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...

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 ...

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.

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

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.

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

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

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.

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

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

[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.

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.

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.

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.

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

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.

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.

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....

[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.

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

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.

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.

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.

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

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 ...

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)

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

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

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

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…

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.

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.

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.

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.

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

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.

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

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.

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.

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.

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.

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.

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.

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.

[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.

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)

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...

Advanced Off-Gas Control System Design For Radioactive And Mixed Waste Treatment

International Nuclear Information System (INIS)

Nick Soelberg

2005-01-01

Treatment of radioactive and mixed wastes is often required to destroy or immobilize hazardous constituents, reduce waste volume, and convert the waste to a form suitable for final disposal. These kinds of treatments usually evolve off-gas. Air emission regulations have become increasingly stringent in recent years. Mixed waste thermal treatment in the United States is now generally regulated under the Hazardous Waste Combustor (HWC) Maximum Achievable Control Technology (MACT) standards. These standards impose unprecedented requirements for operation, monitoring and control, and emissions control. Off-gas control technologies and system designs that were satisfactorily proven in mixed waste operation prior to the implementation of new regulatory standards are in some cases no longer suitable in new mixed waste treatment system designs. Some mixed waste treatment facilities have been shut down rather than have excessively restrictive feed rate limits or facility upgrades to comply with the new standards. New mixed waste treatment facilities in the U. S. are being designed to operate in compliance with the HWC MACT standards. Activities have been underway for the past 10 years at the INL and elsewhere to identify, develop, demonstrate, and design technologies for enabling HWC MACT compliance for mixed waste treatment facilities. Some specific off-gas control technologies and system designs have been identified and tested to show that even the stringent HWC MACT standards can be met, while minimizing treatment facility size and cost

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.

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...

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.

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...

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.

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.

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.

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.

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.

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

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.

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.

[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.

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

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.

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.

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.

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

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

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

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

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.

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.

Ambient plasma treatment of silicon wafers for surface passivation recovery

Science.gov (United States)

Ge, Jia; Prinz, Markus; Markert, Thomas; Aberle, Armin G.; Mueller, Thomas

2017-08-01

In this work, the effect of an ambient plasma treatment powered by compressed dry air on the passivation quality of silicon wafers coated with intrinsic amorphous silicon sub-oxide is investigated. While long-time storage deteriorates the effective lifetime of all samples, a short ambient plasma treatment improves their passivation qualities. By studying the influence of the plasma treatment parameters on the passivation layers, an optimized process condition was identified which even boosted the passivation quality beyond its original value obtained immediately after deposition. On the other hand, the absence of stringent requirement on gas precursors, vacuum condition and longtime processing makes the ambient plasma treatment an excellent candidate to replace conventional thermal annealing in industrial heterojunction solar cell production.

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.

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.

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

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.

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

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.)

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.

Treatment of ORNL liquid low-level waste

International Nuclear Information System (INIS)

Berry, J.B.; Brown, C.H. Jr.; Fowler, V.L.; Robinson, S.M.

1988-01-01

Discontinuation of the hydrofracture disposal method at Oak Ridge National Laboratory (ORNL) has caused intensive efforts to reduce liquid waste generation. Improving the treatment of slightly radioactive liquid waste, called process waste, has reduced the volume of the resulting contaminated liquid radioactive waste effluent by 66%. Proposed processing improvements could eliminate the contaminated liquid effluent and reduce solid low-level waste by an additional one-third. The improved process meets stringent discharge limits for radionuclides. Discharge limits for radionuclides are expected to be enforced at the outfall of the treatment plant to a creek; currently, limits are enforced at the reservation boundary. Plant discharge is monitored according to the National Pollutant Discharge Elimination System (NPDES) permit for ORNL. 1 ref., 4 figs., 2 tabs

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

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

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.

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

Characterizing costs and benefits of uncertain future regulatory requirements on the U.S. natural gas industry

International Nuclear Information System (INIS)

Godec, M.L.; Smith, G.E.; Fitzgibbon, T.

1995-01-01

Environmental regulatory requirements at both the state and federal level are constantly changing, making it difficult for industry and R ampersand D program managers to project future compliance requirements and costs. Even if a company is trying to keep abreast of various proposed regulatory initiatives, the number of possible combinations of initiatives that could occur in the future seems virtually limitless. Uncertainty associated with potential future environmental compliance requirements makes the identification and evaluation of future investment and R ampersand D opportunities exceedingly difficult, and makes the process of systematic strategic planning increasingly complex. This paper describes a methodology for accounting for uncertain future environmental compliance costs in a systematic, comprehensive manner. Through analysis of proposed initiatives for making future environmental requirements more stringent, forecasting the likelihood of occurrence and potential timing of each initiative, and estimating potential future compliance costs associated with each initiative, a thorough process for incorporating regulatory uncertainty into strategic planning and project evaluation is described. This approach can be used for evaluating R ampersand D opportunities to determine where development of new technologies or assessment of risks posed by industry operations may have the greatest impact on future industry costs of compliance. This approach could also be used to account for the uncertainty of future environmental costs in corporate strategic planning or for factoring future compliance costs into project evaluation. This approach could also be enhanced through use in conjunction with other modeling and forecasting systems that could consider a broad range of impacts, including impacts on gas production, industry activity levels, and tax revenues

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

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.

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.

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.

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.

Exploring the future role of Asia utilizing a Scenario Matrix Architecture and Shared Socio-economic Pathways

International Nuclear Information System (INIS)

Eom, Jiyong; Calvin, Kate; Clarke, Leon; Edmonds, Jae; Kim, Sonny; Kopp, Robert; Kyle, Page; Luckow, Patrick; Moss, Richard; Patel, Pralit; Wise, Marshall

2012-01-01

We explore the implications that alternative pathways for human population and economic development have for the role of Asia in reference no-climate-policy scenarios and scenarios in which climate forcing is limited. We consider three different pathways of socioeconomic development, which we refer to as Shared Socio-economic Pathways (SSPs) and four different levels of limitation on climate forcing, which we refer to as Shared Climate Policy Assumptions (SPAs). SSPs are differentiated by population and economic growth assumptions, while SPAs are differentiated on the level of radiative forcing in the year 2100. Regardless of the scenarios we examined Asia plays a central role in shaping the world's future with nearly half of the world's people and more than half of the world's economic activity and energy consumption. The future of Asia and the world are dramatically different across the various combinations of SSPs and SPAs. High population worlds place significant stress on Asian resources and ecosystems. In high population SSPs the poorest members of the population face high energy and food prices and the more stringent the level of emissions mitigation, the more stress poor populations experience, though the more stringent the emissions mitigation, the larger the area of unmanaged ecosystems that are preserved. - Highlights: ► We explore the implications of alternative population and economic pathways for the role of Asia. ► High population world places significant stress on Asian resources and ecosystems. ► In high population world, the poorest members of the population face high energy and food prices. ► The greater level of emissions mitigation, the more stress poor people experience. ► The greater the emissions mitigation, the larger the area of unmanaged ecosystems preserved.

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.

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.

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.

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.

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.

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.

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

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

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

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.

Electron treatment of wood pulp for the viscose process

Science.gov (United States)

Stepanik, T. M.; Ewing, D. E.; Whitehouse, R.

2000-03-01

Electron processing is currently being evaluated by several viscose producers for integration into their process. The viscose industry converts dissolving wood pulp into products such as staple fibre, filament, cord, film, packaging, and non-edible sausage casings. These materials are used in the clothing, drapery, hygiene, automobile, food, and packaging industries. Viscose producers are facing increasingly high production costs and stringent environmental regulations that have forced some plants to close. Electron treatment of wood pulp can significantly reduce the amounts of chemicals used for producing viscose and the production of hazardous pollutants. Acsion Industries has worked with companies worldwide to demonstrate the benefits of using electron treated pulp for producing viscose (rayon). This paper describes the viscose process, the benefits of using electron treatment in the viscose process, and Acsion's efforts in developing this technology.

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-.

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.

Full scale validation of helminth ova (Ascaris suum) inactivation by different sludge treatment processes

Energy Technology Data Exchange (ETDEWEB)

Paulsrud, B.; Gjerde, B.; Lundar, A.

2003-07-01

The Norwegian sewage sludge regulation requires disinfection (hygienisation) of all sludges for land application, and one of the criteria is that disinfected sludge should not contain viable helminth ova. All disinfection processes have to be designed and operated in order to comply with this criteria, and four processes employed in Norway (thermophilic aerobic pre-treatment, pre-pasteurisation, thermal vacuum drying in membrane filter presses and lime treatment) have been tested in full scale by inserting semipermeable bags of Ascaris suum eggs into the processes for certain limes. For lime treatment supplementary laboratory tests have been conducted. The paper presents the results of the experiments, and it could be concluded that all processes, except lime treatment, could be operated at less stringent time-temperature regimes than commonly experienced at Norwegian plants today. (author)

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

Expectations and drivers of future greenhouse gas emissions from Canada's oil sands: An expert elicitation

International Nuclear Information System (INIS)

McKellar, Jennifer M.; Sleep, Sylvia; Bergerson, Joule A.; MacLean, Heather L.

2017-01-01

The greenhouse gas (GHG) emissions intensity of oil sands operations has declined over time but has not offset absolute emissions growth due to rapidly increasing production. Policy making, decisions about research and development, and stakeholder discourse should be informed by an assessment of future emissions intensity trends, however informed projections are not easily generated. This study investigates expected trends in oil sands GHG emissions using expert elicitation. Thirteen experts participated in a survey, providing quantitative estimates of expected GHG emissions intensity changes and qualitative identifications of drivers. Experts generally agree that emissions intensity reductions are expected at commercially operating projects by 2033, with the greatest reductions expected through the use of technology in the in situ area of oil sands activity (40% mean reduction at multiple projects, averaged across experts). Incremental process changes are expected to contribute less to reducing GHG emissions intensity, however their potentially lower risk and cost may result in larger cumulative reductions. Both technology availability and more stringent GHG mitigation policies are required to realize these emissions intensity reductions. This paper demonstrates a method to increase rigour in emissions forecasting activities and the results can inform policy making, research and development and modelling and forecasting studies. - Highlights: • Expert elicitation used to investigate expected trends in oil sands GHG emissions. • Overall, emissions intensity reductions are expected at commercial projects by 2033. • Reductions are expected due to both technology changes and process improvements. • Technology availability and more stringent GHG policies are needed for reductions. • Method used increases rigour in emissions forecasting, and results inform policy.

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

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.

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.

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.

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.

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

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.

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

Successful Treatment of Retinal Angiomatous Proliferation with Intravitreal Triamcinolone and Ranibizumab Injections in a 67-Year-Old Male

Directory of Open Access Journals (Sweden)

Adnaan Haq

2014-11-01

Full Text Available A 67-year-old male who presented to the eye casualty department with deterioration in his vision was diagnosed with retinal angiomatous proliferation. After initial deterioration with ranibizumab intravitreal injections, we have demonstrated successful treatment and stabilised vision with ranibizumab and a single intravitreal triamcinolone injection. Stringent follow-up and top-up ranibizumab injections have stabilised his vision and have shown foveal improvement on optical coherence tomography imaging.

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....

WE-A-304-02: Strategies and Technologies for Cranial Radiosurgery Planning: Gamma Knife

International Nuclear Information System (INIS)

Schlesinger, D.

2015-01-01

The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Future directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB

WE-A-304-00: Stereotactic Radiosurgery

International Nuclear Information System (INIS)

2015-01-01

The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Future directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB

WE-A-304-01: Strategies and Technologies for Cranial Radiosurgery Planning: MLC-Based Linac

Energy Technology Data Exchange (ETDEWEB)

Kim, G. [University of California, San Diego (United States)

2015-06-15

The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Future directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB.

WE-A-304-00: Stereotactic Radiosurgery

Energy Technology Data Exchange (ETDEWEB)

NONE

2015-06-15

The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Future directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB.

WE-A-304-02: Strategies and Technologies for Cranial Radiosurgery Planning: Gamma Knife

Energy Technology Data Exchange (ETDEWEB)

Schlesinger, D. [University of Virginia Health Systems (United States)

2015-06-15

The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Future directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB.

WE-A-304-01: Strategies and Technologies for Cranial Radiosurgery Planning: MLC-Based Linac

International Nuclear Information System (INIS)

Kim, G.

2015-01-01

The high fractional doses, stringent requirements for accuracy and precision, and surgical perspective characteristic of intracranial radiosurgery create considerations for treatment planning which are distinct from most other radiotherapy procedures. This session will introduce treatment planning techniques specific to two popular intracranial SRS modalities: Gamma Knife and MLC-based Linac. The basic treatment delivery characteristics of each device will be reviewed with a focus on how those characteristics determine the paradigm used for treatment planning. Basic techniques for treatment planning will be discussed, including considerations such as isodose selection, target and organ-at-risk definition, quality indices, and protection of critical structures. Future directions for SRS treatment planning will also be discussed. Learning Objectives: Introduce the basic physical principles of intracranial radiosurgery and how they are realized in the treatment planning paradigms for Gamma Knife and Linac radiosurgery. Demonstrate basic treatment planning techniques. Discuss metrics for evaluating SRS treatment plan quality. Discuss recent and future advances in SRS treatment planning. D. Schlesinger receives research support from Elekta, AB

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.

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)

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.

Nevada Test Site, site treatment plan 1999 annual update

International Nuclear Information System (INIS)

1999-03-01

A Site Treatment Plan (STP) is required for facilities at which the US Department of Energy Nevada Operations Office (DOE/NV) generates or stores mixed waste (MW), defined by the Federal Facility Compliance Act (FFC Act) as waste containing both a hazardous waste subject to the Resource Conservation and Recovery Act (RCRA) and a radioactive material subject to the Atomic Energy Act. This STP was written to identify specific treatment facilities for treating DOE/NV generated MW and provides proposed implementation schedules. This STP was approved by the Nevada Division of Environmental Protection (NDEP) and provided the basis for the negotiation and issuance of the FFC Act Consent Order (CO) dated March 6, 1996, and revised June 15, 1998. The FFC Act CO sets forth stringent regulatory requirements to comply with the implementation of the STP

Application of the nanofiltration and pervaporation in the treatment of waste water

International Nuclear Information System (INIS)

Mora M, J.; Vatai, G.; Bekassy-Molnare

2002-01-01

This paper is about the application of membrane technologies in waste water treatment. Membrane operations are applied to a number of environmental problems as the result of more stringent regulations. For economical reasons applications are still generally limited to the cases where contaminants and/or water can be recovered for recycle or reuse. In the following will present the results experiments where Nanofiltration and Pervaporation of industrial wastewater treatment had been used. The examined waste water, containing methanol an salt, was originated from the drilling procedure of the MOL Rt. Hungary. Previously this wastewater had been treated by distillation or ionic exchange. The distillation removes the methanol by heat supply, which is an expensive method, and the salt precipitation causes difficulties in the cleaning of the apparatus. The ion exchange treatment experiments were not very efficient and economic. (Author) [es

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.

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

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

Future Automotive Aftertreatment Solutions: The 150°C Challenge Workshop Report

Energy Technology Data Exchange (ETDEWEB)

Zammit, Michael; DiMaggio, Craig L.; Kim, Chang H.; Lambert, Christine; Muntean, George G.; Peden, Charles HF; Parks, James E.; Howden, Ken

2013-10-15

With future fuel economy standards enacted, the U.S. automotive manufacturers (OEMs) are committed to pursuing a variety of high risk/highly efficient stoichiometric and lean combustion strategies to achieve superior performance. In recognition of this need, the U.S. Department of Energy (DOE) has partnered with domestic automotive manufacturers through U.S. DRIVE to develop these advanced technologies. However, before these advancements can be introduced into the U.S. market, they must also be able to meet increasingly stringent emissions requirements. A significant roadblock to this implementation is the inability of current catalyst and aftertreatment technologies to provide the required activity at the much lower exhaust temperatures that will accompany highly efficient combustion processes and powertrain strategies. Therefore, the goal of this workshop and report is to create a U.S. DRIVE emission control roadmap that will identify new materials and aftertreatment approaches that offer the potential for 90% conversion of emissions at low temperature (150°C) and are consistent with highly efficient combustion technologies currently under investigation within U.S. DRIVE Advanced Combustion and Emission Control (ACEC) programs.

Nevada Test Site site treatment plan. Final annual update. Revision 1

International Nuclear Information System (INIS)

1998-04-01

A Site Treatment Plan (STP) is required for facilities at which the US Department of Energy Nevada Operations Office (DOE/NV) generates or stores mixed waste (MW), defined by the Federal Facility Compliance Act (FFCAct) as waste containing both a hazardous waste subject to the Resource Conservation and Recovery Act (RCRA) and a radioactive material subject to the Atomic Energy Act. This STP was written to identify specific treatment facilities for treating DOE/NV generated MW and provides proposed implementation schedules. This STP was approved by the Nevada Division of Environmental Protection (NDEP) and provided the basis for the negotiation and issuance of the FFCAct Consent Order (CO) dated March 6, 1996. The FFCAct CO sets forth stringent regulatory requirements to comply with the implementation of the STP

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.

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.

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.

IGCC - fuel-flexible technology for the future

Energy Technology Data Exchange (ETDEWEB)

Karg, J.; Hannemann, F. [Siemens AG Power Generation, Erlangen (Germany)

2004-07-01

According to IEA's World Energy Investment Outlook 2003 the electricity sector will dominate with about 60% of the total investment requirements expected until 2030 for worldwide energy-supply infrastructure. Around 45% of the capital needed for the electricity sector will be for power generation. The investment will be needed for capacity additions and to replace existing older facilities. According to the estimates the global primary energy demand is projected to grow by two thirds over the next three decades and electricity demand is expected to double by 2030. The natural gas for power generation is projected to increase significantly, but coal will remain the largest source of electricity generation throughout the projection period. These trends must be seen against the background that environmental regulations, are becoming tighter, and that environmental legislation will increasingly address greenhouse gas emissions. The necessity for more efficient use of primary energies in combination with more stringent environmental regulations for fossil-fuelled power plants therefore pushes concepts with increased efficiencies and reduced CO{sub 2} emissions, respectively. Since significant reduction of CO{sub 2} emissions cannot only be achieved via increased efficiencies or application of fuels with low carbon content, CO{sub 2} removal options also need to be considered for future power plant configurations. Considering this, IGCC is again one of the most promising solutions which are of relevance in this context. However, these new IGCC applications require further overall a plant concept and component development efforts. One essential step for performance improvement of future IGCC applications is to further develop syngas capabilities of advanced gas turbines, thereby considering the experience and lessons learned from operational plants. 11 refs., 7 figs., 5 tabs.

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

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.

Determining treatment frequency for controlling weeds on traffic islands using chemical and non-chemical weed control

DEFF Research Database (Denmark)

Rask, Anne Merete; Larsen, S.U.; Andreasen, Christian

2013-01-01

Many public authorities rely on the use of non-chemical weed control methods, due to stringent restrictions on herbicide use in urban areas. However, these methods usually require more repeated treatments than chemical weed management, resulting in increased costs of weed management. In order...... of treatments per year were required: glyphosate 2.5, hot water 3, flames 5, hot air/flames 5.5 and steam 5.5 treatments. The results demonstrate that the weed control should be adjusted to the prescribed quality for the traffic islands by regularly assessing the need for weed control. They also show...... to investigate the efficacy of four non-chemical weed control methods and glyphosate treatment, experiments were carried out on traffic islands in the growing seasons 2005 and 2006. Three trial sites were each divided into six treatment areas, which were either treated with glyphosate, flame, steam, hot air...

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...

Pre-treatment and membrane ultrafiltration using treated palm oil mill effluent (POME

Directory of Open Access Journals (Sweden)

Wong Pui Wah

2002-11-01

Full Text Available Treatment of palm oil mill effluent (POME has always been a topic of research in Malaysia. This effluent that is extremely rich in organic content needs to be properly treated to minimize environmental hazards before it is released into watercourses. The common practice for treating POME in Malaysia involves a combination of aerobic and anaerobic methods. The purpose of tertiary treatment is to allow the treated water to be reused in the mill operations for other purposes such as feed water. The proposed treatment will also ensure the industry to meet a more stringent discharge standard in terms of the BOD, COD and nitrogen values. In this study membrane ultrafiltration is used as the tertiary treatment method. Before the actual membrane operation was conducted, the samples were pre-treated using three separate method namely filtration, centrifugation and coagulation. It was found that the combination of filtrationultrafiltration treatment POME produced the best-treated sample quality in terms of pollutant contents elimination, namely % BOD, % COD and % nitrogen removal.

Rational energy use at sewage treatment plants; Rationelle Energieverwendung in Klaeranlagen

Energy Technology Data Exchange (ETDEWEB)

Sommer, J.; Maurer, P. [ISET - Inst. fuer Solare Energieversorgungstechnik e.V., Hanau (Germany). Abt. Prozess- und Verfahrenstechnik

1999-07-01

As pollutant concentration limits for effluent from sewage treatment plant have become more stringent in recent years, great efforts in the form of construction measures have been made in order to enhance sewage cleaning performance. However, enhanced cleaning efficiency as a rule involves higher energy consumption. The present paper describes a standardized procedure for effective implementation of the energetic optimization of sewage treatment plant. Furthermore, an MS-Excel-based software tool for rough and detailed analyses of municipal sewage treatment plants is described. (orig.) [German] Die Verschaerfung der Einleitungsgrenzwerte fuer Klaeranlagen hat in den letzten Jahren zu intensiven Baumassnahmen mit dem Ziel der Erhoehung der Reinigungsleistung gefuehrt. Bedauerlicherweise ist eine Steigerung der Reinigungsleistung meist auch mit einem erhoehten Energieverbrauch verbunden. Der vorliegende Beitrag stellt eine standardisierte Vorgehensweise zur effektiven Durchfuehrung der energetischen Optimierung von Klaeranlagen vor. Ferner wird ein auf MS-Excel basierendes Software-Tool zur energetischen Grob- und Feinanalyse von kommunalen Klaeranlagen vorgestellt. (orig.)

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.

The Uncertain Future of Nuclear Energy

OpenAIRE

Bunn, Matthew G.; von Hippel, Frank; Diakov, Anatoli; Ding, Ming; Katsuta, Tadahiro; McCombie, Charles; Ramana, M.V.; Suzuki, Tatsujiro; Voss, Susan; Yu, Suyuan

2010-01-01

In the 1970s, nuclear energy was expected to quickly become the dominant generator of electrical power. Its fuel costs are remarkably low because a million times more energy is released per unit weight by fission than by combustion. But its capital costs have proven to be high. Safety requires redundant cooling and control systems, massive leak-tight containment structures, very conservative seismic design and extremely stringent quality control. The routine health risks and greenhouse-gas...

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

Implications and applications of systematic reviews for evidence-based dentistry and comparative effectiveness research: A sample study on antibiotics for oro-facial cellulitis treatment

OpenAIRE

Quyen Bach; Vandan Kasar; Francesco Chiappelli

2015-01-01

Introduction: Comparative effectiveness and efficacy research for analysis and practice (CEERAP) was performed to assess the effects of penicillin-based versus erythromycin-based antibiotic treatments in patients with skin and soft tissue infections (SSTIs) including cellulitis, impetigo, and erysipelas. Because SSTIs, especially orofacial cellulitis, are volatile infectious diseases of a life-threatening nature, research on the most efficacious remedies is necessary. Methods: The stringent b...

JSC Advanced Curation: Research and Development for Current Collections and Future Sample Return Mission Demands

Science.gov (United States)

Fries, M. D.; Allen, C. C.; Calaway, M. J.; Evans, C. A.; Stansbery, E. K.

2015-01-01

Curation of NASA's astromaterials sample collections is a demanding and evolving activity that supports valuable science from NASA missions for generations, long after the samples are returned to Earth. For example, NASA continues to loan hundreds of Apollo program samples to investigators every year and those samples are often analyzed using instruments that did not exist at the time of the Apollo missions themselves. The samples are curated in a manner that minimizes overall contamination, enabling clean, new high-sensitivity measurements and new science results over 40 years after their return to Earth. As our exploration of the Solar System progresses, upcoming and future NASA sample return missions will return new samples with stringent contamination control, sample environmental control, and Planetary Protection requirements. Therefore, an essential element of a healthy astromaterials curation program is a research and development (R&D) effort that characterizes and employs new technologies to maintain current collections and enable new missions - an Advanced Curation effort. JSC's Astromaterials Acquisition & Curation Office is continually performing Advanced Curation research, identifying and defining knowledge gaps about research, development, and validation/verification topics that are critical to support current and future NASA astromaterials sample collections. The following are highlighted knowledge gaps and research opportunities.

Water within the Shared Socioeconomic Pathways: Constraints and the Impact on Future Global Change Scenarios

Science.gov (United States)

Graham, N. T.; Hejazi, M. I.; Davies, E. G.; Calvin, K. V.; Kim, S. H.; Miralles-Wilhelm, F.

2017-12-01

The Shared Socioeconomic Pathways (SSPs) represent the next generation of future global change scenarios and their inclusion in the Coupled Model Intercomparison Project Phase 6 (CMIP6) scenarios reinforces the importance of a complete understanding of the SSPs. This study uses the Global Change Assessment Model (GCAM) to investigate the effects of limited water supplies on future withdrawals at regional and water basin scales across all SSPs in combination with various climate mitigation scenarios. Water supply is calculated using a global hydrologic model and water data from five ISI-MIP models across the four RCP scenarios. When water constraints are incorporated, our results show that water withdrawals are reduced by as much as 40% across all SSP scenarios without climate policies. As climate policies are imposed and become more stringent, water withdrawals increase in regions already affected by water stress in order to allow for greater biomass production. The results of this research show the importance of including water resource constraints within the SSP scenarios for establishing water withdrawal scenarios under a wide range of scenarios including different climate policies. The results will also provide data products - such as gridded land use and water demand estimates - of potential interest to the impact, adaptation, and vulnerability community following the SSP scenarios.

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.

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...

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

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.

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.

Arguing about climate change. Judging the handling of climate risk to future generations by comparison to the general standards of conduct in the case of risk to contemporaries

International Nuclear Information System (INIS)

Davidson, M.D.

2009-01-01

Intergenerational justice requires that climate risks to future generations be handled with the same reasonable care deemed acceptable by society in the case of risks to contemporaries. Such general standards of conduct are laid down in tort law, for example. Consequently, the validity of arguments for or against more stringent climate policy can be judged by comparison to the general standards of conduct applying in the case of risk to contemporaries. That this consistency test is able to disqualify certain arguments in the climate debate is illustrated by a further investigation of the debate on the social discount rate, used in cost-benefit analysis of climate policy

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...

Studies on the reverse osmosis treatment of uranyl nitrate solution

International Nuclear Information System (INIS)

Prabhakar, S.; Panicker, S.T.; Misra, B.M.; Ramani, P.S.

1992-01-01

The aqueous effluent generated in uranium processing, particularly in the nuclear fuel fabrication step, contains mainly uranium nitrate. This requires treatment before discharge into the environment to meet stringent standards. This paper presents the performance of cellulose acetate membranes with regard to rejection of uranium under reverse osmotic conditions for feed concentrations up to 200 mg/l of uranium, which corresponds to the levels normally prevalent in the effluents. The use of additives like the disodium salt of ethylenediaminetetraacetic acid and sodium sulfate for the improvement of reverse osmosis performance of the above membranes was also investigated. In the light of the experimental results, the suitability of reverse osmosis for the decontamination of uranium effluents is discussed

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.

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

Diagnosis and management of Alzheimer's disease: past, present and future ethical issues.

Science.gov (United States)

Gauthier, S; Leuzy, A; Racine, E; Rosa-Neto, P

2013-11-01

There is great interest in the ethical issues associated with Alzheimer's disease (AD) and related dementias given the prevalence of AD and the evolving neuroscience landscape in matters of diagnoses and therapeutics. Much of the ethics discussion arises in the tension between the principle of not doing harm (principle of non-maleficence) in this vulnerable population and the development of effective treatments (principle of beneficence). Autonomy and capacity issues are also numerous, wide-ranging, and concern (1) day to day affairs such as driving safely and spending money wisely, (2) life-time events such as designating a legal representative in case of incapacity, making a will, (3) consenting to treatment and diagnostic procedures, (4) participating in research. The latter issue is particularly thorny and illustrates well the complexity of tackling concerns related to capacity. The impetus to protect AD patients has partly led to ethics regulation and policies making research on inapt patients more difficult because of stringent requirements for signed informed consent or for showing the value of the research to this specific patient population. New issues are arising that relate to earlier diagnosis using biomarkers and (possibly soon) the use of drugs that modify disease progression. We here summarize and discuss the different ethical issues associated with AD from a historical perspective, with emphasis on diagnostic and treatments issues. Copyright © 2013 Elsevier Ltd. All rights reserved.

Prospects of type-II seesaw models at future colliders in light of the DAMPE e+e- excess

Science.gov (United States)

Sui, Yicong; Zhang, Yongchao

2018-05-01

The DAMPE e+e- excess at around 1.4 TeV could be explained in the type-II seesaw model with a scalar dark mater D which is stabilized by a discrete Z2 symmetry. The simplest scenario is the annihilation D D →H++H- followed by the subsequent decay H±±→e±e±, with both the DM and triplet scalars roughly 3 TeV with a small mass splitting. In addition to the Drell-Yan process at future 100 TeV hadron colliders, the doubly charged components could also be produced at lepton colliders like ILC and CLIC in the off shell mode and mediate lepton flavor violating processes e+e-→ℓi±ℓj∓ (with i ≠j ). A wide range of parameter space of the type-II seesaw could be probed, which are well below the current stringent lepton flavor constraints.

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

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.

Future radioactive liquid waste streams study

Energy Technology Data Exchange (ETDEWEB)

Rey, A.S.

1993-11-01

This study provides design planning information for the Radioactive Liquid Waste Treatment Facility (RLWTF). Predictions of estimated quantities of Radioactive Liquid Waste (RLW) and radioactivity levels of RLW to be generated are provided. This information will help assure that the new treatment facility is designed with the capacity to treat generated RLW during the years of operation. The proposed startup date for the RLWTF is estimated to be between 2002 and 2005, and the life span of the facility is estimated to be 40 years. The policies and requirements driving the replacement of the current RLW treatment facility are reviewed. Historical and current status of RLW generation at Los Alamos National Laboratory are provided. Laboratory Managers were interviewed to obtain their insights into future RLW activities at Los Alamos that might affect the amount of RLW generated at the Lab. Interviews, trends, and investigation data are analyzed and used to create scenarios. These scenarios form the basis for the predictions of future RLW generation and the level of RLW treatment capacity which will be needed at LANL.

Future radioactive liquid waste streams study

International Nuclear Information System (INIS)

Rey, A.S.

1993-11-01

This study provides design planning information for the Radioactive Liquid Waste Treatment Facility (RLWTF). Predictions of estimated quantities of Radioactive Liquid Waste (RLW) and radioactivity levels of RLW to be generated are provided. This information will help assure that the new treatment facility is designed with the capacity to treat generated RLW during the years of operation. The proposed startup date for the RLWTF is estimated to be between 2002 and 2005, and the life span of the facility is estimated to be 40 years. The policies and requirements driving the replacement of the current RLW treatment facility are reviewed. Historical and current status of RLW generation at Los Alamos National Laboratory are provided. Laboratory Managers were interviewed to obtain their insights into future RLW activities at Los Alamos that might affect the amount of RLW generated at the Lab. Interviews, trends, and investigation data are analyzed and used to create scenarios. These scenarios form the basis for the predictions of future RLW generation and the level of RLW treatment capacity which will be needed at LANL

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.

Past, present, and possible future limits on the photon rest mass

International Nuclear Information System (INIS)

Nieto, M.M.

1992-01-01

In an historical context, present limits on the photon rest mass are reviewed. More stringent, yet speculative, limits which have been proposed are mentioned. Finally, new theoretical ideas and possible experimental improvements on the present limits are discussed, along with possible relationships between these two areas

Personnel Safety for Future Magnetic Fusion Power Plants

Energy Technology Data Exchange (ETDEWEB)

Lee Cadwallader

2009-07-01

The safety of personnel at existing fusion experiments is an important concern that requires diligence. Looking to the future, fusion experiments will continue to increase in power and operating time until steady state power plants are achieved; this causes increased concern for personnel safety. This paper addresses four important aspects of personnel safety in the present and extrapolates these aspects to future power plants. The four aspects are personnel exposure to ionizing radiation, chemicals, magnetic fields, and radiofrequency (RF) energy. Ionizing radiation safety is treated well for present and near-term experiments by the use of proven techniques from other nuclear endeavors. There is documentation that suggests decreasing the annual ionizing radiation exposure limits that have remained constant for several decades. Many chemicals are used in fusion research, for parts cleaning, as use as coolants, cooling water cleanliness control, lubrication, and other needs. In present fusion experiments, a typical chemical laboratory safety program, such as those instituted in most industrialized countries, is effective in protecting personnel from chemical exposures. As fusion facilities grow in complexity, the chemical safety program must transition from a laboratory scale to an industrial scale program that addresses chemical use in larger quantity. It is also noted that allowable chemical exposure concentrations for workers have decreased over time and, in some cases, now pose more stringent exposure limits than those for ionizing radiation. Allowable chemical exposure concentrations have been the fastest changing occupational exposure values in the last thirty years. The trend of more restrictive chemical exposure regulations is expected to continue into the future. Other issues of safety importance are magnetic field exposure and RF energy exposure. Magnetic field exposure limits are consensus values adopted as best practices for worker safety; a typical

Personnel Safety for Future Magnetic Fusion Power Plants

International Nuclear Information System (INIS)

Cadwallader, Lee

2009-01-01

The safety of personnel at existing fusion experiments is an important concern that requires diligence. Looking to the future, fusion experiments will continue to increase in power and operating time until steady state power plants are achieved; this causes increased concern for personnel safety. This paper addresses four important aspects of personnel safety in the present and extrapolates these aspects to future power plants. The four aspects are personnel exposure to ionizing radiation, chemicals, magnetic fields, and radiofrequency (RF) energy. Ionizing radiation safety is treated well for present and near-term experiments by the use of proven techniques from other nuclear endeavors. There is documentation that suggests decreasing the annual ionizing radiation exposure limits that have remained constant for several decades. Many chemicals are used in fusion research, for parts cleaning, as use as coolants, cooling water cleanliness control, lubrication, and other needs. In present fusion experiments, a typical chemical laboratory safety program, such as those instituted in most industrialized countries, is effective in protecting personnel from chemical exposures. As fusion facilities grow in complexity, the chemical safety program must transition from a laboratory scale to an industrial scale program that addresses chemical use in larger quantity. It is also noted that allowable chemical exposure concentrations for workers have decreased over time and, in some cases, now pose more stringent exposure limits than those for ionizing radiation. Allowable chemical exposure concentrations have been the fastest changing occupational exposure values in the last thirty years. The trend of more restrictive chemical exposure regulations is expected to continue into the future. Other issues of safety importance are magnetic field exposure and RF energy exposure. Magnetic field exposure limits are consensus values adopted as best practices for worker safety; a typical

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

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.

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

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.

Assessment of economic impact of offshore and coastal discharge requirements on present and future operations in the Gulf of Mexico. Final report

International Nuclear Information System (INIS)

Lindsey, R.

1996-06-01

The high potential costs of compliance associated with new effluent guidelines for offshore and coastal oil and gas operations could significantly affect the economics of finding, developing, and producing oil and gas in the Gulf of Mexico. This report characterizes the potential economic impacts of alternative treatment and discharge regulations for produced water on reserves and production in Gulf of Mexico coastal, territorial and outer continental shelf (OCS) waters, quantifying the impacts of both recent regulatory changes and possible more stringent requirements. The treatment technologies capable of meeting these requirements are characterized in terms of cost, performance, and applicability to coastal and offshore situations. As part of this analysis, an extensive database was constructed that includes oil and gas production forecasts by field, data on existing platforms, and the current treatment methods in place for produced water treatment and disposal on offshore facilities. This work provides the first comprehensive evaluation of the impacts of alternative regulatory requirements for produced water management and disposal in coastal and offshore areas of the Gulf of Mexico

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

Trend and future of diesel engine: Development of high efficiency and low emission low temperature combustion diesel engine

International Nuclear Information System (INIS)

Ho, R J; Yusoff, M Z; Palanisamy, K

2013-01-01

Stringent emission policy has put automotive research and development on developing high efficiency and low pollutant power train. Conventional direct injection diesel engine with diffused flame has reached its limitation and has driven R and D to explore other field of combustion. Low temperature combustion (LTC) and homogeneous charge combustion ignition has been proven to be effective methods in decreasing combustion pollutant emission. Nitrogen Oxide (NO x ) and Particulate Matter (PM) formation from combustion can be greatly suppressed. A review on each of method is covered to identify the condition and processes that result in these reductions. The critical parameters that allow such combustion to take place will be highlighted and serves as emphasis to the direction of developing future diesel engine system. This paper is written to explore potential of present numerical and experimental methods in optimizing diesel engine design through adoption of the new combustion technology.

Trend and future of diesel engine: Development of high efficiency and low emission low temperature combustion diesel engine

Science.gov (United States)

Ho, R. J.; Yusoff, M. Z.; Palanisamy, K.

2013-06-01

Stringent emission policy has put automotive research & development on developing high efficiency and low pollutant power train. Conventional direct injection diesel engine with diffused flame has reached its limitation and has driven R&D to explore other field of combustion. Low temperature combustion (LTC) and homogeneous charge combustion ignition has been proven to be effective methods in decreasing combustion pollutant emission. Nitrogen Oxide (NOx) and Particulate Matter (PM) formation from combustion can be greatly suppressed. A review on each of method is covered to identify the condition and processes that result in these reductions. The critical parameters that allow such combustion to take place will be highlighted and serves as emphasis to the direction of developing future diesel engine system. This paper is written to explore potential of present numerical and experimental methods in optimizing diesel engine design through adoption of the new combustion technology.

Sustainable sludge management - what are the challenges for the future?

Energy Technology Data Exchange (ETDEWEB)

Rulkens, Wim H.

2003-07-01

Sewage sludge is a serious problem due to the high treatment costs and the risks to environment and human health. Future sludge treatment will be progressively focused on an improved efficiency and environmental sustainability of the process. In this context a survey is given of most relevant sludge treatment options and separate treatment steps. Special attention is paid to those processes that are simultaneously focused on the elimination of the risks for environment and human health and on the recovery or beneficial use of the valuable compounds in the sludge such as organic carbon compounds, inorganic non-toxic substances, phosphorous and nitrogen containing compounds. Also, a brief assessment is given of the specific future technological developments regarding the various treatment steps. Furthermore, it is discussed how to assess the various pathways which can lead to the required developments. In such an assessment the technical and economic feasibility, the environmental sustainability, the societal acceptance and the implementation route are important factors. The optimal approach also strongly depends on the local and regional situation of concern and the relevant current and future boundary conditions. (author)

Hormone treatment of gender identity disorder in a cohort of children and adolescents.

Science.gov (United States)

Hewitt, Jacqueline K; Paul, Campbell; Kasiannan, Porpavai; Grover, Sonia R; Newman, Louise K; Warne, Garry L

2012-05-21

To describe the experience of hormone treatment of gender identity disorder (GID) in children and adolescents within a specialist clinic. Cohort study by medical record review of children aged 0-17 years referred during 2003-2011 for management at the GID clinic in a tertiary paediatric referral centre - the Royal Children's Hospital, Melbourne, Victoria. Clinical characteristics of the patient population, hormone treatment provided, frequency of referrals with time. Thirty-nine children and adolescents were referred for gender dysphoria. Seventeen individuals were pubertal with persistent GID, and were considered eligible for hormone treatment. Seven patients, comprising three biological males and four biological females, had legally endorsed hormone treatment. In this group, gender dysphoria was first noted at 3-6 years of age. Hormone treatment with GnRH analogue to suppress pubertal progression (phase 1) was given at 10-16 years of age. Treatment with cross-sex hormones (phase 2) was given at 15.6-16 years. One patient purchased cross-sex hormone treatment overseas. One patient received oestrogen and progesterone for menstrual suppression before phase 1. The annual frequency of new referrals increased continuously over the study period. Hormone treatment for pubertal suppression and subsequent gender transition needs to be individualised within stringent protocols in multidisciplinary specialist units.

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

Phenol wastewater remediation: advanced oxidation processes coupled to a biological treatment.

Science.gov (United States)

Rubalcaba, A; Suárez-Ojeda, M E; Stüber, F; Fortuny, A; Bengoa, C; Metcalfe, I; Font, J; Carrera, J; Fabregat, A

2007-01-01

Nowadays, there are increasingly stringent regulations requiring more and more treatment of industrial effluents to generate product waters which could be easily reused or disposed of to the environment without any harmful effects. Therefore, different advanced oxidation processes were investigated as suitable precursors for the biological treatment of industrial effluents containing phenol. Wet air oxidation and Fenton process were tested batch wise, while catalytic wet air oxidation and H2O2-promoted catalytic wet air oxidation processes were studied in a trickle bed reactor, the last two using over activated carbon as catalyst. Effluent characterisation was made by means of substrate conversion (using high liquid performance chromatography), chemical oxygen demand and total organic carbon. Biodegradation parameters (i.e. maximum oxygen uptake rate and oxygen consumption) were obtained from respirometric tests using activated sludge from an urban biological wastewater treatment plant (WWTP). The main goal was to find the proper conditions in terms of biodegradability enhancement, so that these phenolic effluents could be successfully treated in an urban biological WWTP. Results show promising research ways for the development of efficient coupled processes for the treatment of wastewater containing toxic or biologically non-degradable compounds.

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.

GUT models at current and future hadron colliders and implications to dark matter searches

Science.gov (United States)

Arcadi, Giorgio; Lindner, Manfred; Mambrini, Yann; Pierre, Mathias; Queiroz, Farinaldo S.

2017-08-01

Grand Unified Theories (GUT) offer an elegant and unified description of electromagnetic, weak and strong interactions at high energy scales. A phenomenological and exciting possibility to grasp GUT is to search for TeV scale observables arising from Abelian groups embedded in GUT constructions. That said, we use dilepton data (ee and μμ) that has been proven to be a golden channel for a wide variety of new phenomena expected in theories beyond the Standard Model to probe GUT-inspired models. Since heavy dilepton resonances feature high signal selection efficiencies and relatively well-understood backgrounds, stringent and reliable bounds can be placed on the mass of the Z‧ gauge boson arising in such theories. In this work, we obtain 95% C.L. limits on the Z‧ mass for several GUT-models using current and future proton-proton colliders with √{ s} = 13 TeV , 33 TeV ,and 100 TeV, and put them into perspective with dark matter searches in light of the next generation of direct detection experiments.

GUT models at current and future hadron colliders and implications to dark matter searches

Directory of Open Access Journals (Sweden)

Giorgio Arcadi

2017-08-01

Full Text Available Grand Unified Theories (GUT offer an elegant and unified description of electromagnetic, weak and strong interactions at high energy scales. A phenomenological and exciting possibility to grasp GUT is to search for TeV scale observables arising from Abelian groups embedded in GUT constructions. That said, we use dilepton data (ee and μμ that has been proven to be a golden channel for a wide variety of new phenomena expected in theories beyond the Standard Model to probe GUT-inspired models. Since heavy dilepton resonances feature high signal selection efficiencies and relatively well-understood backgrounds, stringent and reliable bounds can be placed on the mass of the Z′ gauge boson arising in such theories. In this work, we obtain 95% C.L. limits on the Z′ mass for several GUT-models using current and future proton–proton colliders with s=13 TeV,33 TeV,and100 TeV, and put them into perspective with dark matter searches in light of the next generation of direct detection experiments.

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.

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)

Innovative physico-chemical treatment of wastewater incorporating Moringa oleifera seed coagulant.

Science.gov (United States)

Bhuptawat, Hitendra; Folkard, G K; Chaudhari, Sanjeev

2007-04-02

Moringa oleifera is a pan tropical, multipurpose tree whose seeds contain a high quality edible oil (up to 40% by weight) and water soluble proteins that act as effective coagulants for water and wastewater treatment. The use of this natural coagulant material has not yet realised its potential. A water extract of M. oleifera seed was applied to a wastewater treatment sequence comprising coagulation-flocculation-sedimentation-sand filtration. The study was laboratory based using an actual wastewater. Overall COD removals of 50% were achieved at both 50 and 100mg/l M. oleifera doses. When 50 and 100mg/l seed doses were applied in combination with 10mg/l of alum, COD removal increased to 58 and 64%, respectively. The majority of COD removal occurred during the filtration process. In the tests incorporating alum, sludge generation and filter head loss increased by factors of 3 and 2, respectively. These encouraging treatment results indicate that this may be the first treatment application that can move to large scale adoption. The simple water extract may be obtained at minimal cost from the presscake residue remaining after oil extraction from the seed. The regulatory compliance issues of adopting 'new materials' for wastewater treatment are significantly less stringent than those applying to the production of potable water.

Treatment of oily wastes by agglomeration techniques to produce an auxiliary carbonaceous fuel with low SO2 emissions

International Nuclear Information System (INIS)

Majid, A.; Capes, C.E.; Sparks, B.D.

1992-01-01

Oily sludges and organic wastes are produced by a number of industries, particularly those related to the recovery of processing of petroleum. Traditional sludge disposal methods, involving concentration by impoundment followed by land filling or land farming, are meeting with increasingly stringent regulations. Further treatment of the wastes and reduction of volume and recycle are being encouraged and legislated. Such treatment may range from separation of constituents into higher value products, such as the separation of oil or other organic components from mineral (ash forming) impurities and water, to stabilization of impurities to prevent leaching or to reduce emissions during combustion. This paper reports on liquid phase agglomeration (LPA) which has the potential to play a major role in oily waste treatment processes. It can be adapted to separate finely divided solids or liquids from immiscible liquid suspensions or emulsions

Heat Treatment Optimization Studies on PIT Nb$_3$Sn Strand for the NED Project

CERN Document Server

Boutboul, T; den Ouden, A; Pedrini, D; Seeber, B; Volpini, G

2009-01-01

For the Next European Dipole (NED) program, a Powder-In-Tube (PIT) strand was successfully developed by SMI. This high-performance Nb$_{3}$Sn strand presents a non-copper critical current density of ~ 2500 A/mm2 at 12 T applied field and 4.2 K and a filament diameter around 50 µm. Extensive heat treatment optimization studies were performed in order to maximize both critical current and RRR, with a plateau temperature down to 625 oC and duration up to 400 hours. It appears that a critical current enhancement of ~ 10 % can be achieved for a reaction schedule of 320 hours at 625 oC with non-copper critical current density respectively exceeding 2700 and 1500 A/mm2 at 12 and 15 T (4.2 K). Thanks to this modified heat treatment, this strand completely fulfils the NED stringent specification.

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

DESALINATION AND WATER TREATMENT RESEARCH AT SANDIA NATIONAL LABORATORIES.

Energy Technology Data Exchange (ETDEWEB)

Rigali, Mark J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Miller, James E. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Altman, Susan J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Biedermann, Laura [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Brady, Patrick Vane. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Kuzio, Stephanie P. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Nenoff, Tina M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Rempe, Susan [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

2016-11-01

Water is the backbone of our economy - safe and adequate supplies of water are vital for agriculture, industry, recreation, and human consumption. While our supply of water today is largely safe and adequate, we as a nation face increasing water supply challenges in the form of extended droughts, demand growth due to population increase, more stringent health-based regulation, and competing demands from a variety of users. To meet these challenges in the coming decades, water treatment technologies, including desalination, will contribute substantially to ensuring a safe, sustainable, affordable, and adequate water supply for the United States. This overview documents Sandia National Laboratories' (SNL, or Sandia) Water Treatment Program which focused on the development and demonstration of advanced water purification technologies as part of the larger Sandia Water Initiative. Projects under the Water Treatment Program include: (1) the development of desalination research roadmaps (2) our efforts to accelerate the commercialization of new desalination and water treatment technologies (known as the 'Jump-Start Program),' (3) long range (high risk, early stage) desalination research (known as the 'Long Range Research Program'), (4) treatment research projects under the Joint Water Reuse & Desalination Task Force, (5) the Arsenic Water Technology Partnership Program, (6) water treatment projects funded under the New Mexico Small Business Administration, (7) water treatment projects for the National Energy Technology Laboratory (NETL) and the National Renewable Energy Laboratory (NREL), (8) Sandia- developed contaminant-selective treatment technologies, and finally (9) current Laboratory Directed Research and Development (LDRD) funded desalination projects.

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

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

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

Sludge quantification at water treatment plant and its management scenario.

Science.gov (United States)

Ahmad, Tarique; Ahmad, Kafeel; Alam, Mehtab

2017-08-15

Large volume of sludge is generated at the water treatment plants during the purification of surface water for potable supplies. Handling and disposal of sludge require careful attention from civic bodies, plant operators, and environmentalists. Quantification of the sludge produced at the treatment plants is important to develop suitable management strategies for its economical and environment friendly disposal. Present study deals with the quantification of sludge using empirical relation between turbidity, suspended solids, and coagulant dosing. Seasonal variation has significant effect on the raw water quality received at the water treatment plants so forth sludge generation also varies. Yearly production of the sludge in a water treatment plant at Ghaziabad, India, is estimated to be 29,700 ton. Sustainable disposal of such a quantity of sludge is a challenging task under stringent environmental legislation. Several beneficial reuses of sludge in civil engineering and constructional work have been identified globally such as raw material in manufacturing cement, bricks, and artificial aggregates, as cementitious material, and sand substitute in preparing concrete and mortar. About 54 to 60% sand, 24 to 28% silt, and 16% clay constitute the sludge generated at the water treatment plant under investigation. Characteristics of the sludge are found suitable for its potential utilization as locally available construction material for safe disposal. An overview of the sustainable management scenario involving beneficial reuses of the sludge has also been presented.

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.

Irradiation from a phytosanitary treatment perspective

International Nuclear Information System (INIS)

Zulkifli Kamaruzzaman; Asna Booty Othman; Chan Ah Kiow

2002-01-01

Recognizing that with the advent of globalisation and initiatives towards liberalization of trade through the elimination of tariff and non-tariff barriers, the challenge towards gaining international market access will hinge primarily on quality of agricultural commodities. Besides aiming for efficiency in production it is crucial to emphasise on quality so that it not only provide a competitive edge but also enables them to penetrate markets that have stringent phytosanitary requirements. The need for an alternative quarantine treatment against agricultural pests has been pressing as according to the Montreal Protocol, fumigation with methyl bromide, the most widely used fumigant, will be globally phased out due to environment reasons. Irradiation is a relatively new technology and lately it has been accepted as one of the phytosanitary measures by the International Plant Protection Convention (IPPC). It provides one of the alternative technologies available to the food industries to control organisms that cause food borne diseases, to reduce food losses due to spoilage and deterioration, and to overcome barriers in food trade. Taking cognizance that irradiation has potential as a treatment technology for the disinfestation of pests of agricultural commodities, efforts have been stepped up to ensure the pre-requisites are in place for its implementation. (Author)

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

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)

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…

Positive futures? The impact of HIV infection on achieving health, wealth and future planning.

Science.gov (United States)

Harding, Richard; Molloy, Tim

2008-05-01

Although HIV is now cast as a chronic condition with favourable clinical outcomes under new treatments, it is unclear how living with HIV affects expectations and planning for the future. This mixed-methods study aimed to investigate UK gay men's expectations of their own future when living with HIV, and to identify the heath and social interventions required to enhance roles, participation and personal fulfilment. A preliminary focus group identified relevant domains of enquiry for a subsequent online cross-sectional survey. A total of 347 gay men living in the UK with HIV participated in the survey, and 56.6% were currently on treatment. However, high 7-day prevalence of psychological and physical symptoms was identified (42.6% in pain, 80.2% worrying); 57.8% perceived reduced career options due to their infection and 71.8% reduced life expectancy. Being on treatment was not significantly associated with perceived life expectancy. Coded open-ended survey data identified eight principle themes related to goal planning and attainment. The integrated open and closed data items offer an understanding of barriers and challenges that focus on poor mental health due to clinical inattention, discrimination and stigma, poor career and job opportunities due to benefit and workplace inflexibility and lack of understanding, a lack of personal goals and associated skills deficit related to confidence and self esteem. Gay men living with HIV require an integrated holistic approach to wellbeing that incorporates clinical, social and individual intervention in order to lead productive lives with maximum benefit from treatment gains.

Artificial wetland for wastewater treatment

International Nuclear Information System (INIS)

Arias I, Carlos A; Brix, Hans

2003-01-01

The development of constructed wetland technology for wastewater treatment has gone a long way and from an experimental and unknown empirical method, which was capable of handling wastewater a sound technology was developed. Thanks to research, and the work of many public and private companies that have gather valuable operation information, constructed wetland technology has evolved to be a relievable, versatile and effective way to treat wastewater, run off, handle sludge and even improve environmental quality and provide recreation sites, while maintaining low operation and maintenance costs, and at the same time, producing water of quality that can meet stringent regulations, while being and environmental friendly solution to treat waste-waters. Constructed wetlands can be established in many different ways and its characteristics can differ greatly, according to the user needs, the geographic site and even the climatic conditions of the area. The following article deals with the general characteristics of the technology and the physical and chemical phenomena that govern the pollution reduction with in the different available systems

Distillery spent wash: Treatment technologies and potential applications

International Nuclear Information System (INIS)

Mohana, Sarayu; Acharya, Bhavik K.; Madamwar, Datta

2009-01-01

Distillery spent wash is the unwanted residual liquid waste generated during alcohol production and pollution caused by it is one of the most critical environmental issue. Despite standards imposed on effluent quality, untreated or partially treated effluent very often finds access to watercourses. The distillery wastewater with its characteristic unpleasant odor poses a serious threat to the water quality in several regions around the globe. The ever-increasing generation of distillery spent wash on the one hand and stringent legislative regulations of its disposal on the other has stimulated the need for developing new technologies to process this effluent efficiently and economically. A number of clean up technologies have been put into practice and novel bioremediation approaches for treatment of distillery spent wash are being worked out. Potential microbial (anaerobic and aerobic) as well as physicochemical processes as feasible remediation technologies to combat environmental pollution are being explored. An emerging field in distillery waste management is exploiting its nutritive potential for production of various high value compounds. This review presents an overview of the pollution problems caused by distillery spent wash, the technologies employed globally for its treatment and its alternative use in various biotechnological sectors

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.

A new water treatment scheme for thermal development : the SIBE process

Energy Technology Data Exchange (ETDEWEB)

Pedenaud, P.; Dang, F. [Total, Paris (France)

2008-10-15

The production of extra heavy oil or bitumen through thermal methods such as steam assisted gravity drainage (SAGD) involves the generation and injection into the reservoir of large quantities of steam which is recirculated with the produced bitumen. It is expected that maximizing the recycling of the produced water into steam will be mandatory, because of the need to minimize fresh water consumption and the possibility of increasingly stringent environmental regulations. The SAGD water treatment scheme is complex. It depends on the water characteristics, the steam generator type selected, and the decision to completely eliminate waste water disposal or use other waste handling and disposal methods. Other challenges such as the high silica content in the produced water, are encountered with SAGD water treatment. This paper presented an overview of the current water treatment process options for SAGD, as well as a new patented process called silica inhibition and blowdown evaporation (SIBE). The paper also presented an estimate of the economic benefit of the new SIBE process relative to conventional process schemes. Treatment objectives and water characteristics and the steps involved in conventional water treatment were first outlined. It was concluded that the silica and hardness removal scheme combined with the boiler blowdown evaporator were less economical because of higher investment cost due to the evaporation unit. 1 ref., 3 tabs., 4 figs.

A Future Market Reduces Bubbles but Allows Greater Profit for More Sophisticated Traders

NARCIS (Netherlands)

Noussair, C.N.; Tucker, S.; Xu, Yilong

2014-01-01

We study the effect of the addition 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 futures market are active

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)

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.

Test beam results of the GE1/1 prototype for a future upgrade of the CMS high-$\\eta$ muon system

CERN Document Server

Abbaneo, D; Armagnaud, C; Aspell, P; Ban, Y; Bally, S; Benussi, L; Berzano, U; Bianco, S; Bos, J; Bunkowski, K; Cai, J; Chatelain, J P; Christiansen, J; Colafranceschi, S; Colaleo, A; Conde Garcia, A; David, E; de Robertis, G; De Oliveira, R; Duarte Pinto, S; Ferry, S; Formenti, F; Franconi, L; Gnanvo, K; Gutierrez, A; Hohlmann, M; Karchin, P E; Loddo, F; Magazzú, G; Maggi, M; Marchioro, A; Marinov, A; Mehta, K; Merlin, J; Mohapatra, A; Moulik, T; Nemallapudi, M V; Nuzzo, S; Oliveri, E; Piccolo, D; Postema, H; Raffone, G; Rodrigues, A; Ropelewski, L; Saviano, G; Sharma, A; Staib, M J; Teng, H; Tytgat, M; Tupputi, S A; Turini, N; Smilkjovic, N; Villa, M; Zaganidis, N; Zientek, M

2011-01-01

Gas Electron Multipliers (GEM) are an interesting technology under consideration for the future upgrade of the forward region of the CMS muon system, specifically in the $1.6<| \\eta |<2.4$ endcap region. With a sufficiently fine segmentation GEMs can provide precision tracking as well as fast trigger information. The main objective is to contribute to the improvement of the CMS muon trigger. The construction of large-area GEM detectors is challenging both from the technological and production aspects. In view of the CMS upgrade we have designed and built the largest full-size Triple-GEM muon detector, which is able to meet the stringent requirements given the hostile environment at the high-luminosity LHC. Measurements were performed during several test beam campaigns at the CERN SPS in 2010 and 2011. The main issues under study are efficiency, spatial resolution and timing performance with different inter-electrode gap configurations and gas mixtures. In this paper results of the performance of the pro...

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.

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.

Future Targets for Female Sexual Dysfunction.

Science.gov (United States)

Farmer, Melissa; Yoon, Hana; Goldstein, Irwin

2016-08-01

Female sexual function reflects a dynamic interplay of central and peripheral nervous, vascular, and endocrine systems. The primary challenge in the development of novel treatments for female sexual dysfunction is the identification and targeted modulation of excitatory sexual circuits using pharmacologic treatments that facilitate the synthesis, release, and/or receptor binding of neurochemicals, peptides, and hormones that promote female sexual function. To develop an evidence-based state-of-the-art consensus report that critically integrates current knowledge of the therapeutic potential for known molecular and cellular targets to facilitate the physiologic processes underlying female sexual function. State-of-the-art review representing the opinions of international experts developed in a consensus process during a 1-year period. Expert opinion was established by grading the evidence-based medical literature, intensive internal committee discussion, public presentation, and debate. Scientific investigation is urgently needed to expand knowledge and foster development of future treatments that maintain genital tissue integrity, enhance genital physiologic responsiveness, and optimize positive subjective appraisal of internal and external sexual cues. This article critically condenses the current knowledge of therapeutic manipulation of molecular and cellular targets within biological systems responsible for female sexual physiologic function. Future treatment targets include pharmacologic modulation of emotional learning circuits, restoration of normal tactile sensation, growth factor therapy, gene therapy, stem cell-based therapies, and regenerative medicine. Concurrent use of centrally and peripherally acting therapies could optimize treatment response. Copyright © 2016 International Society for Sexual Medicine. Published by Elsevier Inc. All rights reserved.

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

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…

Joint optimisation of the future Danish waste and energy system

DEFF Research Database (Denmark)

Münster, Marie; Pizarro, Amalia Rosa; Salvucci, Raffaele

2015-01-01

in future scenarios with higher biomass consumption, where the average heat prices are higher. In both scenarios, biogas produced from organic waste is upgraded and fed into the natural gas grid and waste is incinerated rather than being centrally sorted in a material recovery facility.......In this article the impact of the future development of the energy system on the feasibility of waste treatment options is analysed. In the article two different optimization tools are used: a regional electricity model (Balmorel) and a national waste treatment and district heating model (Opti......Waste). When performing optimization by minimizing the socio-economic costs, into future energy systems with high wind power production, it proves feasible primarily to incinerate waste in large scale combined heat and power (CHP) plants, whereas more incineration takes place in decentralized CHP plants...

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.

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

[Current status and future perspectives of hepatocyte transplantation].

Science.gov (United States)

Pareja, Eugenia; Cortés, Miriam; Gómez-Lechón, M José; Maupoey, Javier; San Juan, Fernando; López, Rafael; Mir, Jose

2014-02-01

The imbalance between the number of potential beneficiaries and available organs, originates the search for new therapeutic alternatives, such as Hepatocyte transplantation (HT).Even though this is a treatment option for these patients, the lack of unanimity of criteria regarding indications and technique, different cryopreservation protocols, as well as the different methodology to assess the response to this therapy, highlights the need of a Consensus Conference to standardize criteria and consider future strategies to improve the technique and optimize the results.Our aim is to review and update the current state of hepatocyte transplantation, emphasizing the future research attempting to solve the problems and improve the results of this treatment. Copyright © 2013 AEC. Published by Elsevier Espana. All rights reserved.

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.)

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

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.

EPA/DOE joint efforts on mixed waste treatment

International Nuclear Information System (INIS)

Lee, C.C.; Huffman, G.L.; Nalesnik, R.P.

1995-01-01

Under the requirements of the Federal Facility Compliance Act (FFCA), the Department of Energy (DOE) is directed to develop treatment plans for their stockpile of wastes generated at their various sites. As a result, DOE is facing the monumental problem associated with the treatment and ultimate disposal of their mixed (radioactive and hazardous) waste. Meanwhile, the Environmental Protection Agency (EPA) issued a final open-quotes Hazardous Waste Combustion Strategyclose quotes in November 1994. Under the Combustion Strategy, EPA permit writers have been given the authority to use the Omnibus Provision of the Resource Conservation and Recovery Act (RCRA) to impose more stringent emission limits for waste combustors prior to the development of new regulations. EPA and DOE established a multi-year Interagency Agreement (IAG) in 1991. The main objective of the IAG (and of the second IAG that was added in 1993) is to conduct a research program on thermal technologies for treating mixed waste and to establish permit procedures for these technologies particularly under the new requirements of the above-mentioned EPA Combustion Strategy. The objective of this Paper is to summarize the results of the EPA/DOE joint efforts on mixed waste treatment since the establishment of the original Interagency Agreement. Specifically, this Paper will discuss six activities that have been underway; namely: (1) National Technical Workgroup (NTW) on Mixed Waste Treatment, (2) State-of-the-Art Assessment of APC (Air Pollution Control) and Monitoring Technologies for the Rocky Flats Fluidized Bed Unit, (3) Initial Study of Permit open-quotes Roadmapclose quotes Development for Mixed Waste Treatment, (4) Risk Assessment Approach for a Mixed Waste Thermal Treatment Facility, (5) Development and Application of Technology Selection Criteria for Mixed Waste Thermal Treatment, and (6) Performance Testing of Mixed Waste Incineration: In-Situ Chlorine Capture in a Fluidized Bed Unit

An Advanced Rapid Cycling CO2 and H2O Control System for PLSS, Phase II

Data.gov (United States)

National Aeronautics and Space Administration — NASA's planned future missions set stringent demands on the design of the Portable Life Support Systems (PLSS), requiring dramatic reductions in weight, decreased...

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.

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.

Energy Data Management Manual for the Wastewater Treatment Sector

Energy Technology Data Exchange (ETDEWEB)

Lemar, Paul [Resource Dynamics Corporation, McLean, VA (United States); De Fontaine, Andre [Dept. of Energy (DOE), Washington DC (United States)

2017-12-01

Energy efficiency has become a higher priority within the wastewater treatment sector, with facility operators and state and local governments ramping up efforts to reduce energy costs and improve environmental performance. Across the country, municipal wastewater treatment plants are estimated to consume more than 30 terawatt hours per year of electricity, which equates to about $2 billion in annual electric costs. Electricity alone can constitute 25% to 40% of a wastewater treatment plant’s annual operating budget and make up a significant portion of a given municipality’s total energy bill. These energy needs are expected to grow over time, driven by population growth and increasingly stringent water quality requirements. The purpose of this document is to describe the benefits of energy data management, explain how it can help drive savings when linked to a strong energy management program, and provide clear, step-by-step guidance to wastewater treatment plants on how to appropriately track energy performance. It covers the basics of energy data management and related concepts and describes different options for key steps, recognizing that a single approach may not work for all agencies. Wherever possible, the document calls out simpler, less time-intensive approaches to help smaller plants with more limited resources measure and track energy performance. Reviews of key, publicly available energy-tracking tools are provided to help organizations select a tool that makes the most sense for them. Finally, this document describes additional steps wastewater treatment plant operators can take to build on their energy data management systems and further accelerate energy savings.

Treatment of malignant pleural mesothelioma

International Nuclear Information System (INIS)

Yusa, Toshikazu

2007-01-01

In Japan, it is predicted that mesothelioma will rapidly increase in the future. Malignant pleural mesothelioma that accounts for approximately 90% of mesothelioma as a whole has a median survival time of approximately nine months which is considered a poor prognosis. As for the treatment of this disease, extrapleural pneumonectomy or pleurectomy/decortication are available for those patients who can be surgically operated on. However, since a complete cure rate is low when only surgical treatment is performed, generally a multimodality treatment is performed wherein chemotherapy and/or radiotherapy are combined. For chemotherapy, a large-scale randomized phase III study demonstrated that a treatment using two agents: pemetrexed, which is a new multitargeted antifolate, and cisplatin is effective. Pemetrexed will be the drug of first choice for mesothelioma in the future. As other treatment methods, chemohyperthermia, treatments using various kinds of cytokines and angiogenesis inhibitors, genetic treatment and photodynamic therapy have been attempted. The current treatment results for this disease are very poor, and there has been a strong demand for establishing an effective treatment method. (author)

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.

Osteoporosis in older persons: current pharmacotherapy and future directions.

Science.gov (United States)

Duque, Gustavo

2013-10-01

Osteopororic fractures are highly prevalent in older persons having catastrophic consequences in their quality of life and increasing disability and mortality in this population. The mechanisms of osteoporosis in older persons are unique in terms of cellular changes and response to osteoporosis treatment. Therefore, specifically targeted treatments are required in this particular population. This paper provides an overview on the particular mechanisms of osteoporosis in older persons and the current and future therapeutic strategies to improve bone mass and prevent fractures in this population. Osteoporosis in older persons (especially in the old-old) has a unique pathophysiology that predisposes them to fractures thus having catastrophic consequences. Identification of patients at risk followed by therapies targeted to their cellular changes is pivotal to close the care gap observed in osteoporosis, predominantly in the older population. The treatment of osteoporosis has evolved from daily to yearly dosing thus facilitating compliance and effectiveness. It is expected that future biologically targeted treatments will have a similar separate dosing regime with better anti-fracture efficacy and lower incidence of side effects.

Worrying about the future: An episodic specificity induction impacts problem solving, reappraisal, and well-being.

Science.gov (United States)

Jing, Helen G; Madore, Kevin P; Schacter, Daniel L

2016-04-01

Previous research has demonstrated that an episodic specificity induction--brief training in recollecting details of a recent experience--enhances performance on various subsequent tasks thought to draw upon episodic memory processes. Existing work has also shown that mental simulation can be beneficial for emotion regulation and coping with stressors. Here we focus on understanding how episodic detail can affect problem solving, reappraisal, and psychological well-being regarding worrisome future events. In Experiment 1, an episodic specificity induction significantly improved participants' performance on a subsequent means-end problem solving task (i.e., more relevant steps) and an episodic reappraisal task (i.e., more episodic details) involving personally worrisome future events compared with a control induction not focused on episodic specificity. Imagining constructive behaviors with increased episodic detail via the specificity induction was also related to significantly larger decreases in anxiety, perceived likelihood of a bad outcome, and perceived difficulty to cope with a bad outcome, as well as larger increases in perceived likelihood of a good outcome and indicated use of active coping behaviors compared with the control. In Experiment 2, we extended these findings using a more stringent control induction, and found preliminary evidence that the specificity induction was related to an increase in positive affect and decrease in negative affect compared with the control. Our findings support the idea that episodic memory processes are involved in means-end problem solving and episodic reappraisal, and that increasing the episodic specificity of imagining constructive behaviors regarding worrisome events may be related to improved psychological well-being. (c) 2016 APA, all rights reserved).

Safeguards technology: present posture and future impact

International Nuclear Information System (INIS)

Keepin, G.R.

1976-01-01

With widespread and growing concern over the issues of nuclear safeguards, international nuclear trade and nuclear weapons proliferation, the full development of the world's nuclear energy potential could well depend on how effectively the strategic nuclear materials that fuel nuclear power are controlled and safeguarded. The broad U.S. program in nuclear safeguards and security is directed toward a balanced safeguards system incorporating the two major components of physical security and materials control. The current posture of modern safeguards technology, its impact on plant operations, and the key role it must play in the implementation of stringent cost-effective safeguards systems in facilities throughout the nuclear fuel cycle are outlined

Wastewater treatment technologies to satisfy 1990's energy conservation/pollution prevention goals

International Nuclear Information System (INIS)

Keith, L.W.; Beers, A.R.

1993-01-01

Anheuser-Busch, like most other companies, relied through the mid-1970's on end-of-pipe, energy-intensive aerobic treatment systems for its wastewater. Little if any attention was placed on source reduction. There are several factors that help explain why industry had adopted this approach. Energy was relatively cheap, sludge disposal was not a major problem and many municipalities provided wastewater treatment capacity to industry as an inducement for industry to locate there. The saying for A-B was open-quotes We know how to make beer - municipalities know how to treat our wastewater - let's not mix the two.close quotes The 1973 oil embargo and the resulting mid-1970's energy crisis changed Anheuser-Busch's wastewater treatment philosophy. The days of cheap energy and wastewater treatment were gone. This was only exaggerated by the more stringent treatment requirements resulting from the passage of PL92-500 (Clean Water Act). Increasing sludge disposal problems with associated increased disposal costs also occurred. From the mid-1970's to the mid-1980's Anheuser-Busch performed significant developmental work on land application of wastewater. This technology, which requires only about 10% of the energy of aerobic activated sludge treatment systems and produces no sludge for disposal, was installed at six Anheuser-Busch locations. During this time period considerable improvement was made in the area of waste load reduction. However, the main driving force was economics; that is, it was done if cheaper than wastewater treatment. Anheuser-Busch still had a basic end-of-pipe treatment philosophy

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

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

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)

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)

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)

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.

Investigation into the use of cement kiln dust in high density sludge (HDS) treatment of acid mine water.

Science.gov (United States)

Mackie, Allison L; Walsh, Margaret E

2015-11-15

The purpose of this study was to investigate the potential to replace lime with cement kiln dust (CKD) in high density sludge (HDS) treatment of acid mine drainage (AMD). The bench-scale study used two water samples: AMD sampled from a lead-zinc mine with high concentrations of iron (Fe), zinc (Zn), and arsenic (As) (Fe/Zn-AMD) and a synthetic AMD solution (Syn-AMD) spiked with ferric sulfate (Fe2(SO4)3). Arsenic was found to be significantly reduced with CKD-HDS treatment of Fe/Zn-AMD compared to lime-HDS treatment, to concentrations below the stringent mine effluent discharge regulation of 0.10 mg As/L (i.e., 0.04 ± 0.02 mg/L). Both CKD- and lime-HDS treatment of the two AMD samples resulted in settled water Fe concentrations above the stringent discharge guideline of 0.3 mg Fe/L. CKD addition in the HDS process also resulted in high settled water turbidity, above typical discharge guidelines of 15 mg TSS/L. CKD-HDS treatment was found to result in significantly improved settled solids (i.e., sludge) quality compared to that generated in the lime-HDS process. HDS treatment with CKD resulted in 25-88% lower sludge volume indices, 2 to 9 times higher % wet solids, and 10 to 20 times higher % dry solids compared to lime addition. XRD and XPS testing indicated that CKD-HDS sludge consisted of mainly CaCO3 and SiO2 with Fe(3+) precipitates attached at particle surfaces. XRD and XPS testing of the lime-HDS generated sludge showed that it consisted of non-crystalline Fe oxides typical of sludge formed from precipitates with a high water concentration. Increased sedimentation rates were also found for CKD (1.3 cm/s) compared to lime (0.3 cm/s). The increased solids loading with CKD addition compared to lime addition in the HDS process was suggested to both promote surface complexation of metal precipitates with insoluble CKD particles and increase compression effects during Type IV sedimentation. These mechanisms collectively contributed to the reduced water content of

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.

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.

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

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

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...

Treatment of Arsenazo III contaminated heavy water stored at Darlington

International Nuclear Information System (INIS)

Suryanarayan, S.; Husain, A.; Williams, D.

2010-01-01

Darlington Nuclear Generating Station (DNGS) has accumulated over 48 drums of chemistry laboratory waste arising from analysis of heavy water (D 2 O). Several organic, including Arsenazo III, and inorganic contaminants present in these drums results in high total organic carbon (TOC) and conductivity. These drums have not been processed due to uncertainties related to clean-up of Arsenazo III contaminated heavy water. This paper provides details of chemical characterization as well as bench scale studies performed to demonstrate the feasibility of treating the downgraded D 2 O to the stringent target specifications of <1 ppm TOC and <0.1mS/m conductivity, required for feed to the Station Upgrading Plant (SUP). Both ionic organic species such as glycolate, acetate and formate as well as neutral organics such as acetone, methanol and ethylene glycol were detected in all the samples. Morpholine and propylene glycol were detected in one sample. Arsenazo III was determined to be not a major contaminant (maximum 8.4 ppm) in these waste drums, compared to the other organic contaminants present. Various unit processes such as pH adjustment, granular activated carbon (GAC), ion exchange resin (IX), UV-peroxide oxidation (UV-H 2 O 2 ) treatments, nanofiltration (NF) as well as reverse osmosis (RO) were tested on a bench scale both singly as well as in various combinations to evaluate their ability to achieve the stringent target conductivity and TOC specifications. Among the various bench scale tests evaluated, the successive processing train used at DNGS and consisting of GAC+IX+UV/H 2 O 2 +IX (polishing) unit operations was found to meet target specifications for both conductivity and TOC. Unit processes comprising (GAC+IX) and (RO-double pass + GAC+IX) met conductivity targets but failed to meet TOC specifications. The results of GAC+IX tests clearly emphasize the importance of using low flow rates for successful reduction in both conductivity as well as TOC. Detailed

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.

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.

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.

A Study Regarding the Efficiency of the Electromagnetic Induction Thermal Treatment Process Depending to the Work Frequency

Directory of Open Access Journals (Sweden)

MICH-VANCEA Claudiu

2011-05-01

Full Text Available The paper is focused on the induction heating for thermal treatments to make more efficient this process, using the numerical simulation. In the first part we analyze the parameters that can changethe dept penetration of the electromagnetic field in the hardened piece. The frequency of the electromagnetic field can be imposed, and by this parameter we can control the hardened layer in piece. In second part of the paper, is presented the numerical simulation in 1Dfor the induction heating process for hardening. The results obtained are helping the designer and the enduser to choose the best configuration of the induction heating and cooling systems that fulfils the most stringent requirements needed for hardened piece.

Treatment of textile wastewater by a hybrid electrocoagulation/nanofiltration process.

Science.gov (United States)

Aouni, Anissa; Fersi, Cheïma; Ben Sik Ali, Mourad; Dhahbi, Mahmoud

2009-09-15

Untreated effluents from textile industries are usually highly coloured and contain a considerable amount of contaminants and pollutants. Stringent environmental regulation for the control of textile effluents is enforced in several countries. Previous studies showed that many techniques have been used for the treatment of textile wastewater, such as adsorption, biological treatment, oxidation, coagulation and/or flocculation, among them coagulation is one of the most commonly used techniques. Electrocoagulation is a process consisting in creating metallic hydroxide flocks within the wastewater by the electrodissolution of soluble anodes, usually made of iron or aluminium. This method has been practiced for most of the 20th century with limited success. In recent years, however, it started to regain importance with the progress of the electrochemical processes and the increase in environmental restrictions in effluent wastewater. This paper examines the use of electrocoagulation treatment process followed by nanofiltration process of a textile effluent sample. The electrocoagulation process was studied under several conditions such as various current densities and effect of experimental tense. Efficiencies of COD and turbidity reductions and colour removal were studied for each experiment. The electrochemical treatment was indented primarily to remove colour and COD of wastewater while nanofiltration was used to further improve the removal efficiency of the colour, COD, conductivity, alkalinity and total dissolved solids (TDS). The experimental results, throughout the present study, have indicated that electrocoagulation treatment followed by nanofiltration processes were very effective and were capable of elevating quality of the treated textile wastewater effluent.

Retrieval of past and future positive and negative autobiographical experiences.

Science.gov (United States)

García-Bajos, Elvira; Migueles, Malen

2017-09-01

We studied retrieval-induced forgetting for past or future autobiographical experiences. In the study phase, participants were given cues to remember past autobiographical experiences or to think about experiences that may occur in the future. In both conditions, half of the experiences were positive and half negative. In the retrieval-practice phase, for past and future experiences, participants retrieved either half of the positive or negative experiences using cued recall, or capitals of the world (control groups). Retrieval practice produced recall facilitation and enhanced memory for the practised positive and negative past and future experiences. While retrieval practice on positive experiences did not impair the recall of other positive experiences, we found inhibition for negative past and future experiences when participants practised negative experiences. Furthermore, retrieval practice on positive future experiences inhibited negative future experiences. These positivity biases for autobiographical memory may have practical implications for treatment of emotional disorders.

An Advanced Rapid Cycling CO2 and H2O Control System for PLSS, Phase I

Data.gov (United States)

National Aeronautics and Space Administration — NASA's planned future missions set stringent demands on the design of the Portable Life Support Systems (PLSS) used to cool the astronaut and provide them with air....

Future Investment in Drinking Water and Wastewater Infrastructure

National Research Council Canada - National Science Library

Beider, Perry

2002-01-01

... in maintaining and replacing their pipes, treatment plants, and other infrastructure. But there is neither consensus on the size and timing of future investment costs nor agreement on the impact of those costs on households and other water ratepayers...

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.

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

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.

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.

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).

Treatment Cost Analysis Tool (TCAT) for estimating costs of outpatient treatment services.

Science.gov (United States)

Flynn, Patrick M; Broome, Kirk M; Beaston-Blaakman, Aaron; Knight, Danica K; Horgan, Constance M; Shepard, Donald S

2009-02-01

A Microsoft Excel-based workbook designed for research analysts to use in a national study was retooled for treatment program directors and financial officers to allocate, analyze, and estimate outpatient treatment costs in the U.S. This instrument can also be used as a planning and management tool to optimize resources and forecast the impact of future changes in staffing, client flow, program design, and other resources. The Treatment Cost Analysis Tool (TCAT) automatically provides feedback and generates summaries and charts using comparative data from a national sample of non-methadone outpatient providers. TCAT is being used by program staff to capture and allocate both economic and accounting costs, and outpatient service costs are reported for a sample of 70 programs. Costs for an episode of treatment in regular, intensive, and mixed types of outpatient treatment were $882, $1310, and $1381 respectively (based on 20% trimmed means and 2006 dollars). An hour of counseling cost $64 in regular, $85 intensive, and $86 mixed. Group counseling hourly costs per client were $8, $11, and $10 respectively for regular, intensive, and mixed. Future directions include use of a web-based interview version, much like some of the commercially available tax preparation software tools, and extensions for use in other modalities of treatment.

[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.

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.

Design and operation of UASB—A/O process for treatment starch and VB12 wastewater

Directory of Open Access Journals (Sweden)

Yuanyuan CHEN

2016-12-01

Full Text Available Starch and VB12 wastewater with higher COD and ammonia nitrogen concentration, contains a large number of difficult biodegradable material, complex composition, is difficult to deal with. In recent years, with the increasingly stringent wastewater discharge standards, require the use of a stable and efficient wastewater treatment process for purification treatment of high concentration of ammonia nitrogen in wastewater and the refractory organic pollutants, to achieve discharge standards. Upflow Anaerobic Sludge Blanket (UASB—Anoxic/Oxic(A/O process was employed in a wastewater treatment of starch and Vitamin B12 wastewater, which was 5 000 m3/d with highly concentrated organic pollutants and ammonia. The efficiency and reliability of the process has been proven. The results of the system operation show that the concentration of the effluent COD, ammonia and total nitrogen (TN were at 78.4 mg/L, 18.7 mg/L and 41.1 mg/L, and the treatment efficiencies of COD, ammonia and TN reached over 99%, 92.1%, 82.7%, respectively, when the influent COD and TN concentration were in the ranges of 8 544~9 720 mg/L and 240~250 mg/L. The quality of the treated wastewater met the first-class discharge standards in Integrated Wastewater Discharge Standard(GB 8978—1996.

Nuclear Power – current status and future development

International Nuclear Information System (INIS)

Bychkov, A.

2011-01-01

Conclusions • Nuclear energy is extensively used in the world today as reliable base-load energy • Nuclear energy planning at the low level demand involves building of significant number of new NPPs around the world • Highest rate of new builds is expected in Eastern Asia • New advanced reactor designs known as Gen 3 and 3+ have emerged in recent years • As a result of the Fukushima event in Japan, the advanced reactors will be subjected to additional level of scrutiny and design improvements and changes • As a result of the Fukushima event, the regulatory requirements will become more stringent and demanding

Psychotherapy in psychiatry: the current situation and future directions in Germany.

Science.gov (United States)

Schnell, Knut; Herpertz, Sabine C

2011-11-01

The aim of this article is to review how psychotherapy is dispensed to patients in psychiatric treatment and to render the future perspectives of psychotherapy in psychiatric outpatient and inpatient care in Germany. We demonstrate that--according to the currently available data about healthcare providers, allocation of financial resources and curricular regulations--the presently used definition of the term "psychotherapy" is ambiguous. One major problem for the application of psychotherapy in psychiatry is obviously constituted by the dominance of the major guideline therapies ("Richtlinienverfahren") within psychiatric services. Here, guideline therapies do not meet the needs of a significant proportion of acutely, severely and/or chronically ill psychiatric patients and restrain the application of scientifically approved, disorder-oriented and context compliant interventions in psychiatric practice. As a future perspective, we suggest that the training of psychiatrists should impart profound interpersonal skills and provide the competence to offer psychotherapy within a multimodal, modular, and flexible treatment plan on the background of the self-conception of psychiatry as a medical discipline. Moreover, future concepts of psychiatric psychotherapy should promote an evidence-based selection and application of scientifically approved, disorder-oriented, and integrative treatment methods, which are available in growing number.

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.

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.

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 ...

Cancer, Fertility Preservation, and Future Pregnancy: A Comprehensive Review

OpenAIRE

Matthews, Michelle L.; Hurst, Bradley S.; Marshburn, Paul B.; Usadi, Rebecca S.; Papadakis, Margaret A.; Sarantou, Terry

2012-01-01

Given the increases in 5-year cancer survival and recent advances in fertility preserving technologies, an increasing number of women with cancer are presenting for discussion of fertility preserving options. This review will summarize the risk of infertility secondary to cancer treatment, available treatment options for fertility preservation, and techniques to reduce future risks for patients. Concerns that will be addressed include the risk of the medications and procedures, the potential ...

TREATMENT OF LANDFILL LEACHATE BY COUPLING COAGULATION-FLOCCULATION OR OZONATION TO GRANULAR ACTIVATED CARBON ADSORPTION.

Science.gov (United States)

Oloibiri, Violet; Ufomba, Innocent; Chys, Michael; Audenaert, Wim; Demeestere, Kristof; Van Hulle, Stijn W H

2015-01-01

A major concern for landfilling facilities is the treatment of their leachate. To optimize organic matter removal from this leachate, the combination of two or more techniques is preferred in order to meet stringent effluent standards. In our study, coagulation-flocculation and ozonation are compared as pre- treatment steps for stabilized landfill leachate prior to granular activated carbon (GAC) adsorption. The efficiency of the pre treatment techniques is evaluated using COD and UVA254 measurements. For coagulation- flocculation, different chemicals are compared and optimal dosages are determined. After this, iron (III) chloride is selected for subsequent adsorption studies due to its high percentage of COD and UVA254 removal and good sludge settle-ability. Our finding show that ozonation as a single treatment is effective in reducing COD in landfill leachate by 66% compared to coagulation flocculation (33%). Meanwhile, coagulation performs better in UVA254 reduction than ozonation. Subsequent GAC adsorption of ozonated effluent, coagulated effluent and untreated leachate resulted in 77%, 53% and 8% total COD removal respectively (after 6 bed volumes). The effect of the pre-treatment techniques on GAC adsorption properties is evaluated experimentally and mathematically using Thomas and Yoon-Nelson models. Mathematical modelling of the experimental GAC adsorption data shows that ozonation increases the adsorption capacity and break through time with a factor of 2.5 compared to coagulation-flocculation.

Future Wildfire and Managed Fire Interactions in the Lake Tahoe Basin

Science.gov (United States)

Scheller, R.; Kretchun, A.

2017-12-01

Managing large forested landscape in the context of a changing climate and altered disturbance regimes presents new challenges and require integrated assessments of forest disturbance, management, succession, and the carbon cycle. Successful management under these circumstances will require information about trade-offs among multiple objectives and opportunities for spatially optimized landscape-scale management. Improved information about the effects of climate on forest communities, disturbance feedbacks, and the effectiveness of mitigation strategies enables actionable options for landscape managers. We evaluated the effects of fire suppression, wildfires, and forest fuel (thinning) treatments on the long-term carbon storage potential for Lake Tahoe Basin (LTB) forests under various climate futures. We simulated management scenarios that encompass fuel treatments across the larger landscape, beyond the Wildland Urban Interface. We improved upon current fire modeling under climate change via an integrated fire modeling module that, a) explicitly captures the influence of climate, fuels, topography, active fire management (e.g., fire suppression), and fuel treatments, and b) can be parameterized from available data, e.g., remote sensing, field reporting, fire databases, expert opinion. These improvements increase geographic flexibility and decrease reliance on broad historical fire regime statistics - imperfect targets for a no analog future and require minimal parameterization and calibration. We assessed the interactions among fuel treatments, prescribe fire, fire suppression, and stochastically recurring wildfires. Predicted changes in climate and ignition patterns in response to future climatic conditions, vegetation dynamics, and fuel treatments indicate larger potential long-term effects on C emissions, forest structure, and forest composition than prior studies.

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...

[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.

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...

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.

Internet interventions: Past, present and future

Directory of Open Access Journals (Sweden)

Gerhard Andersson

2018-06-01

Full Text Available Internet interventions have been around now for about 20 years. While the field still suffers from a scattered terminology a large number of programs and studies exist. In the present paper I present an overview of my experiences of studying internet-supported cognitive-behaviour therapy (ICBT, but also mention other approaches including the use of smartphones. The paper covers the history of ICBT, short-term effects in controlled trials for a range of conditions, long-term effects, comparisons against face-to-face therapy, effectiveness studies, prediction studies, how the treatment is perceived, critique, and finally future directions. I conclude that we have now reached a stage in which we have numerous evidence-based treatments and procedures, and increasingly internet interventions including ICBT are disseminated. Keywords: Internet treatment, Therapist guidance, Anxiety, Mood disorders, Somatic disorders

Treatment and Reuse of Wastewater from Beverage Industry

International Nuclear Information System (INIS)

Haroon, H.; Mahmood, Q.

2013-01-01

Summary: Water is used in most process industries for a wide range of applications. Processes and systems using water today are being subjected to increasingly stringent environmental regulations on effluents and there is growing demand for fresh water. These changes have increased the need for better water management and wastewater minimization. The combination of water demand management and cleaner production concepts have resulted in both economical and ecological benefits. Beverage industry requires huge amount of fresh water, generating considerable amount of polluted waste water during different processes including drink production, washing bottles, plant washdown as well as washing the floors and the general work area. Most of the industries do not reuse the waste water and consuming bulk of fresh water. The beverage industry is one of the major industries in Pakistan and the present study was conducted on the beverage/soft drink industry at Hattar Industrial Estate, Hattar, Pakistan to assess the feasibility of reuse of wastewater form bottle washing plant by conducting treatment test, like dilution of the waste water in different ratios, reverse osmosis and ion exchange. (author)

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 ...

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.

Congenital hypothyroidism: insights into pathogenesis and treatment

OpenAIRE

Cherella, Christine E.; Wassner, Ari J.

2017-01-01

Congenital hypothyroidism occurs in approximately 1 in 2000 newborns and can have devastating neurodevelopmental consequences if not detected and treated promptly. While newborn screening has virtually eradicated intellectual disability due to severe congenital hypothyroidism in the developed world, more stringent screening strategies have resulted in increased detection of mild congenital hypothyroidism. Recent studies provide conflicting evidence about the potential neurodevelopmental risks...

The PolicyRelevance of WearEmissions fromRoad Transport,Nowand in the Future-An InternationalWorkshop Report and Consensus Statement

NARCIS (Netherlands)

Denier van der Gon, H.A.C.; Gerlofs-Nijland, M.E.; Gehrig, R.; Gustafsson, M.; Janssen, N.; Harrison, R.M.; Hulskotte, J.; Johansson, C.; Jozwicka, M.; Keuken, M.; Krijgsheld, K.; Ntziachristos, L.; Riediker, M.; Cassee, F.R.

2013-01-01

Road transport emissions are a major contributor to ambient particulate matter concentrations and have been associated with adverse health effects. Therefore, these emissions are targeted through increasingly stringent European emission standards. These policies succeed in reducing exhaust

Childhood Leukemia--A Look at the Past, the Present and the Future.

Science.gov (United States)

Findeisen, Regina; Barber, William H.

1997-01-01

Provides an overview of childhood leukemia. The causes, the survival period, different types (acute lymphocytic leukemia, acute myeloid leukemia, chronic lymphocytic leukemia, chronic myeloid leukemia, and hairy cell leukemia), symptoms, treatment, side effects of treatment (including learning problems), and the expected future direction of…

Helicobacter pylori infection: past, present and future | Jemilohun ...

African Journals Online (AJOL)

Helicobacter pylori infection: past, present and future. ... The discovery of Helicobacter pylori (H. pylori) by Warren and Marshall in 1982 was preceded by nearly a hundred year of inconspicuous publications in ... A major challenge is the absence of a specific antibiotic monotherapy for effective treatment of the infection.

The future of psychiatry as clinical neuroscience.

Science.gov (United States)

Reynolds, Charles F; Lewis, David A; Detre, Thomas; Schatzberg, Alan F; Kupfer, David J

2009-04-01

Psychiatry includes the assessment, treatment, and prevention of complex brain disorders, such as depression, bipolar disorder, anxiety disorders, schizophrenia, developmental disorders (e.g., autism), and neurodegenerative disorders (e.g., Alzheimer dementia). Its core mission is to prevent and alleviate the distress and impairment caused by these disorders, which account for a substantial part of the global burden of illness-related disability. Psychiatry is grounded in clinical neuroscience. Its core mission, now and in the future, is best served within this context because advances in assessment, treatment, and prevention of brain disorders are likely to originate from studies of etiology and pathophysiology based in clinical and translational neuroscience. To ensure its broad public health relevance in the future, psychiatry must also bridge science and service, ensuring that those who need the benefits of its science are also its beneficiaries. To do so effectively, psychiatry as clinical neuroscience must strengthen its partnerships with the disciplines of public health (including epidemiology), community and behavioral health science, and health economics.The authors present a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of psychiatry and identify strategies for strengthening its future and increasing its relevance to public health and the rest of medicine. These strategies encompass new approaches to strengthening the relationship between psychiatry and neurology, financing psychiatry's mission, emphasizing early and sustained multidisciplinary training (research and clinical), bolstering the academic infrastructure, and reorganizing and refinancing mental health services both for preventive intervention and cost-effective chronic disease management.

The Future of Psychiatry as Clinical Neuroscience

Science.gov (United States)

Reynolds, Charles F.; Lewis, David A.; Detre, Thomas; Schatzberg, Alan F.; Kupfer, David J.

2009-01-01

Psychiatry includes the assessment, treatment, and prevention of complex brain disorders, such as depression, bipolar disorder, anxiety disorders, schizophrenia, developmental disorders (e.g., autism), and neurodegenerative disorders (e.g., Alzheimer dementia). Its core mission is to prevent and alleviate the distress and impairment caused by these disorders, which account for a substantial part of the global burden of illness-related disability. Psychiatry is grounded in clinical neuroscience. Its core mission, now and in the future, is best served within this context because advances in assessment, treatment, and prevention of brain disorders are likely to originate from studies of etiology and pathophysiology based in clinical and translational neuroscience. To ensure its broad public health relevance in the future, psychiatry must also bridge science and service, ensuring that those who need the benefits of its science are also its beneficiaries. To do so effectively, psychiatry as clinical neuroscience must strengthen its partnerships with the disciplines of public health (including epidemiology), community and behavioral health science, and health economics. The authors present a Strengths, Weaknesses, Opportunities, and Threats (SWOT) analysis of psychiatry and identify strategies for strengthening its future and increasing its relevance to public health and the rest of medicine. These strategies encompass new approaches to strengthening the relationship between psychiatry and neurology, financing psychiatry’s mission, emphasizing early and sustained multidisciplinary training (research and clinical), bolstering the academic infrastructure, and reorganizing and refinancing mental health services both for preventive intervention and cost-effective chronic disease management. PMID:19318776

Introducing New Biosimilars Into Current Treatment Algorithms

Directory of Open Access Journals (Sweden)

John D. Isaacs

2016-07-01

Full Text Available Three biosimilar products are now licensed for the treatment of rheumatic diseases in Europe. The European Medicines Agency (EMA requires that similarity between a biosimilar and its reference product is demonstrated using a rigorous, stepwise process that includes extensive physicochemical and biological analytical testing, non-clinical pharmacology, clinical evaluations, and pharmacovigilance plans. Each step is highly sensitive to any differences between products and progressively reduces any uncertainty over similarity; all steps must be satisfied to demonstrate biosimilarity. The US Food and Drug Administration (FDA requires a similar stringent biosimilar development process. The etanercept biosimilar SB4 (Benepali®, recently approved for the treatment of rheumatoid arthritis, psoriatic arthritis, axial spondyloarthritis (ankylosing spondylitis, non-radiographic axial spondyloarthritis, and plaque psoriasis, is herein used to demonstrate the detailed analytical characterisation and clinical testing that are required by the EMA before biosimilars are approved for use. A comprehensive characterisation study involving >55 physiochemical and >25 biological assays demonstrated that SB4 has highly similar structural, physicochemical, and biological quality attributes to reference etanercept. A Phase I study demonstrated pharmacokinetic equivalence between SB4 and reference etanercept in healthy male subjects. Furthermore, a Phase III, randomised, controlled trial performed in patients with moderate-to-severe rheumatoid arthritis despite treatment with methotrexate (MTX showed that SB4 was equivalent to etanercept in terms of efficacy, safety, and immunogenicity. In conclusion, the biosimilar development process performed according to EMA or FDA guidelines is highly rigorous and comprehensive. Biosimilars such as SB4 are now available in clinical practice and are likely to improve access, reduce costs, and ultimately, improve health outcomes.

Requirements on the Redshift Accuracy for future Supernova and Number Count Surveys

International Nuclear Information System (INIS)

Huterer, Dragan; Kim, Alex; Broderick, Tamara

2004-01-01

We investigate the required redshift accuracy of type Ia supernova and cluster number-count surveys in order for the redshift uncertainties not to contribute appreciably to the dark energy parameter error budget. For the SNAP supernova experiment, we find that, without the assistance of ground-based measurements, individual supernova redshifts would need to be determined to about 0.002 or better, which is a challenging but feasible requirement for a low-resolution spectrograph. However, we find that accurate redshifts for z < 0.1 supernovae, obtained with ground-based experiments, are sufficient to immunize the results against even relatively large redshift errors at high z. For the future cluster number-count surveys such as the South Pole Telescope, Planck or DUET, we find that the purely statistical error in photometric redshift is less important, and that the irreducible, systematic bias in redshift drives the requirements. The redshift bias will have to be kept below 0.001-0.005 per redshift bin (which is determined by the filter set), depending on the sky coverage and details of the definition of the minimal mass of the survey. Furthermore, we find that X-ray surveys have a more stringent required redshift accuracy than Sunyaev-Zeldovich (SZ) effect surveys since they use a shorter lever arm in redshift; conversely, SZ surveys benefit from their high redshift reach only so long as some redshift information is available for distant (zgtrsim1) clusters

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.

Comparative study of the methods used for treatment and final disposal of sewage sludge in European countries.

Science.gov (United States)

Kelessidis, Alexandros; Stasinakis, Athanasios S

2012-06-01

Municipal wastewater treatment results to the production of large quantities of sewage sludge, which requires proper and environmentally accepted management before final disposal. In European Union, sludge management remains an open and challenging issue for the Member States as the relative European legislation is fragmentary and quite old, while the published data concerning sludge treatment and disposal in different European countries are often incomplete and inhomogeneous. The main objective of the current study was to outline the current situation and discuss future perspectives for sludge treatment and disposal in EU countries. According to the results, specific sludge production is differentiated significantly between European countries, ranging from 0.1 kg per population equivalent (p.e.) and year (Malta) to 30.8 kg per p.e. and year (Austria). More stringent legislations comparing to European Directive 86/278/EC have been adopted for sludge disposal in soil by several European countries, setting lower limit values for heavy metals as well as limit values for pathogens and organic micropollutants. A great variety of sludge treatment technologies are used in EU countries, while differences are observed between Member States. Anaerobic and aerobic digestion seems to be the most popular stabilization methods, applying in 24 and 20 countries, respectively. Mechanical sludge dewatering is preferred comparing to the use of drying beds, while thermal drying is mainly applied in EU-15 countries (old Member States) and especially in Germany, Italy, France and UK. Regarding sludge final disposal, sludge reuse (including direct agricultural application and composting) seems to be the predominant choice for sludge management in EU-15 (53% of produced sludge), following by incineration (21% of produced sludge). On the other hand, the most common disposal method in EU-12 countries (new Member States that joined EU after 2004) is still landfilling. Due to the obligations

Future orientation and suicide ideation and attempts in depressed adults ages 50 and over.

Science.gov (United States)

Hirsch, Jameson K; Duberstein, Paul R; Conner, Kenneth R; Heisel, Marnin J; Beckman, Anthony; Franus, Nathan; Conwell, Yeates

2006-09-01

The objective of this study was to test the hypothesis that future orientation is associated with lower levels of suicide ideation and lower likelihood of suicide attempt in a sample of patients in treatment for major depression. Two hundred two participants (116 female, 57%) ages 50-88 years were recruited from inpatient and outpatient settings. All were diagnosed with major depression using a structured diagnostic interview. Suicide ideation was assessed with the Scale for Suicide Ideation (both current and worst point ratings), and a measure of future orientation was created to assess future expectancies. The authors predicted that greater future orientation would be associated with less current and worst point suicide ideation, and would distinguish current and lifetime suicide attempters from nonattempters. Hypotheses were tested using multivariate logistic regression and linear regression analyses that accounted for age, gender, hopelessness, and depression. As hypothesized, higher future orientation scores were associated with lower current suicidal ideation, less intense suicidal ideation at its worst point, and lower probability of a history of attempted suicide after accounting for covariates. Future orientation was not associated with current attempt status. Future orientation holds promise as a cognitive variable associated with decreased suicide risk; a better understanding of its putative protective role is needed. Treatments designed to enhance future orientation might decrease suicide risk.

SU-E-T-133: Assessing IMRT Treatment Delivery Accuracy and Consistency On a Varian TrueBeam Using the SunNuclear PerFraction EPID Dosimetry Software

Energy Technology Data Exchange (ETDEWEB)

Dieterich, S [UC Davis Medical Center, Sacramento, CA (United States); Trestrail, E; Holt, R [Pacific Crest Medical Physics, Chico, CA (United States); Saini, S [Sun Nuclear Corporation, Melbourne, FL (Australia); Pfeiffer, I [VMTH, UC Davis, Davis, CA (United States); Kent, M; Hansen, K [Surgical and Radiological Sciences, UC Davis, Davis, CA (United States)

2015-06-15

Purpose: To assess if the TrueBeam HD120 collimator is delivering small IMRT fields accurately and consistently throughout the course of treatment using the SunNuclear PerFraction software. Methods: 7-field IMRT plans for 8 canine patients who passed IMRT QA using SunNuclear Mapcheck DQA were selected for this study. The animals were setup using CBCT image guidance. The EPID fluence maps were captured for each treatment field and each treatment fraction, with the first fraction EPID data serving as the baseline for comparison. The Sun Nuclear PerFraction Software was used to compare the EPID data for subsequent fractions using a Gamma (3%/3mm) pass rate of 90%. To simulate requirements for SRS, the data was reanalyzed using a Gamma (3%/1mm) pass rate of 90%. Low-dose, low- and high gradient thresholds were used to focus the analysis on clinically relevant parts of the dose distribution. Results: Not all fractions could be analyzed, because during some of the treatment courses the DICOM tags in the EPID images intermittently change from CU to US (unspecified), which would indicate a temporary loss of EPID calibration. This technical issue is still being investigated. For the remaining fractions, the vast majority (7/8 of patients, 95% of fractions, and 96.6% of fields) are passing the less stringent Gamma criteria. The more stringent Gamma criteria caused a drop in pass rate (90 % of fractions, 84% of fields). For the patient with the lowest pass rate, wet towel bolus was used. Another patient with low pass rates experienced masseter muscle wasting. Conclusion: EPID dosimetry using the PerFraction software demonstrated that the majority of fields passed a Gamma (3%/3mm) for IMRT treatments delivered with a TrueBeam HD120 MLC. Pass rates dropped for a DTA of 1mm to model SRS tolerances. PerFraction pass rates can flag missing bolus or internal shields. Sanjeev Saini is an employee of Sun Nuclear Corporation. For this study, a pre-release version of PerFRACTION 1

Numerical computation of tyre radiaion noise: a comparative study of different techniques

NARCIS (Netherlands)

Karthik, B.; Makwana, B.K.; Patel, C.; Bekke, Dirk

2012-01-01

Increasingly stringent noise regulations concerning automotive vehicles particularly in Europe are forcing Tyre manufacturers as well as the automotive manufacturers to reduce radiated noise. With the future moving towards electric/hybrid vehicles, the ever present tyre noise will become more

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.

Artificial lightweight aggregates as utilization for future ashes - A case study.

Science.gov (United States)

Sarabèr, Angelo; Overhof, Robert; Green, Terry; Pels, Jan

2012-01-01

In the future, more electricity in the Netherlands will be produced using coal with co-combustion. Due to this, the generated annual ash volume will increase and the chemical composition will be influenced. One of the options for utilization if present markets are saturated and for use of fly ashes with different compositions, is as raw material for lightweight aggregates. This was selected as one of the best utilizations options regarding potential ash volume to be applied, environmental aspects and status of technology. Because of this, a study has been performed to assess the potential utilization of fly ash for the production of lightweight aggregate. Lightweight aggregate has been produced in a laboratory scale rotary kiln. The raw material consisted of class F fly ash with high free lime content. An addition of 8% clay was necessary to get green pellets with sufficient green strength. The basic properties of the produced lightweight aggregate and its behaviour in concrete have been investigated. The concrete has a good compressive strength and its leaching behaviour meets the most stringent requirements of Dutch environmental regulations. The carbon foot print of concrete will be negatively influenced if only the concrete itself is taken into account, but the reduction of the volume weight has advantages regarding design, transport emissions and isolation properties which may counteract this. In the Dutch situation the operational costs are higher than expected potential selling price for the LWA, which implies that the gate fee for the fly ash is negative. Copyright © 2011 Elsevier Ltd. All rights reserved.

Immunotherapy for pancreatic cancer: present and future.

Science.gov (United States)

Aroldi, Francesca; Zaniboni, Alberto

2017-06-01

Despite the identification of some efficient drugs for the treatment of metastatic pancreatic cancer, this tumor remains one of the most lethal cancers and is characterized by a strong resistance to therapies. Pancreatic cancer has some unique features including the presence of a microenvironment filled with immunosuppressive mediators and a dense stroma, which is both a physical barrier to drug penetration and a dynamic entity involved in immune system control. Therefore, the immune system has been hypothesized to play an important role in pancreatic cancer. Thus, therapies acting on innate or adaptive immunity are being investigated. Here, we review the literature, report the most interesting results and hypothesize future treatment directions.

Medical rescue of naval combat: challenges and future.

Science.gov (United States)

Jin, Hai; Hou, Li-Jun; Fu, Xiao-Bing

2015-01-01

There has been no large-scale naval combat in the last 30 years. With the rapid development of battleships, weapons manufacturing and electronic technology, naval combat will present some new characteristics. Additionally, naval combat is facing unprecedented challenges. In this paper, we discuss the topic of medical rescue at sea: what challenges we face and what we could do. The contents discussed in this paper contain battlefield self-aid buddy care, clinical skills, organized health services, medical training and future medical research programs. We also discuss the characteristics of modern naval combat, medical rescue challenges, medical treatment highlights and future developments of medical rescue at sea.

Planned Environmental Microbiology Aspects of Future Lunar and Mars Missions

Science.gov (United States)

Ott, C. Mark; Castro, Victoria A.; Pierson, Duane L.

2006-01-01

With the establishment of the Constellation Program, NASA has initiated efforts designed similar to the Apollo Program to return to the moon and subsequently travel to Mars. Early lunar sorties will take 4 crewmembers to the moon for 4 to 7 days. Later missions will increase in duration up to 6 months as a lunar habitat is constructed. These missions and vehicle designs are the forerunners of further missions destined for human exploration of Mars. Throughout the planning and design process, lessons learned from the International Space Station (ISS) and past programs will be implemented toward future exploration goals. The standards and requirements for these missions will vary depending on life support systems, mission duration, crew activities, and payloads. From a microbiological perspective, preventative measures will remain the primary techniques to mitigate microbial risk. Thus, most of the effort will focus on stringent preflight monitoring requirements and engineering controls designed into the vehicle, such as HEPA air filters. Due to volume constraints in the CEV, in-flight monitoring will be limited for short-duration missions to the measurement of biocide concentration for water potability. Once long-duration habitation begins on the lunar surface, a more extensive environmental monitoring plan will be initiated. However, limited in-flight volume constraints and the inability to return samples to Earth will increase the need for crew capabilities in determining the nature of contamination problems and method of remediation. In addition, limited shelf life of current monitoring hardware consumables and limited capabilities to dispose of biohazardous trash will drive flight hardware toward non-culture based methodologies, such as hardware that rapidly distinguishes biotic versus abiotic surface contamination. As missions progress to Mars, environmental systems will depend heavily on regeneration of air and water and biological waste remediation and

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.

Identification of manganese as a toxicant in a groundwater treatment system: Addressing naturally occurring toxicants

International Nuclear Information System (INIS)

Goodfellow, W. Jr.; Sohn, V.; Richey, M.; Yost, J.

1995-01-01

Effluent from a groundwater remediation system at a bulk oil storage and distribution terminal has been chronically toxic to Ceriodaphnia dubia. The remediation system was designed in response to a hydrocarbon plume in the area of the terminal. The remediation system consists of a series of groundwater recovery wells and groundwater intercept trench systems with groundwater treatment and phased-separated hydrocarbon recovery systems. The groundwater treatment and petroleum recovery systems consist of oil/water separators, product recovery tanks, air strippers, filters, and carbon adsorption units. The characteristics of this effluent are low total suspended solids, total dissolved solids, and hardness concentrations as well as meeting stringent NPDES permit requirements for lead, copper, zinc, mercury, total petroleum hydrocarbons, and BTEX. Additional priority pollutant evaluations revealed no compounds of concern. Performance of a Toxicity identification Evaluation (TIE) indicated that manganese was the principle toxicant in the effluent. Manganese is a naturally occurring constituent in this groundwater source and is not added to the treatment system. This paper will present the results of the TIE with a discussion of treatability/control options for manganese control at this facility. Recommendations for addressing naturally occurring toxicants that are not a result of the facility's operations will also be presented

Problematic Internet use, maladaptive future time perspective and school context.

Science.gov (United States)

Díaz-Aguado, María J; Martín-Babarro, Javier; Falcón, Laia

2018-05-01

Spain is among the European countries with the highest prevalence of adolescents at risk of Internet addiction, a problem that could be linked to youth unemployment and leaving education early. This research evaluated the role of three variables relative to school context on Problematic Internet Use (PIU) and on the relationship between PIU and Maladaptive Future Time Perspective (MFTP, defined as an excessive focus on the present and a fatalistic attitude towards the future, a variable that had not previously been studied in terms of its relationship to adolescents' PIU). The study was carried out with 1288 adolescents, aged 12 to 16 years old, enrolled at 31 secondary schools in Madrid, Spain. As expected, we found that MFTP and hostile treatment by teachers were associated with an increase in PIU, whereas school appreciation was associated with a decrease in PIU. In addition, hostile treatment by teachers had a moderate effect on the MFTP-PIU relationship. In order to prevent PIU it is important to foster confidence in adolescents in their own potential to build the future from the present through positive interaction with teachers, stimulating an appreciation of school within these digital natives' peer group culture.

US Renewable Futures in the GCAM

Energy Technology Data Exchange (ETDEWEB)

Smith, Steven J.; Mizrahi, Andrew H.; Karas, Joseph F.; Nathan, Mayda

2011-10-06

This project examines renewable energy deployment in the United States using a version of the GCAM integrated assessment model with detailed a representation of renewables, the GCAM-RE. Electricity generation was modeled in four generation segments and 12-subregions. This level of regional and sectoral detail allows a more explicit representation of renewable energy generation. Wind, solar thermal power, and central solar PV plants are implemented in explicit resource classes with new intermittency parameterizations appropriate for each technology. A scenario analysis examines a range of assumptions for technology characteristics, climate policy, and long-distance transmission. We find that renewable generation levels grow over the century in all scenarios. As expected, renewable generation increases with lower renewable technology costs, more stringent climate policy, and if alternative low-carbon technology are not available. The availability of long distance transmission lowers policy costs and changes the renewable generation mix.

Drug and Nondrug Treatment in Tension-type Headache

DEFF Research Database (Denmark)

Bendtsen, Lars

2009-01-01

efficacy and fewer side effects is urgently needed. Future studies should also examine the relative efficacy of the various treatment modalities; for example, psychological, physical and pharmacological treatments, and clarify how treatment programs should be optimized to best suit the individual patient....

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

Development of a task-based design approach for solution crystallization processes

NARCIS (Netherlands)

Lakerveld, R.

2010-01-01

Crystallization is historically one of the most important separation and product formation technologies in chemical industry. The future impact of crystallization is expected to increase as new high-added value products are often in crystalline form and need to comply with increasingly stringent

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

Magnetic resonance imaging in psoriatic arthritis -- update on current status and future perspectives

DEFF Research Database (Denmark)

Østergaard, Mikkel; Poggenborg, René Panduro

2012-01-01

and future development of MRI and other modern imaging modalities in PsA. This review, presented at the GRAPPA 2010 annual meeting, describes the current status of MRI in PsA, with a focus on its use in diagnosis, monitoring, and prediction of the disease course and treatment response. Important areas...... for future research are also outlined....

Antimalarial drug policy in India: past, present & future.

Science.gov (United States)

Anvikar, Anupkumar R; Arora, Usha; Sonal, G S; Mishra, Neelima; Shahi, Bharatendu; Savargaonkar, Deepali; Kumar, Navin; Shah, Naman K; Valecha, Neena

2014-02-01

The use of antimalarial drugs in India has evolved since the introduction of quinine in the 17 th century. Since the formal establishment of a malaria control programme in 1953, shortly after independence, treatments provided by the public sector ranged from chloroquine, the mainstay drug for many decades, to the newer, recently introduced artemisinin based combination therapy. The complexity of considerations in antimalarial treatment led to the formulation of a National Antimalarial Drug Policy to guide procurement as well as communicate best practices to both public and private healthcare providers. Challenges addressed in the policy include the use of presumptive treatment, the introduction of alternate treatments for drug-resistant malaria, the duration of primaquine therapy to prevent relapses of vivax malaria, the treatment of malaria in pregnancy, and the choice of drugs for chemoprophylaxis. While data on antimalarial drug resistance and both public and private sector treatment practices have been recently reviewed, the policy process of setting national standards has not. In this perspective on antimalarial drug policy, this review highlights its relevant history, analyzes the current policy, and examines future directions.

Replacing a failed mini-implant with a miniplate to prevent interruption during orthodontic treatment.

Science.gov (United States)

Lee, Jin-Hwa; Choo, Hyeran; Kim, Seong-Hun; Chung, Kyu-Rhim; Giannuzzi, Lucille A; Ngan, Peter

2011-06-01

When mini-implants fail during orthodontic treatment, there is a need to have a backup plan to either replace the failed implant in the adjacent interradicular area or wait for the bone to heal before replacing the mini-implant. We propose a novel way to overcome this problem by replacement with a miniplate so as not to interrupt treatment or prolong treatment time. The indications, advantages, efficacy, and procedures for switching from a mini-implant to a miniplate are discussed. Two patients who required replacement of failed mini-implants are presented. In the first patient, because of the proximity of the buccal vestibule to the mini-implant, it was decided to replace the failed mini-implant by an I-shaped C-tube miniplate. In the second patient, radiolucencies were found around the failed mini-implants, making the adjacent alveolar bone unavailable for immediate placement of another mini-implant. In addition, the maxillary sinus pneumatization was expanded deeply into the interradicular spaces; this further mandated an alternative placement site. One failed mini-implant was examined under a scanning electron microscope for bone attachment. Treatment was completed in both patients after replacement with miniplates without interrupting the treatment mechanics or prolonging the treatments. Examination under the scanning electron microscope showed partial bone growth into the coating pores and titanium substrate interface even after thorough cleaning and sterilization. Replacement with a miniplate is a viable solution for failed mini-implants during orthodontic treatment. The results from microscopic evaluation of the failed mini-implant suggest that stringent guidelines are needed for recycling used mini-implants. Copyright © 2011 American Association of Orthodontists. Published by Mosby, Inc. All rights reserved.

Past and future evolution of Abies alba forests in Europe - comparison of a dynamic vegetation model with palaeo data and observations.

Science.gov (United States)

Ruosch, Melanie; Spahni, Renato; Joos, Fortunat; Henne, Paul D; van der Knaap, Willem O; Tinner, Willy

2016-02-01

Information on how species distributions and ecosystem services are impacted by anthropogenic climate change is important for adaptation planning. Palaeo data suggest that Abies alba formed forests under significantly warmer-than-present conditions in Europe and might be a native substitute for widespread drought-sensitive temperate and boreal tree species such as beech (Fagus sylvatica) and spruce (Picea abies) under future global warming conditions. Here, we combine pollen and macrofossil data, modern observations, and results from transient simulations with the LPX-Bern dynamic global vegetation model to assess past and future distributions of A. alba in Europe. LPX-Bern is forced with climate anomalies from a run over the past 21 000 years with the Community Earth System Model, modern climatology, and with 21st-century multimodel ensemble results for the high-emission RCP8.5 and the stringent mitigation RCP2.6 pathway. The simulated distribution for present climate encompasses the modern range of A. alba, with the model exceeding the present distribution in north-western and southern Europe. Mid-Holocene pollen data and model results agree for southern Europe, suggesting that at present, human impacts suppress the distribution in southern Europe. Pollen and model results both show range expansion starting during the Bølling-Allerød warm period, interrupted by the Younger Dryas cold, and resuming during the Holocene. The distribution of A. alba expands to the north-east in all future scenarios, whereas the potential (currently unrealized) range would be substantially reduced in southern Europe under RCP8.5. A. alba maintains its current range in central Europe despite competition by other thermophilous tree species. Our combined palaeoecological and model evidence suggest that A. alba may ensure important ecosystem services including stand and slope stability, infrastructure protection, and carbon sequestration under significantly warmer

LOW LEVEL LIQUID RADIOACTIVE WASTE TREATMENT AT MURMANSK, RUSSIA: FACILITY UPGRADE AND EXPANSION

International Nuclear Information System (INIS)

BOWERMAN, B.; CZAJKOWSKI, C.; DYER, R.S.; SORLIE, A.

2000-01-01

Today there exist many almost overfilled storage tanks with liquid radioactive waste in the Russian Federation. This waste was generated over several years by the civil and military utilization of nuclear power. The current waste treatment capacity is either not available or inadequate. Following the London Convention, dumping of the waste in the Arctic seas is no longer an alternative. Waste is being generated from today's operations, and large volumes are expected to be generated from the dismantling of decommissioned nuclear submarines. The US and Norway have an ongoing co-operation project with the Russian Federation to upgrade and expand the capacity of a treatment facility for low level liquid waste at the RTP Atomflot site in Murmansk. The capacity will be increased from 1,200 m 3 /year to 5,000 m 3 /year. The facility will also be able to treat high saline waste. The construction phase will be completed the first half of 1998. This will be followed by a start-up and a one year post-construction phase, with US and Norwegian involvement for the entire project. The new facility will consist of 9 units containing various electrochemical, filtration, and sorbent-based treatment systems. The units will be housed in two existing buildings, and must meet more stringent radiation protection requirements that were not enacted when the facility was originally designed. The US and Norwegian technical teams have evaluated the Russian design and associated documentation. The Russian partners send monthly progress reports to US and Norway. Not only technical issues must be overcome but also cultural differences resulting from different methods of management techniques. Six to eight hour time differentials between the partners make real time decisions difficult and relying on electronic age tools becomes extremely important. Language difficulties is another challenge that must be solved. Finding a common vocabulary, and working through interpreters make the process very

Regenerative endodontics and tissue engineering: what the future holds?

Science.gov (United States)

Goodis, Harold E; Kinaia, Bassam Michael; Kinaia, Atheel M; Chogle, Sami M A

2012-07-01

The work performed by researchers in regenerative endodontics and tissue engineering over the last decades has been superb; however, many questions remain to be answered. The basic biologic mechanisms must be elucidated that will allow the development of dental pulp and dentin in situ. Stress must be placed on the many questions that will lead to the design of effective, safe treatment options and therapies. This article discusses those questions, the answers to which may become the future of regenerative endodontics. The future remains bright, but proper support and patience are required. Copyright © 2012 Elsevier Inc. All rights reserved.

The option value of innovative treatments in the context of chronic myeloid leukemia.

Science.gov (United States)

Sanchez, Yuri; Penrod, John R; Qiu, Xiaoli Lily; Romley, John; Thornton Snider, Julia; Philipson, Tomas

2012-11-01

To quantify in the context of chronic myeloid leukemia (CML) the additional value patients receive when innovative treatments enable them to survive until the advent of even more effective future treatments (ie, the "option value"). Observational study using data from the Surveillance, Epidemiology and End Results (SEER) cancer registry comprising all US patients with CML diagnosed between 2000 and 2008 (N = 9,760). We quantified the option value of recent breakthroughs in CML treatment by first conducting retrospective survival analyses on SEER data to assess the effectiveness of TKI treatments, and then forecasting survival from CML and other causes to measure expected future medical progress. We then developed an analytical framework to calculate option value of innovative CML therapies, and used an economic model to value these gains. We calculated the option value created both by future innovations in CML treatment and by medical progress in reducing background mortality. For a recently diagnosed CML patient, the option value of innovative therapies from future medical innovation amounts to 0.76 life-years. This option value is worth $63,000, equivalent to 9% of the average survival gains from existing treatments. Future innovations in CML treatment jointly account for 96% of this benefit. The option value of innovative treatments has significance in the context of CML and, more broadly, in disease areas with rapid innovation. Incorporating option value into traditional valuations of medical innovations is both a feasible and a necessary practice in health technology assessment.

Implementation of a method for patient-specific IMRT treatment verification using dynalog files; Aplicacion de un metodo para la verificacion de tratamientos de imrt sobre la anatomia del paciente utilizando archivos dynalog

Energy Technology Data Exchange (ETDEWEB)

Calama Santiago, J. A.; Infante Utrilla, M. A.; Lavado Rodriguez, M. E.

2011-07-01

The aim of this work is to implement a simple method of intensity modulated radiation therapy (IMRT) verification on the patient anatomy using dynalog files. Monitor units (MU) fraction and leaf positions, both planned and actually positioned during treatment, are sampled every 55 ms and stored in these files. This information was used in the treatment planning system to reconstruct the given fluence and to recalculate the absorbed dose in the patients CT, comparing absorbed dose distributions and histograms with those initially planned. Differences mainly appeared in areas with high absorbed dose gradients at the beginning and at the end of the radiation fields. These differences were lower than 3% in absorbed dose for most cases. No significant differences were found on dose-volume histograms. With proper linac and multileaf collimator commissioning, and a more stringent linac, treatment planning and record and verify system quality assurance program, this procedure allows patient-specific IMRT treatment verification, unlike conventional methods. (Author) 15 refs.

Pastoral research: past, present, and future.

Science.gov (United States)

Gleason, John J

2004-01-01

In healthcare environments of excellence, clinically trained chaplains are valued members of the medical treatment team. There are skills and values they hold in common with medicine and allied health disciplines: enhancing the health and well-being of the patient as a unity of body, mind, and spirit within a unique family and cultural system. This article examines the past, present, and future of pastoral research, including the chaplain's moral imperative to examine practice and to share what is found.

Experimental and numerical study of the effects of a nanocrystallisation treatment on high-temperature oxidation of a zirconium alloy

International Nuclear Information System (INIS)

Panicaud, B.; Retraint, D.; Grosseau-Poussard, J.-L.; Li, L.; Guérain, M.; Goudeau, P.; Tamura, N.; Kunz, M.

2012-01-01

Highlights: ► SMAT leads to a modification of surface properties of an M5 zirconium alloy (grain size and roughness. ► SMAT induces a change in the oxidation kinetics during high temperature oxidation. ► A diffusion model is able to reproduce kinetics and emphasise the consequences of SMAT on dissolution of oxygen in Zr. - Abstract: In the present work, the effects of a nanocrystallisation treatment on the high-temperature oxidation of a zirconium alloy are investigated. Surface Mechanical Attrition Treatment is a recent process designed to nanocrystallise the surface of materials. The particular effects of this treatment on an M5 zirconium alloy are studied using different experimental techniques at several scales. This material is of considerable interest, especially to the nuclear industry where very stringent conditions apply. High temperature oxidation was performed in order to show the benefits of this type of nanocrystallisation on the corrosion resistance of the alloy concerned. Microstructure development mechanisms, which improve the oxidation resistance of zirconium alloys have been identified during high-temperature corrosion. Those mechanisms have been discussed in further detail in relation to numerical calculations concerning the oxidation kinetics.

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�

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.

Field of Psychiatry: Current Trends and Future Directions: An Indian Perspective

OpenAIRE

Dave, Kishore P.

2016-01-01

Attempting to predict future is dangerous. This is particularly true in medical science where change is a result of chance discoveries. Currently, practicing psychiatrists are aware of deficiencies in psychiatric practice. However, we have a number of genuine reasons for optimism and excitement. Genetics, novel treatment approaches, new investigative techniques, large-scale treatment trials, and research in general medicine and neurology will give better insights in psychiatric disorders and ...

A review of current practices and the future for deep well injection in the upper Miocene Stevens sand, Kern County, California

International Nuclear Information System (INIS)

Kiser, S.C.; Chenot, D.W.

1991-01-01

Waste-water disposal is a major concern of the petroleum business, especially because of complications associated with many produced-water surface-impoundment percolation facilities. In the San Joaquin Valley, California, the current environmental regulations protecting the potentially usable groundwaters are stringent. the Stevens has significant potential as a disposal zone that may offer considerable capacity when the project is designed using proper geologic and engineering studies. The Stevens sands are well known for their oil-producing capabilities, however, not much has been published regarding its suitability as a zone for deep well injection. Conditions that make the Stevens potentially suitable include (1) adequate confinement providing geologic separation from the groundwater sources in the basin, (2) storage capacity, and (3) large areal extent. Because the search for acceptable disposal options is becoming critical, the current class II disposal options is becoming critical, the current class II disposal activities in the Stevens sands were reviewed and the areas offering the greatest future potential were identified. The authors then discuss class II disposal projects in Stevens sands in the West Bellevue and Midway Sunset oil fields and estimate the ultimate basin-wide disposal capacity of the Stevens

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.

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.

Treatment of stress urinary incontinence

DEFF Research Database (Denmark)

Fischer-Rasmussen, W

1990-01-01

This review presents reported cure and improvement rates of stress urinary incontinence in women obtained by different treatment modalities. Apart from the urodynamic findings, histological and histochemical changes of the pelvic floor may be clinically relevant to treatment in the future. Long......-term cure and improvement rates achieved by non-surgical treatment (physiotherapy, biofeedback, bladder training, electrostimulation) are commented on. These rates range from 40-60% for physiotherapy and electrostimulation but are considerably less after biofeedback and bladder training. Pharmacotherapy...

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…

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...

Achondroplasia: Current Options and Future Perspective.

Science.gov (United States)

Bouali, Houda; Latrech, Hanane

2015-06-01

Achondroplasia is a human bone genetic disorder of the growth plate and is the most common form of inherited disproportionate short stature. It is inherited as an autosomal dominant disease with essentially complete penetrance. Of these most have the same point mutation in the gene for fibroblast growth factor receptor 3 (FGFR3) which is a negative regulator of bone growth. The clinical and radiological features of achondroplasia can easily be identified; they include disproportionate short stature with rhizomelic shortening, macrocephaly with frontal bossing, midface hypoplasia, lumbar hyperlordosis, and a trident hand configuration. The majority of achondroplasts have a normal intelligence, but many social and medical complications may compromise a full and productive life. Some of them have serious health consequences related to hydrocephalus, craniocervical junction compression, or upper-airway obstruction. In this article, we discuss a number of treatments from the surgical limb lengthening approach and the Recombinant Growth Hormone (rhGH) treatment, to future treatments, which include the Natriuretic Peptide C-type (CNP). The discussion is a comparative study of the complications and drawbacks of various experiments using numerous strategies.

Cogan's syndrome: present and future directions.

LENUS (Irish Health Repository)

Murphy, Grainne

2009-08-01

Cogan\\'s syndrome, typified by the combination of interstitial keratitis and immune-mediated sensorineural hearing loss, is a rare condition, and commonly associated with a diagnostic delay. Using a standard search protocol, we review the literature to date, focusing on a number of key areas pertaining to diagnosis, presentation and treatment. Using a case illustration of atypical disease which led to fulminant aortic regurgitation, we highlight the need for continued and collaborative research in order to identify negative prognostic factors and thus tailor therapeutic regimens. Atypical Cogan\\'s syndrome is more commonly associated with systemic manifestations than typical disease, and may be refractory to immunosuppressive treatment. We discuss the application of laboratory (e.g antibodies targeting inner ear antigens) and radiological (PET-CT) aids to disease confirmation and detection of sub-clinical vascular inflammation. As illustrated by the included case description, some patients remain refractory to intense immunosuppression and delineation of adverse prognostic factors which may direct treatment, perhaps including the use of PET-CT, will contribute in the future to improving patient outcomes.

Review: Drug and nondrug treatment in tension-type headache

DEFF Research Database (Denmark)

Bendtsen, Lars

2009-01-01

efficacy and fewer side effects is urgently needed. Future studies should also examine the relative efficacy of the various treatment modalities; for example, psychological, physical and pharmacological treatments, and clarify how treatment programs should be optimized to best suit the individual patient...

EnerFuture Energy Scenarios to 2035 'Understanding our Energy Future'. Key graphs and analysis, Enerdata - Global Energy Forecasting - February 2014

International Nuclear Information System (INIS)

2014-01-01

The EnerFuture service provides projections to 2035 of energy supply and demand across the world, powered by the POLES model, to help you with what to expect in the energy industry in the mid-term. Our energy forecasting team have developed three key energy scenarios (Balance, Emergence and Renaissance) to illustrate possible futures. Balance scenario: Balance provides an outlook of the energy system up to 2035 based on current policies and trends. Sustained growth of China and other emerging countries is a powerful driver of global energy demand, but confirmed energy policy commitments in several regions play a key role in controlling the pace of growth. However, non-coordinated policies result in soaring CO_2 emissions across the world and energy prices rise. Emergence scenario: This scenario explores the implications of more stringent climate policies, with more ambitious efforts on energy efficiency, initiatives to phase out fossil fuel subsidies and a real emergence of renewable technologies. Europe goes beyond its -20% targets by 2020, and the OECD and emerging countries meet their Copenhagen objectives. Following this, a new green deal is launched to reduce world emissions by a factor of 2 by 2050. Renaissance scenario: With strong efforts in the exploitation and production of unconventional oil and gas resources, the world encounters a fossil fuels renaissance with the appearance of new key actors and ultimately new geopolitical configurations changing the energy independence of several countries. For climate efforts, this new paradigm leads to progressively weaker policies. Further analysis and key findings are available here: - Increasing economic activity and wealth drives energy consumption, in a balance between energy prices and innovation; - As Non-OECD exceeds OECD oil demand, massive financial flows underlie the shifts in global oil trade; - Optimistic resource assumptions and moderate production costs would lead to an oil production Renaissance

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.

Treatment selection in a randomized clinical trial via covariate-specific treatment effect curves.

Science.gov (United States)

Ma, Yunbei; Zhou, Xiao-Hua

2017-02-01

For time-to-event data in a randomized clinical trial, we proposed two new methods for selecting an optimal treatment for a patient based on the covariate-specific treatment effect curve, which is used to represent the clinical utility of a predictive biomarker. To select an optimal treatment for a patient with a specific biomarker value, we proposed pointwise confidence intervals for each covariate-specific treatment effect curve and the difference between covariate-specific treatment effect curves of two treatments. Furthermore, to select an optimal treatment for a future biomarker-defined subpopulation of patients, we proposed confidence bands for each covariate-specific treatment effect curve and the difference between each pair of covariate-specific treatment effect curve over a fixed interval of biomarker values. We constructed the confidence bands based on a resampling technique. We also conducted simulation studies to evaluate finite-sample properties of the proposed estimation methods. Finally, we illustrated the application of the proposed method in a real-world data set.

[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.

Antimalarial drug policy in India: Past, present & future

Directory of Open Access Journals (Sweden)

Anupkumar R Anvikar

2014-01-01

Full Text Available The use of antimalarial drugs in India has evolved since the introduction of quinine in the 17 th century. Since the formal establishment of a malaria control programme in 1953, shortly after independence, treatments provided by the public sector ranged from chloroquine, the mainstay drug for many decades, to the newer, recently introduced artemisinin based combination therapy. The complexity of considerations in antimalarial treatment led to the formulation of a National Antimalarial Drug Policy to guide procurement as well as communicate best practices to both public and private healthcare providers. Challenges addressed in the policy include the use of presumptive treatment, the introduction of alternate treatments for drug-resistant malaria, the duration of primaquine therapy to prevent relapses of vivax malaria, the treatment of malaria in pregnancy, and the choice of drugs for chemoprophylaxis. While data on antimalarial drug resistance and both public and private sector treatment practices have been recently reviewed, the policy process of setting national standards has not. In this perspective on antimalarial drug policy, this review highlights its relevant history, analyzes the current policy, and examines future directions.

Procrastination, consideration of future consequences, and episodic future thinking.

Science.gov (United States)

Rebetez, Marie My Lien; Barsics, Catherine; Rochat, Lucien; D'Argembeau, Arnaud; Van der Linden, Martial

2016-05-01

Despite the intrinsic temporal nature of procrastination, little research has examined the link between this form of self-regulatory failure and the consideration of future consequences, and no study has addressed the link between procrastination and episodic future thinking. The aim of the present study was to explore these relationships. Participants were asked to project themselves into possible future events and to rate the amount of sensory-perceptual details and autonoetic consciousness associated with their representations. They were also asked to complete questionnaires that assessed procrastination, the consideration of future consequences, and negative affect. Results showed that both the consideration of future consequences and episodic future thinking were associated with procrastination, and in particular with procrastination-related decision making abilities and procrastination-related motivational dispositions, respectively. Copyright © 2016 Elsevier Inc. All rights reserved.

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.

Trend and current practices of palm oil mill effluent polishing: Application of advanced oxidation processes and their future perspectives.

Science.gov (United States)

Bello, Mustapha Mohammed; Abdul Raman, Abdul Aziz

2017-08-01

Palm oil processing is a multi-stage operation which generates large amount of effluent. On average, palm oil mill effluent (POME) may contain up to 51, 000 mg/L COD, 25,000 mg/L BOD, 40,000 TS and 6000 mg/L oil and grease. Due to its potential to cause environmental pollution, palm oil mills are required to treat the effluent prior to discharge. Biological treatments using open ponding system are widely used for POME treatment. Although these processes are capable of reducing the pollutant concentrations, they require long hydraulic retention time and large space, with the effluent frequently failing to satisfy the discharge regulation. Due to more stringent environmental regulations, research interest has recently shifted to the development of polishing technologies for the biologically-treated POME. Various technologies such as advanced oxidation processes, membrane technology, adsorption and coagulation have been investigated. Among these, advanced oxidation processes have shown potentials as polishing technologies for POME. This paper offers an overview on the POME polishing technologies, with particularly emphasis on advanced oxidation processes and their prospects for large scale applications. Although there are some challenges in large scale applications of these technologies, this review offers some perspectives that could help in overcoming these challenges. Copyright © 2017 Elsevier Ltd. All rights reserved.

Trends in desulphurisation and denitration techniques in the cement industry

Energy Technology Data Exchange (ETDEWEB)

Kupper, D

1991-03-01

A wide ranging article which examines various topics including primary SOx and NOx control measures, staged combustion, preheaters, precalciners, and comments on prospects for the future. As emission limits become more stringent, regulations for kiln systems will be adapted to those applicable to general combustion systems.

Status of the U.S. nuclear option, conditions leading to its resurgence, and current licensing requirements

International Nuclear Information System (INIS)

Ioannidi, J.

2007-01-01

The projected increase in electricity demand, increased concern over emissions along with more stringent emission requirements, volatility of the gas and oil supplies and prices, and the convergence of favourable conditions and legislation make nuclear power a practical option for meeting future electricity base-load demands. (author)

Experimentarium as arena for common learning during change processes

DEFF Research Database (Denmark)

Kofoed, L.B.; Rosenørn, T.U.; Jensen, Lars Peter

1999-01-01

in a medium size Danish company is presented in this paper. The case study demonstrates that it is feasible to generate employee participation in designing their future working environment in the experimentarium when careful attention is given to the influence of situational factors and a stringent...

Genetics of Common Endocrine Disease: The Present and the Future.

Science.gov (United States)

Goodarzi, Mark O

2016-03-01

In honor of the 75th issue of the Journal of Clinical Endocrinology and Metabolism, the author was invited to present his perspectives on genetics in human endocrinology. This paper reviews what the field has achieved in the genetics of common endocrine disease, and offers predictions on where the field will move in the future and its impact on endocrine clinical practice. The October 2015 data release of the National Human Genome Research Institute-European Bioinformatics Institute (NHGRI-EBI) Catalog of Published Genome-wide Association Studies was queried regarding endocrinologic diseases and traits. PubMed searches were focused on genetic prediction of disease, genetic findings and drug targets, functional interrogation of genetic loci, use of genetics to subtype disease, missing heritability, systems genomics, and higher order chromatin structures as regulators of gene function. Nearly a quarter of genome wide association study findings concern endocrinologic diseases and traits. While these findings have not yet dramatically altered clinical care, genetics will have a major impact by providing the drug targets of tomorrow, facilitated by experimental and bioinformatic advances that will shorten the time from gene discovery to drug development. Use of genetic findings to subtype common endocrine disease will allow more precise prevention and treatment efforts. Future advances will allow us to move away from the common view of DNA as a string of letters, allowing exploration of higher order structure that likely explains much "missing heritability." The future will see a greater role of genetics at the bedside, with genetic epidemiologic discoveries leading not only to new treatments of endocrine disease, but also helping us prescribe the right drug to the right patients by allowing subclassification of common heterogeneous endocrine conditions. Future technological breakthroughs will reveal the heritable mysteries hidden in chromatin structure, leading to a

Fit-for-purpose wastewater treatment: Testing to implementation of decision support tool (II).

Science.gov (United States)

Chhipi-Shrestha, Gyan; Hewage, Kasun; Sadiq, Rehan

2017-12-31

This paper is the second in a series of two papers. In Paper I, a decision support tool (DST), FitWater, was developed for evaluating the potential of wastewater treatment (WWT) trains for various water reuse applications. In the present paper, the proposed DST has been tested and implemented. FitWater has been tested with several existing WWT plants in Canada and the USA, demonstrating FitWater's effectiveness in estimating life cycle cost (LCC), health risk, and energy use. FitWater has also been implemented in a newly planned neighbourhood in the Okanagan Valley (BC, Canada) by developing 12 alternative WWT trains for water reuse in lawn and public parks irrigation. The results show that FitWater can effectively rank WWT train alternatives based on LCC, health risk, amount of reclaimed water, energy use, and carbon emissions. Moreover, functions have been developed for the variation of unit annualized LCC and energy intensity per unit log removal of microorganisms in different treatment technologies with varying plant capacities. The functions have power relations, showing the economies of scale. FitWater can be applied to identify a cost-effective, risk-acceptable, and energy efficient wastewater treatment train with a plant capacity of 500m 3 /day or more. Furthermore, FitWater can be used to assess potential economic impacts of developing microbiologically stringent effluent standards. The capability of FitWater can be enhanced by including physio-chemical quality of wastewater, additional treatment technologies, and carbon emissions from wastewater decomposition processes. Copyright © 2017 Elsevier B.V. All rights reserved.

A Point Source of a Different Color: Identifying a Gap in United States Regulatory Policy for “Green” CSO Treatment Using Constructed Wetlands

Directory of Open Access Journals (Sweden)

Zeno F. Levy

2014-04-01

Full Text Available Up to 850 billion gallons of untreated combined sewer overflow (CSO is discharged into waters of the United States each year. Recent changes in CSO management policy support green infrastructure (GI technologies as “front of the pipe” approaches to discharge mitigation by detention/reduction of urban stormwater runoff. Constructed wetlands for CSO treatment have been considered among suites of GI solutions. However, these wetlands differ fundamentally from other GI technologies in that they are “end of the pipe” treatment systems that discharge from a point source, and are therefore regulated in the U.S. under the National Pollution Discharge Elimination System (NPDES. We use a comparative regulatory analysis to examine the U.S. policy framework for CSO treatment wetlands. We find in all cases that permitting authorities have used best professional judgment to determine effluent limits and compliance monitoring requirements, referencing technology and water quality-based standards originally developed for traditional “grey” treatment systems. A qualitative comparison with Europe shows less stringent regulatory requirements, perhaps due to institutionalized design parameters. We recommend that permitting authorities develop technical guidance documents for evaluation of “green” CSO treatment systems that account for their unique operational concerns and benefits with respect to sustainable development.

Children with Specific Language Impairment and Their Families: A Future View of Nature Plus Nurture and New Technologies for Comprehensive Language Intervention Strategies.

Science.gov (United States)

Rice, Mabel L

2016-11-01

Future perspectives on children with language impairments are framed from what is known about children with specific language impairment (SLI). A summary of the current state of services is followed by discussion of how these children can be overlooked and misunderstood and consideration of why it is so hard for some children to acquire language when it is effortless for most children. Genetic influences are highlighted, with the suggestion that nature plus nurture should be considered in present as well as future intervention approaches. A nurture perspective highlights the family context of the likelihood of SLI for some of the children. Future models of the causal pathways may provide more specific information to guide gene-treatment decisions, in ways parallel to current personalized medicine approaches. Future treatment options can build on the potential of electronic technologies and social media to provide personalized treatment methods available at a time and place convenient for the person to use as often as desired. The speech-language pathologist could oversee a wide range of treatment options and monitor evidence provided electronically to evaluate progress and plan future treatment steps. Most importantly, future methods can provide lifelong language acquisition activities that maintain the privacy and dignity of persons with language impairment, and in so doing will in turn enhance the effectiveness of speech-language pathologists. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Future of brain stimulation: new targets, new indications, new technology.

Science.gov (United States)

Hariz, Marwan; Blomstedt, Patric; Zrinzo, Ludvic

2013-11-01

In the last quarter of a century, DBS has become an established neurosurgical treatment for Parkinson's disease (PD), dystonia, and tremors. Improved understanding of brain circuitries and their involvement in various neurological and psychiatric illnesses, coupled with the safety of DBS and its exquisite role as a tool for ethical study of the human brain, have unlocked new opportunities for this technology, both for future therapies and in research. Serendipitous discoveries and advances in structural and functional imaging are providing abundant "new" brain targets for an ever-increasing number of pathologies, leading to investigations of DBS in diverse neurological, psychiatric, behavioral, and cognitive conditions. Trials and "proof of concept" studies of DBS are underway in pain, epilepsy, tinnitus, OCD, depression, and Gilles de la Tourette syndrome, as well as in eating disorders, addiction, cognitive decline, consciousness, and autonomic states. In parallel, ongoing technological development will provide pulse generators with longer battery longevity, segmental electrode designs allowing a current steering, and the possibility to deliver "on-demand" stimulation based on closed-loop concepts. The future of brain stimulation is certainly promising, especially for movement disorders-that will remain the main indication for DBS for the foreseeable future-and probably for some psychiatric disorders. However, brain stimulation as a technique may be at risk of gliding down a slippery slope: Some reports indicate a disturbing trend with suggestions that future DBS may be proposed for enhancement of memory in healthy people, or as a tool for "treatment" of "antisocial behavior" and for improving "morality." © 2013 International Parkinson and Movement Disorder Society.

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...

Immunotherapy for advanced melanoma: future directions.

Science.gov (United States)

Valpione, Sara; Campana, Luca G

2016-02-01

As calculated by the meta-analysis of Korn et al., the prognosis of metastatic melanoma in the pretarget and immunological therapy era was poor, with a median survival of 6.2 and a 1-year life expectancy of 25.5%. Nowadays, significant advances in melanoma treatment have been gained, and immunotherapy is one of the promising approaches to get to durable responses and survival improvement. The aim of the present review is to highlight the recent innovations in melanoma immunotherapy and to propose a critical perspective of the future directions of this enthralling oncology subspecialty.

Current situation and future prospects for the Australian beef industry.

Science.gov (United States)

Greenwood, Paul Leo; Ferguson, Drewe M

2018-04-12

Beef production extends over almost half of Australia, with about 47,000 cattle producers that contribute about 20% ($A12.7 billion GVP) of the total value of farm production in Australia. Australia is one of the world's most efficient producers of cattle and was the world's third largest beef exporter in 2016. The Australian beef industry had 25 million head of cattle in 2016-17, with a national beef breeding herd of 11.5 million head. Australian beef production includes pasture based cow-calf systems, a backgrounding or grow-out period on pasture, and feedlot or pasture finishing. Feedlot finishing has assumed more importance in recent years to assure the eating quality of beef entering the relatively small Australian domestic market, and to enhance the supply of higher value beef for export markets. Maintenance of Australia's preferred status as a quality assured supplier of high value beef produced under environmentally sustainable systems from 'disease-free' cattle is of highest importance. Stringent livestock and meat quality regulations and quality assurance systems, and productivity growth and efficiency across the supply chain to ensure price competiveness, are crucial for continued export market growth in the face of increasing competition. Major industry issues, that also represent research, development and adoption priorities and opportunities for the Australian beef industry have been captured within exhaustive strategic planning processes by the red meat and beef industries. At the broadest level, these issues include consumer and industry support, market growth and diversification, supply chain efficiency, productivity and profitability, environmental sustainability, and animal health and welfare. This review provides an overview of the Australian beef industry including current market trends and future prospects, and major issues and opportunities for the continued growth, development and profitability of the industry.

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.

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...

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.

Broad support for regulating the clinical implementation of future reproductive techniques.

Science.gov (United States)

Hendriks, S; Vliegenthart, R; Repping, S; Dancet, E A F

2018-01-01

Do gynaecologists, infertile patients and the general public, consider that regulation of the clinical implementation of stem cell-based fertility treatments is required? There is broad support from gynaecologists, patients and the general public for regulating the clinical implementation of future stem cell-based fertility treatments. There is debate on the need to regulate the clinical implementation of novel techniques. Regulation may hinder their swift adoption and delay benefits for patients, but may prevent the implementation of ineffective or harmful techniques. Stem cell-based fertility treatments, which involve creating oocytes or spermatozoa by manipulating stem cells, are likely to be implemented in clinical practice in the near future and will probably impact future generations as well as the current one. A cross-sectional survey was conducted among gynaecologists working in fertility clinics (n = 179), patients with severe infertility (n = 348) and a representative sample of the general public (n = 1250). The questionnaire was disseminated in the Netherlands in the winter of 2015-2016. The newly developed questionnaire was reviewed by experts and tested among the general public. The questionnaire assessed whether participants wanted each of nine potential negative consequences of the clinical implementation of stem cell-based fertility treatments to be regulated. In addition, the importance of all negative and positive potential consequences, the appropriate regulatory body and its need to consult with advisors from various backgrounds was questioned. In total, 958 respondents completed the questionnaire (response rate: 54%). A large majority of each participant group (>85%) wanted regulation, for at least one potential negative consequence of the clinical implementation of stem cell-based fertility treatments. The majority of all participant groups wanted regulation for serious health risks for intended parents, serious health risks for children and

Forecasting land cover change impacts on drinking water treatment costs in Minneapolis, Minnesota

Science.gov (United States)

Woznicki, S. A.; Wickham, J.

2017-12-01

Source protection is a critical aspect of drinking water treatment. The benefits of protecting source water quality in reducing drinking water treatment costs are clear. However, forecasting the impacts of environmental change on source water quality and its potential to influence future treatment processes is lacking. The drinking water treatment plant in Minneapolis, MN has recognized that land cover change threatens water quality in their source watershed, the Upper Mississippi River Basin (UMRB). Over 1,000 km2 of forests, wetlands, and grasslands in the UMRB were lost to agriculture from 2008-2013. This trend, coupled with a projected population increase of one million people in Minnesota by 2030, concerns drinking water treatment plant operators in Minneapolis with respect to meeting future demand for clean water in the UMRB. The objective of this study is to relate land cover change (forest and wetland loss, agricultural expansion, urbanization) to changes in treatment costs for the Minneapolis, MN drinking water utility. To do this, we first developed a framework to determine the relationship between land cover change and water quality in the context of recent historical changes and projected future changes in land cover. Next we coupled a watershed model, the Soil and Water Assessment Tool (SWAT) to projections of land cover change from the FOREcasting SCEnarios of Land-use Change (FORE-SCE) model for the mid-21st century. Using historical Minneapolis drinking water treatment data (chemical usage and costs), source water quality in the UMRB was linked to changes in treatment requirements as a function of projected future land cover change. These analyses will quantify the value of natural landscapes in protecting drinking water quality and future treatment processes requirements. In addition, our study provides the Minneapolis drinking water utility with information critical to their planning and capital improvement process.

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...

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.

Gaps in Current Knowledge and Priorities for Future Research in Dry Eye.

Science.gov (United States)

Saldanha, Ian J; Dickersin, Kay; Hutfless, Susan T; Akpek, Esen K

2017-12-01

Dry eye, a common yet underrecognized and evolving field, has few recommended treatment algorithms, mostly based on expert consensus rather than robust research evidence. There are high costs associated with managing dry eye and conducting research to identify effective and safe long-term treatments. To support evidence-based management of dry eye, our purpose was to identify and prioritize important clinical research questions for future clinical research. We translated recommendations from the American Academy of Ophthalmology's 2013 Preferred Practice Patterns for dry eye into answerable clinical research questions about treatment effectiveness. Clinicians around the world who manage patients with dry eye rated each question's importance from 0 (not important) to 10 (very important) using a 2-round online Delphi survey. We considered questions as "important" if ≥75% of respondents assigned a rating of 6 or more in round 2. We mapped the identified important clinical research questions to reliable systematic reviews published up to March 2016. Seventy-five clinicians from at least 21 countries completed both Delphi rounds. Among the 58 questions, 24 met our definition of "important": 9/24 and 7/24 addressed topical and systemic treatments, respectively. All 4 questions with the highest 25th percentiles addressed topical treatments. Although 6/24 "important" questions were associated with 4 existing reliable systematic reviews, none of these reviews came to a definitive conclusion about treatment effectiveness. We identified gaps pertaining to treatment options for dry eye. Future clinical research on the management of dry eye should strongly consider these prioritized questions.

Uranium mine tailings and obligations to future generations

International Nuclear Information System (INIS)

Brook, A.

1980-01-01

Low-level wastes from uranium mine/mill operations, because of their huge volume, are a serious problem, yet relatively little attention has been paid to them. Management of tailings piles and waste liquids in the short term is fairly effective. However these management techniques involve continuous, active treatment of the wastes, which may not continue after operations shut down, and rely on containment structures with a short effective life. Tailings can probably be rendered safe for future generations if sufficient resources are devoted to the task. The central moral question is whether we are obligated to assume the costs of tailings management, or whether it is permissible to pass them on to future generations. The basic moral principle that each person has the same value as any other implies that the generation that reaps the benefits of nuclear power must assume the costs of managing mine tailings and not discriminate in favour of one group of persons, our own generation. The argument that people who may exist in the future have intrinsically less value than people currently alive is not accepted by the author. The methodology for determining obligations to future generations which has been applied to mine/mill wastes could be applied to other nuclear issues, too. (LL)

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.

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.

Immunotherapy for the Treatment of Glioblastoma

Science.gov (United States)

Thomas, Alissa A.; Ernstoff, Marc S.; Fadul, Camilo E.

2012-01-01

Glioblastoma, the most aggressive primary brain tumor, thrives in a microenvironment of relative immunosuppression within the relatively immune-privileged central nervous system. Despite treatments with surgery, radiation therapy, and chemotherapy, prognosis remains poor. The recent success of immunotherapy in the treatment of other cancers has renewed interest in vaccine therapy for the treatment of gliomas. In this article, we outline various immunotherapeutic strategies, review recent clinical trials data, and discuss the future of vaccine therapy for glioblastoma. PMID:22290259

Uterus transplantation: current progress and future prospects

Directory of Open Access Journals (Sweden)

Johannesson L

2016-02-01

Full Text Available Liza Johannesson, Stina Järvholm Department of Obstetrics and Gynecology, Sahlgrenska Academy, University of Gothenburg, Sahlgrenska University Hospital, Gothenburg, Sweden Abstract: Even if reproductive medicine has been remarkably successful during the past few decades, with the introduction of in vitro fertilization in the late 1970s and intracytoplasmic sperm injection in the early 1990s, it has been repeatedly mocked by infertility due to an absolute uterine factor. No treatment has been available for the women suffering from an absent or dysfunctional uterus, in terms of carrying a pregnancy. Approximately one in 500 women suffer from absolute uterine infertility, and the option so far to become a mother has been to either adopt or utilize gestational surrogacy. As of today, a total of eleven cases of human uterus transplantations have been reported worldwide, conducted in three different countries. The results of these initial experimental cases far exceed what might be expected of a novel surgical method. Many more uterus transplantations are to be expected in the near future, as other research teams’ preparations are being ready to be put into clinical practice. In this review, we summarize the current worldwide experience of uterus transplantation as a treatment of absolute uterine factor infertility and the future prospects of human uterus transplantation. Keywords: uterus, transplantation, infertility

Uranium R and D directed to low-grade ores

International Nuclear Information System (INIS)

Anon.

1976-01-01

The treatment of depleted uranium ores by in-situ leaching and by counterflow ion exchange in the USA is described. In-situ leaching is mainly suitable for sandstone deposits. The research was originally focused on leaching with an acid and with carbonates. Phosphoric acid appears to be a promising leaching agent. The equipment for continuous ion exchange may be used for sludge processing but the application depends on the type of equipment and mineralogy of processed ores. The method is advantageous for lower capital costs and for smooth operation. Ion exchange is also used for uranium extraction from mine waters in the USA as well as in Canada. For example, in Grants, New Mexico, a yield exceeding 90% was reached in mine waters only containing 5 to 7 ppm U 3 O 8 . In the future, the treatment of ores with a low uranium content will require more selective extraction methods in view of the more stringent technical conditions of uranium concentrate processing. (J.P.)

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.

Changes in future air quality, deposition, and aerosol-cloud interactions under future climate and emission scenarios

Energy Technology Data Exchange (ETDEWEB)

Glotfelty, Timothy; Zhang, Yang; Karamchandani, Prakash; Streets, David G.

2016-08-01

treatment of GU-WRF/Chem and cannot simulate the impacts of changing climate and emissions with the same level of detailed treatments. This study indicates that effective climate mitigation and emission control strategies are needed to prevent future health impact and ecosystem stress. Further, studies that are used to develop these strategies should use fully coupled models with sophisticated chemical and aerosol-interaction treatments that can provide a more realistic representation of the atmosphere.

Omics-based nanomedicine: the future of personalized oncology.

Science.gov (United States)

Rosenblum, Daniel; Peer, Dan

2014-09-28

The traditional "one treatment fits all" paradigm disregards the heterogeneity between cancer patients, and within a particular tumor, thus limit the success of common treatments. Moreover, current treatment lacks specificity and therefore most of the anticancer drugs induce severe adverse effects. Personalized medicine aims to individualize therapeutic interventions, based on the growing knowledge of the human multiple '-oms' (e.g. genome, epigenome, transcriptome, proteome and metabolome), which has led to the discovery of various biomarkers that can be used to detect early stage cancers and predict tumor progression, drug response, and clinical outcome. Nanomedicine, the application of nanotechnology to healthcare, holds great promise for revolutionizing disease management such as drug delivery, molecular imaging, reduced adverse effects and the ability to contain both therapeutic and diagnostic modalities simultaneously termed theranostics. Personalizednanomedicine has the power of combining nanomedicine with clinical and molecular biomarkers ("OMICS" data) achieving improve prognosis and disease management as well as individualized drug selection and dosage profiling to ensure maximal efficacy and safety. Tumor's heterogeneity sets a countless challenge for future personalized therapy in cancer, however the use of multi-parameter 'omic's data for specific molecular biomarkers recognition together with versatile drug delivery nanocarriers, which could target concomitantly and specifically tumor cells subpopulations, might heralds a brighter future for personalized cancer management. In this review, we present the current leading technologies available for personalized oncology. We discusses the immense potential of combining the best of these two worlds, nanomedicine and high throughput OMICS technologies to pave the way towards cancer personalized medicine. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

Multifactor valuation models of energy futures and options on futures

Science.gov (United States)

Bertus, Mark J.

The intent of this dissertation is to investigate continuous time pricing models for commodity derivative contracts that consider mean reversion. The motivation for pricing commodity futures and option on futures contracts leads to improved practical risk management techniques in markets where uncertainty is increasing. In the dissertation closed-form solutions to mean reverting one-factor, two-factor, three-factor Brownian motions are developed for futures contracts. These solutions are obtained through risk neutral pricing methods that yield tractable expressions for futures prices, which are linear in the state variables, hence making them attractive for estimation. These functions, however, are expressed in terms of latent variables (i.e. spot prices, convenience yield) which complicate the estimation of the futures pricing equation. To address this complication a discussion on Dynamic factor analysis is given. This procedure documents latent variables using a Kalman filter and illustrations show how this technique may be used for the analysis. In addition, to the futures contracts closed form solutions for two option models are obtained. Solutions to the one- and two-factor models are tailored solutions of the Black-Scholes pricing model. Furthermore, since these contracts are written on the futures contracts, they too are influenced by the same underlying parameters of the state variables used to price the futures contracts. To conclude, the analysis finishes with an investigation of commodity futures options that incorporate random discrete jumps.

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

Adsorption desalination—Principles, process design, and its hybrids for future sustainable desalination

KAUST Repository

Shahzad, Muhammad Wakil; Burhan, Muhammad; Ang, Li; Ng, Kim Choon

2018-01-01

The energy, water, and environment nexus is a crucial factor when considering the future development of desalination plants or industry in water-stressed economies. The new generation of desalination processes or plants has to meet the stringent environment discharge requirements and yet the industry remains highly energy efficient and sustainable when producing good potable water. Water sources, either brackish or seawater, have become more contaminated as feed while the demand for desalination capacities increases around the world. One immediate solution for energy efficiency improvement comes from the hybridization of the proven desalination processes to the newer processes of desalination: For example, the integration of the available heat-driven to adsorption desalination (AD) cycles where significant thermodynamic synergy can be attained when cycles are combined. For these hybrid cycles, a quantum improvement in energy efficiency as well as an increase in water production can be expected. The advent of MED with AD cycles, or simply called the MED-AD cycles, is one such example where seawater desalination can be pursued and operated in cogeneration with the electricity production plants: The hybrid desalination cycles utilize only the low exergy bled-stream at low temperatures, complemented with waste exhaust or renewable solar thermal heat at temperatures between 60°C and 80°C. In this chapter, the authors have reported their pioneered research on aspects of AD and related hybrid MED-AD cycles, both at theoretical models and experimental pilots. Using the cogeneration of electricity and desalination concepts, the authors examine the cost apportionment of fuel cost by the quality or exergy of the working steam for such cogeneration configurations.

Adsorption desalination—Principles, process design, and its hybrids for future sustainable desalination

KAUST Repository

Shahzad, Muhammad Wakil

2018-05-03

The energy, water, and environment nexus is a crucial factor when considering the future development of desalination plants or industry in water-stressed economies. The new generation of desalination processes or plants has to meet the stringent environment discharge requirements and yet the industry remains highly energy efficient and sustainable when producing good potable water. Water sources, either brackish or seawater, have become more contaminated as feed while the demand for desalination capacities increases around the world. One immediate solution for energy efficiency improvement comes from the hybridization of the proven desalination processes to the newer processes of desalination: For example, the integration of the available heat-driven to adsorption desalination (AD) cycles where significant thermodynamic synergy can be attained when cycles are combined. For these hybrid cycles, a quantum improvement in energy efficiency as well as an increase in water production can be expected. The advent of MED with AD cycles, or simply called the MED-AD cycles, is one such example where seawater desalination can be pursued and operated in cogeneration with the electricity production plants: The hybrid desalination cycles utilize only the low exergy bled-stream at low temperatures, complemented with waste exhaust or renewable solar thermal heat at temperatures between 60°C and 80°C. In this chapter, the authors have reported their pioneered research on aspects of AD and related hybrid MED-AD cycles, both at theoretical models and experimental pilots. Using the cogeneration of electricity and desalination concepts, the authors examine the cost apportionment of fuel cost by the quality or exergy of the working steam for such cogeneration configurations.

A NuSTAR observation of the center of the coma cluster

DEFF Research Database (Denmark)

Gastaldello, Fabio; Wik, Daniel R.; Molendi, S.

2015-01-01

. The brightness of the thermal component in this central region does not allow more stringent upper limits on the IC component when compared with non-imaging instruments with much larger fields of view where claims of detections have been made. Future mosaic NuSTAR observations of Coma will further address...

Past, present and future aspects of studies of heavy ion radiotherapy. 2. Future view of clinical studies of heavy ion radiotherapy

International Nuclear Information System (INIS)

Tsujii, Hirohiko; Kamata, Tadashi

2007-01-01

The purpose of clinical studies of heavy ion radiotherapy (HIR, using carbon beam) in National Institute of Radiological Sciences (NIRS) is, in treatment of cancers, to elucidate its potential and significance for establishing the methodology for curing the disease safely and reliably to further spread the therapy. Here is presented a future view of clinical studies of HIR based on the past results and along authorities' medical policy. NIRS has treated 3,100 or more cancer patients in about 50 clinical trials from the start of HIR in 1994. In those studies, curing the intractable malignancies has become possible in a short term of therapy, and the irradiating machine is being miniaturized (actually under construction in Gunma Univ.). At the end of 2006, about 4,000 patients have been treated with HIR globally: the impact of NIRS HIR. There are such future HIR plans as the promotion of clinical trials, development of irradiation technology, promotion and efficient practice as an advanced frontier medicare, imaging diagnosis for the aim of treatment, biological studies, and comparative studies to elucidate the usefulness. Cooperation of NIRS, manufacturers and authorities will make HIR a more useful, less burdensome mean to treat patients with more intractable cancers. (R.T.)

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.

[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.

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

Eying the future: Eye movement in past and future thinking.

Science.gov (United States)

El Haj, Mohamad; Lenoble, Quentin

2017-06-07

We investigated eye movement during past and future thinking. Participants were invited to retrieve past events and to imagine future events while their scan path was recorded by an eye-tracker. Past thinking triggered more fixation (p thinking. Past and future thinking triggered a similar duration of fixations and saccades, as well as a similar amplitude of saccades. Interestingly, participants rated past thinking as more vivid than future thinking (p thinking seems to be accompanied by an increased number of fixations and saccades. Fixations and saccades in past thinking can be interpreted as an attempt by the visual system to find (through saccades) and activate (through fixations) stored memory representations. The same interpretation can be applied to future thinking as this ability requires activation of past experiences. However, future thinking triggers fewer fixations and saccades than past thinking: this may be due to its decreased demand on visual imagery, but could also be related to a potentially deleterious effect of eye movements on spatial imagery required for future thinking. Copyright © 2017 Elsevier Ltd. All rights reserved.

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.

Emissions control techniques applied to industrial vehicles

Energy Technology Data Exchange (ETDEWEB)

Martin, B.

2004-12-15

As emission standards for industrial vehicles become increasingly stringent, many research projects are seeking to develop after-treatment systems. These systems will have to combine efficiency, durability and low operating cost.

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...

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...

The Future of Multicultural Social Work

Directory of Open Access Journals (Sweden)

Rowena Fong

2005-05-01

Full Text Available Multicultural social work has been evolving over the last forty years despite challenges in limited knowledge, insufficient resources, and inadequate infusion into the curriculum. Discussions continue about appropriate conceptual frameworks, culturally sensitive terms, traditional and indigenous practice approaches and treatments, and relevant outcome measures and evaluation methods. Future directions foster the inclusion of cultural values as strengths. Intersectionality guides practice approaches and systems of care. Service learning requirements, national ethnic resource centers, and ethnic resource centers, and ethnic studies dual degree programs are innovative initiatives yet to be fully integrated into social work curriculum.

Financial Burden of Cancer Drug Treatment in Lebanon.

Science.gov (United States)

Elias, Fadia; Khuri, Fadlo R; Adib, Salim M; Karam, Rita; Harb, Hilda; Awar, May; Zalloua, Pierre; Ammar, Walid

2016-01-01

The Ministry of Public Health (MOPH) in Lebanon provides cancer drugs free of charge for uninsured patients who account for more than half the total caseload. Other categories of cancer care are subsidized under more stringent eligibility criteria. MOPH's large database offers an excellent opportunity to analyze the cost of cancer treatment in Lebanon. Using utilization and spending data accumulated at MOPH during 20082013, the cost to the public budget of cancer drugs was assessed per case and per drug type. The average annual cost of cancer drugs was 6,475$ per patient. Total cancer drug costs were highest for breast cancer, followed by chronic myeloid leukemia (CML), colorectal cancer, lung cancer, and NonHodgkin's lymphoma (NHL), which together represented 74% of total MOPH cancer drug expenditure. The annual average cancer drug cost per case was highest for CML ($31,037), followed by NHL ($11,566). Trastuzumab represented 26% and Imatinib 15% of total MOPH cancer drug expenditure over six years. Sustained increase in cancer drug cost threatens the sustainability of MOPH coverage, so crucial for socially vulnerable citizens. To enhance the bargaining position with pharmaceutical firms for drug cost containment in a small market like Lebanon, drug price comparisons with neighboring countries which have already obtained lower prices may succeed in lowering drug costs.

New techniques for the treatment of uranium ores

International Nuclear Information System (INIS)

Renaud, J.; Boutonnet, G.

1977-01-01

The growth in nuclear power programmes since 1970 has led to an increasing demand for uranium, and tenders have been invited from all parts of the world for the construction of new treatment plants. What types of plant could be suggested. The diversity of ores and sites, even more stringent safety requirements, greater care for the environment and economic facts called for numerous, if not basic, reviews of the conventional techniques. Two examples illustrate this point. In the case of a plant to treat a refractory ore situated in a desert area with limited water resources, Pechiney Ugine Kuhlmann studied and applied a new technique of leaching by sulphuric acid pulping, which gives a considerable saving of sulphuric acid and water in comparison with conventional leaching techniques. In dealing with a problem which arose at a plant situated in a mountainous region of touristic interest, where a tailings settling tank could not be installed, Pechiney Ugine Kuhlmann studied and developed techniques involving the use of band filters for solid-liquid separation and pulp washing. Apart from lowering investment costs by about 15% in comparison with the techniques used so far, this technique produces the tailings in solid form so that they do not require a settling tank for storage. (author)

Psychosocial therapies for children and adolescents: overview and future directions.

Science.gov (United States)

Cohen, D J

1995-02-01

The assessment and psychosocial treatment of children must consider developmental phase and stage, developmental tasks, the nature of the disorder (does it affect a narrow sector or one developmental line or is there a broad disruption of development?) and biological contributions (including constitution, maturational rate, and factors such as the onset of puberty). Treatments can be distinguished along dimensions, including theoretical emphases, degrees of definition of the treatment, scope, the "patient" (child, family), duration, frequency of contacts, combination with other modalities, etc. Similarly, choice of treatment is based on many factors, including the clinician's expertise, availability of resources, wishes of parents, cost, etc. Future research should be grounded in a theory of child development as well as a theory of therapeutic action. Treatments should be well defined and currently practiced, provided by experts, and arise from realistic situations. The study of therapies bridges basic and applied research and provides data of profound relevance for theories of child development.

Wastewater treatment by nanofiltration membranes

Science.gov (United States)

Mulyanti, R.; Susanto, H.

2018-03-01

Lower energy consumption compared to reverse osmosis (RO) and higher rejection compared to ultrafiltration make nanofiltration (NF) membrane get more and more attention for wastewater treatment. NF has become a promising technology not only for treating wastewater but also for reusing water from wastewater. This paper presents various application of NF for wastewater treatments. The factors affecting the performance of NF membranes including operating conditions, feed characteristics and membrane characteristics were discussed. In addition, fouling as a severe problem during NF application is also presented. Further, future prospects and challenges of NF for wastewater treatments are explained.

Making the future palpable: Notes from a major incident Future Laboratory

DEFF Research Database (Denmark)

Büscher, Monika; Kristensen, Margit; Mogensen, Preben Holst

2008-01-01

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. However, they readily invent new ways of working in engagement with new technologies and, by facilitating realistic use...... of prototype 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. Many raise tough questions rather than provide quick answers. In addition, many also...

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

Emerging treatments in alopecia.

Science.gov (United States)

Falto-Aizpurua, Leyre; Choudhary, Sonal; Tosti, Antonella

2014-12-01

Alopecia is a common concern encountered in the medical practice. Treatment approach varies according to the type and severity of alopecia. However, available treatment options have limited efficacy and several adverse effects. Presently, there are different treatment options being studied to overcome these limitations. Additionally, cellular pathways involved in the pathophysiology of alopecia are further being clarified to potentially target pathogenic molecules. We searched the literature for recently published articles discussing new treatment options as well as mechanisms involved in alopecia. We discuss the use of stem cells, growth factors, cellular pathways and robotic hair transplant, among other emerging therapies used for alopecia. Future looks very promising and new effective treatments such as janus kinase inhibitors could possibly be available for alopecia areata. The stem-cell technology is advancing and companies involved in hair follicle neogenesis are starting clinical trials on patients with androgenetic alopecia.

US major crops’ uncertain climate change risks and greenhouse gas mitigation benefits

International Nuclear Information System (INIS)

Wing, Ian Sue; Monier, Erwan; Stern, Ari; Mundra, Anupriya

2015-01-01

We estimate the costs of climate change to US agriculture, and associated potential benefits of abating greenhouse gas emissions. Five major crops’ yield responses to climatic variation are modeled empirically, and the results combined with climate projections for a no-policy, high-warming future, as well as moderate and stringent mitigation scenarios. Unabated warming reduces yields of wheat and soybeans by 2050, and cotton by 2100, but moderate warming increases yields of all crops except wheat. Yield changes are monetized using the results of economic simulations within an integrated climate-economy modeling framework. Uncontrolled warming’s economic effects on major crops are slightly positive—annual benefits <$4 B. These are amplified by emission reductions, but subject to diminishing returns—by 2100 reaching $17 B under moderate mitigation, but only $7 B with stringent mitigation. Costs and benefits are sensitive to irreducible uncertainty about the fertilization effects of elevated atmospheric carbon dioxide, without which unabated warming incurs net costs of up to $18 B, generating benefits to moderate (stringent) mitigation as large as $26 B ($20 B). (letter)

Alopecia areata: medical treatments

Directory of Open Access Journals (Sweden)

Zonunsanga

2015-01-01

Full Text Available Alopecia areata (AA is a non-scarring, autoimmune, inflammatory, relapsing hair loss affecting the scalp and/or body. In acute-phase AA, CD4+ and CD8+ T cells infiltrated in the juxta-follicular area. In chronic-phase AACD8+ T cells dominated the infiltrate around hair bulbs which contributes to the prolonged state of hair loss. Treatments include mainly corticosteroids, topical irritants, minoxidil, cytotoxic drugs and biologicals. This review highlights mainly the pathomechanism and pathology, classifications and associated diseases with regard to their importance for current and future treatment.

among People Receiving Antiretroviral Treatment in Western Uganda

African Journals Online (AJOL)

In this paper, we use survey (n=87) and interview (n=30) data to investigate orientations towards future childbearing among people receiving antiretroviral treatment and their family members in western Uganda. We investigate how reproductive options are perceived, by those receiving treatment and those closest to them, ...

Adjuvant chemotherapy for gastric cancer: Current evidence and future challenges

Science.gov (United States)

Miceli, Rosalba; Tomasello, Gianluca; Bregni, Giacomo; Di Bartolomeo, Maria; Pietrantonio, Filippo

2014-01-01

Gastric cancer still represents one of the major causes of cancer mortality worldwide. Patients survival is mainly related to stage, with a high proportion of patients with metastatic disease at presentation. Thus, the cure rate largely depend upon surgical resection. Despite the additional, albeit small, benefit of adjuvant chemotherapy has been clearly demonstrated, no general consensus has been reached on the best treatment option. Moreover, the narrow therapeutic index of adjuvant chemotherapy (i.e., limited survival benefit with considerable toxicity) requires a careful assessment of expected risks and benefits for individual patients. Treatment choices vary widely based on the different geographic areas, with chemotherapy alone more often preferred in Europe or Asia and chemoradiotherapy in the United States. In the present review we discuss the current evidence and future challenges regarding adjuvant chemotherapy in curatively resected gastric cancer with particular emphasis on the recently completed landmark studies and meta-analyses. The most recent patient-level meta-analysis demonstrated the benefit of adjuvant chemotherapy over curative surgery; the same Authors also showed that disease-free survival may be used as a surrogate end-point for overall survival. We finally discuss future research issues such as the need of economic evaluations, development of prognostic or predictive biomarkers, and the unmet clinical need of trials comparing perioperative chemotherapy with adjuvant treatment. PMID:24782604

LOW LEVEL LIQUID RADIOACTIVE WASTE TREATMENT AT MURMANSK, RUSSIA: FACILITY UPGRADE AND EXPANSION

Energy Technology Data Exchange (ETDEWEB)

BOWERMAN,B.; CZAJKOWSKI,C.; DYER,R.S.; SORLIE,A.

2000-03-01

Today there exist many almost overfilled storage tanks with liquid radioactive waste in the Russian Federation. This waste was generated over several years by the civil and military utilization of nuclear power. The current waste treatment capacity is either not available or inadequate. Following the London Convention, dumping of the waste in the Arctic seas is no longer an alternative. Waste is being generated from today's operations, and large volumes are expected to be generated from the dismantling of decommissioned nuclear submarines. The US and Norway have an ongoing co-operation project with the Russian Federation to upgrade and expand the capacity of a treatment facility for low level liquid waste at the RTP Atomflot site in Murmansk. The capacity will be increased from 1,200 m{sup 3}/year to 5,000 m{sup 3} /year. The facility will also be able to treat high saline waste. The construction phase will be completed the first half of 1998. This will be followed by a start-up and a one year post-construction phase, with US and Norwegian involvement for the entire project. The new facility will consist of 9 units containing various electrochemical, filtration, and sorbent-based treatment systems. The units will be housed in two existing buildings, and must meet more stringent radiation protection requirements that were not enacted when the facility was originally designed. The US and Norwegian technical teams have evaluated the Russian design and associated documentation. The Russian partners send monthly progress reports to US and Norway. Not only technical issues must be overcome but also cultural differences resulting from different methods of management techniques. Six to eight hour time differentials between the partners make real time decisions difficult and relying on electronic age tools becomes extremely important. Language difficulties is another challenge that must be solved. Finding a common vocabulary, and working through interpreters make the

Initial Clinical Experience Performing Patient Treatment Verification With an Electronic Portal Imaging Device Transit Dosimeter

Energy Technology Data Exchange (ETDEWEB)

Berry, Sean L., E-mail: BerryS@MSKCC.org [Department of Applied Physics and Applied Mathematics, Columbia University, New York, New York (United States); Department of Medical Physics, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Polvorosa, Cynthia; Cheng, Simon; Deutsch, Israel; Chao, K. S. Clifford; Wuu, Cheng-Shie [Department of Radiation Oncology, Columbia University, New York, New York (United States)

2014-01-01

Purpose: To prospectively evaluate a 2-dimensional transit dosimetry algorithm's performance on a patient population and to analyze the issues that would arise in a widespread clinical adoption of transit electronic portal imaging device (EPID) dosimetry. Methods and Materials: Eleven patients were enrolled on the protocol; 9 completed and were analyzed. Pretreatment intensity modulated radiation therapy (IMRT) patient-specific quality assurance was performed using a stringent local 3%, 3-mm γ criterion to verify that the planned fluence had been appropriately transferred to and delivered by the linear accelerator. Transit dosimetric EPID images were then acquired during treatment and compared offline with predicted transit images using a global 5%, 3-mm γ criterion. Results: There were 288 transit images analyzed. The overall γ pass rate was 89.1% ± 9.8% (average ± 1 SD). For the subset of images for which the linear accelerator couch did not interfere with the measurement, the γ pass rate was 95.7% ± 2.4%. A case study is presented in which the transit dosimetry algorithm was able to identify that a lung patient's bilateral pleural effusion had resolved in the time between the planning CT scan and the treatment. Conclusions: The EPID transit dosimetry algorithm under consideration, previously described and verified in a phantom study, is feasible for use in treatment delivery verification for real patients. Two-dimensional EPID transit dosimetry can play an important role in indicating when a treatment delivery is inconsistent with the original plan.

Clinical trials in orthopaedics and the future direction of clinical investigations for femoroacetabular impingement

DEFF Research Database (Denmark)

Clohisy, John C; Kim, Young-Jo; Lurie, Jon

2013-01-01

to be further defined. To date, clinical research reports have included primarily surgical case series. Future clinical investigations are needed to establish improved clinical evidence to guide patient care. Most urgent is the need to better understand the potential role of standardized nonsurgical treatment......Femoroacetabular impingement (FAI) represents a heterogeneous group of disorders that affect a diverse patient population. The natural history of the disease, the role of nonsurgical management, the indications for surgery, optimal surgical techniques, and the predictors of treatment outcomes need...... options for FAI and to define the predictors of surgical and nonsurgical outcomes. Future randomized controlled trials and large observational cohort studies targeted at these clinical research deficiencies will strengthen the evidence and improve informed decision making regarding the management...

Deciding about treatments that prolong life

Science.gov (United States)

... you are receiving or may need in the future. Learn about the treatments and how they would ... patients and their families. In: Goldman L, Schafer AI, eds. Goldman's Cecil Medicine . 25th ed. Philadelphia, PA: ...

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

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...

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

Iron-based subsurface arsenic removal technologies by aeration: A review of the current state and future prospects.

Science.gov (United States)

Luong, Vu T; Cañas Kurz, Edgardo E; Hellriegel, Ulrich; Luu, Tran L; Hoinkis, Jan; Bundschuh, Jochen

2018-04-15

Arsenic contamination in groundwater is a critical issue and one that raises great concern around the world as the cause of many negative health impacts on the human body, including internal and external cancers. There are many ways to remove or immobilize arsenic, including membrane technologies, adsorption, sand filtration, ion exchange, and capacitive deionization. These exhibit many different advantages and disadvantages. Among these methods, in-situ subsurface arsenic immobilization by aeration and the subsequent removal of arsenic from the aqueous phase has shown to be very a promising, convenient technology with high treatment efficiency. In contrast to most of other As remediation technologies, in-situ subsurface immobilization offers the advantage of negligible waste production and hence has the potential of being a sustainable treatment option. This paper reviews the application of subsurface arsenic removal (SAR) technologies as well as current modeling approaches. Unlike subsurface iron removal (SIR), which has proven to be technically feasible in a variety of hydrogeochemical settings for many years, SAR is not yet an established solution since it shows vulnerability to diverse geochemical conditions such as pH, Fe:As ratio, and the presence of co-ions. In some situations, this makes it difficult to comply with the stringent guideline value for drinking water recommended by the WHO (10 μg L -1 ). In order to overcome its limitations, more theoretical and experimental studies are needed to show long-term application achievements and help the development of SAR processes into state-of-the-art technology. Copyright © 2018 Elsevier Ltd. All rights reserved.

Addressing Therapeutic Options for Ebola Virus Infection in Current and Future Outbreaks.

Science.gov (United States)

Haque, Azizul; Hober, Didier; Blondiaux, Joel

2015-10-01

Ebola virus can cause severe hemorrhagic disease with high fatality rates. Currently, no specific therapeutic agent or vaccine has been approved for treatment and prevention of Ebola virus infection of humans. Although the number of Ebola cases has fallen in the last few weeks, multiple outbreaks of Ebola virus infection and the likelihood of future exposure highlight the need for development and rapid evaluation of pre- and postexposure treatments. Here, we briefly review the existing and future options for anti-Ebola therapy, based on the data coming from rare clinical reports, studies on animals, and results from in vitro models. We also project the mechanistic hypotheses of several potential drugs against Ebola virus, including small-molecule-based drugs, which are under development and being tested in animal models or in vitro using various cell types. Our paper discusses strategies toward identifying and testing anti-Ebola virus properties of known and medically approved drugs, especially those that can limit the pathological inflammatory response in Ebola patients and thereby provide protection from mortality. We underline the importance of developing combinational therapy for better treatment outcomes for Ebola patients. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

Emergent future situation awareness: a temporal probabilistic reasoning in the absence of domain experts

CSIR Research Space (South Africa)

Osunmakinde, I

2009-04-01

Full Text Available ). The treatment records from the behavior of a diabetes patient were captured electronically as MTS. It contains several treatment measurement codes such as 33 (regular insulin dose), 48 (unspecified blood glucose), etc. It is expected here to predict treatment... measurements required in future for the patient based on the historical behavioral patterns. For instance, equation (6) below is a situation which predicts how much of the minimum (about 7 units) measurement of regular insulin dose will be required...

Imagining Future Forests: What Models Can Learn from Field Data.

Science.gov (United States)

Ward, E. J.; Domec, J. C.; Laviner, M. A.; Fox, T. D.; Sun, G.; McNulty, S. G.; King, J.; Noormets, A.

2014-12-01

General circulation models predict that future forests in the U.S. Southeast will experience higher temperatures and more variable precipitation in the future, resulting in a moderate decrease in water availability (precipitation minus evapotranspiration), though considerable uncertainty in and disagreement between projections remain. The Pine Integrated Network: Education, Mitigation, and Adaptation Project (PINEMAP) represents an effort to understand the future of 20 million acres of planted pine forests managed by private landowners in the Atlantic and Gulf coastal states. Decades of productivity research on loblolly pine (Pinus taeda) has led to a widespread practice of mid-rotation fertilization of loblolly plantations, supplying additional nutrients as stands approach canopy closure. It remains an open question what the effects of fertilization of pine forests in this region will be in the face of periodic or persistent droughts, in terms of forest water use and its implications to other water uses downstream. Therefore, we will review key results from past ecophysiological research on the responses of loblolly pine to fertilization, elevated CO2 and water availability, as well as a recent PINEMAP field trial of fertilization and drought imposed through rainfall displacement over two growing seasons. Despite high rainfall in 2013 (1224 mm compared an average 1120 mm) and a lack of leaf area response, transpiration decreased in response to fertilization and through rainfall displacement. Treatment differences were greatest in the growing season of 2013, when transpiration was on average 13.6, 20.2 and 28.7% lower in the rainfall displacement, fertilization and combined treatment than the control (46 mm/month), respectively. We will conclude by reviewing the important lessons from this research for regional models of future forests in this region in terms of LAI, transpiration, growth and water use efficiency.

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

CHEMICAL LEUCODERMA: INDIAN SCENARIO, PROGNOSIS, AND TREATMENT

Science.gov (United States)

Bajaj, A K; Saraswat, Abir; Srivastav, P K

2010-01-01

Chemical leucoderma is an industrial disorder in developed countries and the common causative chemicals are phenols and catechols. Due to stringent controls and preventive measures the incidence has come down. In the recent past various chemicals in consumer products have also been documented to produce depigmentation. In India due to lax quality control measures chemical leucoderma due to consumer items is not uncommon.The various consumer items documented to cause contact depigmentation are sticker bindis, rain shoes, plastic chappals, hair dye/ black henna(kali mehndi), alta, wallets and even mobile plastic covers. PMID:21063517

Chemical leucoderma: Indian scenario, prognosis, and treatment

Directory of Open Access Journals (Sweden)

Bajaj A

2010-01-01

Full Text Available Chemical leucoderma is an industrial disorder in developed countries and the common causative chemicals are phenols and catechols. Due to stringent controls and preventive measures the incidence has come down. In the recent past various chemicals in consumer products have also been documented to produce depigmentation.In India due to lax quality control measures chemical leucoderma due to consumer items is not uncommon.The various consumer items documented to cause contact depigmentation are sticker bindis,rain shoes,plastic chappals,hair dye/ black henna( kali mehndi, alta, wallets and even mobile plastic covers.

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.

Current and emerging treatments for the management of myasthenia gravis

Science.gov (United States)

Sathasivam, Sivakumar

2011-01-01

Myasthenia gravis is an autoimmune neuromuscular disorder. There are several treatment options, including symptomatic treatment (acetylcholinesterase inhibitors), short-term immunosuppression (corticosteroids), long-term immunosuppression (azathioprine, cyclosporine, cyclophosphamide, methotrexate, mycophenolate mofetil, rituximab, tacrolimus), rapid acting short-term immunomodulation (intravenous immunoglobulin, plasma exchange), and long-term immunomodulation (thymectomy). This review explores in detail these different treatment options. Potential future treatments are also discussed. PMID:21845054

Parent perspectives on information about late effects of childhood cancer treatment and their role in initial treatment decision making.

Science.gov (United States)

Greenzang, Katie A; Dauti, Angela; Mack, Jennifer W

2018-06-01

Though most childhood cancer survivors experience late effects of treatment, we know little about parent preferences for late effects information during therapy, or how parents weigh late effects when making treatment decisions. Our objective was to explore how parents of children with cancer consider late effects in initial treatment decision making and during active cancer treatment. Semistructured interviews were conducted with 12 parents of children with cancer who were actively receiving treatment at Dana-Farber/Boston Children's Cancer and Blood Disorders Center. Interviews were audio-recorded, transcribed verbatim, and qualitatively analyzed using thematic analysis. Ten of 12 parents reported that they had to decide between two or more treatment options for their child's cancer. Of those, 50% (5/10) considered late effects to be an important factor in their decision making. Most parents wanted early and detailed information about their child's risk of late effects to make treatment decisions and to feel prepared for the future. However, a few parents felt too overwhelmed to focus on late effects at diagnosis. While many recalled extensive late effects information in informed consent discussions, some parents felt these issues were minimally addressed. Parents desire detailed information about late effects to make informed treatment decisions and prepare for the future. Despite the role of late effects in treatment decision making, some parents feel that late effects are either inadequately addressed or too overwhelming to process at diagnosis. Parents may benefit from early assessment of their information needs and a return to these issues over time. © 2018 Wiley Periodicals, Inc.

Shanghai Futures Exchange Published Draft of Tin and Nickel Futures Contract

Institute of Scientific and Technical Information of China (English)

2015-01-01

Shanghai Futures Exchange published draft for soliciting opinions for tin and nickel futures contract on its official website on January 19,which implies the marketing time of the long awaited tin and nickel futures is drawing near.According to the draft for soliciting opinions,the transaction unit of tin futures contract is 1tonne/lot,minimum variation unit is 10 yuan/tonne,daily maximum price fluctuation shall

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....

Uncertain Environmental Footprint of Current and Future Battery Electric Vehicles.

Science.gov (United States)

Cox, Brian; Mutel, Christopher L; Bauer, Christian; Mendoza Beltran, Angelica; van Vuuren, Detlef P

2018-04-17

The future environmental impacts of battery electric vehicles (EVs) are very important given their expected dominance in future transport systems. Previous studies have shown these impacts to be highly uncertain, though a detailed treatment of this uncertainty is still lacking. We help to fill this gap by using Monte Carlo and global sensitivity analysis to quantify parametric uncertainty and also consider two additional factors that have not yet been addressed in the field. First, we include changes to driving patterns due to the introduction of autonomous and connected vehicles. Second, we deeply integrate scenario results from the IMAGE integrated assessment model into our life cycle database to include the impacts of changes to the electricity sector on the environmental burdens of producing and recharging future EVs. Future EVs are expected to have 45-78% lower climate change impacts than current EVs. Electricity used for charging is the largest source of variability in results, though vehicle size, lifetime, driving patterns, and battery size also strongly contribute to variability. We also show that it is imperative to consider changes to the electricity sector when calculating upstream impacts of EVs, as without this, results could be overestimated by up to 75%.

Use of an integrated biophysical process for the treatment of halo- and nitro- organic wastes

Directory of Open Access Journals (Sweden)

Liron Shoshani

2017-07-01

Full Text Available This study assessed the use of an integrated biophysical process incorporating the addition of powdered activated carbon (PAC to a dual-sludge biological process, in order to improve the removal of problematic contaminants from complex herbicides production wastewater. The main focus was on the removal of nitrogen compounds, total organic carbon (TOC, and halogenated organics (AOX. The dual-sludge pilot setup comprised a conventional activated sludge (CAS system followed by a membrane bioreactor (MBR system. The dilution ratio of raw wastewater was gradually decreased (with groundwater from 0.8 to 0 (no dilution, and PAC was added in the last phase of the study to maintain an equilibrium concentration of 2000 mg/L. PAC addition stimulated a high and steady removal (98% of the ammoniacal nitrogen, conforming to the sea discharge limit of 5 mg/L. However, the effluent concentrations of total nitrogen, TOC, and AOX were still above the stringent discharge limits of 20, 100 and 0.5 mg/L respectively. Furthermore, it was shown that synergistic effect of various toxic organic compounds, rather than mineral salinity, was the major cause for the acute inhibitions of nitrification and AOX removal. The study showed that the proposed process can function as an efficient treatment system for the complex wastewater typically produced in the herbicide industry, however, it is recommended that complementary physico-chemical treatment steps be added to the treatment process.

A Review of Behavioral Conceptualizations and Treatments of Child Noncompliance.

Science.gov (United States)

Houlihan, Daniel; And Others

1992-01-01

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

Renewable Electricity Futures Study. Volume 1. Exploration of High-Penetration Renewable Electricity Futures

Energy Technology Data Exchange (ETDEWEB)

Hand, M. M. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Baldwin, S. [U.S. Dept. of Energy, Washington, DC (United States); DeMeo, E. [Renewable Energy Consulting, Chicago, IL (United States); Reilly, J. M. [Massachusetts Inst. of Technology (MIT), Cambridge, MA (United States); Mai, T. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Arent, D. [Joint Inst. for Strategic Energy Analysis, Boulder, CO (United States); Porro, G. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Meshek, M. [National Renewable Energy Lab. (NREL), Golden, CO (United States); Sandor, D. [National Renewable Energy Lab. (NREL), Golden, CO (United States)

2012-06-15

The Renewable Electricity Futures (RE Futures) Study investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. The analysis focused on the sufficiency of the geographically diverse U.S. renewable resources to meet electricity demand over future decades, the hourly operational characteristics of the U.S. grid with high levels of variable wind and solar generation, and the potential implications of deploying high levels of renewables in the future. RE Futures focused on technical aspects of high penetration of renewable electricity; it did not focus on how to achieve such a future through policy or other measures. Given the inherent uncertainties involved with analyzing alternative long-term energy futures as well as the multiple pathways that might be taken to achieve higher levels of renewable electricity supply, RE Futures explored a range of scenarios to investigate and compare the impacts of renewable electricity penetration levels (30%–90%), future technology performance improvements, potential constraints to renewable electricity development, and future electricity demand growth assumptions. RE Futures was led by the National Renewable Energy Laboratory (NREL) and the Massachusetts Institute of Technology (MIT). Learn more at the RE Futures website. http://www.nrel.gov/analysis/re_futures/

Cognitive impairment in the remitted state of unipolar depressive disorder: A systematic review

DEFF Research Database (Denmark)

Hasselbalch, Bo Jacob; Knorr, Ulla; Kessing, Lars Vedel

2010-01-01

BACKGROUND: It is unclear whether cognitive impairment is prevalent in the remitted state of unipolar disorder. AIM: To evaluate whether cognitive function is impaired in the remitted state in patients with unipolar depression compared with healthy control individuals, and to investigate...... were prevalent including non-stringent definition of remission and non-correction for multiple testing. Only few studies investigated the association between cognition and prior course of illness and the results were divergent. LIMITATIONS: Stringent criteria were used in the assessment of eligibility...... of studies. The studies were first and foremost selected according to the criteria for remission used. CONCLUSION: Cognitive dysfunction seems to be present in individuals suffering from unipolar disorder in the remitted state. We recommend that future studies should focus on disentangling the state...

Alopecia areata: Treatment options

Directory of Open Access Journals (Sweden)

E. Kasumagić-Halilović

2006-02-01

Full Text Available Alopecia areata (AA is a common cause of reversible hair loss afflictingapproximately1-2%ofthegeneralpopulation. It commonly present as round patches of hair loss which can be the firstmanifestationofamoreseverealopecia totalis or universalis. The cause of AA is unknown although most evidence supports the hypothesis that AA is an immunologically mediated disease. Treatment of AA may be divided into four different categories of widely accepted therapeutic modalities: immune inhibitors (steroid or psoralen and UVA light- PUVA, topicalsensitizers (squaric acid dibutylester and diphenylcyclopropenone, non-specificirritants(anthralinandthevasodilatator minoxidil. Improved future treatments may be immunosuppressive or immunomodulatory or they may otherwise protect hair follicles from the injurious effects of inflammation.Theaimofthisarticleistoreviewavailable data on current and potential agents for the treatment of AA.

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...

Optical spectroscopy: current advances and future applications in cancer diagnostics and therapy

NARCIS (Netherlands)

Evers, Daniel; Evers, D.J.; Hendriks, B.; Lucassen, G.W.; Lucassen, Gerald; Ruers, Theo J.M.

2012-01-01

Optical spectroscopy (OS) is a tissue-sensing technique that could enhance cancer diagnosis and treatment in the near future. With OS, tissue is illuminated with a selected light spectrum. Different tissue types can be distinguished from each other based on specific changes in the reflected light

Baltic 2 offshore wind farm. Challenges and solutions during design and erection of a 288 MW offshore wind power plant; Baltic 2 Offshore Windpark. Herausforderungen und Loesungen waehrend der Design- und Errichtungsphase eines 288 MW Offshore-Windkraftwerks

Energy Technology Data Exchange (ETDEWEB)

Stamatelopoulos, Georg-Nikolaus; Kansy, Stefan [EnBW Energie Baden-Wuerttemberg AG, Stuttgart (Germany); Hannibal, John Michael [Siemens AG, Hamburg (Germany). Wind Power and Renewables Div.; Frettloehr, Bjoern [EnBW Energie Baden-Wuerttemberg AG, Hamburg (Germany). Wind und Maritime Technik

2015-05-01

Offshore wind offers a great potential for reliable power supply with markedly less future costs. However, offshore also means special requirements related to transport and installation at sea. Even if these requirements alone are very stringent, they are not the only ones that apply. Meeting these challenges requires project organisation comparable to other major projects.

The MELOX MOX fabrication facility: history of an industrial success and future prospects

International Nuclear Information System (INIS)

Arslan, M.; Jacquet, R.; Krellmann, J.

2005-01-01

Along with the La Hague reprocessing plant, MELOX is part of the two industrial facilities that ensure the closure of the nuclear fuel cycle in France. Since started up in 1995, MELOX has specialized into recycling separated plutonium recovered from reprocessing operations performed at La Hague on spent UO 2 fuel. Capitalizing on the unique know-how acquired through thirty years of plutonium-based fuel fabrication at the Cadarache plant, this subsidiary of AREVA group has quickly become a worldwide expert in the industrial process of fabricating MOX: a fuel blend comprised of both uranium and plutonium oxides that allows at safely exploiting the energetic potential of plutonium. In order to address the various factors responsible for this industrial breakthrough, we will first present an overview of MELOX's history in regards of the emergence of a global MOX market. The added-value provided through treatment and recycling operations on spent fuel will be further described in terms of waste volume and radiotoxicity reduction. The emphasis will then be put on the total quality management policy that is at the core of MELOX's corporate strategy. Because MELOX has succeeded in meeting both productivity requirements and stringent quality constraints, it has won confidence from its European and Japanese clients. With increased production capacity of diversified MOX designs, MELOX is demonstrating the industrial efficiency of a new concept of MOX plants that is inspiring large construction projects in Japan, the US, and Russia. (authors)

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)

[TMJ and orthodontics, "past, present and future"].

Science.gov (United States)

Manière-Ezvan, A; Oueiss, A; Busson, F

2016-12-01

In the past, the ATM was mainly associated with the growth of the mandibular condyle. Many studies (on rats) showed the role of condylar cartilage in the growth response following stimulation by orthopedic appliances. From where, Class II dysmorphosis "orthopedic" treatments to grow the mandible; but this concept is discussed in the literature in the absence of fully conclusive results and especially since the contribution of orthognathic surgery. Currently, the operating concept is the mechanical stimulation and therefore the function will shape the ATM during growth and that, from an early age. Prevention of dysmorphoses must go through behavioral counseling to be adopted by parents from the birth of their child: to stimulate mandibular propulsion breastfeeding, then by a hard diet inducing an alternating unilateral chewing. Ignorance of the specificity of temporomandibular dysfunction (TMD) notably among teenagers has, in the past, left a doubt about the positive or negative role that could have orthodontic treatment on the TMJ. Currently, the best knowledge of TMJ and TMD provides a better therapeutic conduct: behavioral counseling especially for the girl hyperdivergente with small condyles, control of the condylar position, occlusal adjustments at the end of orthodontic treatment. The future of TMJ in relation with orthodontics is based on prevention, screening and deepening of our knowledge. The orthodontist will thus not make a treatment in patients at risk or will identify it and finish the treatment perfectly. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

The Use of Treatment Manuals in Cognitive Therapy: Experience and Issues.

Science.gov (United States)

Dobson, Keith S.; Shaw, Brian F.

1988-01-01

Traces historical developments in use of treatment manuals in psychotherapy research and reviews characteristics that have facilitated development of cognitive therapy manuals. Reviews arguments in favor of and opposed to further development of treatment manuals. Discusses relevant research and suggests three areas for future treatment manual…

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.

Meningiomas in 2009: controversies and future challenges.

Science.gov (United States)

Campbell, Belinda A; Jhamb, Ashu; Maguire, John A; Toyota, Brian; Ma, Roy

2009-02-01

Meningiomas are the most common intracranial primary neoplasm in adults. Over recent years, interest in this clinically diverse group of tumors has intensified, bringing new questions and challenges to the fore, particularly in the fields of epidemiology, radiology, pathology, genetics, and treatment. Interest in modern meningioma research has been stimulated by the high tumor prevalence and the advances in technology. The incidence of meningiomas is climbing, and may indicate increased exposure to environmental risk factors or more sensitive diagnostic modalities. Technological advances have dramatically improved radiologic imaging and radiotherapy treatments, and further refinements are under investigation. Furthermore, the current era of tumor genetics and molecular biology is challenging translational researchers to discover new, targeted, therapeutic agents. This review is an update on the recent advances in the understanding of meningiomas and their management, and highlights pertinent research questions to be addressed in the future.

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)

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)

HYDROGEN USE IN INTERNAL COMBUSTION ENGINE:

OpenAIRE

Ciniviz, Murat

2012-01-01

Fast depletion of fossil fuels is urgently demanding a carry out work for research to find out the viable alternative fuels for meeting sustainable energy demand with minimum environmental impact. In the future, our energy systems will need to be renewable and sustainable, efficient and cost-effective, convenient and safe. Hydrogen is expected to be one of the most important fuels in the near future to meet the stringent emission norms. The use of the hydrogen as fuel in the internal combusti...

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)

Melodic Intonation Therapy: Back to Basics for Future Research

Directory of Open Access Journals (Sweden)

Anna eZumbansen

2014-01-01

Full Text Available We present a critical review of the literature on Melodic intonation therapy (MIT, one of the most formalized treatments used by speech-language therapist in Broca’s aphasia. We suggest basic clarifications to enhance the scientific support of this promising treatment. First, MIT is a program, not a single speech facilitation technique. The goal of MIT is to restore propositional speech. The rational is that patients can learn a new way to speak through singing by using language-capable regions of the right cerebral hemisphere. We argue that many treatment programs covered in systematic reviews on MIT’s efficacy do not match MIT’s therapeutic goal and rationale. Second, we distinguish between the immediate effect of MIT’s main speech facilitation technique (i.e., intoned-speech and the effect of the entire program on language recovery. Many results in the MIT literature can be explained by this duration factor. Finally, we propose that MIT can be viewed as a treatment of apraxia of speech more than aphasia. This issue should be explored in future experimental studies.

Outcome of E1224-Benznidazole Combination Treatment for Infection with a Multidrug-Resistant Trypanosoma cruzi Strain in Mice.

Science.gov (United States)

Diniz, Lívia de Figueiredo; Mazzeti, Ana Lia; Caldas, Ivo Santana; Ribeiro, Isabela; Bahia, Maria Terezinha

2018-06-01

Combination therapy has been proposed as an alternative therapeutic approach for the treatment of Chagas disease. In this study, we evaluated the effect of treatment with benznidazole combined with E1224 (ravuconazole prodrug) in an experimental murine model of acute infection. The first set of experiments assessed the range of E1224 doses required to induce parasitological cure using Trypanosoma cruzi strains with different susceptibilities to benznidazole (Y and Colombian). All E1224 doses were effective in suppressing the parasitemia and preventing death; however, parasitological cure was observed only in mice infected with Y strain. Considering these results, we evaluated the effect of combined treatment against Colombian, a multidrug-resistant T. cruzi strain. After exclusion of antagonistic effects using in vitro assays, infected mice were treated with E1224 and benznidazole in monotherapy or in combination at day 4 or 10 postinoculation. All treatments were well tolerated and effective in suppressing parasitemia; however, parasitological and PCR assays indicated no cure among mice treated with monotherapies. Intriguingly, the outcome of combination therapy was dependent on treatment onset. Early treatment using optimal doses of E1224-benznidazole induced a 100% cure rate, but this association could not eliminate a well-established infection. The beneficial effect of combination therapy was evidenced by further reductions of the patent parasitemia period in the group receiving combined therapy compared with monotherapies. Our results demonstrated a positive interaction between E1224 and benznidazole against murine T. cruzi infection using a multidrug-resistant strain and highlighted the importance of a stringent experimental model in the evaluation of new therapies. Copyright © 2018 Diniz et al.

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

Factors affecting future specialty choice among medical students in Kuwait.

Science.gov (United States)

Al-Fouzan, Rawan; Al-Ajlan, Sarah; Marwan, Yousef; Al-Saleh, Mervat

2012-01-01

Choosing a medical specialty can be either a daunting and confusing experience for some medical students and junior doctors or a foregone conclusion to others. The aim of this study is to evaluate factors affecting future specialty choice among medical students in Kuwait University. A self-administered questionnaire was used to collect data from medical students registered in Kuwait University during the academic year 2011/2012. Chi-square test and logistic regression were used to test the association between deciding a future specialty and students' sociodemographic and academic factors. Of the 422 students approached, 387 (91.7%) decided to participate. A total of 144 (37.2%) students made a decision regarding their choice of future medical specialty. Pediatrics, general surgery, and cardiology were the most desired specialties - 18 (12.5%), 17 (11.8%), and 16 (11.1%) students requested these specialties, respectively. Only 61 (42.4%) of those who selected a future specialty received advice regarding their choice. Looking for a good treatment outcome for patients (66; 45.8%) and a challenging specialty (58; 40.3%) were the most influencing incentives when selecting a future specialty. Students in the clinical phase of their study were 3.014 (95% CI: 1.498-6.065) more likely to report on their decision regarding a future specialty compared to students in the basic medical sciences phase (p=0.002). A variety of factors appeared to inspire medical students in Kuwait to choose a future medical specialty. When identified, these factors can be used by mentors of medical students and directors of residency training programs to motivate students to choose specialties that are limited in Kuwait.

Constraining dark matter annihilation with the isotropic γ-ray background: Updated limits and future potential

Science.gov (United States)

Bringmann, Torsten; Calore, Francesca; Di Mauro, Mattia; Donato, Fiorenza

2014-01-01

The nature of the isotropic γ-ray background (IGRB) measured by the Large Area Telescope (LAT) on the Fermi γ-ray space telescope (Fermi) remains partially unexplained. Non-negligible contributions may originate from extragalactic populations of unresolved sources such as blazars, star-forming galaxies or galactic millisecond pulsars. A recent prediction of the diffuse γ-ray emission from active galactic nuclei (AGN) with a large viewing angle with respect to the line of sight has demonstrated that this faint but numerous population is also expected to contribute significantly to the total IGRB intensity. A more exotic contribution to the IGRB invokes the pair annihilation of dark matter (DM) weakly interacting massive particles (WIMPs) into γ rays. In this work, we evaluate the room left for galactic DM at high latitudes (>10∘) by including photons from both prompt emission and inverse Compton scattering, emphasizing the impact of the newly discovered contribution from misaligned AGN (MAGN) for such an analysis. Summing up all significant galactic and extragalactic components of the IGRB, we find that an improved understanding of the associated astrophysical uncertainties is still mandatory to put stringent bounds on thermally produced DM. On the other hand, we also demonstrate that the IGRB has the potential to be one of the most competitive future ways to test the DM WIMP hypothesis, once the present uncertainties are even slightly reduced. In fact, if MAGN contribute even at 90% of the maximal level consistent with our current understanding, thermally produced WIMPs would be severely constrained as DM candidates for masses up to several TeV.

Renewable Electricity Futures Study. Volume 1: Exploration of High-Penetration Renewable Electricity Futures

Energy Technology Data Exchange (ETDEWEB)

Mai, T.; Wiser, R.; Sandor, D.; Brinkman, G.; Heath, G.; Denholm, P.; Hostick, D.J.; Darghouth, N.; Schlosser, A.; Strzepek, K.

2012-06-01

The Renewable Electricity Futures (RE Futures) Study investigated the challenges and impacts of achieving very high renewable electricity generation levels in the contiguous United States by 2050. The analysis focused on the sufficiency of the geographically diverse U.S. renewable resources to meet electricity demand over future decades, the hourly operational characteristics of the U.S. grid with high levels of variable wind and solar generation, and the potential implications of deploying high levels of renewables in the future. RE Futures focused on technical aspects of high penetration of renewable electricity; it did not focus on how to achieve such a future through policy or other measures. Given the inherent uncertainties involved with analyzing alternative long-term energy futures as well as the multiple pathways that might be taken to achieve higher levels of renewable electricity supply, RE Futures explored a range of scenarios to investigate and compare the impacts of renewable electricity penetration levels (30%-90%), future technology performance improvements, potential constraints to renewable electricity development, and future electricity demand growth assumptions. RE Futures was led by the National Renewable Energy Laboratory (NREL) and the Massachusetts Institute of Technology (MIT).

Billing and coding for osteopathic manipulative treatment.

Science.gov (United States)

Snider, Karen T; Jorgensen, Douglas J

2009-08-01

Some osteopathic physicians are not properly reimbursed by insurance companies after providing osteopathic manipulative treatment (OMT) to their patients. Common problems associated with lack of reimbursements include insurers bundling OMT with the standard evaluation and management service and confusing OMT with chiropractic manipulative treatment or physical therapy services. The authors suggest methods of appeal for denied reimbursement claims that will also prevent future payment denials.

Intrapersonal positive future thinking predicts repeat suicide attempts in hospital-treated suicide attempters.

Science.gov (United States)

O'Connor, Rory C; Smyth, Roger; Williams, J Mark G

2015-02-01

Although there is clear evidence that low levels of positive future thinking (anticipation of positive experiences in the future) and hopelessness are associated with suicide risk, the relationship between the content of positive future thinking and suicidal behavior has yet to be investigated. This is the first study to determine whether the positive future thinking-suicide attempt relationship varies as a function of the content of the thoughts and whether positive future thinking predicts suicide attempts over time. A total of 388 patients hospitalized following a suicide attempt completed a range of clinical and psychological measures (depression, hopelessness, suicidal ideation, suicidal intent and positive future thinking). Fifteen months later, a nationally linked database was used to determine who had been hospitalized again after a suicide attempt. During follow-up, 25.6% of linked participants were readmitted to hospital following a suicide attempt. In univariate logistic regression analyses, previous suicide attempts, suicidal ideation, hopelessness, and depression-as well as low levels of achievement, low levels of financial positive future thoughts, and high levels of intrapersonal (thoughts about the individual and no one else) positive future thoughts predicted repeat suicide attempts. However, only previous suicide attempts, suicidal ideation, and high levels of intrapersonal positive future thinking were significant predictors in multivariate analyses. Positive future thinking has predictive utility over time; however, the content of the thinking affects the direction and strength of the positive future thinking-suicidal behavior relationship. Future research is required to understand the mechanisms that link high levels of intrapersonal positive future thinking to suicide risk and how intrapersonal thinking should be targeted in treatment interventions. (PsycINFO Database Record (c) 2015 APA, all rights reserved).

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

Hazardous fuel treatments, suppression cost impacts, and risk mitigation

Science.gov (United States)

Matthew P. Thompson; Michael S. Hand; Julie W. Gilbertson-Day; Nicole M. Vaillant; Darek J. Nalle

2013-01-01

Land management agencies face uncertain tradeoffs regarding investments in preparedness and fuels management versus future suppression costs and impacts to valued resources and assets. Prospective evaluation of fuel treatments allows for comparison of alternative treatment strategies in terms of socioeconomic and ecological impacts, and can facilitate tradeoff analysis...

Rape: psychopathology, theory and treatment.

Science.gov (United States)

Gannon, Theresa A; Collie, Rachael M; Ward, Tony; Thakker, Jo

2008-07-01

Whether treatment programs are effective at rehabilitating rapists is yet to be determined empirically. From a scientist-practitioner perspective, treatment should be based on an empirical understanding of rape and rapists, and evidence-based knowledge of treatment outcome with rapists. In this paper we comprehensively review the characteristics of rapists, etiological features implicated in the commission of rape, and relevant treatment outcome research. We pay particular attention to contemporary knowledge about the core vulnerabilities and features required to understand and treat rapists effectively, and, where possible, highlight similarities and differences between rapists, child molesters and non-sexual violent offenders. We use an epistemological framework to (a) critique the various etiological accounts of rape available and (b) help guide professionals' use of such knowledge in both treatment design and evaluation. Gaps in the understanding of rapists' characteristics and etiological features are highlighted, as are discrepancies between current knowledge and treatment approaches. We conclude by highlighting areas for future research and practice innovation.

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.)

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.)

Towards Narrative Futuring in Psychology: Becoming Resilient by Imagining the Future

NARCIS (Netherlands)

Sools, Anna Maria; Mooren, J.H.M.

2012-01-01

In this article we develop a narrative psychological approach to futuring (imagining the future). We explore how this approach addresses the question of how people can become resilient in order to anticipate (social) crisis and change. Firstly, we bring to the fore how futuring takes shape in

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...

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.

A survey on staging and treatment in uterine cervical carcinoma in the Radiotherapy Cooperative Group of the European Organization for Research and Treatment of Cancer

International Nuclear Information System (INIS)

Coucke, P.A.; Ciernik, I.F.; Maingon, P.; Do, H.P.

2000-01-01

The treatment outcome of advanced stage uterine cervical carcinoma remains unsatisfactory. In order to elaborate a novel trial within The Radiotherapy Cooperative Group (RCG) of the European Organization for Research and Treatment of Cancer (EORTC), we conducted a survey in 1997-1998 to determine the variability of pre-treatment assessment and treatment options. The variability of choosing surgery, defined radiation therapy techniques and chemotherapy are investigated, as well as the center's choices of future treatment strategies. Fifty two of 81 RCG centers from the RCG have participated in the survey. As one would expect, there is a large variation in the techniques used for pretreatment evaluation and treatment options. There is no 'standard' for reporting acute and late side effects. Chemotherapy is used neither systematically nor uniformly, and some centers continue to use neadjuvant chemotherapy modalities. Furthermore, the survey reveals that there is a strong demand for the reduction of overall treatment-time, for clinical investigation of novel combined modality treatment strategies, especially chemo-radiation therapy, and also for the use of new radiation sensitizers. We conclude that a more homogeneous approach to the pretreatment evaluation as well as treatment techniques is required in order to allow adequate quality control in any future trial of the RCG in the EORTC. (author)

Adolescent Substance Abuse Treatment: Organizational Change and Quality of Care

Science.gov (United States)

Rieckmann, Traci; Fussell, Holly; Doyle, Kevin; Ford, Jay; Riley, Katherine J.; Henderson, Stuart

2011-01-01

Substance abuse treatment agencies serving youth face unique barriers to providing quality care. Interviews with 17 adolescent programs found that family engagement, community involvement, and gender and diversity issues affected treatment delivery. Programs report organizational change efforts with implications for future process improvement…

Future prospects of therapeutic clinical trials in acute myeloid leukemia

Science.gov (United States)

Khan, Maliha; Mansoor, Armaghan-e-Rehman; Kadia, Tapan M

2017-01-01

Acute myeloid leukemia (AML) is a markedly heterogeneous hematological malignancy that is most commonly seen in elderly adults. The response to current therapies to AML is quite variable, and very few new drugs have been recently approved for use in AML. This review aims to discuss the issues with current trial design for AML therapies, including trial end points, patient enrollment, cost of drug discovery and patient heterogeneity. We also discuss the future directions in AML therapeutics, including intensification of conventional therapy and new drug delivery mechanisms; targeted agents, including epigenetic therapies, cell cycle regulators, hypomethylating agents and chimeric antigen receptor T-cell therapy; and detail of the possible agents that may be incorporated into the treatment of AML in the future. PMID:27771959

Anticipating Their Future: Adolescent Values for the Future Predict Adult Behaviors

Science.gov (United States)

Finlay, Andrea K.; Wray-Lake, Laura; Warren, Michael; Maggs, Jennifer

2015-01-01

Adolescent future values--beliefs about what will matter to them in the future--may shape their adult behavior. Utilizing a national longitudinal British sample, this study examined whether adolescent future values in six domains (i.e., family responsibility, full-time job, personal responsibility, autonomy, civic responsibility, and hedonistic…

Performance and future development of the ASDBLR ASIC for the ATLAS TRT

CERN Document Server

Bevensee, B E; Newcomer, F M; Tyrrell, B; Van Berg, R; Williams, H H; Romaniouk, A

1998-01-01

The ATLAS TRT straw tracker will consist of more than 420 K straw tubes filled with a Xenon-based fast gas located in a magnetic field of 2 T. Some tubes will operate at rates in excess of 20 MHz. Stringent signal processing goals $9 have been determined using both simulation tools and measurement standards set by hand tuned discrete component prototypes. These include the ability to detect the earliest clusters from ionizing tracks as well as energetic $9 transition radiation photons without baseline shifts in a low noise and low power design. We report on measurements of two ASIC's fabricated in different processes that appear to be capable of achieving these goals. (2 refs).

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…

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 ...

Albedo feedbacks to future climate via climate change impacts on dryland biocrusts

Science.gov (United States)

Rutherford, William A.; Painter, Thomas H.; Ferrenberg, Scott; Belnap, Jayne; Okin, Gregory S.; Flagg, Cody B.; Reed, Sasha C.

2017-01-01

Drylands represent the planet’s largest terrestrial biome and evidence suggests these landscapes have large potential for creating feedbacks to future climate. Recent studies also indicate that dryland ecosystems are responding markedly to climate change. Biological soil crusts (biocrusts) ‒ soil surface communities of lichens, mosses, and/or cyanobacteria ‒ comprise up to 70% of dryland cover and help govern fundamental ecosystem functions, including soil stabilization and carbon uptake. Drylands are expected to experience significant changes in temperature and precipitation regimes, and such alterations may impact biocrust communities by promoting rapid mortality of foundational species. In turn, biocrust community shifts affect land surface cover and roughness—changes that can dramatically alter albedo. We tested this hypothesis in a full-factorial warming (+4 °C above ambient) and altered precipitation (increased frequency of 1.2 mm monsoon-type watering events) experiment on the Colorado Plateau, USA. We quantified changes in shortwave albedo via multi-angle, solar-reflectance measurements. Warming and watering treatments each led to large increases in albedo (>30%). This increase was driven by biophysical factors related to treatment effects on cyanobacteria cover and soil surface roughness following treatment-induced moss and lichen mortality. A rise in dryland surface albedo may represent a previously unidentified feedback to future climate.

Albedo feedbacks to future climate via climate change impacts on dryland biocrusts

Science.gov (United States)

Rutherford, William A.; Painter, Thomas H.; Ferrenberg, Scott; Belnap, Jayne; Okin, Gregory S.; Flagg, Cody; Reed, Sasha C.

2017-03-01

Drylands represent the planet’s largest terrestrial biome and evidence suggests these landscapes have large potential for creating feedbacks to future climate. Recent studies also indicate that dryland ecosystems are responding markedly to climate change. Biological soil crusts (biocrusts) ‒ soil surface communities of lichens, mosses, and/or cyanobacteria ‒ comprise up to 70% of dryland cover and help govern fundamental ecosystem functions, including soil stabilization and carbon uptake. Drylands are expected to experience significant changes in temperature and precipitation regimes, and such alterations may impact biocrust communities by promoting rapid mortality of foundational species. In turn, biocrust community shifts affect land surface cover and roughness—changes that can dramatically alter albedo. We tested this hypothesis in a full-factorial warming (+4 °C above ambient) and altered precipitation (increased frequency of 1.2 mm monsoon-type watering events) experiment on the Colorado Plateau, USA. We quantified changes in shortwave albedo via multi-angle, solar-reflectance measurements. Warming and watering treatments each led to large increases in albedo (>30%). This increase was driven by biophysical factors related to treatment effects on cyanobacteria cover and soil surface roughness following treatment-induced moss and lichen mortality. A rise in dryland surface albedo may represent a previously unidentified feedback to future climate.

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.

Recent advances in treatment for Benign Prostatic Hyperplasia

OpenAIRE

van Rij, Simon; Gilling, Peter

2015-01-01

Clinical benign prostatic hyperplasia (BPH), often identified as a worsening ability of a male to pass urine, is a significant problem for men in our society. In 2015, the use of personalised medicine is tailoring treatment to individual patient needs and to genetic characteristics. Technological advances in surgical treatment are changing the way BPH is treated and are resulting in less morbidity. The future of BPH treatments is exciting, and a number of novel techniques are currently under ...

The Treatment of Neuromyelitis Optica

Science.gov (United States)

Kowarik, Markus C.; Soltys, John; Bennett, Jeffrey L.

2014-01-01

Neuromyelitis optica (NMO) is an autoimmune disorder of the central nervous system directed against astrocytes. Initially diagnosed in individuals with monophasic or relapsing optic neuritis and transverse myelitis, NMO is now recognized as a demyelinating disorder with pleiotropic presentations due to the identification of a specific autoantibody response against the astrocyte water channel aquaporin-4 in the majority of individuals. As visual impairment and neurologic dysfunction in NMO are commonly severe, aggressive treatment of relapses and prophylactic immunomodulatory therapy are the focus of treatment. Although there are no approved treatments for NMO, medications and therapeutic interventions for acute and chronic treatment have been the subject of retrospective study and case reports. The goal of this review is to familiarize the reader with biologic and clinical data supporting current treatments in NMO and highlight future strategies based on advancements in our understanding of NMO pathogenesis. PMID:24531318

Cancer prehabilitation: an opportunity to decrease treatment-related morbidity, increase cancer treatment options, and improve physical and psychological health outcomes.

Science.gov (United States)

Silver, Julie K; Baima, Jennifer

2013-08-01

Cancer prehabilitation, a process on the continuum of care that occurs between the time of cancer diagnosis and the beginning of acute treatment, includes physical and psychological assessments that establish a baseline functional level, identifies impairments, and provides targeted interventions that improve a patient's health to reduce the incidence and the severity of current and future impairments. There is a growing body of scientific evidence that supports preparing newly diagnosed cancer patients for and optimizing their health before starting acute treatments. This is the first review of cancer prehabilitation, and the purpose was to describe early studies in the noncancer population and then the historical focus in cancer patients on aerobic conditioning and building strength and stamina through an appropriate exercise regimen. More recent research shows that opportunities exist to use other unimodal or multimodal prehabilitation interventions to decrease morbidity, improve physical and psychological health outcomes, increase the number of potential treatment options, decrease hospital readmissions, and reduce both direct and indirect healthcare costs attributed to cancer. Future research may demonstrate increased compliance with acute cancer treatment protocols and, therefore, improved survival outcomes. New studies suggest that a multimodal approach that incorporates both physical and psychological prehabilitation interventions may be more effective than a unimodal approach that addresses just one or the other. In an impairment-driven cancer rehabilitation model, identifying current and anticipating future impairments are the critical first steps in improving healthcare outcomes and decreasing costs. More research is urgently needed to evaluate the most effective prehabilitation interventions, and combinations thereof, for survivors of all types of cancer.

Small Vessel Cerebrovascular Disease: The Past, Present, and Future

Directory of Open Access Journals (Sweden)

Réza Behrouz

2012-01-01

Full Text Available Brain infarction due to small vessel cerebrovascular disease (SVCD—also known as small vessel infarct (SVI or “lacunar” stroke—accounts for 20% to 25% of all ischemic strokes. Historically, SVIs have been associated with a favorable short-term prognosis. However, studies over the years have demonstrated that SVCD/SVI is perhaps a more complex and less benign phenomenon than generally presumed. The currently employed diagnostic and therapeutic strategies are based upon historical and contemporary perceptions of SVCD/SVI. What is discovered in the future will unmask the true countenance of SVCD/SVI and help furnish more accurate prognostication schemes and effective treatments for this condition. This paper is an overview of SVCD/SVI with respect to the discoveries of the past, what is known now, and what will the ongoing investigations evince in the future.

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

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.

Stories of change in drug treatment

DEFF Research Database (Denmark)

Andersen, Ditte

2015-01-01

’ (story content) and ‘the hows’ (storying process) the article presents four findings: (1) stories of change function locally as an institutional requirement; (2) professional drug treatment providers edit young people's storytelling through different techniques; (3) the narrative environment of the drug...... treatment. Building on the sociology of storytelling and ethnographic fieldwork conducted at two drug treatment institutions for young people in Denmark, this article argues that studying stories in the context of their telling brings forth novel insights. Through a narrative analysis of both ‘the whats...... treatment institution shapes how particular stories make sense of the past, present and future; and (4) storytelling in drug treatment is an interactive achievement. A fine-grained analysis illuminates in particular how some stories on gender and drug use are silenced, while others are encouraged...

Not my future? Core values and the neural representation of future events.

Science.gov (United States)

Brosch, Tobias; Stussi, Yoann; Desrichard, Olivier; Sander, David

2018-06-01

Individuals with pronounced self-transcendence values have been shown to put greater weight on the long-term consequences of their actions when making decisions. Using functional magnetic resonance imaging, we investigated the neural mechanisms underlying the evaluation of events occurring several decades in the future as well as the role of core values in these processes. Thirty-six participants viewed a series of events, consisting of potential consequences of climate change, which could occur in the near future (around 2030), and thus would be experienced by the participants themselves, or in the far future (around 2080). We observed increased activation in anterior VMPFC (BA11), a region involved in encoding the personal significance of future events, when participants were envisioning far future events, demonstrating for the first time that the role of the VMPFC in future projection extends to the time scale of decades. Importantly, this activation increase was observed only in participants with pronounced self-transcendence values measured by self-report questionnaire, as shown by a statistically significant interaction of temporal distance and value structure. These findings suggest that future projection mechanisms are modulated by self-transcendence values to allow for a more extensive simulation of far future events. Consistent with this, these participants reported similar concern ratings for near and far future events, whereas participants with pronounced self-enhancement values were more concerned about near future events. Our findings provide a neural substrate for the tendency of individuals with pronounced self-transcendence values to consider the long-term consequences of their actions.

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...

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.

Gambling Disorder in Veterans: A Review of the Literature and Implications for Future Research.

Science.gov (United States)

Levy, Lauren; Tracy, J Kathleen

2018-02-09

To review the scientific literature examining gambling behavior in military veterans in order to summarize factors associated with gambling behavior in this population. Database searches were employed to identify articles specifically examining gambling behavior in military veterans. Cumulative search results identified 52 articles (1983-2017) examining gambling behavior in veteran populations. Articles generally fell into one or more of the following categories: prevalence, psychological profiles and psychiatric comorbidities, treatment evaluations, measurement, and genetic contributions to gambling disorder. Results from reviewed articles are presented and implications for future research discussed. Research to date has provided an excellent foundation to inform potential screening, intervention and research activities going forward. The authors suggest that a public health approach to future research endeavors would strengthen the evidence base regarding gambling in veteran populations and better inform strategies for screening, prevention and treatment.

Regenerative medicine blueprint.

Science.gov (United States)

Terzic, Andre; Harper, C Michel; Gores, Gregory J; Pfenning, Michael A

2013-12-01

Regenerative medicine, a paragon of future healthcare, holds unprecedented potential in extending the reach of treatment modalities for individuals across diseases and lifespan. Emerging regenerative technologies, focused on structural repair and functional restoration, signal a radical transformation in medical and surgical practice. Regenerative medicine is poised to provide innovative solutions in addressing major unmet needs for patients, ranging from congenital disease and trauma to degenerative conditions. Realization of the regenerative model of care predicates a stringent interdisciplinary paradigm that will drive validated science into standardized clinical options. Designed as a catalyst in advancing rigorous new knowledge on disease causes and cures into informed delivery of quality care, the Mayo Clinic regenerative medicine blueprint offers a patient-centered, team-based strategy that optimizes the discovery-translation-application roadmap for the express purpose of science-supported practice advancement.

Supercomputing - Use Cases, Advances, The Future (2/2)

CERN Multimedia

CERN. Geneva

2017-01-01

Supercomputing has become a staple of science and the poster child for aggressive developments in silicon technology, energy efficiency and programming. In this series we examine the key components of supercomputing setups and the various advances – recent and past – that made headlines and delivered bigger and bigger machines. We also take a closer look at the future prospects of supercomputing, and the extent of its overlap with high throughput computing, in the context of main use cases ranging from oil exploration to market simulation. On the second day, we will focus on software and software paradigms driving supercomputers, workloads that need supercomputing treatment, advances in technology and possible future developments. Lecturer's short bio: Andrzej Nowak has 10 years of experience in computing technologies, primarily from CERN openlab and Intel. At CERN, he managed a research lab collaborating with Intel and was part of the openlab Chief Technology Office. Andrzej also worked closely and i...

Neurodevelopmental Sequelae of Pediatric Acute Lymphoblastic Leukemia and Its Treatment

Science.gov (United States)

Janzen, Laura A.; Spiegler, Brenda J.

2008-01-01

This review will describe the neurocognitive outcomes associated with pediatric acute lymphoblastic leukemia (ALL) and its treatment. The literature is reviewed with the aim of addressing methodological issues, treatment factors, risks and moderators, special populations, relationship to neuroimaging findings, and directions for future research.…

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

Pharmacogenetic considerations in the treatment of HIV.

Science.gov (United States)

Mattevi, Vanessa S; Tagliari, Carmela Fs

2017-01-01

After the introduction of highly active antiretroviral therapy in the 1990s, the perception of the diagnosis of HIV infection gradually shifted from a 'death sentence' to a chronic disease requiring long-term treatment. The host genetic variability has been shown to play a relevant role in both antiretroviral drugs bioavailability and adverse effects susceptibility. Knowledge about pharmacogenetics role in HIV infection treatment has largely increased over the last years, and is reviewed in the present report, as well as future perspectives for the inclusion of pharmacogenetics information in the directing of HIV infection treatment.

Environmental Scanning, Futures Research, Strategic Foresight and Organizational Future Orientation

DEFF Research Database (Denmark)

Rohrbeck, René; Bade, Manuel

to adjacent research disciplines. Through such integration and linkage research should produce better recommendations for managers on how to build an organizational future orientation, drive organizational adaptation, and make their firms robust towards external discontinuous change.......In this paper we explore the current understanding on how firms explore future changes and trends as well as plan their managerial responses. We review literature in four research streams: (1) environmental scanning, (2) futures research, (3) peripheral vision, and (4) corporate/strategic foresight....... Through the analysis of more than 250 articles we (a) trace the evolution over time, (b) highlight the linkages between the different research streams, and (c) give recommendations for future research. Overall we call for more cross-fertilization of the different research streams and a stronger linkage...