientific presentations, roundtable discussions, and recommendations from this think tank. © 2016 The Author(s).

  8. The future of pain research, education, and treatment: a summary of the IOM report "Relieving pain in America: a blueprint for transforming prevention, care, education, and research".

    Science.gov (United States)

    Steglitz, Jeremy; Buscemi, Joanna; Ferguson, Molly Jean

    2012-03-01

    The fifth column on Evidence-Based Behavioral Medicine is focused on the Institute of Medicine's (IOM) report entitled "Relieving Pain in America: A Blueprint for Transforming Prevention, Care, Education, and Research." The IOM has reported that chronic pain affects 116 million American adults, which is greater than the total of heart disease, cancer, and diabetes combined. It is recommended that data collection takes place at regular intervals using standardized questions, survey protocols, and electronic medical records with the aim of the identifying the following: subpopulations at risk; characteristics of acute and chronic pain; health consequences of pain, including death, disease, and disability; and longitudinal trends of pain. In addition, health education programs should be redesigned to include information about self-management, actions to prevent injuries at the individual and community level, advocacy for pain treatment, and support for improved prevention and control policies. Through teamwork between various professions, from physicians, nurses, and psychologists to physical therapists, pharmacists, and policy makers, advancements in pain awareness, education, research, and treatment should begin to materialize.

  9. Ear Infection Treatment Shouldn't Be Shortened

    Science.gov (United States)

    ... treatments might also reduce other side effects. A new NIH-funded study provides some answers—at least for children under age 2. The study enrolled 520 children, ages 6 to 23 months, who had middle-ear infections diagnosed using stringent criteria. Kids were ...

  10. Toluene : biological waste-gas treatment, toxicity and microbial adaptation

    NARCIS (Netherlands)

    Weber, F.J.

    1995-01-01

    Due to the increasing stringent legislation concerning the emission of volatile organic compounds, there is nowadays a growing interest to apply biological waste-gas treatment techniques for the removal of higher concentrations of specific contaminants from waste gases. Fluctuations in the

  11. Microalgae for third generation biofuel production, mitigation of greenhouse gas emissions and wastewater treatment: Present and future perspectives – A mini review

    International Nuclear Information System (INIS)

    Maity, Jyoti Prakash; Bundschuh, Jochen; Chen, Chien-Yen; Bhattacharya, Prosun

    2014-01-01

    The extensive use of fossil fuels is increasingly recognized as unsustainable as a consequence of depletion of supplies and the contribution of these fuels to climate change by GHG (greenhouse gas) emissions into the atmosphere. Microalgae indicate alternative renewable sustainable energy sources as they have a high potential for producing large amounts of biomass which in turn can be used for production of different third-generation biofuels at large scale. Microalgae transform the solar energy into the carbon storage products, leads to lipid accumulation, including TAG (triacylglycerols), which then can be transformed into biodiesel, bioethanol and biomethanol. This paper reviews the selection, production and accumulation of target bioenergy carrier's strains and their advantages as well as the technological development for oil, biodiesel, ethanol, methanol, biogas production and GHG mitigation. The feedstock of promising algal strain exhibits the suitable biofuel production. The current progress of hybrid-technologies (biomass production, wastewater treatment, GHG mitigation) for production of prime-products as biofuels offer atmospheric pollution control such as the reduction of GHG (CO 2 fixation) coupling wastewater treatment with microalgae growth. The selection of efficient strain, microbial metabolism, cultivation systems, biomass production are key parameters of viable technology for microalgae-based biodiesel-production. - Highlights: • Microalgae are promising feedstock for biofuel production within lower farming area. • Production rate (L/ha) of oil from microalgae is much higher than other feedstock. • Lipid of Chlorella emersonii, Botryococcus braunii, Dunaliella tertiolecta, are high (>60% of dw biomass). • Remove pollutant from wastewater during feedstock production by selective strains. • Ecofriendly route to mitigate GHG (greenhouse gas) and water pollution during microalgae production

  12. Future food.

    Science.gov (United States)

    Wahlqvist, Mark L

    2016-12-01

    Food systems have changed markedly with human settlement and agriculture, industrialisation, trade, migration and now the digital age. Throughout these transitions, there has been a progressive population explosion and net ecosystem loss and degradation. Climate change now gathers pace, exacerbated by ecological dysfunction. Our health status has been challenged by a developing people-environment mismatch. We have regarded ecological conquest and innovative technology as solutions, but have not understood how ecologically dependent and integrated we are. We are ecological creatures interfaced by our sensoriness, microbiomes, shared regulatory (endocrine) mechanisms, immune system, biorhythms and nutritional pathways. Many of us are 'nature-deprived'. We now suffer what might be termed ecological health disorders (EHD). If there were less of us, nature's resilience might cope, but more than 9 billion people by 2050 is probably an intolerable demand on the planet. Future food must increasingly take into account the pressures on ecosystem-dependent food systems, with foods probably less biodiverse, although eating in this way allows optimal health; energy dysequilibrium with less physical activity and foods inappropriately energy dense; and less socially-conducive food habits. 'Personalised Nutrition', with extensive and resource-demanding nutrigenomic, metabolomic and microbiomic data may provide partial health solutions in clinical settings, but not be justified for ethical, risk management or sustainability reasons in public health. The globally prevalent multidimensional malnutritional problems of food insecurity, quality and equity require local, regional and global action to prevent further ecosystem degradation as well as to educate, provide sustainable livelihoods and encourage respectful social discourse and practice about the role of food.

  13. Using virtual reality to improve the efficacy of cognitive-behavioral therapy (CBT) in the treatment of late-life anxiety: preliminary recommendations for future research.

    Science.gov (United States)

    Grenier, Sébastien; Forget, Hélène; Bouchard, Stéphane; Isere, Sébastien; Belleville, Sylvie; Potvin, Olivier; Rioux, Marie-Ève; Talbot, Mélissa

    2015-07-01

    Cognitive-behavioral therapy (CBT) using traditional exposure techniques (i.e. imaginal and in vivo) seems less effective to treat anxiety in older adults than in younger ones. This is particularly true when imaginal exposure is used to confront the older patient to inaccessible (e.g. fear of flying) or less tangible/controllable anxiety triggers (e.g. fear of illness). Indeed, imaginal exposure may become less effective as the person gets older since normal aging is characterized by the decline in cognitive functions involved in the creation of vivid/detailed mental images. One way to circumvent this difficulty is to expose the older patient to a virtual environment that does not require the ability to imagine the frightening situation. In virtuo exposure has proven to be efficient to treat anxiety in working-age people. In virtuo exposure could be employed to improve the efficacy of CBT with exposure sessions in the treatment of late-life anxiety? The current paper explores this question and suggests new research avenues.

  14. The International College of Neuropsychopharmacology (CINP) Treatment Guidelines for Bipolar Disorder in Adults (CINP-BD-2017), Part 4: Unmet Needs in the Treatment of Bipolar Disorder and Recommendations for Future Research.

    Science.gov (United States)

    Fountoulakis, Konstantinos N; Vieta, Eduard; Young, Allan; Yatham, Lakshmi; Grunze, Heinz; Blier, Pierre; Moeller, Hans Jurgen; Kasper, Siegfried

    2017-02-01

    The current fourth paper on the International College of Neuropsychopharmacology guidelines for the treatment of bipolar disorder reports on the unmet needs that became apparent after an extensive review of the literature and also serves as a conclusion to the project of the International College of Neuropsychopharmacology workgroup. The systematic review of the literature that was performed to develop the International College of Neuropsychopharmacology guidelines for bipolar disorder identified and classified a number of potential shortcomings. Problems identified concerned the reliability and validity of the diagnosis of bipolar disorder and especially of bipolar depression. This, in turn, has profound consequences for early detection and correct treatment of the disorder. Another area that needs improvement is the unsatisfactory efficacy and effectiveness of therapeutic options, especially in special populations such as those with mixed features and rapid cycling course. Gender issues and adherence problems constitute an additional challenge. The literature suggests that while treatment providers are concerned more with treatment-related issues, patients and their caregivers worry more about issues pertaining to the availability of services and care, quality of life, and various types of burden. The workgroup identified additional unmet needs related to the current standard of research in bipolar disorder. These include the fragmentation of bipolar disorder into phases that are handled as being almost absolutely independent from each other, and thus the development of an overall therapeutic strategy on the basis of the existing evidence is very difficult. Trials are not always designed in a way that outcomes cover the most important aspects of bipolar disorder, and often the reporting of the results is biased and unsatisfactory. The data on combination treatments and high dosages are sparse, whereas they are common in real world practice. The workgroup endorses

  15. The future of breast cancer radiotherapy: From one size fits all to taylor-made treatment; L'avenir de la radiotherapie du cancer du sein: de la taille unique au sur-mesure

    Energy Technology Data Exchange (ETDEWEB)

    Hennequin, C. [Service de cancerologie-radiotherapie, hopital Saint-Louis, 1, avenue Claude-Vellefaux, 75475 Paris (France); Azria, D. [Departement de cancerologie radiotherapie, CRLC Val-d' Aurelle-Paul-Lamarque, rue Croix-Verte, 34298 Montpellier cedex 5 (France); Universite de Montpellier I, 5, boulevard Henri-IV, CS 19044, 34967 Montpellier cedex 2 (France); Inserm U896, institut de recherche en cancerologie de Montpellier, CRLC Val-d' Aurelle-Paul-Lamarque, rue Croix-Verte, 34298 Montpellier cedex 5 (France)

    2011-10-15

    Various subgroups of breast tumours have been identified during the last 10 years according to the risk of local relapse. Prognostic factors for local relapse are age, surgical margins, tumour size, Her2 expression and hormonal receptors status. For tumours with a high risk of local relapse, an increased in boost dose or the addition of new drugs (trastuzumab, anti-angiogenics, PARP inhibitors) could be considered. For low risk tumours, hypo-fractionated, accelerated partial breast and intraoperative radiotherapy are being evaluated. The classical schedule (45-50 Gy to the whole gland followed by a boost dose of 16 Gy) is no longer the universal rule. Treatment individualization, according to clinical and biological characteristics of the tumour and - possibly - to the radiobiological profile of the patient, is likely to be the future of breast cancer radiotherapy. (authors)

  16. Economic and environmental performance of future fusion plants in comparison

    International Nuclear Information System (INIS)

    Hamacher, T.; Saez, R.M.; Lako, P.

    2001-01-01

    If the good performance of fusion as technology with no CO 2 emission during normal operation and rather low external costs, reflecting the advantageous environmental and safety characteristics, are considered in future energy regulations, fusion can win considerable market shares in future electricity markets. The economic performance was elaborated for Western Europe for the time period till 2100. The software tool MARKAL widely used in energy research was used to simulate and optimise the development of the Western European energy system. Two different scenarios were considered, the main difference was the interest rate for investments. Stringent CO 2 -emission strategies lead to considerable market shares for fusion. As a comprehensive indicator of the environmental and safety performance of fusion plants the external costs following the ExternE method was used. External costs of fusion are rather low, much below the cost of electricity, and are in the same range as photovoltaics and wind energy. (author)

  17. [The future of ESWL].

    Science.gov (United States)

    Köhrmann, K U; Neisius, D; Rassweiler, J

    2008-05-01

    With the introduction of the Dornier HM3 lithotripter, the successful history of extracorporeal shock wave lithotripsy (ESWL) for noninvasive treatment of urinary stones began about 25 years ago. The development of newer lithotripters has not been able to improve clinical efficacy because the shock wave parameters specifically responsible for stone disintegration or tissue trauma and pain induction have not yet been identified. Actual research in lithotripter technology deals with modification of the focal point. The evolution of endoscopic procedures, ureterorenoscopy, and percutaneous nephrolithotomy took longer but was more successful in terms of clinical efficacy. Nowadays, ESWL or an endoscopic procedure is offered as a reasonable option for most urinary stone cases. Therefore, economic aspects and the surgeon's expertise will become greater factors when a procedure is chosen. ESWL, with or without anaesthesia, will be an inherent part of future treatment modalities for urinary stones.

  18. Current and future treatment options in osteoporosis.

    LENUS (Irish Health Repository)

    Brewer, Linda

    2011-04-01

    The incidence of osteoporosis-related fractures will increase substantially over the coming decades as the population ages globally. This has important economic and public health implications, contributing substantially to morbidity and excess mortality in this population.

  19. Future of obesity prevention and treatment.

    Science.gov (United States)

    Ness-Abramof, Rosane; Apovian, Caroline M

    2009-01-01

    The prevalence of obesity has risen sharply during the last 4 decades imposing a serious health burden to modern society. Obesity is known to cause and exacerbate many chronic diseases such as diabetes, hypertension, dyslipidemia, coronary heart disease, stroke, obstructive sleep apnea and certain cancers, among many others. The rise in obesity prevalence is mainly caused by overconsumption of energy, coupled to a sedentary life in susceptible individuals. Weight homeostasis is paramount for survival and its control is coordinated by neural and endocrine signals emanating from the fat tissue, digestive system and brain. During thousands of years humans were challenged by nutrient deprivation, developing an efficient mechanism to store energy. It explains the difficulty in losing weight, making obesity prevention the main effective health approach to halt the obesity epidemic.

  20. Safety evaluation of BWR off-gas treatment systems

    International Nuclear Information System (INIS)

    Schultz, R.J.; Schmitt, R.C.

    1975-01-01

    Some of the results of a safety evaluation performed on current generic types of BWR off-gas treatment systems including cooled and ambient temperature adsorber beds and cryogenics are presented. The evaluation covered the four generic types of off-gas systems and the systems of five major vendors. This study was part of original work performed under AEC contract for the Directorate of Regulatory Standards. The analysis techniques employed for the safety evaluation of these systems include: Fault Tree Analysis; FMECA (Failure Mode Effects and Criticality Analysis); general system comparisons, contaminant, system control, and design adequacy evaluations; and resultant Off-Site Dose Calculations. The salient areas presented are some of the potential problem areas, the approach that industry has taken to mitigate or design against potential upset conditions, and areas where possible deficiencies still exist. Potential problem areas discussed include hydrogen detonation, hydrogen release to equipment areas, operator/automatic control interface, and needed engineering evaluation to insure safe system operation. Of the systems reviewed, most were in the category of advanced or improved over that commonly in use today, and a conclusion from the study was that these systems offer excellent potential for noble gas control for BWR power plants where more stringent controls may be specified -- now or in the future. (U.S.)

  1. FutureCoast: "Listen to your futures"

    Science.gov (United States)

    Pfirman, S. L.; Eklund, K.; Thacher, S.; Orlove, B. S.; Diane Stovall-Soto, G.; Brunacini, J.; Hernandez, T.

    2014-12-01

    Two science-arts approaches are emerging as effective means to convey "futurethinking" to learners: systems gaming and experiential futures. FutureCoast exemplifies the latter: by engaging participants with voicemails supposedly leaking from the cloud of possible futures, the storymaking game frames the complexities of climate science in relatable contexts. Because participants make the voicemails themselves, FutureCoast opens up creative ways for people to think about possibly climate-changed futures and personal ways to talk about them. FutureCoast is a project of the PoLAR Partnership with a target audience of informal adult learners primarily reached via mobile devices and online platforms. Scientists increasingly use scenarios and storylines as ways to explore the implications of environmental change and societal choices. Stories help people make connections across experiences and disciplines and link large-scale events to personal consequences. By making the future seem real today, FutureCoast's framework helps people visualize and plan for future climate changes. The voicemails contributed to FutureCoast are spread through the game's intended timeframe (2020 through 2065). Based on initial content analysis of voicemail text, common themes include ecosystems and landscapes, weather, technology, societal issues, governance and policy. Other issues somewhat less frequently discussed include security, food, industry and business, health, energy, infrastructure, water, economy, and migration. Further voicemail analysis is examining: temporal dimensions (salient time frames, short vs. long term issues, intergenerational, etc.), content (adaptation vs. mitigation, challenges vs. opportunities, etc.), and emotion (hopeful, resigned, etc. and overall emotional context). FutureCoast also engaged audiences through facilitated in-person experiences, geocaching events, and social media (Tumblr, Twitter, Facebook, YouTube). Analysis of the project suggests story

  2. ENLIGHT envisions its future

    CERN Multimedia

    Antonella Del Rosso

    2015-01-01

    Last week, the European Network for LIGht-ion Hadron Therapy (ENLIGHT) met in Cracow to discuss how to best imagine its future. Over its 13 years of life, the network has succeeded in blending traditionally separate scientific communities with the common goal of more effective treatments against cancer and improving patient outcome.   Group photo of the ENLIGHT members participating in the network's annual meeting, held in Cracow on 18-19 September, 2015. Today, ENLIGHT includes over 300 members from more than 20 countries. Clinicians, physicists, biologists and engineers with experience and interest in particle therapy are working in unison under the network’s umbrella. ENLIGHT has run four EU-funded projects – ULICE, PARTNER, ENVISION and ENTERVISION – and has managed to gather experts from the various fields to design common strategies to fight cancer with particles. “ENLIGHT has worked as an open collaborative network ...

  3. NOx emissions trading: Precursor to future growth

    International Nuclear Information System (INIS)

    Colella, A.

    1993-01-01

    Title I of the Clean Air Act Amendments (CAAA) of 1990 specified the framework for enhanced regulation in ozone non-attainment areas with increasingly stringent requirements dependent on the area classification - marginal, moderate, serious, severe or extreme. Before the CAAA were passed, only volatile organic compounds (VOCs) were regulated as precursors to ozone formation, Now, by statute, emissions of nitrogen oxides (NO x ) are also regulated as ozone precursor. Under the CAAA, new sources and modifications of existing sources are subject to Title I permitting requirements in ozone non-attainment areas if emissions of NO x and/or VOCs exceed certain triggering levels. For many new or facility expansion projects, especially power generation, the NO x thresholds are easily exceeded thus triggering Title I non-attainment new source review which requires application of control technology to new equipment which results in the Lowest Achievable Emission Rate (LAER), and securing emission reductions either internally or from other major sources to offset the increased emission from the new or modified source. The selection of a LAER technology is generally within an applicant's control. An applicant can determine up-front the engineering and cost considerations associated with LAER technology is assessing a project's viability. However, without a clear source of emission offsets of a means to secure them, assessing project viability could be difficult if not impossible. No available emission offsets means no industrial growth. For sources of NO x undergoing Title I new source review, a regional or state banking system that facilitates NO x emissions trading is needed as a precursor to future growth. This paper presents an overview of EPA's Emissions Trading Policy and Title I new source review offset provisions. Industry's concerns about emissions trading and recommendations for future trading programs are presented

  4. Evidence-Based Psychosocial Treatments for Child and Adolescent Bipolar Spectrum Disorders

    Science.gov (United States)

    Fristad, Mary A.; MacPherson, Heather A.

    2013-01-01

    Objective Pediatric bipolar spectrum disorders (BPSDs) are serious conditions associated with morbidity and mortality. Although most treatment research examined pharmacotherapy for pediatric BPSDs, growing literature suggests that psychosocial interventions are also important to: provide families with an understanding of symptoms, course, and treatment of BPSDs; teach youth and parents methods for coping with symptoms (e.g., problem-solving, communication, cognitive-behavioral skills); and prevent relapse. Method Thirteen psychosocial intervention trials for pediatric BPSDs were identified via a comprehensive literature search and evaluated according to the Task Force on the Promotion and Dissemination of Psychological Procedures guidelines. All interventions were examined adjunctive to pharmacotherapy and/or treatment as usual (TAU). Results No well-established or questionably efficacious treatments were identified. Family psychoeducation plus skill building was probably efficacious (i.e., Multi-Family Psychoeducational Psychotherapy, Family-Focused Treatment); cognitive-behavioral therapy (CBT) was possibly efficacious. Dialectical behavior therapy (DBT) and interpersonal and social rhythm therapy (IPSRT) were experimental. Limited research precluded subdivision of treatments by format and age. Only single- and multiple-family psychoeducation plus skill building and CBT were evaluated with children. Only single-family psychoeducation plus skill building and DBT, and individual (commonly with limited familial involvement) CBT and IPSRT were evaluated with adolescents. Conclusions Psychosocial interventions that involve families, psychoeducation, and skill building may offer added benefit to pharmacotherapy and/or other TAU. Limitations of current research include few outcome studies, small samples, and failure to use stringent control conditions or randomization. The review concludes with a discussion of mediators and moderators, recommendations for best practice

  5. The Future Multiple

    DEFF Research Database (Denmark)

    Spaniol, Matthew Jon; Rowland, Nicholas James

    2015-01-01

    /value – The original contribution is in demonstrating how plural futures and the singular future co-exist in practice. Thus, an eclipse of the future by futures can only ever be partial. For “futures” to be conceptually potent, “the future” must be at least provisionally believable and occasionally useful. Otherwise......, if “the future” were so preposterous an idea, then “futures” would cease to be a critical alternative to it. Futures needs the future; they are relationally bound together in a multiplicity. This paper considers what such a logical reality implies for a field that distances itself from the future and self......). Multiplicity, as a post-ANT sensibility, helps one make sense of the empirical materials. This paper examines the possibility that rather than being alternatives to one another, plural futures and the singular future might co-exist in practice, and, thus, constitute a multiplicity. Design...

  6. The Future of Pediatric Obesity.

    Science.gov (United States)

    Hutchinson, Jeff; Emerick, Jill; Saxena, Harshita

    2016-03-01

    The National Health and Nutrition Examination Survey from the Centers for Disease Control and Prevention reports a steady increase in obesity over the last 30 years. The greatest increase was seen in 15 to 19 year olds, whose obesity prevalence almost doubled from 10.5% to 19.4%. The solution to pediatric obesity requires a multidisciplinary approach addressing cultural norms, technologic advances, and family engagement. Future treatment strategies to combat the obesity epidemic will have to extend beyond the health care provider's office. Behavior modification remains the key component to pediatric obesity prevention and treatment. Published by Elsevier Inc.

  7. Neuroprotección en la encefalopatia hipóxico isquémica perinatal: Tratamientos con eficacia clínica demostrada y perspectivas futuras Neuroprotection in perinatal hypoxic-ischemic encephalopathy: Effective treatment and future perspectives

    Directory of Open Access Journals (Sweden)

    Agustín Legido

    2007-01-01

    present the future perspectives of other clinical and basic research investigations. Therapies with demonstrated clinical efficacy: Allopurinol: It blocks the production of free radicals following hypoxia-ischemia. In a recent study, infants with hypoplastic left heart syndrome treated with allopurinol, but not those with other congenital cardiopathies, had significantly less number of complications than controls, including death, seizures, coma or cardiac events. Opioids: In another recent study, newborns with HIE treated with morphine or phentanyl, had less severe brain damage on MRI and a better neurological outcome. Hypothermia: Both local (head cooling or systemic (whole body hypothermia have a neuroprotective effect in selected newborns with HIE, Future perspectives: Antiepileptic drugs. They have multiple mechanisms of action that can block the biochemical cascade of neuronal damage in HIE. Other therapeutic modalities. Among them the following should be emphasized: combined neuroprotective treatments, growth factors, genetic therapies, stem cell transplant, and neuroprotective immunization. In conclusión, a better knowledge of the molecular mechanisms of HIE pathogenesis and better clinical studies of neuroprotective therapies will open new possibilities aplicable to clinical practice. These advances will undoubtedly improve the prognosis of newborns with HIE.

  8. Making the Future Palpable

    DEFF Research Database (Denmark)

    Büscher, Monika; Kristensen, Margit; Mogensen, Preben Holst

    2007-01-01

    In this paper we describe experiences from a Future Laboratory. Future laboratories allow users to experiment with prototypes of future technologies in as realistic as possible conditions. We have devised this method because, to realize the potential of advanced ubiquitous computing technologies...... it is essential to anticipate and design for future practices, but for prospective users it is often difficult to imagine and articulate future practices and provide design specifications. They readily invent new ways of working in engagement with new technologies, through and, by facilitating as realistic...... as possible use of prototype future technologies in Future Laboratories designers and users can define and study both opportunities and constraints for design. We present 11 scenes from a Major Incidents Future Laboratory held in September 2005. In relation to each scene we point out key results. Many raise...

  9. Future accelerators: physics issues

    International Nuclear Information System (INIS)

    Bjorken, J.D.

    1977-11-01

    High energy physics of the future using future accelerators is discussed. The proposed machines and instruments, physics issues and opportunities including brief sketches of outstanding recent results, and the way the proposed machines address these issues are considered. 42 references

  10. Money market futures

    OpenAIRE

    Anatoli Kuprianov

    1992-01-01

    Virtually all financial innovation in the U.S. money market during the past 20 years has centered on interest rate derivatives, including futures and swaps. Furthermore, money market futures--especially futures contracts on Eurodollar time deposits--have been at the vanguard of the recent explosion of trading activity in interest rate derivatives. While futures markets traditionally have been viewed as markets for the transfer of price risk, recent research shows that they may serve other imp...

  11. Greening the Future

    Science.gov (United States)

    Williamson, Norma Velia

    2011-01-01

    Because educators vicariously touch the future through their students, the author believes that they sometimes have the uncanny ability to see the future. One common future forecast is the phenomenal growth of green jobs in the emerging green economy, leading to the creation of the "Reach of the Sun" Solar Energy Academy at La Mirada…

  12. Future planning - utopia

    International Nuclear Information System (INIS)

    Boernke, F.

    1978-01-01

    Our life develops as the anticipation of future. Everything we wish, hope, plan and carry out and think is or should be related to future and will have its effects in future. The certainty may spread that it is a necessary obligation to learn to find out our actual being more clearly to be able to develop a thinking and acting that is directed to future that has also a total of responsability as its essence. We will later atone for the failed outlooks into future or for only moderate or uncompleted starts of planning. For this reason we should consider that future does not come for its own, not without our demands, not without our acting. Only if our reflection and aspiration, thinking and acting is done with moderate and circumspect sense in the right way it will be a good fundamental for the future. (orig.) [de

  13. Detecting Chemical Weapons: Threats, Requirements, Solutions, and Future Challenges

    Science.gov (United States)

    Boso, Brian

    2011-03-01

    Although chemicals have been reportedly used as weapons for thousands of years, it was not until 1915 at Ypres, France that an industrial chemical, chlorine, was used in World War I as an offensive weapon in significant quantity, causing mass casualties. From that point until today the development, detection, production and protection from chemical weapons has be an organized endeavor of many of the world's armed forces and in more recent times, non-governmental terrorist organizations. The number of Chemical Warfare Agents (CWAs) has steadily increased as research into more toxic substances continued for most of the 20 th century. Today there are over 70 substances including harassing agents like tear gas, incapacitating agents, and lethal agents like blister, blood, chocking, and nerve agents. The requirements for detecting chemical weapons vary depending on the context in which they are encountered and the concept of operation of the organization deploying the detection equipment. The US DoD, for example, has as a requirement, that US forces be able to continue their mission, even in the event of a chemical attack. This places stringent requirements on detection equipment. It must be lightweight (developed for this application, including, but not limited to: mass spectroscopy, IR spectroscopy, RAMAN spectroscopy, MEMs micro-cantilever sensors, surface acoustic wave sensors, differential mobility spectrometry, and amplifying fluorescence polymers. In the future the requirements for detection equipment will continue to become even more stringent. The continuing increase in the sheer number of threats that will need to be detected, the development of binary agents requiring that even the precursor chemicals be detected, the development of new types of agents unlike any of the current chemistries, and the expansion of the list of toxic industrial chemical will require new techniques with higher specificity and more sensitivity.

  14. Investigators' viewpoint of clinical trials in India: Past, present and future

    Directory of Open Access Journals (Sweden)

    Mohandas K Mallath

    2017-01-01

    Full Text Available India's success in producing food and milk for its population (Green Revolution and White Revolution happened because of scientific research and field trials. Likewise improving the health of Indians needs clinical research and clinical trials. A Large proportion of the sick Indians are poor, illiterate with no access to good health care. They are highly vulnerable to inducement and exploitation in clinical trials. The past two decades saw the rise and fall of clinical trials in India. The rise happened when our regulators created a favorable environment, and Indian investigators were invited to participate in global clinical trials. The gap between the demand and supply resulted in inadequate protection of the trial participants. Reports of abuses of the vulnerable trial participants followed by public interest litigations led to strengthening of regulations by the regulators. The stringent new regulations made the conduct of clinical trials more laborious and increased the cost of clinical trials in India. There was a loss of interest in sponsored clinical trials resulting in the fall in global clinical trials in India. Following repeated appeals by the investigators, the Indian regulators have recently relaxed some of the stringent regulations, while continuing to ensure the adequate patient protection. Clinical trials that are relevant to our population and conducted by well-trained investigators and monitored by trained and registered Ethics Committees will increase in the future. We must remain vigilant, avoid previous mistakes, and strive hard to protect the trial participants in the future trials.

  15. Governance of the future

    DEFF Research Database (Denmark)

    Galløe, Lotte Rannveig

    a different future for both parents and children. Thus, the approach to PMTO as a technology of the future indicates its expected prevalence in the future and its attempt to reach in to the future becoming of the child. The technology’s involvement of the relatives and its orientation towards shaping......In my presentation I will explore the concept, ‘technology of the future’, in public governance. Public governance within social services aims at changing the existing conditions for the marginalized citizens including children with special needs. I pose the question: what happens if public...... governance seek to chance the possible future conditions and targets the marginalized child’s relatives? Parent Management Training (PMTO) is studied as a technology of the future that expands and transforms governance. PMTO targets parents with aggressive and asocial children and aims to “create the parent...

  16. Future-Oriented LCA

    DEFF Research Database (Denmark)

    Olsen, Stig Irving; Borup, Mads; Andersen, Per Dannemand

    2018-01-01

    LCA is often applied for decision-making that concerns actions reaching near or far into the future. However, traditional life cycle assessment methodology must be adjusted for the prospective and change-oriented purposes, but no standardised way of doing this has emerged yet. In this chapter some...... challenges are described and some learnings are derived. Many of the future-oriented LCAs published so far perform relatively short-term prediction of simple comparisons. But for more long-term time horizons foresight methods can be of help. Scenarios established by qualified experts about future...... technological and economic developments are indispensable in future technology assessments. The uncertainties in future-oriented LCAs are to a large extent qualitative and it is important to emphasise that LCA of future technologies will provide a set of answers and not ‘the’ answer....

  17. Future carbon regulations and current investments in alternative coal-fired power plant technologies

    International Nuclear Information System (INIS)

    Sekar, Ram C.; Parsons, John E.; Herzog, Howard J.; Jacoby, Henry D.

    2007-01-01

    We analyze how uncertain future US carbon regulations shape the current choice of the type of power plant to build. Our focus is on two coal-fired technologies, pulverized coal (PC) and integrated coal gasification combined cycle technology (IGCC). The PC technology is cheapest-assuming there is no need to control carbon emissions. The IGCC technology may be cheaper if carbon must be captured. Since power plants last many years and future regulations are uncertain, a US electric utility faces a standard decision under uncertainty. A company will confront the range of possible outcomes, assigning its best estimate of the probability of each scenario, averaging the results and determining the power plant technology with the lowest possible cost inclusive of expected future carbon related costs, whether those costs be in the form of emissions charges paid or capital expenditures for retrofitting to capture carbon. If the company assigns high probability to no regulation or to less stringent regulation of carbon, then it makes sense for it to build the PC plant. But if it assigns sufficient probability to scenarios with more stringent regulation, then the IGCC technology is warranted. We provide some useful benchmarks for possible future regulation and show how these relate back to the relative costs of the two technologies and the optimal technology choice. Few of the policy proposals widely referenced in the public discussion warrant the choice of the IGCC technology. Instead, the PC technology remains the least costly. However, recent carbon prices in the European Emissions Trading System are higher than these benchmarks. If it is any guide to possible future penalties for emissions in the US, then current investment in the IGCC technology is warranted. Of course, other factors need to be factored into the decision as well

  18. Evidence-Base Update of Psychosocial Treatments for Child and Adolescent Depression

    Science.gov (United States)

    Weersing, V. Robin; Jeffreys, Megan; Do, Minh-Chau T.; Schwartz, Karen T. G.; Bolano, Carl

    2017-01-01

    Depression in youth is prevalent and disabling and tends to presage a chronic and recurrent course of illness and impairment in adulthood. Clinical trial research in youth depression has a 30 year history, and evidence-based treatment reviews appeared in 1998 and 2008. The current review of 42 randomized controlled trials (RCTs) updates these reviews to include RCTs published between 2008 and 2014 (N = 14) and re-evaluates previously reviewed literature. Given the growing maturity of the field, this review utilized a stringent set of methodological criteria for trial inclusion, most notable for excluding trials based in sub-clinical samples of youth that had been included in previous reviews (N = 12) and including well-designed RCTs with null and negative findings (N = 8). Findings from the current review suggest that evidence for child treatments is notably weaker than for adolescent interventions, with no child treatments achieving well-established status and the evidentiary basis of treatments downgraded from previous reports. Cognitive behavioral therapy (CBT) for clinically depressed children appears to be possibly efficacious, with mixed findings across trials. For depressed adolescents, both CBT and Interpersonal Psychotherapy (IPT) are well-established interventions, with evidence of efficacy in multiple trials by independent investigative teams. This positive conclusion is tempered by the small size of the IPT literature (N = 6) and concern that CBT effects may be attenuated in clinically complicated samples and when compared against active control conditions. In conclusion, data on predictors, moderators, and mediators are examined and priorities for future research discussed. PMID:27870579

  19. Evidence Base Update of Psychosocial Treatments for Child and Adolescent Depression.

    Science.gov (United States)

    Weersing, V Robin; Jeffreys, Megan; Do, Minh-Chau T; Schwartz, Karen T G; Bolano, Carl

    2017-01-01

    Depression in youth is prevalent and disabling and tends to presage a chronic and recurrent course of illness and impairment in adulthood. Clinical trial research in youth depression has a 30-year history, and evidence-based treatment reviews appeared in 1998 and 2008. The current review of 42 randomized controlled trials (RCTs) updates these reviews to include RCTs published between 2008 and 2014 (N = 14) and reevaluates previously reviewed literature. Given the growing maturity of the field, this review utilized a stringent set of methodological criteria for trial inclusion, most notable for excluding trials based in subclinical samples of youth that had been included in previous reviews (N = 12) and including well-designed RCTs with null and negative findings (N = 8). Findings from the current review suggest that evidence for child treatments is notably weaker than for adolescent interventions, with no child treatments achieving well-established status and the evidentiary basis of treatments downgraded from previous reports. Cognitive behavioral therapy (CBT) for clinically depressed children appears to be possibly efficacious, with mixed findings across trials. For depressed adolescents, both CBT and interpersonal psychotherapy are well-established interventions, with evidence of efficacy in multiple trials by independent investigative teams. This positive conclusion is tempered by the small size of the interpersonal psychotherapy literature (N = 6) and concern that CBT effects may be attenuated in clinically complicated samples and when compared against active control conditions. Data on predictors, moderators, and mediators are examined and priorities for future research discussed.

  20. Considering a healthy future

    NARCIS (Netherlands)

    Beek, van Jannette

    2016-01-01

    Trade-offs between current and future consequences are characteristic for the domain of health behavior. Therefore, both eating and exercising behavior could be determined by time orientation, which refers to an individual’s general orientation toward the present or the future. The main aim of

  1. Mobile energy sharing futures

    DEFF Research Database (Denmark)

    Worgan, Paul; Knibbe, Jarrod; Plasencia, Diego Martinez

    2016-01-01

    We foresee a future where energy in our mobile devices can be shared and redistributed to suit our current task needs. Many of us are beginning to carry multiple mobile devices and we seek to re-evaluate the traditional view of a mobile device as only accepting energy. In our vision, we can...... sharing futures....

  2. The Future as Fiction.

    Science.gov (United States)

    Jennings, Lane

    Because good future studies and good fiction have a great deal in common, futurists need to recognize and apply the skills of word artists from all genres, particularly novelists and short-story writers. One form of science fiction that futurists could use is the scenario, which is an exploration of an alternative future. A good scenario should be…

  3. Framework for the Future

    Science.gov (United States)

    Schuller, Tom

    2008-01-01

    The main goal of the Inquiry into the Future for Lifelong Learning is to provide a "strategic framework" for the future. In this article, the author considers the key components that will make up the framework. These are: (1) a statement of vision and values; (2) a stock-take of the current position; (3) an "investment…

  4. (Some) Computer Futures: Mainframes.

    Science.gov (United States)

    Joseph, Earl C.

    Possible futures for the world of mainframe computers can be forecast through studies identifying forces of change and their impact on current trends. Some new prospects for the future have been generated by advances in information technology; for example, recent United States successes in applied artificial intelligence (AI) have created new…

  5. Summaries and future projections

    International Nuclear Information System (INIS)

    Egelstaff, P.A.

    1989-01-01

    In this paper the author gives a brief summary of this meeting. He discusses the status at the current neutron sources and future sources. The current problems with targets, moderators, performance of storage rings and shields are briefly mentioned. Finally, he speculates on the prospects of neutron sources for the future and gives his version of the ultimate source

  6. Portfolio Diversification with Commodity Futures: Properties of Levered Futures

    NARCIS (Netherlands)

    Woodard, J.D.; Egelkraut, T.M.; Garcia, P.; Pennings, J.M.E.

    2005-01-01

    Portfolio Diversification with Commodity Futures: Properties of Levered Futures This study extends previous work on the impact of commodity futures on portfolio performance by explicitly incorporating levered futures into the portfolio optimization problem. Using data on nine individual commodity

  7. New technologies of silicon position-sensitive detectors for future tracker systems

    CERN Document Server

    Bassignana, Daniela; Lozano, M

    In view of the new generation of high luminosity colliders, HL-LHC and ILC, a farther investigation of silicon radiation detectors design and technology is demanded, in order to satisfy the stringent requirements of the experiments at such sophisticated machines. In this thesis, innovative technologies of silicon radiation detectors for future tracking systems are proposed. Three dierent devices have been studied and designed with the help of dierent tools for computer simulations. They have been manufactured in the IMB-CNM clean room facilities in Barcelona and characterized with proper experimental set-ups in order to test the detectors capabilities and the quality and suitability of the technologies used for their fabrication. The rst technology deals with the upgrade of dedicated sensors for laser alignment systems in future tracker detectors. The design and technology of common single-sided silicon microstrip detectors have been slightly modied in order to improve IR light transmittance of the devices. T...

  8. Treatment, Processing and Future Disposal of Radioactive Wastes at the Idaho Chemical Processing Plant; Traitement et Elimination Future des Dechets Radioactifs a l'Usine de Traitement Chimique de L'Idaho; 0410 041d 0414 ; Tratamiento y Evacuacion de Desechos Radiactivos en la Planta de Tratamiento Quimico de Idaho

    Energy Technology Data Exchange (ETDEWEB)

    Stevens, James I. [Phillips Petroleum Company, Atomic Energy Division, Idaho Falls (United States)

    1960-07-01

    Acidic wastes from the recovery of enriched uranium from aluminium, zirconium, and stainless-steel fuels at the Idaho Chemical Processing Plant are stored in underground tanks of two configurations and nominal sizes of 30,000 and 300,000 gallons. The design and operation of the waste-tank farm as well as the methods of environmental disposal of low-level wastes is described. The ''concentrate and contain'' philosophy of waste disposal has as its ultimate aim the production of a solid mass containing the fission products. The disadvantage of increased treatment costs may or may not be offset by reduction in storage costs. The low thermal conductivity of solids makes storage temperature considerations more important than for liquids. The acid aluminium nitrate wastes from the processing of fuels of the Material Testing Reactor type may be converted to granular alumina by calcining in a fluidized bed from 350 Degree-Sign to 550 Degree-Sign C. The major process components are the NaK heated calciner, an off-gas cleaning system and the solids storage vessels. The process design and the research and development programme are reviewed. On the basis of the successful demonstration of fluidized-bed calcining and high-temperature solids storage in conjunction with other considerations, a number of future storage concepts and their environmental connotations are discussed. (author) [French] A l'usine de traitement chimique de l'Idaho, les dechets acides provenant de la recuperation de l'uranium enrichi contenu dans les cartouches de combustible en aluminium, zirconium, et acier inoxydable sont stockes dans des reservoirs souterrains de deux formes differentes et d'une capacite theorique de 30,000 et de 300,000 gallons. L'auteur donne une description du plan et du fonctionnement de l'annexe ou se trouvent les reservoirs a dechets, ainsi que des methodes d'elimination des dechets de faible activite dans le milieu ambiant. Le but meme du systeme qui consiste a concentrer et a

  9. Research review: the role of diet in the treatment of attention-deficit/hyperactivity disorder--an appraisal of the evidence on efficacy and recommendations on the design of future studies

    NARCIS (Netherlands)

    Stevenson, J.; Buitelaar, J.K.; Cortese, S.; Ferrin, M.; Konofal, E.; Lecendreux, M.; Simonoff, E.; Wong, I.C.; Sonuga-Barke, E.

    2014-01-01

    BACKGROUND: The efficacy of three dietary treatments for ADHD has been repeatedly tested in randomized controlled trials (RCTs). These interventions are restricted elimination diets (RED), artificial food colour elimination (AFCE) and supplementation with free fatty acids (SFFA). There have been

  10. The future of the electric utility industry in Canada

    International Nuclear Information System (INIS)

    Threlkeld, R.

    1995-01-01

    A discussion of future changes in the electric power utility industry in Canada was presented. The impacts of deregulation were considered, including increased competition, and reduced profits resulting from it. Restructuring measures taken by BC Hydro to prepare for industry changes were described. Competition was not only expected to result from new electric utilities, but also gas utilities that are establishing themselves in the home heating business. Emphasis was placed on making the utilities' priorities, the same as their customers'. Flexibility of rate scheduling and increased dependence on customer-owned generation were needed to remain competitive. Exportation of surplus electricity and development of power utilities in developing nations was considered as a potentially lucrative development strategy. It was suggested that making use of strategic alliances within Canada and worldwide, will help to keep utilities ahead of the competition. A warning was issued to the effect that environmental concerns must always be considered well in advance of regulations since they are continually becoming more stringent. Making common cause with customers, and continuous improvement were considered to be the most important keys to future success for the industry

  11. Anaerobic treatment for C and S removal in 'zero-discharge' paper mills: effects of process design on S removal efficiencies.

    NARCIS (Netherlands)

    Lier, van J.B.; Lens, P.N.L.; Hulshoff Pol, L.W.

    2001-01-01

    Stringent environmental laws in Europe and Northern America lead to the development towards closure of the process water streams in pulp and paper mills. Application of a "zero-discharge" process is already a feasible option for the board and packaging paper industry, provided in-line treatment is

  12. Future Transient Testing of Advanced Fuels

    Energy Technology Data Exchange (ETDEWEB)

    Jon Carmack

    2009-09-01

    The transient in-reactor fuels testing workshop was held on May 4–5, 2009 at Idaho National Laboratory. The purpose of this meeting was to provide a forum where technical experts in transient testing of nuclear fuels could meet directly with technical instrumentation experts and nuclear fuel modeling and simulation experts to discuss needed advancements in transient testing to support a basic understanding of nuclear fuel behavior under off-normal conditions. The workshop was attended by representatives from Commissariat à l'Énergie Atomique CEA, Japanese Atomic Energy Agency (JAEA), Department of Energy (DOE), AREVA, General Electric – Global Nuclear Fuels (GE-GNF), Westinghouse, Electric Power Research Institute (EPRI), universities, and several DOE national laboratories. Transient testing of fuels and materials generates information required for advanced fuels in future nuclear power plants. Future nuclear power plants will rely heavily on advanced computer modeling and simulation that describes fuel behavior under off-normal conditions. TREAT is an ideal facility for this testing because of its flexibility, proven operation and material condition. The opportunity exists to develop advanced instrumentation and data collection that can support modeling and simulation needs much better than was possible in the past. In order to take advantage of these opportunities, test programs must be carefully designed to yield basic information to support modeling before conducting integral performance tests. An early start of TREAT and operation at low power would provide significant dividends in training, development of instrumentation, and checkout of reactor systems. Early start of TREAT (2015) is needed to support the requirements of potential users of TREAT and include the testing of full length fuel irradiated in the FFTF reactor. The capabilities provided by TREAT are needed for the development of nuclear power and the following benefits will be realized by

  13. Future Transient Testing of Advanced Fuels

    International Nuclear Information System (INIS)

    Carmack, Jon

    2009-01-01

    The transient in-reactor fuels testing workshop was held on May 4-5, 2009 at Idaho National Laboratory. The purpose of this meeting was to provide a forum where technical experts in transient testing of nuclear fuels could meet directly with technical instrumentation experts and nuclear fuel modeling and simulation experts to discuss needed advancements in transient testing to support a basic understanding of nuclear fuel behavior under off-normal conditions. The workshop was attended by representatives from Commissariat energie Atomique CEA, Japanese Atomic Energy Agency (JAEA), Department of Energy (DOE), AREVA, General Electric - Global Nuclear Fuels (GE-GNF), Westinghouse, Electric Power Research Institute (EPRI), universities, and several DOE national laboratories. Transient testing of fuels and materials generates information required for advanced fuels in future nuclear power plants. Future nuclear power plants will rely heavily on advanced computer modeling and simulation that describes fuel behavior under off-normal conditions. TREAT is an ideal facility for this testing because of its flexibility, proven operation and material condition. The opportunity exists to develop advanced instrumentation and data collection that can support modeling and simulation needs much better than was possible in the past. In order to take advantage of these opportunities, test programs must be carefully designed to yield basic information to support modeling before conducting integral performance tests. An early start of TREAT and operation at low power would provide significant dividends in training, development of instrumentation, and checkout of reactor systems. Early start of TREAT (2015) is needed to support the requirements of potential users of TREAT and include the testing of full length fuel irradiated in the FFTF reactor. The capabilities provided by TREAT are needed for the development of nuclear power and the following benefits will be realized by the

  14. Focus on the future

    International Nuclear Information System (INIS)

    Hanner, M.S.

    1988-01-01

    An assessment is made of what was learned from Halley and recommendations are made for future directions for infrared studies of comets and supporting lab investigations. The following issues are addressed: (1) What steps can be taken to achieve consistent interpretation of Halley infrared data; (2) How successful has the Halley Watch been for infrared studies; (3) What supporting lab research is needed; (4) What are the key infrared observations needed for future comets; and (5) How do current and future NASA programs relate to comet studies

  15. Back to the futures

    International Nuclear Information System (INIS)

    Ahrens, F.

    1991-01-01

    A futures contract simply is this: an agreement to buy or sell a certain amount of a certain item for an agreed-upon price at some time in the future - for instance, an agreement to buy 10,000 million British thermal units (MMBtu) of natural gas six months from now at $2.00 per MMBtu. Futures contracts are used for commodities that experience a great deal of price volatility. The gas industry, like the wheat farmer, also has concerns about price volatility

  16. Crystallization of a stringent response factor from Aquifex aeolicus

    DEFF Research Database (Denmark)

    Kristensen, Ole; Laurberg, Martin; Gajhede, Michael

    2002-01-01

    a = 50.8, b = 70.3, c = 90.9 A. Methionine residues were introduced by mutation and deliberate oxidation of the protein allowed us to produce additional crystal forms with reproducible diffraction ability and increased phasing potential. This is the first report on the crystallization of a member...

  17. Stringent cost management and preservation of safety culture, a contradiction?

    International Nuclear Information System (INIS)

    Petersen, Klaus; Pamme, H.

    2002-01-01

    Full text: Competition in the deregulated electricity market does not leave nuclear power plants unaffected. Hence the question is to answer, whether the safety is going to suffer under the cost pressure on the market. Therefore the target of NPP operator's cost management is to run plants at maximum availability and with optimized cost structures that lead to minimized specific generating costs. The c osts of safety , with their fixed-cost character, are elements of this cost structure. The process of economic optimization of the cost structure does not permit cost minimization on its own sake in the area of operation cost and fuel cost (front and back end). The basis of economical assessment rather must be the minimization of potential risks which could entail losses of availability. However, many investments like plant modifications or preventive maintenance efforts made in order to avoid losses of availability to a large extent also imply at least a preservation or even higher levels of safety. Thus, economic efficiency and safety are closely correlated. Public opinion is very sensible as soon as the high level of plant safety seems to be touched by economic pressure. But realizing that German NPP are endowed with mature design and safety features, improvements of safety standards can only marginally be increased by further technical optimizations. Therefore plant management, man-machine-interface and the individual behaviour of the employees are targets for improvement of nuclear safety and economic efficiency by increasing the efficiency of processes. An even more efficient use of scarce funds and a tolerable political environment should allow the safety level of NPP to be upheld, and safety culture could be maintained and even be improved. (author)

  18. The effect of increasingly stringent diagnostic criteria on sex ...

    African Journals Online (AJOL)

    The male/female ratio rose from 1.6 among those meeting the CATEGO 'broad' criteria for schizophrenia to 3.7 among those satisfying DSM-III criteria. Of 76 women meeting the former criteria, 53 were excluded by the latter, the majority rediagnosed as affective or schizo-affective psychosis. Consequently, although women ...

  19. Futures markets, cognitive ability, and mispricing in experimental asset markets

    NARCIS (Netherlands)

    Noussair, Charles; Tucker, Steven; Xu, Yilong

    2016-01-01

    We study the effect of a futures market, in which contracts maturing in the last period of the life of the asset can be traded. Our experiment has two treatments, one in which a spot market operates on its own, and a second treatment, in which a spot and a futures market are active simultaneously.

  20. Future pharmacological therapy in hypertension.

    Science.gov (United States)

    Stewart, Merrill H; Lavie, Carl J; Ventura, Hector O

    2018-04-26

    Hypertension (HTN) is a widespread and growing disease, with medication intolerance and side-effect present among many. To address these obstacles novel pharmacotherapy is an active area of drug development. This review seeks to explore future drug therapy for HTN in the preclinical and clinical arenas. The future of pharmacological therapy in HTN consists of revisiting old pathways to find new targets and exploring wholly new approaches to provide additional avenues of treatment. In this review, we discuss the current status of the most recent drug therapy in HTN. New developments in well trod areas include novel mineralocorticoid antagonists, aldosterone synthase inhibitors, aminopeptidase-A inhibitors, natriuretic peptide receptor agonists, or the counter-regulatory angiotensin converting enzyme 2/angiotensin (Ang) (1-7)/Mas receptor axis. Neprilysin inhibitors popularized for heart failure may also still hold HTN potential. Finally, we examine unique systems in development never before used in HTN such as Na/H exchange inhibitors, vasoactive intestinal peptide agonists, and dopamine beta hydroxylase inhibitors. A concise review of future directions of HTN pharmacotherapy.

  1. Looking to the future (perspectives of oncopediatry)

    International Nuclear Information System (INIS)

    Durnov, L.A.

    1995-01-01

    The 30-year experience of children oncology in Russia is analyzed using the Central Research Institute of Children Oncology as an example. The experience allows to look into the future of children oncology. A great attention is paid and will continue to be paid to the study of parents-child-tumor link (age of parents, disease incidence during pregnancy, occupation of parents, etc). The role of radiation techniques of diagnostics and treatment in children oncology will diminish in the future. The preference will be given to laboratory diagnostic techniques and medicamentous therapy. As regards radiation treatment techniques, the preference will be given to laser therapy and radiation surgery

  2. Counseling For Future Shock

    Science.gov (United States)

    Morgan, Lewis B.

    1974-01-01

    In this article the author looks at some of the searing prophecies made by Alvin Toffler in his book Future Shock and relates them to the world of the professional counselor and the clientele the counselor attempts to serve. (Author)

  3. Future neutrino experiments

    CERN Document Server

    Di Lella, L

    2001-01-01

    Future experiments to search for neutrino oscillations using neutrinos from the Sun, from reactors and accelerators are reviewed. Possible long-term developments based on neutrino factories are also described. (29 refs).

  4. Queering Aging Futures

    Directory of Open Access Journals (Sweden)

    Linn J. Sandberg

    2017-08-01

    Full Text Available This paper explores the potential for cultural gerontology to extend its ideas of diversity in aging experiences by opening space to rethink conceptions of successful aging futures. We propose a ‘queering’ of aging futures that disrupts the ways that expectations of a good later life and happy aging are seen to adhere to some bodies and subjectivities over others. Drawing on feminist, queer, and crip theories, we build on existing critiques of ‘successful aging’ to interrogate the assumptions of heteronormativity, able-bodiedness and able-mindedness that shape the dividing lines between success and failure in aging, and which inform attempts to ‘repair’ damaged futures. Conclusions suggest that recognizing diversity in successful aging futures is important in shaping responses to the challenges of aging societies, and presents an opportunity for critical cultural gerontology to join with its theoretical allies in imagining more inclusive alternatives.

  5. Introduced Terrestrial Species (Future)

    Data.gov (United States)

    U.S. Environmental Protection Agency — These data represent predicted future potential distributions of terrestrial plants, animals, and pathogens non-native to the Middle-Atlantic region. These data are...

  6. Future Integrated Fire Control

    National Research Council Canada - National Science Library

    Young, Bonnie W

    2005-01-01

    Future advances in fire control for air and missile defense depend largely on a network-enabled foundation that enables the collaborative use of distributed warfare assets for time-critical operations...

  7. Back to the Future

    CERN Multimedia

    Collins, Graham

    2004-01-01

    "Predictions are hard to make, especially about the future" said Nobel physicist Niels Bohr, many years ago. But two months ago, 150 leading physicists gathered at the University of California to engage in just that daunting task (1 page)

  8. Backup to the Future

    DEFF Research Database (Denmark)

    Rasmus, Handberg; Conrad, Anders S.; Svendsen, Michael

    2017-01-01

    What if something horrible happens in the future? Great Scott! Do we have a backup? Is a backup even enough? At the Kepler Asteroseismic Science Operations Center (KASOC) we have a goal that all data and information from Kepler and KASC is preserved for the future. The benchmark is that the data ...... should be useful for, at least, the next 50 years. But how do we ensure that hundreds of terabytes of data are understandable or even readable in half a century?...

  9. Exoplanet Biosignatures: Future Directions

    OpenAIRE

    Walker, Sara I.; Bains, William; Cronin, Leroy; DasSarma, Shiladitya; Danielache, Sebastian; Domagal-Goldman, Shawn; Kacar, Betul; Kiang, Nancy Y.; Lenardic, Adrian; Reinhard, Christopher T.; Moore, William; Schwieterman, Edward W.; Shkolnik, Evgenya L.; Smith, Harrison B.

    2017-01-01

    Exoplanet science promises a continued rapid accumulation of new observations in the near future, energizing a drive to understand and interpret the forthcoming wealth of data to identify signs of life beyond our Solar System. The large statistics of exoplanet samples, combined with the ambiguity of our understanding of universal properties of life and its signatures, necessitate a quantitative framework for biosignature assessment Here, we introduce a Bayesian framework for guiding future di...

  10. Demystifying Managed Futures

    DEFF Research Database (Denmark)

    Hurst,, Brian; Hua Ooi, Yao; Heje Pedersen, Lasse

    2013-01-01

    We show that the returns of Managed Futures funds and CTAs can be explained by time series momentum strategies and we discuss the economic intuition behind these strategies. Time series momentum strategies produce large correlations and high R-squares with Managed Futures indices and individual m...... of implementation issues relevant to time series momentum strategies, including risk management, risk allocation across asset classes and trend horizons, portfolio rebalancing frequency, transaction costs, and fees....

  11. The Future of Telecommuting

    OpenAIRE

    Handy, Susan; Mokhtarian, Patricia

    1996-01-01

    Interest in telecommuting is growing among workers, employers, transportation planners, communities, the telecommunications industry, and others. But actual levels of telecommuting appear to be increasing slowly, although there is little reliable data on trends. The future of telecommuting depends on whether employers provide the opportunity to telecommute and whether workers take advantage of this opportunity; government policies can encourage both. This article addresses that future by outl...

  12. Best available technology for the Los Alamos National Laboratory Radioactive Liquid Waste Treatment Facility

    International Nuclear Information System (INIS)

    Midkiff, W.S.; Romero, R.L.; Suazo, I.L.; Garcia, R.; Parsons, R.M.

    1993-01-01

    The existing Los Alamos National Laboratory TA-50 liquid radioactive waste treatment plant RLWP has been in service for over thirty years, during this period many technical, regulatory, and processing changes have occurred. The existing facility can no longer comply with the demands and requirements for continued operation, and would not be able to comply with anticipated stringent future contaminant discharge limitations. Either a major upgrading or replacement of the existing facility is required. In order to assess the most appropriate means of providing an adequate facility to comply with predicted requirements for Ta-50, this Best Available Technology (BAT) Study was conducted to compare feasible technical and economic alternatives in order to define the most favorable technology configuration. This report consists of eleven sections. Section 1 provides a general introduction and background of the TA-50 operations and the basis for this study. Section 2 provides a technical discussion of the unit processes at TA-50 and several other comparable operations at other DOE sites. Section 3 addresses the evaluation and selection of appropriate treatment processes. Section 4 provides an analysis of environmental issues and concerns. Section 5 presents the rationale for the selection of preferred process configurations. Section 6 is the evaluation of operational issues. Section 7 addresses energy and resource use topics. Section 8 provides an economic analysis, and Section 9 summarizes the evaluation and the identification of the BAT. These sections are augmented by appendices. The report identifies the construction of a new radioactive liquid waste treatment facility as the BAT. Based on the information analyzed for this study, this option appears to provide the best combination of environmental compliance, operability, and economic value

  13. FUTURE CLIMATE ANALYSIS

    International Nuclear Information System (INIS)

    R.M. Forester

    2000-01-01

    This Analysis/Model Report (AMR) documents an analysis that was performed to estimate climatic variables for the next 10,000 years by forecasting the timing and nature of climate change at Yucca Mountain (YM), Nevada (Figure l), the site of a potential repository for high-level radioactive waste. The future-climate estimates are based on an analysis of past-climate data from analog meteorological stations, and this AMR provides the rationale for the selection of these analog stations. The stations selected provide an upper and a lower climate bound for each future climate, and the data from those sites will provide input to the infiltration model (USGS 2000) and for the total system performance assessment for the Site Recommendation (TSPA-SR) at YM. Forecasting long-term future climates, especially for the next 10,000 years, is highly speculative and rarely attempted. A very limited literature exists concerning the subject, largely from the British radioactive waste disposal effort. The discussion presented here is one method, among many, of establishing upper and lower bounds for future climate estimates. The method used here involves selecting a particular past climate from many past climates, as an analog for future climate. Other studies might develop a different rationale or select other past climates resulting in a different future climate analog

  14. FUTURE CLIMATE ANALYSIS

    Energy Technology Data Exchange (ETDEWEB)

    R.M. Forester

    2000-03-14

    This Analysis/Model Report (AMR) documents an analysis that was performed to estimate climatic variables for the next 10,000 years by forecasting the timing and nature of climate change at Yucca Mountain (YM), Nevada (Figure l), the site of a potential repository for high-level radioactive waste. The future-climate estimates are based on an analysis of past-climate data from analog meteorological stations, and this AMR provides the rationale for the selection of these analog stations. The stations selected provide an upper and a lower climate bound for each future climate, and the data from those sites will provide input to the infiltration model (USGS 2000) and for the total system performance assessment for the Site Recommendation (TSPA-SR) at YM. Forecasting long-term future climates, especially for the next 10,000 years, is highly speculative and rarely attempted. A very limited literature exists concerning the subject, largely from the British radioactive waste disposal effort. The discussion presented here is one method, among many, of establishing upper and lower bounds for future climate estimates. The method used here involves selecting a particular past climate from many past climates, as an analog for future climate. Other studies might develop a different rationale or select other past climates resulting in a different future climate analog.

  15. Research Review: The Role of Diet in the Treatment of Attention-Deficit/Hyperactivity Disorder--An Appraisal of the Evidence on Efficacy and Recommendations on the Design of Future Studies

    Science.gov (United States)

    Stevenson, Jim; Buitelaar, Jan; Cortese, Samuele; Ferrin, Maite; Konofal, Eric; Lecendreux, Michel; Simonoff, Emily; Wong, Ian C. K.; Sonuga-Barke, Edmund

    2014-01-01

    Background: The efficacy of three dietary treatments for ADHD has been repeatedly tested in randomized controlled trials (RCTs). These interventions are restricted elimination diets (RED), artificial food colour elimination (AFCE) and supplementation with free fatty acids (SFFA). There have been three systematic reviews and associated…

  16. Future Climate Analysis

    International Nuclear Information System (INIS)

    James Houseworth

    2001-01-01

    This Analysis/Model Report (AMR) documents an analysis that was performed to estimate climatic variables for the next 10,000 years by forecasting the timing and nature of climate change at Yucca Mountain (YM), Nevada (Figure 1), the site of a potential repository for high-level radioactive waste. The future-climate estimates are based on an analysis of past-climate data from analog meteorological stations, and this AMR provides the rationale for the selection of these analog stations. The stations selected provide an upper and a lower climate bound for each future climate, and the data from those sites will provide input to the infiltration model (USGS 2000) and for the total system performance assessment for the Site Recommendation (TSPA-SR) at YM. Forecasting long-term future climates, especially for the next 10,000 years, is highly speculative and rarely attempted. A very limited literature exists concerning the subject, largely from the British radioactive waste disposal effort. The discussion presented here is one method, among many, of establishing upper and lower bounds for future climate estimates. The method used here involves selecting a particular past climate from many past climates, as an analog for future climate. Other studies might develop a different rationale or select other past climates resulting in a different future climate analog. Revision 00 of this AMR was prepared in accordance with the ''Work Direction and Planning Document for Future Climate Analysis'' (Peterman 1999) under Interagency Agreement DE-AI08-97NV12033 with the U.S. Department of Energy (DOE). The planning document for the technical scope, content, and management of ICN 01 of this AMR is the ''Technical Work Plan for Unsaturated Zone (UZ) Flow and Transport Process Model Report'' (BSC 2001a). The scope for the TBV resolution actions in this ICN is described in the ''Technical Work Plan for: Integrated Management of Technical Product Input Department''. (BSC 2001b, Addendum B

  17. Fit between Future Thinking and Future Orientation on Creative Imagination

    Science.gov (United States)

    Chiu, Fa-Chung

    2012-01-01

    The purpose of the current study is to investigate the impact of future thinking, and the fit between future thinking and future orientation on creative thinking. In Study 1, 83 undergraduates were randomly assigned to three groups: 50-year future thinking, 5-year future thinking, and the present-day thinking. First, the priming tasks, in which…

  18. Future trends in reprocessing

    International Nuclear Information System (INIS)

    Rouyer, H.

    1994-01-01

    This paper about future trends in reprocessing essentially reflects French experience and points of view as an example of countries which, like England and Japan, consider that reprocessing is the best solution for the back end of the fuel cycle. In order to know what the future will be, it is necessary to look back at the past and try to find what have been the main reasons for evolution in that period. For reprocessing, it appears that these motivations have been 'safety and economics'. They will remain the motivations for the future. In addition, new motivations for development are starting to appear which are still imprecise but can be expressed as follows: 'which guarantees will public opinion require in order to be convinced that solutions for waste management, proposed by specialists shall ensure that a healthy environment is preserved for the use of future generations'. Consequently the paper examines successively the evolution of reprocessing in the recent past, what the immediate future could be and finally what should be necessary in the long term. (Author)

  19. White paper on future technologies

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2012-12-15

    This book describes the role of technology and challenge of future like why we focus on future technologies and future, human being and technology, methodology on development for future technologies such as global monitoring system for investigation on environmental change, investigation of research front for paper and patent and COMPAS, and domestic and foreign organization for discover on future technologies. It also introduces KISTI selection future technologies 500 : healthy society, smart society, safety society, and future technologies 500.

  20. The effect of advanced treatment of sewage effluents on metal speciation and (bio)availability.

    Science.gov (United States)

    Peters, A; Merrington, G; Leverett, D; Ellor, B; Lofts, S; Gravell, A

    2014-02-01

    The bioavailability of metals can be strongly influenced by dissolved organic carbon (DOC). Wastewater treatment effluents add considerable quantities of DOC and metals to receiving waters, and as effluent controls become more stringent advanced effluent treatments may be needed. We assessed the effects of two types of advanced treatment processes on metal availability in wastewater effluents. Trace metal availability was assessed using diffuse gradients in thin films and predicted through speciation modelling. The results show little difference in metal availability post-advanced treatment. EDTA-like compounds are important metal complexants in the effluents.

  1. Mobilities, Futures & the City

    DEFF Research Database (Denmark)

    Freudendal-Pedersen, Malene; Kesselring, Sven

    2016-01-01

    significant attention to these shifts in societies’ discursive patterns and structures. For making up powerful and strong visions and policies for sustainable cities, ‘collaborative storytelling’ plays a key role. The theoretical outset for the research project ‘Mobilities, Futures & the City’, which grounds......The future of cities and regions will be strongly shaped by the mobilities of people, goods, modes of transport, waste and information. In many ways, the ‘why and ‘for what’ often get lost in discourses on planning and designing mobilities. The predominant planning paradigm still conceptualizes...... the future of cities and mobilities as a matter of rather more efficient technologies than of social cohesion, integration and connectivity. Sustainable mobility needs the mobilities of ideas and concepts and the reflexivity of policies. Communicative planning theory and the ‘argumentative turn’ have given...

  2. Physics at Future Colliders

    CERN Document Server

    Ellis, John R.

    1999-01-01

    After a brief review of the Big Issues in particle physics, we discuss the contributions to resolving that could be made by various planned and proposed future colliders. These include future runs of LEP and the Fermilab Tevatron collider, B factories, RHIC, the LHC, a linear electron-positron collider, an electron-proton collider in the LEP/LHC tunnel, a muon collider and a future larger hadron collider (FLHC). The Higgs boson and supersymmetry are used as benchmarks for assessing their capabilities. The LHC has great capacities for precision measurements as well as exploration, but also shortcomings where the complementary strengths of a linear electron-positron collider would be invaluable. It is not too soon to study seriously possible subsequent colliders.

  3. Prospects for future climate

    International Nuclear Information System (INIS)

    Anon.

    1990-01-01

    The different climates of the past and model simulations of future climates convincingly indicate that the continuing emissions of greenhouse gases will lead to significant global warming and to changes in precipitation and other climatic variables. The projected changes in atmospheric composition and, consequently, in climatic conditions will be unique and more rapid than at any time in the past. The developing understanding of the chemical cycles controlling atmospheric composition and of the processes and behavior controlling the climate system can provide significant guidance about how the future climate will change. This chapter first summarizes the many scientific advances described in the preceding chapters that can help one better understand and describe the climate system and the resulting agricultural and hydrological impacts of these changes in climate. The chapter then draws from this understanding to outline the prospects for future climate

  4. The Future of Audit

    Directory of Open Access Journals (Sweden)

    Danielle Lombardi

    2014-10-01

    Full Text Available The purpose of this study is to discuss the current state and future of auditing. Expert consensus is used as a basis to examine the current state of auditing and generate modifications both needed and likely to occur in the audit profession. This study contributes to the literature by using the Delphi method to develop predictions as to the direction of the audit industry and discuss the implications associated with these predictions. If auditors can better understand where the profession stands and where it is headed, then they can better prepare for the future. Some predictions emerging from this study relative to future audit practices include increasing automation of audit procedures, more predictive financial statements, continuous auditing of financial statements and transactions, and an increasingly global perspective regarding audit activities.

  5. Settlements of the future

    Directory of Open Access Journals (Sweden)

    Domen Zupančič

    2002-01-01

    Full Text Available Current ongoing societal processes allow me to say that all humanity must foresee the great opportunity to change direction from market driven development to human scale sustainable development as the only way to achieve whole scale growth. In the achievement of this transition the most important observation is that it could be achieved without miraculous technologies or drastic transformations of human societies. The main requirement is the translation of basic knowledge to the people, especially in less developed countries and to the younger generations. Without sincere political will our common future cannot be reached. In my essay I tried to demonstrate what may happen in the future, if the no-dialogue community develops. Sustainable development is the only correct route if we want to get where we are going – the future well being of all human kind.

  6. Executive Summary - Future plans

    International Nuclear Information System (INIS)

    2005-01-01

    ophthalmologists at the Collegium Medicum (Jagiellonian University) and radiotherapists at the Centre of Oncology. Our Institute is capable of providing PET isotopes to the local medical community. We will continue to upgrade our technical infrastructure and research equipment basing on Structural Funds of the European Commission. We are able to achieve this through our Centres of Excellence and Centres of Advanced Technologies. We will further continue to strongly support the application of methods of nuclear physics in biological and medical research, such as single-ion studies of the effects of low-radiation doses, Nuclear Magnetic Resonance research in physiology, the Atomic Force microscope for studying properties of cell and membranes, the chromosome aberration/DNA studies for biological dosimetry, or advanced dosimetry techniques for medical physics and space dosimetry. We shall also continue our obligation to serve the national and local authorities with our expertise in radiation protection and dosimetry. We intend to further support the development of geophysical methods for searching natural resources. In view of the current discussion on the future sources of energy in Poland, our Institute will actively engage in promoting nuclear energy, based on new-generation reactor technology. We will be actively seeking the opportunity of maintaining the tradition of our Institute being focused around its major accelerator facility. While the present AIC-144 cyclotron is no longer adequate for treatment of deep-seated tumors, a medium-sized synchrotron able to accelerate light ions to energies of some several hundred MeV/amu, capable of generating ion beams suitable for light-ion radiotherapy, could fulfill this role, stimulating a renewal of our past close collaboration with radiotherapists in fighting cancer. Such radiotherapy centres are currently under development in other parts of the European Community. We will actively seek the opportunities to obtain external funding for

  7. Future Climate Analysis

    International Nuclear Information System (INIS)

    Cambell, C. G.

    2004-01-01

    This report documents an analysis that was performed to estimate climatic variables for the next 10,000 years by forecasting the timing and nature of climate change at Yucca Mountain, Nevada, the site of a repository for spent nuclear fuel and high-level radioactive waste. The future-climate estimates are based on an analysis of past-climate data from analog meteorological stations, and this report provides the rationale for the selection of these analog stations. The stations selected provide an upper and a lower climate bound for each future climate, and the data from those sites will provide input to the following reports: ''Simulation of Net Infiltration for Present-Day and Potential Future Climates'' (BSC 2004 [DIRS 170007]), ''Total System Performance Assessment (TSPA) Model/Analysis for the License Application'' (BSC 2004 [DIRS 168504]), ''Features, Events, and Processes in UZ Flow and Transport'' (BSC 2004 [DIRS 170012]), and ''Features, Events, and Processes in SZ Flow and Transport'' (BSC 2004 [DIRS 170013]). Forecasting long-term future climates, especially for the next 10,000 years, is highly speculative and rarely attempted. A very limited literature exists concerning the subject, largely from the British radioactive waste disposal effort. The discussion presented here is one available forecasting method for establishing upper and lower bounds for future climate estimates. The selection of different methods is directly dependent on the available evidence used to build a forecasting argument. The method used here involves selecting a particular past climate from many past climates, as an analog for future climate. While alternative analyses are possible for the case presented for Yucca Mountain, the evidence (data) used would be the same and the conclusions would not be expected to drastically change. Other studies might develop a different rationale or select other past climates resulting in a different future climate analog. Other alternative

  8. Imagining the Future University

    DEFF Research Database (Denmark)

    Bengtsen, Søren Smedegaard; Barnett, Ronald

    'Imagining the Future University' is a special issue in the journal Philosophy and Theory in Higher Education, published by Peter Lang. Editor in Chief of the journal is John Petrovic, University of Alabama. The speciale issue is edited by Søren Bengtsen and Ronald Barnett.......'Imagining the Future University' is a special issue in the journal Philosophy and Theory in Higher Education, published by Peter Lang. Editor in Chief of the journal is John Petrovic, University of Alabama. The speciale issue is edited by Søren Bengtsen and Ronald Barnett....

  9. Future of color

    Science.gov (United States)

    Ladson, Jack A.; Turner, Laraine B.; Green-Armytage, Paul; Hunt, Robert W. G.

    2002-06-01

    We live in a world in which styles and technologies are nearly the same from place to place, but change daily. This changing global culture is unprecedented, and reinforced by emerging new technologies that affect us all. The Future of Color, examines new technologies, how they will affect the selection and promulgation of color in the near future, and their impact upon us. We examine this topic from many perspectives - technological, business and commercial. Most importantly, as we understand how our world is emerging, we can position ourselves strategically for tomorrow.

  10. Future of gas

    International Nuclear Information System (INIS)

    Forbes, A.; Widdershoven, C.; Nicola, S.; Cragg, C.

    2009-01-01

    Two articles and two columns in this section on the future of natural gas. In the first article attention is paid to the possibility that large natural gas producers are setting up a cartel a la OPEC. Most experts argue that the structure of gas markets makes the gas business much less amenable to cartelisation than the oil business. If that is true, why are so many people in the gas industry afraid of a gas cartel? The second article focuses on the future role of North Africa in the supply of natural gas

  11. Futures of cities

    DEFF Research Database (Denmark)

    Bogen dokumenterer resultater fra den internationale kongres Futures of Cities arrangeret af IFHP International Federation of Housing and Planning, Realdania, Kunstakademiets Arkitektskole og City of Copenhagen. Kongressen blev afholdt i september 2007 i Øksnehallen og på Kunstakademiets...... Arkitektskole. Bogen  har 3 dele. Principles: Copenhagen Agenda for Sustainable Living, 10 principper udviklet af Ugebrevet Mandag Morgen illustreret af arkitektstuderende. Congress: Futures of Cities, Emerging Urbanisms- Emerging Practices, oplæg fra unge tegnestuer til temaet fremlagt på Student Congress...

  12. News from the future

    DEFF Research Database (Denmark)

    Reinecke Hansen, Kenneth

    2016-01-01

    This article presents a corpus linguistic analysis of the development in future-oriented political journalism in four Danish newspapers in the period 1997–2013 (N = 2954 full articles = 1,553,038 word tokens). Keyword analysis and concordance analysis are applied within a framework of grammatical......-semantic theory of tense and modal verbs and semantic-pragmatic theory of time meaning, modality and speech acts. The results suggest, unexpectedly, that the newspapers – and news reports in particular – seem to have become less future-oriented in the period. At the same time, however, the articles...

  13. Future Information Technology

    CERN Document Server

    Stojmenovic, Ivan; Choi, Min; Xhafa, Fatos; FutureTech 2013

    2014-01-01

    Future technology information technology stands for all of continuously evolving and converging information technologies, including digital convergence, multimedia convergence, intelligent applications, embedded systems, mobile and wireless communications, bio-inspired computing, grid and cloud computing, semantic web, user experience and HCI, security and trust computing and so on, for satisfying our ever-changing needs. In past twenty five years or so, Information Technology (IT) influenced and changed every aspect of our lives and our cultures. These proceedings foster the dissemination of state-of-the-art research in all future IT areas, including their models, services, and novel applications associated with their utilization.

  14. World Energy Future

    International Nuclear Information System (INIS)

    Forbes, A.; Van der Linde, C.; Nicola, S.

    2009-01-01

    In the section World Energy Future of this magazine two articles, two interviews and one column are presented. The article 'A green example to the world' refers briefly to the second World Future Energy Summit in Abu Dhabi, which was held from 18-21 January, 2009. The second article, 'Green Utopia in the desert' attention is paid to the Abu Dhabi government-driven Masdar Initiative. The two interviews concern an interview with BP Alternative Energy ceo Vivienne Cox, and an interview with the founder and CEO of New Energy Finance Michael Liebreich. The column ('An efficient response') focuses on the impact of the economic crisis on energy policy

  15. The Future of Gravity

    CERN Multimedia

    CERN. Geneva

    2007-01-01

    Of the four fundamental forces, gravity has been studied the longest, yet gravitational physics is one of the most rapidly developing areas of science today. This talk will give a broad brush survey of the past achievements and future prospects of general relativistic gravitational physics. Gravity is a two frontier science being important on both the very largest and smallest length scales considered in contemporary physics. Recent advances and future prospects will be surveyed in precision tests of general relativity, gravitational waves, black holes, cosmology and quantum gravity. The aim will be an overview of a subject that is becoming increasingly integrated with experiment and other branches of physics.

  16. Renewable Electricity Futures (Presentation)

    Energy Technology Data Exchange (ETDEWEB)

    Mai, T.

    2012-08-01

    This presentation library summarizes findings of NREL's Renewable Electricity Futures study, published in June 2012. RE Futures investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. It was presented at the 2012 RE AMP Annual Meeting. RE-AMP is an active network of 144 nonprofits and foundations across eight Midwestern states working on climate change and energy policy with the goal of reducing global warming pollution economy-wide 80% by 2050.

  17. Future Climate Analysis

    Energy Technology Data Exchange (ETDEWEB)

    C. G. Cambell

    2004-09-03

    This report documents an analysis that was performed to estimate climatic variables for the next 10,000 years by forecasting the timing and nature of climate change at Yucca Mountain, Nevada, the site of a repository for spent nuclear fuel and high-level radioactive waste. The future-climate estimates are based on an analysis of past-climate data from analog meteorological stations, and this report provides the rationale for the selection of these analog stations. The stations selected provide an upper and a lower climate bound for each future climate, and the data from those sites will provide input to the following reports: ''Simulation of Net Infiltration for Present-Day and Potential Future Climates'' (BSC 2004 [DIRS 170007]), ''Total System Performance Assessment (TSPA) Model/Analysis for the License Application'' (BSC 2004 [DIRS 168504]), ''Features, Events, and Processes in UZ Flow and Transport'' (BSC 2004 [DIRS 170012]), and ''Features, Events, and Processes in SZ Flow and Transport'' (BSC 2004 [DIRS 170013]). Forecasting long-term future climates, especially for the next 10,000 years, is highly speculative and rarely attempted. A very limited literature exists concerning the subject, largely from the British radioactive waste disposal effort. The discussion presented here is one available forecasting method for establishing upper and lower bounds for future climate estimates. The selection of different methods is directly dependent on the available evidence used to build a forecasting argument. The method used here involves selecting a particular past climate from many past climates, as an analog for future climate. While alternative analyses are possible for the case presented for Yucca Mountain, the evidence (data) used would be the same and the conclusions would not be expected to drastically change. Other studies might develop a different rationale or select other past

  18. Interpersonal Psychotherapy: Past, Present and Future

    OpenAIRE

    Markowitz, John C.; Weissman, Myrna M.

    2012-01-01

    The authors briefly describe the origins, theory, and development of interpersonal psychotherapy: its roots in clinical outcome research, its spread from major depression to other psychiatric disorders and its increasing dissemination as an empirically validated clinical intervention included in treatment guidelines. They attempt to forecast research, organizational and training issues the growing interpersonal psychotherapy community may face in the future.

  19. The future(s) of emission allowances

    International Nuclear Information System (INIS)

    Rosenzweig, K.M.; Villarreal, J.A.

    1993-01-01

    The Clean Air Act Amendments of 1990 (CAAA) established a sulfur dioxide emission allowance system to be implemented by the US Environmental Protection Agency (EPA). Under the two-phase implementation of the program, electric utilities responsible for approximately 70 percent of SO 2 emissions in the United States will be issued emission allowances, each representing authorization to emit one ton of sulfur dioxide during a specified calendar year or a later year. Allowances will be issued to utilities with electric-generating units affected by the CAAA limits, as well as to certain entities which may choose to opt-in to the program. Each utility or other emission source must hold a number of allowances at least equal to its total SO 2 emissions during any given year. Unused allowances may be sold, traded, or held in inventory for use against SO 2 emissions in future years. Anyone can buy and hold allowances, including affected utilities, non-utility companies, SO 2 allowances brokers and dealers, environmental groups, and individuals. During Phase I of the program, allowances equivalent to approximately 6.4 million tons of SO 2 emissions will be allocated annually to a group of 110 large, high-SO 2 -emitting power plants. In Phase II, virtually all power-generating utilities (representing approximately 99.4 percent of total US utility emissions) will be subject to the program. The number of allowances issued will increase to approximately 8.9 million a year, with certain special allocations raising the actual number issued to 9.48 million between the years 2000 to 2009, and 8.95 million yearly thereafter. Thus, the CAAA goal of annual emissions of 9 million tons should be achieved by 2010, when virtually all US emission sources will be participating in the program

  20. Travel intensity and climate policy: The influence of different mobility futures on the diffusion of battery integrated vehicles

    International Nuclear Information System (INIS)

    Longden, Thomas

    2014-01-01

    The importance of a focus on mobility and the kilometres travelled using light duty vehicles is reflected in the persistence of strong demand for personal mobility and emissions that tend to be linked with population and economic growth. Simulation results using the WITCH model show that changes in the kilometres driven per year using light duty vehicles have a notable impact on investments related to the development of battery related technologies. As a result, different mobility futures have notably different optimal vehicle fleet compositions. As climate policy becomes more stringent, achieving abatement with increased mobility implies large investments in battery related technologies in comparison to the 2010 level. The model results also show that the Electric Vehicles Initiative goal of a 2% share of vehicles in 2020 could be achieved with climate policy in place. However, notable cost reductions and the removal of barriers to diffusion will need to continue for the EVI goal to be achieved. - Highlights: • Travel intensity of GDP at the national level shows signs of stability over an extended period. • Different mobility futures imply notably different optimal vehicle fleet compositions. • As climate policy becomes more stringent, investments in battery related technologies increase substantially. • The model results show that the Electric Vehicles Initiative goal of a 2% share of vehicles in 2020 could be achieved. • Cost reductions and the removal of barriers to diffusion will need to continue for the EVI goal to be achieved

  1. Future Home Network Requirements

    DEFF Research Database (Denmark)

    Charbonnier, Benoit; Wessing, Henrik; Lannoo, Bart

    This paper presents the requirements for future Home Area Networks (HAN). Firstly, we discuss the applications and services as well as their requirements. Then, usage scenarios are devised to establish a first specification for the HAN. The main requirements are an increased bandwidth (towards 1...

  2. New Futures, New Pasts

    DEFF Research Database (Denmark)

    Feldt, Jakob Egholm

    2016-01-01

    for all. Nevertheless, Kallen avoided the concept of cosmopolitanism because of the deep controversy over Jews and Jewishness entangled in the history of cosmopolitan thought since the Enlightenment. As an alternative, Kallen re-invented a new Jewish past to suit a future when Jewishness could be a model...

  3. LOS ALAMOS: Hadron future

    International Nuclear Information System (INIS)

    Ernst, David J.

    1992-01-01

    At a Workshop on the Future of Hadron Facilities, held on 15-16 August at Los Alamos National Laboratory, several speakers pointed out that the US physics community carrying out fixed target experiments with hadron beam had not been as successful with funding as it deserved. To rectify this, they said, the community should be better organized and present a more united front

  4. Longevity for future Europeans

    DEFF Research Database (Denmark)

    Christensen, K.

    2015-01-01

    of Success", i.e., an increasing proportion of the population is living to the highest ages in better health than previous generations. The planning of and policy development for the future care of the oldest-old will be highly dependent on whether one or both genders are experiencing the "Failure of Success...

  5. Digital imaging - future visions

    International Nuclear Information System (INIS)

    Sanford, L.

    1993-01-01

    The reality of a filmless future in medicine is closer in the UK than in the US. The initiative with digital data processing, however, is not. Despite the glowing promises in the literature of such visionware', there is as yet no filmless system anywhere in the World. This article examines research in this field. (Author)

  6. Perception of future goals

    DEFF Research Database (Denmark)

    Ottsen, Christina L.; Berntsen, Dorthe

    The current study: a cross-cultural comparison between the Middle East and Scandinavia. Two societies that offer a unique opportunity to examine gender and cultural differences in perception of personal goals. Previous studies show that imagined future events are affected by memories of personal...

  7. Potential Futures for Information.

    Energy Technology Data Exchange (ETDEWEB)

    Ackermann, Mark R. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-11-01

    Information is one of the most powerful tools available today. All advances in technology may be used, as David Sarnoff said, for the benefit or harm of society. Information can be used to shape the future by free people, or used to control people by less than benevolent governments, as has been demonstrated since the mid - 1930s, and with growing frequency over the past 50 years. What promised to once set people free and fuel an industrial revolution that might improve the standard of living over most of the world, has also been used to manipulate and enslave entire populations. The future of information is tied to the future of technologies that support the collection of data, processing those data into information and knowledge, and distribution. Technologies supporting the future of information must include technologies that help protect the integrity of data and information, and help to guarantee its discoverability and appropriate availability -- often to the whole of society. This Page Intentionally Left Blank

  8. Future Educators' Explaining Voices

    Science.gov (United States)

    de Oliveira, Janaina Minelli; Caballero, Pablo Buenestado; Camacho, Mar

    2013-01-01

    Teacher education programs must offer pre-service students innovative technology-supported learning environments, guiding them in the revision of their preconceptions on literacy and technology. This present paper presents a case study that uses podcast to inquiry into future educators' views on technology and the digital age. Results show future…

  9. Future Electricity Markets

    DEFF Research Database (Denmark)

    Pinson, Pierre

    2015-01-01

    The changing face of energy production in Europe necessitates a rethink in the way that electricity markets are structured. The ‘5s’ (Future Electricity Markets) project is a multi-disciplinary project that is looking to challenge the current approach to the design and operation of electricity...

  10. FutureKids

    CERN Multimedia

    Association du personnel

    2012-01-01

    Offers 15% discount for the Staff Association members who enroll their children in summer FUTUREKIDS activities. Extracurricular Activities For Your Children FUTUREKIDS Computer Camps STRATEGIOS Strategy Games Workshops For more information : http://cern.ch/association/en/OtherActivities/FutureKids.html

  11. Future flare compositions

    NARCIS (Netherlands)

    Lingen, J.L.N. van; Meuken, D.; Hackspik, M.M.; Mäkeläinen, T.; Weiser, V.; Poulson, G.W.

    2014-01-01

    This poster describes the work done within the Category B joint research project under the European Defence Agency (EDA) on Future Flare Compositions [1]. Contributing members were Finland, Germany, United Kingdom and the Netherlands. The program was aimed to identify the technology gaps that apply

  12. Directors of the Future

    DEFF Research Database (Denmark)

    Buur, Jacob; Arnal, Luis; Have, Claus

    in a storytelling process with actors from the Dacapo Theatre to create a concrete scenario of what the future might hold. Theatre has the capacity to speak directly to personal experiences and emotions. With this panel we wanted to move beyond the slightly distanced, reflective stance that ethnographers may take...

  13. Energy futures-2

    International Nuclear Information System (INIS)

    Anon.

    1991-01-01

    This book covers the proceedings of the Symposium on Energy Futures II. Topics covered include: The National Energy Strategy; The Gas and petroleum industry; energy use in the paper industry; solar energy technology; hydroelectric power; biomass/waste utilization; engine emissions testing laboratories; integrated coal gassification-combined-cycle power plants

  14. Franchising the Future

    Science.gov (United States)

    Colomb, Gregory G.

    2010-01-01

    Central to the future of rhetoric and composition (or writing studies or whatever label we use) is the service mission of composition: to teach students to write. But that term "service" has not and will not serve us well. This essay examines the limitations and dangers of a service mission and explores a different model, that of a franchise, a…

  15. Future of nuclear science

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    A report is presented by the Ad Hoc Panel on the Future of Nuclear Science on its assessment of the scientific objectives and unexplored questions of nuclear science and recommendations of the manpower, funding, and facilities required to realize its full potential. Nuclear research and its facilities and budgetary, sociological, and application aspects of this research are considered

  16. Energies of the future

    International Nuclear Information System (INIS)

    2005-12-01

    This document takes stock on the researches concerning the energies of the future. The hydrogen and the fuel cells take the main part with also the new fuels. Some researches programs are detailed as the costs decrease of the hydrogen engines, the design of an hydrogen production reactor from ethanol or the conversion of 95% of ethanol in gaseous hydrogen. (A.L.B.)

  17. Nuclear Security Futures Scenarios

    International Nuclear Information System (INIS)

    Keller, Elizabeth James Kistin; Warren, Drake Edward; Hayden, Nancy Kay; Passell, Howard D.; Malczynski, Leonard A.; Backus, George A.

    2017-01-01

    This report provides an overview of the scenarios used in strategic futures workshops conducted at Sandia on September 21 and 29, 2016. The workshops, designed and facilitated by analysts in Center 100, used scenarios to enable thought leaders to think collectively about the changing aspects of global nuclear security and the potential implications for the US Government and Sandia National Laboratories.

  18. CANDU, building the future

    International Nuclear Information System (INIS)

    Stern, F.

    1997-01-01

    The CEO of Stern Laboratories delivered a speech on the problems and challenges facing the nuclear industry. The CANDU system is looked at as the practical choice for the future of our energy source. The people of the industry must be utilized and respected to deliver to the best of their ability

  19. Nanovision: engineering the future

    National Research Council Canada - National Science Library

    Milburn, Colin

    2008-01-01

    ... of this planet, without doing a single thing to change ourselves, or the way we live. . . . And so I say that among the many things we transform on [this planet], ourselves and our social reality should be among them. We must terraform . . . ourselves. -Kim Stanley Robinson, Red Mars Like the future itself, this book has been a while in the making. My fascination...

  20. Scoping endangered futures

    DEFF Research Database (Denmark)

    Blok, Anders

    2017-01-01

    , in the imaginative politics of climatic projections. To rethink the resultant political aesthetics of climate change, the article maps out the visual, experiential, and affective forms in which endangered climatic futures come to saturate public culture. Such encounters, the article suggests, constitute inter-media...

  1. Nuclear Security Futures Scenarios.

    Energy Technology Data Exchange (ETDEWEB)

    Keller, Elizabeth James Kistin [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Warren, Drake Edward [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Hayden, Nancy Kay [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Passell, Howard D. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Malczynski, Leonard A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Backus, George A. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-01-01

    This report provides an overview of the scenarios used in strategic futures workshops conducted at Sandia on September 21 and 29, 2016. The workshops, designed and facilitated by analysts in Center 100, used scenarios to enable thought leaders to think collectively about the changing aspects of global nuclear security and the potential implications for the US Government and Sandia National Laboratories.

  2. CANDU, building the future

    Energy Technology Data Exchange (ETDEWEB)

    Stern, F. [Stern Laboratories (Canada)

    1997-07-01

    The CEO of Stern Laboratories delivered a speech on the problems and challenges facing the nuclear industry. The CANDU system is looked at as the practical choice for the future of our energy source. The people of the industry must be utilized and respected to deliver to the best of their ability.

  3. LOS ALAMOS: Hadron future

    Energy Technology Data Exchange (ETDEWEB)

    Ernst, David J.

    1992-11-15

    At a Workshop on the Future of Hadron Facilities, held on 15-16 August at Los Alamos National Laboratory, several speakers pointed out that the US physics community carrying out fixed target experiments with hadron beam had not been as successful with funding as it deserved. To rectify this, they said, the community should be better organized and present a more united front.

  4. Tales of future weather

    NARCIS (Netherlands)

    Hazeleger, W.; Van den Hurk, B.J.J.M.; Min, E.; Van Oldenborgh, G.J.; Petersen, A.C.; Stainforth, D.A.; Vasileiadou, E.; Smith, L.A.

    2015-01-01

    Society is vulnerable to extreme weather events and, by extension, to human impacts on future events. As climate changes weather patterns will change. The search is on for more effective methodologies to aid decision-makers both in mitigation to avoid climate change and in adaptation to changes. The

  5. Future generations in democracy

    DEFF Research Database (Denmark)

    Jensen, Karsten Klint

    2015-01-01

    of future generations. The analysis reveals that they tend to overlook the democratic costs of such representation (violation of political equality, risk of distortion of the deliberation and undermining of autonomy), while they seem to ignore the alternative of giving consideration to the interests...

  6. Reading the Future.

    Science.gov (United States)

    Nettle, Keith

    Given the strong sense of passing time which seems to be wired into human beings, it is only natural that the Year 2000, or Y2K in contemporary jargon, should lead to serious speculation about the future. Reading and literacy, old skills relatively speaking, continue rightly to figure in those predictions (along with the technologically advanced…

  7. Future Network Architectures

    DEFF Research Database (Denmark)

    Wessing, Henrik; Bozorgebrahimi, Kurosh; Belter, Bartosz

    2015-01-01

    This study identifies key requirements for NRENs towards future network architectures that become apparent as users become more mobile and have increased expectations in terms of availability of data. In addition, cost saving requirements call for federated use of, in particular, the optical...

  8. Future Climate Analysis

    Energy Technology Data Exchange (ETDEWEB)

    James Houseworth

    2001-10-12

    This Analysis/Model Report (AMR) documents an analysis that was performed to estimate climatic variables for the next 10,000 years by forecasting the timing and nature of climate change at Yucca Mountain (YM), Nevada (Figure 1), the site of a potential repository for high-level radioactive waste. The future-climate estimates are based on an analysis of past-climate data from analog meteorological stations, and this AMR provides the rationale for the selection of these analog stations. The stations selected provide an upper and a lower climate bound for each future climate, and the data from those sites will provide input to the infiltration model (USGS 2000) and for the total system performance assessment for the Site Recommendation (TSPA-SR) at YM. Forecasting long-term future climates, especially for the next 10,000 years, is highly speculative and rarely attempted. A very limited literature exists concerning the subject, largely from the British radioactive waste disposal effort. The discussion presented here is one method, among many, of establishing upper and lower bounds for future climate estimates. The method used here involves selecting a particular past climate from many past climates, as an analog for future climate. Other studies might develop a different rationale or select other past climates resulting in a different future climate analog. Revision 00 of this AMR was prepared in accordance with the ''Work Direction and Planning Document for Future Climate Analysis'' (Peterman 1999) under Interagency Agreement DE-AI08-97NV12033 with the U.S. Department of Energy (DOE). The planning document for the technical scope, content, and management of ICN 01 of this AMR is the ''Technical Work Plan for Unsaturated Zone (UZ) Flow and Transport Process Model Report'' (BSC 2001a). The scope for the TBV resolution actions in this ICN is described in the ''Technical Work Plan for: Integrated Management of Technical

  9. The future of PACS

    International Nuclear Information System (INIS)

    Nagy, Paul G.

    2007-01-01

    How will the future of picture archiving and communication systems (PACS) look, and how will this future affect the practice of radiology? We are currently experiencing disruptive innovations that will force an architectural redesign, making the majority of today’s commercial PACS obsolete as the field matures and expands to include imaging throughout the medical enterprise. The common architecture used for PACS cannot handle the massive amounts of data being generated by even current versions of computed tomography and magnetic resonance scanners. If a PACS cannot handle today’s technology, what will happen as the field expands to encompass pathology imaging, cone-beam reconstruction, and multispectral imaging? The ability of these new technologies to enhance research and clinical care will be impaired if PACS architectures are not prepared to support them. In attempting a structured approach to predictions about the future of PACS, we offer projections about the technologies underlying PACS as well as the evolution of standards development and the changing needs of a broad range of medical imaging. Simplified models of the history of the PACS industry are mined for the assumptions they provide about future innovations and trends. The physicist frequently participates in or directs technical assessments for medical equipment, and many physicists have extended these activities to include imaging informatics. It is hoped that by applying these speculative but experienced-based predictions, the interested medical physicist will be better able to take the lead in setting information technology strategies that will help facilities not only prepare for the future but continue to enjoy the benefits of technological innovations without disruptive, expensive, and unexpected changes in architecture. A good PACS strategy can help accelerate the time required for innovations to go from the drawing board to clinical implementation.

  10. Future requirements for petroleum fuels - an environmental perspective

    International Nuclear Information System (INIS)

    White, R.

    1998-01-01

    The environmental impacts of fuel emissions were discussed. Emissions from petroleum fuels are the largest contributor to a wide range of environmental problems including damage to the ozone layer and risks to human health. Forecasts indicate that future demand for fossil fuels for energy will continue to grow. The transportation sector is the largest single source of air emissions in Canada. The environmental requirements for all fuels will become progressively more stringent. The pollutants of primary concern include toxics, nitrogen oxides, volatile organic compounds, carbon monoxide, sulphur dioxide, and particulates. The U.S. auto-oil research program has conducted considerable research to understand the impact of fuel parameters of vehicle tailpipe emissions. In Canada, lead was removed from Canadian gas a decade ago. Since January 1998, low sulphur diesel (less than 500 ppm) is required for on-road use. Regulations have also been passed to reduce the level of benzene in gasoline to less than one per cent by mid-1999. It will be necessary to manage our fossil fuels to minimize the environmental impacts from combustion. In the longer term, it will be necessary to minimize fossil fuel use through conservation and shift to less polluting fuels

  11. Tests of gravity with future space-based experiments

    Science.gov (United States)

    Sakstein, Jeremy

    2018-03-01

    Future space-based tests of relativistic gravitation—laser ranging to Phobos, accelerometers in orbit, and optical networks surrounding Earth—will constrain the theory of gravity with unprecedented precision by testing the inverse-square law, the strong and weak equivalence principles, and the deflection and time delay of light by massive bodies. In this paper, we estimate the bounds that could be obtained on alternative gravity theories that use screening mechanisms to suppress deviations from general relativity in the Solar System: chameleon, symmetron, and Galileon models. We find that space-based tests of the parametrized post-Newtonian parameter γ will constrain chameleon and symmetron theories to new levels, and that tests of the inverse-square law using laser ranging to Phobos will provide the most stringent constraints on Galileon theories to date. We end by discussing the potential for constraining these theories using upcoming tests of the weak equivalence principle, and conclude that further theoretical modeling is required in order to fully utilize the data.

  12. THE FUTURE OF ECONOMIC GROWTH: CERTAINTY AND UNCERTAINTY ILLUSION?

    Directory of Open Access Journals (Sweden)

    Cristian Dan Pîrvu

    2011-12-01

    Full Text Available Starting from the concrete realities of the contemporary world reflected in the system of crises which affects the worldwide economy, the outlooks of economical growing and development, the poverty which includes a bigger percent of Earth’s population, the uncertainty about the future of economy, the existing article tries to offer answers at some stringent problems with which the humanity confronts. The global economical and financial crise triggered in 2008 is one of the components of the „bunch” of actual crises next to the ecological one, power, alimentary, water’s one and not least educational and moral crise. These crises manifest at the scale of the whole planet, but they have different degrees from a region to another, from a state to another. The main cause is, in our opinion, the human, the society in its ensemble, which in the effort of adancing, of a better life thought only in this spirit, neglecting the environment which has degraded more and more.

  13. Veterinary public health in India: current status and future needs.

    Science.gov (United States)

    Ghatak, S; Singh, B B

    2015-12-01

    Veterinary public health (VPH) assumes huge significance in developing countries such as India. However, the implementation of VPH services throughout the country is still in its infancy. From 1970 onwards, many institutes, national and international organisations, professional societies, policies and personalities have contributed towards the development of VPH in India. Nevertheless, there is an urgent need to develop VPH still further as there are many issues, such as high population density, the re-emergence of zoonotic pathogens, environmental pollution and antimicrobial resistance, that require attention. The time has surely come to involve all stakeholders, ranging from primary producers (e.g., farmers) to policy-makers, so as to garner support for the holistic implementation of VPH services in India. To improve VPH activities and services, science-based policies enforced through stringent regulation are required to improve human, animal and environmental health. The emergence of the 'One Health' concept has ushered in new hopes for the resurrection of VPH in India. Applying tools such as the World Organisation for Animal Health (OlE) Day One Competencies and the OlE Tool for the Evaluation of Performance of Veterinary Services (PVS Tool) is essential to improve the quality of national Veterinary Services and to identify gaps and weaknesses in service provision, which can be remedied to comply with the OlE international standards. VPH initiatives started modestly but they continue to grow. The present review is focused on the current status and future needs of VPH in India.

  14. ACCOUNTING TREATMENTS ON FORESTRY SPECIAL FUNDS AND SPECIFIC PROBLEMS IN ROMANIA

    Directory of Open Access Journals (Sweden)

    Hada Teodor

    2013-07-01

    Full Text Available This study, theoretically and practically, presents the accounting system for forestry special purpose funds in Romania. In addition, the main problems Romanian forestry faces nowadays are highlighted in the content, given the legislative changes expected in the near future. Accounting treatments specific to Romanian forestry regarding special funds, namely the conservation and regeneration fund, the accessibility fund, the environmental fund and the improvement fund are governed in the current law, mainly by the Forestry Code in Romania - Law 46/2008 supplemented by other specialized works used within the National Forest Directorate in Romania. Among the specific forestry regulations, special purpose funds are an area of interest in the current economic crisis being presented under several aspects: establishing the Fund, its utility and calculation method, its recording into accounting, or its specific tax implications. The main objective of this paper is to provide both a framework for analysis and presentation of the problems faced by forestry activity in Romania, and the accounting treatments specific to forestry activities, by illustrating the main entries made through financial and accounting documents. Given that we fully realize the environment’s importance in our lives, we understand the very close relationship between the forestry business’ enactment, its financing and its supervision. Special funds are the basis for financing forestry projects. Their study covers a gap in the specialized literature, providing specialists, practitioners and other stakeholders a framework. In the current economic and political context, the forestry problems, environmental issues in general are perceived to be more stringent. The solutions identified as a firm response to the existing problems are therefore of major importance, of which, in this study, we have identified and proposed several solutions. Practical examples have as grounds real data

  15. The future of energy

    International Nuclear Information System (INIS)

    Romer, A.

    2001-01-01

    The article discusses not only the future of energy and resource consumption in various areas of the world, but also its development over the centuries since the industrial revolution. The present situation, with large discrepancies between the energy consumption of industrialised nations and the developing countries is examined. Social and environmental aspects are discussed and the sustainable use of the Earth's resources and the inconsistencies in this area is looked at. Rather than adopting a moralistic approach, the article appeals to man's powers of innovation and sense of responsibility in order to develop solutions to today's and future energy supply problems. The article is richly illustrated with diagrams and graphs on world energy and social statistics

  16. Future accelerators in Japan

    International Nuclear Information System (INIS)

    Toge, Nobu

    1993-01-01

    This paper presents a brief report on the present status of future accelerator projects at the National Laboratory for High Energy Physics (KEK), Japan. The KEK laboratory has been successfully operating the TRISTAN accelerator complex since 1986. It consists of a 2.5 GeV electron/positron linac, an 8 GeV Accumulation Ring (AR) and a 29 GeV Main Ring (MR). Concurrently with this operation, in response to recommendations by the Japanese High Energy Physics Committee, survey studies have been continued on new accelerator facilities at KEK. They have two major future projects, namely, the asymmetric e + e - B-factory based on TRISTAN (TRISTAN-II) and the Japan Linear Collider (JLC). The purpose of this paper is to outline those research activities and to present an update on their status

  17. Building a Circular Future

    DEFF Research Database (Denmark)

    Merrild, Heidi

    2016-01-01

    Natural resources are scarce and construction accounts for 40 percent of the material and energy consumption in Europe. This means that a switch to a circular future is necessary. ’Building a Circular Future’ maps out where we are, where we are going, and what is needed for this conversion to take...... on the project’s strategies. The financial result is a profit of DKK 35 million on the structure alone in the demolition of a building built for the cost of DKK 860 million. The total potential for the whole building, calculated in projected material prices, is estimated to be up to 16% of the total construction...... of the circular strategies is not only in the future. Increased flexibility, optimized operation and maintenance, as well as a healthier building, is low-hanging fruit that can be harvested today. The project’s principles can be implemented in industrialized construction in a large scale today. That is proven...

  18. FUTURES with Jaime Escalante

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1996-08-01

    The United States Department of Energy awarded the Foundation for Advancements in Science and Education (FASE) $826,000 as support to produce the second set of FUTURES segments consisting of 12, 15-minute programs. The programs provide motivation for students to study math by connecting math to the work place and real-life problem scenarios. The programs are broadcast in 50 states through PBS Elementary and Secondary Service (E/SS). The grant term ended on December 16, 1993 and this final report documents program and financial activity results. The 12 episodes are titled: Animal Care, Meteorology, Mass Communication, Advanced Energy, Oceanography, Graphic Design, Future Habitats, Environmental Science & Technology, Fitness & Physical Performance, Interpersonal Communications, Advanced Transportation and Product Design. Each program addresses as many as ten careers or job types within the broader field named. Minority and gender-balanced role models appear throughout the programs.

  19. Future of palliative medicine

    Directory of Open Access Journals (Sweden)

    Sushma Bhatnagar

    2015-01-01

    Full Text Available A ′need-supply′ and ′requirement-distribution mismatch′ along with a continuingneed explosion are the biggest hurdles faced by palliative medicine today. It is the need of the hour to provide an unbiased, equitable and evidence-based palliative care to those in need irrespective of the diagnosis, prognosis, social and economic status or geographical location. Palliative care as a fundamental human right, ensuring provision throughout the illness spectrum, global as well as region-specific capacity building, uniform availability of essential drugs at an affordable price, a multidisciplinary team approachand caregiver-support are some of the achievable goals for the future. This supplanted with a strong political commitment, professional dedication and ′public-private partnerships′ are necessaryto tackle the existing hurdles and the exponentially increasing future need. For effectively going ahead it is of utmost importance to integrate palliative medicine into medical education, healthcare system and societal framework.

  20. Witnessing the Future

    DEFF Research Database (Denmark)

    Elgaard Jensen, Torben

    2007-01-01

    and the problematic work life elsewhere. Finally, it notes that the manager's strategy enacts a timeworld characterised by dramatic epochal changes, which is radically different from the more stable and knowable time-world that is enacted in ordinary scientific discourses. Key words: actor-network theory, witnessing......Abstract: The paper explores the phenomenon of witnessing the future through a case study of how a Scandinavian new economy firm managed to persuade a number of business journalists that it was "the future". It describes the procedures and rhetorical strategies that the manager deployed to turn...... the journalists into witnesses. It compares the manager's strategy to other cases of effective witnessing in courtrooms and in science. It concludes that the manager's persuasiveness is derived from his ability to articulate a series of pointed contrasts between the attractive working life within the firm...

  1. World Energy Future

    Energy Technology Data Exchange (ETDEWEB)

    Forbes, A.; Van der Linde, C.; Nicola, S.

    2009-03-15

    In the section World Energy Future of this magazine two articles, two interviews and one column are presented. The article 'A green example to the world' refers briefly to the second World Future Energy Summit in Abu Dhabi, which was held from 18-21 January, 2009. The second article, 'Green Utopia in the desert' attention is paid to the Abu Dhabi government-driven Masdar Initiative. The two interviews concern an interview with BP Alternative Energy ceo Vivienne Cox, and an interview with the founder and CEO of New Energy Finance Michael Liebreich. The column ('An efficient response') focuses on the impact of the economic crisis on energy policy.

  2. The future of physics

    International Nuclear Information System (INIS)

    Aspect, A.; Balian, R.; Balibar, S.; Brezin, E.; Cabane, B.; Fauve, St.; Kaplan, D.; Lena, P.; Poirier, J.P.; Prost, J.

    2004-01-01

    A group of physicists present their discipline to the general public in an entirely new way. They do not expose the results of physics like established dogmas, on the contrary they describe the questions that remain open and that might be solved in a more or less distant future. These questions are the most fundamental that one can pose: the origin of the Big-bang, the future of the universe, the existence of the Higgs boson, the true nature of the core of the earth, superconductivity, the new quantum revolution which may upset all the computer industry, the modeling of climate, or the physics of soft matter that invades our watches, our screens of computers or television sets. The 14 chapters of this book are 14 journeys to the borders of today's knowledge. (A.C.)

  3. The alternative energy future

    International Nuclear Information System (INIS)

    Spitzley, H.

    1989-02-01

    The alternative energy future can be achieved only by making energy conservation programmes successful, and by fully committing to the utilization of soft energy sources. This is the perspective drawn by the author who in this book investigates the fundamentals of an ecologically and socially sound energy policy for the future. Looking at California, USA, where completely near concepts have been put to work in the energy sector since the mid-seventies, the author shows how it can be done, by rewarding energy conserving activities, using available energy sources more efficiently, developing the means for renewable energy exploitation wherever appropriate. A turn in energy policy is feasible also in West Germany, both in technical and political terms. Starting from the experience gained in the USA, the author presents an outline of options and potentials of a new energy strategy for the Federal Republic of Germany. (orig./HP) [de

  4. Ketosis treatment in lactating dairy cattle.

    Science.gov (United States)

    Gordon, Jessica L; Leblanc, Stephen J; Duffield, Todd F

    2013-07-01

    This article provides an update on ketosis treatment regimens. The ketosis treatment literature is reviewed and the findings are summarized. Current treatment recommendations and areas for future research are provided. Copyright © 2013 Elsevier Inc. All rights reserved.

  5. Future prospects of pregeometry

    International Nuclear Information System (INIS)

    Terazawa, Hidezumi.

    1991-06-01

    Pregeometry is a theory, first suggested by Sakharov in 1967, in which gravity is taken as a quantum effect of matter fields and in which Einstein's theory of general relativity for gravity appears as an approximate and effective theory at long distances. It is shown by reviewing the extensive developments of pregeometric theories of gravity for the last more than a decade that the original idea by Sakharov is really working. Many future prospects of the theories are discussed in some detail. (author)

  6. Surveying Future Surveys

    Science.gov (United States)

    Carlstrom, John E.

    2016-06-01

    The now standard model of cosmology has been tested and refined by the analysis of increasingly sensitive, large astronomical surveys, especially with statistically significant millimeter-wave surveys of the cosmic microwave background and optical surveys of the distribution of galaxies. This talk will offer a glimpse of the future, which promises an acceleration of this trend with cosmological information coming from new surveys across the electromagnetic spectrum as well as particles and even gravitational waves.

  7. Future directions for QCD

    International Nuclear Information System (INIS)

    Bjorken, J.D.

    1996-10-01

    New directions for exploring QCD at future high-energy colliders are sketched. These include jets within jets. BFKL dynamics, soft and hard diffraction, searches for disoriented chiral condensate, and doing a better job on minimum bias physics. The new experimental opportunities include electron-ion collisions at HERA, a new collider detector at the C0 region of the TeVatron, and the FELIX initiative at the LHC

  8. Preparing for the future

    CERN Multimedia

    Panos Charitos

    2016-01-01

    The second annual meeting of the Future Circular Collider (FCC) design study took place from 11 to 15 April in Rome.   The participants in the second annual meeting of the FCC design study. (Photo: Vinicio Tullio/INFN) More than 450 scientists, researchers and leaders of high-tech industry gathered in Rome to review the progress of the Future Circular Collider (FCC) design study. The study was kicked off in 2014 as a response to a statement in the European Strategy for Particle Physics, and today embraces 74 institutes from 26 countries. With the LHC programme well under way, particle physicists are at an exciting juncture. New results from the 13 TeV run could show that we are on the threshold of an eye-opening era that presents new challenges and calls for developments. “To prepare for its future, CERN should continue to develop a vibrant R&D programme that should take advantage of its strengths and uniqueness, pursue design studies for...

  9. Future nuclear power generation

    International Nuclear Information System (INIS)

    Mosbah, D.S.; Nasreddine, M.

    2006-01-01

    The book includes an introduction then it speaks about the options to secure sources of energy, nuclear power option, nuclear plants to generate energy including light-water reactors (LWR), heavy-water reactors (HWR), advanced gas-cooled reactors (AGR), fast breeder reactors (FBR), development in the manufacture of reactors, fuel, uranium in the world, current status of nuclear power generation, economics of nuclear power, nuclear power and the environment and nuclear power in the Arab world. A conclusion at the end of the book suggests the increasing demand for energy in the industrialized countries and in a number of countries that enjoy special and economic growth such as China and India pushes the world to search for different energy sources to insure the urgent need for current and anticipated demand in the near and long-term future in light of pessimistic and optimistic outlook for energy in the future. This means that states do a scientific and objective analysis of the currently available data for the springboard to future plans to secure the energy required to support economy and welfare insurance.

  10. Toward sustainable energy futures

    Energy Technology Data Exchange (ETDEWEB)

    Pasztor, J. (United Nations Environment Programme, Nairobi (Kenya))

    1990-01-01

    All energy systems have adverse as well as beneficial impacts on the environment. They vary in quality, quantity, in time and in space. Environmentally sensitive energy management tries to minimize the adverse impacts in an equitable manner between different groups in the most cost-effective ways. Many of the enviornmental impacts of energy continue to be externalized. Consequently, these energy systems which can externalize their impacts more easily are favoured, while others remain relatively expensive. The lack of full integration of environmental factors into energy policy and planning is the overriding problem to be resolved before a transition towards sustainable energy futures can take place. The most pressing problem in the developing countries relates to the unsustainable and inefficient use of biomass resources, while in the industrialized countries, the major energy-environment problems arise out of the continued intensive use of fossil fuel resources. Both of these resource issues have their role to play in climate change. Although there has been considerable improvement in pollution control in a number of situations, most of the adverse impacts will undoubtedly increase in the future. Population growth will lead to increased demand, and there will also be greater use of lower grade fuels. Climate change and the crisis in the biomass resource base in the developing countries are the most critical energy-environment issues to be resolved in the immediate future. In both cases, international cooperation is an essential requirement for successful resolution. 26 refs.

  11. The future petroleum geologist

    International Nuclear Information System (INIS)

    Berg, R.R.

    1992-01-01

    This paper reports that in July 1985, AAPG President William L. Fisher appointed a select committee to determine the capabilities that will be required of petroleum geologists in the future. His charge to the committee was based on the profound changes and uncertainties that were beginning to be felt in the industry and would surely affect the employment of geologists and their professional practice. These changes are well known: the supply of oil had exceeded demand, the price of oil was unstable, many companies were threatened by debt and buy-outs, and corporate restructuring was underway to meet changing economic conditions. All contributed to great uncertainty about the need and requirements of geological employment and practice. Specifically, President Fisher charged the committee to distinguish those elements of recent times that are cyclic and those that are long-term in their effects; to characterize the state of the industry for the next 25 years; to predict the capabilities that the future petroleum geologist should posses to meet the challenges of the future; and most importantly, the define the role of AAPG and its commitments to the membership under these changing conditions

  12. Our future energy

    Energy Technology Data Exchange (ETDEWEB)

    2011-11-15

    The Danish Government's plan ''Our Future Energy'' seeks to create green growth and help the country convert to 100 percent renewable energy use by 2050. The Danish Government in November 2011 presented its plan for how the country can secure its energy future. Titled ''Our Future Energy'', the strategy presents specific measures for fulfilling the Government's goal of stimulating green growth. The plan is based on the previous government's Energy Strategy 2050, but raises the bar higher. The long-term goal of the plan is to implement an energy and transport network that relies solely on renewable energy sources. By 2020, the initiatives will lead to extensive reductions in energy consumption, making it possible for half of the country's electricity consumption to be covered by wind power. Coal is to be phased out of Danish power plants by 2030. And by 2035, all electricity and heating will be generated using renewable sources. (Author)

  13. Impact of reformulated gasoline on emissions from current and future vehicles

    International Nuclear Information System (INIS)

    Colucci, J.M.; Benson, J.D.

    1993-01-01

    Gasolines reformulated specifically for reducing vehicle emissions will result in the most significant changes in the U.S. refining industry since the advent of unleaded gasoline. This paper will review the results from the Auto/Oil Air Quality Improvement Research Program showing the beneficial effects on vehicle emissions of individually decreasing gasoline aromatic, olefin and sulfur contents, 90% distillation temperature, and Reid vapor pressure, and of adding oxygenates. The paper discusses the importance of reformulated gasolines for reducing emissions from existing vehicles by complying with requirements in the Clean Air Act and California's Low Emission Vehicle/Clean Fuels Program. It will show the importance of controlling Vehicle/Clean Fuels Program. It will show the importance of controlling specific aromatic and olefin compounds in gasoline, and it will discuss how automotive manufacturers will utilize reformulated gasolines to meet future stringent vehicle emission standards

  14. Inhibition strategies of Listeria monocytogenes biofilms-current knowledge and future outlooks.

    Science.gov (United States)

    Oloketuyi, Sandra F; Khan, Fazlurrahman

    2017-09-01

    There is an increasing trend in the food industry on the Listeria monocytogenes biofilm formation and inhibition. This is attributed to its easy survival on contact surfaces, resistance to disinfectants or antibiotics and growth under the stringent condition used for food processing and preservation thereby leading to food contamination products by direct or indirect exposure. Though, there is a lack of conclusive evidences about the mechanism of biofilm formation, in this review, the concept of biofilm formation and various chemical, physical, and green technology approaches to prevent or control the biofilm formed is discussed. State-of-the-art approaches ranging from the application of natural to synthetic molecules with high effectiveness and non-toxicity targeted at the different steps of biofilm formation could positively influence the biofilm inhibition in the future. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. Systematic review of catatonia treatment

    Directory of Open Access Journals (Sweden)

    Pelzer ACM

    2018-01-01

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

  16. Future directions in radiation oncology

    International Nuclear Information System (INIS)

    Peters, L.

    1996-01-01

    Full text: Cancer treatment has evolved progressively over the years as a joint result of improvements in technology and better understanding of the biological responses of neoplastic and normal cells to cytotoxic agents. Although major therapeutic 'breakthroughs' are unlikely absent the discovery of exploitable fundamental differences between cancer cells and their normal homologs, further incremental improvements in cancer treatment results can confidently be expected as we apply existing knowledge better and take advantage of new research insights. Areas in which I can foresee significant improvements (in approximate chronological order) are as follows: better physical radiation dose distributions; more effective radiation and chemoradiation protocols based on radiobiological principles; more rational use of radiation adjuvants based on biologic criteria; use of novel targets and vectors for systemic radionuclide therapy; use of genetic markers of radiosensitivity to determine radiation dose tolerances; and use of radiation as a modulator of therapeutic gene expression. Radiation research has contributed greatly to the efficacy of radiation oncology as it is now practised but has even greater potential for the future

  17. Present and future strategies for neutrinoless double beta decay ...

    Indian Academy of Sciences (India)

    doubled exposure, with signal shape analysis to discard Compton events, a heavy ... sonable amount to put stringent (and competitive) limits on 0νDBD. ..... with an impressive reduced electronic noise and an almost eliminated risk of de-.

  18. Effluent treatment for nuclear thermal propulsion ground testing

    Science.gov (United States)

    Shipers, Larry R.

    1993-01-01

    The objectives are to define treatment functions, review concept options, discuss PIPET effluent treatment system (ETS), and outline future activities. The topics covered include the following: reactor exhaust; effluent treatment functions; effluent treatment categories; effluent treatment options; concept evaluation; PIPETS ETS envelope; PIPET effluent treatment concept; and future activities.

  19. What fluids are given during air ambulance treatment of patients with trauma in the UK, and what might this mean for the future? Results from the RESCUER observational cohort study

    Science.gov (United States)

    Naumann, David N; Hancox, James M; Raitt, James; Smith, Iain M; Crombie, Nicholas; Doughty, Heidi; Perkins, Gavin D; Midwinter, Mark J

    2018-01-01

    Objectives We investigated how often intravenous fluids have been delivered during physician-led prehospital treatment of patients with hypotensive trauma in the UK and which fluids were given. These data were used to estimate the potential national requirement for prehospital blood products (PHBP) if evidence from ongoing trials were to report clinical superiority. Setting The Regional Exploration of Standard Care during Evacuation Resuscitation (RESCUER) retrospective observational study was a collaboration between 11 UK air ambulance services. Each was invited to provide up to 5 years of data and total number of taskings during the same period. Participants Patients with hypotensive trauma (systolic blood pressure 1 type. The most common fluid was 0.9% saline, given to 486/537 (90.5%) of patients who received fluids, at a median volume of 750 (IQR 300–1500) mL. Three per cent of patients received PHBP. Estimated projections for patients eligible for PHBP at these 11 services and in the whole UK were 313 and 794 patients per year, respectively. Conclusions One in 40 air ambulance taskings were manned by physicians to retrievepatients with hypotensive trauma. The most common fluid delivered was 0.9% saline. If evidence justifies universal provision of PHBP, approximately 800 patients/year would be eligible in the UK, based on our data combined with others published. Prospective investigations are required to confirm or adjust these estimations. PMID:29362272

  20. Technology and the future of healthcare

    Directory of Open Access Journals (Sweden)

    Harold Thimbleby

    2013-12-01

    Full Text Available Healthcare changes dramatically because of technological developments, from anesthetics and antibiotics to magnetic resonance imaging scanners and radiotherapy. Future technological innovation is going to keep transforming healthcare, yet while technologies (new drugs and treatments, new devices, new social media support for healthcare, etc will drive innovation, human factors will remain one of the stable limitations of breakthroughs. No predictions can satisfy everybody; instead, this article explores fragments of the future to see how to think more clearly about how to get where we want to go.