Garland Eric L
Full Text Available Abstract Background Irritable bowel syndrome (IBS, a functional bowel disorder with symptoms of abdominal pain and disturbed defecation experienced by 10% of U.S. adults, results in significant disability, impaired quality of life, and health-care burden. Conventional medical care focusing on pharmacological approaches, diet, and lifestyle management has been partially effective in controlling symptoms. Behavioral treatments, such as cognitive-behavioral therapy and hypnosis, are promising. This paper describes an on-going feasibility study to assess the efficacy of mindfulness training, a behavioral treatment involving directing and sustaining attention to present-moment experience, for the treatment of IBS. Methods/Design The study design involves randomization of adult women with IBS according to Rome II criteria, to either an eight-week mindfulness training group (based on a Mindfulness-based Stress Reduction [MBSR] format or a previously validated IBS social-support group as an attention-control condition. The primary hypothesis is that, compared to Support Group participants, those in the Mindfulness Program will demonstrate significant improvement in IBS symptoms as measured by the IBS Symptom Severity Scale 1. Discussion 214 individuals have been screened for eligibility, of whom 148 were eligible for the study. Of those, 87 were enrolled, with 21 withdrawing after having given consent. 66 have completed or are in the process of completing the interventions. It is feasible to undertake a rigorous randomized clinical trial of mindfulness training for people with IBS, using a standardized MBSR protocol adapted for those experiencing IBS, compared to a control social-support group previously utilized in IBS studies. Trial Registration Clinical Trials.gov Identifier: NCT00680693
Khalil, Asma; Perry, Helen; Duffy, James; Reed, Keith; Baschat, Ahmet; Deprest, Jan; Hecher, Kurt; Lewi, Liesbeth; Lopriore, Enrico; Oepkes, Dick
Twin-Twin Transfusion Syndrome (TTTS) is associated with an increased risk of perinatal mortality and morbidity. Several treatment interventions have been described for TTTS, including fetoscopic laser surgery, amnioreduction, septostomy, expectant management, and pregnancy termination. Over the last decade, fetoscopic laser surgery has become the primary treatment. The literature to date reports on many different outcomes, making it difficult to compare results or combine data from individual studies, limiting the value of research to guide clinical practice. With the advent and ongoing development of new therapeutic techniques, this is more important than ever. The development and use of a core outcome set has been proposed to address these issues, prioritising outcomes important to the key stakeholders, including patients. We aim to produce, disseminate, and implement a core outcome set for TTTS. An international steering group has been established to oversee the development of this core outcome set. This group includes healthcare professionals, researchers and patients. A systematic review is planned to identify previously reported outcomes following treatment for TTTS. Following completion, the identified outcomes will be evaluated by stakeholders using an international, multi-perspective online modified Delphi method to build consensus on core outcomes. This method encourages the participants towards consensus 'core' outcomes. All key stakeholders will be invited to participate. The steering group will then hold a consensus meeting to discuss results and form a core outcome set to be introduced and measured. Once core outcomes have been agreed, the next step will be to determine how they should be measured, disseminated, and implemented within an international context. The development, dissemination, and implementation of a core outcome set in TTTS will enable its use in future clinical trials, systematic reviews and clinical practice guidelines. This is
Wall, Peter Dh; Dickenson, Edward J; Robinson, David; Hughes, Ivor; Realpe, Alba; Hobson, Rachel; Griffin, Damian R; Foster, Nadine E
Femoroacetabular impingement (FAI) syndrome is increasingly recognised as a cause of hip pain. As part of the design of a randomised controlled trial (RCT) of arthroscopic surgery for FAI syndrome, we developed a protocol for non-operative care and evaluated its feasibility. In phase one, we developed a protocol for non-operative care for FAI in the UK National Health Service (NHS), through a process of systematic review and consensus gathering. In phase two, the protocol was tested in an internal pilot RCT for protocol adherence and adverse events. The final protocol, called Personalised Hip Therapy (PHT), consists of four core components led by physiotherapists: detailed patient assessment, education and advice, help with pain relief and an exercise-based programme that is individualised, supervised and progressed over time. PHT is delivered over 12-26 weeks in 6-10 physiotherapist-patient contacts, supplemented by a home exercise programme. In the pilot RCT, 42 patients were recruited and 21 randomised to PHT. Review of treatment case report forms, completed by physiotherapists, showed that 13 patients (62%) received treatment that had closely followed the PHT protocol. 13 patients reported some muscle soreness at 6 weeks, but there were no serious adverse events. PHT provides a structure for the non-operative care of FAI and offers guidance to clinicians and researchers in an evolving area with limited evidence. PHT was deliverable within the National Health Service, is safe, and now forms the comparator to arthroscopic surgery in the UK FASHIoN trial (ISRCTN64081839). ISRCTN 09754699. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
de Barros Barbosa, C.; de barros Barbosa, C.; Ferreira Pires, Luis
This paper presents a method to develop frameworks for protocol implementation. Frameworks are software structures developed for a specific application domain, which can be reused in the implementation of various different concrete systems in this domain. The use of frameworks support a protocol
The effect of reduced disclusion time in the treatment of myofascial pain dysfunction syndrome using immediate complete anterior guidance development protocol monitored by digital analysis of occlusion.
Thumati, Prafulla; Manwani, Rakhi; Mahantshetty, Minal
Chronic myofascial pain dysfunction syndrome (MPDS) has been a nightmare for patients suffering from it, who have been treated with various treatment options with varied outcomes. This population of patients has been neglected, due to nagging revisits to a clinician and decreased percentage of success. T-Scan-based immediate complete anterior guidance development (ICAGD) has been shown by a researcher to reduce the muscle hyperactivity consistent with MPDS. The purpose of this study is to evaluate the effect of reduced disclusion time in lateral excursions in treating the MPDS symptoms. Fifty-one myofascial pain patients with symptoms in the area of the head and neck region were treated with ICAGD. The quantified force and time data from T-Scan records were used to correct the prolonged disclusion time, and the subjects were assessed for the symptom relief. The Wilcoxon Signed Ranks Test was used for statistical analysis (P<0·05 denotes significant changes). The changes in disclusion time and intensity of various symptoms were found to be statistically significant (P<0·05) from Day 1 onwards, and patients were relieved of their symptoms after reduction of disclusion time of less than 0·5 seconds. The results clearly indicated that ICAGD protocol reduces musculoskeletal-based symptoms of MPDS patients, and this protocol can prove beneficial for the clinical treatment success.
Schwartz, C.; Gavin, P.
This report describes research performed at the WSU College of Veterinary Medicine in which a large animal model was developed and used to study the effects of boron neutron capture therapy (BNCT) on normal and neoplastic canine brain tissue. The studies were performed using borocaptate sodium (BSH) and epithermal neutrons and had two major foci: biodistribution of BSH in animals with spontaneously occurring brain tumors; and effects of BNCT in normal and neoplastic brain tissue
Fakhr Tabatabaei SA
Full Text Available Failed back surgery syndrome (FBSS is many a times an intractable problem confronted in patients with surgical disease of lumbar spine and at the same time is a pressing problem for the physicians as well. This clinical entity is defined as continuation of pain in the lumbar region and lower extremities following surgery of the lumbar spine. Knowledge of the etiological factors and their prevention is the best line of treatment to overcome the evolution of this syndrome. During this study, which was conducted in Imam Khomeini hospital Tehran from the year 1989 till 1990, 43 out of 114 patients developed "FBSS". 23 cases responded to conservative treatment and psychotherapy whereas medical treatment failed to achieve fruitful results in the rest. The latter underwent extensive radiological investigations and repeat surgery. According to this study, we recommend that in the initial management of these patients. The surgeon should observe the dictum of "5-mis" to overcome and minimize the "FBSS" entity
Pei, Ping; Petrenko, Y. N.
In this paper, we introduce a Mesh network protocol evaluation and development. It has a special protocol. We could easily to understand that how different protocols are used in mesh network. In addition to our comprehension, Multi – hop routing protocol could provide robustness and load balancing to communication in wireless mesh networks.
Teytelman, Leonid; Stoliartchouk, Alexei; Kindler, Lori; Hurwitz, Bonnie L
The detailed know-how to implement research protocols frequently remains restricted to the research group that developed the method or technology. This knowledge often exists at a level that is too detailed for inclusion in the methods section of scientific articles. Consequently, methods are not easily reproduced, leading to a loss of time and effort by other researchers. The challenge is to develop a method-centered collaborative platform to connect with fellow researchers and discover state-of-the-art knowledge. Protocols.io is an open-access platform for detailing, sharing, and discussing molecular and computational protocols that can be useful before, during, and after publication of research results.
Klein Harald H
Full Text Available Abstract Background Non-thyroidal illness syndrome (NTIS is a characteristic functional constellation of thyrotropic feedback control that frequently occurs in critically ill patients. Although this condition is associated with significantly increased morbidity and mortality, there is still controversy on whether NTIS is caused by artefacts, is a form of beneficial adaptation, or is a disorder requiring treatment. Trials investigating substitution therapy of NTIS revealed contradictory results. The comparison of heterogeneous patient cohorts may be the cause for those inconsistencies. Objectives Primary objective of this study is the identification and differentiation of different functional states of thyrotropic feedback control in order to define relevant evaluation criteria for the prognosis of affected patients. Furthermore, we intend to assess the significance of an innovative physiological index approach (SPINA in differential diagnosis between NTIS and latent (so-called "sub-clinical" thyrotoxicosis. Secondary objective is observation of variables that quantify distinct components of NTIS in the context of independent predictors of evolution, survival or pathophysiological condition and influencing or disturbing factors like medication. Design The approach to a quantitative follow-up of non-thyroidal illness syndrome (AQUA FONTIS study is designed as both a cross-sectional and prospective longitudinal observation trial in critically ill patients. Patients are observed in at least two evaluation points with consecutive assessments of thyroid status, physiological and clinical data in additional weekly observations up to discharge. A second part of the study investigates the neuropsychological impact of NTIS and medium-term outcomes. The study design incorporates a two-module structure that covers a reduced protocol in form of an observation trial before patients give informed consent. Additional investigations are performed if and after
dos Santos, Michele R; Moro, Claudia M C; Vosgerau, Dilmeire S R
Fibromyalgia syndrome (FMS) is a chronic disease that causes pain and fatigue, presenting a negative impact on quality of life. Exercise helps maintaining physical fitness and influences directly on the improvement of quality of life. Develop a protocol for health-related physical fitness assessment of patients with FMS with tests that are feasible and appropriate for this population. An exploratory and analytical literature review was performed, seeking to determine the tests used by the scientific community. With this in mind, we performed a literature revision through the use of virtual libraries databases: PubMed, Bireme, Banco de Teses e Dissertações da Capes and Biblioteca Digital Brasileira de Teses e Dissertações, published in between 1992-2012. A variety of tests was found; the following, by number of citations, stood out: Body Mass Index (BMI) and bioimpedance; 6-minute walk; handgrip strength (dynamometer, 1RM [Repetition Maximum]); Sit and reach and Shoulder flexibility; Foot Up and Go, and Flamingo balance. These are the tests that should make up the protocol for the physical evaluation of FMS patients, emphasizing their ease of use.
Dhaifalah, Ishraq; Salek, Tomas; Langova, Dagmar; Cuckle, Howard
The article aimed to assess the benefit of incorporating maternal serum thyroid disease marker levels (thyroid-stimulating hormone and free thyroxine) into first trimester Down syndrome screening protocols. Statistical modelling was used to predict performance with and without the thyroid markers. Two protocols were considered: the combined test and the contingent cell-free DNA (cfDNA) test, where 15-40% women are selected for cfDNA because of increased risk based on combined test results. Published parameters were used for the combined test, cfDNA and the Down syndrome means for thyroid-stimulating hormone and free thyroxine; other parameters were derived from a series of 5230 women screened for both thyroid disease and Down syndrome. Combined test: For a fixed 85% detection rate, the predicted false positive rate was reduced from 5.3% to 3.6% with the addition of the thyroid markers. Contingent cfDNA test: For a fixed 95% detection rate, the proportion of women selected for cfDNA was reduced from 25.6% to 20.2%. When screening simultaneously for maternal thyroid disease and Down syndrome, thyroid marker levels should be used in the calculation of Down syndrome risk. The benefit is modest but can be achieved with no additional cost. © 2017 John Wiley & Sons, Ltd. © 2017 John Wiley & Sons, Ltd.
Crazzolara, Federico; Milicia, Giuseppe
It is of paramount importance that a security protocol effectively enforces the desired security requirements. The apparent simplicity of informal protocol descriptions hides the inherent complexity of their interactions which, often, invalidate informal correctness arguments and justify the effort...... of formal protocol verification. Verification, however, is usually carried out on an abstract model not at all related with a protocol’s implementation. Experience shows that security breaches introduced in implementations of successfully verified models are rather common. The χ-Spaces framework...... is an implementation of SPL (Security Protocol Language), a formal model for studying security protocols. In this paper we discuss the use of χ-Spaces as a tool for developing robust security protocol implementations. To make the case, we take a family of key-translation protocols due to Woo and Lam and show how χ...
O. V. Baturina
Full Text Available The use of modern accelerated diagnostic protocols in patients with suspected acute coronary syndrome is discussed. Evidence base that can give occasion to selection of acceptable accelerated diagnostic protocol for safe exclusion of acute myocardial infarction early after seeking medical attention is presented. Advantages and disadvantages of certain protocols are discussed.
Newell, John D; Sieren, Jered; Hoffman, Eric A
The purpose of this review article is to review the process of developing optimal computed tomography (CT) protocols for quantitative lung CT (QCT). In this review, we discuss the following important topics: QCT-derived metrics of lung disease; QCT scanning protocols; quality control; and QCT image processing software. We will briefly discuss several QCT-derived metrics of lung disease that have been developed for the assessment of emphysema, small airway disease, and large airway disease. The CT scanning protocol is one of the most important elements in a successful QCT. We will provide a detailed description of the current move toward optimizing the QCT protocol for the assessment of chronic obstructive pulmonary disorder and asthma. Quality control of CT images is also a very important part of the QCT process. We will discuss why it is necessary to use CT scanner test objects (phantoms) to provide frequent periodic checks on the CT scanner calibration to ensure precise and accurate CT numbers. We will discuss the use of QCT image processing software to segment the lung and extract the desired QCT metrics of lung disease. We will discuss the practical issues of using this software. The data obtained from the image processing software are then combined with those from other clinical examinations, health status questionnaires, pulmonary physiology, and genomics to increase our understanding of obstructive lung disease and improve our ability to design new therapies for these diseases.
Cooper, R. [Harvard Univ., Barrow, AK (United States); Guesneris, R. [College de France, 75 - Paris (France)
From the author R. Cooper point of view the Kyoto Protocol is a flawed concept. The reasons for dropping Kyoto are presented in this paper insisting that rejecting Kyoto not means to imply that global climate change is not a serious problem. After a presentation of the US policy facing the Climatic Change, some concluding propositions are proposed. (A.L.B.)
Ajayi, Oluwaseun Jessica; Smith, Ebony Jeannae; Viangteeravat, Teeradache; Huang, Eunice Y; Nagisetty, Naga Satya V Rao; Urraca, Nora; Lusk, Laina; Finucane, Brenda; Arkilo, Dimitrios; Young, Jennifer; Jeste, Shafali; Thibert, Ronald; Reiter, Lawrence T
Chromosome 15q11.2-q13.1 duplication syndrome (Dup15q syndrome) is a rare disorder caused by duplications of chromosome 15q11.2-q13.1, resulting in a wide range of developmental disabilities in affected individuals. The Dup15q Alliance is an organization that provides family support and promotes research to improve the quality of life of patients living with Dup15q syndrome. Because of the low prevalence of this condition, the establishment of a single research repository would have been difficult and more time consuming without collaboration across multiple institutions. The goal of this project is to establish a national deidentified database with clinical and survey information on individuals diagnosed with Dup15q syndrome. The development of a multiclinic site repository for clinical and survey data on individuals with Dup15q syndrome was initiated and supported by the Dup15q Alliance. Using collaborative workflows, communication protocols, and stakeholder engagement tools, a comprehensive database of patient-centered information was built. We successfully established a self-report populating, centralized repository for Dup15q syndrome research. This repository also resulted in the development of standardized instruments that can be used for other studies relating to developmental disorders. By standardizing the data collection instruments, it allows us integrate our data with other national databases, such as the National Database for Autism Research. A substantial portion of the data collected from the questionnaires was facilitated through direct engagement of participants and their families. This allowed for a more complete set of information to be collected with a minimal turnaround time. We developed a repository that can efficiently be mined for shared clinical phenotypes observed at multiple clinic sites and used as a springboard for future clinical and basic research studies. ©Oluwaseun Jessica Ajayi, Ebony Jeannae Smith, Teeradache Viangteeravat
Brantingham, James W; Globe, Gary A; Jensen, Muffit L; Cassa, Tammy K; Globe, Denise R; Price, Jennifer L; Mayer, Stephan N; Lee, Felix T
The purpose of this pilot study was to determine the feasibility of (1) using the existing clinic, clinicians, interns, faculty, and staff from our college in conducting all components of a planned randomized controlled clinical trial; (2) successfully recruiting patients with patellofemoral pain syndrome (PFPS); and (3) consistently, effectively, and safely implementing the study protocols and therapy. Diagnostic, treatment, and blind assessment procedures were carried out while recruitment and administrative techniques for managing long-term storage of data and files were developed. Thirty-one patients were randomized into a local manipulative group (group A) or to a full kinetic chain manipulative therapy group (group B), each combined with exercise and soft tissue treatment. The Anterior Knee Pain Scale, visual analog scale, and Patient Satisfaction Scale were used. All phases of the feasibility study including use of the clinic, staff, recruitment techniques, treatment protocols, data collection, input, and analysis were effectively and safely carried out. A feasibility study investigating the ability to conduct a randomized controlled trial of a manipulative therapy protocol for PFPS using available chiropractic college infrastructure was accomplished. A fully powered PFPS trial is feasible and merited.
Chronic Atypical Neutrophilic Dermatosis With Lipodystrophy and Elevated Temperature (CANDLE); Juvenile Dermatomyositis (JDM); Stimulator of Interferon Genes (STING)-Associated Vasculopathy With Onset During Infancy (SAVI); Aicardi-Goutières Syndrome (AGS)
A yeast-based assay protocol developed for detecting oestrogenic activity in activated sludge (AS) supernatant is described. The protocol used Saccharomyces cerevisiae construct RMY/ER-ERE with human oestrogen receptor (ERα) and lacZ reporter genes, and was developed by modifying existing assays for use with AS ...
Roberts, Joanne E; Price, Johanna; Malkin, Cheryl
Although there is considerable variability, most individuals with Down syndrome have mental retardation and speech and language deficits, particularly in language production and syntax and poor speech intelligibility. This article describes research findings in the language and communication development of individuals with Down syndrome, first briefly describing the physical and cognitive phenotype of Down syndrome, and two communication related domains-hearing and oral motor skills. Next, we describe language development in Down syndrome, focusing on communication behaviors in the prelinguistic period, then the development of language in children and adolescents, and finally language development in adults and the aging period. We describe language development in individuals with Down syndrome across four domains: phonology, semantics, syntax, and pragmatics. Wethen suggest strategies for intervention and directions for research relating to individuals with Down syndrome. Copyright 2007 Wiley-Liss, Inc.
An efficient and reproducible plant regeneration protocol for the South African sweet potato (Ipomoea batatas Lam.) cultivar Blesbok was developed in this study. The effect of different hormone combinations and type of explant on shoot regeneration was evaluated in order to optimize the regeneration protocol. Explants in ...
Rizzo, John-Ross; Thai, Peter; Li, Edward J; Tung, Terence; Hudson, Todd E; Herrera, Joseph; Raghavan, Preeti
To determine the feasibility and efficacy of using a structured Nintendo Wii protocol to improve range of motion, strength, and quality of life in patients with shoulder impingement syndrome. A total of 14 patients with shoulder pain were randomized to perform a structured Wii protocol (n=8) or conventional therapy (n=6). Pain-free shoulder range of motion, strength, shoulder pain and disability, and quality of life were assessed pre- and post-treatment. All 8 patients completed the Wii protocol, and 3 completed conventional therapy. The Wii protocol conferred significant improvements in shoulder range of motion, pain and disability, and quality of life but not strength, whereas conventional therapy conferred a significant improvement in strength. As compared to conventional treatment, the structured Wii protocol implemented in this pilot study was a viable adjunct to therapy for shoulder impingement syndrome. Gaming may have a supplemental benefit by increasing motivation, pleasure, and/or adherence. Further investigation in larger cohorts is warranted. Copyright © 2016 Elsevier Masson SAS. All rights reserved.
Luis,Margarita Antonia Villar; Lunetta,Ana Carolina Fuza; Ferreira,Paulo Sérgio
OBJECTIVES: This work speaks of a pilot test administered in four public services with emergency care (one at a hospital and three at community clinics) in the city of Ribeirão Preto, São Paulo, to test an assessment protocol for Alcohol Withdrawal Syndrome. Involved were auxiliaries, technicians and soon-to-be-nurses. The object was to evaluate the protocol´s potential as a guide to nursing care, and to test whether it was adequate in terms of comprehension and applicability. METHODS: A prot...
Wilson, D.L.; Dudney, C.S.; Gammage, R.B.
Over the past several years, considerable research has been devoted by the US Environmental Protection Agency (USEPA) and others to develop radon sampling protocols for single family residences and schools. However, very little research has been performed on measuring radon in the work place. To evaluate possible sampling protocols, 833 buildings throughout the United States were selected for extensive radon testing. The buildings tested (warehouses, production plants and office buildings) were representative of commercial buildings across the country both in design, size and use. Based on the results, preliminary radon sampling protocols for the work place have been developed
Roberts, Jane E.; McCary, Lindsay M.; Shinkareva, Svetlana V.; Bailey, Donald B., Jr.
This study examined the developmental profile of male infants with fragile X syndrome (FXS) and its divergence from typical development and development of infants at high risk for autism associated with familial recurrence (ASIBs). Participants included 174 boys ranging in age from 5 to 28 months. Cross-sectional profiles on the Mullen Scales of…
CDM) as a transition mechanism to Kenya's green economy and the contribution of CDM projects towards sustainable development in Kenya. Accordingly, a positive checklist approach to sustainable development indicators was applied as ...
The UC Berkeley Traffic Safety Center (TSC) has produced this report under a contract from the California Department of Transportation : (Caltrans). The aim is to address workplace injuries and accidents among Caltrans employees and develop recommend...
, is serving as rigorous framework to reduce the complexity of the setup configuration by a fundamental separation of tasks. As a consequence, the general idea of this framework is not limited to experiments with color centers in diamond, but can find application in any laboratory environment. The measurement......The work presented in this thesis revolves around quantum enhanced magnetic field sensing. The core of the study is the nitrogen-vacancy (NV) center, a point defect in the diamond lattice with atomic like properties and magnetic field susceptibility. The central task was to develop control schemes......, attributed to the drive, and from external magnetic noise thereby prolonging the coherence time and reaching the lifetime limitation of the quantum states. We measured a coherence time of 1.43 ms at room temperature in a diamond crystal with a natural abundance of 13C atoms, resulting in a smallest...
Marciniuk, Kristen; Taschuk, Ryan; Napper, Scott
Prion diseases denote a distinct form of infectivity that is based in the misfolding of a self-protein (PrP(C)) into a pathological, infectious conformation (PrP(Sc)). Efforts to develop vaccines for prion diseases have been complicated by the potential dangers that are associated with induction of immune responses against a self-protein. As a consequence, there is considerable appeal for vaccines that specifically target the misfolded prion conformation. Such conformation-specific immunotherapy is made possible through the identification of vaccine targets (epitopes) that are exclusively presented as a consequence of misfolding. An immune response directed against these targets, termed disease-specific epitopes (DSEs), has the potential to spare the function of the native form of the protein while clearing, or neutralizing, the infectious isomer. Although identification of DSEs represents a critical first step in the induction of conformation-specific immune responses, substantial efforts are required to translate these targets into functional vaccines. Due to the poor immunogenicity that is inherent to self-proteins, and that is often associated with short peptides, substantial efforts are required to overcome tolerance-to-self and maximize the resultant immune response following DSE-based immunization. This often includes optimization of target sequences in terms of immunogenicity and development of effective formulation and delivery strategies for the associated peptides. Further, these vaccines must satisfy additional criteria from perspectives of specificity (PrP(C) vs. PrP(Sc)) and safety (antibody-induced template-driven misfolding of PrP(C)). The emphasis of this report is on the steps required to translate DSEs into prion vaccines and subsequent evaluation of the resulting immune responses.
Rubarth, Lori Baas; Quinn, Jenny
Respiratory development is crucial for all newborn infants. Premature infants may be born at an early stage of development and lack sufficient surfactant production. This results in respiratory distress syndrome. This article reviews the normal fetal development of the lung as well as the disorder that develops because of an early birth.
Botezelli José D
Full Text Available Abstract Background An increase in the prevalence of obesity entails great expenditure for governments. Physical exercise is a powerful tool in the combat against obesity and obesity-associated diseases. This study sought to determine the effect of three different exercise protocols on metabolic syndrome and lipid peroxidation markers and the activity of antioxidant enzymes in adult Wistar rats (120 days old. Methods Animals were randomly divided into four groups: the control (C group was kept sedentary throughout the study; the aerobic group (A swam1 h per day, 5 days per week, at 80% lactate threshold intensity; the strength group (S performed strength training with four series of 10 jumps, 5 days per week; and the Concurrent group (AS was trained using the aerobic protocol three days per week and the strength protocol two days per week. Results Groups A and S exhibited a reduction in body weight compared to group C. All exercised animals showed a reduction in triglyceride concentrations in fatty tissues and the liver. Exercised animals also exhibited a reduction in lipid peroxidation markers (TBARS and an increase in serum superoxide dismutase activity. Animals in group A had increased levels of liver catalase and superoxide dismutase activities. Conclusions We concluded that all physical activity protocols improved the antioxidant systems of the animals and decreased the storage of triglycerides in the investigated tissues.
Zakaria, Norasalwa, E-mail: email@example.com [Waste Technology Development Centre, Malaysian Nuclear Agency, 43000 Kajang, Selangor (Malaysia); Wafa, Syed Asraf [Radioisotop Technology and Innovation, Malaysian Nuclear Agency, 43000 Kajang, Selangor (Malaysia); Wo, Yii Mei [Radiochemistry and Environment, Malaysian Nuclear Agency, 43000 Kajang, Selangor (Malaysia); Mahat, Sarimah [Material Technology Group, Malaysian Nuclear Agency, 43000 Kajang, Selangor (Malaysia)
Mixed liquid organic waste generated from health-care and research activities containing tritium, carbon-14, and other radionuclides posed specific challenges in its management. Often, these wastes become legacy waste in many nuclear facilities and being considered as ‘problematic’ waste. One of the most important recommendations made by IAEA is to perform multistage processes aiming at declassification of the waste. At this moment, approximately 3000 bottles of mixed liquid waste, with estimated volume of 6000 litres are currently stored at the National Radioactive Waste Management Centre, Malaysia and some have been stored for more than 25 years. The aim of this study is to develop a characterization protocol towards reclassification of these wastes. The characterization protocol entails waste identification, waste screening and segregation, and analytical radionuclides profiling using various analytical procedures including gross alpha/ gross beta, gamma spectrometry, and LSC method. The results obtained from the characterization protocol are used to establish criteria for speedy classification of the waste.
encryption method may be the fastest most reliable encryption method for nanosatellites. Utilizing Python as a development and testing platform for the...immediately by the state of health data. F. NERDP PROOF OF CONCEPT PLATFORM DEVELOPMENT In order to test the validity of the design of NERDP, a proof of...bandwidth reliable network protocol that can support a cryptographic system for encrypted communications using commercial off-the-shelf components
Sant'Anna, G M; Keszler, M
Mechanical ventilation is a resource-intensive complex medical intervention associated with high morbidity. Considerable practice style variation exists in most hospitals and is not only confusing for parents, but the lack of consistently high standard of optimal ventilation deprives some infants of the benefits of state-of-the-art care. Developing a unit protocol for mechanical ventilation requires exhaustive research, inclusion of all stake-holders, thoughtful protocol development and careful implementation after a thorough educational process, followed by monitoring. A protocol for respiratory support should be comprehensive, addressing respiratory support in the delivery room, the use of non-invasive support, intubation criteria, surfactant administration, specific ventilation modes and settings, criteria for escalating therapy, weaning protocols, extubation criteria, and post-extubation management. Evidence favors the use of non-invasive support as first line treatment, progressing to assist/control or pressure support ventilation combined with volume guarantee, if needed, and high-frequency ventilation only for specific indications. The open lung strategy is crucial to lung-protective ventilation. Copyright © 2012 Elsevier Ltd. All rights reserved.
Adamson, Lauren B.; Deckner, Deborah F.; Bakeman, Roger
This study examines how spontaneous interests in people and in objects relate to joint engagement in typically developing toddlers and young children with autism or Down syndrome. Ratings of interests were made repeatedly during intermissions in a laboratory-based protocol focused on caregiver-child interactions. Interests were moderated by…
Lee, J Y L; Leonard, H; Piek, J P; Downs, J
This study utilized developmental profiling to examine symptoms in 14 girls with genetically confirmed Rett syndrome and whose families were participating in the Australian Rett syndrome or InterRett database. Regression was mostly characterized by loss of hand and/or communication skills (13/14) except one girl demonstrated slowing of skill development. Social withdrawal and inconsolable crying often developed simultaneously (9/14), with social withdrawal for shorter duration than inconsolable crying. Previously acquired gross motor skills declined in just over half of the sample (8/14), mostly observed as a loss of balance. Early abnormalities such as vomiting and strabismus were also seen. Our findings provide additional insight into the early clinical profile of Rett syndrome. © 2013 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Groth, Camilla; Debes, Nanette Mol; Skov, Liselotte
Tourette syndrome (TS) is a neurodevelopmental disorder characterized by frequent comorbidities and a wide spectrum of phenotype presentations. This study aimed to describe the development of phenotypes in TS and tic-related impairment in a large longitudinal study of 226 children and adolescents...
Zimet, P O; Endo, C
It is essential that symptomatic fractures of teeth be suitably diagnosed to prevent propagation of the fracture and continuation of the symptoms. The importance of understanding the mechanism and progression of fractures within teeth is essential when considering the management of fractures within teeth. The relation of the fracture line to the pulp, periodontal ligament and root will influence the management protocols for the involved teeth. When does a Cracked Tooth Syndrome (CTS) become a cracked tooth i.e., unrestorable? Consideration is also required regarding when endodontic treatment should be commenced. Further, suitable-coronal restoration of teeth is required to prevent propagation of the fracture line and persistence of the symptoms. Patients diagnosed with CTS should be counselled in strategies to prevent CTS in other teeth.
Aalberts, Jan J. J.; van Tintelen, J. Peter; Hillege, Hans L.; Boonstra, Piet W.; van den Berg, Maarten P.; Waterbolk, T
Background: Current guidelines recommending prophylactic aortic root replacement in Marfan syndrome are based on absolute diameters of the aortic root. However, aortic root diameter is a function of body surface area (BSA). Here, we report our experience with a protocol for prophylactic aortic root
Kol, Shahar; Homburg, Roy; Alsbjerg, Birgit
Polycystic ovary syndrome (PCOS) patients are prone to develop ovarian hyperstimulation syndrome (OHSS), a condition which can be minimized or completely eliminated by the use of a gonadotropin-releasing hormone agonist (GnRHa) trigger. In this commentary paper, we maintain that the gonadotropin...
Hibino, Satoshi; Uemura, Osamu; Nagai, Takuhito; Yamakawa, Satoshi; Iwata, Naoyuki; Ito, Hidekazu; Nakano, Masaru; Tanaka, Kazuki
This retrospective study was performed to assess the 3 year outcome of a unified protocol for childhood idiopathic nephrotic syndrome. Cyclosporine A (CsA) or CsA plus mycophenolate mofetil (MMF) were used in patients without remission on high-dose steroid therapy. CsA was maintained at an area under the whole blood concentration-time curve up to 4 h after dose (AUC0-4 ) of 1500 and 2000 ng·h/mL in steroid-dependent nephrotic syndrome (SDNS) and steroid-resistant nephrotic syndrome (SRNS), respectively. Ninety-one children were enrolled in the study (SDNS, n = 64; SRNS, n = 18). Patients were divided into minimal change (MC) and focal segmental glomerulosclerosis (FSGS) groups. Three year outcome was evaluated using clinical severity defined as degree of dependence on immunosuppressive therapy for maintenance of remission. In the SDNS group, the numbers of MC and no biopsy were 51 and 13, respectively. No patient had FSGS. Twelve SRNS patients had FSGS and six had MC. In SDNS, 15/64 patients (23%) received no medication. CsA was effective as steroid-sparing agent in 31/38 patients (82%). MMF was effective in all eight patients for whom CsA was unsuccessful. Remission rate in the SRNS group was 14/18 (78%; eight with CsA, and six with a combination of CsA + MMF). Five of the 14 SRNS remission patients received methylprednisolone pulse therapy. Four were resistant to therapy, and had impaired renal function. The clinical severity of MC and FSGS overlapped. Treatment with CsA and combination of CsA plus MMF was useful for SDNS and for remission induction in SRNS. © 2014 Japan Pediatric Society.
NASCIMENTO, P. S.
Full Text Available Data management in environments based on several clouds (cloud-of-clouds should be dependable and secure. DEPSKY may assure that characteristics through mechanisms as cryptography and data replication, however DEPSKY does not support concurrent writing, a desirable functionality for many applications. This paper presents the development and a performance analysis of a lock algorithmfor DEPSKY storage system. The paper also presents validation test and performance test of the algorithm. Such protocol allows concurrent writing, through a low contention lock mechanism that uses lock filesfi to dene who is allowed to write in a data unit.
Park, S. W.; Baek, J. I.; Lee, S. H.; Park, C. S.; Park, K. H.; Shin, J. M.
Communication devices in the safety system of nuclear power plants are distinguished from those developed for commercial purposes in terms of a strict requirement of safety. The concept of safety covers the determinability, the reliability, and the separation/isolation to prevent the undesirable interactions among devices. The safety also requires that these properties be never proof less. Most of the current commercialized communication products rarely have the safety properties. Moreover, they can be neither verified nor validated to satisfy the safety property of implementation process. This research proposes the novel architecture and protocol of a data communication network for the safety system in nuclear power plants
Park, S. W.; Baek, J. I.; Lee, S. H.; Park, C. S.; Park, K. H.; Shin, J. M. [Hannam Univ., Daejeon (Korea, Republic of)
Communication devices in the safety system of nuclear power plants are distinguished from those developed for commercial purposes in terms of a strict requirement of safety. The concept of safety covers the determinability, the reliability, and the separation/isolation to prevent the undesirable interactions among devices. The safety also requires that these properties be never proof less. Most of the current commercialized communication products rarely have the safety properties. Moreover, they can be neither verified nor validated to satisfy the safety property of implementation process. This research proposes the novel architecture and protocol of a data communication network for the safety system in nuclear power plants.
Cody, Dianna D. [University of Texas M.D. Anderson Cancer Center, Department of Imaging Physics, Houston, TX (United States)
When determining a strategy for pediatric CT scanning, clinical staff can either elect to adjust routine adult-protocol parameter settings on a case-by-case basis or rely on pre-set pediatric protocol parameters. The advantages of the latter approach are the topic of this manuscript. This paper outlines specific options to consider, including the need for regular protocol review. (orig.)
Kamil Nahit Ozmenler
Full Text Available The battles that have come to this day had spectacular psychologic and psychiatric effects. Battle stres reactions in historical development phase has been mentioned with such different names as nostalgia, shell shock, soldiers heart, Da Costra Syndrome, old sergeant syndrome, agent orange effect and post traumatic stress disorder (PTSD due to the symptoms coming into prominence. On the othere hand they do tend to show similarities (palpilation, stomach complaints, rhomatizmal aches, neurological and psychiatric symptoms, etc. in the context of symptoms and findigs. During the historical phase, the transition of methods have also infliuenced the prominent clinical characteristics of the war stress syndromes. The symptoms that arose during the gulf War have exhibited neither similarities nor explainable characteristics with previous war stress reactions of the past. Therefore, in the context of diagnostics systems, there is no clarity about where it should be incorporated. The inability to find any satisfactory organic pathology in war stress reactions have been the unchanging characteristic of the illness. In collaboration with the increasing mortality and morbidity that arise in wars it is not only an important factor but the resistance of patients, who had been effected, to amelioration is continuing to be an important concern which preoccupies governments, military authorities and doctors. [TAF Prev Med Bull 2010; 9(1.000: 63-70
Jeong, K. I.; Kim, D. H.; Lee, J. C.
The communication protocol, which provide overall communication rules and methods and give ways how to exchange information, is the most important part and it can affect the overall performance of communication network. Therefore, the first step of development of the communication network of an NPP is its own communication protocol design, which conforms to the requirements and characteristics of an NPP I and C. To manage the protocol development process, we establish development procedure and define detail substantive based on the procedure and we examine the adaptability of existing commercial communication protocols to the communication protocol of an NPP I and C. Existing commercial communication protocols based on Information Technology(IT) can be categorized into 3 groups: general commercial communication protocols, industrial communication protocols, military communication protocols. We analyze the design criteria and performance requirements of popular protocols in each group. And also, we examine the adaptability to the communication protocol of an NPP. Based on these results, we developed our own protocol for NPP I and C, which meet the required specifications through design overall protocol architecture and data frame format, definition of functional requirements and specifications
Full Text Available Objective: The aim of this study was to evaluate the recent treatment protocols for Neer stage III subacromial impingement syndrome with open anterior acromioplasty and rotator cuff repair. Material and Methods: Twenty-two patients (8 males, 14 females; mean age: 52.9±10.2 who were diagnosed with a rotator cuff tear based on clinical and radiological findings between 2009 and 2010 participated in the study.. We used the open surgical decompression technique which was previously described by Neer. The ruptured tendon ends were isolated and were fixed to the bones with appropriate suture anchors and transosseoz sutures. Preoperative, postoperative and the final follow-up Constant and UCLA shoulder scores were evaluated. Results: The mean preoperative Constant score was 34.4±6.6 and UCLA score was 13.8±3.3. The mean postoperative Constant score was 73±7.6 and UCLA score was 31.7±3.3. Significant improvement was observed in postoperative shoulder scores (p<0.01 and postoperative shoulder range of motion in all patients (p<0.01. Conclusion: Currently, clinical and functional results of open and arthroscopic subacromial rotator cuff decompression are similar. However, many surgeons prefer the open method and achieve successful results. (The Me di cal Bul le tin of Ha se ki 2012; 50: 59-63
Hardwick, J.; Mencik, C.; McLaren, C.; Young, C.; Scadden, S.; Mashford, P.; McHugh, K.; Beckett, M.; Calvert, M.; Marsden, P.J.
This paper describes how the requirement for operating protocols for standard radiological practice was expanded to provide a comprehensive aide to the operator conducting a medical exposure. The protocols adopted now include justification criteria, patient preparation, radiographic technique, standard exposure charts, diagnostic reference levels and image quality criteria. In total, the protocols have been welcomed as a tool for ensuring that medical exposures are properly optimised. (author)
Troxel, Wendy M; Buysse, Daniel J; Matthews, Karen A; Kip, Kevin E; Strollo, Patrick J; Hall, Martica; Drumheller, Oliver; Reis, Steven E
Sleep complaints are highly prevalent and associated with cardiovascular disease (CVD) morbidity and mortality. This is the first prospective study to report the association between commonly reported sleep symptoms and the development of the metabolic syndrome, a key CVD risk factor. Participants were from the community-based Heart Strategies Concentrating on Risk Evaluation study. The sample was comprised of 812 participants (36% African American; 67% female) who were free of metabolic syndrome at baseline, had completed a baseline sleep questionnaire, and had metabolic syndrome evaluated 3 years after baseline. Apnea-hypopnea index (AHI) was measured cross-sectionally using a portable monitor in a subset of 290 participants. Logistic regression examined the risk of developing metabolic syndrome and its components according to individual sleep symptoms and insomnia syndrome. Specific symptoms of insomnia (difficulty falling asleep [DFA] and "unrefreshing" sleep), but not a syndromal definition of insomnia, were significant predictors of the development of metabolic syndrome. Loud snoring more than doubled the risk of developing the metabolic syndrome and also predicted specific metabolic abnormalities (hyperglycemia and low high-density lipoprotein cholesterol). With further adjustment for AHI or the number of metabolic abnormalities at baseline, loud snoring remained a significant predictor of metabolic syndrome, whereas DFA and unrefreshing sleep were reduced to marginal significance. Difficulty falling asleep, unrefreshing sleep, and, particularly, loud snoring, predicted the development of metabolic syndrome in community adults. Evaluating sleep symptoms can help identify individuals at risk for developing metabolic syndrome.
Cagle, John C; Reinhall, Per G; Hafner, Brian J; Sanders, Joan E
A set of protocols was created to characterize prosthetic liners across six clinically relevant material properties. Properties included compressive elasticity, shear elasticity, tensile elasticity, volumetric elasticity, coefficient of friction (CoF), and thermal conductivity. Eighteen prosthetic liners representing the diverse range of commercial products were evaluated to create test procedures that maximized repeatability, minimized error, and provided clinically meaningful results. Shear and tensile elasticity test designs were augmented with finite element analysis (FEA) to optimize specimen geometries. Results showed that because of the wide range of available liner products, the compressive elasticity and tensile elasticity tests required two test maxima; samples were tested until they met either a strain-based or a stress-based maximum, whichever was reached first. The shear and tensile elasticity tests required that no cyclic conditioning be conducted because of limited endurance of the mounting adhesive with some liner materials. The coefficient of friction test was based on dynamic coefficient of friction, as it proved to be a more reliable measurement than static coefficient of friction. The volumetric elasticity test required that air be released beneath samples in the test chamber before testing. The thermal conductivity test best reflected the clinical environment when thermal grease was omitted and when liner samples were placed under pressure consistent with load bearing conditions. The developed procedures provide a standardized approach for evaluating liner products in the prosthetics industry. Test results can be used to improve clinical selection of liners for individual patients and guide development of new liner products.
Bocanegra, J. [PEMEX, Mexico City (Mexico)
ARPEL's (Regional Association of Oil and Natural Gas Companies in Latin America and the Carribean) interest in clean development mechanisms is described. Several uncertainties related to the Kyoto Protocol and the CDM were addressed, such as the science behind the climate change phenomena, the impact on oil demand, the cost of emission reduction to the oil industry and the 'additionality' criteria. Relative benefits of participating in CDM projects by member companies of ARPEL were examined, with due regard to the fact that Latin American countries are not now required to reduce emissions. Some actions that individual companies in ARPEL could take to consider investing in CDM projects were also reviewed. With reference to PEMEX (Petroleos Mexicanos), the speaker explained the PEMEX view of the climate change issue, how it is integrated into the company's sustainable development strategy, and how CDM could become an important means to accessing the financial and technology support needed to implement CDM projects. An industrial prototype project that PEMEX could implement to reduce its carbon dioxide emissions was also described as an indication of PEMEX's capacity to contribute towards mitigating global climate change.
Mohd Ruddin Ab. Ghani
Full Text Available This paper reviewed all the possible interfacing communication protocols for remote terminal unit (RTU. Supervisory Control and Data Acquisition (SCADA system is a central station that can communicate with other network using the protocol. Fundamentally, the architectures of all networks are based on the seven layers of open system interconnection (OSI and International Standard Organization (ISO. The objective of designing the protocols is to check the status of all the input and output field devices and send the report according to that status. The corresponding protocol and communication parameters between the connecting devices will be included in designing a complex SCADA system. The available protocols to develop the communication of RTU are Modbus/ASCII, distributed network protocol (DNP3, controller area network (CAN, International Electro-technical Commission (IEC 60870, transmission control protocol/internet protocol (TCP/IP.
Jahangiry, Leila; Shojaeizadeh, Davoud; Najafi, Mahdi; Mohammad, Kazem; Abbasalizad Farhangi, Mahdieh; Montazeri, Ali
Although effectiveness of web-based interventions on lifestyle changes are recognized, the potential of such programs on metabolic syndrome has not been explored. We describe the protocol of a randomized controlled trial that aims to determine the feasibility, acceptability, usability, and effectiveness of interactive technology on lifestyle intervention in a population with metabolic syndrome. This is a two-arm randomized controlled trial. The study includes 160 participants (n = 80 per arm) who will be recruited via online registration on the study website. The inclusion criteria are that they should have metabolic syndrome and have access to the Internet. All participants will receive information on dietary intake and physical activity through the study website. The intervention group will receive additional resources via the study website including interactive Healthy Heart Profile and calorie restricted diet tailored to the participants. The primary outcomes are feasibility, acceptability, usability, and the change in metabolic syndrome components. The secondary outcomes are comparing quality of life, physical activity and food intake among the study arms. The participants will be followed up to 6 months with data collection scheduled at baseline, 3 and 6 months. There is a need for developing and evaluating web-based interventions that target people with high risk for cardiovascular diseases. This study will therefore make an important contribution to this novel field of research and practice. IRCT201111198132N1.
Dammeyer, Jesper Herup
OBJECTIVE: Individuals with Usher syndrome or CHARGE syndrome are faced with a number of difficulties concerning hearing, vision, balance, and language development. The aim of the study is to describe the developmental characteristics of children with Usher syndrome and CHARGE syndrome......, respectively. METHOD: Data about the developmental characteristics of 26 children with Usher syndrome and 17 children with CHARGE syndrome was obtained. Associations between deafblindness (dual sensory loss), motor development (age of walking), language abilities, and intellectual outcome of these children...... were explored for each group independently. RESULTS: Both groups of children face a number of difficulties associated with vision, hearing, language, balance and intellectual outcome. Intellectual disability and/or language delay was found among 42% of the children with Usher syndrome and among 82...
McCoy, Allen; Dalby, Craig
The purpose of the project was to conduct research that will guide development of a standard approach to monitoring several components of prairies within the North Coast and Cascades Network (NCCN) parks. Prairies are an important element of the natural environment at many parks, including San Juan Island National Historical Park (NHP) and Ebey's Landing National Historical Reserve (NHR). Forests have been encroaching on these prairies for many years, and so monitoring of the prairies is an important resource issue. This project specifically focused on San Juan Island NHP. Prairies at Ebey's Landing NHR will be monitored in the future, but that park was not mapped as part of this prototype project. In the interest of efficiency, the Network decided to investigate two main issues before launching a full protocol development effort: (1) the imagery requirements for monitoring prairie components, and (2) the effectiveness of software to assist in extracting features from the imagery. Several components of prairie monitoring were initially identified as being easily tracked using aerial imagery. These components included prairie/forest edge, broad prairie composition (for example, shrubs, scattered trees), and internal exclusions (for example, shrubs, bare ground). In addition, we believed that it might be possible to distinguish different grasses in the prairies if the imagery were of high enough resolution. Although the areas in question at San Juan Island NHP are small enough that mapping on the ground with GPS (Global Positioning System) would be feasible, other applications could benefit from aerial image acquisition on a regular, recurring basis and thereby make the investment in aerial imagery worthwhile. The additional expense of orthorectifying the imagery also was determined to be cost-effective.
Veiga, Daniela Francescato; Ferreira, Lydia Masako
To develop a proposal for metrics for protocols and other technical products to be applied in assessing the Postgraduate Programs of Medicine III - Capes. The 2013 area documents of all the 48 Capes areas were read. From the analysis of the criteria used by the areas at the 2013's Triennal Assessment, a proposal for metrics for protocols and other technical products was developed to be applied in assessing the Postgraduate Programs of Medicine III. This proposal was based on the criteria of Biological Sciences I and Interdisciplinary areas. Only seven areas have described a scoring system for technical products. The products considered and the scoring varied widely. Due to the wide range of different technical products which could be considered relevant, and that would not be punctuated if they were not previously specified, it was developed, for the Medicine III, a proposal for metrics in which five specific criteria to be analyzed: Demand, Relevance/Impact, Scope, Complexity and Adherence to the Program. Based on these criteria, each product can receive 10 to 100 points. This proposal can be applied to the item Intellectual Production of the evaluation form, in subsection "Technical production, patents and other relevant production". The program will be scored as Very Good when it reaches mean ≥150 points/permanent professor/quadrennium; Good, mean between 100 and 149 points; Regular, mean between 60 and 99 points; Weak mean between 30 and 59 points; Insufficient, up to 29 points/permanent professor/quadrennium. Desenvolver proposta de métricas para protocolos e outras produções técnicas a serem aplicadas na avaliação dos Programas de Pós-Graduação da Área Medicina III da Capes. Foram lidos os documentos de área de 2013 de todas as 48 Áreas da Capes. A partir da análise dos critérios utilizados por elas na avaliação trienal 2013, foi desenvolvida uma proposta de métricas para protocolos e outras produções técnicas. Esta proposta foi baseada
Full Text Available Abstract Background Shoulder muscle fatigue has been proposed as a possible link to explain the association between repetitive arm use and the development of rotator cuff disorders. To our knowledge, no standardized clinical endurance protocol has been developed to evaluate the effects of muscle fatigue on shoulder function. Such a test could improve clinical examination of individuals with shoulder disorders. Therefore, the purpose of this study was to establish a reliable protocol for objective assessment of shoulder muscle endurance. Methods An endurance protocol was developed on a stationary dynamometer (Biodex System 3. The endurance protocol was performed in isotonic mode with the resistance set at 50% of each subject's peak torque as measured for shoulder external (ER and internal rotation (IR. Each subject performed 60 continuous repetitions of IR/ER rotation. The endurance protocol was performed by 36 healthy individuals on two separate occasions at least two days apart. Maximal isometric shoulder strength tests were performed before and after the fatigue protocol to evaluate the effects of the endurance protocol and its reliability. Paired t-tests were used to evaluate the reduction in shoulder strength due to the protocol, while intraclass correlation coefficients (ICC and minimal detectable change (MDC were used to evaluate its reliability. Results Maximal isometric strength was significantly decreased after the endurance protocol (P 0.84. Conclusions Changes in muscular performance observed during and after the muscular endurance protocol suggests that the protocol did result in muscular fatigue. Furthermore, this study established that the resultant effects of fatigue of the proposed isotonic protocol were reproducible over time. The protocol was performed without difficulty by all volunteers and took less than 10 minutes to perform, suggesting that it might be feasible for clinical practice. This protocol could be used to induce
Møller, Steen Henrik; Hansen, Steffen W; Rousing, Tine
European Fur Breeder's Association initiated the "WelFur" project in 2009 in order to develop a welfare assessment protocol for mink and fox farms after the Welfare Quality® standards. The assessment is based on four welfare principles (Good feeding, good housing, good health and appropriate...... behaviour) and 12 underlying criteria, to be measured on-farm. The major steps in the development of the WelFur mink protocols are described: (1) Writing leterature reviews and listing potential measures. (2) Identifying valid, reliable and feasable welfare measures. (3) Developing registration protocols......, descriptions, and schemes. (4) Testing preliminary protocols in relevant seasons of the annual production. This paper focus on the evaluation of validity, reliability anf feasibility of the 22 measures that have been selected for the WelFur assessment protocols. These protocols haev been tested in the three...
Mokhtar, Sara; Sadeghi, Mohammad Reza; Akhondi, Mohammad Mehdi; Zafardoust, Simin; Badenush, Bita; Fatemi, Farnaz; Nazari, Fattane; Kamali, Koorosh; Mohammadzade, Afsaneh
Background: Since increased LH in the early follicular phase in PCOS patients especially in GnRH antagonist protocol could be associated with reduced oocyte quality and pregnancy and impared implantation. The current study was conducted to determine ART outcomes in GnRH antagonist protocol (flexible) and long GnRH agonist protocol and compare them with adding GnRH antagonist in GnRH antagonist (flexible) protocol during early follicular phase in patients with polycystic ovary syndrome undergoing ICSI. Methods: In this randomized clinical trial, 150 patients with polycystic ovary syndrome undergoing ICSI were enrolled from 2012 to 2014 and randomly assigned to receive either GnRH antagonist protocol during early and late follicular phase or GnRH antagonist protocol (flexible) or long GnRH agonist protocol. The clinical and laboratory pregnancy in three groups was determined and compared. In this context, the chi-square and Fisher's exact test and ANOVA were used for data analysis. Statistical significance was defined as p<0.05. Results: There was no statistically significant difference with respect to chemical pregnancy and clinical pregnancy between the three groups. Also, other indices such as number and quality of oocytes and embryos were alike. Conclusion: Totally, according to our results, GnRH antagonist protocol during early and late follicular phase and GnRH antagonist protocol (flexible) and long GnRH agonist protocol in patients with polycystic ovary syndrome undergoing ICSI are similarly effective and use of each one based on patients' condition and physicians' opinion could be considered. PMID:26913233
Pontes, Flávia Sirotheau Corrêa; Conte Neto, Nicolau; da Costa, Rodrigo Moreira Bringel; Loureiro, Arlison Miranda; do Nascimento, Liliane Silva; Pontes, Hélder Antônio Rebelo
Sturge-Weber syndrome (SWS) is a very rare condition characterized by abnormal vascular formations that encompass several manifestations: cutaneous, neurologic, ocular, and oral. Neurologic conditions are the most important factor, especially epilepsy, which frequently leads patients to make use of anticonvulsants. These drugs are capable of inducing abnormal tissue growth in the oral cavity that can be situated over areas with vascular malformation, requiring special attention by the clinician. This report describes 1 case of SWS and performs a literature review of treatments for this condition, providing a protocol of treatment for these clinical situations.
By establishing the needs for institution of new technologies in the process of food processing, in this case a randomized choice of electron beam accelerator facility, arises the need for designing a protocol for safe and secure performance of the facility. The protocol encompasses safety and security measures for protection from ionizing radiation of the individuals who work at the facility, as well as, the population and the environment in the immediate neighborhood of the facility. Thus, the adopted approach is the establishment of appropriate systems responding to the protocol. Dosimetry system, which includes appropriate procedures for accurate measure and recording of the absorbed dose values, according to the provisions for protection from ionizing radiation. Ionizing radiation protection system and providing the safety and security of the facility for food processing by means of ionizing radiation. System for providing quality and safety control of the facility for food processing by means of ionizing radiation. Pursuant to the designed a protocol for safe and secure performance of the facility for electron beam food processing, contributes to protection against ionizing radiation as occupationally exposed persons as well the population. (Author)
This project aims to use information from the Sabie catchment to produce and implement a protocol which will combine and integrate the knowledge of water resource management from diverse but related fields in order to enhance catchment-based integrated water resource management. It also aims to extract and ...
Garcia de Alba, G O; Gamboa Marrufo, J D; Valencia Mayoral, P; Delgadillo, J F
We report the case of a 3 month old female with a diagnosis of Reye Syndrome, confirmed with laboratory exams. Three months after apparently recovering from the acute clinical picture, the patient developed massive spasms and psychomotor delay with an EEG tracing typical of hypsarrythmia, the classic triade which suggests West Syndrome.
Sheperis, Carl J.; Doggett, R. Anthony; Hoda, Nicholas E.; Blanchard, Tracy; Renfro-Michel, Edina L.; Holdiness, Sacky H.; Schlagheck, Robyn
Proposes a battery of semi-structured interviews, global assessment scales, attachment-specific scales, and behavioral observations to help mental health counselors identify Reactive Attachment Disorder, a syndrome associated with extreme attachment problems. (Contains 25 references and 2 tables.) (GCP)
There are benefits to adopting radio frequency identification (RFID) technology, although there are methods of attack that can compromise the system. This research determined how that may happen and what possible solutions can keep that from happening. Protocols were developed to implement better security. In addition, new topologies were developed to handle the problems of the key management. Previously proposed protocols focused on providing mutual authentication and privacy between readers and tags. However, those protocols are still vulnerable to be attacked. These protocols were analyzed and the disadvantages shown for each one. Previous works assumed that the channels between readers and the servers were secure. In the proposed protocols, a compromised reader is considered along with how to prevent tags from being read by that reader. The new protocols provide mutual authentication between readers and tags and, at the same time, remove the compromised reader from the system. Three protocols are proposed. In the first protocol, a mutual authentication is achieved and a compromised reader is not allowed in the network. In the second protocol, the number of times a reader contacts the server is reduced. The third protocol provides authentication and privacy between tags and readers using a trusted third party. The developed topology is implemented using python language and simulates work to check the efficiency regarding the processing time. The three protocols are implemented by writing codes in C language and then compiling them in MSP430. IAR Embedded workbench is used, which is an integrated development environment with the C/C++ compiler to generate a faster code and to debug the microcontroller. In summary, the goal of this research is to find solutions for the problems on previously proposed protocols, handle a compromised reader, and solve key management problems.
Brissie, Megan A; Zomorodi, Meg; Soares-Sardinha, Sharmila; Jordan, J Dedrick
Through evaluation of the literature and working with a team of multidisciplinary healthcare providers, our objective was to refine an interprofessional Neuro Early Mobilisation Protocol for complex patients in the Neuroscience Intensive Care Unit. Using the literature as a guide, key stakeholders, from multiple professions, designed and refined a Neuro Early Mobilisation Protocol. This project took place at a large academic medical center in the southeast United States classified as both a Level I Trauma Center and Comprehensive Stroke Center. Goals for protocol development were to: (1) simplify the protocol to allow for ease of use, (2) make the protocol more generalizable to the patient population cared for in the Neuroscience Intensive Care Unit, (3) receive feedback from those using the original protocol on ways to improve the protocol and (4) ensure patients were properly screened for inclusion and exclusion in the protocol. Using expert feedback and the evidence, an evidence-based Neuro Early Mobilisation Protocol was created for use with all patients in the Neuroscience Intensive Care Unit. Future work will consist of protocol implementation and evaluation in order to increase patient mobilisation in the Neuroscience Intensive Care Unit. Copyright © 2017 Elsevier Ltd. All rights reserved.
Full Text Available On the long multistage pathway of biosynthesis of steroid hormones from cholesterol to cortisol, testosterone and estradiol, due to mutations in genes, there is the deficiency of steroidogenesis enzymes in the adrenal glands: cholesterol desmolase, 3β-hydroxysteroid dehydrogenase, 17α-hydroxylase, 21-hydroxylase, and enzymes of steroidogenesis in the testis: 17,20-desmolasis, 17β-hydroxystyrol dehydroreductase and others, as well as a complex of widespread congenital diseases of heterogeneous group with autosomal recessive type of inheritance — adrenogenital syndrome (AGS. Deficiency of any of these enzymes or transport proteins leads to partial or complete loss of their activity. Phenotypic manifestations of AGS are quite polymorphic: phenomenon of hypoadrenocorticism; violation of the nature and rates of sexual development; bilateral increasing of adrenal glands; hypercorticotropinemia sensitive to dexamethasone; oligo- or amenorrhea; anovulatory infertility, miscarriage in early pregnancy. Pathogenetic component of these signs is congenital disorder of steroidogenesis caused by 11β-hydroxylase deficiency and symptoms of androgen excess. In AGS, there are distinguished a phenotype and nonclassical forms of steroidogenesis enzyme deficiency. In most cases, both types of diseases occur in persons of both sexes with different course — from mild to severe forms of the disease.
Kamphuis, C.; Dela Rue, B.T.; Eastwood, C.R.
This paper reports on a field validation of previously developed protocols for evaluating the performance of in-line mastitis-detection systems. The protocols outlined 2 requirements of these systems: (1) to detect cows with clinical mastitis (CM) promptly and accurately to enable timely and
Alejandro Seisdedos Benzal
Full Text Available Canine Cognitive Dysfunction Syndrome (CCD is a neurodegenerative disease affecting aging dogs. CCD is an underdiagnosed disease that involves at least 14% of geriatric dogs, but apparently less than 2% of diseased dogs are diagnosed. There are several physiopathological similarities between Alzheimer disease (AD and CCD, developing amyloid-β deposits in brain parenchyma and blood vessels, brain atrophy and neuronal loss. The clinical signs lead to behavioural changes. They are unspecific and could appear as soon as seven years of age, but are more relevant in senior dogs. The abnormal behaviour could be classified following the acronym DISHA: Disorientation in the immediate environment; altered Interactions with humans and other animals; Sleep-wake cycle disturbances; House-soiling; and changes in Activity levels. There is no specific diagnostic test or biomarker to demonstrate the presence of CCD; therefore, it is often assessed by ruling out other diseases that may cause similar behavioural changes. Veterinarians have to be able to make an accurate account of veterinary history asking for abnormal behaviour that could be misreported by the owners. CCD is a neurodegenerative disorder that cannot be cured. It is possible to delay the progression of the clinical signs and improve the quality of life of patients, but like in AD, the progression of the illness will depend on the individual. There are three treatment pathways, which could be used in combination: drug therapy to improve cognition and reduce anxiety, antioxidant diet and nutraceutical supplements to reduce the progression of the illness, and finally, environmental enrichment to maintain brain activity. The aim of this review article is to contribute to the knowledge of the illness, presenting recent advances in the pathophysiology, diagnosis and treatment of the disease
Abbeduto, Leonard; Brady, Nancy; Kover, Sara T.
Fragile X syndrome (FXS) is the leading inherited cause of mental retardation. In this article, we review what is known about the language and related problems of individuals with FXS. In doing so, we focus on the syndrome-specific features of the language phenotype and on the organismic (i.e., genetic and individual neurocognitive and behavioral)…
de Rooij, Mariëtte; van der Leeden, Marike; Avezaat, Ellis; Häkkinen, Arja; Klaver, Rob; Maas, Tjieu; Peter, Wilfred F; Roorda, Leo D; Lems, Willem F; Dekker, Joost
Background Exercise therapy is generally recommended for patients with osteoarthritis (OA) of the knee. Comorbidity, which is highly prevalent in OA, may interfere with exercise therapy. To date, there is no evidence-based protocol for the treatment of patients with knee OA and comorbidity. Special protocols adapted to the comorbidity may facilitate the application of exercise therapy in patients with knee OA and one or more comorbidities. Purpose The purpose of this study was to develop comorbidity-adapted exercise protocols for patients with knee OA and comorbidity. Method Several steps were undertaken to develop comorbidity-adapted protocols: selection of highly prevalent comorbidities in OA, a literature search to identify restrictions and contraindications for exercise therapy for the various comorbid diseases, consultation of experts on each comorbid disease, and field testing of the protocol in eleven patients with knee OA and comorbidity. Results Based on literature and expert opinion, comorbidity-adapted protocols were developed for highly prevalent comorbidities in OA. Field testing showed that the protocols provided guidance in clinical decision making in both the diagnostic and the treatment phase. Because of overlap, the number of exercise protocols could be reduced to three: one for physiological adaptations (coronary disease, heart failure, hypertension, diabetes type 2, chronic obstructive pulmonary diseases, obesity), one for behavioral adaptations (chronic a-specific pain, nonspecific low back pain, depression), and one for environmental adaptations (visual or hearing impairments). Evaluation of patient outcome after treatment showed significant (Pexercise protocols for patients with knee OA were developed, providing guidance in clinical reasoning with regard to diagnostics and treatment. To evaluate the effectiveness of treatment in line with our protocols, a randomized clinical trial should be performed. PMID:24868151
Mayhorn, Ebony T. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sullivan, Greg P. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Petersen, Joseph M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Baechler, Michael C. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)
This document presents a Draft Plan proposed to develop a common test protocol that can be used to evaluate the performance requirements of Non-Intrusive Load Monitoring. Development on the test protocol will be focused on providing a consistent method that can be used to quantify and compare the performance characteristics of NILM products. Elements of the protocols include specifications for appliances to be used, metrics, instrumentation, and a procedure to simulate appliance behavior during tests. In addition, three priority use cases for NILM will be identified and their performance requirements will specified.
Teixeira, M. Ines; Caldas, Linda V.E.; Chohfi, Adriana C.S.; Figueiredo, Zenaide A.
For accomplishment of a mammogram should be considered several factors such as equipment used and the classification of breast cancer patients. The density of the breast is different of patient to patient, thus making it difficult many precocious diagnostic of breast cancer. There is a significant variation in the breast to be radiographed, depending on several factors presented in the breast tissue of breast prosthesis with or without breasts or with implants. This work had as objective main to make a survey of the factors that influence in the classification of mammary fabrics. With this survey and classification it can be better adjusted the protocols which will be more efficient in the mammography exam, preventing excess of radiation dose, stress for the patient, economy of raw material, control of the quality and rapidity in the process of image attainment. (author)
Shamshirsaz, Alireza A; Ravangard, Samadh F; Turner, Garry; Borgida, Adam; Janicki, Mary Beth; Campbell, Winston A; Zelop, Carolyn; Shamshirsaz, Amirhoushang A; Spiel, Melissa; Prabulos, Anne Marie; Feldman, Deborah; Rodis, John; Ingardia, Charles J; Gurram, Padmalatha; Fuller, Kisti; Fang, Yu M; Benn, Peter; Egan, James F X
The purpose of this study was to evaluate the efficacy of the genetic sonogram in Down syndrome screening for women who have received the stepwise sequential test. This retrospective cohort study included women with singleton pregnancies who underwent stepwise sequential (first-trimester combined and second-trimester serum) screening and then had a genetic sonogram between March 2005 and January 2010. Stepwise sequential Down syndrome risks were multiplied by either a positive or negative likelihood ratio based on the second-trimester sonographic findings to determine the final Down syndrome risk. A final Down syndrome risk of 1:270 or higher was considered screen positive. A total of 6286 women fulfilled our criteria, including 17 with Down syndrome-affected fetuses. After stepwise sequential testing, the Down syndrome detection rate was 88.2% (15 of 17), and after the genetic sonogram, there was a non-significant reduction in detection to 82.4% (14 of 17; P > .05). For the 6269 unaffected pregnancies, the genetic sonogram converted 58 screen-negative results (1%) to positive and 183 screen-positive results (3.1%) to negative. The net effect was a change in the false-positive rate from 6.2% (390 of 6269) after stepwise sequential screening to 4.2% (266 of 6269) after the genetic sonogram. The genetic sonogram should be applied cautiously for women who have received prior prenatal screening tests. Women with screen-positive results need to be counseled that a negative sonographic result can be falsely reassuring. Conversely, for women with screen-negative results who have a risk close to the cutoff, a sonographic examination could assist in the decision of whether to accept or reject amniocentesis.
Full Text Available Background: Treacher-Collins syndrome is a congenital craniofacial disorder with multiple anomalies. This syndrome affects the maxilla, mandible, eyes, middle and outer ears, and soft palate. Conductive hearing loss due to the deformities of the middle and external ears is prevalent. The characteristics of this syndrome include multiple and serious threats to normal communication development in children. In this study, speech and language features of a Persian speaking child with this syndrome are presented.Case: The case was an 8-year old girl with Treacher-Collins syndrome and bilateral moderate conductive hearing loss due to atretic canal. In language and speech assessments, moderate hypernasality, numerous compensatory errors and morphosyntactic deficits were observed. There were 13 phonemes that were incorrectly produced at least in one position. Besides, she used 22 types of phonological processes that were abnormal and disappear before the age of three in normal Persian speaking children.Conclusion: Moderate hearing loss, velopharyngeal incompetency, malocclusion and dental anomalies, attention deficit/hyperactivity disorder (ADHD and environmental factors resulted in severe speech and language disorders in this case. These disorders affected her academic performance as well. Moderate hypernasality, numerous compensatory errors, and excessive and abnormal use of phonological processes were not presented as prevalent characteristics of Treacher-Collins syndrome in other resources.
For the past 30 years, the IAEA's safeguards system has contributed to the international non-proliferation regime by providing, inter alia, assurances regarding the peaceful uses of declared nuclear material. However, the discovery of a clandestine nuclear weapons program in Iraq in 1991 drew world-wide attention to the need to strengthen the system to address the absence of undeclared nuclear material and activities. Efforts to strengthen the IAEA's safeguards system began in 1991 and culminated in 1997 when the IAEA's Board of Governors approved a Model Protocol Additional to IAEA Safeguards Agreements which greatly expands the legal basis and scope of IAEA safeguards. Within this strengthened system it is expected that the IAEA be able to provide assurance not only of the absence of diversion of declared nuclear material but also on the absence of undeclared nuclear material and activities. This is to be done within a safeguards system that uses an optimal combination of all safeguards measures available, thereby achieving maximum effectiveness and efficiency within the available resources. The paper summarizes the evolution of the safeguards system, describes strengthened safeguards, reports on the status of implementing the strengthening measures, and outlines plans for integrating all available safeguards measures. (author)
Aagaard, James S.; And Others
This two-volume document specifies a protocol that was developed using the Reference Model for Open Systems Interconnection (OSI), which provides a framework for communications within a heterogeneous network environment. The protocol implements the features necessary for bibliographic searching, record maintenance, and mail transfer between…
de Witte Pieter
Full Text Available Abstract Background The Subacromial Impingement Syndrome (SIS is the most common diagnosed disorder of the shoulder in primary health care, but its aetiology is unclear. Conservative treatment regimes focus at reduction of subacromial inflammatory reactions or pathologic scapulohumeral motion patterns (intrinsic aetiology. Long-lasting symptoms are often treated with surgery, which is focused at enlarging the subacromial space by resection of the anterior part of the acromion (based on extrinsic aetiology. Despite that acromionplasty is in the top-10 of orthopaedic surgical procedures, there is no consensus on its indications and reported results are variable (successful in 48-90%. We hypothesize that the aetiology of SIS, i.e. an increase in subacromial pressure or decrease of subacromial space, is multi-factorial. SIS can be the consequence of pathologic scapulohumeral motion patterns leading to humerus cranialisation, anatomical variations of the scapula and the humerus (e.g. hooked acromion, a subacromial inflammatory reaction (e.g. due to overuse or micro-trauma, or adjoining pathology (e.g. osteoarthritis in the acromion-clavicular-joint with subacromial osteophytes. We believe patients should be treated according to their predominant etiological mechanism(s. Therefore, the objective of our study is to identify and discriminate etiological mechanisms occurring in SIS patients, in order to develop tailored diagnostic and therapeutic strategies. Methods In this cross-sectional descriptive study, applied clinical and experimental methods to identify intrinsic and extrinsic etiologic mechanisms comprise: MRI-arthrography (eligibility criteria, cuff status, 3D-segmented bony contours; 3D-motion tracking (scapulohumeral rhythm, arm range of motion, dynamic subacromial volume assessment by combining the 3D bony contours and 3D-kinematics; EMG (adductor co-activation and dynamometry instrumented shoulder radiographs during arm tasks (force and
Bernal Daniel DL
Full Text Available Abstract Background Despite continual improvements in the management of acute coronary syndromes, adherence to guideline-based medications remains suboptimal. We aim to improve adherence with guideline-based therapy following acute coronary syndrome using an existing service that is provided by specifically trained pharmacists, called a Home Medicines Review. We have made two minor adjustments to target the focus of the existing service including an acute coronary syndrome specific referral letter and a training package for the pharmacists providing the service. Methods/Design We will be conducting a randomized controlled trial to compare the directed home medicines review service to usual care following acute coronary syndromes. All patients aged 18 to 80 years and with a working diagnosis of acute coronary syndrome, who are admitted to two public, acute care hospitals, will be screened for enrolment into the trial. Exclusion criteria will include: not being discharged home, documented cognitive decline, non-Medicare eligibility, and presence of a terminal malignancy. Randomization concealment and sequence generation will occur through a centrally-monitored computer program. Patients randomized to the control group will receive usual post-discharge care. Patients randomized to receive the intervention will be offered usual post-discharge care and a directed home medicines review at two months post-discharge. The study endpoints will be six and twelve months post-discharge. The primary outcome will be the proportion of patients who are adherent to a complete, guideline-based medication regimen. Secondary outcomes will include hospital readmission rates, length of hospital stays, changes in quality of life, smoking cessation rates, cardiac rehabilitation completion rates, and mortality. Discussion As the trial is closely based on an existing service, any improvements observed should be highly translatable into regular practice. Possible
Full Text Available Abstract Introduction Irritable bowel syndrome affects as many as 14% of high school-aged students. Symptoms include discomfort in the abdomen, along with diarrhea and/or constipation and other gastroenterological symptoms that can significantly impact quality of life and daily functioning. Emotional stress appears to exacerbate irritable bowel syndrome symptoms suggesting that mind-body interventions reducing arousal may prove beneficial. For many sufferers, symptoms can be traced to childhood and adolescence, making the early manifestation of irritable bowel syndrome important to understand. The current study will focus on young people aged 14-26 years with irritable bowel syndrome. The study will test the potential benefits of Iyengar yoga on clinical symptoms, psychospiritual functioning and visceral sensitivity. Yoga is thought to bring physical, psychological and spiritual benefits to practitioners and has been associated with reduced stress and pain. Through its focus on restoration and use of props, Iyengar yoga is especially designed to decrease arousal and promote psychospiritual resources in physically compromised individuals. An extensive and standardized teacher-training program support Iyengar yoga's reliability and safety. It is hypothesized that yoga will be feasible with less than 20% attrition; and the yoga group will demonstrate significantly improved outcomes compared to controls, with physiological and psychospiritual mechanisms contributing to improvements. Methods/Design Sixty irritable bowel syndrome patients aged 14-26 will be randomly assigned to a standardized 6-week twice weekly Iyengar yoga group-based program or a wait-list usual care control group. The groups will be compared on the primary clinical outcomes of irritable bowel syndrome symptoms, quality of life and global improvement at post-treatment and 2-month follow-up. Secondary outcomes will include visceral pain sensitivity assessed with a standardized
Hyperserotonemia; Serotonergic syndrome; Serotonin toxicity; SSRI - serotonin syndrome; MAO - serotonin syndrome ... brain area. For example, you can develop this syndrome if you take migraine medicines called triptans together ...
Gnanathicam Victoria NAOMI
Full Text Available Introduction:most teachers of hearing and visually impaired children in India have to learn more about the prevalence and characteristics of Usher Syndrome. Keeping in mind the need to address this neglected population, the present study was designed and executed in South India.Goals:the goals of the study were to identify students with Usher Syndrome in educational settings using indigenous techniques, and to develop and describe a protocol for identifying these students.Methodology:seven hundred hearing impaired students studying in residential and inclusive schools in four districts of the State Tamil Nadu were screened using tools which included screening for distance and near vision, field of vision, dark adaptation, glare and contrast sensitivity.Results:ten students between the age of 14- 20 were found to be at risk of having Usher Syndrome. Finally, 6 subjects who had a diagnosis of retinitis pigmentosa were clinically identified with Usher Syndrome.Conclusion:these identification strategies will assist special education and rehabilitation professionals in recognizing symptoms of Usher Syndrome so that they will be able to refer these children for diagnostic and supportive services.
The greatest challenge of the Southern African Development Community (SADC) continues to be the need to build a life for its people free from poverty, diseases, human rights abuses, gender inequality and environmental degradation. Gender activists played a lead role in influencing the development and adoption, on the ...
Back, Hyang-Im; Ha, Ki-Chan; Kim, Hye-Mi; Kim, Min-Gul; Yu, Ok-Kyeong; Byun, Moon-Sun; Jeong, Do-Youn; Jeong, Seong-Yeop; Cha, Youn-Soo; Park, Tae-Sun
Metabolic syndrome is a set of disorders that increases the risk of developing cardiovascular disease. The primary target of treatment of patients with metabolic syndrome is therapeutic lifestyle change. Numerous preclinical study have reported positive effects of chungkookjang in in vivo models of diabetes and obesity, but there is a paucity of controlled clinical trials on variables of metabolic syndrome in obese subjects. Thus, the objective of this trial is to examine the effect of chungkookjang compared to placebo on variables of metabolic syndrome in overweight/obese subjects. This double-blind randomized controlled crossover trial will be conducted on 120 overweight/obese subjects; aged 19-29 years. Subjects will be recruited from the Chonbuk National University, Jeonju, South Korea. Enrolled subjects will be randomly assigned to two groups of equal number; one group received 35 g of chungkookjang (n = 60) and the other group received placebo (n = 60) on a regular daily basis for 12 weeks. After a 12-week washout period, the groups will be crossed over. In addition to anthropometric measures and blood pressure, glucose parameter, lipid profile, adipocytokine, and carnitine assay will be determined at baseline and 12 week. Also, safety will be assessing by measuring total bilirubin, alkaline phosphatase, alanine transaminase, aspartate aminotransferase, total protein, albumin, blood urea nitrogen, creatinine, and creatine kinase at baseline and 12 weeks. 24-hour dietary recalls were collected at the baseline and at the end of the trial. This trial will evaluate the effects of chungkookjang on variables of metabolic syndrome in overweight/obese subjects. The results of this study may contribute to the reduction of risk factor for metabolic syndrome caused by obesity. Clinical trials NCT01811511.
Zampini, Laura; D'Odorico, Laura
Although children with Down's syndrome show some delays in each area of language development, their morphosyntactic competence appears to be more severely compromised than their lexical skills and, therefore, they are frequently mentioned as an example of dissociation between grammar and lexicon. The principal aim of the present study was to compare the lexical and syntactic development of Italian children with Down's syndrome with that of typically developing children, considering their spontaneous production. Particular attention was given to the relationships between these linguistic areas and the transition from single-word utterances to multiword combinations (that is, transitional forms). Twenty-four children participated in the study: twelve with Down's syndrome and twelve typically developing children. On average, the children with Down's syndrome participating in the study had a vocabulary size of about 450 words; and their mean chronological age was 54 months, whereas their mean developmental age was 30 months. The criteria for inclusion in the typically developing children group were a mean vocabulary size similar to that of the participants with Down's syndrome and a mean chronological age equivalent to the mean developmental age of the children with Down's syndrome. Each child's spontaneous verbal production was assessed during a parent-child play session. Data analyses focused on both lexical variables (type and tokens, vocabulary composition) and syntactic variables (frequency and types of transitional forms, frequency of utterances with different degree of complexity, and argument structure of verbs). The vocabulary composition of the children with Down's syndrome appeared to be simpler than that of the typically developing children at the same lexical size. Children with Down's syndrome used a higher number of transitional forms, but their production of multi-word utterances was less frequent; they were able to use word combinations, but they
This project developed a statewide policy and criteria for collecting, analyzing, and managing global position system (GPS) survey data. The research project determined the needs of the Department in adopting the GPS real time kinetic (GPS RTK) stake...
National Oceanic and Atmospheric Administration, Department of Commerce — Cruise objectives include: 1) Investigate performance characteristics of new research bottom trawl; 2) Develop standard operating procedures for the NEFSC Bottom...
antimicrobials are employed and the entire bacteria population is not killed. Bacteria that possess resistance genes or have developed resistance to...to combat the resistant pathogenic strains (Knobler et al. 2003). This strategy may provide an opportunity for the bacterial pool to be further...Bacillus anthracis. As the current application of broad-spectrum antimicrobials promotes the development of multi- drug resistant microorganisms
Galeote, Miguel; Soto, Pilar; Sebastian, Eugenia; Checa, Elena; Sanchez-Palacios, Concepcion
The objective of this work was to analyze morphosyntactic development in a wide sample of children with Down syndrome (DS) ("n" = 92) and children with typical development (TD) ("n" = 92) with a mental age (MA) of 20 to 29 months. Children were individually matched for gender and MA (Analysis 1) and for vocabulary size…
Tarman, T.D.; Pierson, L.G.; Brenkosh, J.P. [and others
This is the summary report for the Protocol Extensions for Asynchronous Transfer Mode project, funded under Sandia`s Laboratory Directed Research and Development program. During this one-year effort, techniques were examined for integrating security enhancements within standard ATM protocols, and mechanisms were developed to validate these techniques and to provide a basic set of ATM security assurances. Based on our experience during this project, recommendations were presented to the ATM Forum (a world-wide consortium of ATM product developers, service providers, and users) to assist with the development of security-related enhancements to their ATM specifications. As a result of this project, Sandia has taken a leading role in the formation of the ATM Forum`s Security Working Group, and has gained valuable alliances and leading-edge experience with emerging ATM security technologies and protocols.
Kamphuis, C; Dela Rue, B T; Eastwood, C R
This paper reports on a field validation of previously developed protocols for evaluating the performance of in-line mastitis-detection systems. The protocols outlined 2 requirements of these systems: (1) to detect cows with clinical mastitis (CM) promptly and accurately to enable timely and appropriate treatment and (2) to identify cows with high somatic cell count (SCC) to manage bulk milk SCC levels. Gold standard measures, evaluation tests, performance measures, and performance targets were proposed. The current study validated the protocols on commercial dairy farms with automated in-line mastitis-detection systems using both electrical conductivity (EC) and SCC sensor systems that both monitor at whole-udder level. The protocol for requirement 1 was applied on 3 commercial farms. For requirement 2, the protocol was applied on 6 farms; 3 of them had low bulk milk SCC (128×10(3) cells/mL) and were the same farms as used for field evaluation of requirement 1. Three farms with high bulk milk SCC (270×10(3) cells/mL) were additionally enrolled. The field evaluation methodology and results were presented at a workshop including representation from 7 international suppliers of in-line mastitis-detection systems. Feedback was sought on the acceptance of standardized performance evaluation protocols and recommended refinements to the protocols. Although the methodology for requirement 1 was relatively labor intensive and required organizational skills over an extended period, no major issues were encountered during the field validation of both protocols. The validation, thus, proved the protocols to be practical. Also, no changes to the data collection process were recommended by the technology supplier representatives. However, 4 recommendations were made to refine the protocols: inclusion of an additional analysis that ignores small (low-density) clot observations in the definition of CM, extension of the time window from 4 to 5 milkings for timely alerts for CM
Carl Houtman; Nancy Ross Sutherland; David Bormett; Donald Donermeyer
The ultimate goal of the US Postal Service (USPS) Environmentally Benign Stamp Program is to develop stamp adhesives that can be removed by unit operations found in recycling mills. The maintenance of final product quality specifications for a recycling mill while loading the feedstock with a significant quantity of adhesive is the criterion for success of this program...
This paper is based on a project that employed a systematic approach to involve and mobilise rural communities in water quality control programmes. The aim of the project is to develop methodologies that could be employed in rural areas to control the generation of diffuse pollution. The investigation is based on a pilot ...
Full Text Available Purpose. Comparative analysis of central and peripheral corneal thickness in PEX patients using three different imaging systems: Pentacam-Scheimpflug device, time-domain optical coherence tomography (OCT Visante, and swept-source OCT Casia. Materials and Methods. 128 eyes of 80 patients with diagnosed PEX were examined and compared with 112 normal, non-PEX eyes of 72 cataract patients. The study parameters included 5 measured zones: central and 4 peripheral (superior, inferior, nasal, and temporal. Results. The mean CCT in eyes with PEX syndrome measured with all three instruments was thicker than that in normal eyes. Corneal thickness measurements in the PEX group were statistically significantly different between Pentacam and OCT Casia: central corneal thickness (p=0.04, inferior corneal zone (p=0.01, and nasal and temporal corneal zones (p<0.01. Between Pentacam and OCT Visante inferior, nasal and temporal corneal zones were statistically significantly different (p<0.01. Between OCT Casia and OCT Visante, there were no statistically significant differences in measured parameters values. Conclusion. The central corneal thickness in eyes with PEX syndrome measured with three different independent methods is higher than that in the non-PEX group, and despite variable peripheral corneal thickness, this one parameter is still crucial in intraocular pressure measurements.
Full Text Available Many congenital diseases are associated with growth failure, and patients with these diseases have specific growth patterns. As the growth patterns of affected individuals differ from those of normal populations, it is challenging to detect additional conditions that can influence growth using standard growth charts. Disease-specific growth charts are thus very useful tools and can be helpful for understanding the growth pattern and pathogenesis of congenital diseases. In addition, disease-specific growth charts allow doctors to detect deviations from the usual growth patterns for early diagnosis of an additional condition and can be used to evaluate the effects of growth-promoting treatment for patients. When developing these charts, factors that can affect the reliability of the charts should be considered. These factors include the definition of the disease with growth failure, selection bias in the measurements used to develop the charts, secular trends of the subjects, the numbers of subjects of varying ages and ethnicities, and the statistical method used to develop the charts. In this review, we summarize the development of disease-specific growth charts for Japanese individuals with Turner syndrome and Noonan syndrome and evaluate the efforts to collect unbiased measurements of subjects with these diseases. These charts were the only available disease-specific growth charts of Turner syndrome and Noonan syndrome for Asian populations and were developed using a Japanese population. Therefore, when these charts are adopted for Asian populations other than Japanese, different growth patterns should be considered.
Isojima, Tsuyoshi; Yokoya, Susumu
Many congenital diseases are associated with growth failure, and patients with these diseases have specific growth patterns. As the growth patterns of affected individuals differ from those of normal populations, it is challenging to detect additional conditions that can influence growth using standard growth charts. Disease-specific growth charts are thus very useful tools and can be helpful for understanding the growth pattern and pathogenesis of congenital diseases. In addition, disease-specific growth charts allow doctors to detect deviations from the usual growth patterns for early diagnosis of an additional condition and can be used to evaluate the effects of growth-promoting treatment for patients. When developing these charts, factors that can affect the reliability of the charts should be considered. These factors include the definition of the disease with growth failure, selection bias in the measurements used to develop the charts, secular trends of the subjects, the numbers of subjects of varying ages and ethnicities, and the statistical method used to develop the charts. In this review, we summarize the development of disease-specific growth charts for Japanese individuals with Turner syndrome and Noonan syndrome and evaluate the efforts to collect unbiased measurements of subjects with these diseases. These charts were the only available disease-specific growth charts of Turner syndrome and Noonan syndrome for Asian populations and were developed using a Japanese population. Therefore, when these charts are adopted for Asian populations other than Japanese, different growth patterns should be considered.
Assessing the feasibility, acceptability, and potential effectiveness of a behavioral-automaticity focused lifestyle intervention for African Americans with metabolic syndrome: The Pick two to Stick to protocol
Full Text Available Background: Metabolic syndrome (MetS significantly increases the risk of developing diabetes and cardiovascular disease. Being physically active and eating a healthy diet can reduce MetS risk factors. Too frequently, however, studies report that the effects of interventions targeting those factors are not maintained once interventions are withdrawn. A potential solution to the problem is targeting behavioral automaticity (habit-development to aid in initiation and maintenance of health-behavior changes. The Pick two to Stick To (P2S2, is an 8-week, theory-based hybrid (face-to-face/telecoaching habit focused lifestyle intervention designed to increase healthful physical activity and dietary behavioral automaticity. The purpose of this article is to describe the rationale and protocol for evaluating the P2S2 program's feasibility, acceptability and potential effectiveness. Methods: Using a prospective, non-comparative design, the P2S2 program will be implemented by trained occupational therapy ‘coaches’ to 40 African Americans aged 40 and above with MetS recruited from the emergency department. Semi-structured interviews with participants, bi-weekly research meetings with study staff, and observations of intervention delivery will provide data for a process evaluation. Estimates of effectiveness include weight, blood pressure, waist circumference, BMI, and behavioral automaticity measures that will be collected at baseline and week 20. Conclusion: The P2S2 program could facilitate the development of healthful dietary and physical activity habits in an underserved population. Whether interventions aimed at changing habits can feasibly influence this automaticity, particularly for high-risk, low resource communities where other barriers exist, is not known. This pilot study, therefore, will fill an important gap, providing insight to inform subsequent trials. Keywords: Habits, Behavioral automaticity, Health behavior, Metabolic syndrome
and the environment. Nanomaterials are also being developed for a myriad of military applications, such as sensors, coatings, electronics, textiles ...Tissue Resistance Measurement Chamber to instrument with electrode leads (longer electrode lead wire should attach to bottom portion of chamber to...obtain correct polarity). If electrodes have been stored dry, fill chamber with PBS deep enough to immerse top electrode and equilibrate electrodes for
Cheema, B.; Molyneux, E. M.; Emmanuel, J. C.; M'baya, B.; Esan, M.; Kamwendo, H.; Kalilani-Phiri, L.; Boele van Hensbroek, M.
Severe anaemia is a common childhood emergency in developing countries. Practical evidence-based guidance on when to transfuse, volume of transfusion and ideal duration of transfusion is lacking. The aim of this study is to develop a paediatric transfusion protocol for use in under-resourced
Ana R Cabrera
Full Text Available A novel feeding protocol for delivery of bio-active agents to Varroa mites was developed by providing mites with honey bee larva hemolymph supplemented with cultured insect cells and selected materials delivered on a fibrous cotton substrate. Mites were starved, fed on treated hemolymph to deliver selected agents and then returned to bee larvae. Transcript levels of two reference genes, actin and glyceraldehyde 3-phosphate dehydrogenase (GAPDH, as well as for nine selected genes involved in reproductive processes showed that the starvation and feeding protocol periods did not pose a high level of stress to the mites as transcript levels remained comparable between phoretic mites and those completing the protocol. The feeding protocol was used to deliver molecules such as hormone analogs or plasmids. Mites fed with Tebufenozide, an ecdysone analog, had higher transcript levels of shade than untreated or solvent treated mites. In order to extend this feeding protocol, cultured insect cells were incorporated to a final ratio of 1 part cells and 2 parts hemolymph. Although supplementation with Bombyx mori Bm5 cells increased the amount of hemolymph consumed per mite, there was a significant decrease in the percentage of mites that fed and survived. On the other hand, Drosophila melanogaster S2 cells reduced significantly the percentage of mites that fed and survived as well as the amount of hemolymph consumed. The feeding protocol provides a dynamic platform with which to challenge the Varroa mite to establish efficacy of control agents for this devastating honey bee pest.
Cabrera, Ana R; Shirk, Paul D; Teal, Peter E A
A novel feeding protocol for delivery of bio-active agents to Varroa mites was developed by providing mites with honey bee larva hemolymph supplemented with cultured insect cells and selected materials delivered on a fibrous cotton substrate. Mites were starved, fed on treated hemolymph to deliver selected agents and then returned to bee larvae. Transcript levels of two reference genes, actin and glyceraldehyde 3-phosphate dehydrogenase (GAPDH), as well as for nine selected genes involved in reproductive processes showed that the starvation and feeding protocol periods did not pose a high level of stress to the mites as transcript levels remained comparable between phoretic mites and those completing the protocol. The feeding protocol was used to deliver molecules such as hormone analogs or plasmids. Mites fed with Tebufenozide, an ecdysone analog, had higher transcript levels of shade than untreated or solvent treated mites. In order to extend this feeding protocol, cultured insect cells were incorporated to a final ratio of 1 part cells and 2 parts hemolymph. Although supplementation with Bombyx mori Bm5 cells increased the amount of hemolymph consumed per mite, there was a significant decrease in the percentage of mites that fed and survived. On the other hand, Drosophila melanogaster S2 cells reduced significantly the percentage of mites that fed and survived as well as the amount of hemolymph consumed. The feeding protocol provides a dynamic platform with which to challenge the Varroa mite to establish efficacy of control agents for this devastating honey bee pest.
Ben-Dor, Itsik; Fuchs, Shmuel; Kornowski, Ran
Cell transplantation has recently emerged as a promising therapeutic approach to ischemic cardiomyopathy syndromes. Clinical studies suggest important benefits, including improved myocardial perfusion and function. The safety profile so far seems to be high overall, although the technique may harbor several adverse effects, such as ventricular arrhythmia, acceleration of atherosclerosis or restenosis, and induction of ischemic events. Multiple factors may affect the safety of cell infusion into the diseased heart, including the mode of delivery, the type of cells injected, compound characterization, and the heart status, function, and arrhythmogenic potential. Also, any adjunctive treatment used to enhance cellular homing and/or transdifferentiation increases the likelihood of unexpected local or systemic toxicity or side effects. In the present review, we discuss the potential hazards of this novel treatment and its relationship to technical considerations.
Full Text Available The fascinating process of organ formation and patterns of forms acquistion stick together in plant and animal development intriguing the observers, from the great greek philosopher to the great Johann Wolfgang von Goethe, from D’Arcy Wentworth Thompson and Conrad Hal Waddington to present day biologists, scientists and laypeople! Each of us is fascinated by these natural phenomena and wondering how the genome, the same genome (constantly the very same genome in each cell, from the fertilized egg, with the only exception of those organisms were gene expression is primarily controlled by pre-transcription coarse mechanisms like chromatin elimination, not infrequently occurring in Nematoda, Insects and Crustacea to name a few reach such a fine tuning capacity to modulate and direct gene expressions patterns towards specific organ formation and form acquisition. Which are ultimately based on the production of specific sets of proteins characterizing the different cell types.....
Song, Misoon; Choi, Suyoung; Kim, Se-An; Seo, Kyoungsan; Lee, Soo Jin
Development of behavior theory-based health promotion programs is encouraged with the paradigm shift from contents to behavior outcomes. This article describes the development process of the diabetes self-management program for older Koreans (DSME-OK) using intervention mapping (IM) protocol. The IM protocol includes needs assessment, defining goals and objectives, identifying theory and determinants, developing a matrix to form change objectives, selecting strategies and methods, structuring the program, and planning for evaluation and pilot testing. The DSME-OK adopted seven behavior objectives developed by the American Association of Diabetes Educators as behavioral outcomes. The program applied an information-motivation-behavioral skills model, and interventions were targeted to 3 determinants to change health behaviors. Specific methods were selected to achieve each objective guided by IM protocol. As the final step, program evaluation was planned including a pilot test. The DSME-OK was structured as the 3 determinants of the IMB model were intervened to achieve behavior objectives in each session. The program has 12 weekly 90-min sessions tailored for older adults. Using the IM protocol in developing a theory-based self-management program was beneficial in terms of providing a systematic guide to developing theory-based and behavior outcome-focused health education programs.
Ridder, Hanne Mette Ochsner; Wigram, Tony; Ottesen, Anne Marie
. As an example of a non-pharmacologic treatment procedure music therapy was investigated. With the focus to develop a research protocol for a future larger population study a pilot study was carried out. In two case studies a combination of data collection methods were examined with the overall goal to document...... of Life (ADRQL), the Cohen-Mansfield Agitation Inventory (CMAI), and the Neuro-Psychiatric Inventory (NPI), and related to case descriptions and video analyses. Results: Recommendations for a mixed method research protocol focused on measuring the effect of music therapy with persons with frontotemporal......, and pharmacological treatment of the psychiatric symptoms is difficult, requiring specialist proficiency in the field. Pilot study: As there is not yet sufficient research that examines the effects of non-pharmacologic treatment with this group there is a need to develop valid and reliable research protocols...
There is a considerable and growing body of research investigating reading development in children with Down syndrome. However, there appears to be a common gap between the research evidence and instructional practices. It has been argued that teachers have insufficient information to enable them to implement effective literacy instruction with…
Marschik, Peter B.; Kaufmann, Walter E.; Sigafoos, Jeff; Wolin, Thomas; Zhang, Dajie; Bartl-Pokorny, Katrin D.; Pini, Giorgio; Zappella, Michele; Tager-Flusberg, Helen; Einspieler, Christa; Johnston, Michael V.
We delineated the achievement of early speech-language milestones in 15 young children with Rett syndrome ("MECP2" positive) in the first two years of life using retrospective video analysis. By contrast to the commonly accepted concept that these children are normal in the pre-regression period, we found markedly atypical development of…
O'toole, Ciara; Chiat, Shula
Background: Understanding the relationship between preverbal skills and language development has important implications for identifying communication delay/disorders and for early childhood intervention. In the case of children with Down syndrome, it is well established that symbolic play is associated with the emergence of language. However, the…
Koshy, Beena; Navamani, Kirubakaran; Oommen, Samuel Philip; Srivastava, Vivi M
In this retrospective study, we describe the profile of 88 children with Down syndrome. The average BMI for children showed a progressive increase with age. Compared to the previously published development profile, there was a significant improvement in the language domain.
Full Text Available Abstract Background In recent years, the genome biology community has expended considerable effort to confront the challenges of managing heterogeneous data in a structured and organized way and developed laboratory information management systems (LIMS for both raw and processed data. On the other hand, electronic notebooks were developed to record and manage scientific data, and facilitate data-sharing. Software which enables both, management of large datasets and digital recording of laboratory procedures would serve a real need in laboratories using medium and high-throughput techniques. Results We have developed iLAP (Laboratory data management, Analysis, and Protocol development, a workflow-driven information management system specifically designed to create and manage experimental protocols, and to analyze and share laboratory data. The system combines experimental protocol development, wizard-based data acquisition, and high-throughput data analysis into a single, integrated system. We demonstrate the power and the flexibility of the platform using a microscopy case study based on a combinatorial multiple fluorescence in situ hybridization (m-FISH protocol and 3D-image reconstruction. iLAP is freely available under the open source license AGPL from http://genome.tugraz.at/iLAP/. Conclusion iLAP is a flexible and versatile information management system, which has the potential to close the gap between electronic notebooks and LIMS and can therefore be of great value for a broad scientific community.
Wevrett, J.; Fenwick, A.; Scuffham, J.; Nisbet, A.
Within the field of molecular radiotherapy, there is a significant need for standardisation in dosimetry, in both quantitative imaging and dosimetry calculations. Currently, there are a wide range of techniques used by different clinical centres and as a result there is no means to compare patient doses between centres. To help address this need, a 3 year project was funded by the European Metrology Research Programme, and a number of clinical centres were involved in the project. One of the required outcomes of the project was to develop a calibration protocol for three dimensional quantitative imaging of volumes of interest. Two radionuclides were selected as being of particular interest: iodine-131 (131I, used to treat thyroid disorders) and lutetium-177 (177Lu, used to treat neuroendocrine tumours). A small volume of activity within a scatter medium (water), representing a lesion within a patient body, was chosen as the calibration method. To ensure ease of use in clinical centres, an "off-the-shelf" solution was proposed - to avoid the need for in-house manufacturing. The BIODEX elliptical Jaszczak phantom and 16 ml fillable sphere were selected. The protocol was developed for use on SPECT/CT gamma cameras only, where the CT dataset would be used to correct the imaging data for attenuation of the emitted photons within the phantom. The protocol corrects for scatter of emitted photons using the triple energy window correction technique utilised by most clinical systems. A number of clinical systems were tested in the development of this protocol, covering the major manufacturers of gamma camera generally used in Europe. Initial imaging was performed with 131I and 177Lu at a number of clinical centres, but due to time constraints in the project, some acquisitions were performed with 177Lu only. The protocol is relatively simplistic, and does not account for the effects of dead-time in high activity patients, the presence of background activity surrounding
Brassil, Donna; Kost, Rhonda G; Dowd, Kathleen A; Hurley, Arlene M; Rainer, Tyler-Lauren; Coller, Barry S
The development of translational clinical research protocols is complex. To assist investigators, we developed a structured supportive guidance process (Navigation) to expedite protocol development to the standards of good clinical practice (GCP), focusing on research ethics and integrity. Navigation consists of experienced research coordinators leading investigators through a concerted multistep protocol development process from concept initiation to submission of the final protocol. To assess the effectiveness of Navigation, we collect data on the experience of investigators, the intensity of support required for protocol development, IRB review outcomes, and protocol start and completion dates. One hundred forty-four protocols underwent Navigation and achieved IRB approval since the program began in 2007, including 37 led by trainee investigators, 26 led by MDs, 9 by MD/PhDs, 57 by PhDs, and 12 by investigators with other credentials (e.g., RN, MPH). In every year, more than 50% of Navigated protocols were approved by the IRB within 30 days. For trainees who had more than one protocol navigated, the intensity of Navigation support required decreased over time. Navigation can increase access to translational studies for basic scientists, facilitate GCP training for investigators, and accelerate development and approval of protocols of high ethical and scientific quality. © 2014 Wiley Periodicals, Inc.
The main objective of this project was to develop and layout a protocol for the long-term monitoring and assessment of the performance of concrete deck and crack sealants in the field. To accomplish this goal, a total of six bridge decks were chosen ...
Protocols were developed and evaluated to assess the efficacy and environmental safety of commercial oil spill bioremediation agents (CBAs). Test systems that simulate oil slicks on open water or oiled sandy beaches were used to test the effectiveness of CBAs. Gravimetric and gas...
Huebner, Lois A.; Weitzman, Lauren M.; Mountain, Lisa M.; Nelson, Kris L.; Oakley, Danielle R.; Smith, Michael L.
Counseling centers have been challenged to effectively treat the growing number of college students who struggle with disordered eating. In response to this critical issue, an Eating Disorder Assessment and Treatment Protocol (EDATP) was developed to assist clinical disposition in the counseling center setting and identify treatment guidelines…
Renggaman, Anriansyah; Choi, Hong L; Sudiarto, Sartika Ia; Alasaarela, Laura; Nam, Ok S
Due to increased interest in animal welfare, there is now a need for a comprehensive assessment protocol to be used in intensive pig farming systems. There are two current welfare assessment protocols for pigs: Welfare Quality® Assessment Protocols (applicable in the Europe Union), that mostly focuses on animal-based measures, and the Swine Welfare Assurance Program (applicable in the United States), that mostly focuses on management- and environment-based measures. In certain cases, however, animal-based measures might not be adequate for properly assessing pig welfare status. Similarly, welfare assessment that relies only on environment- and management-based measures might not represent the actual welfare status of pigs. Therefore, the objective of this paper was to develop a new welfare protocol by integrating animal-, environment-, and management-based measures. The background for selection of certain welfare criteria and modification of the scoring systems from existing welfare assessment protocols are described. The developed pig welfare assessment protocol consists of 17 criteria that are related to four main principles of welfare (good feeding, good housing, good health, and appropriate behavior). Good feeding, good housing, and good health were assessed using a 3-point scale: 0 (good welfare), 1 (moderate welfare), and 2 (poor welfare). In certain cases, only a 2-point scale was used: 0 (certain condition is present) or 2 (certain condition is absent). Appropriate behavior was assessed by scan sampling of positive and negative social behaviors based on qualitative behavior assessment and human-animal relationship tests. Modification of the body condition score into a 3-point scale revealed pigs with a moderate body condition (score 1). Moreover, additional criteria such as feed quality confirmed that farms had moderate (score 1) or poor feed quality (score 2), especially those farms located in a high relative humidity region. The developed protocol can be
We outline a step-by-step protocol that incorporates a number of theoretical and computational methodologies to evaluate the structural and electronic properties of pi-conjugated semiconducting materials in the condensed phase. Our focus is on methodologies appropriate for the characterization, at the molecular level, of the morphology in blend systems consisting of an electron donor and electron acceptor, of importance for understanding the performance properties of bulk-heterojunction organic solar cells. The protocol is formulated as an introductory manual for investigators who aim to study the bulk-heterojunction morphology in molecular details, thereby facilitating the development of structure morphology property relationships when used in tandem with experimental results.
Full Text Available What is the threshold for the prediction of moderate to severe or severe ovarian hyperstimulation syndrome (OHSS based on the number of growing follicles ≥ 11 mm and/or estradiol (E2 levels?The optimal threshold of follicles ≥11 mm on the day of hCG to identify those at risk was 19 for both moderate to severe OHSS and for severe OHSS. Estradiol (E2 levels were less prognostic of OHSS than the number of follicles ≥ 11 mm.In comparison to long gonadotropin-releasing hormone (GnRH agonist protocols, the risk of severe OHSS is reduced by approximately 50% in a GnRH antagonist protocol for ovarian stimulation prior to in vitro fertilisation (IVF, while the two protocols provide equal chances of pregnancy per initiated cycle. Nevertheless, moderate to severe OHSS may still occur in GnRH antagonist protocols if human chorionic gonadotropin (hCG is administered to trigger final oocyte maturation, especially in high responder patients. Severe OHSS following hCG trigger may occur with an incidence of 1-2% in a relatively young (aged 18 to 36 years IVF population treated in a GnRH-antagonist protocol.From the Engage, Ensure and Trust trials, in total, 2,433 women who received hCG for oocyte maturation and for whom the number of follicles ≥ 11 mm and the level of E2 on the day of hCG administration were known were included in the analyses.The threshold for OHSS prediction of moderate and severe OHSS was assessed in women treated with corifollitropin alfa or daily recombinant follicle stimulation hormone (rFSH in a gonadotropin-releasing hormone (GnRH-antagonist protocol. Receiver operating characteristics curve analyses for moderate to severe OHSS and severe OHSS were performed on the combined dataset and the sensitivity and specificity for the optimal threshold of number of follicles ≥ 11 mm, E2 levels on the day of (hCG, and a combination of both, were determined.The optimal threshold of follicles ≥ 11 mm on the day of hCG to identify those at
Mokhnach, Larisa; Anderson, Marilyn; Glorioso, Rachelle; Loeffler, Katie; Shinabarger, Kelly; Thorngate, Lauren; Yates, Marna; Diercks, Kristi; Berkan, Maureen; Hou, Shwu-Shin; Millar, April; Thomas, Karen A; Walker, Wendy; Zbirun, Ilona
Neonates in the neonatal intensive care nursery experience multiple, painful, tissue-damaging procedures daily. Pain among neonates is often underestimated and untreated, producing untoward consequences. A literature review established strong evidence supporting the use of sucrose as an analgesic for minor procedural pain among neonates. A review of unit practices and nurses' experiential evidence initiated the production of a standardized protocol in our unit at the University of Washington Medical Center NICU in Seattle.Nursing practices surrounding sucrose use differed widely in dose, timing, and patient application. We carefully evaluated evidence documenting the effectiveness as well as the safety of sucrose administration and wrote a protocol and practice standards for our primarily premature patient population. This article describes the development and execution of a standardized, nurse-implemented, sucrose protocol to reduce procedural pain.
Wolf, A; Mörgeli, R; Müller, A; Weiss, B; Spies, C
Intensive care treatment has long-term consequences that are often not immediately apparent to the health care providers. The combination of muscle weakness, cognitive damage, and psychological disorders is comprised under the term post-intensive care syndrome (PICS). Analgesia and sedation protocols, as well as nonpharmacological preventive and therapeutic approaches, are effective tools for avoiding complications and improving long-term survival. The principle of "early goal-directed therapy" is fundamental. Here, a treatment target is defined and continuously re-evaluated by validated monitoring methods. Evidence clearly supports a paradigm shift towards patients that are awake, attentive, and able to participate in their therapy. Individualized analgesia and (non)sedation approaches allow a Richmond Agitation-Sedation Scale (RASS) target value of 0/-1 for the majority of patients. Should sedation indeed be necessary, there must be a focus on avoiding oversedation, especially an early deep sedation.
Friberg, Eva G.
Doses to pediatric patients from CT examinations are known to be unnecessarily high if scan protocols developed for adult patients are adopted. This overexposure is most often not recognized by the operating radiographer, due to the digital behavior of the imaging system. Use of optimized size-specific pediatric scan protocols is therefore essential to keep the doses at an appropriate level. The aim of this study was to investigate the doses to pediatric patients from CT examinations and to evaluate the level of optimization of the scan protocols. Patient data, applied scan parameters together with the dose parameters volume computed tomography dose index (CTD vol ) and dose length product (DLP) for examinations of the head, chest and abdomen were collected by means of a questionnaire from five university hospitals. The effective dose was estimated from the total DLP by use of region-specific conversion coefficients (E DLP ). Totally 136, 108 and 82 questionnaires were received for examinations of the head, chest and abdomen, respectively. Large variations in patient doses between the hospitals were observed, addressing the need for optimization of the scan protocols in general. Most of the hospitals applied successive lower mAs with decreasing patient age for all scan areas, while the use of lower tube voltage for small patients and a higher tube voltage for large patients were more rarely. This indicates the presence, to a certain level, of size specific scan protocols at some Norwegian hospitals. Focus on developing size-specific scan protocols for pediatric patients are important to reduce the doses and risks associated with pediatric CT examinations. (author)
López, Jose R; Lorenzo, Laura; Marcelino-Pozuelo, Cinta; Marin-Arjona, M Carmen; Navas, Jose I
Pseudomonas baetica is a pathogen isolated in 2012 from wedge sole (Dicologoglossa cuneata). The aims of this study were (i) to determine the influence of temperature on its virulence, and (ii) to develop specific protocols for rapid diagnosis. Virulence assays carried out by bath using Senegalese sole fry showed that virulence is strongly influenced by temperature: LD50 at 14°C was 8.5 × 105 cfu ml-1 while at 20°C no mortalities were recorded. On the other hand, the high mortality rates observed in virulence assays involving intraperitoneal injection of 2.5 × 105 cfu g-1 suggest that P. baetica may be pathogenic for the five fish species tested (wedge sole, Senegalese sole, sea bream, European sea bass and meagre). Two PCR protocols, using specific primers targeting the gyrB and rpoD genes, were developed for rapid diagnosis from pure cultures. An additional protocol, using both primer sets, was also optimized for detection from fish tissue samples. Specificity was tested using 81 strains from 66 bacterial species, taxonomically and/or ecologically related; only the P. baetica strains showed the expected DNA amplicons. A specific dot-blot assay using polyclonal antibodies was also developed for differentiation of P. baetica from related species. Altogether, the protocols described here will constitute useful tools for diagnosis and clarify the relevance of this pathogen. © FEMS 2016. All rights reserved. For permissions, please e-mail: firstname.lastname@example.org.
Amit Dias, MD
Full Text Available Because depression is a major source of the global burden of illness-related disability, developing effective strategies for reducing its incidence is an important public health priority, especially in low-income countries, where resources for treating depression are scarce. We describe in this report an intervention development project, funded by the US National Institute of Mental Health, to address “indicated” prevention of depression in older adults attending rural and urban primary care clinics in Goa, India. Specifically, participants in the “DIL” (“Depression in Later Life” trial were older adults living with mild, subsyndromal symptoms of depression and anxiety and thus at substantial risk for transitioning to fully syndromal major depression and anxiety disorders. Building upon the MANAS treatment trial (“Promoting Mental Health” led by Patel et al. in the same locale, we present here lessons learned in the development and implementation of a protocol utilizing lay health counsellors (LHCs who deliver a multi-component depression prevention intervention organized conceptually around Problem Solving Therapy for Primary Care (PST, with additional components addressing brief behavioural treatment of sleep disturbances such as insomnia, meeting basic social casework needs, and education in self-management of prevalent comorbid chronic diseases, such as diabetes mellitus. To our knowledge, DIL is the first randomized clinical trial addressing the prevention of depressive disorders ever conducted in a low- or middle-income country.
Dahlem, Chin Hwa Y; Horstman, Molly J; Williams, Brent C
To describe the development, implementation, and preliminary evaluation of Opioid Overdose Response Protocol using intranasal (IN) naloxone in a homeless shelter. Opioid Overdose Response Protocol and training curriculum were developed using the Massachusetts Department of Public Health Opioid Overdose Education and Naloxone Distribution (OEND) flow chart, the American Heart Association (AHA) simplified adult basic life support algorithm, and resources through Harms Reduction Coalition. Intranasal naloxone offers a safe and effective method for opioid reversal. To combat the rising incidence of opioid overdose, IN naloxone should be made available at homeless shelters and other facilities with high frequency of opioid overdose, including the training of appropriate staff. This project has demonstrated the effective training and implementation of an Opioid Overdose Response Protocol, based on feedback received from cardiopulmonary resuscitation (CPR) trained nonhealthcare staff. Nurse practitioners (NPs), with our focus on patient care, prevention, and education, are well suited to the deployment of this life-saving protocol. NPs are in critical positions to integrate opioid overdose prevention education and provide naloxone rescue kits in clinical practices. ©2015 American Association of Nurse Practitioners.
Full Text Available Susmeeta T Sharma,1 Lynnette K Nieman,1 Richard A Feelders2 1Program in Reproductive and Adult Endocrinology, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA; 2Division of Endocrinology, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, the Netherlands Abstract: Cushing’s syndrome is a rare disorder resulting from prolonged exposure to excess glucocorticoids. Early diagnosis and treatment of Cushing’s syndrome is associated with a decrease in morbidity and mortality. Clinical presentation can be highly variable, and establishing the diagnosis can often be difficult. Surgery (resection of the pituitary or ectopic source of adrenocorticotropic hormone, or unilateral or bilateral adrenalectomy remains the optimal treatment in all forms of Cushing’s syndrome, but may not always lead to remission. Medical therapy (steroidogenesis inhibitors, agents that decrease adrenocorticotropic hormone levels or glucocorticoid receptor antagonists and pituitary radiotherapy may be needed as an adjunct. A multidisciplinary approach, long-term follow-up, and treatment modalities customized to each individual are essential for optimal control of hypercortisolemia and management of comorbidities. Keywords: Cushing’s syndrome, hypercortisolemia, treatment, epidemiology
Burman, Michael A; Simmons, Cassandra A; Hughes, Miles; Lei, Lei
Classical fear conditioning is commonly used to study the biology of fear, anxiety and memory. Previous research demonstrated that delay conditioning requires a neural circuit involving the amygdala, but not usually the hippocampus. Trace and contextual fear conditioning require the amygdala and hippocampus. While these paradigms were developed primarily using rat models, they are increasingly being used in mice. The current studies develop trace fear conditioning and control paradigms to allow for the assessment of trace and delay fear conditioning in C57BL/6N mice. Our initial protocol yielded clear delay and contextual conditioning. However, trace conditioning failed to differentiate from an unpaired group and was not hippocampus-dependent. These results suggested that the protocol needed to be modified to specifically accommodate trace conditioning the mice. In order to reduce unconditioned freezing and increase learning, the final protocol was developed by decreasing the intensity of the tone and by increasing the inter-trial interval. Our final protocol produced trace conditioned freezing that was significantly greater than that followed unpaired stimulus exposure and was disrupted by hippocampus lesions. A review of the literature produced 90 articles using trace conditioning in mice. Few of those articles used any kind of behavioral control group, which is required to rule out non-associative factors causing fearful behavior. Fewer used unpaired groups involving tones and shocks within a session, which is the optimal control group. Our final trace conditioning protocol can be used in future studies examining genetically modified C57BL/6N mice. Copyright © 2013 Elsevier B.V. All rights reserved.
Beran, David; Yudkin, John S; de Courten, Maximilian
In order to improve the health of people with Type 1 diabetes in developing countries, a clear analysis of the constraints to insulin access and diabetes care is needed. We developed a Rapid Assessment Protocol for Insulin Access, comprising a series of questionnaires as well as a protocol...
Anderson, Rodney U; Wise, David; Sawyer, Tim; Nathanson, Brian H; Nevin Smith, J
Both men and women require treatment for urologic chronic pelvic pain syndromes (UCPPS), which includes interstitial cystitis/painful bladder syndrome, pelvic floor dysfunction, and chronic prostatitis/chronic pelvic pain syndrome. However, it is unknown if men and women respond differently to a protocol that includes specific physical therapy self-treatment using an internal trigger point wand and training in paradoxical relaxation. We performed a retrospective analysis by gender in a single arm, open label, single center clinical trial designed to evaluate the safety and effectiveness of a protocol for the treatment of UCPPS from October, 2008 to May, 2011. 314 adult men (79.9 %) and 79 (20.1 %) women met inclusion criteria. The median duration of symptoms was 60 months. The protocol required an initial 6-day clinic for training followed by a 6-month self-treatment period. The treatment included self-administered pelvic floor trigger point release with an internal trigger point device for physical therapy along with paradoxical relaxation training. Notable gender differences in prior treatments were observed. Men had a lower median [Interquartile Range] NIH-CPSI score at baseline than women (27 [21, 31] vs. 29 [22, 33], p = 0.04). Using a 1-10 scale with 10 = Most Severe, the median reduction in trigger point sensitivity was 3 units for both men and women after 6 months therapy (p = 0.74). A modified Intention to Treat analysis and a multivariate regression analysis found similar results. We conclude that men and women have similar, significant reductions in trigger point sensitivity with this protocol.
Purica, Ionut; John Saroudis
At the beginning of 2001 Romania ratified the Kyoto Protocol (Law 3/2001) thus becoming the first European country to do so. The mechanisms of the Kyoto Protocol are now opening new ways to sponsor the financing of nuclear projects. In May 2001 Societatea Nationala Nuclearoelectrica S.S. (SNN) and Atomic Energy of Canada Limited and ANSALDO of Italy signed a contract to complete the second CANDU unit at Cernavoda thus giving a new momentum to the nuclear program in Romania. The Government of Romania has indicated its desire to proceed with the completion of the other units on the Cernavoda site and is open to explore every potential financing mechanism to make this a reality. Although the Kyoto Protocol was not ratified by those countries that have the greatest need to reduce emissions, a market for emissions trading has developed, Canada being one of the important players in this market. Since the emission reduction per dollar invested in the Romanian nuclear program would bring much more reduction than the marginal reduction per dollar invested in environmental protection programs in Canada, where the saturation effect is already taking place, we consider that the application of the Kyoto Protocol mechanisms represents a realistic source for a sustainable cooperation of the two countries. This trend is in line with the latest activities of the International Atomic Energy Agency (IAEA). This paper analyzes the impact that the use of emissions credits would have on a typical financing scheme for a future CANDU project in Romania given the present situation and also proposes a model for the structure of the emissions trade that would generate a source of funding for the project. The conclusion is that there is real potential in using Kyoto Protocol mechanisms for financing nuclear development with benefits for both Romania and Canada. (authors)
Fonda, James W; Zawodniok, Maciej; Jagannathan, S; Watkins, Steve E
The development and the implementation issues of a reactive optimized energy-delay sub-network routing (OEDSR) protocol for wireless sensor networks (WSN) are introduced and its performance is contrasted with the popular ad hoc on-demand distance vector (AODV) routing protocol. Analytical results illustrate the performance of the proposed OEDSR protocol, while experimental results utilizing a hardware testbed under various scenarios demonstrate improvements in energy efficiency of the OEDSR protocol. A hardware platform constructed at the University of Missouri-Rolla (UMR), now the Missouri University of Science and Technology (MST), based on the Generation 4 Smart Sensor Node (G4-SSN) prototyping platform is also described. Performance improvements are shown in terms of end-to-end (E2E) delay, throughput, route-set-up time and drop rates and energy usage is given for three topologies, including a mobile topology. Additionally, results from the hardware testbed provide valuable lessons for network deployments. Under testing OEDSR provides a factor of ten improvement in the energy used in the routing session and extends network lifetime compared to AODV. Depletion experiments show that the time until the first node failure is extended by a factor of three with the network depleting and network lifetime is extended by 6.7%
Silvia Maria M. Magalhães
heterogeneous clinical and laboratorial presentations, which result in progressive bone marrow failure and evolve to acute leukemia. Anemia is a common symptom. In elderly patients, it is not attributed to the normal aging process and the cause is identified in most cases. The presence of cytopenias associated with bone marrow dysplastic disorders may also be due to secondary and reversible non clonal disorders. Cytogenetic abnormalities found in a proportion of patients with myelodysplastic syndromes may be helpful in the differential diagnosis and to evaluate the prognosis. Ancillary laboratory tests to show clonality are not usually available. The diagnosis of myelodysplastic syndromes is, therefore, made by exclusion, sometimes helped by the passage of time. Considering the proposed multistep myelodysplastic syndrome pathogenesis, patients at the lowest grade, presenting minimal dysplastic features may be difficult to diagnose. Vitamin B12 and/or folate deficiency, recent exposure to heavy metals and recent cytotoxic or growth factor therapy should be considered absolute exclusion factors precluding the definite diagnosis. Alcohol use, chronic inflammatory states, auto-immune disorders, chronic liver or kidney diseases, hormonal disorders and viral infections including HIV must be ruled out or interpreted with caution. Some diseases of the pluripotential stem cells must also be distinguished from myelodysplastic syndromes. Exclusion of paroxysmal nocturnal hemoglobinuria and aplastic anemia may be difficult in the less common hypocellular myelodysplastic syndromes. Dysplastic abnormalities of the bone marrow, therefore, do not in themselves establish a diagnosis of myelodysplasia and a protocol of exclusion should be carried out.
Augeray, Céline; Magalie, Mouton; Nathalie, Broustet; Marie-France, Perdereau; Chloé, Laconici; Jeanne, Loyen; Corinne, Fayolle; Jean-Louis, Picolo
The development of metrology of iron-55 in low-level radioactivity in environmental solid matrices was realised for conducting radioecological studies. A protocol was developed based on the adaptation of existing methods for the purification of iron-55 with selective chromatographic resin, which was then measured with liquid scintillation. The loss attached treatment chemical steps were quantified with elemental iron by Inductively Coupled Plasma Atomic Emission Spectrometry (ICP-AES). The tests were used to define the iron retention capacity of selective chromatographic resin, a key element in chemical treatment, and test sample size needed to reach the detection limit of 30 Bq kg −1 dry. The solid samples were analysed with the developed protocol. The activities obtained from iron-55 were below the detection limit of 30 Bq kg −1 dry. - Highlights: • To obtain the desired detection limit in environmental solid matrices, the choice of method was realised. • A protocol was thus developed with our resources to obtain a 30 Bq kg-1 dry detection limit. • The optimisation of the operating conditions is described and the activities obtained are presented
At the 43rd regular session of the IAEA General Conference, Member States requested the IAEA to help countries in assessing nuclear power's role in light of global environmental challenges and energy needs. Such assistance should include support for implementing national case studies, and facilitating access to relevant information about nuclear power's role in achieving sustainable development in developing countries and in mitigating GHG emissions. The dissemination of information on CDM is of particular importance to developing countries, so as to enable Member States interested in the mechanism to take an active and informed role in the debate regarding the Kyoto Protocol and eligible CDM technologies. Therefore, the Secretariat organized a series of information seminars, workshops and training courses for Member States on the Kyoto Protocol, the Clean Development Mechanism, Joint Implementation and Emissions Trading with particular emphasis on the potential role of nuclear power for GHG mitigation. On request, the Secretariat also provided training and assistance to several Member States in the preparation of national case studies that explore the potential role of nuclear power as a CDM technology. These case studies will be presented by the respective national study teams during this side event at the 44th IAEA General Conference. Within the general criteria included in the Kyoto Protocol, the decision on which technologies are eligible for GHG mitigation under the flexibility mechanisms is a sovereign decision of each country
Rodriguez S, Liliana
The climatic behavior of the planet and its consequences has favored debates about the models of development of the countries responsible for the accelerated deterioration of the atmosphere and of the natural phenomena by these recurrent days. Nevertheless, countries as United States, after signing commitments as the Convention on Climatic Change, refuse to acquire the obligations of the Kyoto Protocol, from fear of undergoing deterioration in their economies. In this setting, where the nation responsible for the emission of approximately 36% of the turned out effect greenhouse gases result of the human action in the planet does not commit itself to adopt restrictive policies to make its models of production but friendly with the nature although these measures begin to be imposed to other nations as determining factors in the international commercial negotiations, seems to be that the adoption of the Kyoto Protocol for developing countries as Colombia is not absolutely beneficial
H.J. Simonsz (Huib); K.E. Bärlocher; A. Rötig
textabstractDocumenta Ophthalmologica 1992, Volume 82, Issue 1-2, pp 73-79 Kearns-Sayre's syndrome developing in a boy who survived Pearson's syndrome caused by mitochondrial DNA deletion Dr H. J. Simonsz, K. Bärlocher, A. Rötig … show all 3 hide » Download PDF (2,322 KB) Abstract A 7-year-old
Assessing the feasibility, acceptability, and potential effectiveness of a behavioral-automaticity focused lifestyle intervention for African Americans with metabolic syndrome: The Pick two to Stick to protocol.
Fritz, Heather; Brody, Aaron; Levy, Philip
Metabolic syndrome (MetS) significantly increases the risk of developing diabetes and cardiovascular disease. Being physically active and eating a healthy diet can reduce MetS risk factors. Too frequently, however, studies report that the effects of interventions targeting those factors are not maintained once interventions are withdrawn. A potential solution to the problem is targeting behavioral automaticity (habit-development) to aid in initiation and maintenance of health-behavior changes. The Pick two to Stick To (P2S2), is an 8-week, theory-based hybrid (face-to-face/telecoaching) habit focused lifestyle intervention designed to increase healthful physical activity and dietary behavioral automaticity. The purpose of this article is to describe the rationale and protocol for evaluating the P2S2 program's feasibility, acceptability and potential effectiveness. Using a prospective, non-comparative design, the P2S2 program will be implemented by trained occupational therapy 'coaches' to 40 African Americans aged 40 and above with MetS recruited from the emergency department. Semi-structured interviews with participants, bi-weekly research meetings with study staff, and observations of intervention delivery will provide data for a process evaluation. Estimates of effectiveness include weight, blood pressure, waist circumference, BMI, and behavioral automaticity measures that will be collected at baseline and week 20. The P2S2 program could facilitate the development of healthful dietary and physical activity habits in an underserved population. Whether interventions aimed at changing habits can feasibly influence this automaticity, particularly for high-risk, low resource communities where other barriers exist, is not known. This pilot study, therefore, will fill an important gap, providing insight to inform subsequent trials.
Vallejos, Javier A.; Estay, Rodrigo A.
A common characteristic of deep mines in hard rock is induced seismicity. This results from stress changes and rock failure around mining excavations. Following large seismic events, there is an increase in the levels of seismicity, which gradually decay with time. Restricting access to areas of a mine for enough time to allow this decay of seismic events is the main approach in re-entry strategies. The statistical properties of aftershock sequences can be studied with three scaling relations: (1) Gutenberg-Richter frequency magnitude, (2) the modified Omori's law (MOL) for the temporal decay, and (3) Båth's law for the magnitude of the largest aftershock. In this paper, these three scaling relations, in addition to the stochastic Reasenberg-Jones model are applied to study the characteristic parameters of 11 large magnitude mining-induced aftershock sequences in four mines in Ontario, Canada. To provide guidelines for re-entry protocol development, the dependence of the scaling relation parameters on the magnitude of the main event are studied. Some relations between the parameters and the magnitude of the main event are found. Using these relationships and the scaling relations, a space-time-magnitude re-entry protocol is developed. These findings provide a first approximation to concise and well-justified guidelines for re-entry protocol development applicable to the range of mining conditions found in Ontario, Canada.
Damario, Mark A
The identification of patients at high risk for excessive responses to ovarian stimulation for in vitro fertilization and embryo transfer is essential in the tailoring of safe and effective treatment strategies. Known factors associated with increased sensitivity to gonadotropins include polycystic ovary syndrome, young age, prior ovarian hyperstimulation syndrome (OHSS), high baseline antral follicle count, and high baseline ovarian volume. Although several treatment strategies have been proposed for these patients, this report describes the experience using the dual suppression with gonadotropin step-down protocol. This protocol uses oral contraceptive pretreatment in combination with a long gonadotropin-releasing hormone agonist followed by a programmed step-down in gonadotropin dosing. Hormonal characteristics of dual suppression include an improved luteinizing hormone-to-follicle-stimulating hormone ratio and lower serum androgens, particularly dehydroepiandrosterone sulfate. Clinical characteristics of the protocol include a lower cancellation rate and favorable clinical and ongoing pregnancy rates per initiated cycle while mitigating the risk of OHSS. © Thieme Medical Publishers.
Paoletti, Claudia; Esbensen, Kim H
Material heterogeneity influences the effectiveness of sampling procedures. Most sampling guidelines used for assessment of food and/or feed commodities are based on classical statistical distribution requirements, the normal, binomial, and Poisson distributions-and almost universally rely on the assumption of randomness. However, this is unrealistic. The scientific food and feed community recognizes a strong preponderance of non random distribution within commodity lots, which should be a more realistic prerequisite for definition of effective sampling protocols. Nevertheless, these heterogeneity issues are overlooked as the prime focus is often placed only on financial, time, equipment, and personnel constraints instead of mandating acquisition of documented representative samples under realistic heterogeneity conditions. This study shows how the principles promulgated in the Theory of Sampling (TOS) and practically tested over 60 years provide an effective framework for dealing with the complete set of adverse aspects of both compositional and distributional heterogeneity (material sampling errors), as well as with the errors incurred by the sampling process itself. The results of an empirical European Union study on genetically modified soybean heterogeneity, Kernel Lot Distribution Assessment are summarized, as they have a strong bearing on the issue of proper sampling protocol development. TOS principles apply universally in the food and feed realm and must therefore be considered the only basis for development of valid sampling protocols free from distributional constraints.
Ali, Azhar Tareq; Warip, Mohd Nazri Mohd; Yaakob, Naimah; Abduljabbar, Waleed Khalid; Atta, Abdu Mohammed Ali
Vehicular Ad-hoc Networks (VANETs) is an area of wireless technologies that is attracting a great deal of interest. There are still several areas of VANETS, such as security and routing protocols, medium access control, that lack large amounts of research. There is also a lack of freely available simulators that can quickly and accurately simulate VANETs. The main goal of this paper is to develop a freely available VANETS simulator and to evaluate popular mobile ad-hoc network routing protocols in several VANETS scenarios. The VANETS simulator consisted of a network simulator, traffic (mobility simulator) and used a client-server application to keep the two simulators in sync. The VANETS simulator also models buildings to create a more realistic wireless network environment. Ad-Hoc Distance Vector routing (AODV), Dynamic Source Routing (DSR) and Dynamic MANET On-demand (DYMO) were initially simulated in a city, country, and highway environment to provide an overall evaluation.
Ivancic, William D.
The Satellite Networks and Architectures Branch of NASA's Lewis Research is addressing the issue of seamless interoperability of satellite networks with terrestrial networks. One of the major issues is improving reliable transmission protocols such as TCP over long latency and error-prone links. Many tuning parameters are available to enhance the performance of TCP including segment size, timers and window sizes. There are also numerous congestion avoidance algorithms such as slow start, selective retransmission and selective acknowledgment that are utilized to improve performance. This paper provides a strategy to characterize the performance of TCP relative to various parameter settings in a variety of network environments (i.e. LAN, WAN, wireless, satellite, and IP over ATM). This information can then be utilized to develop expert-system-based Internet protocols.
van Wersch, A.; Bonnema, J.; Prinsen, B.; Pruyn, J.; Wiggers, Th.; van Geel, A. N.
A multidisciplinary care protocol was developed to achieve continuity and integration of information. The protocol integrates medical, nursing, and a variety of extramural events and activities into a comprehensive description of 15 "moments" in the care of breast cancer surgery patients. Implementation and evaluation are reported and…
Mononen, J; Møller, Steen Henrik; Hansen, Steffen W
The WelFur project aims at the development of on-farm welfare assessment protocols for farmed foxes (the blue fox [Vulpes lagopus], the silver fox [Vulpes vulpes]) and mink (Neovison vison). The WelFur protocols are based on Welfare Quality® (WQ) principles and criteria. Here, we describe the Wel...
Full Text Available This study aims to explore and investigate the linguistic developments regarding children with Down syndrome. The study was conducted by interviewing children with Down syndrome. The study shows many problems with these children associated with difficulties with the reasoning attention, imitation, routines, and language development of children with Down syndrome, such as, speech problem, a problem related to pronunciation, sound or voice. This study uses the (Inductive and Qualitative primary research (deductive method with six case studies of children with Down syndrome, being induced on the Problems and difficulties of children with the Down syndrome in the field of language development.
Achsah A Mitchell
Full Text Available The transfer of ballast by the international shipping industry has negatively impacted the environment. To design such a protocol for the area, the ballast water tanks of seven bulk cargo vessels entering a Jamaican port were sampled between January 28, 2010 and August 17, 2010. Vessels originated from five ports and used three main routes, some of which conducted ballast water exchange. Twenty-six preserved and 22 live replicate zooplankton samples were obtained. Abundance and richness were higher than at temperate ports. Exchange did not alter the biotic composition but reduced the abundance. Two of the live sample replicates, containing 31.67 and 16.75 viable individuals m-3, were non-compliant with the International Convention for the Control and Management of Ships’ Ballast Water and Sediments. Approximately 12% of the species identified in the ballast water were present in the waters nearest the port in 1995 and 11% were present in the entire bay in 2005. The protocol designed from this study can be used to aid the establishment of a ballast water management system in the Caribbean or used as a foundation for the development of further protocols.
Full Text Available The Session Initiation Protocol (SIP is an application layer signaling protocol used to create, manage, and terminate sessions in an IP based network. SIP is considered as a transactional protocol. There are two main SIP transactions, the INVITE transaction and the non-INVITE transaction. The SIP INVITE transaction specification is described in an informal way in Request for Comments (RFC 3261 and modified in RFC 6026. In this paper we focus on the INVITE transaction of SIP, over reliable and unreliable transport mediums, which is used to initiate a session. In order to ensure the correctness of SIP, the INVITE transaction is modeled and verified using event-B method and its Rodin platform. The Event-B refinement concept allows an incremental development by defining the studied system at different levels of abstraction, and Rodin discharges almost all proof obligations at each level. This interaction between modeling and proving reduces the complexity and helps in assuring that the INVITE transaction SIP specification is correct, unambiguous, and easy to understand.
Paulo José Guimarães Da-Silva
Full Text Available Abstract Introduction In this work, the effect of a dynamic visual stimulation (DS protocol was used to induce egomotion, the center of pressure (COP displacement response. Methods DS was developed concerning the scenario structure (chessboard-pattern floor and furniture and luminance. To move the scenario in a discrete forward (or backward direction, the furniture is expanded (or reduced and the black and white background is reversed during floor translation while the luminance is increased (or reduced by steps of 2 cd/m2. This protocol was evaluated using COP signals from 29 healthy volunteers: standing on a force platform observing the virtual scene (1.72 × 1.16 m projected 1 m ahead (visual incidence angle: θl = 81.4° and θv = 60.2°, which moves with constant velocity (2 m/s during 250 ms. A set of 100 DS was applied in random order, interspersed by a 10 s of static scene. Results The Tukey post-hoc test (p < 0.001 indicated egomotion in the same direction of DS. COP displacement increased over stimulation (8.4 ± 1.7 to 22.6 ±5.3 mm, as well as time to recover stability (4.1 ± 0.4 to 7.2 ± 0.6 s. The peak of egomotion during DSF occurred 200 ms after DSB (Wilcoxon, p = 0.002. Conclusion The dynamic configuration of this protocol establishes virtual flow effects of linear egomotion dependent on the direction of the dynamic visual stimulation. This finding indicates the potential application of the proposed virtual dynamic stimulation protocol to investigate the cortical visual evoked response in postural control studies.
Elsman, Ellen B M; Leerlooijer, Joanne N; Ter Beek, Josien; Duijzer, Geerke; Jansen, Sophia C; Hiddink, Gerrit J; Feskens, Edith J M; Haveman-Nies, Annemien
Although lifestyle interventions have shown to be effective in reducing the risk for type 2 diabetes mellitus, maintenance of achieved results is difficult, as participants often experience relapse after the intervention has ended. This paper describes the systematic development of a maintenance programme for the extensive SLIMMER intervention, an existing diabetes prevention intervention for high-risk individuals, implemented in a real-life setting in the Netherlands. The maintenance programme was developed using the Intervention Mapping protocol. Programme development was informed by a literature study supplemented by various focus group discussions and feedback from implementers of the extensive SLIMMER intervention. The maintenance programme was designed to sustain a healthy diet and physical activity pattern by targeting knowledge, attitudes, subjective norms and perceived behavioural control of the SLIMMER participants. Practical applications were clustered into nine programme components, including sports clinics at local sports clubs, a concluding meeting with the physiotherapist and dietician, and a return session with the physiotherapist, dietician and physical activity group. Manuals were developed for the implementers and included a detailed time table and step-by-step instructions on how to implement the maintenance programme. The Intervention Mapping protocol provided a useful framework to systematically plan a maintenance programme for the extensive SLIMMER intervention. The study showed that planning a maintenance programme can build on existing implementation structures of the extensive programme. Future research is needed to determine to what extent the maintenance programme contributes to sustained effects in participants of lifestyle interventions.
Wood, M.D.; Knowles, J.D.; Whittaker, J.H.; Copplestone, D.; Malcolm, H.M.; Bielby, S.; Zinger, I.
The EC-funded FASSET (Framework for Assessment of Environmental Impact) project collated information on the transfer, dosimetry, and effects of ionising radiation on wildlife. A major output from the project is the FASSET Radiation Effects Database (FRED). A review of the information contained within FRED highlighted that information on the effects of low-dose, chronic exposure was, at best, fragmentary. However, these data are required to define the dose effect relationships needed to underpin the assessment tools that are being developed. To address this requirement, a series of four Good Practice Guides (GPGs) has been produced as part of a protocol development framework. This framework aims to harmonise experimental approaches, with a view to ensuring that all necessary data on appropriate endpoints are collected, so that dose effect relationships can be determined. The GPGs cover test species selection, endpoint selection, radiation exposure and experimental design considerations. A key is used to guide researchers through the GPGs and the decisions made are recorded on an output pro-forma. The completed pro-forma forms the basis of the experimental protocol. The pro-forma also indicates the information that should be included when presenting the results of the experiment. Standardising approaches ensures that results are comparable between experiments and that they are suitable for determining dose effect relationships. This protocol development framework has been adopted by the UK Environment Agency as a document upon which future Agency-funded experimental work on the effects of chronic, low-level exposure to ionising radiation will be based. It is hoped that the framework will gain acceptance in the wider scientific community and facilitate addressing the knowledge gaps that have been identified in order that successful protection of non-human biota can be demonstrated. (author)
N. I. Shcherbakova
neuromuscular disease in newborn at birth, 4 one day delay in the development of transient neonatal myasthenic syndrome, 5 postpartum mothers deterioration that increases while breastfeeding.
de Groot, P. G.; Meijers, J. C. M.; Urbanus, R. T.
The antiphospholipid syndrome is an autoimmune disease that manifests clinically as recurrent thrombotic complications or foetal losses and serologically with elevated levels of antiphospholipid antibodies in the plasmas of these patients. The term 'antiphospholipid syndrome' is confusing, because
van Mol, Margo; Nijkamp, Marjan; Markham, Christine; Ista, Erwin
Admission into an intensive care unit (ICU) may result in long-term physical, cognitive, and emotional consequences for patients and their relatives. The care of the critically ill patient does not end upon ICU discharge; therefore, integrated and ongoing care during and after transition to the follow-up ward is pivotal. This study described the development of an intervention that responds to this need. Intervention Mapping (IM), a six-step theory- and evidence-based approach, was used to guide intervention development. The first step, a problem analysis, comprised a literature review, six semi-structured telephone interviews with former ICU-patients and their relatives, and seven qualitative roundtable meetings for all eligible nurses (i.e., 135 specialized and 105 general ward nurses). Performance and change objectives were formulated in step two. In step three, theory-based methods and practical applications were selected and directed at the desired behaviors and the identified barriers. Step four designed a revised discharge protocol taking into account existing interventions. Adoption, implementation and evaluation of the new discharge protocol (IM steps five and six) are in progress and were not included in this study. Four former ICU patients and two relatives underlined the importance of the need for effective discharge information and supportive written material. They also reported a lack of knowledge regarding the consequences of ICU admission. 42 ICU and 19 general ward nurses identified benefits and barriers regarding discharge procedures using three vignettes framed by literature. Some discrepancies were found. For example, ICU nurses were skeptical about the impact of writing a lay summary despite extensive evidence of the known benefits for the patients. ICU nurses anticipated having insufficient skills, not knowing the patient well enough, and fearing legal consequences of their writings. The intervention was designed to target the knowledge
Kelly, Lauren E; Jansson, Lauren M; Moulsdale, Wendy; Pereira, Jodi; Simpson, Sarah; Guttman, Astrid; Allegaert, Karel; Askie, Lisa; Roukema, Henry; Lacaze, Thierry; Davis, Jonathan M; Finnegan, Loretta; Williamson, Paula; Offringa, Martin
The prevalence of neonatal abstinence syndrome (NAS) is increasing globally resulting in an increased incidence of adverse neonatal outcomes and health system costs. Evidence regarding the effectiveness of NAS prevention and management strategies is very weak and further research initiatives are critically needed to support meta-analysis and clinical practice guidelines. In NAS research, the choice of outcomes and the use of valid, responsive and feasible measurement instruments are crucial. There is currently no consensus and evidence-based core outcome set (COS) for NAS. The development of the NAS-COS will include five stages led by an international Multidisciplinary Steering Committee: (1) qualitative interviews with parents/families and a systematic review (SR) to identify items for inclusion in a COS. The SR will also identify participants for the Delphi survey, (2) a three-round Delphi survey to gain expert opinion on the importance of health outcomes influencing NAS management decisions, (3), a consensus meeting to finalize the items and definitions with experts and COS users, (4) feasibility and pilot testing, development of the COS and explanatory document and (5) implementation planning. Since standardized outcome measurement and reporting will improve NAS clinical research consistency, efficacy and impact, this COS will reflect the minimum set of health outcomes which should be measured in trials evaluating interventions for preventing or treating NAS.
O'Connor, Owen J
To develop low-dose thin-section computed tomographic (CT) protocols for assessment of cystic fibrosis (CF) in pediatric patients and determine the clinical usefulness thereof compared with chest radiography.
Aggarwal, Neil R; Brower, Roy G; Hager, David N; Thompson, B Taylor; Netzer, Giora; Shanholtz, Carl; Lagakos, Adrian; Checkley, William
% CI, -2.09 to -0.68). We observed a dose-response relationship between the cumulative above goal oxygen exposure and worsened clinical outcomes for participants with mild, moderate, or severe acute respiratory distress syndrome, suggesting that the observed relationship is not primarily influenced by severity of illness. Oxygen exposure resulting in arterial oxygen tensions above the protocol goal occurred frequently and was associated with worse clinical outcomes at all levels of acute respiratory distress syndrome severity.
Andy Hickner; Christopher R. Friese; Margaret Irwin
Objective – The study aimed to develop a search protocol and evaluate reviewers' satisfaction with an evidence-based practice (EBP) review by embedding a library science student in the process.Methods – The student was embedded in one of four review teams overseen by a professional organization for oncology nurses (ONS). A literature search protocol was developed by the student following discussion and feedback from the review team. Organization staff provided process feedback. Reviewers from...
Mervis, Carolyn B.
Williams syndrome is a rare neurodevelopmental disorder caused by deletion of approximately 25 genes on chromosome 7q11.23. Children with the syndrome evidence large individual differences in both broad language and reading abilities. Nevertheless, as a group, children with this syndrome show a consistent pattern characterized by relative…
Full Text Available An internship period spent in the north of Morocco kingdom (Tetouan gave a contribute to the organization activity in promoting sustainable development in the rural areas under the Kyoto Protocol. The multitasking project will increase biodiversity planting trees for wood, forage and fruits productions. The paper show a first step study to evaluate the possibility to reach an agreement with the propriety and the manager of these areas in a multifunctional reforestation project. The eligible site suitable for reforestation in accordance with the CDM international scheme is a large plateau (more than 5000 hectares 600 meters high on the sea level far from the Cannabis crops area. The evaluation of the project costs and of the social benefits for the population consider (using different species the indigenous communities necessity. The evaluation of carbon sequestration show the small scale of the reforestation project on behalf of the Kyoto Protocol, but give also an idea about the people rights and necessities. The normal afforestation and reforestation projects, under the Kyoto Protocol, try to maximize the CO2 sequestration in a short time, than business laws usually require. A small scale project could be self-managing, less expensive (international certification costs and more interesting for local communities.
Hellström, M; El-Akouri, R R; Sihlbom, C; Olsson, B M; Lengqvist, J; Bäckdahl, H; Johansson, B R; Olausson, M; Sumitran-Holgersson, S; Brännström, M
Uterus transplantation (UTx) may be the only possible curative treatment for absolute uterine factor infertility, which affects 1 in every 500 females of fertile age. We recently presented the 6-month results from the first clinical UTx trial, describing nine live-donor procedures. This routine involves complicated surgery and requires potentially harmful immune suppression to prevent rejection. However, tissue engineering applications using biomaterials and stem cells may replace the need for a live donor, and could prevent the required immunosuppressive treatment. To investigate the basic aspects of this, we developed a novel whole-uterus scaffold design for uterus tissue engineering experiments in the rat. Decellularization was achieved by perfusion of detergents and ionic solutions. The remaining matrix and its biochemical and mechanical properties were quantitatively compared from using three different protocols. The constructs were further compared with native uterus tissue composition. Perfusion with Triton X-100/dimethyl sulfoxide/H2O led to a compact, weaker scaffold that showed evidence of a compromised matrix organization. Sodium deoxycholate/dH2O perfusion gave rise to a porous scaffold that structurally and mechanically resembled native uterus better. An innovative combination of two proteomic analyses revealed higher fibronectin and versican content in these porous scaffolds, which may explain the improved scaffold organization. Together with other important protocol-dependent differences, our results can contribute to the development of improved decellularization protocols for assorted organs. Furthermore, our study shows the first available data on decellularized whole uterus, and creates new opportunities for numerous in vitro and in vivo whole-uterus tissue engineering applications. Copyright © 2014 Acta Materialia Inc. Published by Elsevier Ltd. All rights reserved.
Ray, John M; Kemp, Lakiesha L; Hubbard, Amanda; Cucciare, Michael A
Computer-delivered cognitive behavioural therapy (cCBT) is an effective alternative to provider-delivered treatment for depression and anxiety, but high attrition poses a significant challenge to its use. Peer support is a feasible approach to improving cCBT engagement, but less is known about its acceptability among Veterans. To obtain feedback from Veterans (n = 24) with depression and/or anxiety on their preferences for (a) activities of Veterans Administration Peer Support Specialists (VA PSS) in helping Veterans use Moving Forward, a cCBT-based protocol developed by VA, and (b) methods for delivering support to Veterans using this programme. Four focus groups (5-7 Veterans per group) provided feedback to be used in the development of a peer-supported engagement intervention to help Veterans with depression and anxiety use Moving Forward. Content areas included roles that a VA PSS might play in supporting the use of and engagement in Moving Forward, as well as methods of delivering that support. Veteran preferences for PSS activity focused on practical aspects of using Moving Forward, including orientation to the programme, technical support, and monitoring progress. Feedback also suggested that Veterans preferred more personal roles for the PSS, including emotional support, as well as application of Moving Forward to 'real life' problems. The findings extend the literature on online, patient-facing mental health protocols by identifying emotional support and 'real life' skills application as Veteran-preferred components of a peer-support protocol designed to enhance use of and engagement in cCBT for depression and anxiety.
Mapanga, Witness; Elhakeem, Ahmed; Feresu, Shingairai A; Maseko, Fresier; Chipato, Tsungai
Over 85% of cervical cancer cases and deaths occur in developing countries. HIV-seropositive women are more likely to develop precancerous lesions that lead to cervical cancer than HIV-negative women. However, the literature on cervical cancer prevention in seropositive women in developing countries has not been reviewed. The aim of this study is to systematically review cervical cancer prevention modalities available for HIV-seropositive women in developing countries. This protocol was developed by following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Protocols (PRISMA-P) statement, and the systematic review will be reported in accordance with the PRISMA guidelines. Embase, MEDLINE, PubMed, CINAHL and Cochrane Library will be searched from inception up to date of final search, and additional studies will be located through citation and reference list tracking. Eligible studies will be randomised controlled trials, prospective and retrospective cohort studies, case-control and cross-sectional studies carried out in developing countries. Studies will be included if they are published in English and examine cervical cancer prevention modalities in HIV-seropositive women. Results will be summarised in tables and, where appropriate, combined using meta-analysis. This review will address the gap in evidence by systematically reviewing the published literature on the different prevention modalities being used to prevent cervical cancer in HIV-seropositive women in developing countries. The findings may be used to inform evidence-based guidelines for prevention of cervical cancer in seropositive women as well as future research. PROSPERO CRD42017054678 .
Full Text Available Ikenna Kingsley Ndu Department of Paediatrics, Enugu State University Teaching Hospital, Enugu, Nigeria Abstract: Sudden infant death syndrome (SIDS is defined as the sudden unexpected death of an infant <1 year of age, with onset of the fatal episode apparently occurring during sleep, that remains unexplained after a thorough investigation including performance of a complete autopsy and review of the circumstances of death and the clinical history. SIDS contributes to infant mortality and resulted in ~15,000 deaths globally in 2013. Most of the risk factors of SIDS are common in developing countries; yet, there has been little interest in SIDS by researchers in Africa. This review looks at the extent of the attention given to SIDS in a developing country like Nigeria, and factors responsible for the scarce data concerning this significant cause of mortality. Keywords: SIDS, mortality, Nigeria
Full Text Available A female foetus in her mother’s womb was exposed to high concentrations of alcohol at each stage of pregnancy on a long-term basis, which resulted in a permanent disability. In addition to a number of deficiencies in the overall functioning of the body of the child, there are serious problems pertaining to verbal communication. This thesis aims to describe foetal alcohol syndrome (FAS disease and present the basic problems with communication functions in a child, caused by damage of brain structures responsible for speech development. The thesis includes a speech diagnosis and therapy program adapted to the presented case. In the Discussion Section we have presented characteristics of communication disorders in case of children with FAS and the description of developmental malformations, neurobehavioral disorders, and environmental factors affecting the development of the child’s speech.
Wherever humans go, they inevitably carry along the critters that live in and on them. Conventional wisdom has long held that it is unlikely those critters could survive the space environment, but in 2007 some microscopic aquatic animals called Tardigrades survived exposure to space and in 2008 Cyanobacteria lived for 548 days outside the ISS. Unlike the Mars rovers that were cleaned once and sent on their way, crew members will provide a constantly regenerating contaminant source. Are we prepared to certify that we can meet forward contamination protocols as we search for life at new destinations? What about the organisms we might reasonably expect a crewed spacecraft to leak or vent? Do we even know what they are? How long might our tiny hitch-hikers survive in close proximity to a warm spacecraft that periodically leaks/vents water or oxygen and how might they mutate with long-duration exposure? How will these contaminants migrate from their source in conditions encountered in space or on other planetary surfaces? This project aims to answer some of these questions by bringing together key stakeholder communities to develop a human forward contamination test, analysis, and integration plan. A system engineering approach to identify the experiments, analysis, and modeling needed to develop the contamination control protocols required will be used as a roadmap to integrate the many different parts of this problem - from launch to landing, living, and working on another planetary surface.
Khushi, Matloob; Carpenter, Jane E; Balleine, Rosemary L; Clarke, Christine L
Human transcription error is an acknowledged risk when extracting information from paper records for entry into a database. For a tissue bank, it is critical that accurate data are provided to researchers with approved access to tissue bank material. The challenges of tissue bank data collection include manual extraction of data from complex medical reports that are accessed from a number of sources and that differ in style and layout. As a quality assurance measure, the Breast Cancer Tissue Bank (http:\\\\www.abctb.org.au) has implemented an auditing protocol and in order to efficiently execute the process, has developed an open source database plug-in tool (eAuditor) to assist in auditing of data held in our tissue bank database. Using eAuditor, we have identified that human entry errors range from 0.01% when entering donor's clinical follow-up details, to 0.53% when entering pathological details, highlighting the importance of an audit protocol tool such as eAuditor in a tissue bank database. eAuditor was developed and tested on the Caisis open source clinical-research database; however, it can be integrated in other databases where similar functionality is required.
Hoekema, A; de Lange, J; Stegenga, B; de Bont, LGM
Purpose: The present study comprises a retrospective evaluation of the potential application of mandibular repositioning appliance (MRA) therapy preceding maxillomandibular advancement (MMA) surgery in the treatment of the Obstructive Sleep Apnea-Hypopnea Syndrome (OSAHS). Our initial experiences
Brasil, Virginia; Oliveira, Gabriela; Moraes, Katarinne Lima
The objective of this systematic review is to evaluate the psychometric properties and clinical utility of patient-reported outcome measures that assess health-related quality of life in patients with a clinical diagnosis of acute coronary syndrome.
Kaltenboeck, Alexander; Friedrich, Fabian; Hinterbuchinger, Barbara; Litvan, Zsuzsa; Mossaheb, Nilufar
22q11.2 deletion syndrome (clinically also known as velocardiofacial or DiGeorge syndrome) is the most common human microdeletion syndrome and can be associated with a multitude of clinical features. In this article we report the case of a 22-year-old patient from Austria who was diagnosed with previously unknown 22q11.2 deletion syndrome in the context of newly developed psychosis. Using this case as an example, we then discuss the implications of 22q11.2 deletion syndrome for clinical psychiatric practice.
Effectiveness of individualized physiotherapy on pain and functioning compared to a standard exercise protocol in patients presenting with clinical signs of subacromial impingement syndrome. A randomized controlled trial.
Kromer, Thilo O; de Bie, Rob A; Bastiaenen, Caroline H G
Shoulder impingement syndrome is a common musculoskeletal complaint leading to significant reduction of health and disability. Physiotherapy is often the first choice of treatment although its effectiveness is still under debate. Systematic reviews in this field highlight the need for more high quality trials to investigate the effectiveness of physiotherapy interventions in patients with subacromial impingement syndrome. This randomized controlled trial will investigate the effectiveness of individualized physiotherapy in patients presenting with clinical signs and symptoms of subacromial impingement, involving 90 participants aged 18-75. Participants are recruited from outpatient physiotherapy clinics, general practitioners, and orthopaedic surgeons in Germany. Eligible participants will be randomly allocated to either individualized physiotherapy or to a standard exercise protocol using central randomization. The control group will perform the standard exercise protocol aiming to restore muscular deficits in strength, mobility, and coordination of the rotator cuff and the shoulder girdle muscles to unload the subacromial space during active movements. Participants of the intervention group will perform the standard exercise protocol as a home program, and will additionally be treated with individualized physiotherapy based on clinical examination results, and guided by a decision tree. After the intervention phase both groups will continue their home program for another 7 weeks. Outcome will be measured at 5 weeks and at 3 and 12 months after inclusion using the shoulder pain and disability index and patients' global impression of change, the generic patient-specific scale, the average weekly pain score, and patient satisfaction with treatment. Additionally, the fear avoidance beliefs questionnaire, the pain catastrophizing scale, and patients' expectancies of treatment effect are assessed. Participants' adherence to the protocol, use of additional treatments
Effectiveness of individualized physiotherapy on pain and functioning compared to a standard exercise protocol in patients presenting with clinical signs of subacromial impingement syndrome. A randomized controlled trial
de Bie Rob A
Full Text Available Abstract Background Shoulder impingement syndrome is a common musculoskeletal complaint leading to significant reduction of health and disability. Physiotherapy is often the first choice of treatment although its effectiveness is still under debate. Systematic reviews in this field highlight the need for more high quality trials to investigate the effectiveness of physiotherapy interventions in patients with subacromial impingement syndrome. Methods/Design This randomized controlled trial will investigate the effectiveness of individualized physiotherapy in patients presenting with clinical signs and symptoms of subacromial impingement, involving 90 participants aged 18-75. Participants are recruited from outpatient physiotherapy clinics, general practitioners, and orthopaedic surgeons in Germany. Eligible participants will be randomly allocated to either individualized physiotherapy or to a standard exercise protocol using central randomization. The control group will perform the standard exercise protocol aiming to restore muscular deficits in strength, mobility, and coordination of the rotator cuff and the shoulder girdle muscles to unload the subacromial space during active movements. Participants of the intervention group will perform the standard exercise protocol as a home program, and will additionally be treated with individualized physiotherapy based on clinical examination results, and guided by a decision tree. After the intervention phase both groups will continue their home program for another 7 weeks. Outcome will be measured at 5 weeks and at 3 and 12 months after inclusion using the shoulder pain and disability index and patients' global impression of change, the generic patient-specific scale, the average weekly pain score, and patient satisfaction with treatment. Additionally, the fear avoidance beliefs questionnaire, the pain catastrophizing scale, and patients' expectancies of treatment effect are assessed. Participants
Full Text Available Acute infectious gastroenteritis is one of the most commonly identifiable risk factors for the development of irritable bowel syndrome (IBS. A number of bacterial, viral and parasitic pathogens have been found to be associated with the development of IBS and other functional gastrointestinal (GI disorders. Epidemiological studies have identified demographic and acute enteritis-related risk factors for the development of post-infectious-IBS (PI-IBS. Immune dysregulation, alterations in barrier function, serotonergic and mast cell activation have been identified as potential pathophysiological mechanisms. Additionally, variations in host genes involved in barrier function, antigen presentation and cytokine response have been associated with PI-IBS development. However, it is unknown whether specific pathogens have unique effects on long-term alterations in gut physiology or different pathogens converge to cause common alterations resulting in similar phenotype. The role of microbial virulence and pathogenicity factors in development of PI-IBS is also largely unknown. Additionally, alterations in host gut sensation, motility, secretion, and barrier function in PI-IBS need to be elucidated. Finally, both GI infections and antibiotics used to treat these infections can cause long-term alterations in host commensal microbiota. It is plausible that alteration in the commensal microbiome persists in a subset of patients predisposing them to develop PI-IBS.
Full Text Available Background Epidendreae is one of the most diverse tribes among the orchids with remarkable variation in life form, floral morphology and pollination syndromes. Its circumscription was recently revised and subtribes Agrostophyllinae and Calypsoinae were transferred into this tribe. One of the principal floral characters utilized in classification of orchids is the incumbency or bending of the column. This study records and compares late stages of anther, column and lip development, and discusses anther characters in fifteen representative taxa of five of the six subtribes in Epidendreae with respect to classification and pollination biology. Methods A series of late floral stages were sampled and fixed for examination under scanning electron microscope. Results Anther incumbency or bending in this group varies from 90° to almost 180°. Incumbency in the late stages of development is reached in Bletiinae, Ponerinae, Pleurothallidinae and Laeliinae whereas incumbency is reached early in its development in Corallorhiza and Govenia of Calypsoinae. Discussion Our observations indicate that the position of Chysis in subtribe Bletiinae needs revision based on differences in a number floral, and in particular of anther characters; and that Coelia only shares the early anther incumbency with Calypsoinae members, but not the rest of floral and anther characters. Anatomical characters such as crystals around the actinocytic stomata on the anther cap and sugar crystals in Laeliinae; lack of rostellum in Bletiinae; coalescent anther with the column, lack of trichomes and papillae on lip keels, and underdeveloped rostellum in Chysis; a mechanism by which the anther cap comes off (it is joined with the grooved lip by a claw in Isochilus are all related to pollination syndromes and reproductive biology.
Philip H. Kass
Full Text Available In an effort to recognize and address communicable and point-source epidemics in dog and cat populations, this project created a near real-time syndromic surveillance system devoted to companion animal health in the United States. With over 150 million owned pets in the US, the development of such a system is timely in light of previous epidemics due to various causes that were only recognized in retrospect. The goal of this study was to develop epidemiologic and statistical methods for veterinary hospital-based surveillance, and to demonstrate its efficacy by detection of simulated foodborne outbreaks using a database of over 700 hospitals. Data transfer protocols were established via a secure file transfer protocol site, and a data repository was constructed predominantly utilizing open-source software. The daily proportion of patients with a given clinical or laboratory finding was contrasted with an equivalent average proportion from a historical comparison period, allowing construction of the proportionate diagnostic outcome ratio and its confidence interval for recognizing aberrant heath events. A five-tiered alert system was used to facilitate daily assessment of almost 2,000 statistical analyses. Two simulated outbreak scenarios were created by independent experts, blinded to study investigators, and embedded in the 2010 medical records. Both outbreaks were detected almost immediately by the alert system, accurately detecting species affected using relevant clinical and laboratory findings, and ages involved. Besides demonstrating proof-in-concept of using veterinary hospital databases to detect aberrant events in space and time, this research can be extended to conducting post-detection etiologic investigations utilizing exposure information in the medical record.
Full Text Available Abstract High blood pressure is an important constituent of the metabolic syndrome. However, the underlying mechanisms for development of hypertension in the metabolic syndrome are very complicated and remain still obscure. Visceral/central obesity, insulin resistance, sympathetic overactivity, oxidative stress, endothelial dysfunction, activated renin-angiotensin system, increased inflammatory mediators, and obstructive sleep apnea have been suggested to be possible factors to develop hypertension in the metabolic syndrome. Here, we will discuss how these factors influence on development of hypertension in the metabolic syndrome.
Cognitive development in Dravet's syndrome is accompanied by a slowing or stagnation of the cognitive abilities during childhood. The fact that the syndrome is classified within the group of epileptic encephalopathies suggests that the epileptiform activity plays an important role in the genesis of the cognitive disorders. In this review it is shown that the epileptic phenotype and the critical and intercritical activity do not, by themselves, explain the cognitive development in children with Dravet's syndrome. Substantial changes in the treatment, with impact on cognitive development, will probably come with therapies that act by directly modifying the pathophysiology of the syndrome rather than its consequences.
This study aims to explore and investigate the linguistic developments regarding children with Down syndrome. The study was conducted by interviewing children with Down syndrome. The study shows many problems with these children associated with difficulties with the reasoning attention, imitation, routines, and language development of children with Down syndrome, such as, speech problem, a problem related to pronunciation, sound or voice. This study uses the (Inductive) and Qualitative primar...
Blumenthal, David E; Malemud, Charles J
The US Federal Drug Administration (FDA) approved 3 medications for treating fibromyalgia syndrome (FMS). There have been no additional FDA approvals since January 2009 and the efficacy of the FDA-approved medications for FMS has been questioned. Areas covered: The "search for studies" tool using clinicaltrials.gov and PubMed were employed. The term, "fibromyalgia" was used for clinicaltrials.gov. The terms employed for PubMed were "Name-of-Drug Fibromyalgia", "Fibromyalgia Treatment" or "Fibromyalgia Drug Treatment." Clinical trials were reviewed if they were prospective and blinded, and if they employed a comparator, either placebo or another pharmaceutical. Expert commentary: Progress toward standardizing the outcome measures for FMS clinical trials have been made but challenges remain. Several pharmaceutical candidates for FMS have been tested since 2009. The results of these studies with potential novel targets for drug development for FMS were reviewed including the results of trials with sodium oxybate, quetiapine, esreboxetine, nabilone, memantine, naltrexone, and melatonin.
Sarheed, Omar; Rasool, Bazigha K Abdul
It has now been known for over a decade that low frequency ultrasound can be used to effectively enhance transdermal drug penetration - an approach termed sonophoresis. Mechanistically, acoustic cavitation results in the creation of defects in the stratum corneum that allow accelerated absorption of topically applied molecules. The aim of this study was to develop an optimised sonophoresis protocol for studying transdermal drug delivery in vitro. To this end, caffeine was selected as a model hydrophilic drug while porcine skin was used as a model barrier. Following acoustic validation, 20kHz ultrasound was applied for different durations (range: 5 s to 10 min) using three different modes (10%, 33% or 100% duty cycles) and two distinct sonication procedures (either before or concurrent with drug deposition). Each ultrasonic protocol was assessed in terms of its heating and caffeine flux-enhancing effects. It was found that the best regimen was a concurrent 5 min, pulsed (10% duty cycle) beam of SATA intensity 0.37 W/cm(2). A key insight was that in the case of pulsed beams of 10% duty cycle, sonication concurrent with drug deposition was superior to sonication prior to drug deposition and potential mechanisms for this are discussed.
Ashayeri-Panah, M; Eftekhar, F; Feizabadi, M M
To develop an optimized random amplified polymorphic DNA (RAPD) protocol for fingerprinting clinical isolates of Klebsiella pneumoniae. Employing factorial design of experiments, repeatable amplification patterns were obtained for 54 nosocomial isolates using 1 μmol 1(-1) primer, 4 mmol 1(-1) MgCl(2), 0·4 mmol 1(-1) dNTPs, 2·5 U Taq DNA polymerase and 90 ng DNA template in a total volume of 25 μl. The optimum thermocycling program was: initial denaturation at 94°C for 4 min followed by 50 cycles of 1 min at 94°C, 2 min at 34°C, 2 min at 72°C and a final extension at 72°C for 10 min. The optimized RAPD protocol was highly discriminatory (Simpson's diversity index, 0·982), and all isolates were typable with repeatable patterns (Pearson's similarity coefficient ≈ 100%). Seven main clusters were obtained on a similarity level of 70% and 32 distinct clusters on a similarity level of 85%, reflecting the heterogeneity of the isolates. Systematic optimization of RAPD generated reliable DNA fingerprints for nosocomial isolates of K. pneumoniae. This is the first report on RAPD optimization based on factorial design of experiments for discrimination of K. pneumoniae. © 2012 The Authors. Letters in Applied Microbiology © 2012 The Society for Applied Microbiology.
Ghio, Alain; Dufour, Sophie; Wengler, Aude; Pouchoulin, Gilles; Revis, Joana; Giovanni, Antoine
The purpose of this study was to develop and test a training protocol for the perceptual evaluation of dysphonia. A group of 38 inexperienced listeners participated in a three-phase experiment: a pretest to evaluate their initial performance on categorization of dysphonic voices, a training phase, and a posttest to detect training-related changes in performance. In parallel, a different group of 14 listeners who were experts in voice assessment took a test that was identical to the posttest taken by the inexperienced subjects. The corpus used for the tests was made up of recordings of 142 voices of women reading aloud, with a sampling of voice qualities ranging from normal to severely degraded. The learners' performance on judgments of moderate and severe dysphonia improved between the pretest and the posttest. No improvement was observed for normal voices, whose initial detection was already good, nor for slight dysphonias, which appear to be the most difficult to learn. The improvements were still present on a delayed posttest taken a week later. Unexpectedly, the inexperienced listeners' initial performance was similar to that of the experts. After the training phase, their scores for severely deteriorated voices were even better than the experts'. In conclusion, our training protocol seems to be effective and could therefore be proposed to voice therapists. However, judging intermediate degrees of dysphonia remains fragile and therefore needs to be reinforced by repeated training. Copyright © 2015. Published by Elsevier Inc.
Cairolli, Fábio Fabregas; Bonuzzi, Giordano Marcio Gatinho; Palma, Gisele Carla dos Santos; Soares, Marcos Antônio Arlindo; Pompeu, José Eduardo; Faria, Christina Danielli Coelho de Morais; Torriani-Pasin, Camila
The virtual reality has been frequently required in rehabilitation settings. However, it still lacks specificity, making it necessary to establish specific criteria to classify the most relevant aspects of electronic games to allow interventions based on virtual reality. Therefore, the purpose of this study is to develop a “Perceptual and motor demands assessment protocol for virtual reality systems” and to investigate its content validity and intra and inter observer agreement. The protocol ...
The Combined Intervention with Germinated Vigna radiata and Aerobic Interval Training Protocol Is an Effective Strategy for the Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD) and Other Alterations Related to the Metabolic Syndrome in Zucker Rats.
Kapravelou, Garyfallia; Martínez, Rosario; Nebot, Elena; López-Jurado, María; Aranda, Pilar; Arrebola, Francisco; Cantarero, Samuel; Galisteo, Milagros; Porres, Jesus M
Metabolic syndrome (MetS) is a group of related metabolic alterations that increase the risk of developing non-alcoholic fatty liver disease (NAFLD). Several lifestyle interventions based on dietary treatment with functional ingredients and physical activity are being studied as alternative or reinforcement treatments to the pharmacological ones actually in use. In the present experiment, the combined treatment with mung bean ( Vigna radiata ), a widely used legume with promising nutritional and health benefits that was included in the experimental diet as raw or 4 day-germinated seed flour, and aerobic interval training protocol (65-85% VO₂ max) has been tested in lean and obese Zucker rats following a 2 × 2 × 2 (2 phenotypes, 2 dietary interventions, 2 lifestyles) factorial ANOVA (Analysis of Variance) statistical analysis. Germination of V. radiata over a period of four days originated a significant protein hydrolysis leading to the appearance of low molecular weight peptides. The combination of 4 day-germinated V. radiata and aerobic interval training was more efficient compared to raw V. radiata at improving the aerobic capacity and physical performance, hepatic histology and functionality, and plasma lipid parameters as well as reverting the insulin resistance characteristic of the obese Zucker rat model. In conclusion, the joint intervention with legume sprouts and aerobic interval training protocol is an efficient treatment to improve the alterations of glucose and lipid metabolism as well as hepatic histology and functionality related to the development of NAFLD and the MetS.
The Combined Intervention with Germinated Vigna radiata and Aerobic Interval Training Protocol Is an Effective Strategy for the Treatment of Non-Alcoholic Fatty Liver Disease (NAFLD and Other Alterations Related to the Metabolic Syndrome in Zucker Rats
Full Text Available Metabolic syndrome (MetS is a group of related metabolic alterations that increase the risk of developing non-alcoholic fatty liver disease (NAFLD. Several lifestyle interventions based on dietary treatment with functional ingredients and physical activity are being studied as alternative or reinforcement treatments to the pharmacological ones actually in use. In the present experiment, the combined treatment with mung bean (Vigna radiata, a widely used legume with promising nutritional and health benefits that was included in the experimental diet as raw or 4 day-germinated seed flour, and aerobic interval training protocol (65–85% VO2 max has been tested in lean and obese Zucker rats following a 2 × 2 × 2 (2 phenotypes, 2 dietary interventions, 2 lifestyles factorial ANOVA (Analysis of Variance statistical analysis. Germination of V. radiata over a period of four days originated a significant protein hydrolysis leading to the appearance of low molecular weight peptides. The combination of 4 day-germinated V. radiata and aerobic interval training was more efficient compared to raw V. radiata at improving the aerobic capacity and physical performance, hepatic histology and functionality, and plasma lipid parameters as well as reverting the insulin resistance characteristic of the obese Zucker rat model. In conclusion, the joint intervention with legume sprouts and aerobic interval training protocol is an efficient treatment to improve the alterations of glucose and lipid metabolism as well as hepatic histology and functionality related to the development of NAFLD and the MetS.
Seror, Raphaele; Ravaud, Philippe; Mariette, Xavier; Bootsma, Hendrika; Theander, Elke; Hansen, Arne; Ramos-Casals, Manel; Doerner, Thomas; Bombardieri, Stefano; Hachulla, Eric; Brun, Johan G.; Kruize, Aike A.; Praprotnik, Sonja; Tomsic, Matija; Gottenberg, Jacques-Eric; Devauchelle, Valerie; Devita, Salvatore; Vollenweider, Cristina; Mandl, Thomas; Tzioufas, Athanasios; Carsons, Steven; Saraux, Alain; Sutcliffe, Nurhan; Vitali, Claudio; Bowman, Simon J.
Objectives To develop a score for assessment of patients' symptoms in primary Sjogren's syndrome (SS): the EULAR SS Patient Reported Index (ESSPRI). Methods Dryness, pain, somatic and mental fatigue were identified as the main symptoms of patients with primary SS, in studies developing the Profile
Souza, Mariana A. P.; Ferreira, Fabiane R.; César, Cibele C.; Furtado, Sheyla R. C.; Coster, Wendy J.; Mancini, Marisa C.; Sampaio, Rosana F.
Objective: This paper describes the development of the Protocol for Identification of Problems for Rehabilitation (PLPR), a tool to standardize collection of functional information based on the International Classification of Functioning, Disability and Health (ICF). Development of the protocol: The PLPR was developed for use during the initial contact with adult patients within a public network of rehabilitation services. Steps to develop the protocol included: survey of the ICF codes most used by clinical professionals; compilation of data from functional instruments; development and pilot testing of a preliminary version in the service settings; discussion with professionals and development of the final version. The final version includes: user identification; social and health information; brief functional description (BFD); summary of the BFD; and PLPR results. Further testing of the final version will be conducted. Conclusions: The protocol standardizes the first contact between the user and the rehabilitation service. Systematic use of the protocol could also help to create a functional database that would allow comparisons between rehabilitation services and countries over time. PMID:26786075
Sakuraya, Asuka; Watanabe, Kazuhiro; Kawakami, Norito; Imamura, Kotaro; Ando, Emiko; Asai, Yumi; Eguchi, Hisashi; Kobayashi, Yuka; Nishida, Norimitsu; Arima, Hideaki; Shimazu, Akihito; Tsutsumi, Akizumi
Metabolic syndrome is an important public health target because of its high prevalence worldwide. Work-related psychosocial factors have been identified as determinants of metabolic syndrome components. However, there have been no systematic reviews or meta-analyses conducted to evaluate the relationship between work-related psychosocial factors and metabolic syndrome as an aggregated cluster. The aim of this study is to examine this association from published prospective studies. The systematic review and meta-analysis will be conducted using published studies that will be identified from electronic databases (ie, PubMed, EMBASE, PsycINFO, PsycARTICLES and Japan Medical Abstracts Society). Studies that (1) examined the association between work-related psychosocial factors and the onset of metabolic syndrome, (2) had a longitudinal or prospective cohort design, (3) were conducted among workers, (4) provided sufficient data for calculating ORs or relative risk with a 95% CI, (5) were published as original articles written in English or Japanese, and (6) having been published until the end of 2016 will be included. Study selection, data collection, quality assessment and statistical syntheses will be conducted based on discussions among investigators. Ethics approval was not required for this study because it was based on published studies. The results and findings of this study will be submitted and published in a scientific peer-reviewed journal. The findings from this study could be useful for assessing metabolic syndrome risk factors in the workplace, and determining approaches for prevention of metabolic syndrome in the future. PROSPERO CRD42016039096 (http://www.crd.york.ac.uk/PROSPERO_REBRANDING/display_record.asp?ID=CRD42016039096). © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Vivian T W Poon
Full Text Available Metabolic syndrome (MetS is a constellation of metabolic aberrations that collectively increase the risk for cardiovascular disease and type 2 diabetes. Greater understanding of MetS developments may provide insight into targeted prevention strategies for individuals at greatest risk. The purpose of this study was to i identify distinct patterns of longitudinal MetS development and; ii develop a character profile that differentiates groups by level of MetS risk.Data from the Coronary Artery Risk Development in Young Adults (CARDIA study (n = 3 804; 18-30 y was obtained by limited access application from the National Heart, Lung, and Blood Institute and used for this analysis. MetS, as defined by the Harmonized criteria, was assessed over a 20 year follow-up period. Group-level trajectory analysis identified 4 distinct groups with varying rates of component development [No (23.8% of sample; Low (33.5%; Moderate (35.3%; and High MetS (7.4%]. After adjusting for covariates, individuals in the At-Risk groups (Low, Moderate and High MetS were more likely to be of black ethnicity (1.37, 1.14-1.66, have a family history of cardiovascular disease (1.61, 1.31-1.97 and history of dieting (1.69, 1.20-2.39 when compared to the No Risk trajectory group (No MetS. Conversely, increasing baseline education (0.76, 0.65-0.89 and aerobic fitness (0.55, 0.47-0.64 was inversely associated with At-Risk group membership.Results suggest distinct profiles of MetS development that can be identified by baseline risk factors. Further research is necessary to understand the clinical implication of intermediate MetS development groups with respect to overall cardiometabolic risk.
Taylor, Natalie; Long, Janet C; Debono, Deborah; Williams, Rachel; Salisbury, Elizabeth; O'Neill, Sharron; Eykman, Elizabeth; Braithwaite, Jeffrey; Chin, Melvin
Lynch syndrome is an inherited disorder associated with a range of cancers, and found in 2-5 % of colorectal cancers. Lynch syndrome is diagnosed through a combination of significant family and clinical history and pathology. The definitive diagnostic germline test requires formal patient consent after genetic counselling. If diagnosed early, carriers of Lynch syndrome can undergo increased surveillance for cancers, which in turn can prevent late stage cancers, optimise treatment and decrease mortality for themselves and their relatives. However, over the past decade, international studies have reported that only a small proportion of individuals with suspected Lynch syndrome were referred for genetic consultation and possible genetic testing. The aim of this project is to use behaviour change theory and implementation science approaches to increase the number and speed of healthcare professional referrals of colorectal cancer patients with a high-likelihood risk of Lynch syndrome to appropriate genetic counselling services. The six-step Theoretical Domains Framework Implementation (TDFI) approach will be used at two large, metropolitan hospitals treating colorectal cancer patients. Steps are: 1) form local multidisciplinary teams to map current referral processes; 2) identify target behaviours that may lead to increased referrals using discussion supported by a retrospective audit; 3) identify barriers to those behaviours using the validated Influences on Patient Safety Behaviours Questionnaire and TDFI guided focus groups; 4) co-design interventions to address barriers using focus groups; 5) co-implement interventions; and 6) evaluate intervention impact. Chi square analysis will be used to test the difference in the proportion of high-likelihood risk Lynch syndrome patients being referred for genetic testing before and after intervention implementation. A paired t-test will be used to assess the mean time from the pathology test results to referral for high
Taylor Nicholas F
Full Text Available Abstract Background Muscle strength is important for young people with Down syndrome as they make the transition to adulthood, because their workplace activities typically emphasise physical rather than cognitive skills. Muscle strength is reduced up to 50% in people with Down syndrome compared to their peers without disability. Progressive resistance training improves muscle strength and endurance in people with Down syndrome. However, there is no evidence on whether it has an effect on work task performance or physical activity levels. The aim of this study is to investigate if a student-led community-based progressive resistance training programme can improve these outcomes in adolescents and young adults with Down syndrome. Methods A randomised controlled trial will compare progressive resistance training with a control group undertaking a social programme. Seventy adolescents and young adults with Down syndrome aged 14-22 years and mild to moderate intellectual disability will be randomly allocated to the intervention or control group using a concealed method. The intervention group will complete a 10-week, twice a week, student-led progressive resistance training programme at a local community gymnasium. The student mentors will be undergraduate physiotherapy students. The control group will complete an arts/social programme with a student mentor once a week for 90 minutes also for 10 weeks to control for the social aspect of the intervention. Work task performance (box stacking, pail carry, muscle strength (1 repetition maximum for chest and leg press and physical activity (frequency, duration, intensity over 7-days will be assessed at baseline (Week 0, following the intervention (Week 11, and at 3 months post intervention (Week 24 by an assessor blind to group allocation. Data will be analysed using ANCOVA with baseline measures as covariates. Discussion This paper outlines the study protocol for a randomised controlled trial on the
Vesseur, Annemarie; Langereis, Margreet; Free, Rolien; Snik, Ad; van Ravenswaaij-Arts, Conny; Mylanus, Emmanuel
Hearing loss and cognitive delay are frequently occurring features in CHARGE syndrome that may contribute to impaired language development. However, not much is known about language development in patients with CHARGE syndrome. In this retrospective study, hearing loss, cognitive abilities, and
Cregg, M; Woodhouse, JM; Stewart, Ruth E.; Pakeman, VH; Bromham, NR; Gunter, HL; Trojanowska, L; Parker, M; Fraser, WI
PURPOSE. To investigate the development of refractive errors and strabismus in a cohort of children with Down syndrome. METHOD. Data for 55 children with Down syndrome who are participating in this longitudinal study of visual development, first examined by us when aged less than 2 years and on at
Toret, Gokhan; Acarlar, Funda
The purpose of this study was to examine gesture use in Turkish children with autism, Down syndrome, and typically developing children. Participants included 30 children in three groups: Ten children with Down syndrome, ten children with autism between 24-60 months of age, and ten typically developing children between 12-18 months of age.…
Venuti, P.; de Falco, S.; Esposito, G.; Bornstein, Marc H.
Child solitary and collaborative mother-child play with 21 children with Down syndrome and 33 mental-age-matched typically developing children were compared. In solitary play, children with Down syndrome showed less exploratory but similar symbolic play compared to typically developing children. From solitary to collaborative play, children with…
Linden, M.S. van der; Vucic, S.; Marrewijk, D.J.F. van; Ongkosuwito, E.M.
OBJECTIVE: In children with Down syndrome, the timing of dental eruption is important for orthodontics treatment planning. Aim of this study was to determine whether tooth eruption and development of the dentition in children with Down syndrome are impaired. MATERIAL AND METHODS: Dental development
Pruess, James B.; And Others
The review of research on language development in young children with Down's syndrome indicates that these children develop language in the same sequence as children without Down's syndrome, but that they experience delays. Educators should initiate language programs as early as possible, enlist parent participation, and select normative language…
Parker, K; Pabla, R; Hay, N; Ayliffe, P
Ter Haar syndrome is a rare genetic syndrome with <30 cases reported worldwide. There is nothing within the published literature regarding the dental development and dental features of these patients. This case series examines three patients with Ter Haar syndrome and tracks their dental development and identifies common dental and skeletal features. All three patients received dental treatment and regular follow-up at Great Ormond Street Hospital Dental Department. These patients have many common dental and craniofacial features which poses the question as to whether these features are due to Ter Haar syndrome.
Rajasekariah, G R; Dhage, K R; Deb, B N; Bose, S
Two-day-old baby hamsters were infected initially with the infective larvae of hamster-adapted human hookworm, Necator americanus (NaL3). After a specified period they were again infected orally with infective larvae of Ancylostoma ceylanicum (AcL3). Three weeks after the second infection they were killed and the establishment of N. americanus and A. ceylanicum was assessed. The effect of different infection levels and exposure period of N. americanus on the concurrent establishment of A. ceylanicum was also examined. An infection with 50 NaL3 percutaneously, and 3 weeks later, a second infection with 50 AcL3 orally has produced reasonably equal number of hookworms (no statistical difference in the burden of N. americanus and A. ceylanicum) in the intestine of hamsters. Thus this protocol of dual infection was found suitable to develop two species of hookworms in hamsters for anthelmintic screening.
Hubenthal, M.; Brudzinski, M. R.; Colella, H.
Research Experiences for Undergraduate (REU) sites pair interns with scientists expected to oversee and guide an intern's scientific research, and assist in the development of skills, knowledge, and connections that will enhance the intern's professional and personal growth. This aspect of REU sites is generally recognized as a powerful, yet complicated, component that has a strong influence on the overall success of the intern's experience. Evaluations indicate that the quality and consistency of mentoring in REU sites can be highly variable. Traditional strategies to influence mentorship generally include reading lists or short trainings at the beginning of the summer. The efficacy of these approaches is questionable. As a result many REU Site facilitators are deeply interested in the question 'How can REU programs challenge scientists to raise their participation to the level of (truly) mentoring?' The Incorporated Research Institutions for Seismology (IRIS) REU site is developing a 13-item rubric measuring research skills, and a protocol of training and intern-mentor meetings to discuss progress. The goal of the intervention is to both increase the extent to which the mentoring relationship is centered on the intern, and to enable interns and mentors to feel more effective monitoring interns' personal/professional growth. This intervention was piloted in 2011, refined, and fully implemented in 2012. During the initial week of the program, interns assess their skills, complete the rubric independently, and discuss the completed rubric with their mentor. Midway through the summer interns and mentors each review the rubric and assess the intern's skills. The intern-mentor pairs then meet to collaborate and complete the rubric together. Finally, in the last week of the program, interns and mentors independently assess the intern's skills and complete the rubric, and the pairs again meet to discuss and negotiate these independent assessments. Survey data from 2012
Shumchenia, Emily J; Smith, Sarah L; McCann, Jennifer; Carnevale, Michelle; Fugate, Grover; Kenney, Robert D; King, John W; Paton, Peter; Schwartz, Malia; Spaulding, Malcolm; Winiarski, Kristopher J
Offshore renewable energy developments (OREDs) are projected to become common in the United States over the next two decades. There are both a need and an opportunity to guide efforts to identify and track impacts to the marine ecosystem resulting from these installations. A monitoring framework and standardized protocols that can be applied to multiple types of ORED would streamline scientific study, management, and permitting at these sites. We propose an adaptive and reactive framework based on indicators of the likely changes to the marine ecosystem due to ORED. We developed decision trees to identify suites of impacts at two scales (demonstration and commercial) depending on energy (wind, tidal, and wave), structure (e.g., turbine), and foundation type (e.g., monopile). Impacts were categorized by ecosystem component (benthic habitat and resources, fish and fisheries, avian species, marine mammals, and sea turtles) and monitoring objectives were developed for each. We present a case study at a commercial-scale wind farm and develop a monitoring plan for this development that addresses both local and national environmental concerns. In addition, framework has provided a starting point for identifying global research needs and objectives for understanding of the potential effects of ORED on the marine environment.
Abela-Dimech, Frances; Johnston, Kim; Strudwick, Gillian
A mental health organization in Ontario, Canada, noted an increase in unsafe items entering locked inpatient units. The purpose of this project was to develop and implement a search protocol to improve patient, staff, and visitor safety by preventing unsafe items from entering a locked inpatient unit. Under the guidance of a clinical nurse specialist, an interprofessional team used the Failure Mode and Effects Analysis framework to identify what items were considered unsafe, how these unsafe items were entering the unit, and what strategies could be used to prevent these items from entering the unit. A standardized search protocol was identified as a strategy to prevent items from entering the unit. The standardized search protocol was developed and piloted on 1 unit. To support the search protocol, an interprofessional team created a poster using a mnemonic aid to educate patients, staff, and visitors about which items could not be brought onto the unit. Educational sessions on the search protocol were provided for staff. The difference between the number of incidents before and after the implementation of the search protocol was statistically significant. Safety on an inpatient unit was increased as incidents of unsafe items entering the unit decreased.
Sheppard, Jeremy M; Nimphius, Sophia; Haff, Greg G; Tran, Tai T; Spiteri, Tania; Brooks, Hedda; Slater, Gary; Newton, Robert U
Appropriate and valid testing protocols for evaluating the physical performances of surfing athletes are not well refined. The purpose of this project was to develop, refine, and evaluate a testing protocol for use with elite surfers, including measures of anthropometry, strength and power, and endurance. After pilot testing and consultation with athletes, coaches, and sport scientists, a specific suite of tests was developed. Forty-four competitive junior surfers (16.2 ± 1.3 y, 166.3 ± 7.3 cm, 57.9 ± 8.5 kg) participated in this study involving a within-day repeated-measures analysis, using an elite junior group of 22 international competitors (EJG), to establish reliability of the measures. To reflect validity of the testing measures, a comparison of performance results was then undertaken between the EJG and an age-matched competitive junior group of 22 nationally competitive surfers (CJG). Percent typical error of measurement (%TEM) for primary variables gained from the assessments ranged from 1.1% to 3.0%, with intraclass correlation coefficients ranging from .96 to .99. One-way analysis of variance revealed that the EJG had lower skinfolds (P = .005, d = 0.9) than the CJG, despite no difference in stature (P = .102) or body mass (P = .827). The EJG were faster in 15-m sprint-paddle velocity (P < .001, d = 1.3) and had higher lower-body isometric peak force (P = .04, d = 0.7) and superior endurance-paddling velocity (P = .008, d = 0.9). The relatively low %TEM of these tests in this population allows for high sensitivity to detect change. The results of this study suggest that competitively superior junior surfers are leaner and possess superior strength, paddling power, and paddling endurance.
Granville G. de Oliveira
Full Text Available Abstract Introduction: Multiple organ failure syndrome (MOFS is a pathology associated to unspecified and severe trauma, characterized by elevated morbidity and mortality. The complex inflammatory MOFS-related reactions generate important ischemia-reperfusion responses in the induction of this syndrome. Nitric oxide elevation, through the activation of cyclic guanosine monophosphate (cGMP, has the potential of counteracting the typical systemic vasoconstriction, and platelet-induced hypercoagulation. Tadalafil would possibly act protectively by reducing cGMP degradation with consequent diffuse vasodilatation, besides reduction of platelet-induced hypercoagulation, thus, preventing multiple organ failure syndrome development. Methods: The experimental protocol was previously approved by an institution animal research committee. Experimental MOFS was induced through the stereotaxic micro-neurosurgical bilateral anterior hypothalamic lesions model. Groups of 10 Wistar rats were divided into: a Non-operated control; b Operated control group; c 2 hours after tadalafil-treated operated group; d 4 hours after tadalafil-treated operated group; e 8 hours after post-treated operated group. The animals were sacrificed 24 hours after the neurosurgical procedure and submitted to histopathologic examination of five organs: brain, lungs, stomach, kidneys, and liver. Results: The electrolytic hypothalamic lesions resulted in a full picture of MOFS with disseminated multiple-organs lesions, provoked primarily by diffusely spread micro-thrombi. The treatment with tadalafil 2 hours after the micro-neurosurgical lesions reduced the experimental MOFS lesions development, in a highly significant level (P<0.01 of 58.75%. The treatment with tadalafil, 4 hours after the micro-neurosurgically-induced MOFS lesions, also reduced in 49.71%, in a highly significant level (P<0.01. Finally, the treatment with tadalafil 8 hours after the neurosurgical procedure resulted in a
Giesen, J. H.
Development and operation of a marine oil spill management simulator system at Texas A and M University's Galveston Center for Marine Training and Safety was described. The Spill Management Simulator is a multi-year joint program between the U. S. Coast Guard and the Center. Essentially, it is a a computer-based modelling and scenario generator for conducting and evaluating incident management training. An independent evaluation group has been set up by the U.S.Coast Guard to evaluate the Galveston and similar programs established under the same legislation throughout the United States. This paper discusses the creation of a development and implementation protocol for Spill Management Team simulation as a foundation upon which to integrate available and future technology and for making it available to the response community as a whole. 12 refs.,1 tab., 4 figs
Hartley, Christopher Ahlvin
Current building energy auditing techniques are outdated and lack targeted, actionable information. These analyses only use one year's worth of monthly electricity and gas bills to define energy conservation and efficiency measures. These limited data sets cannot provide robust, directed energy reduction recommendations. The need is apparent for an overhaul of existing energy audit protocols to utilize all data that is available from the building's utility provider, installed energy management system (EMS), and sub-metering devices. This thesis analyzed the current state-of-the-art in energy audits, generated a next generation energy audit protocol, and conducted both audits types on four case study buildings to find out what additional information can be obtained from additional data sources and increased data gathering resolutions. Energy data from each case study building were collected using a variety of means including utility meters, whole building energy meters, EMS systems, and sub-metering devices. In addition to conducting an energy analysis for each case study building using the current and next generation energy audit protocols, two building energy models were created using the programs eQuest and EnergyPlus. The current and next generation energy audit protocol results were compared to one another upon completion. The results show that using the current audit protocols, only variations in season are apparent. Results from the developed next generation energy audit protocols show that in addition to seasonal variations, building heating, ventilation and air conditioning (HVAC) schedules, occupancy schedules, baseline and peak energy demand levels, and malfunctioning equipment can be found. This new protocol may also be used to quickly generate accurate building models because of the increased resolution that yields scheduling information. The developed next generation energy auditing protocol is scalable and can work for many building types across the
Lockshin, M. D.; Derksen, R. H. W. M.
Systemic lupus erythematosus is the disease in which the antiphospholipid syndrome was first described more than 20 years ago and which is the most frequent underlying disorder in secondary antiphospholipid syndrome. With respect to pathogenic concepts and treatment, the subjects of this review, no
Gameren-Oosterom, Hillegonda Bertine Matthea van
In this thesis, four studies on children and adolescents with Down syndrome are described. The first study showed that the number of live births of children with Down syndrome in the Netherlands remained stable over the period 1997-2007 on 14.6 per 10,000 births. Of these, 85% were live born. In
Rigoldi, Chiara; Galli, Manuela; Albertini, Giorgio
In this work we studied and evaluated the effects of aging in a group of individuals with Down syndrome, using gait analysis as tool of investigation. 32 individuals suffering from Down syndrome (DS) were enrolled in this study as group of pathological participants. The control group (CG) was composed by 36 healthy subjects (10 children, 15…
S.T. Sharma; L.K. Nieman; R.A. Feelders (Richard)
textabstractCushing’s syndrome is a rare disorder resulting from prolonged exposure to excess glucocorticoids. Early diagnosis and treatment of Cushing’s syndrome is associated with a decrease in morbidity and mortality. Clinical presentation can be highly variable, and establishing the diagnosis
Finestack, Lizbeth H.; Richmond, Erica K.; Abbeduto, Leonard
Fragile X syndrome (FXS) is the leading inherited cause of intellectual disability. The syndrome is caused by a single gene mutation on the X chromosome. Although individual differences are large, most individuals with FXS display weaknesses across all language and literacy domains compared with peers of the same chronological age with typical…
Roelofs, R.L.; Janssen, N.; Wingbermühle, P.A.M.; Kessels, R.P.C.; Egger, J.I.M.
INTRODUCTION: Although cognitive impairments in adults with Noonan syndrome seem to be limited to a low-average intelligence and slower processing speed, studies in children with Noonan syndrome have demonstrated more extensive cognitive problems. These include deficits in language skills, memory,
Song, Ki Sang; Kim, Young Sik [Korea National University of Education, Chongwon (Korea); No, Hee Chon [Korea Advanced Institute of Science and Technology, Taejon (Korea)
In this research, we first define protocol subsets for SMART(System-integrated Modular Advanced Reactor) communication network based on the requirement of SMART MMIS transmission delay and traffic requirements and OSI(Open System Interconnection) 7 layers' network protocol functions. Also, current industrial purpose LAN protocols are analyzed and the applicability of commercialized protocols are checked. For the suitability test, we have applied approximated SMART data traffic and maximum allowable transmission delay requirement. With the simulation results, we conclude that IEEE 802.5 and FDDI which is an ANSI standard, is the most suitable for SMART. We further analyzed the FDDI and token ring protocols for SMART and nuclear plant network environment including IEEE 802.4, IEEE 802.5, and ARCnet. The most suitable protocol for SMART is FDDI and FDDI MAC and RMT protocol specifications have been verified with LOTOS and the verification results show that FDDI MAC and RMT satisfy the reachability and liveness, but does not show deadlock and livelock. Therefore, we conclude that FDDI MAC and RMT is highly reliable protocol for SMART MMIS network. After that, we consider the stacking fault of IEEE 802.5 token ring protocol and propose a fault tolerant MAM(Modified Active Monitor) protocol. The simulation results show that the MAM protocol improves lower priority traffic service rate when stacking fault occurs. Therefore, proposed MAM protocol can be applied to SMART communication network for high reliability and hard real-time communication purpose in data acquisition and inter channel network. (author). 37 refs., 79 figs., 39 tabs.
Pacing, Conventional Physical Activity and Active Video Games to Increase Physical Activity for Adults with Myalgic Encephalomyelitis/Chronic Fatigue Syndrome: Protocol for a Pilot Randomized Controlled Trial.
Ferrar, Katia Elizabeth; Smith, Ashleigh E; Davison, Kade
of the intervention. Health-related outcomes (eg, physical activity, blood samples, quality of life, and functioning) will be collected at baseline, end of intervention, and 6 months after intervention completion. This protocol was developed after 6 months of extensive stakeholder and community consultation. Enrollment began in January 2017; as of publication, 12 participants were enrolled. Baseline testing is scheduled to commence in mid-2017. This pilot study will provide essential feasibility and acceptability data which will guide the use of active video games for people with ME/CFS to increase their physical activity levels. Physical activity promotion in this clinical population has been poorly and under-researched, and any exploration of alternative physical activity options for this population is much needed. Australia New Zealand Clinical Trials Registry: ACTRN12616000285459; https://www.anzctr.org.au/Trial/Registration/TrialReview.aspx?id=370224 (Archived by WebCite at http://www.webcitation.org/6qgOLhWWf). ©Katia Elizabeth Ferrar, Ashleigh E Smith, Kade Davison. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 01.08.2017.
Vallés-Carrascosa, Eva; Gallego-Izquierdo, Tomás; Jiménez-Rejano, José Jesús; Plaza-Manzano, Gustavo; Pecos-Martín, Daniel; Hita-Contreras, Fidel; Achalandabaso Ochoa, Alexander
Randomized clinical trial. Eccentric exercise (EE) was shown to be an effective treatment in tendinopathies. However, the evidence of its effectiveness in subacromial syndrome (SS) is scarce. Moreover, consensus has not been reached on whether best results for SS are obtained by means of EE with or without pain. The purpose of this is to compare the effect on pain, active range of motion (AROM), and shoulder function of an exercise protocol performed with pain shoulder function using the modified Constant-Murley Score (CMS) before and after intervention. All dependent variables improved significantly in both groups (P shoulder AROM. Furthermore, PEE does not provide greater benefits. Further studies are needed with long-term follow-up to reinforce these results. Copyright © 2017. Published by Elsevier Inc.
Smith, Ashlyn L.; Romski, MaryAnn; Sevcik, Rose A.; Adamson, Lauren B.; Barker, R. Michael
This study extended research on the Down syndrome advantage by examining differences in parent stress and parent perceptions of language development between 29 parents of young children with Down syndrome and 82 parents of children with other developmental disabilities. Parents of children with Down syndrome reported lower levels of total stress, child-related stress, and stress surrounding the parent-child interaction. Parents of children in both groups reported that they felt successful in ...
Bijarania, Sunil Kumar; Saini, Sushma Kumari; Verma, Sanjay; Kaur, Sukhwinder
To develop standard operational protocol (SOP) on oral drug administration and checklist to assess the implementation of the developed SOP. In this prospective methodological study, SOPs were developed in five phases. In the first phase, the preliminary draft of SOPs and checklists were prepared based on literature review, assessment of current practices and focus group discussion (FGD) with bedside working nurses. In the second phase, content validity was checked with the help of Delphi technique (12 experts). Total four drafts were prepared in stages and necessary modifications were made as per suggestions after each Delphi round. Fourth Delphi round was performed after conducting a pilot study. In the fourth phase, all bedside nurses were trained as per SOPs and asked to practice accordingly and observation of thirty oral drug administrations in children was done to check reliability of checklists for implementation of SOPs. In Phase-V, 7 FGDs were conducted with bedside nurses to assess the effectiveness of SOPs. The Content Validity Index (CVI) of SOP and checklists was 99.77%. Overall standardized Cronbach's alpha was calculated as 0.94. All the nurses felt that the SOP is useful. Valid and feasible SOP for drug administration to children through oral route along with valid and reliable checklist were developed. It is recommended to use this document for drug administration to children.
Stickley, Christopher D; Presuto, Melanie M; Radzak, Kara N; Bourbeau, Christina M; Hetzler, Ronald K
Although the risk of osteoarthritis development after acute knee injury has been widely studied, the long-term consequences of knee overuse injury are not well understood. To identify the relationship between gait-related risk factors associated with osteoarthritis and the development of iliotibial band syndrome (ITBS) in members of a single University Army Reserve Officers' Training Corps unit. Prospective cohort study. Biomechanics laboratory. Sixty-eight cadets undergoing standardized physical fitness training. Three-dimensional lower extremity kinematics (240 Hz) and kinetics (960 Hz) were collected for 3 bilateral trials during shod running at 4.0 m/s ± 10%. Injury tracking was conducted for 7 months of training. Biomechanical variables, including varus thrust and knee-adduction moment, were compared between the injured and control groups. Twenty-six cadets with no history of overuse injury served as the control group, whereas 6 cadets (7 limbs) who developed ITBS that required them to modify their training program or seek medical care (or both) served as the injured group. Maximum varus velocity was higher ( P = .006) and occurred sooner during stance ( P = .04) in the injured group than in the control group, indicating greater varus thrust. Maximum knee-varus angle and maximum knee-adduction moment were higher ( P = .02 and P = .002, respectively) and vertical stiffness was lower ( P = .03) in the injured group. Measures of dynamic varus stability appeared to be altered in individuals who developed ITBS. Biomechanical knee variables previously identified as increasing the risk for knee osteoarthritis were also associated with the development of ITBS in healthy adults.
Heliövaara, Arja; Rantanen, Irma; Arte, Sirpa
BACKGROUND. Variations in dental development and tooth agenesis have been reported in children with velocardiofacial syndrome (VCFS). AIM. The aim was to evaluate the dental development and missing permanent teeth in children with VCFS. DESIGN. Forty-five children (23 girls) with VCFS who had visited the cleft palate and craniofacial centre were studied retrospectively from orthopantomograms taken at the mean age of 7.9 years (range 5.8-12.9). Thirteen of the children with VCFS had palatal clefts. The deletion of 22q11 was verified by FISH techniques. The dental stages were assessed by the method of Demirjian, and the dental age was calculated according to the Finnish dental maturity reference values. A paired Student's t-test was used in the statistical analysis. RESULTS. Eight children (17%), four with palatal clefts, had tooth agenesis. Four children (9%) had agenesis of mandibular incisors. The missing teeth (n = 19) were mainly mandibular incisors (n = 6), maxillary lateral incisors (n = 2), and maxillary second premolars (n = 4). The dental age of the children with VCFS was not different from their chronological age, but there was great individual variation. CONCLUSIONS. A high prevalence of missing permanent teeth, especially mandibular incisors, was observed. The need for thorough clinical and radiological dental examination in children with VCFS is emphasized. © 2011 The Authors. International Journal of Paediatric Dentistry © 2011 BSPD, IAPD and Blackwell Publishing Ltd.
Royall, Dawna; Brauer, Paula; Bjorklund, Laura; O'Young, Olivia; Tremblay, Angelo; Jeejeebhoy, Khursheed; Heyland, Daren; Dhaliwal, Rupinder; Klein, Doug; Mutch, David M
Metabolic syndrome (MetS) refers to a particular cluster of metabolic abnormalities (hypertension, dyslipidemia, type 2 diabetes, and visceral fat deposition) that can lead to a 1.5- to 2-fold increased relative risk of cardiovascular disease. Various combinations of healthier eating patterns and increased physical activity have been shown to improve metabolic abnormalities and reduce MetS prevalence. Dietitians who counsel MetS patients are challenged to integrate guidance from various medical management guidelines and research studies with effective behavioural change strategies and specific advice on what food and eating pattern changes will be most effective, feasible, and acceptable to clients. As part of a demonstration project that is currently underway, we developed a care map (decision aid) that represents the key decision processes involved in diet counselling for MetS. The care map is based on evidence from both clinical and health behaviour change studies and expert consensus and has undergone limited dietitian review. It is being used to help project dietitians clearly articulate their specific food intake change goals. Additional studies to directly compare counselling strategies could inform future development of the map. In the meantime, dietitians may find this care map helpful in clarifying counselling goals and strategies in this client group.
Scott Jimenez, Stephanie
Security and waste management protocols are developed for the laboratory de la Escuela de Ingenieria Quimica at the Universidad de Costa Rica. The protocols are elaborated according to the provisions and guidelines stipulated in the Costa Rican legislation, technical references and documents issued by the chemical regency of the Universidad de Costa Rica. An inspection guide was prepared and applied as diagnostic tool for the evaluation of the safety conditions and handling of chemical substances in the laboratory. Inspections of the physical plant and interviews to area managers were realized. The results obtained have allowed to implement improvements of the activities in safe working environment conditions and teaching; and an adequate signaling and demarcation of the facilities, location and recharge of fire extinguishers. An emergency plan is elaborated for the Laboratorio de Ingenieria Quimica, by performing a sequence of stages proposed by Comision Nacional de Emergencias. In addition, a plan for the safe and effective management of waste generated is made based on the reagents most frequently used in the different practices. The method of storage Flinn Scientific was selected as the most appropriate method to organize and distribute chemicals in the laboratory reagent storage area, obtaining the highest percentage in the decision matrix. Security aspects in the registration and documentation system implemented in the laboratory administration are evaluated by a checklist. This assessment has allowed to propose improvements, to increase the efficiency and to obtain an easy storage, control and a fast search of the information by means of the procedures documented and elaborated. Some of the recommendations proposed have been the establishment of an emergency action committee, the reduction of unnecessary quantities of chemicals stored, training on safety, operation of fire extinguisher and first aid; and construction of an emergency exit, etc. [es
Ethics and dissemination: The protocol will provide us a roadmap to systematically develop evidence-based CPG for intra-articular injection for knee OA. The work will be disseminated electronically and in print. The guideline would be the first CPG that is developed primarily by orthopedic specialists in China and strictly based on systematic methodology.
Kher, Sucharita; Roberts, Russel J; Garpestad, Erik; Kunkel, Chris; Howard, William; Didominico, Dorothy; Fergusson, Anne; Devlin, John W
While one controlled trial found that a daily awakening and spontaneous breathing trial (DA-SBT) decreases time on mechanical ventilation (MV), there is a paucity of real-world data surrounding the development, implementation, and impact of DA-SBT protocols. We describe a multidisciplinary process improvement effort in 2, 10-bed medical intensive care units (MICUs) at a 330-bed academic medical center that focused on the development, implementation, and evaluation of a new DA-SBT protocol. A DA-SBT protocol, developed using results from a nursing survey literature and available institutional resources, was implemented after extensive clinician education and institution of quality reminders to boost use. Postprotocol compliance was evaluated. Use of sedation, DA and SBT practices, and clinical outcomes were retrospectively compared between the before and after DA-SBT protocol groups (ie, consecutive MICU patients requiring a continuously infused sedative [CIS] ≥24 hours). In the after group (n = 32), the DA and SBT compliances were 44% and 84%, respectively. Compared with the before group (n = 33), after group patients received CIS on fewer days of MV (100% vs 67%, P = .003) and had their CIS down-titrated by ≥25% on more days of CIS (40% vs 71%, P = .006). Neither total CIS dose (P = .49), total MV days (P = .75), days of MV where a SBT occurred (P = .38), nor episodes of self-extubation (15% vs 6%, P = .43) differed between the 2 groups. Despite the implementation of a DA-SBT protocol that was individualized to clinician preferences and institutional resources and accompanied by substantial education and reminders for use, compliance to the DA component of this protocol was low and duration of MV remained unchanged. Additional quality improvement strategies are needed to overcome barriers to DA-SBT protocol use that may not exist in controlled clinical trials.
Peng, Daogang; Zhang, Hao; Weng, Jiannian; Li, Hui; Xia, Fei
Industrial Ethernet is a new technology for industrial network communications developed in recent years. In the field of industrial automation in China, EPA is the first standard accepted and published by ISO, and has been included in the fourth edition IEC61158 Fieldbus of NO.14 type. According to EPA standard, Field devices such as industrial field controller, actuator and other instruments are all able to realize communication based on the Ethernet standard. The Atmel AT91RM9200 embedded development board and open source embedded Linux are used to develop an information inquiry service system of EPA protocol based on embedded ARM Linux in this paper. The system is capable of designing an EPA Server program for EPA data acquisition procedures, the EPA information inquiry service is available for programs in local or remote host through Socket interface. The EPA client can access data and information of other EPA equipments on the EPA network when it establishes connection with the monitoring port of the server.
Montgomery, Catherine M
Global product development partnerships (PDPs) for new health technologies have become an increasingly important part of the science and development landscape over the past two decades. Polarised positions are adopted by those scrutinising the power and governance of these public-private formations; on the one hand, they are seen as successful social technology innovations, on the other as regressive and imperialistic regimes of neo-colonialism. Answering recent calls for research to examine the actors, governance, context and dynamics of PDPs, this article presents a sociological case study of one particular partnership, the Microbicides Development Programme (MDP). Interviews were conducted with a cross-section of programme staff in the UK and Zambia, and discourses analysed through a Foucauldian lens of governmentality. This article suggests that two tools of government were central to MDP's cohesiveness: institutional discourses of participatory democracy and capacity building and scientific protocols. Through these material-semiotic tools, the scientific community, junior operational researchers and the funder were successfully enrolled into the programme and governed by a central body based in the UK. This article draws on Nikolas Rose's work to discuss these socio-scientific discourses as technologies of government, and provides a non-dualistic account of power and governance in a North-South PDP. © 2012 The Author. Sociology of Health & Illness © 2012 Foundation for the Sociology of Health & Illness/Blackwell Publishing Ltd.
Hawamdeh, Ziad M.; Alshraideh, Mohammad A.; Al-Ajlouni, Jihad M.; Salah, Imad K.; Holm, Margo B.; Otom, Ali H.
To design a medical decision support system (MDSS) that would accurately predict the rehabilitation protocols prescribed by the physicians for patients with knee osteoarthritis (OA) using only their demographic and clinical characteristics. The demographic and clinical variables for 170 patients receiving one of three treatment protocols for knee…
Schumacher, Gary; Grigsby, Bettye; Vesey, Winona
This study proposes a research-based teacher selection protocol. The protocol is intended to offer school district hiring authorities a tool to identify teacher candidates with the behaviors expected to predict effective teaching. It is hypothesized that a particular series of research-based interview questions focusing on teaching behaviors in…
Dominguez-Mayoral, A; Gutierrez, C; Lopez-Dominguez, J M; Eichau, S; Abril, J; Navarro-Mascarell, G; Quesada-Garcia, M A; Ramos, M; Alvarez-Lopez, M; Menendez-De Leon, C; Izquierdo, G
Guillain-Barre syndrome is classically defined as a symmetrical ascending acute polyradiculoneuropathy, although there are atypical variants that make diagnosis difficult. The medical data of six patients in our hospital area are collected during the first quarter of 2013. Lumbar punctures, imaging, neurophysiological studies, ganglioside antibodies and serologies have been proposed in all cases. We focus on the atypical features as late hyporeflexia, increased frequency of asymmetry and distal paresis and initial fever. From a neurophysiological point of view, all patients presented sensorimotor axonal forms. The most consistent datas in early studies is the F wave's alteration. A Miller Fisher variant associated with faciocervicobraquial paresis and cerebral reversible vasoconstriction syndrome has been detected. A bilateral brachial paresis and lumbar polyradiculopathy in the context of influenza A infection is other interesting case. The saltatory variant with cranial nerve involvement and lower limbs paresis has been demonstrated in one patient. Bands in cerebrospinal fluid are positive in three cases and anti-ganglioside antibodies in one patient. The syndrome of inappropriate secretion of antidiuretic hormone may explain some of the hyponatremias registered. The first line of treatment are inmunoglobulins in all patients. Plasmapheresis exchanges has been used as an additional therapy in four cases. These clusters of six axonal cases with atypical clinical features justifies the need for knowledge of these variants in order to achieve an early treatment. Late hyporeflexia and brachialfaciocervico, saltatory and lumbar forms should be considered in the spectrum of Guillain-Barre syndrome. The etiological study should rule out a lots of pathogens as influenza A.
Călina Mirela-Lucia; Rusu Ligia; Elena Taina Avramescu; Denisa Enescu-Bieru; Eugenia Rosulescu; Dragomir Mihai
The current paper aims to evaluate the lumbar-sacral algo-functional syndromes with a muscular-ligament cause and to establish a staged program for its functional recovery which would also prevent reoccurrences and/ or complications, these being relatively frequent and with important functional implications . These ailments,specific to patients who are at an active age have a particular social impact, important morbidity and can be easily mistaken for more serious lumbar-sacral ailments, t...
Full Text Available The current paper aims to evaluate the lumbar-sacral algo-functional syndromes with a muscular-ligament cause and to establish a staged program for its functional recovery which would also prevent reoccurrences and/ or complications, these being relatively frequent and with important functional implications . These ailments,specific to patients who are at an active age have a particular social impact, important morbidity and can be easily mistaken for more serious lumbar-sacral ailments, thus leading to disproportionately serious, but inefficient for thereal cause, treatments .The study was made over a period of 6 months, on 18 patients with lumbar-sacral syndrome with a muscularligament cause, diagnosed as a result of clinical and paraclinic evaluation, an alternative etiology of the syndrome being excluded. The patients were integrated into a functional re-education programme which included drug therapy (anti-inflammatory +/- relaxant medication, physically-kinetically supported (thermal-kinetic-massage therapy, staged into 2 weeks, one and 3-6 months intervals, respectively. The results obtained emphasise the improvement in the clinical parameters form one stage to the other, in the third stage of the programme reaching asemi-complete (over 90% recovery of the affected areas, compared to the initial stages.
Simonsz, Huib; Bärlocher, K.E.; Rötig, A.
textabstractDocumenta Ophthalmologica 1992, Volume 82, Issue 1-2, pp 73-79 Kearns-Sayre's syndrome developing in a boy who survived Pearson's syndrome caused by mitochondrial DNA deletion Dr H. J. Simonsz, K. Bärlocher, A. Rötig … show all 3 hide » Download PDF (2,322 KB) Abstract A 7-year-old boy presented with bilateral ptosis and atypical retinitis pigmentosa. Before age two, he had had an Fe-refractory anemia, with neutropenia and thrombopenia. Just prior to the ophthalmic examination, th...
Yu V Naugol'nih
Full Text Available The influence of parental metabolic state on development of psychovegetative syndrome in children. The data from the present study which involved neuropsychological assessment shows significant deteriorations in immediate audio vocal, visial memory and attention in children with metabolic syndrome which have parents with type 2 diabetes mellitus
Cleave, Patricia; Bird, Elizabeth Kay-Raining; Czutrin, Rachael; Smith, Lindsey
The present study examined narrative development in children and adolescents with Down syndrome longitudinally. Narratives were collected from 32 children and adolescents with Down syndrome three times over a 1-year period. Both micro- and macrolevel analyses were conducted. Significant growth over the 1-year period was seen in semantic complexity…
Leonard, Hayley C.; Annaz, Dagmara; Karmiloff-Smith, Annette; Johnson, Mark H.
The current study investigated whether contrasting face recognition abilities in autism and Williams syndrome could be explained by different spatial frequency biases over developmental time. Typically-developing children and groups with Williams syndrome and autism were asked to recognise faces in which low, middle and high spatial frequency…
Morrison, JA; Friedman, LA; Harlan, WR; Harlan, LC; Barton, BA; Schreiber, GB; Klein, DJ
Background. The metabolic syndrome, associated with increased risk of type 2 diabetes mellitus and cardiovascular disease, begins to develop during adolescence. Objective. We sought to identify early predictors of the presence of the syndrome at the ages of 18 and 19 years in black and white girls.
de Courten Maximilian
Full Text Available Abstract Background In order to improve the health of people with Type 1 diabetes in developing countries, a clear analysis of the constraints to insulin access and diabetes care is needed. We developed a Rapid Assessment Protocol for Insulin Access, comprising a series of questionnaires as well as a protocol for the gathering of other data through site visits, discussions, and document reviews. Methods The Rapid Assessment Protocol for Insulin Access draws on the principles of Rapid Assessment Protocols which have been developed and implemented in several different areas. This protocol was adapted through a thorough literature review on diabetes, chronic condition management and medicine supply in developing countries. A visit to three countries in sub-Saharan Africa and meetings with different experts in the field of diabetes helped refine the questionnaires. Following the development of the questionnaires these were tested with various people familiar with diabetes and/or healthcare in developing countries. The Protocol was piloted in Mozambique then refined and had two further iterations in Zambia and Mali. Translations of questionnaires were made into local languages when necessary, with back translation to ensure precision. Results In each country the protocol was implemented in 3 areas – the capital city, a large urban centre and a predominantly rural area and their respective surroundings. Interviews were carried out by local teams trained on how to use the tool. Data was then collected and entered into a database for analysis. Conclusion The Rapid Assessment Protocol for Insulin Access was developed to provide a situational analysis of Type 1 diabetes, in order to make recommendations to the national Ministries of Health and Diabetes Associations. It provided valuable information on patients' access to insulin, syringes, monitoring and care. It was thus able to sketch a picture of the health care system with regards to its ability to
De Tobel, Jannick; Hillewig, Elke; Bogaert, Stephanie; Deblaere, Karel; Verstraete, Koenraad
Established dental age estimation methods in sub-adults study the development of third molar root apices on radiographs. In living individuals, however, avoiding ionising radiation is expedient. Studying dental development with magnetic resonance imaging complies with this requirement, adding the advantage of imaging in three dimensions. To elaborate the development of an MRI protocol to visualise all third molars for forensic age estimation, with particular attention to the development of the root apex. Ex vivo scans of porcine jaws and in vivo scans of 10 volunteers aged 17-25 years were performed to select adequate sequences. Studied parameters were T1 vs T2 weighting, ultrashort echo time (UTE), fat suppression, in plane resolution, slice thickness, 3D imaging, signal-to-noise ratio, and acquisition time. A bilateral four-channel flexible surface coil was used. Two observers evaluated the suitability of the images. T2-weighted images were preferred to T1-weighted images. To clearly distinguish root apices in (almost) fully developed third molars an in plane resolution of 0.33 × 0.33 mm 2 was deemed necessary. Taking acquisition time limits into account, only a T2 FSE sequence with slice thickness of 2 mm generated images with sufficient resolution and contrast. UTE, thinner slice T2 FSE and T2 3D FSE sequences could not generate the desired resolution within 6.5 minutes. Three Tesla MRI of the third molars is a feasible technique for forensic age estimation, in which a T2 FSE sequence can provide the desired in plane resolution within a clinically acceptable acquisition time.
Melillo, E. M.; Sethi, J. M.; Mohsenin, V.
Guillain-Barré syndrome is the most common polyneuropathy causing major disability and respiratory failure. Respiratory complications are the main cause of death. Improved respiratory care and new treatment strategies such as plasmaphoresis and immunoglobulin have been shown to improve outcome. We studied the course and outcome of 37 patients with Guillain-Barré syndrome who were admitted to a rehabilitation and respiratory care facility over a 10-year period. There were 21 males and 16 femal...
Rummel, John D; Kminek, Gerhard
The last time NASA envisioned a sample return mission from Mars, the development of a protocol to support the analysis of the samples in a containment facility resulted in a "Draft Test Protocol" that outlined required preparations "for the safe receiving, handling, testing, distributing, and archiving of martian materials here on Earth" (Rummel et al., 2002 ). This document comprised a specific protocol to be used to conduct a biohazard test for a returned martian sample, following the recommendations of the Space Studies Board of the US National Academy of Sciences. Given the planned launch of a sample-collecting and sample-caching rover (Mars 2020) in 2 years' time, and with a sample return planned for the end of the next decade, it is time to revisit the Draft Test Protocol to develop a sample analysis and biohazard test plan to meet the needs of these future missions. Key Words: Biohazard detection-Mars sample analysis-Sample receiving facility-Protocol-New analytical techniques-Robotic sample handling. Astrobiology 18, 377-380.
Anastasi, Joyce K.; Capili, Bernadette; Chang, Michelle
Traditional Chinese medicine encompasses many different practices, most notably acupuncture and moxibustion. Traditionally, these modalities are used in combination to augment treatment but seldom are they tested together in clinical studies. Numerous acupuncture studies have been conducted in Asia, Europe, and the United States but there have been few randomized controlled trials utilizing moxibustion outside of East Asia. Limited studies have described the use of a moxibustion control or pl...
Paris, Michael T; Lafleur, Benoit; Dubin, Joel A; Mourtzakis, Marina
Ultrasound is a non-invasive and readily available tool that can be prospectively applied at the bedside to assess muscle mass in clinical settings. The four-site protocol, which images two anatomical sites on each quadriceps, may be a viable bedside method, but its ability to predict musculature has not been compared against whole-body reference methods. Our primary objectives were to (i) compare the four-site protocol's ability to predict appendicular lean tissue mass from dual-energy X-ray absorptiometry; (ii) optimize the predictability of the four-site protocol with additional anatomical muscle thicknesses and easily obtained covariates; and (iii) assess the ability of the optimized protocol to identify individuals with low lean tissue mass. This observational cross-sectional study recruited 96 university and community dwelling adults. Participants underwent ultrasound scans for assessment of muscle thickness and whole-body dual-energy X-ray absorptiometry scans for assessment of appendicular lean tissue. Ultrasound protocols included (i) the nine-site protocol, which images nine anterior and posterior muscle groups in supine and prone positions, and (ii) the four-site protocol, which images two anterior sites on each quadriceps muscle group in a supine position. The four-site protocol was strongly associated (R 2 = 0.72) with appendicular lean tissue mass, but Bland-Altman analysis displayed wide limits of agreement (-5.67, 5.67 kg). Incorporating the anterior upper arm muscle thickness, and covariates age and sex, alongside the four-site protocol, improved the association (R 2 = 0.91) with appendicular lean tissue and displayed narrower limits of agreement (-3.18, 3.18 kg). The optimized protocol demonstrated a strong ability to identify low lean tissue mass (area under the curve = 0.89). The four-site protocol can be improved with the addition of the anterior upper arm muscle thickness, sex, and age when predicting appendicular lean tissue mass
Wu, D; France, E; Lambert, J; Hinkle, J
Purpose: Medical Physics teams can now play a critical role to help plan and provide studied approaches for traumatic brachial plexus MR imaging (tbpMRI). This is especially important for coordination with uncommon applications, since it is challenging to select the right modality, parameters, and train technologists on the essential components. For this work, we started with a review of the medical literature, performed crossover/volunteer studies to bring tbpMRI to practice with greater image QC and protocol management. Methods: To the best of our knowledge, we reviewed the known searchable domain for tbpMRI. We found 69 total articles since 2000. Articles were evaluated with our published protocol for literature management (LIMES3). Two physicists and two radiologists condensed the information from all articles into a knowledgebase. Results: The initial literature demonstrated great heterogeneity, which was a sign that this area needed greater consistency. Despite inconsistency and imprecision, we extracted the most relevant targets using our long-term experience with protocol development in MSK. We ran volunteers on six different magnets of various field strengths with multiple receiver coils, and rebuilt a coherent protocol for tbpMRI. Our radiologists rated LIMES3 work as superior. We have received referrals from the ER and have conducted four patient evaluations. Conclusion: Traumatic brachial plexus MRI has great possible benefits for patients. This work supports the complexity of tbpMRI scanning. As this is rarely performed, it requires a more diligent protocol workflow, coordination of caregivers, and education within multiple clinical departments. Choosing the correct imaging exam can be critical, as patients can have significant neuropathy and/or paralysis. The LIMES3 protocol is well liked at our institution, and forms the cornerstone of understanding for our work. Our literature management led to a better clinical protocol creation despite the diffuse
Wu, D; France, E; Lambert, J; Hinkle, J [The University of Oklahoma Health Sciences Center, Oklahoma City, OK (United States)
Purpose: Medical Physics teams can now play a critical role to help plan and provide studied approaches for traumatic brachial plexus MR imaging (tbpMRI). This is especially important for coordination with uncommon applications, since it is challenging to select the right modality, parameters, and train technologists on the essential components. For this work, we started with a review of the medical literature, performed crossover/volunteer studies to bring tbpMRI to practice with greater image QC and protocol management. Methods: To the best of our knowledge, we reviewed the known searchable domain for tbpMRI. We found 69 total articles since 2000. Articles were evaluated with our published protocol for literature management (LIMES3). Two physicists and two radiologists condensed the information from all articles into a knowledgebase. Results: The initial literature demonstrated great heterogeneity, which was a sign that this area needed greater consistency. Despite inconsistency and imprecision, we extracted the most relevant targets using our long-term experience with protocol development in MSK. We ran volunteers on six different magnets of various field strengths with multiple receiver coils, and rebuilt a coherent protocol for tbpMRI. Our radiologists rated LIMES3 work as superior. We have received referrals from the ER and have conducted four patient evaluations. Conclusion: Traumatic brachial plexus MRI has great possible benefits for patients. This work supports the complexity of tbpMRI scanning. As this is rarely performed, it requires a more diligent protocol workflow, coordination of caregivers, and education within multiple clinical departments. Choosing the correct imaging exam can be critical, as patients can have significant neuropathy and/or paralysis. The LIMES3 protocol is well liked at our institution, and forms the cornerstone of understanding for our work. Our literature management led to a better clinical protocol creation despite the diffuse
Del Papa, Nicoletta; Vitali, Claudio
For many years primary Sjögren's syndrome (pSS) has been considered an orphan disease, since no specific therapies were recognized as being capable of contrasting the development and progression of this disorder. The treatment of oral and ocular features, as well as of the systemic organ involvement, has been entrusted to the joint management of different subspecialty physicians, like ophthalmologists, otolaryngologists, dentists and rheumatologists. These latter subspecialty doctors are usually more involved in the treatment of systemic extraglandular involvement and, to do it, they have long been using the conventional therapies borrowed by the treatment schedules adopted in other systemic autoimmune diseases. The increasing knowledge of the biological pathways that are operative in patients with pSS, and the parallel development of molecular biology technology, have allowed the production and availability of a number of biological agents able to positively act on different disease mechanisms, and thus are candidates for testing in therapeutic trials. Meanwhile, the scientific community has made a great effort to develop new accurate and validated classification criteria and outcome measures to be applied in the selection of patients to be included and monitored in therapeutic studies. Some of the new-generation biotechnological agents have been tested in a number of open-label and randomized controlled trials that have produced in many cases inconclusive or contradictory results. Behind the differences in trial protocols, adopted outcome measures and predefined endpoints, reasons for such unsatisfactory results can be found in the large heterogeneity of clinical subtypes in the examined cohorts. The future challenge for a substantial advancement in the therapeutic approach to pSS could be to identify the pathologic mechanisms, outcome tools and biomarkers that characterize the different subsets of the disease in order to test carefully selected target therapies
Visootsak, J; Hess, B; Bakeman, R; Adamson, L B
Down syndrome (DS, OMIM #190685) is the most commonly identified genetic form of intellectual disability with congenital heart defect (CHD) occurring in 50% of cases. With advances in surgical techniques and an increasing lifespan, this has necessitated a greater understanding of the neurodevelopmental consequences of CHDs. Herein, we explore the impact of CHD on language development in children with DS. Twenty-nine children with DS were observed systematically in parent-child interactions using the Communication Play Protocol to evaluate their language use; they also completed the Mullen Scales of Early Learning and MacArthur Communication Development Inventory. Mean ages were 31.2 months for children with DS and CHD (DS + CHD, n = 12) and 32.1 months for children with DS and a structurally normal heart (DS - CHD, n = 17). Compared with the DS - CHD controls, the DS + CHD group revealed lower scores in multiple areas, including fine motor skills and expressive and receptive vocabulary. Whereas most differences were not statistically significant, the Communication Development Inventory word count and symbol-infused joint engagement differed significantly (P language delay allows us to consider the specific mechanisms underlying the impact of CHDs on language acquisition in children with DS. Conclusions from this first study on early language outcomes of children with DS + CHD may be useful for clinicians in providing developmental surveillance and early intervention programmes with specific emphasis on language therapy as part of long-term follow-up for children with DS + CHD. © 2012 The Authors. Journal of Intellectual Disability Research © 2012 John Wiley & Sons Ltd, MENCAP & IASSID.
National Aeronautics and Space Administration — The study protocol was successfully pilot tested with N=7 subjects (6 NASA flight surgeons and 1 Behavioral Health and Performance element Operations professional)...
Venuti, P; de Falco, S; Esposito, G; Bornstein, Marc H
Child solitary and collaborative mother-child play with 21 children with Down syndrome and 33 mental-age-matched typically developing children were compared. In solitary play, children with Down syndrome showed less exploratory but similar symbolic play compared to typically developing children. From solitary to collaborative play, children with Down syndrome increased their exploratory play, attaining the same level as typically developing children. Pretense significantly increased from solitary to collaborative play only in typically developing children. Differences between mothers' play in the two groups mirrored those between their children. Both groups showed similar attunement and synchrony. Mothers contribute to the play development of children with Down syndrome through their own adaptation to their children's limitations and potentialities.
Full Text Available Introduction: Hepatic transarterial chemoembolization is a widely used technique for the treatment of hepatocellular carcinoma. The most common complication of this procedure is postembolization syndrome. The main objective of this study was to assess risk factors for the development of postembolization syndrome. Material and Methods: Single-centre retrospective analysis of 563 hepatic transarterial chemoembolization procedures from January 1st, 2014 – December 31st, 2015. Hepatic transarterial chemoembolization was performed with ½ - 2 vials of 100 - 300 μm microspheres loaded with doxorubicin. Patients who experienced postembolization syndrome were identified based on prolongation of hospitalization due to pain, fever, nausea and/or vomiting. A control group with the patients who did not have postembolization syndrome was randomly created (three controls for one case. Descriptive analysis and multivariate logistic regression were performed. Results: The overall prevalence of postembolization syndrome was 6.2%. Hepatic transarterial chemoembolization with doxorubicin dosage above 75 mg (more than one vial, the size of the largest nodule and female gender had statistically significant relation with development of postembolization syndrome (p = 0.030, p = 0.046 and p = 0.037, respectively. Discussion: Doxorrubicin dosage above 75 mg is associated with a higher risk of postembolization syndrome. This result can be helpful for decision-making in clinical practice, whenever it is possible to avoid a higher dose without compromising the efficacy of the treatment. The size of the largest nodule and female gender also constitute risk factors for postembolization syndrome. The other variables studied were not related to the development of postembolization syndrome. Conclusion: The dose of doxorrubicin, the size of the largest nodule treated and female gender are potential risk factors for the development of postembolization syndrome after hepatic
The world is confronted with a variety of interdependent problems, including scarcity, unsustainability, inequality, pollution and poor governance. Tackling such complex challenges requires coordinated action. The present paper proposes the development of a self-organizing system for coordination, called an "offer network", that would use the distributed intelligence of the Internet to match the offers and needs of all human, technological and natural agents on the planet. This would maximize synergy and thus minimize waste and scarcity of resources. Implementing such coordination requires a protocol that formally defines agents, offers, needs, and the network of condition-action rules or reactions that interconnect them. Matching algorithms can then determine self-sustaining subnetworks in which each consumed resource (need) is also produced (offer). After sketching the elements of a mathematical foundation for offer networks, the paper proposes a roadmap for their practical implementation. This includes step-by-step integration with technologies such as the Semantic Web, ontologies, the Internet of Things, reputation and recommendation systems, reinforcement learning, governance through legal constraints and nudging, and ecosystem modeling. The resulting intelligent platform should be able to tackle nearly all practical and theoretical problems in a bottom-up, distributed manner, thus functioning like a Global Brain for humanity.
Julie, E. Golden; Selvi, S. Tamil
Wireless sensor networks (WSNs) consist of sensor nodes with limited processing capability and limited nonrechargeable battery power. Energy consumption in WSN is a significant issue in networks for improving network lifetime. It is essential to develop an energy aware clustering protocol in WSN to reduce energy consumption for increasing network lifetime. In this paper, a neuro-fuzzy energy aware clustering scheme (NFEACS) is proposed to form optimum and energy aware clusters. NFEACS consists of two parts: fuzzy subsystem and neural network system that achieved energy efficiency in forming clusters and cluster heads in WSN. NFEACS used neural network that provides effective training set related to energy and received signal strength of all nodes to estimate the expected energy for tentative cluster heads. Sensor nodes with higher energy are trained with center location of base station to select energy aware cluster heads. Fuzzy rule is used in fuzzy logic part that inputs to form clusters. NFEACS is designed for WSN handling mobility of node. The proposed scheme NFEACS is compared with related clustering schemes, cluster-head election mechanism using fuzzy logic, and energy aware fuzzy unequal clustering. The experiment results show that NFEACS performs better than the other related schemes. PMID:26881269
Spugnini, E P; Azzarito, T; Fais, S; Fanciulli, M; Baldi, A
Tumor microenvironment is one of the major obstacles to the efficacy of chemotherapy in cancer patients. The abnormal blood flow within the tumor results in uneven drug distribution. Electrochemotherapy (ECT) is a tumor treatment that adopts the systemic or local delivery of anticancer drugs with the application of permeabilizing electric pulses having appropriate amplitude and waveforms. This allows the use of lipophobic drugs that frequently have a narrow therapeutic index maintaining at the same time a reduced patient morbidity and preserving appropriate anticancer efficacy. Its use in humans is addressed to the treatment of cutaneous neoplasms or the palliation of skin tumor metastases, and a standard operating procedure has been devised. On the other hand, in veterinary oncology this approach is gaining popularity, thus becoming a first line treatment for different cancer histotypes, in a variety of clinical conditions due to its high efficacy and low toxicity. This review summarizes the state of the art in veterinary oncology as a preclinical model and reports the new protocols in terms of drugs and therapy combination that have been developed.
Groot, Gary; Waldron, Tamara; Carr, Tracey; McMullen, Linda; Bandura, Lori-Ann; Neufeld, Shelley-May; Duncan, Vicky
The practicality of applying evidence to healthcare systems with the aim of implementing change is an ongoing challenge for practitioners, policy makers, and academics. Shared decision- making (SDM), a method of medical decision-making that allows a balanced relationship between patients, physicians, and other key players in the medical decision process, is purported to improve patient and system outcomes. Despite the oft-mentioned benefits, there are gaps in the current literature between theory and implementation that would benefit from a realist approach given the value of this methodology to analyze complex interventions. In this protocol, we outline a study that will explore: "In which situations, how, why, and for whom does SDM between patients and health care providers contribute to improved decision making?" A seven step iterative process will be described including preliminary theory development, establishment of a search strategy, selection and appraisal of literature, data extraction, analysis and synthesis of extracted results from literature, and formation of a revised program theory with the input of patients, physicians, nurse navigators, and policy makers from a stakeholder session. The goal of the realist review will be to identify and refine a program theory for SDM through the identification of mechanisms which shape the characteristics of when, how, and why SDM will, and will not, work. PROSPERO CRD42017062609.
Julie, E Golden; Selvi, S Tamil
Wireless sensor networks (WSNs) consist of sensor nodes with limited processing capability and limited nonrechargeable battery power. Energy consumption in WSN is a significant issue in networks for improving network lifetime. It is essential to develop an energy aware clustering protocol in WSN to reduce energy consumption for increasing network lifetime. In this paper, a neuro-fuzzy energy aware clustering scheme (NFEACS) is proposed to form optimum and energy aware clusters. NFEACS consists of two parts: fuzzy subsystem and neural network system that achieved energy efficiency in forming clusters and cluster heads in WSN. NFEACS used neural network that provides effective training set related to energy and received signal strength of all nodes to estimate the expected energy for tentative cluster heads. Sensor nodes with higher energy are trained with center location of base station to select energy aware cluster heads. Fuzzy rule is used in fuzzy logic part that inputs to form clusters. NFEACS is designed for WSN handling mobility of node. The proposed scheme NFEACS is compared with related clustering schemes, cluster-head election mechanism using fuzzy logic, and energy aware fuzzy unequal clustering. The experiment results show that NFEACS performs better than the other related schemes.
Full Text Available The objective of this paper was (1 to assess compliance with the National Veterans Affairs Guidelines for the use of troglitazone and rosiglitazone and (2 to develop and implement a conversion protocol that allows effective management of patients receiving troglitazone. A retrospective chart review was conducted to assess adherence to guidelines for all patients receiving troglitazone and rosiglitazone at the medical center. Appropriateness of therapy through indication evaluation, safety through alanine aminotransferase (ALT monitoring compliance, and efficacy through hemoglobin A1c (HbA1c changes were used to assess adherence. According to National Veterans Affairs (VA Guidelines, 68% of troglitazone and 63% of rosiglitazone patients had an appropriate indication for the use of these agents. Baseline ALT levels were obtained in 40% of troglitazone and 71% of rosiglitazone patients. Full compliance with continual ALT monitoring was seen in 6 and 54% of patients, respectively. Goal HbA1c was achieved in 57 and 29% of patients, respectively. Of the 33 patients receiving troglitazone, 19 were converted to rosiglitazone therapy; 11 were maintained on current regimens without troglitazone, and 3 were lost to follow up. Adherence to guidelines needs to be reinforced, in particular, compliance with ALT monitoring. However, there were no reported cases of hepatotoxicity in the patients reviewed. Many patients did not achieve a HbA1c
Pacchiarotti, Jason; Ramos, Thomas; Howerton, Kyle; Greilach, Scott; Zaragoza, Karina; Olmstead, Marnie; Izadyar, Fariborz
Recent work in preservation of female fertility as well as new information on the nature of spermatogonial stem cells has prompted an investigation into the possibility of an effective clinical-grade procedure for the cryopreservation of testicular cells and/or tissue. Clinical-grade reagents, validated equipment, and protocols consistent with cGTP/cGMP standards were used in developing a procedure suitable for the safe and effective cryopreservation of human testicular cells and tissues. These procedures were designed to be compliant with the relevant FDA regulations. The procedure proved to effectively cryopreserve both testicular cells and tissue. The cryopreservation of testicular tissue was comparable in most aspects we measured to the cryopreservation of isolated cells, except that the viability of the cells from cryopreserved testicular tissue was found to be significantly higher. On the other hand, cryopreservation of cells is preferred for cell analysis, quality control, and sterility testing. This study demonstrates that testicular tissue and cells from sexual reassignment patients can be successfully cryopreserved with a clinical-grade procedure and important cell populations are not only preserved but also enriched by the process. Further studies will determine whether these findings from hormone-treated patients can be generalized to other patients. PMID:23509810
E. Golden Julie
Full Text Available Wireless sensor networks (WSNs consist of sensor nodes with limited processing capability and limited nonrechargeable battery power. Energy consumption in WSN is a significant issue in networks for improving network lifetime. It is essential to develop an energy aware clustering protocol in WSN to reduce energy consumption for increasing network lifetime. In this paper, a neuro-fuzzy energy aware clustering scheme (NFEACS is proposed to form optimum and energy aware clusters. NFEACS consists of two parts: fuzzy subsystem and neural network system that achieved energy efficiency in forming clusters and cluster heads in WSN. NFEACS used neural network that provides effective training set related to energy and received signal strength of all nodes to estimate the expected energy for tentative cluster heads. Sensor nodes with higher energy are trained with center location of base station to select energy aware cluster heads. Fuzzy rule is used in fuzzy logic part that inputs to form clusters. NFEACS is designed for WSN handling mobility of node. The proposed scheme NFEACS is compared with related clustering schemes, cluster-head election mechanism using fuzzy logic, and energy aware fuzzy unequal clustering. The experiment results show that NFEACS performs better than the other related schemes.
Supena, E.D.J.; Suharsono, S.; Jacobsen, E.; Custers, J.B.M.
Various systems of anther and microspore cultures were studied to establish an efficient doubled haploid production method for Indonesian hot pepper (Capsicum annuum L.). A shed-microspore culture protocol was developed which outperformed all the previously reported methods of haploid production in
Killian, John T; Lane, Jane B; Cutter, Gary R; Skinner, Steven A; Kaufmann, Walter E; Tarquinio, Daniel C; Glaze, Daniel G; Motil, Kathleen J; Neul, Jeffrey L; Percy, Alan K
Rett syndrome is a unique neurodevelopmental disorder, affecting approximately one in 10,000 live female births, most experiencing reduced growth. We characterized pubertal trajectories in females with Rett syndrome. We hypothesized that pubertal trajectory deviates from the general female population with early pubertal onset and delayed menarche. Participants were individuals enrolled in the Rett Syndrome Natural History Study with clinical diagnosis of Rett syndrome or mutations in MECP2. Intervals to thelarche, adrenarche, and menarche were assessed by survival analysis; body mass index, mutation type, clinical severity, and pubertal milestone relationships were assessed by log-likelihood test; pathway synchrony (relationship between thelarche, adrenarche, and menarche) was assessed by chi-squared analysis. Compared with the general female population, more than 25% initiated puberty early, yet entered menarche later (median age 13.0 years). A total of 19% experienced delayed menarche. Median length of puberty, from thelarche to menarche, was 3.9 years. Higher body mass index correlated with earlier thelarche and adrenarche but not menarche; milder mutations correlated with earlier menarche; and milder clinical presentation correlated with earlier thelarche and menarche. Fifty-two percent entered puberty in synchrony, but different from the general population, 15% led with thelarche and 32% with adrenarche. Pubertal trajectories in Rett syndrome differ from general population, entering puberty early and reaching menarche later. Body mass index affects pubertal timing, but the relationship between specific mutations, clinical presentation, and underlying neuroendocrine pathology is less clear. Copyright © 2014 Elsevier Inc. All rights reserved.
Kim, Soo Ji; Jo, Uiri
Based on the anatomical and functional commonality between singing and speech, various types of musical elements have been employed in music therapy research for speech rehabilitation. This study was to develop an accent-based music speech protocol to address voice problems of stroke patients with mixed dysarthria. Subjects were 6 stroke patients with mixed dysarthria and they received individual music therapy sessions. Each session was conducted for 30 minutes and 12 sessions including pre- and post-test were administered for each patient. For examining the protocol efficacy, the measures of maximum phonation time (MPT), fundamental frequency (F0), average intensity (dB), jitter, shimmer, noise to harmonics ratio (NHR), and diadochokinesis (DDK) were compared between pre and post-test and analyzed with a paired sample t-test. The results showed that the measures of MPT, F0, dB, and sequential motion rates (SMR) were significantly increased after administering the protocol. Also, there were statistically significant differences in the measures of shimmer, and alternating motion rates (AMR) of the syllable /K$\\inve$/ between pre- and post-test. The results indicated that the accent-based music speech protocol may improve speech motor coordination including respiration, phonation, articulation, resonance, and prosody of patients with dysarthria. This suggests the possibility of utilizing the music speech protocol to maximize immediate treatment effects in the course of a long-term treatment for patients with dysarthria.
Mahaffy, Paul R.; Atreya, Sushil K.
The Mars Science Laboratory (MSL) is under development by NASA with several international partners for launch in 2009. MSL is designed to quantitatively explore a local region on Mars as a potential habitat for present or past life (http://mars.jpl.nasa.gov/msl). The goals of MSL are to (1) assess the past or present biological potential of the target environment, (2) to characterize its geology and geochemistry, (3) to study planetary processes that influence habitability, and (4) to characterize the surface radiation. The last substantial search for organic molecules on the surface of Mars was with the Viking Landers in 1976 [Biemann, et al., 19771. In that mission, no organics were detected in near surface fines and presently a more comprehensive search is required to understand the potential of that planet to support life. While the Mars Exploration Rovers are able to identify mineralogical signatures of aqueous alteration, they are not equipped to search for organics. The planned capabilities of the MSL rover payload will enable a search for a wide range of organic molecules in both solid samples of rocks and fines and atmospheric samples. MSL will also provide a determination of definitive mineralogy of the solid samples and precision isotope measurements of several volatile elements. Contact and remote surface and subsurface survey tools will establish context for Analytical Laboratory measurements and will facilitate sample selection. The Sample Analysis at Mars (SAM) suite of MSL addresses several of the mission's core measurement goals. SAM includes a gas chromatograph, a mass spectrometer, and a tunable laser spectrometer. We will describe the range of measurement protocols under development and test for SAM and the relationship of our planned measurements to outstanding issues of martian habitability.
Russell, Rachel; Ormerod, Marcus; Newton, Rita
Modifying the home environments of older people as they age in place is a well-established health and social care intervention. Using design and construction methods to redress any imbalance caused by the ageing process or disability within the home environment, occupational therapists are seen as the experts in this field of practice. However, the process used by occupational therapists when modifying home environments has been criticised for being disorganised and not founded on theoretical principles and concepts underpinning the profession. To address this issue, research was conducted to develop a design and construction process protocol specifically for home modifications. A three-stage approach was taken for the analysis of qualitative data generated from an online survey, completed by 135 occupational therapists in the UK. Using both the existing occupational therapy intervention process model and the design and construction process protocol as the theoretical frameworks, a 4-phase, 9-subphase design and construction process protocol for home modifications was developed. Overall, the study is innovative in developing the first process protocol for home modifications, potentially providing occupational therapists with a systematic and effective approach to the design and delivery of home modification services for older and disabled people.
Full Text Available Objective – The study aimed to develop a search protocol and evaluate reviewers' satisfaction with an evidence-based practice (EBP review by embedding a library science student in the process.Methods – The student was embedded in one of four review teams overseen by a professional organization for oncology nurses (ONS. A literature search protocol was developed by the student following discussion and feedback from the review team. Organization staff provided process feedback. Reviewers from both case and control groups completed a questionnaire to assess satisfaction with the literature search phases of the review process. Results – A protocol was developed and refined for use by future review teams. The collaboration and the resulting search protocol were beneficial for both the student and the review team members. The questionnaire results did not yield statistically significant differences regarding satisfaction with the search process between case and control groups. Conclusions – Evidence-based reviewers' satisfaction with the literature searching process depends on multiple factors and it was not clear that embedding an LIS specialist in the review team improved satisfaction with the process. Future research with more respondents may elucidate specific factors that may impact reviewers' assessment.
Cho, Geum Joon; Park, Jong Heon; Shin, Soon-Ae; Oh, Min-Jeong; Seo, Hong Seog
The aim of this study was to investigate the association between metabolic syndrome in the non-pregnant state and the development of preeclampsia. We enrolled 212,463 Korean women who had their first delivery between January, 2011 and December, 2012 and had undergone a national health screening examination through the National Health Insurance during the 1-2 years before their first delivery. Women who had hypertension in the non-pregnant state were excluded. The presence of metabolic syndrome was defined using the modified criteria published in National Cholesterol Education Program Adult Treatment Panel III criteria. The prevalence of metabolic syndrome in non-pregnant state was 1.2%. Preeclampsia developed in 3.1% and its prevalence among women with and without metabolic syndrome was 7.3% and 3.0%, respectively. The pre-pregnancy prevalence of metabolic syndrome was higher in women who developed preeclampsia compared to that in those who had a normal pregnancy (1.1% vs. 2.8%; ppreeclampsia (odds ratio: 1.48; 95% CI: 1.26 to 1.74) compared to that in those without metabolic syndrome, after adjusting for age, family history of hypertension, smoking status, and pre-pregnancy body mass index. The risk of preeclampsia increased with a rise in the number of components of metabolic syndrome. Metabolic syndrome in the non-pregnant state was associated with the development of preeclampsia. Further studies are needed to evaluate whether early intervention for metabolic syndrome before pregnancy can decrease the risk of developing preeclampsia. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.
Steve, Trevor A; Yasuda, Clarissa L; Coras, Roland; Lail, Mohjevan; Blumcke, Ingmar; Livy, Daniel J; Malykhin, Nikolai; Gross, Donald W
Recent findings have demonstrated that hippocampal subfields can be selectively affected in different disease states, which has led to efforts to segment the human hippocampus with in vivo magnetic resonance imaging (MRI). However, no studies have examined the histological accuracy of subfield segmentation protocols. The presence of MRI-visible anatomical landmarks with known correspondence to histology represents a fundamental prerequisite for in vivo hippocampal subfield segmentation. In the present study, we aimed to: 1) develop a novel method for hippocampal body segmentation, based on two MRI-visible anatomical landmarks (stratum lacunosum moleculare [SLM] & dentate gyrus [DG]), and assess its accuracy in comparison to the gold standard direct histological measurements; 2) quantify the accuracy of two published segmentation strategies in comparison to the histological gold standard; and 3) apply the novel method to ex vivo MRI and correlate the results with histology. Ultra-high resolution ex vivo MRI was performed on six whole cadaveric hippocampal specimens, which were then divided into 22 blocks and histologically processed. The hippocampal bodies were segmented into subfields based on histological criteria and subfield boundaries and areas were directly measured. A novel method was developed using mean percentage of the total SLM distance to define subfield boundaries. Boundary distances and subfield areas on histology were then determined using the novel method and compared to the gold standard histological measurements. The novel method was then used to determine ex vivo MRI measures of subfield boundaries and areas, which were compared to histological measurements. For direct histological measurements, the mean percentages of total SLM distance were: Subiculum/CA1 = 9.7%, CA1/CA2 = 78.4%, CA2/CA3 = 97.5%. When applied to histology, the novel method provided accurate measures for CA1/CA2 (ICC = 0.93) and CA2/CA3 (ICC = 0.97) boundaries, but not for the
Wildes, T S; Winter, A C; Maybrier, H R; Mickle, A M; Lenze, E J; Stark, S; Lin, N; Inouye, S K; Schmitt, E M; McKinnon, S L; Muench, M R; Murphy, M R; Upadhyayula, R T; Fritz, B A; Escallier, K E; Apakama, G P; Emmert, D A; Graetz, T J; Stevens, T W; Palanca, B J; Hueneke, R L; Melby, S; Torres, B; Leung, J; Jacobsohn, E; Avidan, M S
Introduction Postoperative delirium, arbitrarily defined as occurring within 5 days of surgery, affects up to 50% of patients older than 60 after a major operation. This geriatric syndrome is associated with longer intensive care unit and hospital stay, readmission, persistent cognitive deterioration and mortality. No effective preventive methods have been identified, but preliminary evidence suggests that EEG monitoring during general anaesthesia, by facilitating reduced anaesthetic exposure and EEG suppression, might decrease incident postoperative delirium. This study hypothesises that EEG-guidance of anaesthetic administration prevents postoperative delirium and downstream sequelae, including falls and decreased quality of life. Methods and analysis This is a 1232 patient, block-randomised, double-blinded, comparative effectiveness trial. Patients older than 60, undergoing volatile agent-based general anaesthesia for major surgery, are eligible. Patients are randomised to 1 of 2 anaesthetic approaches. One group receives general anaesthesia with clinicians blinded to EEG monitoring. The other group receives EEG-guidance of anaesthetic agent administration. The outcomes of postoperative delirium (≤5 days), falls at 1 and 12 months and health-related quality of life at 1 and 12 months will be compared between groups. Postoperative delirium is assessed with the confusion assessment method, falls with ProFaNE consensus questions and quality of life with the Veteran's RAND 12-item Health Survey. The intention-to-treat principle will be followed for all analyses. Differences between groups will be presented with 95% CIs and will be considered statistically significant at a two-sided pAnesthesia to Alleviate Geriatric Syndromes (ENGAGES) is approved by the ethics board at Washington University. Recruitment began in January 2015. Dissemination plans include presentations at scientific conferences, scientific publications, internet-based educational materials and
Pain, C. E.; Constantine, T.; Toplak, N.; Moll, M.; Iking-Konert, C.; Piotto, D. P.; Ayaz, N. Aktay; Nemcova, D.; Hoeger, P. H.; Cutolo, M.; Smith, Vanessa; Foeldvari, I.
Objective. To develop recommendations for investigation and monitoring of children with Raynaud's syndrome, based on paediatric evidence collated by a systematic review. Method. A systematic review was undertaken to establish the paediatric evidence for assessment and monitoring of Raynaud's syndrome. An expert panel including members of the Paediatric Rheumatology European Society (PRES) Scleroderma Working Group, were invited to a consensus meeting where recommendations were developed based...
de Falco, Simona; Venuti, Paola; Esposito, Gianluca; Bornstein, Marc H.
The aim of this study was to compare functional features of maternal and paternal speech directed to children with Down syndrome and developmental age-matched typically developing children. Altogether 88 parents (44 mothers and 44 fathers) and their 44 young children (22 children with Down syndrome and 22 typically developing children) participated. Parents’ speech directed to children was obtained through observation of naturalistic parent–child dyadic interactions. Verbatim transcripts of m...
Background Infections are the leading cause of death in the acute phase following spinal cord injury and qualify as independent risk factor for poor neurological outcome (“disease modifying factor”). The enhanced susceptibility for infections is not stringently explained by the increased risk of aspiration in tetraplegic patients, neurogenic bladder dysfunction, or by high-dose methylprednisolone treatment. Experimental and clinical pilot data suggest that spinal cord injury disrupts the balanced interplay between the central nervous system and the immune system. The primary hypothesis is that the Spinal Cord Injury-induced Immune Depression Syndrome (SCI-IDS) is 'neurogenic’ including deactivation of adaptive and innate immunity with decreased HLA-DR expression on monocytes as a key surrogate parameter. Secondary hypotheses are that the Immune Depression Syndrome is i) injury level- and ii) severity-dependent, iii) triggers transient lymphopenia, and iv) causes qualitative functional leukocyte deficits, which may endure the post-acute phase after spinal cord injury. Methods/Design SCIentinel is a prospective, international, multicenter study aiming to recruit about 118 patients with acute spinal cord injury or control patients with acute vertebral fracture without neurological deficits scheduled for spinal surgery. The assessment points are: i) trauma. Assessment includes infections, concomitant injury, medication and neurological classification using American Spinal Injury Association impairment scale (AIS) and neurological level. Laboratory analyses comprise haematological profiling, immunophenotyping, including HLA-DR expression on monocytes, cytokines and gene expression of immune modulators. We provide an administrative interim analysis of the recruitment schedule of the trial. Discussion The objectives are to characterize the dysfunction of the innate and adaptive immune system after spinal cord injury and to explore its proposed 'neurogenic’ origin
Arabi, Yaseen M; Alothman, Adel; Balkhy, Hanan H; Al-Dawood, Abdulaziz; AlJohani, Sameera; Al Harbi, Shmeylan; Kojan, Suleiman; Al Jeraisy, Majed; Deeb, Ahmad M; Assiri, Abdullah M; Al-Hameed, Fahad; AlSaedi, Asim; Mandourah, Yasser; Almekhlafi, Ghaleb A; Sherbeeni, Nisreen Murad; Elzein, Fatehi Elnour; Memon, Javed; Taha, Yusri; Almotairi, Abdullah; Maghrabi, Khalid A; Qushmaq, Ismael; Al Bshabshe, Ali; Kharaba, Ayman; Shalhoub, Sarah; Jose, Jesna; Fowler, Robert A; Hayden, Frederick G; Hussein, Mohamed A
It had been more than 5 years since the first case of Middle East Respiratory Syndrome coronavirus infection (MERS-CoV) was recorded, but no specific treatment has been investigated in randomized clinical trials. Results from in vitro and animal studies suggest that a combination of lopinavir/ritonavir and interferon-β1b (IFN-β1b) may be effective against MERS-CoV. The aim of this study is to investigate the efficacy of treatment with a combination of lopinavir/ritonavir and recombinant IFN-β1b provided with standard supportive care, compared to treatment with placebo provided with standard supportive care in patients with laboratory-confirmed MERS requiring hospital admission. The protocol is prepared in accordance with the SPIRIT (Standard Protocol Items: Recommendations for Interventional Trials) guidelines. Hospitalized adult patients with laboratory-confirmed MERS will be enrolled in this recursive, two-stage, group sequential, multicenter, placebo-controlled, double-blind randomized controlled trial. The trial is initially designed to include 2 two-stage components. The first two-stage component is designed to adjust sample size and determine futility stopping, but not efficacy stopping. The second two-stage component is designed to determine efficacy stopping and possibly readjustment of sample size. The primary outcome is 90-day mortality. This will be the first randomized controlled trial of a potential treatment for MERS. The study is sponsored by King Abdullah International Medical Research Center, Riyadh, Saudi Arabia. Enrollment for this study began in November 2016, and has enrolled thirteen patients as of Jan 24-2018. ClinicalTrials.gov, ID: NCT02845843 . Registered on 27 July 2016.
McCardle, Peggy; Wilson, Bruce
The FG syndrome is characterized by unusual facies; sudden infant death; developmental delay; and abnormalities of the cardiac, gastrointestinal, and central nervous systems. Serial evaluations of one case with isolated agenesis of the corpus callosum found consistent patterns over time in specific language impairments in syntactic and…
Densow, D.; Fliedner, T.M.; Kindler, H.
Diagnostic guidelines seem to be promising for improving medical care. One aspect of a diagnostic guideline for the acute radiation syndrome has been tested against an extensive case history database. Subsequently, the guideline has been optimized for a small set of case histories. The improved performance has been proven by a test against the rest of the case history database
Cushing`s syndrome or hypercortisolism is one of the most common endocrinopathies in dogs. Besides the ACTH or pituitary-dependent and adrenal or ACTH-independent hypercortisolism, ectopic ACTH secretion and food-dependent hypercortisolism are described in the dog for the very first time. Ectopic
Vilmann, Lea S; Thisted, Ebbe; Baker, Jennifer L
Obesity in adolescents is prevalent worldwide. Polycystic ovary syndrome (PCOS) is often associated with obesity in women, and it has serious metabolic and reproductive health implications. Although PCOS does not become clinically visible until early adolescence, its origins are likely much earlier...
Proton therapy, in particular, and ion therapy, just beginning, are becoming an increasing focus of attention in clinical radiation oncology and medical physics. Both modalities have been criticized of lacking convincing evidence from randomized trials proving their efficacy, justifying the higher costs involved in these therapies. This session will provide an overview of the current status of clinical trials in proton therapy, including recent developments in ion therapy. As alluded to in the introductory talk by Dr. Schulte, opinions are diverging widely as to the usefulness and need for clinical trials in particle therapy and the challenge of equipoise. The lectures will highlight some of the challenges that surround clinical trials in particle therapy. One, presented by Dr. Choy from UT Southwestern, is that new technology and even different types of particles such as helium and carbon ions are introduced into this environment, increasing the phase space of clinical variables. The other is the issue of medical physics quality assurance with physical phantoms, presented by Mrs. Taylor from IROC Houston, which is more challenging because 3D and 4D image guidance and active delivery techniques are in relatively early stages of development. The role of digital phantoms in developing clinical treatment planning protocols and as a QA tool will also be highlighted by Dr. Lee from NCI. The symposium will be rounded off by a panel discussion among the Symposium speakers, arguing pro or con the need and readiness for clinical trials in proton and ion therapy. Learning Objectives: To get an update on the current status of clinical trials allowing or mandating proton therapy. Learn about the status of planned clinical trials in the U.S. and worldwide involving ion therapy. Discuss the challenges in the design and QA of clinical trials in particle therapy. Learn about existing and future physical and computational anthropomorphic phantoms for charged particle clinical trial
Lee, C. [National Cancer Institute (United States)
Proton therapy, in particular, and ion therapy, just beginning, are becoming an increasing focus of attention in clinical radiation oncology and medical physics. Both modalities have been criticized of lacking convincing evidence from randomized trials proving their efficacy, justifying the higher costs involved in these therapies. This session will provide an overview of the current status of clinical trials in proton therapy, including recent developments in ion therapy. As alluded to in the introductory talk by Dr. Schulte, opinions are diverging widely as to the usefulness and need for clinical trials in particle therapy and the challenge of equipoise. The lectures will highlight some of the challenges that surround clinical trials in particle therapy. One, presented by Dr. Choy from UT Southwestern, is that new technology and even different types of particles such as helium and carbon ions are introduced into this environment, increasing the phase space of clinical variables. The other is the issue of medical physics quality assurance with physical phantoms, presented by Mrs. Taylor from IROC Houston, which is more challenging because 3D and 4D image guidance and active delivery techniques are in relatively early stages of development. The role of digital phantoms in developing clinical treatment planning protocols and as a QA tool will also be highlighted by Dr. Lee from NCI. The symposium will be rounded off by a panel discussion among the Symposium speakers, arguing pro or con the need and readiness for clinical trials in proton and ion therapy. Learning Objectives: To get an update on the current status of clinical trials allowing or mandating proton therapy. Learn about the status of planned clinical trials in the U.S. and worldwide involving ion therapy. Discuss the challenges in the design and QA of clinical trials in particle therapy. Learn about existing and future physical and computational anthropomorphic phantoms for charged particle clinical trial
Zheng, Yanhua; Stener-Victorin, Elisabet; Ng, Ernest H Y; Li, Juan; Wu, Xiaoke; Ma, Hongxia
Introduction Hyperinsulinaemia and insulin resistance (IR) are key features of polycystic ovary syndrome (PCOS) and metabolic syndrome. The effect of 5 weeks of acupuncture treatment has been investigated in a completed prospective pilot trial (Clinicaltrials.gov: NCT01457209), and acupuncture with electrical stimulation applied to insulin-resistant rats with dihydrotestosterone-induced PCOS was shown to improve insulin sensitivity. Therefore, we now aim to conduct a prospective pilot study to evaluate whether using the same acupuncture treatment protocol given over a longer period of time (6 months) than in the previous pilot trial will improve insulin sensitivity in women with PCOS and IR. Our hypothesis is that acupuncture with combined manual and low-frequency electrical stimulation of the needles will improve insulin sensitivity in women with PCOS and IR. Methods/analysis This is a prospective pilot trial. A total of 112 women with PCOS and IR will be recruited and categorised according to their body mass index (BMI) as normal weight (BMI=18.5−23 kg/m2) or as overweight/obese (BMI>23 kg/m2). Acupuncture will be applied three times per week for 6 months at 30 min per treatment. The primary outcome will be the change in insulin sensitivity before and after 6 months of acupuncture treatment, as measured by an oral glucose tolerance test. Ethics/dissemination Ethical approval of this study has been granted from the ethics committee of the First Affiliated Hospital of Guangzhou Medical University (No. 2013039). Written and informed consent will be obtained from each patient before any study procedure is performed, according to good clinical practice. The results of this trial will be disseminated in a peer-reviewed journal and presented at international congresses. Trial registration numbers NCT02026323 and ChiCTR-OCH-13003921. PMID:25941189
Zampini, Laura; D'Odorico, Laura
Research findings on vocabulary development (1) in children with Down syndrome are inconsistent. This study aimed to analyse the developmental trend of vocabulary growth in children with Down syndrome and the relationships between vocabulary and chronological and developmental age. Children's vocabulary size was assessed by a parental report (the Italian version of the MacArthur-Bates Communicative Development Inventories [CDI]). A longitudinal study, involving 18 children with Down syndrome, and a cross-sectional study, involving 27 children with Down syndrome, were conducted. The variability in children's vocabulary size increased from a chronological age of 36 months. Both vocabulary size (from 36 months) and developmental level (from 42 months) were significant predictors of lexical outcomes at 48 months. A comparison with normative data showed that children with Down syndrome had a significantly lower vocabulary size than typically developing children at the same developmental age. Although there are similarities with vocabulary growth in typically developing children, lexical development in children with Down syndrome appears to lag behind their cognitive development.
Smith, Ashlyn L.; Romski, MaryAnn; Sevcik, Rose A.; Adamson, Lauren B.; Barker, R. Michael
This study extended research on the Down syndrome advantage by examining differences in parent stress and parent perceptions of language development between 29 parents of young children with Down syndrome and 82 parents of children with other developmental disabilities. Parents of children with Down syndrome reported lower levels of total stress, child-related stress, and stress surrounding the parent-child interaction. Parents of children in both groups reported that they felt successful in their ability to impact their children’s communication development but did differ on perceptions of difficulty such that parents of children with Down syndrome perceived their children’s communication difficulties as less severe despite the children exhibiting similar language skills. Finally, after accounting for potential explanatory confounding variables, child diagnosis remained a significant predictor of parent stress and perceptions of language development. Results highlight the importance of considering etiology when assisting families raising a child with a disability. PMID:24753637
Smith, Ashlyn L; Romski, Maryann; Sevcik, Rose A; Adamson, Lauren B; Barker, R Michael
This study extended research on the Down syndrome advantage by examining differences in parent stress and parent perceptions of language development between 29 parents of young children with Down syndrome and 82 parents of children with other developmental disabilities. Parents of children with Down syndrome reported lower levels of total stress, child-related stress, and stress surrounding the parent-child interaction. Parents of children in both groups reported that they felt successful in their ability to impact their children's communication development but did differ on perceptions of difficulty such that parents of children with Down syndrome perceived their children's communication difficulties as less severe despite the children exhibiting similar language skills. Finally, after accounting for potential explanatory confounding variables, child diagnosis remained a significant predictor of parent stress and perceptions of language development. Results highlight the importance of considering etiology when assisting families raising a child with a disability.
Qurainy, F. A.; Nadeem, M.; Khan, S.; Tarroum, M.; Alansi, S.
Tamarix nilotica is an important medicinal plant grows throughout the Kingdom, except in mountains on high altitude. Propagation of T. nilotica through cuttings and seeds are limited. To supplement harvesting of active ingredient from plants, alternative method for the purpose has been developed. Stem node cuttings were subjected to in vitro culture under the influence of various cytokinin to induce shoot proliferation. Maximum shoot stimulation was found on MS medium comprising 1.0 micro M TDZ followed by 2.5 micro M BA, Kn and 2ip. The number of shoots declined as the concentration of cytokinin increased. A lower shoots obtained on 5.0 and 10.0 micro M concentration of all the four cytokinins tested. After fair multiplication, individual shoots were subjected to different concentration of auxins IBA, NAA, 2,4-D and AA 2.5-10.0 micro M for root induction. Initial screening did not result desired rooting on MS medium. Therefore, pulse treatment of 100 micro M IBA was given to the isolated shoots for 5, 10 and 15 days time. Incubation for 10 days on MS medium supplied with 100.0 micro M resulted in maximum rooting when transferred on MS medium alone. Well rooted microshoots were exposed to four types of soil mixtures for acclimatization of plants. Among these soils, sand and FYM gave 100 percentage survival under controlled green house conditions. This protocol would be helpful in regeneration and conservation of this plant species; and provide an alternative source of biomass for pharmaceutical active ingredients. (author)
Siegmund Kimberly D
Full Text Available Abstract Background Cross-species gene expression analyses using oligonucleotide microarrays designed to evaluate a single species can provide spurious results due to mismatches between the interrogated transcriptome and arrayed probes. Based on the most recent human and chimpanzee genome assemblies, we developed updated and accessible probe masking methods that allow human Affymetrix oligonucleotide microarrays to be used for robust genome-wide expression analyses in both species. In this process, only data from oligonucleotide probes predicted to have robust hybridization sensitivity and specificity for both transcriptomes are retained for analysis. Results To characterize the utility of this resource, we applied our mask protocols to existing expression data from brains, livers, hearts, testes, and kidneys derived from both species and determined the effects probe numbers have on expression scores of specific transcripts. In all five tissues, probe sets with decreasing numbers of probes showed non-linear trends towards increased variation in expression scores. The relationships between expression variation and probe number in brain data closely matched those observed in simulated expression data sets subjected to random probe masking. However, there is evidence that additional factors affect the observed relationships between gene expression scores and probe number in tissues such as liver and kidney. In parallel, we observed that decreasing the number of probes within probe sets lead to linear increases in both gained and lost inferences of differential cross-species expression in all five tissues, which will affect the interpretation of expression data subject to masking. Conclusion We introduce a readily implemented and updated resource for human and chimpanzee transcriptome analysis through a commonly used microarray platform. Based on empirical observations derived from the analysis of five distinct data sets, we provide novel guidelines
Iorio, Alfonso; Keepanasseril, Arun; Foster, Gary; Navarro-Ruan, Tamara; McEneny-King, Alanna; Edginton, Andrea N; Thabane, Lehana
Individual pharmacokinetic assessment is a critical component of tailored prophylaxis for hemophilia patients. Population pharmacokinetics allows using individual sparse data, thus simplifying individual pharmacokinetic studies. Implementing population pharmacokinetics capacity for the hemophilia community is beyond individual reach and requires a system effort. The Web-Accessible Population Pharmacokinetic Service-Hemophilia (WAPPS-Hemo) project aims to assemble a database of patient pharmacokinetic data for all existing factor concentrates, develop and validate population pharmacokinetics models, and integrate these models within a Web-based calculator for individualized pharmacokinetic estimation in patients at participating treatment centers. Individual pharmacokinetic studies on factor VIII and IX concentrates will be sourced from pharmaceutical companies and independent investigators. All factor concentrate manufacturers, hemophilia treatment centers (HTCs), and independent investigators (identified via a systematic review of the literature) having on file pharmacokinetic data and willing to contribute full or sparse pharmacokinetic data will be eligible for participation. Multicompartmental modeling will be performed using a mixed-model approach for derivation and Bayesian forecasting for estimation of individual sparse data. NONMEM (ICON Development Solutions) will be used as modeling software. The WAPPS-Hemo research network has been launched and is currently joined by 30 HTCs from across the world. We have gathered dense individual pharmacokinetic data on 878 subjects, including several replicates, on 21 different molecules from 17 different sources. We have collected sparse individual pharmacokinetic data on 289 subjects from the participating centers through the testing phase of the WAPPS-Hemo Web interface. We have developed prototypal population pharmacokinetics models for 11 molecules. The WAPPS-Hemo website (available at www.wapps-hemo.org, version
Takayama, Shin; Takase, Hiroyuki; Tanaka, Takamitsu; Sugiura, Tomonori; Ohte, Nobuyuki; Dohi, Yasuaki
Smoking cessation is particularly important for maintaining health; however, the subsequent risk of an increased body weight is of major concern. The present study investigated the influence of smoking cessation on the incidence of metabolic syndrome and its components in the Japanese general population. This study enrolled individuals without metabolic syndrome or a history of smoking via our annual health checkup program (n=5,702, 55.2±11.5 years). Participants were divided into three groups mentioned below and followed up with the endpoint being the development of metabolic syndrome: (1) subjects who had never smoked and did not smoke during the observation period (non-smoker); (2) those who continued smoking during the observation period (continuous smoker); and (3) those who ceased smoking during the observation period (smoking cessation). During the observation period (median 1,089 days), 520 subjects developed metabolic syndrome, and Kaplan-Meier analysis showed a higher incidence of metabolic syndrome in the smoking cessation group than in the other groups. Smoking cessation was confirmed as an independent predictor of the new onset of metabolic syndrome by multivariate Cox proportional hazard analysis after adjustment. Subjects only from the smoking cessation group showed a significant deterioration in metabolic factors during the study in correlation with an increased waist circumference after smoking cessation. Smoking cessation without instruction could be followed by the development of metabolic syndrome, and the incidence of metabolic syndrome might reduce the benefit obtained from smoking cessation. Therefore, further educational outreach is needed to prevent the progression of metabolic syndrome during the course of smoking cessation.
Ghoshhajra, Brian B.; Staziaki, Pedro V.; Vadvala, Harshna; Kim, Phillip; Meyersohn, Nandini M.; Janjua, Sumbal A.; Hoffmann, Udo [Massachusetts General Hospital and Harvard Medical School, Cardiac MR PET CT Program, Department of Radiology (Cardiovascular Imaging) and Division of Cardiology, Boston, MA (United States); Takx, Richard A.P. [Massachusetts General Hospital and Harvard Medical School, Cardiac MR PET CT Program, Department of Radiology (Cardiovascular Imaging) and Division of Cardiology, Boston, MA (United States); University Medical Center Utrecht, Department of Radiology, Utrecht (Netherlands); Neilan, Tomas G.; Francis, Sanjeev [Massachusetts General Hospital and Harvard Medical School, Cardiac MR PET CT Program, Department of Radiology (Cardiovascular Imaging) and Division of Cardiology, Boston, MA (United States); Massachusetts General Hospital and Harvard Medical School, Division of Cardiology, Boston, MA (United States); Bittner, Daniel [Massachusetts General Hospital and Harvard Medical School, Cardiac MR PET CT Program, Department of Radiology (Cardiovascular Imaging) and Division of Cardiology, Boston, MA (United States); University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuernberg (FAU), Department of Medicine 2 - Cardiology, Erlangen (Germany); Mayrhofer, Thomas [Massachusetts General Hospital and Harvard Medical School, Cardiac MR PET CT Program, Department of Radiology (Cardiovascular Imaging) and Division of Cardiology, Boston, MA (United States); Stralsund University of Applied Sciences, School of Business Studies, Stralsund (Germany); Greenwald, Jeffrey L. [Massachusetts General Hospital and Harvard Medical School, Department of Medicine, Boston, MA (United States); Truong, Quyhn A. [Massachusetts General Hospital and Harvard Medical School, Cardiac MR PET CT Program, Department of Radiology (Cardiovascular Imaging) and Division of Cardiology, Boston, MA (United States); Weill Cornell College of Medicine, Department of Radiology, New York, NY (United States); Abbara, Suhny [Massachusetts General Hospital and Harvard Medical School, Cardiac MR PET CT Program, Department of Radiology (Cardiovascular Imaging) and Division of Cardiology, Boston, MA (United States); UT Southwestern Medical Center, Department Cardiothoracic Imaging, Dallas, TX (United States); Brown, David F.M.; Nagurney, John T. [Massachusetts General Hospital and Harvard Medical School, Department of Emergency Medicine, Boston, MA (United States); Januzzi, James L. [Massachusetts General Hospital and Harvard Medical School, Division of Cardiology, Boston, MA (United States); Collaboration: MGH Emergency Cardiac CTA Program Contributors
To evaluate the efficiency and safety of emergency department (ED) coronary computed tomography angiography (CTA) during a 3-year clinical experience. Single-center registry of coronary CTA in consecutive ED patients with suspicion of acute coronary syndrome (ACS). The primary outcome was efficiency of coronary CTA defined as the length of hospitalization. Secondary endpoints of safety were defined as the rate of downstream testing, normalcy rates of invasive coronary angiography (ICA), absence of missed ACS, and major adverse cardiac events (MACE) during follow-up, and index radiation exposure. One thousand twenty two consecutive patients were referred for clinical coronary CTA with suspicion of ACS. Overall, median time to discharge home was 10.5 (5.7-24.1) hours. Patient disposition was 42.7 % direct discharge from the ED, 43.2 % discharge from emergency unit, and 14.1 % hospital admission. ACS rate during index hospitalization was 9.1 %. One hundred ninety two patients underwent additional diagnostic imaging and 77 underwent ICA. The positive predictive value of CTA compared to ICA was 78.9 % (95 %-CI 68.1-87.5 %). Median CT radiation exposure was 4.0 (2.5-5.8) mSv. No ACS was missed; MACE at follow-up after negative CTA was 0.2 %. Coronary CTA in an experienced tertiary care setting allows for efficient and safe management of patients with suspicion for ACS. (orig.)
Trottestam, Helena; Beutel, Karin; Meeths, Marie
BACKGROUND: Griscelli syndrome type 2 (GS2), the X-linked lymphoproliferative (XLP) and the Chédiak-Higashi (CHS) syndromes are diseases that all may develop hemophagocytic syndromes. We wanted to investigate whether the treatment protocols for hemophagocytic lymphohistiocytosis (HLH) can also...
Conners, Frances A; Moore, Marie S; Loveall, Susan J; Merrill, Edward C
The purpose of this review was to understand the types of memory impairments that are associated with intellectual disability (ID, formerly called mental retardation) and the implications of these impairments for reading development. Specifically, studies on working memory, delayed memory and learning, and semantic/conceptual memory in Down syndrome, Williams syndrome, and fragile X syndrome were examined. A distinct memory profile emerged for each of the 3 etiologies of ID. Memory profiles are discussed in relation to strengths and weaknesses in reading skills in these three etiologies. We suggest that reading instruction be designed to capitalize on relatively stronger memory skills while providing extra support for especially challenging aspects of reading.
Nazarenko, P M; Bilichenko, V B; Nazarenko, D P; Samgina, T A
We assessed results of examination and treatment of 100 patients with ulcer disease who had undergone Bilroth-1 stomach resection. Chronic disorder of duodenal patency was revealed in 86% of the patients. This condition was shown to play the leading role in the development of post-gastric resection syndrome. Reflux-gastritis was associated with damping syndrome in 66.3% of the patients and with recurrent ulcer in 8.1%. It is concluded that conservative and surgical treatment of post-gastric resection syndrome should be aimed at correction of chronic disorders of duodenal patency.
Barnes, Elizabeth F.; Roberts, Joanne; Mirrett, Penny; Sideris, John; Misenheimer, Jan
This study compared the oral structure and oral-motor skills of 59 boys with fragile X syndrome (FXS), 34 boys with Down syndrome (DS), and 36 developmentally similar typically developing (TD) boys. An adaptation of the J. Robbins and T. Klee (1987) Oral Speech Motor Protocol was administered to participants and their scores on measures of oral…
Pyne, Michael E; Moo-Young, Murray; Chung, Duane A; Chou, C Perry
Reducing the production cost of, and increasing revenues from, industrial biofuels will greatly facilitate their proliferation and co-integration with fossil fuels. The cost of feedstock is the largest cost in most fermentation bioprocesses and therefore represents an important target for cost reduction. Meanwhile, the biorefinery concept advocates revenue growth through complete utilization of by-products generated during biofuel production. Taken together, the production of biofuels from low-cost crude glycerol, available in oversupply as a by-product of bioethanol production, in the form of thin stillage, and biodiesel production, embodies a remarkable opportunity to advance affordable biofuel development. However, few bacterial species possess the natural capacity to convert glycerol as a sole source of carbon and energy into value-added bioproducts. Of particular interest is the anaerobe Clostridium pasteurianum, the only microorganism known to convert glycerol alone directly into butanol, which currently holds immense promise as a high-energy biofuel and bulk chemical. Unfortunately, genetic and metabolic engineering of C. pasteurianum has been fundamentally impeded due to lack of an efficient method for deoxyribonucleic acid (DNA) transfer. This work reports the development of an electrotransformation protocol permitting high-level DNA transfer to C. pasteurianum ATCC 6013 together with accompanying selection markers and vector components. The CpaAI restriction-modification system was found to be a major barrier to DNA delivery into C. pasteurianum which we overcame by in vivo methylation of the recognition site (5'-CGCG-3') using the M.FnuDII methyltransferase. With proper selection of the replication origin and antibiotic-resistance marker, we initially electroporated methylated DNA into C. pasteurianum at a low efficiency of 2.4 × 101 transformants μg-1 DNA by utilizing conditions common to other clostridial electroporations. Systematic investigation of
Um, Keehong; Yoo, Sooyeup
Protocol for digital multiplex with 512 pieces of information is increasingly adopted in the design of illumination systems. In conventional light-emitting diode systems, the receivers are connected in parallel and each of the receiving units receives all the data from the master dimmer console, but each receiving unit operates by recognizing as its own data that which corresponds to the assigned number of the receiver. Because the serial numbers of illumination devices are transmitted in binary code, synchronization is too complicated to be used properly. In order to improve the protocol of illumination control systems, we propose an algorithm of protocol reception to install and manage the system in a simpler and more convenient way. We propose the systems for controlling the light-emitting diode illumination of simplified receiver slaves adopting the digital multiplex-512 protocol where master console and multiple receiver slaves are connected in a daisy chain fashion. The digital multiplex-512 data packet is received according to the sequence order of their locations from the console, without assigning the sequence number of each channel at the receiving device. The purpose of this paper is to design a simple and small-sized controller for the control systems of lamps and lighting adopting the digital multiplex-512 network.
Batch experiments were carried out with activated sludge from laboratory reactors and a full-scale treatment plant spiked with 17β-oestradiol (E2). An oestrogen-sensitive yeast-based assay protocol, described in detail in a related publication, was used to measure reduction of E2-induced total oestrogenic activity from the ...
Armeli Minicante, S; Ambrosi, E; Back, M; Barichello, J; Cattaruzza, E; Gonella, F; Scantamburlo, E; Trave, E
Seaweeds are a reserve of natural dyes (chlorophylls a , b and c ), characterized by low cost and easy supply, without potential environmental load in terms of land subtraction, and also complying with the requirements of an efficient waste management policy. In particular, the brown seaweed Undaria pinnatifida is a species largely present in the Venice Lagoon area, and for it a removal strategy is actually mandatory. In this paper, we set-up an eco-protocol for the best extraction and preparation procedures of the pigment, with the aim of finding an easy and affordable method for chlorophyll c extraction, exploring at the same time the possibility of using these algae within local sustainable management integrated strategies, among which the possible use of chlorophylls as a dye source in dye sensitized solar cells (DSSCs) is investigated. Experimental results suggest that the developed protocols are useful to optimize the chlorophyll c extraction, as shown by optical absorption spectroscopy measurements. The DSSCs built with the chlorophyll extracted by the proposed eco-protocol exhibit solar energy conversion efficiencies are similar to those obtained following extraction protocols with larger environmental impacts. (paper)
Armeli Minicante, S.; Ambrosi, E.; Back, M.; Barichello, J.; Cattaruzza, E.; Gonella, F.; Scantamburlo, E.; Trave, E.
Seaweeds are a reserve of natural dyes (chlorophylls a, b and c), characterized by low cost and easy supply, without potential environmental load in terms of land subtraction, and also complying with the requirements of an efficient waste management policy. In particular, the brown seaweed Undaria pinnatifida is a species largely present in the Venice Lagoon area, and for it a removal strategy is actually mandatory. In this paper, we set-up an eco-protocol for the best extraction and preparation procedures of the pigment, with the aim of finding an easy and affordable method for chlorophyll c extraction, exploring at the same time the possibility of using these algae within local sustainable management integrated strategies, among which the possible use of chlorophylls as a dye source in dye sensitized solar cells (DSSCs) is investigated. Experimental results suggest that the developed protocols are useful to optimize the chlorophyll c extraction, as shown by optical absorption spectroscopy measurements. The DSSCs built with the chlorophyll extracted by the proposed eco-protocol exhibit solar energy conversion efficiencies are similar to those obtained following extraction protocols with larger environmental impacts.
Bloemen, Elizabeth M; Rosen, Tony; Cline Schiroo, Justina A; Clark, Sunday; Mulcare, Mary R; Stern, Michael E; Mysliwiec, Regina; Flomenbaum, Neal E; Lachs, Mark S; Hargarten, Stephen
Photographing injuries in the acute setting allows for improved documentation as well as assessment by clinicians and others who have not personally examined a patient. This tool is important, particularly for telemedicine, tracking of wound healing, the evaluation of potential abuse, and injury research. Despite this, protocols to ensure standardization of photography in clinical practice, forensics, or research have not been published. In preparation for a study of injury patterns in elder abuse and geriatric falls, our goal was to develop and evaluate a protocol for standardized photography of injuries that may be broadly applied. We conducted a literature review for techniques and standards in medical, forensic, and legal photography. We developed a novel protocol describing types of photographs and body positioning for eight body regions, including instructional diagrams. We revised it iteratively in consultation with experts in medical photography; forensics; and elder, child, and domestic abuse. The resulting protocol requires a minimum of four photos of each injury at multiple distances with and without a ruler/color guide. To evaluate the protocol's efficacy, multiple research assistants without previous photography experience photographed injuries from a convenience sample of elderly patients presenting to a single large, urban, academic emergency department. A selection of these patients' images were then evaluated in a blinded fashion by four nontreating emergency medicine physicians and the inter-rater reliability between these physicians was calculated. Among the 131 injuries, from 53 patients, photographed by 18 photographers using this protocol, photographs of 25 injuries (10 bruises, seven lacerations, and eight abrasions) were used to assess characterization of the injury. Physicians' characterizations of the injuries were reliable for the size of the injury (κ = 0.91, 95% confidence interval [CI] = 0.77 to 1.00), side of the body (κ = 0.97, 95
Juliana Hypólito Silva
Full Text Available Atypical Mole Syndrome is the most important phenotypic risk factor for developing cutaneous melanoma, a malignancy that accounts for about 80% of deaths from skin cancer. Because the diagnosis of melanoma at an early stage is of great prognostic relevance, the identification of Atypical Mole Syndrome carriers is essential, as well as the creation of recommended preventative measures that must be taken by these patients.
Full Text Available The article presents the international agreement Alpine Convention. The states which have signed the agreement have undertaken to the common politics for the preservation and sustainable use of sources. The areas covered by the convention: population and culture, physical planning, prevention of air polution, soil conservation, water management, nature conservation and landscape planning, mountain farming, mountain forestry, tourism and recreation, transport, energy and waste management are presented as well as their aims. The primary stress is given to the protocols: "Physical Planning and Sustainable Development" and "Nature Conservation and Landscape Planning",with the emphasis to the sustainable development. They represent cover and their aims are implemented in all the others protocols.
Shimomura, T; Mori, E; Hirono, N; Imamura, T; Yamashita, H
Surgical exclusion of portions of the gastrointestinal tract is a predisposing risk factor for the development of Wernicke-Korsakoff syndrome. When this disease occurs, it is usually within weeks after the gastrointestinal surgery. However, it is not well known that Wernicke-Korsakoff syndrome may occur after a long latent interval following gastrectomy. A research-oriented hospital. Three patients without a history of alcoholism or dietary deprivation developed Wernicke-Korsakoff syndrome 2 to 20 years after undergoing gastrectomy. In these patients, minor changes in dietary habit led to the development of Wernicke-Korsakoff syndrome. In addition to a long-standing latent deficiency in thiamin levels due to defective absorption following gastrectomy or gastrojejunostomy, other minor factors that may influence the intake of thiamin and the need for thiamin in subjects who have undergone gastrectomy may cause a state of thiamin deficiency resulting in Wernicke-Korsakoff syndrome. Results from our study indicate that the following measures are mandatory: educating patients about proper dietary habits, carefully monitoring their thiamin intake, recognizing Wernicke-Korsakoff syndrome early, and treating it immediately with appropriate measures.
Buckley, Sue; And Others
The book summarizes the current state of knowledge concerning language development in children with Down Syndrome (DS). The first chapter reviews language development in normal children, noting such stages as gestures, first sounds, development of understanding, first spoken words, and the two-word stage. The next chapter examines language skills…
Given its limited involvement in and recognition by international organizations, Taiwan is not presently a signatory to the United Nations Framework Convention on Climate Change (UNFCCC) or the Kyoto Protocol. The objective of this study is to analyze how and the extent to which changes in an exogenous factor, namely the Kyoto Protocol and Post-Kyoto climate negotiations, affect and ultimately lead to the formulation of and changes in the Taiwanese government's climate policy. This study applies policy network theory to examine the development of and changes in the Taiwanese government's climate policy. The results demonstrate that international climate agreements and negotiations play a key role in the development of, changes to, and transformation of Taiwan's climate policy. Scarce evidence was found in this study to demonstrate that domestic or internal factors affect climate change policy. Despite its lack of participation in the UNFCCC and the Kyoto Protocol, Taiwan has adopted national climate change strategies, action plans, and programs to reduce greenhouse gas emissions. However, these climate policies and measures are fairly passive and aim to only conform to the minimal requirements for developing countries under international climate agreements and negotiations. This process results in inconsistent and variable climate policies, targets, and regulations. - Highlights: • Taiwan is not a signatory to the UNFCCC or its Kyoto Protocol. • International climate agreements strongly affected Taiwan's climate policy. • Little evidence was found that domestic factors affect Taiwan's climate policy. • New climate policies, regulations, and laws are formulated and implemented. • Climate policies, targets, and regulations change frequently and are inconsistent
Lisa A. Beirn
Full Text Available The fungus Colletotrichum cereale incites anthracnose disease on Poa annua (annual bluegrass turfgrass. Anthracnose disease is geographically widespread throughout the world and highly destructive to cool-season turfgrasses, with infections by C. cereale resulting in extensive turf loss. Comprehensive research aimed at controlling turfgrass anthracnose has been performed in the field, but knowledge of the causal organism and its basic biology is still needed. In particular, the lack of a reliable greenhouse-based inoculation protocol performed under controlled environmental conditions is an obstacle to the study of C. cereale and anthracnose disease. Our objective was to develop a consistent and reproducible inoculation protocol for the two major genetic lineages of C. cereale. By adapting previously successful field-based protocols and combining with components of existing inoculation procedures, the method we developed consistently produced C. cereale infection on two susceptible P. annua biotypes. Approximately 7 to 10 days post-inoculation, plants exhibited chlorosis and thinning consistent with anthracnose disease symptomology. Morphological inspection of inoculated plants revealed visual signs of the fungus (appressoria and acervuli, although acervuli were not always present. After stringent surface sterilization of inoculated host tissue, C. cereale was consistently re-isolated from symptomatic tissue. Real-time PCR detection analysis based on the Apn2 marker confirmed the presence of the pathogen in host tissue, with both lineages of C. cereale detected from all inoculated plants. When a humidifier was not used, no infection developed for any biotypes or fungal isolates tested. The inoculation protocol described here marks significant progress for in planta studies of C. cereale, and will enable scientifically reproducible investigations of the biology, infectivity and lifestyle of this important grass pathogen.
Golusin, Mirjana; Munitlak Ivanovic, Olja
The paper gives reasons for low energy efficiency typical of the Serbian economy, which is based on outdated and dirty technologies. The comparison of selected economic indicators and indicators of energy efficiency in both Serbia and the European Union points out the benefits of the Kyoto Protocol implementation due to the growth of competitiveness in the global market. Serbia has no obligation to reduce GHG emissions, the authors point to the proposals whose implementation along with the mechanisms of the Protocol can enable Serbia the access to markets that trade GHG emissions and the access to dedicated funds, self-financing or attracting foreign investments to raise energy efficiency, which will be accompanied by adequate economic benefits. A similar principle can be applied in all countries that are not obliged to reduce GHG emissions. The application of different mechanisms aiming to increase energy efficiency in Serbia, could contribute to the increase of GDP annual growth rate from 5% to 7%, which cannot be achieved by any other economic instrument. Energy efficiency, which is actually a question of competitiveness of each economy, can finance itself through the mechanisms of the Kyoto Protocol by selling excess emissions resulting from improved energy efficiency. - Research highlights: → Serbia is a country with the outdated technology and low energy efficiency values. → Sustainable economic and energetic growth can be stirred by inserting Kyoto Protocol. → By investing in modern technology Serbia could lessen emission into the atmosphere. → Cut of emission in the atmosphere could help reaching certain carbon credit values. → By selling the carbon credit Serbia could do economic growth of 5-7% on a year level.
Specjalski, Krzysztof; Kita-Milczarska, Karolina; Chełmińska, Marta; Jassem, Ewa
A history of an adverse reaction to amoxicillin, irrespective of the mechanism involved, significantly elevates patients' anxiety and affects therapeutic decisions in the future, leading to unnecessary avoidance of antibiotics. As a consequence, it would be useful to find a safe and reliable protocol for typing safe alternative antibiotics. The aim of the study was to determine negative predictive value of typing safe antibiotic in patients with a history of hypersensitivity reaction to amoxicillin. 71 patients, aged 20-83, with a history of an adverse reaction to amoxicillin were retrospectively analysed. On the basis of the reaction type they were divided into three groups: A - symptoms not typical for hypersensitivity reactions, B - allergy manifested by urticaria and/or angioedema, C - anaphylaxis. In group A amoxicillin was tested, in group B - cefuroxime, and in group C - macrolide: azithromycin or clarithromycin. Telephone follow-up visits were performed twice: 6-12 months and 3-5 years after the clinical assessment to evaluate tolerance of antibiotics. On the basis of the follow-up results, the negative predictive value (NPV) of the protocol was calculated. The full diagnostic protocol was applied in 62 participants. Amoxicillin was found safe in 22, cefuroxime - in 21 and macrolide - in 19 patients. No anaphylactic reactions were observed during the tests. On the basis of the telephone follow-up, the NPV of the protocol was 96% in the first follow-up and 97% in the second one. A stepwise approach including SPTs, ICTs and provocations with amoxicillin / cefuroxime/macrolide - depending on a patient's history - is safe and allows typing an antibiotic in the vast majority of patients.
Klonoff, David C; Lias, Courtney; Beck, Stayce; Parkes, Joan Lee; Kovatchev, Boris; Vigersky, Robert A; Arreaza-Rubin, Guillermo; Burk, Robert D; Kowalski, Aaron; Little, Randie; Nichols, James; Petersen, Matt; Rawlings, Kelly; Sacks, David B; Sampson, Eric; Scott, Steve; Seley, Jane Jeffrie; Slingerland, Robbert; Vesper, Hubert W
Inaccurate blood glucsoe monitoring systems (BGMSs) can lead to adverse health effects. The Diabetes Technology Society (DTS) Surveillance Program for cleared BGMSs is intended to protect people with diabetes from inaccurate, unreliable BGMS products that are currently on the market in the United States. The Surveillance Program will provide an independent assessment of the analytical performance of cleared BGMSs. The DTS BGMS Surveillance Program Steering Committee included experts in glucose monitoring, surveillance testing, and regulatory science. Over one year, the committee engaged in meetings and teleconferences aiming to describe how to conduct BGMS surveillance studies in a scientifically sound manner that is in compliance with good clinical practice and all relevant regulations. A clinical surveillance protocol was created that contains performance targets and analytical accuracy-testing studies with marketed BGMS products conducted by qualified clinical and laboratory sites. This protocol entitled "Protocol for the Diabetes Technology Society Blood Glucose Monitor System Surveillance Program" is attached as supplementary material. This program is needed because currently once a BGMS product has been cleared for use by the FDA, no systematic postmarket Surveillance Program exists that can monitor analytical performance and detect potential problems. This protocol will allow identification of inaccurate and unreliable BGMSs currently available on the US market. The DTS Surveillance Program will provide BGMS manufacturers a benchmark to understand the postmarket analytical performance of their products. Furthermore, patients, health care professionals, payers, and regulatory agencies will be able to use the results of the study to make informed decisions to, respectively, select, prescribe, finance, and regulate BGMSs on the market. © 2015 Diabetes Technology Society.
Harcourt, S E; Fletcher, J; Loveridge, P; Bains, A; Morbey, R; Yeates, A; McCloskey, B; Smyth, B; Ibbotson, S; Smith, G E; Elliot, A J
Syndromic surveillance is vital for monitoring public health during mass gatherings. The London 2012 Olympic and Paralympic Games represents a major challenge to health protection services and community surveillance. In response to this challenge the Health Protection Agency has developed a new syndromic surveillance system that monitors daily general practitioner out-of-hours and unscheduled care attendances. This new national system will fill a gap identified in the existing general practice-based syndromic surveillance systems by providing surveillance capability of general practice activity during evenings/nights, over weekends and public holidays. The system will complement and supplement the existing tele-health phone line, general practitioner and emergency department syndromic surveillance systems. This new national system will contribute to improving public health reassurance, especially to meet the challenges of the London 2012 Olympic and Paralympic Games.
Guidi, Sandra; Stagni, Fiorenza; Bianchi, Patrizia; Ciani, Elisabetta; Giacomini, Andrea; De Franceschi, Marianna; Moldrich, Randal; Kurniawan, Nyoman; Mardon, Karine; Giuliani, Alessandro; Calzà, Laura; Bartesaghi, Renata
Intellectual impairment is a strongly disabling feature of Down's syndrome, a genetic disorder of high prevalence (1 in 700-1000 live births) caused by trisomy of chromosome 21. Accumulating evidence shows that widespread neurogenesis impairment is a major determinant of abnormal brain development and, hence, of intellectual disability in Down's syndrome. This defect is worsened by dendritic hypotrophy and connectivity alterations. Most of the pharmacotherapies designed to improve cognitive performance in Down's syndrome have been attempted in Down's syndrome mouse models during adult life stages. Yet, as neurogenesis is mainly a prenatal event, treatments aimed at correcting neurogenesis failure in Down's syndrome should be administered during pregnancy. Correction of neurogenesis during the very first stages of brain formation may, in turn, rescue improper brain wiring. The aim of our study was to establish whether it is possible to rescue the neurodevelopmental alterations that characterize the trisomic brain with a prenatal pharmacotherapy with fluoxetine, a drug that is able to restore post-natal hippocampal neurogenesis in the Ts65Dn mouse model of Down's syndrome. Pregnant Ts65Dn females were treated with fluoxetine from embryonic Day 10 until delivery. On post-natal Day 2 the pups received an injection of 5-bromo-2-deoxyuridine and were sacrificed after either 2 h or after 43 days (at the age of 45 days). Untreated 2-day-old Ts65Dn mice exhibited a severe neurogenesis reduction and hypocellularity throughout the forebrain (subventricular zone, subgranular zone, neocortex, striatum, thalamus and hypothalamus), midbrain (mesencephalon) and hindbrain (cerebellum and pons). In embryonically treated 2-day-old Ts65Dn mice, precursor proliferation and cellularity were fully restored throughout all brain regions. The recovery of proliferation potency and cellularity was still present in treated Ts65Dn 45-day-old mice. Moreover, embryonic treatment restored
Jothikumar, N; Sobsey, M D; Cromeans, T L
RNA extraction from environmental samples yields frequently an RNA preparation containing inhibitors of molecular reactions. Commercial RNA extraction kits commonly permit extraction of only 0.1-0.2 ml sample volume. An RNA extraction buffer (RNAX buffer) was formulated for the extraction of viral RNA from 4.0 ml using a silica column based protocol. To evaluate the RNAX buffer based protocol, we used hepatitis A virus (HAV) and coxsackievirus B3 (CVB3) to monitor the RNA extraction efficiency from environmental samples. For evaluation of viral RNA recovery from water concentrates which were prepared from river and pond water by PEG concentration, serial ten fold dilutions of two waterborne viruses were added to the water concentrates for evaluation by quantitative detection. Quantitative recovery of HAV and CVB3 was determined by reverse transcriptase quantitative real-time PCR (RT-qPCR). The extracted RNA was compatible with RT-qPCR and sensitivity of detection of 0.8PFU per reaction was found with RNAX buffer and the developed protocol. This level of sensitivity was obtained using viral RNA extracted from 4.0 ml of an inoculated water sample concentrate. The RNAX buffer developed in this study could be applicable to the detection of other pathogens in water and food. Published by Elsevier B.V.
Friedrich, Wernher; Du, Shengzhi; Balt, Karlien
The temporal lobe in conjunction with the hippocampus is responsible for memory processing. The gamma wave is involved with this process. To develop a human brain protocol, a better understanding of the relationship between gamma and long-term memory is vital. A more comprehensive understanding of the human brain and specific analogue waves it uses will support the development of a human brain protocol. Fifty-eight participants aged between 6 and 60 years participated in long-term memory experiments. It is envisaged that the brain could be stimulated through binaural beats (sound frequency) at 40 Hz (gamma) to enhance long-term memory capacity. EEG recordings have been transformed to sound and then to an information standard, namely ASCII. Statistical analysis showed a proportional relationship between long-term memory and gamma activity. Results from EEG recordings indicate a pattern. The pattern was obtained through the de-codification of an EEG recording to sound and then to ASCII. Stimulation of gamma should enhance long term memory capacity. More research is required to unlock the human brains' protocol key. This key will enable the processing of information directly to and from human memory via gamma, the hippocampus and the temporal lobe.
Berton, Pauline; Normand, Valérie; Martineau, Guy-Pierre; Bouchet, Franck; Lebret, Arnaud; Waret-Szkuta, Agnès
Porcine reproductive and respiratory syndrome virus (PRRSV) is responsible for reproductive disorders in sows and respiratory problems in pigs, and has a major economic impact. Controlling PRRSV is therefore a priority for the swine industry. Stabilization of a herd, defined as the production of PRRSV-negative pigs at weaning from seropositive sows, is a common method of control, and different protocols have been described in the literature to achieve this stabilization. The objective of this study was to evaluate wether the combination of mass vaccination of sows and their piglets with a Genotype I modified live virus (MLV) vaccine, with temporal closure to the introduction of replacement animals and unidirectional pig and human flow can result in the production of PRRSV-negative pigs at weaning. The study took place in French farrow-to-finish farms located in a high-density swine area where the disease concerns over 60% of farms and only closely related strains of genotype I have been reported. Twenty-three 100-to-700 sow farrow-to-finish farms were selected prospectively between 2005 and 2014, regardless of their biosecurity level. Those farms adopted a stabilization protocol characterized by the following standardized measures: vaccination of sows, gilts, and piglets with the Genotype I MLV vaccine PORCILIS®PRRS, temporary herd closure, and strict internal biosecurity measures. Monitoring of herd status was then performed using a combination of 3 diagnostic tools: Real-time polymerase chain reaction (RT-PCR), enzyme-linked immunosorbent assay (ELISA), and Open reading frame (ORF) 5 and ORF7 sequencing. The status of finishing units (either active or inactive, meaning PRRSV-positive or PRRSV-negative, respectively) was not considered in this study. At the end of the monitoring period, considering the results of all the analyses, clinical signs, and epidemiology, 19 farms were considered stable and 1 remained unstable. In 3 farms it was commonly agreed to extend
de Falco, Simona; Venuti, Paola; Esposito, Gianluca; Bornstein, Marc H
The aim of this study was to compare functional features of maternal and paternal speech directed to children with Down syndrome and developmental age-matched typically developing children. Altogether 88 parents (44 mothers and 44 fathers) and their 44 young children (22 children with Down syndrome and 22 typically developing children) participated. Parents' speech directed to children was obtained through observation of naturalistic parent-child dyadic interactions. Verbatim transcripts of maternal and paternal language were categorized in terms of the primary function of each speech unit. Parents (both mothers and fathers) of children with Down syndrome used more affect-salient speech compared to parents of typically developing children. Although parents used the same amounts of information-salient speech, parents of children with Down syndrome used more direct statements and asked fewer questions than did parents of typically developing children. Concerning parent gender, in both groups mothers used more language than fathers and specifically more descriptions. These findings held controlling for child age and MLU and family SES. This study highlights strengths and weaknesses of parental communication to children with Down syndrome and helps to identify areas of potential improvement through intervention. Copyright © 2010 Elsevier Inc. All rights reserved.
Goel, R.; De Dios, Y. E.; Gadd, N. E.; Caldwell, E. E.; Peters, B. T.; Bloomberg, J. J.; Oddsson, L. I. E.; Mulavara, A. P.
Astronauts returning from space flight show significant inter-subject variations in their abilities to readapt to a gravitational environment because of their innate sensory weighting. The ability to predict the manner and degree to which each individual astronaut will be affected would improve the effectiveness of countermeasure training programs designed to enhance sensorimotor adaptability. We hypothesize participant's ability to utilize individual sensory information (vision, proprioception and vestibular) influences adaptation in sensorimotor performance after space flight. The goal of this study is to develop a reliable protocol to test proprioceptive utilization in a functional postural control task. Subjects "stand" in a supine position while strapped to a backpack frame holding a friction-free device using air-bearings that allow the subject to move freely in the frontal plane, similar to when in upright standing. The frame is attached to a pneumatic cylinder, which can provide different levels of a gravity-like force that the subject must balance against to remain "upright". The supine posture with eyes closed ensures reduced vestibular and visual contribution to postural control suggesting somatosensory and/or non-otolith vestibular inputs will provide relevant information for maintaining balance control in this task. This setup is called the gravity bed. Fourteen healthy subjects carried out three trials each with eyes open alternated with eyes closed, "standing" on their dominant leg in the gravity bed environment while loaded with 60 percent of their body weight. Subjects were instructed to: "use your sense of sway about the ankle and pressure changes under the foot to maintain balance." Maximum length of a trial was 45 seconds. A force plate underneath the foot recorded forces and moments during the trial and an inertial measurement unit (IMU) attached on the backpack's frame near the center of mass of the subject recorded upper body postural
Rahman, Shaikh M.; Kirkman, Grant A.
This paper examines the cost structure of certified emission reductions (CERs) through various types of projects under the Clean Development Mechanism (CDM) of the Kyoto Protocol. Using the CDM project data, the costs of CERs and their variation across technology and over time and space are estimated by applying alternative functional forms and specifications. Results show that the average cost of CERs decreases with the project scale and duration, scale and duration effects significantly vary across project types, and there is an upward trend in costs. The results also show that the distribution of the projects in the CDM portfolio or a given location does not strictly follow the relative cost structure, nor does the distribution of the CDM projects in different host countries follow the principle of comparative advantage. More than 84% of the CDM portfolio consists of various energy projects with substantially higher costs of CERs than afforestation and reforestation, industrial and landfill gas reduction, and methane avoidance projects, which are only 12% of all projects. While per unit cost of abatement plays an important role in the bottom-up and top-down models to evaluate emission reduction potential and analyze policy alternatives, the findings contradict the presumption of such models that project investors seek out low-cost opportunities. At the aggregate level, the cost of CER by the projects in Asia and Europe is similar but higher than those hosted in Africa, Americas, and Oceania. Yet more than 83% of the projects in the CDM portfolio are located in Asia; more than 69% of the projects are in China and India alone. China appears to have a comparative advantage (i.e., lowest opportunity cost) in energy efficiency projects, while India has a comparative advantage in hydro power projects and Brazil has a comparative advantage in wind power projects. In contrast, energy efficiency category accounts for only 8% of the CDM projects in China, hydro power
After two technical contracts of IAEA, a portable image processing software (PIP) has been developed and some clinical protocols for nuclear medicine studies with IBM PCs which are connected to analogue gamma cameras. In addition, a suitable front end for driving some PC/gamma camera interface cards have been successfully tested and extended. The on-line help facilities and the user interface within PIP was remarkably improved, for medical physicists as developers as well as for technologists as users for routine studies
Carvey, Jayme S.; Bernhardt, B. May
Rubinstein-Taybi syndrome (RTS) is a rare genetic developmental disorder that often shows associated language delay. However, literature on language development in RTS is very limited, particularly for the period of early communicative development, when standardized testing can be minimally informative. The purpose of the current study was to…
Zampini, Laura; Fasolo, Mirco; Spinelli, Maria; Zanchi, Paola; Suttora, Chiara; Salerni, Nicoletta
Background: Many studies have analysed language development in children with Down syndrome to understand better the nature of their linguistic delays and the reason why these delays, particularly those in the morphosyntactic area, seem greater than their cognitive impairment. However, the prosodic characteristics of language development in…
Zampini, L.; Salvi, A.; D'Odorico, L.
Background: Because of their difficulties in language development, various studies have focussed on the precursors of linguistic skills in children with Down syndrome. However, data on the predictive role of joint attention on language development in this population are inconsistent. The present study aimed to analyse attention behaviours in a…
Haebig, Eileen; Sterling, Audra; Hoover, Jill
Purpose: One aspect of morphosyntax, finiteness marking, was compared in children with fragile X syndrome (FXS), specific language impairment (SLI), and typical development matched on mean length of utterance (MLU). Method: Nineteen children with typical development (mean age = 3.3 years), 20 children with SLI (mean age = 4.9 years), and 17 boys…
Atkin, Keith; Lorch, Marjorie Perlman
Prader-Willi syndrome (PWS) is a genetic disorder which has widespread developmental consequences including motor, cognitive and language delay. Previous research on PWS children has focused primarily on phonological development and dysfluency. In the present study, the lexical development of a boy with PWS was investigated in a series of 18 play…
Naess, Kari-Anne B.
Phonological awareness (PA) is the knowledge and understanding of the sound structure of language and is believed to be an important skill for the development of reading. This study explored PA skills in children with Down syndrome and matched typically developing (TD) controls using a dual approach: a meta-analysis of the existing international…
Li, Sophie H; Sandler, Carolina X; Casson, Sally M; Cassar, Joanne; Bogg, Tina; Lloyd, Andrew R; Barry, Benjamin K
Chronic fatigue syndrome (CFS) is a serious and debilitating illness that affects between 0.2%-2.6% of the world's population. Although there is level 1 evidence of the benefit of cognitive behaviour therapy (CBT) and graded exercise therapy (GET) for some people with CFS, uptake of these interventions is low or at best untimely. This can be partly attributed to poor clinician awareness and knowledge of CFS and related CBT and GET interventions. This trial aims to evaluate the effect of participation in an online education programme, compared with a wait-list control group, on allied health professionals' knowledge about evidence-based CFS interventions and their levels of confidence to engage in the dissemination of these interventions. A randomised controlled trial consisting of 180 consenting allied health professionals will be conducted. Participants will be randomised into an intervention group (n=90) that will receive access to the online education programme, or a wait-list control group (n=90). The primary outcomes will be: 1) knowledge and clinical reasoning skills regarding CFS and its management, measured at baseline, postintervention and follow-up, and 2) self-reported confidence in knowledge and clinical reasoning skills related to CFS. Secondary outcomes include retention of knowledge and satisfaction with the online education programme. The influence of the education programme on clinical practice behaviour, and self-reported success in the management of people with CFS, will also be assessed in a cohort study design with participants from the intervention and control groups combined. The study protocol has been approved by the Human Research Ethics Committee at The University of New South Wales (approval number HC16419). Results will be disseminated via peer-reviewed journal articles and presentations at scientific conferences and meetings. ACTRN12616000296437. © Article author(s) (or their employer(s) unless otherwise stated in the text of the
Efficacy and safety of manual acupuncture manipulations with different frequencies on epigastric pain syndrome (EPS) in functional dyspepsia (FD) patients: study protocol for a randomized controlled trial.
Hong, Shou-Hai; Ding, Sha-Sha; Wu, Fei; Bi, Ying; Xu, Fu; Wan, Yi-Jia; Xuan, Li-Hua
Manual acupuncture (MA) manipulations are one of the key factors influencing acupuncture effects in traditional Chinese medicine theory. Different MA manipulations contain different stimulating parameters, thus generating different acupuncture responses or effects. Evidence has demonstrated that acupuncture is effective for functional dyspepsia (FD). However, the effects of different stimulating parameters of MA manipulations on FD remain unclear. This study is a randomized controlled trial with a four-arm, parallel-group structure. Patients with FD with epigastric pain syndrome (EPS) will be included and randomly allocated into four groups: three MA manipulation groups (separately treated with a frequency of 1 Hz, 2 Hz, or 3 Hz) and a control group. All groups will receive omeprazole as a basic treatment and acupuncture: in the MA manipulation groups, the needles will be manipulated manually with three different frequencies on the basis when de qi is reached, while in the control group, the needles will be inserted without any manipulation. All patients will receive acupuncture treatment of five consecutive sessions per week for 2 weeks and be followed up at 4, 8, and 12 weeks. The primary outcomes of the study include patients' response to the treatment. The secondary outcomes include dyspeptic symptoms, quality of life, mental status, fasting serum gastrin, motilin, and ghrelin concentrations, and adverse events. The protocol was approved by the Ethics committee of the First Affiliated Hospital of Zhejiang Chinese Medical University (2016-K-057-01). The aim of this study is to evaluate the efficacy and safety of MA manipulations with different stimulating parameters (different frequencies) on EPS in patients with FD. Chinese Clinical Trial Registry, ChiCTR-IOR-16008189 . Registered on 30 March 2016.
Tran, Van Dinh; Lee, Andy H; Jancey, Jonine; James, Anthony P; Howat, Peter; Thi Phuong Mai, Le
Metabolic syndrome (MetS) is a cluster of risk factors for cardiovascular diseases and type II diabetes. In Vietnam, more than one-quarter of its population aged 50-65 have MetS. This cluster-randomised controlled trial aims to evaluate the effectiveness of interventions to increase levels of physical activity and improve dietary behaviours among Vietnamese adults aged 50-65 years with MetS. This 6-month community-based intervention includes a range of strategies to improve physical activity and nutrition for adults with MetS in Hanam, a province located in northern Vietnam. 600 participants will be recruited from 6 communes with 100 participants per commune. The 6 selected communes will be randomly allocated to either an intervention group (m=3; n=300) or a control group (m=3; n=300). The intervention comprises booklets, education sessions, resistance bands and attending local walking groups that provide information and encourage participants to improve their physical activity and healthy eating behaviours during the 6-month period. The control group participants will receive standard and 1-time advice. Social cognitive theory is the theoretical concept underpinning this study. Measurements will be taken at baseline and postintervention to evaluate programme effectiveness. The research protocol was approved by the Curtin University Human Research Ethics Committee (approval number: HR139/2014). The results of the study will be disseminated through publications, reports and conference presentations. ACTRN12614000811606. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Moin, Shaheen; Gondal, Ghulam Murtaza; Bano, Uzma
To measure the relation of creatinine clearance in type-2 diabetic patients with different components of metabolic syndrome and to quantify the relationship of frequency of incident CKD with increasing number of metabolic syndrome components while controlling for age, gender and duration of diabetes. Cross-sectional descriptive study. Diabetes Clinic, Fauji Foundation Hospital, Rawalpindi, from January to August 2006. Patients having type-2 Diabetes for more than 5 years were enrolled. Information regarding age, gender, duration of diabetes , type of diabetes, treatment taking, complete fasting lipid profile, fasting blood glucose, Body Mass Index (BMI), 24 hours urinary proteins and creatinine clearance, co-existent risk factors like hypertension and ischemic heart disease was taken. Patients were divided into groups having one to all five metabolic syndrome traits. Progressive increase in the metabolic syndrome traits was compared with decline in creatinine clearance. Pearson correlation test and multiple logistic regression were applied to determine correlation with significance at 'r' and 'p' creatinine clearance, 37% had a creatinine clearance between 60-90 ml/min, 19% had a creatinine clearance of 30-59 ml/min, 18% had a creatinine clearance of less than 30 ml/min and 10% were already in stage 5 CKD. The decline in renal function was more severe in subjects evaluated who had a higher number of features of the metabolic syndrome. Age was the only significant determinant of development of CKD (p=0.05). The renal function progressively declined with 3 or more features of the metabolic syndrome.
Diaz, Kristians; Castañeda, Benjamín; Miranda, César; Lavarello, Roberto; Llanos, Alejandro
We developed a protocol for the acquisition of digital images and an algorithm for a color-based automatic segmentation of cutaneous lesions of Leishmaniasis. The protocol for image acquisition provides control over the working environment to manipulate brightness, lighting and undesirable shadows on the injury using indirect lighting. Also, this protocol was used to accurately calculate the area of the lesion expressed in mm2 even in curved surfaces by combining the information from two consecutive images. Different color spaces were analyzed and compared using ROC curves in order to determine the color layer with the highest contrast between the background and the wound. The proposed algorithm is composed of three stages: (1) Location of the wound determined by threshold and mathematical morphology techniques to the H layer of the HSV color space, (2) Determination of the boundaries of the wound by analyzing the color characteristics in the YIQ space based on masks (for the wound and the background) estimated from the first stage, and (3) Refinement of the calculations obtained on the previous stages by using the discrete dynamic contours algorithm. The segmented regions obtained with the algorithm were compared with manual segmentations made by a medical specialist. Broadly speaking, our results support that color provides useful information during segmentation and measurement of wounds of cutaneous Leishmaniasis. Results from ten images showed 99% specificity, 89% sensitivity, and 98% accuracy.
Fábio Fabregas Cairolli
Full Text Available The virtual reality has been frequently required in rehabilitation settings. However, it still lacks specificity, making it necessary to establish specific criteria to classify the most relevant aspects of electronic games to allow interventions based on virtual reality. Therefore, the purpose of this study is to develop a “Perceptual and motor demands assessment protocol for virtual reality systems” and to investigate its content validity and intra and inter observer agreement. The protocol was created through a literature review including classical studies as well as a review of recent articles about motor behavior, physical training, cognitive neuroscience and virtual reality. The previous versions were presented in study group meetings and congresses, and modified accordingly to suggestions of experts. Three examiners used the final version to analyze twice the total of 20 videos of individuals in a virtual environment and answered a questionnaire about its content validity. Most of the obtained values were classified as “good” (concordance from 80% to 89% or “excellent” (concordance from 90% to 100% by the three examiners and the protocol’s content validity was adequate. The protocol is valid, applicable and practical for analyzing different requirements of electronic games in a virtual environment.
Martinez-Leon, M. I.; Ceres-Ruiz, L.; Cuesta, M. A.; Garcia-Martin, F. J.
Ataxia-telangiectasia (AT), or Louis-Bar syndrome, is an autosomal recessive illness characterized by progressive cerebellar ataxia, oculo-cutaneous telangiectasia, immunodeficiency combined with susceptibility to sinopulmonary infections and high incidence of neoplastic development. Nijmegen breakage syndrome (NBS) is a variant of AT, is also an autosomal recessive illness that presents cerebellar ataxia, as well as combined immunodeficiency and a tendency toward tumor development. Contrary to Louis-Bar syndrome, it doesn't present telangiectasia and exhibits a characteristics phenotype (short stature, bird-like face and microcephaly). Both entities are classified as syndrome of chromosomal instability or chromosomal fragility, a group which also includes Bloom syndrome and Fanconi anemia. All of these show an increase in the frequency of neoplastic pathologies, mainly lymphoid tumors. We present three patients,two with AT and one with NBS, who developed different lymphoma types in the course of the illness. We highlight the most outstanding aspects from a clinical-radiological point of view. (Author) 17 refs
Zampini, L; Salvi, A; D'Odorico, L
Because of their difficulties in language development, various studies have focussed on the precursors of linguistic skills in children with Down syndrome. However, data on the predictive role of joint attention on language development in this population are inconsistent. The present study aimed to analyse attention behaviours in a group of children with Down syndrome. The existence of both concurrent and longitudinal relationships between joint attention and vocabulary development was investigated. The participants were 18, 24-month-old, Italian children with Down syndrome. The children's attention skills were assessed during semi-structured free-play sessions in interaction with their mothers. A nominal exhaustive scheme was applied to code the children's behaviour. Moreover, the children's vocabulary development (both receptive and expressive) was assessed with the Italian version of the MacArthur-Bates Communicative Development Inventory at both 24 and 30 months. Data analyses showed that children with Down syndrome spent a large part of the interactive play session in joint attention situations. Moreover, the children's behaviour of proposing a joint attention focus to their communicative partners appeared to be a significant predictor of the children's vocabulary comprehension skills as assessed 6 months later. These results support the hypothesis of continuity between preverbal precursors and vocabulary development in a population with atypical development. © 2015 MENCAP and International Association of the Scientific Study of Intellectual and Developmental Disabilities and John Wiley & Sons Ltd.
Cano-Castillo, M; Casas, J L
We cryopreserved in vitro shoot tips of saltcedar (Tamarix boveana Bunge) using the vitrification technique. The success of the cryopreservation protocol was strongly affected by preculture, loading duration, dehydration duration in plant vitrification solution 2 (PVS2), and medium composition during post-warming regrowth. The highest explant regrowth (50 percent) occurred when the following conditions were employed: preculture in 0.4 M glycerol; treatment with a loading solution (LS) consisting of 2 M glycerol + 0.4 M sucrose in culture medium for 40 min at room temperature; and dehydration in PVS2 at 0 degree C for 45 min before rapid immersion in liquid nitrogen (LN). Rewarming was performed in a water-bath at 40 degree C for 2 min. Explants were then immersed in unloading solution for 10 min before plating on recovery medium supplemented with 0.01 mg per liter thidiazuron (TDZ). TDZ was progressively eliminated from the medium over a period of 6 weeks. Plantlets were transferred to a double-layer medium to enhance rooting. This protocol was successfully applied to three individuals of T. boveana harvested from the wild.
van Kempen, Elise; Devilee, Jeroen; Swart, Wim; van Kamp, Irene
Due to rapid urbanization, the spatial variation between wanted and unwanted sounds will decrease or even disappear. Consequently, the characteristics of (urban) areas where people can temporarily withdraw themselves from urban stressors such as noise may change or become increasingly scarce. Hardly any research has been carried out into the positive health effects of spending time in areas with a good sound quality. One of the problems is that an overview of what aspects determines good sound quality in urban areas and how these are interrelated is lacking. This paper reviews the literature pertaining to the sound quality of urban areas. Aim is to summarize what is known about the influence of social, spatial, and physical aspects other than sounds, on peoples' perception of urban sound qualities. Literature from both conventional sound research and from the so-called soundscape field, published between 2000 and the beginning of 2013 in English or Dutch, was evaluated. Although a general set of validated indicators that can be directly applied, is not available yet, a set of indicators was derived from the literature. These form the basis of a study protocol that will be applied in "Towards a Sustainable acoustic Environment", a project that aims to describe sound qualities at a low-scale level. Key-elements of this study protocol, including a questionnaire and the systematic audit of neighborhoods, were presented in this paper.
Kwon, Ahreum; Hyun, Sei Eun; Jung, Mo Kyung; Chae, Hyun Wook; Lee, Woo Jung; Kim, Tae Hyuk; Kim, Duk Hee; Kim, Ho-Seong
Current guidelines recommend that testing for Y chromosome material should be performed only in patients with Turner syndrome harboring a marker chromosome and exhibiting virilization in order to detect individuals who are at high risk of gonadoblastoma. However, cryptic Y chromosome material is suggested to be a risk factor for gonadoblastoma in patients with Turner syndrome. Here, we aimed to estimate the frequency of cryptic Y chromosome material in patients with Turner syndrome and determine whether Y chromosome material increased the risk for development of gonadoblastoma. A total of 124 patients who were diagnosed with Turner syndrome by conventional cytogenetic techniques underwent additional molecular analysis to detect cryptic Y chromosome material. In addition, patients with Turner syndrome harboring Y chromosome cell lines had their ovaries removed prophylactically. Finally, we assessed the occurrence of gonadoblastoma in patients with Turner syndrome. Molecular analysis demonstrated that 10 patients had Y chromosome material among 118 patients without overt Y chromosome (8.5%). Six patients with overt Y chromosome and four patients with cryptic Y chromosome material underwent oophorectomy. Histopathological analysis revealed that the occurrence of gonadoblastoma in the total group was 2.4%, and gonadoblastoma occurred in one of six patients with an overt Y chromosome (16.7%) and 2 of 10 patients with cryptic Y chromosome material (20.0%). The risk of developing gonadoblastoma in patients with cryptic Y chromosome material was similar to that in patients with overt Y chromosome. Therefore, molecular screening for Y chromosome material should be recommended for all patients with Turner syndrome to detect individuals at a high risk of gonadoblastoma and to facilitate proper management of the disease.
Kreinest, Michael; Gliwitzky, Bernhard; Schüler, Svenja; Grützner, Paul A; Münzberg, Matthias
In order to match the challenges of quickly recognizing and treating any life-threatening injuries, the ABCDE principles were established for the assessment and treatment of trauma patients. The high priority of spine protection is emphasized by the fact that immobilization of the cervical spine is performed at the very first step in the ABCDE principles. Immobilization is typically performed to prevent or minimize secondary damage to the spinal cord if instability of the spinal column is suspected. Due to increasing reports about disadvantages of spinal immobilization, the indications for performing spinal immobilization must be refined. The aim of this study was (i) to develop a protocol that supports decision-making for spinal immobilization in adult trauma patients and (ii) to carry out the first applicability test by emergency medical personnel. A structured literature search considering the literature from 1980 to 2014 was performed. Based on this literature and on the current guidelines, a new protocol that supports on scene decision-making for spinal immobilization has been developed. Parameters found in the literature concerning mechanisms and factors increasing the likelihood of spinal injury have been included in the new protocol. In order to test the applicability of the new protocol two surveys were performed on German emergency care providers by means of a questionnaire focused on correct decision-making if applying the protocol. Based on the current literature and guidelines, the Emergency Medicine Spinal Immobilization Protocol (E.M.S. IMMO Protocol) for adult trauma patients was developed. Following a fist applicability test involving 21 participants, the first version of the E.M.S. IMMO Protocol has to be graphically re-organized. A second applicability test comprised 50 participants with the current version of the protocol confirmed good applicability. Questions regarding immobilization of trauma patients could be answered properly using the E
Esplugues, Ana; Fernández-Patier, Rosalía; Aguilera, Inma; Iñíguez, Carmen; García Dos Santos, Saúl; Aguirre Alfaro, Amelia; Lacasaña, Marina; Estarlich, Marisa; Grimalt, Joan O; Fernández, Marieta; Rebagliato, Marisa; Sala, María; Tardón, Adonina; Torrent, Maties; Martínez, María Dolores; Ribas-Fitó, Núria; Sunyer, Jordi; Ballester, Ferran
The INMA (INfancia y Medio Ambiente [Spanish for Environment and Childhood]) project is a cooperative research network. This project aims to study the effects of environment and diet on fetal and early childhood development. This article aims to present the air pollutant exposure protocol during pregnancy and fetal and early childhood development of the INMA project. The information to assess air pollutant exposure during pregnancy is based on outdoor measurement of air pollutants (nitrogen dioxide [NO2], volatile organic compounds [VOC], ozone, particulate matter [PM10, PM2,5 ] and of their composition [polycyclic aromatic hydrocarbons]); measurement of indoor and personal exposure (VOC and NO2); urinary measurement of a biological marker of hydrocarbon exposure (1-hydroxypyrene); and data gathered by questionnaires and geographic information systems. These data allow individual air pollutant exposure indexes to be developed, which can then be used to analyze the possible effects of exposure on fetal development and child health. This protocol and the type of study allow an approximation to individual air pollutant exposure to be obtained. Finally, the large number of participants (N = 4,000), as well as their geographic and social diversity, increases the study's potential.
Goodess, Clare; Ruti, Paolo; Rousset, Nathalie
During the closing stages of the CLIM-RUN EU FP7 project on Climate Local Information in the Mediterranean region Responding to User Needs, the real-world experiences encountered by the case-study teams are being assessed and synthesised to identify examples of good practice and, in particular, to produce the CLIM-RUN protocol for the development of Mediterranean climate services. The specific case studies have focused on renewable energy (Morocco, Spain, Croatia, Cyprus), tourism (Savoie, Tunisia, Croatia, Cyprus) and wild fires (Greece) as well as one cross-cutting case study (Veneto region). They have been implemented following a common programme of local workshops, questionnaires and interviews, with Climate Expert Team and Stakeholder Expert Team members collaborating to identify and translate user needs and subsequently develop climate products and information. Feedback from stakeholders has been essential in assessing and refining these products. The protocol covers the following issues: the overall process and methodological key stages; identification and selection of stakeholders; communication with stakeholders; identification of user needs; translation of needs; producing products; assessing and refining products; methodologies for evaluating the economic value of climate services; and beyond CLIM-RUN - the lessons learnt. Particular emphasis is given to stakeholder analysis in the context of the participatory, bottom-up approach promoted by CLIM-RUN and to the iterative approach taken in the development of climate products. Recommendations are also made for an envisioned three-tier business model for the development of climate services involving climate, intermediary and stakeholder tiers.
Irritable bowel syndrome (IBS) is a common gastrointestinal disorder, the pathophysiology of which is not completely known, although it has been shown that genetic/social learning factors, diet, intestinal microbiota, intestinal low-grade inflammation, and abnormal gastrointestinal endocrine cells play a major role. Studies of familial aggregation and on twins have confirmed the heritability of IBS. However, the proposed IBS risk genes are thus far nonvalidated hits rather than true predisposing factors. There is no convincing evidence that IBS patients suffer from food allergy/intolerance, with the effect exerted by diet seemingly caused by intake of poorly absorbed carbohydrates and fiber. Obesity is a possible comorbidity of IBS. Differences in the microbiota between IBS patients and healthy controls have been reported, but the association between IBS symptoms and specific bacterial species is uncertain. Low-grade inflammation appears to play a role in the pathophysiology of a major subset of IBS, namely postinfectious IBS. The density of intestinal endocrine cells is reduced in patients with IBS, possibly as a result of genetic factors, diet, intestinal microbiota, and low-grade inflammation interfering with the regulatory signals controlling the intestinal stem-cell clonogenic and differentiation activities. Furthermore, there is speculation that this decreased number of endocrine cells is responsible for the visceral hypersensitivity, disturbed gastrointestinal motility, and abnormal gut secretion seen in IBS patients.
Kennedy, Michael; Gibbins, Chris; Lowe, Steven; Dallas, Helen; Taylor, Jonathan; Lang, Pauline; Saili, Kothelani; Sichingabula, Henry; Murphy, Kevin
The water resources of Zambia are likely to experience increasing multiple pressures in the future as a result of very high predicted population growth, industrial development, land use change, and potentially, altered regional rainfall patterns. It is well known that rivers in tropical regions typically have a rich biodiversity, controlled in part by inter-annual variability in climate and discharge, and in part by local catchment conditions. However, till recently little country-wide work had had been carried out on the biota of Zambian rivers, and little was therefore known about the ecological status, or degree of catchment alteration of many of the rivers. To underpin sustainable water management, protocols have been developed to assess the ecological status of Zambian rivers. This paper describes the development of the protocols and their application to provide the first extensive assessment of the ecological status of rivers in the country. The protocols were designed to be simple, and hence rapid, easy and relatively inexpensive to apply. Status scores were derived for individual sites using sensitivity weightings from 3 major groups (macrophytes, diatoms and macroinvertebrates). The general approach was based on schemes used successfully elsewhere, with species and family sensitivity weightings modified so as be appropriate to Zambia. Modifications were based on a survey of 140 Zambian rivers, incorporating data on species distributions, physical habitat conditions and water quality. Analysis of historical data suggests that established Freshwater Ecoregions reflect hydro-climatic variability across Zambia. Survey data indicate that most of the spatial variation in biological assemblages across the country reflects these same hydro-climatic gradients, in addition to hydrochemical differences linked to geology. Site status scores suggest that rivers are generally in good health, although exceptions occur in some large urban areas and a small number of
Levitan, Denise M.; Schreiber, Madeline E.; Seal, Robert R.; Bodnar, Robert J.; Aylor, Joseph G.
Highlights: • We outline protocols for baseline geochemical surveys of stream sediments and water. • Regression on order statistics was used to handle non-detect data. • U concentrations in stream water near this unmined ore were below regulatory standards. • Concentrations of major and trace elements were correlated with stream discharge. • Methods can be applied to other extraction activities, including hydraulic fracturing. - Abstract: In this study, we determined baseline geochemical conditions in stream sediments and surface waters surrounding an undeveloped uranium deposit. Emphasis was placed on study design, including site selection to encompass geological variability and temporal sampling to encompass hydrological and climatic variability, in addition to statistical methods for baseline data analysis. The concentrations of most elements in stream sediments were above analytical detection limits, making them amenable to standard statistical analysis. In contrast, some trace elements in surface water had concentrations that were below the respective detection limits, making statistical analysis more challenging. We describe and compare statistical methods appropriate for concentrations that are below detection limits (non-detect data) and conclude that regression on order statistics provided the most rigorous analysis of our results, particularly for trace elements. Elevated concentrations of U and deposit-associated elements (e.g. Ba, Pb, and V) were observed in stream sediments and surface waters downstream of the deposit, but concentrations were below regulatory guidelines for the protection of aquatic ecosystems and for drinking water. Analysis of temporal trends indicated that concentrations of major and trace elements were most strongly related to stream discharge. These findings highlight the need for sampling protocols that will identify and evaluate the temporal and spatial variations in a thorough baseline study
Ozawa, T.; Santos, R.A.; Hu, L.H.; Faddegon, B.A.; Lamborn, K.R.; Deen, D.F.
Patients with malignant gliomas are typically treated by surgery, radiation therapy and chemotherapy. Fractionated radiotherapy consists of 30 daily doses of 1.8 to 2 Gy given over a 6-week period. We have investigated a multi-fraction radiation protocol in which rats bearing intracerebral tumors are irradiated once daily for 10 days with a 2-day break in the middle. This scheme simulates the first third of a typical human radiation protocol, and it is a practical scheme to conduct in the laboratory. U-87 MG or U-251 MG human glioblastoma cells were implanted into the right caudate-putamens of male athymic rats. We irradiated rats using an irradiation jig that allowed us to deliver Cesium-137 photons at a dose rate of 280 cGy/minute selectively to the portion of the head containing the tumor. This device adequately shields all other parts of rat, including the critically sensitive oropharynx. Animals received the first radiation dose when intracerebral tumors were ∼20 mg in size. Untreated U-87 MG tumor-bearing rats died with a median survival of 23 days, while tumor bearing rats that were given ten 1-Gy doses died with a median survival of 28.5 days. Untreated U-251 MG tumor-bearing rats died with a median survival of 34.5 days, while tumor-bearing rats that were given ten 1-Gy doses died with a median survival of 58 days. However, 5 of 14 of these rats had a lifespan >68 days and were considered cured. A daily dose of 0.75 Gy produced a median survival of 43 days, but again 2 rats had a lifespan >70 days. Currently, we are seeking a dose that causes reproducible tumor growth delay of 1 to 2 weeks, without curing any animals, to use in future studies that combine radiation with other anti-tumor agents
Stirling, R.J.; Duller, G.A.T.; Roberts, H.M.
Exploiting biogenic carbonates as thermoluminescence dosimeters requires an understanding of trap kinetics and an appropriate sequence with which to measure equivalent dose. The trap kinetics of two high temperature peaks (peaks II and III) from calcitic snail opercula have been investigated resulting in the calculation of lifetimes of 7.4 × 10 7 and 1.4 × 10 11 years for the two peaks respectively. Two measurement sequences, based upon changes in the application and measurement of a test dose, have been applied to peaks II and III, and though both methods were equally successful in dose recovery and production of a dose response curve some differences were observed. Primarily, the use of method 1 lead to dose dependant sensitivity change implying competition effects occurring during irradiation; method 2 did not experience this phenomenon. As a consequence method 2 was chosen as the most appropriate protocol for single-aliquot dating of this material. When assessing the TL behaviour of the two peaks, peak II performed poorly in dose recovery experiments recovering a dose 60–100% larger than that applied. Disproportionate growth of peak II in response to a beta dose applied prior to measurement, compared to growth following regeneration doses indicated that peak II was not suitable for use in single-aliquot protocols. However, dose recovery results for peak III were all within errors of unity of the given dose, and peak III was therefore chosen as the most appropriate peak for TL dosimetry in these single-aliquot procedures. The lifetime of charge in peak III is sufficient to date over many millions of years, and furthermore using the chosen method 2 the dose response curve has a D 0 of 3,250 ± 163 Gy allowing dating to over 3 million years.
Gernhardt, Michael L.; Beaton, Kara H.; Chappell, Steven P.; Bekdash, Omar S.; Abercromby, Andrew F. J.
The NASA Next Space Technologies for Exploration Partnerships (NextSTEP) program is a public-private partnership model that seeks commercial development of deep space exploration capabilities to support human spaceflight missions around and beyond cislunar space. NASA first issued the Phase 1 NextSTEP Broad Agency Announcement to U.S. industries in 2014, which called for innovative cislunar habitation concepts that leveraged commercialization plans for low-Earth orbit. These habitats will be part of the Deep Space Gateway (DSG), the cislunar space station planned by NASA for construction in the 2020s. In 2016, Phase 2 of the NextSTEP program selected five commercial partners to develop ground prototypes. A team of NASA research engineers and subject matter experts (SMEs) have been tasked with developing the ground-test protocol that will serve as the primary means by which these Phase 2 prototypes will be evaluated. Since 2008, this core test team has successfully conducted multiple spaceflight analog mission evaluations utilizing a consistent set of operational tools, methods, and metrics to enable the iterative development, testing, analysis, and validation of evolving exploration architectures, operations concepts, and vehicle designs. The purpose of implementing a similar evaluation process for the Phase 2 Habitation Concepts is to consistently evaluate different commercial partner ground prototypes to provide data-driven, actionable recommendations for Phase 3. This paper describes the process by which the ground test protocol was developed and the objectives, methods, and metrics by which the NextSTEP Phase 2 Habitation Concepts will be rigorously and systematically evaluated. The protocol has been developed using both a top-down and bottom-up approach. Top-down development began with the Human Exploration and Operations Mission Directorate (HEOMD) exploration objectives and ISS Exploration Capability Study Team (IECST) candidate flight objectives. Strategic
Vanderhoeven, Sonia; Branquart, Etienne; Casaer, Jim
Risk assessment tools for listing invasive alien species need to incorporate all available evidence and expertise. Beyond the wealth of protocols developed to date, we argue that the current way of performing risk analysis has several shortcomings. In particular, lack of data on ecological impacts...... process can be applied to better capture opinions of different experts, thereby maximizing the evidential basis. Elaborating on manageability of invasive species is further needed to fully answer all risk analysis requirements. Tackling the issue of invasive species urges better handling of the acquired...
Dumas, Audrée-Anne; Lemieux, Simone; Lapointe, Annie; Provencher, Véronique; Robitaille, Julie; Desroches, Sophie
Low adherence to dietary guidelines and a concurrent rise of obesity-related chronic diseases emphasize the need for effective interventions to promote healthy eating. There is growing recognition that behavior change interventions should draw on theories of behavior change. Online interventions grounded in theory lead to increased effectiveness for health behavior change; however, few theory-driven social media-based health promotion interventions have been described in the literature. The objective of this study was to describe the application of the Intervention Mapping (IM) protocol to develop an evidence-informed blog to promote healthy eating among French-Canadian mothers of preschool and school-aged children. The following six steps of the IM protocol were performed. In Step 1, a preliminary needs assessment included a literature search on theoretical domains predicting Vegetables and Fruits intakes and Milk and Alternatives intakes in adults (ie, knowledge, beliefs about capabilities, beliefs about consequences, intention/goals) and a qualitative study including focus groups to identify female Internet users' perceptions of their use of healthy eating blogs. In Step 2, two behavioral outcomes were selected (ie, increase daily intakes of Vegetables and Fruits and Milk and Alternatives of mothers to reach Canadian dietary recommendations) and subsequently divided into six performance objectives inspired by national and international dietary recommendations such as planning for healthy meals. A matrix of change objectives was then created by crossing performance objectives with theoretical domains predicting Vegetables and Fruits intakes and Milk and Alternatives intakes in adults. Step 3 consisted of selecting theory-based intervention methods (eg, modeling and goal setting) and translating them into practical applications for the context of a dietary intervention delivered through a blog. A 6-month intervention was developed in Step 4 in which we aimed to
Kristoffersen, Kristian Emil
This article reviews research on speech and language abilities in people with cri du chat syndrome (CCS). CCS is a rare genetic disorder, with an estimated incidence between 1 in 15,000 and 1 in 50,000 births, resulting from a deletion on the short arm of chromosome 5. In general, individuals have delayed speech and language development, and some…
Reddy, Vasudevi; Williams, Emma; Costantini, Cristina; Lan, Britta
Children with autism achieve mirror self-recognition appropriate to developmental age, but are nonetheless reported to have problems in other aspects of a sense of self. We observed behaviour in the mirror in 12 pre-school children with autism, 13 pre-school children with Down syndrome (DS) and 13 typically developing (TD) toddlers. Reliable…
Lyer, A.M.; van Scheppingen, J.; Milenkovic, I.; Anink, A.J.; Adle-Biassette, H.; Kovacs, G.G.; Aronica, E.
The mammalian target of rapamycin (mTOR) signaling pathway is a key developmental pathway involved in mechanisms underlying cellular aging and neurodegeneration. We hypothesized that its deregulation may occur during early brain development in patients with Down syndrome (DS). The expression
Tudella, E.; Pereira, K.; Pedronongo Basso, R.; Savelsbergh, G.J.P.
The purpose of the present study was to describe the rate of motor development in infants with Down syndrome in the age range of 3-12 months and identify the difficulties both in performance and acquiring motor skills in prone, supine, sitting and standing positions. Nineteen infants with Down
To determine the relationship of both pubertal development and sex to childhood irritable bowel syndrome (IBS) clinical characteristics including gastrointestinal symptoms (eg, abdominal pain) and psychological factors. Cross-sectional study with children ages 7-17 years (n'='143) with a pediatric R...
The role of abuse in the development of irritable bowel syndrome: a comparative study: research. ... disorder of unknown causes which is characterised by attacks of abdominal pain and change of bowel habit resulting in diarrhoea or constipation or both. ... No such studies have however been conducted in South Africa.
Brantmüller, Éva; Gyuró, Monika; Karácsony, Ilona
Development of the walking ability and self-care of patients with Down syndrome is affected by their body weight determining their lifestyle to a great extent. Objectives: The study aimed at the determination of body mass index for persons living in residential institutions and families, exploration its impact on walking and self-care as two,…
Antshel, Kevin M.; Marrinan, Eileen; Kates, Wendy R.; Fremont, Wanda; Shprintzen, Robert J.
Velo-cardio-facial syndrome (VCFS) is a genetic disorder caused by a microdeletion of chromosome 22q11.2. Although there is some variability, VCFS is associated with a characteristic physical, behavioral, and cognitive phenotype. This review article focuses on aspects of language and literacy development in VCFS, describing what is known and…
Gilmore, Linda; Cuskelly, Monica; Jobling, Anne; Hayes, Alan
Maternal behaviors and child mastery behaviors were examined in 25 children with Down syndrome and 43 typically developing children matched for mental age (24-36 months). During a shared problem-solving task, there were no group differences in maternal directiveness or support for autonomy, and mothers in the two groups used similar verbal…
Milojevich, H.; Lukowski, A.
Background: Whereas research has indicated that children with Down syndrome (DS) imitate demonstrated actions over short delays, it is presently unknown whether children with DS recall information over lengthy delays at levels comparable with typically developing (TD) children matched on developmental age. Method: In the present research, 10…
Fidler, Deborah J.; Philofsky, Amy D.; Hepburn, Susan L.
The aim of this article is to provide an in-depth description of early development in a young child with Smith-Magenis syndrome (SMS). SMS is a multisystem, neurodevelopmental genetic disorder associated with mental retardation that predisposes individuals to a distinct pattern of maladaptive behaviors and other neuropsychological impairments.…
de Campos, Ana Carolina; Rocha, Nelci Adriana Cicuto Ferreira; Savelsbergh, Geert J. P.
Reaching and grasping skills have been described to emerge from a dynamic interaction between intrinsic and extrinsic factors. The aims of the study were to investigate the effect of such intrinsic factors as age and Down syndrome on the development of reaching and grasping skills and on overall gross motor skill, and to test the influence of the…
Zampini, Laura; D'Odorico, Laura
Background: Children with Down's syndrome seem to show a preference for the use of gestural rather than vocal productions during the first stages of language development. This "gestural advantage" could actually be due to a developmental strategy used to compensate the difficulties in verbal production that are typical of language…
Krag, A; Bendtsen, F; Møller, S
OBJECTIVES: Recent studies suggest that cardiac dysfunction precedes development of the hepatorenal syndrome. In this follow-up study, we aimed to investigate the relation between cardiac and renal function in patients with cirrhosis and ascites and the impact of cardiac systolic function...... (130 (SD 46) vs 78 (SD 29) mumol/l, phepatorenal syndrome type 1 within 3 months was higher in the group with low CI than in the high CI group (43% vs 5%, p = 0.04). Patients with the lowest CI (N = 8) had significantly poorer survival at 3, 9, and 12 months...
Mauro, David M.; Flors, Lucia; Norton, Patrick T.; Hagspiel, Klaus D. [University of Virginia Health System, Department of Radiology and Medical Imaging, Charlottesville, VA (United States); Hoyer, Andrew W. [University of Virginia Health System, Department of Pediatrics, Division of Pediatric Cardiology, Charlottesville, VA (United States); Pediatric Cardiology Center of Oregon, Portland, OR (United States)
Noonan syndrome is a constellation of congenital malformations including heart defects, facial anomalies and short stature. The cardiovascular defects are variable and extensive, with the most common being pulmonary stenosis and hypertrophic cardiomyopathy. Coronary artery anomalies have only been reported in a few cases. We report a child with Noonan syndrome status post pulmonary stenosis and atrial septal defect repair, who developed bilateral coronary artery aneurysms. The aneurysms were diagnosed with both cardiac magnetic resonance imaging and coronary computed tomography angiography. There had been no evidence of them on a cardiac MR exam 5 years previously. (orig.)
Cleave, Patricia; Bird, Elizabeth Kay-Raining; Czutrin, Rachael; Smith, Lindsey
The present study examined narrative development in children and adolescents with Down syndrome longitudinally. Narratives were collected from 32 children and adolescents with Down syndrome three times over a 1-year period. Both micro- and macrolevel analyses were conducted. Significant growth over the 1-year period was seen in semantic complexity and narrative structure. However, there was no evidence of growth in syntactic complexity or narrative length. Mental age and comprehension skills at Time 1 predicted scores in all 4 areas at Time 3. Expressive language skills added further to the prediction of syntactic complexity and story length.
Madsen, Michael Tvilling; Isbrand, Anders; Andersen, Ulla Overgaard; Andersen, Lars Juel; Taskiran, Mustafa; Simonsen, Erik; Gögenur, Ismail
Depression following acute coronary syndrome (ACS) constitutes a serious and debilitating problem. Approximately one in five patients will develop significant depression following ACS and less severe depressive symptoms are even more frequent. Furthermore, anxiety symptoms and sleep-wake disturbances are frequent. The objective of the MEDACIS trial is to investigate whether prophylactic treatment with melatonin has a preventive effect on depression, depressive and anxiety symptoms, sleep, and circadian disturbances following ACS. "The effect of MElatonin and Depressive symptoms, Anxiety, CIrcadian and Sleep disturbances in patients after acute coronary syndrome" trial (MEDACIS) is a multicenter, double-blinded, placebo-controlled, randomized clinical trial. A total of 240 patients with ACS and no depressive symptoms will be included in the trial for treatment with either 25 mg melatonin or placebo for a 12-week period. Development and severity of depressive symptoms will be evaluated using Major Depression Inventory every 2 weeks with the purpose of investigating the potential preventive effect of melatonin on depressive symptoms. Previously, only selective serotonin reuptake inhibitors (SSRIs) have been investigated in a primary preventive setup in patients following ACS. However, SSRIs are associated with several side effects. An ideal intervention would constitute the highest degree of prevention of depressive symptoms with the lowest risk of side effects. In this regard, melatonin may have advantages due to its low toxicity as well as its proven anxiolytic and hypnotic effects. ClinicalTrials.gov, Identifier: NCT02451293 . Registered on 12 May 2015. EudraCT nr. 2015-002116-32.
Chu, Anne H Y; Moy, F M
Metabolic syndrome is a highly prevalent health problem within the adult population in developing countries. We aimed to study the association of physical activity levels and metabolic risk factors among Malay adults in Malaysia. Cross-sectional. Body mass index, waist circumference, and systolic/diastolic blood pressure, fasting blood glucose, fasting triglyceride and high-density lipoprotein cholesterol levels were measured in 686 Malay participants (aged 35-74 years). Self-reported physical activity was obtained with the validated International Physical Activity Questionnaire (Malay version) and categorized into low, moderate or high activity levels. Individuals who were classified as overweight and obese predominated (65.6%). On the basis of the modified NCEP ATP III criteria, metabolic syndrome was diagnosed in 31.9% of all participants, of whom 46.1% were men and 53.9% were women. The prevalence of metabolic syndrome among participants with low, moderate or high activity levels was 13.3%, 11.7% and 7.0%, respectively (pactivity categories (pactivity categories were 0.42 (95% CI: 0.27-0.65) and 0.52 (95% CI: 0.35-0.76), respectively, adjusted for gender. Moderate and high activity levels were each associated with reduced odds for metabolic syndrome independent of gender. Although a slightly lower prevalence of metabolic syndrome was associated with high activity than with moderate activity, potential health benefits were observed when moderate activity was performed. Copyright © 2013 Sports Medicine Australia. All rights reserved.
Carla M Startin
Full Text Available Down syndrome (DS is the most common genetic cause of intellectual disability (ID. Abilities relating to executive function, memory and language are particularly affected in DS, although there is a large variability across individuals. People with DS also show an increased risk of developing dementia. While assessment batteries have been developed for adults with DS to assess cognitive abilities, these batteries may not be suitable for those with more severe IDs, dementia, or visual / hearing difficulties. Here we report the development of an informant rated questionnaire, the Cognitive Scale for Down Syndrome (CS-DS, which focuses on everyday abilities relating to executive function, memory and language, and is suitable for assessing these abilities in all adults with DS regardless of cognitive ability. Complete questionnaires were collected about 128 individuals with DS. After final question selection we found high internal consistency scores across the total questionnaire and within the executive function, memory and language domains. CS-DS scores showed a wide range, with minimal floor and ceiling effects. We found high interrater (n = 55 and test retest (n = 36 intraclass correlations. CS-DS scores were significantly lower in those aged 41+ with significant cognitive decline compared to those without decline. Across all adults without cognitive decline, CS-DS scores correlated significantly to measures of general abilities. Exploratory factor analysis suggested five factors within the scale, relating to memory, self-regulation / inhibition, self-direction / initiation, communication, and focussing attention. The CS-DS therefore shows good interrater and test retest reliability, and appears to be a valid and suitable informant rating tool for assessing everyday cognitive abilities in a wide range of individuals with DS. Such a questionnaire may be a useful outcome measure for intervention studies to assess improvements to cognition, in
Weiswald, Louis-Bastien; Guinebretière, Jean-Marc; Richon, Sophie; Bellet, Dominique; Saubaméa, Bruno; Dangles-Marie, Virginie
Multicellular tumour sphere models have been shown to closely mimic phenotype characteristics of in vivo solid tumours, or to allow in vitro propagation of cancer stem cells (CSCs). CSCs are usually characterized by the expression of specific membrane markers using flow cytometry (FC) after enzymatic dissociation. Consequently, the spatial location of positive cells within spheres is not documented. Confocal microscopy is the best technique for the imaging of thick biological specimens after multi-labelling but suffers from poor antibody penetration. Thus, we describe here a new protocol for in situ confocal imaging of protein expression in intact spheroids. Protein expression in whole spheroids (150 μm in diameter) from two human colon cancer cell lines, HT29 and CT320X6, has been investigated with confocal immunostaining, then compared with profiles obtained through paraffin immunohistochemistry (pIHC) and FC. Target antigens, relevant for colon cancer and with different expression patterns, have been studied. We first demonstrate that our procedure overcomes the well-known problem of antibody penetration in compact structures by performing immunostaining of EpCAM, a membrane protein expressed by all cells within our spheroids. EpCAM expression is detected in all cells, even the deepest ones. Likewise, antibody access is confirmed with CK20 and CD44 immunostaining. Confocal imaging shows that 100% of cells express β-catenin, mainly present in the plasma membrane with also cytoplasmic and nuclear staining, in agreement with FC and pIHC data. pIHC and confocal imaging show similar CA 19-9 cytoplasmic and membranar expression profile in a cell subpopulation. CA 19-9 + cell count confirms confocal imaging as a highly sensitive method (75%, 62% and 51%, for FC, confocal imaging and pIHC, respectively). Finally, confocal imaging reveals that the weak expression of CD133, a putative colon CSC marker, is restricted to the luminal cell surface of colorectal cancer acini
Christner, Brent C.; Mikucki, Jill A.; Foreman, Christine M.; Denson, Jackie; Priscu, John C.
Evidence gathered from spacecraft orbiting Mars has shown that water ice exists at both poles and may form a large subsurface reservoir at lower latitudes. The recent exploration of the martian surface by unmanned landers and surface rovers, and the planned missions to eventually return samples to Earth have raised concerns regarding both forward and back contamination. Methods to search for life in these icy environments and adequate protocols to prevent contamination can be tested with earthly analogues. Studies of ice cores on Earth have established past climate changes and geological events, both globally and regionally, but only recently have these results been correlated with the biological materials (i.e., plant fragments, seeds, pollen grains, fungal spores, and microorganisms) that are entrapped and preserved within the ice. The inclusion of biology into ice coring research brings with it a whole new approach towards decontamination. Our investigations on ice from the Vostok core (Antarctica) have shown that the outer portion of the cores have up to 3 and 2 orders of magnitude higher bacterial density and dissolved organic carbon (DOC) than the inner portion of the cores, respectively, as a result of drilling and handling. The extreme gradients that exist between the outer and inner portion of these samples make contamination a very relevant aspect of geomicrobiological investigations with ice cores, particularly when the actual numbers of ambient bacterial cells are low. To address this issue and the inherent concern it raises for the integrity of future investigations with ice core materials from terrestrial and extraterrestrial environments, we employed a procedure to monitor the decontamination process in which ice core surfaces are painted with a solution containing a tracer microorganism, plasmid DNA, and fluorescent dye before sampling. Using this approach, a simple and direct method is proposed to verify the authenticity of geomicrobiological
Farhat, Samina; Banday, Muddasir; Hassan, Iffat
The study sought to identify the magnitude and characteristic of severe cutaneous adverse reactions (SCAR's) like Steven-Johnson syndrome (SJS) and Toxic Epidermal Necrolysis (TEN). A prospective study was conducted by the Department of Pharmacology in association with Department of Dermatology in SMHS hospital. The study was carried out from June 2013-June 2015 on hospitalized cases of cutaneous adverse drug reaction reporting in hospital. The SCAR's were reported in a structured questionnaire based on adverse drug reaction (ADR) reporting form provided by the Central Drug Standard Control Organization (CDSCO) Ministry of Health and Family welfare, Government of India. The SCAR's were analysed for their characteristics, causality, severity and prognosis. Causality assessment was done by using a validated ADR probability scale of Naranjo as well as WHO Uppsala Monitoring Center (WHO-UMC) system for standardized case causality assessment. The management protocol were analysed for their clinical outcome through a proper follow up period. A total of 52 hospitalized cases of cutaneous adverse drug reactions were reported during the study period. We identified a total of 15 cases (28%) of SCAR's involving 9(17%) of SJS and 6 (12%) of TEN. SJS was seen in 2(22%) males and 7(78%) females. TEN was seen in all females (100%) and in no male. Drugs implicated in causing these life threatening reactions were identified as anticonvulsant agents like carbamazepine (CBZ), phenytoin (PHT) and Lamotrigine (LTG), oxicam NSAID, Sulfasalazine and levofloxacin. Despite higher reported mortality rates in SJS and TEN all patients survived with 2 patients surviving TEN suffered from long term opthalmological sequelae of the disease. Present study suggest that drug induced cutaneous eruptions are common ranging from common nuisance rashes to rare life threatening diseases like SJS and TEN, SJS/TEN typically occur 1-3 weeks after initiation of therapy. Aromatic AED's, LTG, oxicam NSAID
Hare David L
Full Text Available Abstract Background Coronary heart disease (CHD and depression are leading causes of disease burden globally and the two often co-exist. Depression is common after Myocardial Infarction (MI and it has been estimated that 15-35% of patients experience depressive symptoms. Co-morbid depression can impair health related quality of life (HRQOL, decrease medication adherence and appropriate utilisation of health services, lead to increased morbidity and suicide risk, and is associated with poorer CHD risk factor profiles and reduced survival. We aim to determine the feasibility of conducting a randomised, multi-centre trial designed to compare a tele-health program (MoodCare for depression and CHD secondary prevention, with Usual Care (UC. Methods Over 1600 patients admitted after index admission for Acute Coronary Syndrome (ACS are being screened for depression at six metropolitan hospitals in the Australian states of Victoria and Queensland. Consenting participants are then contacted at two weeks post-discharge for baseline assessment. One hundred eligible participants are to be randomised to an intervention or a usual medical care control group (50 per group. The intervention consists of up to 10 × 30-40 minute structured telephone sessions, delivered by registered psychologists, commencing within two weeks of baseline screening. The intervention focuses on depression management, lifestyle factors (physical activity, healthy eating, smoking cessation, alcohol intake, medication adherence and managing co-morbidities. Data collection occurs at baseline (Time 1, 6 months (post-intervention (Time 2, 12 months (Time 3 and 24 months follow-up for longer term effects (Time 4. We are comparing depression (Cardiac Depression Scale [CDS] and HRQOL (Short Form-12 [SF-12] scores between treatment and UC groups, assessing the feasibility of the program through patient acceptability and exploring long term maintenance effects. A cost-effectiveness analysis of
Hirata Raquel P
enrollment of this study protocol, the expectation is to encounter predictive NEP values for different degrees of OSA in order to contribute toward an early diagnosis of this condition and reduce its impact and complications among commercial interstate bus drivers. Trial registration Registro Brasileiro de Ensaios Clinicos (local acronym RBEC [Internet]: Rio de Janeiro (RJ: Instituto de Informaçao Cientifica e Tecnologica em Saude (Brazil; 2010 - Identifier RBR-7dq5xx. Cross-sectional study on efficacy of negative expiratory pressure test proposed as screening for obstructive sleep apnea syndrome among commercial interstate bus drivers; 2011 May 31 [7 pages]. Available from http://www.ensaiosclinicos.gov.br/rg/RBR-7dq5xx/.
Ozkan, A.; Ozkalemkas, F.; Ali, R.; Ozkocaman, V.; Ozcelik, T.; Altundal, Y.; Tunali, A.; Hakyemez, B.; Taskapilioglu, O.
Reversible posterior leukoencephalopathy syndrome (RPLS) is a recently described clinical and radiological entity comprising headache, seizures, altered level of consciousness and visual disturbances in association with transient posterior cerebral white-matter abnormalities. We report a young woman with Burkitt's lymphoma who developed RPLS after combined chemotherapy administered during the tumor lysis syndrome. The symptoms in this patient fitted well with those of RPLS; they included abrupt alterations in mental status, seizures, headache, visual changes and characteristic neuroradiological findings. She was given further combination chemotherapy without any neurological complications, at which time she had already recovered from both RPLS and tumor lysis syndrome. Although many etiological factors have been reported in the development of RPLS, the underlying mechanism is not yet well understood. With prompt and appropriate management, RPLS is usually reversible, and chemotherapy can be continued after complete recovery from RPLS. We suggest that tumor lysis syndrome should be considered as a contributory factor to the development of RPLS in patients for whom treatment with combined chemotherapy for hematological malignancies is planned. (orig.)
Tatiane Loureiro da Silva
Full Text Available Sacaca is a medicinal plant from the Amazonian biome and it has been regarded as a substitute for rosewood (Aniba roseaodora to produce linalool. This paper aimed to evaluate in vitro vegetative propagation of sacaca, including the establishment of propagules from the field, decontamination protocols, and determination of multiplication rates, besides describing limiting aspects for the culture during in vitro experiments. We used 1.0 cm microcuttings with an axillary bud, collected from adult plants in the field. Disinfestation treatments were tested in the establishment, and there is an evaluation of the collecting month influence on the contamination rates. After disinfestation, microcuttings were placed in test tubes containing MS medium, added with BAP (0, 1, 2 and 3 mg L-1 and GA3 (0 and 0.5 mg L-1. In vitro establishment of sacaca with 41.9% of sprouted microcuttings was obtained. The contamination rate reached 58.1% (65.4% caused by fungi and 34.6% by bacteria, with greater occurrence when propagules were collected between October and January, the rainiest months in the Amazon region. The increased BAP and GA3 concentrations in the culture medium provided significant improvements in the material multiplication rates. In spite of the results obtained, the species shows peculiarities and limitations to in vitro cultivation that were identified and described in this paper.
Tatiane Loureiro da Silva
Full Text Available http://dx.doi.org/10.5007/2175-7925.2015v28n4p41 Sacaca is a medicinal plant from the Amazonian biome and it has been regarded as a substitute for rosewood (Aniba roseaodora to produce linalool. This paper aimed to evaluate in vitro vegetative propagation of sacaca, including the establishment of propagules from the field, decontamination protocols, and determination of multiplication rates, besides describing limiting aspects for the culture during in vitro experiments. We used 1.0 cm microcuttings with an axillary bud, collected from adult plants in the field. Disinfestation treatments were tested in the establishment, and there is an evaluation of the collecting month influence on the contamination rates. After disinfestation, microcuttings were placed in test tubes containing MS medium, added with BAP (0, 1, 2 and 3 mg L-1 and GA3 (0 and 0.5 mg L-1. In vitro establishment of sacaca with 41.9% of sprouted microcuttings was obtained. The contamination rate reached 58.1% (65.4% caused by fungi and 34.6% by bacteria, with greater occurrence when propagules were collected between October and January, the rainiest months in the Amazon region. The increased BAP and GA3 concentrations in the culture medium provided significant improvements in the material multiplication rates. In spite of the results obtained, the species shows peculiarities and limitations to in vitro cultivation that were identified and described in this paper.
Carvalho,Angela Maria de Amorim; Befi-Lopes,Debora Maria; Limongi,Suelly Cecília Olivan
PURPOSE: To describe the linguistic performance of Brazilian Portuguese-speaking children with Down syndrome by analyzing their Mean Length Utterance; to compare their performance to that of children with Specific Language Impairment and Typical Development; and to verify whether children with Down syndrome present developmental language delay or disorder. METHOD: Participants were 25 children with Down syndrome (Research Group), matched by mental age to a Control Group of typically developin...
Stevenson, Kay; Jackson, Sue; Shufflebotham, Julie; Roddy, Edward; Foster, Nadine E
This paper describes the development, content and delivery of a physiotherapist- led individualised, supervised and progressed exercise programme for use in a factorial randomised controlled trial testing treatments for subacromial impingement syndrome. To develop the intervention, a survey of community physiotherapists and national guidelines provided the basis for a consensus workshop through which a protocol was developed for the SUPPORT trial physiotherapist-led exercise programme (SUPPORT: SUbacromial impingement syndrome and Pain: a randomised controlled trial Of exeRcise and injection). The protocol included three stages of exercise progression: (1) scapular stability and active exercise with no resistance (2) range of motion exercise with scapular control, isometrics and stretches, and (3) through range resistance exercise. A two day training programme was developed for physiotherapists which included the trial background, current evidence and strategies to improve exercise adherence. Twenty physiotherapists were trained to deliver the exercise intervention. In the SUPPORT trial, 128 participants were randomised to physiotherapist-led exercise. Ninety nine (81%) participants had their first physiotherapy session within 2 to 3 weeks and 71 (56%) received six to eight treatment sessions. Frequently-used exercises were: stage 1 scapular setting with glenohumeral joint (GHJ) flexion to 90°, stage 2 GHJ medial rotation stretch, stage 3 scapular setting through lateral rotation, with resistance bands. We combined clinical and research expertise with national guidance in order to develop a physiotherapist-led, individualised, progressed and supervised exercise intervention for use within a randomised trial. The effectiveness of the intervention is being evaluated within the SUPPORT trial. Trial registration number ISRCTN 42399123. Copyright © 2017 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
van der Linden, M S; Vucic, S; van Marrewijk, D J F; Ongkosuwito, E M
In children with Down syndrome, the timing of dental eruption is important for orthodontics treatment planning. Aim of this study was to determine whether tooth eruption and development of the dentition in children with Down syndrome are impaired. Dental development was scored on orthopantomograms (OPTs) of 95 children with Down syndrome. The dental age was determined at the left mandibular side according to the Demirjian method and by converting the assigned scores to the dental maturity score. Dental development scores of control children and DS children were compared with a mixed model linear regression analysis. The model showed statistically significant changes relating to increasing age (Pchildren and the control group after using the Nyström imputation (with and without hypodontia). The findings showed that dental development in DS children is similar to the development of control children and that a relationship exists between hypodontia and dental development. The clinically observed late eruption is probably not due to late dental development but due to the other processes that take place during eruption, such as the possible impaired processes at the apical side and the occlusal side of an erupting element. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.
Full Text Available BackgroundChronic lung allograft dysfunction and its main phenotypes, bronchiolitis obliterans syndrome (BOS and restrictive allograft syndrome (RAS, are major causes of mortality after lung transplantation (LT. RAS and early-onset BOS, developing within 3 years after LT, are associated with particularly inferior clinical outcomes. Prediction models for early-onset BOS and RAS have not been previously described.MethodsLT recipients of the French and Swiss transplant cohorts were eligible for inclusion in the SysCLAD cohort if they were alive with at least 2 years of follow-up but less than 3 years, or if they died or were retransplanted at any time less than 3 years. These patients were assessed for early-onset BOS, RAS, or stable allograft function by an adjudication committee. Baseline characteristics, data on surgery, immunosuppression, and year-1 follow-up were collected. Prediction models for BOS and RAS were developed using multivariate logistic regression and multivariate multinomial analysis.ResultsAmong patients fulfilling the eligibility criteria, we identified 149 stable, 51 BOS, and 30 RAS subjects. The best prediction model for early-onset BOS and RAS included the underlying diagnosis, induction treatment, immunosuppression, and year-1 class II donor-specific antibodies (DSAs. Within this model, class II DSAs were associated with BOS and RAS, whereas pre-LT diagnoses of interstitial lung disease and chronic obstructive pulmonary disease were associated with RAS.ConclusionAlthough these findings need further validation, results indicate that specific baseline and year-1 parameters may serve as predictors of BOS or RAS by 3 years post-LT. Their identification may allow intervention or guide risk stratification, aiming for an individualized patient management approach.
..., .. . . . . .. ,. . . .. . . . . . . . .. . . . . .. . . .. . .. 3 2 Granular Nina Sludge Christiansen, Consortia lndra for Bioremediation, M. Mathrani, and Birgitte K. Ahring . 23 PART II PROTOCOLS...
Bilici, Meki; Gürkan, Fuat; Ece, Aydın
Malatya State Hospital1, Malatya, Dicle University Medical School, Department of Pediatrics2, Diyarbakır, Turkey A child with nephrotic syndrome (NS) presented with peritonitis caused by E. coli susceptible to both cephtriaxone and amikacin. Purulent meningitis developed in accompanying with clinical and laboratory findings at the 5th day of treatment. Pneumococcal antigen was detected in cerebro-spinal fluid and meningitis was treated with meropenem. Development of pneumococal meningit...
Bentenuto, Arianna; De Falco, Simona; Venuti, Paola
The purpose of the present study was to analyze mother-child collaborative play in children with Autism Spectrum Disorders (ASD) compared to children with Down Syndrome (DS) and typical developing children (TD). Children with ASD are often described as having deficient play skills, particularly in the symbolic domain. Caregivers’ involvement in child play activities increases the structural complexity of playing in both typically developing children and children with disabilities. Participant...
The International Atomic Energy Agency is promoting industrial applications of non-destructive testing (NDT) technology, which includes radiography testing (RT) and related methods, to assure safety and reliability of operation of nuclear, petrochemical and other industrial facilities. In many industries such as petroleum, power stations, refineries, petrochemical and chemical plants, desalination pipelines and urban gas installations, the reliability and safety of equipment can be substantially influenced by degradation processes such as corrosion, erosion, deposits and blocking of pipes, which can seriously affect the security and consistency. One of the most important parameters in a piping or pipeline to be monitored and measured is the wall thickness. Among NDT methods, radiography has the advantage in that in the process of an inspection it eliminates the need for the costly removal of the pipe insulation and also the added benefit that it can be carried out in high temperature environments. The Coordinated Research Project (CRP) on Validation of Protocols for Corrosion and Deposits Determination in Small Diameter Pipes by Radiography (CORDEP) was implemented from 1997 to 2000 with the participation of 11 NDT laboratories from Algeria, China, Costa Rica, France, India, Republic of Korea, Malaysia, Sri Lanka, Syrian Arab Republic, Tunisia and Turkey. The CRP tested and validated radiographic measurement of corrosion and deposits in straight and bent pipes made of carbon or stainless steels corroded/eroded on the outer or inner surfaces with or without insulation. Each participating laboratory produced three test specimens of straight and bent pipes containing natural as well as simulated corrosion defects. Typical diameters of these pipes were up to 168 mm. Radiography using X ray machines and radioisotopes of Iridium-192 and Cobalt-60 in conjunction with radiographic film using single and double wall penetrations for total inspection was performed. Selected
Koropchak, Sara C; Daniels, W Lee; Wick, Abbey; Whittecar, G Richard; Haus, Nick
Upland placement of dredge sediments has the potential to provide beneficial reuse of suitable sediments for agricultural uses or urban soil reconstruction. However, the use of many dredge materials is limited by contaminants, and most established screening protocols focus on limiting major contaminants such as heavy metals and polycyclic aromatic hydrocarbons and generally ignore fundamental agronomic parameters. Since 2001, we have placed over 450,000 m of Potomac River fresh water dredge materials and 250,000 m of saline materials from various locations into monitored confined upland facilities in Charles City, VA, and documented their conversion to agricultural uses. Groundwater and soil quality monitoring has indicated no adverse effects from material placement and outstanding agricultural productivity for the freshwater materials. Once placed, saline materials rapidly leach and ripen with quick declines in pH, electrical conductivity, and sodicity, but potentials for local groundwater impacts must be considered. Our experience to date indicates that the most important primary screening parameter is acid-base accounting (potential acidity or lime demand), which should become a mandatory analytical requirement. Our second level of acceptance screening is based on a combination of federal and state residual waste and soil screening standards and basic agronomic principles. High silt+clay and total organic C may also limit rapid use of many dredge materials due to extended dewatering times and physical limitations. This dredge material screening system separates potential upland placement candidates into three soil quality management categories (unsuitable, suitable, and clean fill) with differing monitoring requirements. Similar use of these sediments in urban soil reconstruction is also recommended. Copyright © by the American Society of Agronomy, Crop Science Society of America, and Soil Science Society of America, Inc.
Moin, S.; Gondal, G.M.G.
To measure the relation of creatinine clearance in type-2 diabetic patients with different components of metabolic syndrome and to quantify the relationship of frequency of incident CKD with increasing number of metabolic syndrome components while controlling for age, gender and duration of diabetes. Cross-sectional descriptive study. Patients having type-2 Diabetes for more than 5 years were enrolled. Information regarding age, gender, duration of diabetes, type of diabetes, treatment taking, complete fasting lipid profile, fasting blood glucose, Body Mass Index (BMI), 24 hours urinary proteins and creatinine clearance, co-existent risk factors like hypertension and ischemic heart disease was taken. Patients were divided into groups having one to all five metabolic syndrome traits. Progressive increase in the metabolic syndrome traits was compared with decline in creatinine clearance. Pearson correlation test and multiple logistic regression were applied to determine correlation with significance at r and p <0.05. Out of 104 evaluated female and male patients, 70% had hypertension, ischemic heart disease and a family history of diabetes. While 20% had normal creatinine clearance, 37% had a creatinine clearance between 60-90 ml/min, 19% had a creatinine clearance of 30-59 ml/min, 18% had a creatinine clearance of less than 30 ml/min and 10% were already in stage 5 CKD. The decline in renal function was more severe in subjects evaluated who had a higher number of features of the metabolic syndrome. Age was the only significant determinant of development of CKD (p=0.05). The renal function progressively declined with 3 or more features of the metabolic syndrome. (author)
Sunil Kumar Bijarania
Full Text Available Introduction: Medicine administration is a major role played by registered nurses. Medicines are prescribed by the physician and dispensed by the pharmacist but responsibility for meticulous administration rests with the registered nurse. It becomes even more important when drugs are to be administered to children. Drug administration via Intramuscular (IM, Intradermal (ID and Subcutaneous route is a complex process. Errors are associated with medicine administration. Aim: The objective of this study was to develop Standard Operational Protocol (SOP for IM, ID and Subcutaneous drug administration and checklist to assess the implementation of the developed SOP. Materials and Methods: A methodological research design adapted to carry out the present study to develop standard operational protocol for IM, ID and subcutaneous drug administration for children, admitted in Advanced Paediatric Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India. The study included 58 bedside nurses and 90 observations of medicine administration procedure. Results: The Content Validity Index (CVI was prepared to assess the validity of content (items of SOPs and checklists. Over all Cronbach's-alpha values was calculated to assess the internal consistency of Items in SOPs and checklists. CVI of SOP and checklists were 98.51%, 97.83% and 99.03%. Over all Cronbach'salpha values were calculated 0.96, 0.82 and 0.95. All the nurses felt that SOPs are useful. Conclusion: Valid and feasible SOPs for drug administration in children along with valid and reliable checklists were developed. It is recommended to use this document for drug administration in children to prevent any possible error during drug administration to children.
Turner syndrome is a genetic disorder that affects a girl's development. The cause is a missing or incomplete X ... work properly. Other physical features typical of Turner syndrome are Short, "webbed" neck with folds of skin ...
Pain, Clare E; Constantin, Tamás; Toplak, Natasa; Moll, Monica; Iking-Konert, Christof; Piotto, Daniella P; Aktay Ayaz, Nuray; Nemcova, Dana; Hoeger, Peter H; Cutolo, Maurizio; Smith, Vanessa; Foeldvari, Ivan
To develop recommendations for investigation and monitoring of children with Raynaud's syndrome, based on paediatric evidence collated by a systematic review. A systematic review was undertaken to establish the paediatric evidence for assessment and monitoring of Raynaud's syndrome. An expert panel including members of the Paediatric Rheumatology European Society (PRES) Scleroderma Working Group, were invited to a consensus meeting where recommendations were developed based on evidence graded by the systematic review and where evidence was lacking, consensus opinion. A nominal technique was used where 75% consensus was taken as agreement. The expert panel recommended testing anti-nuclear antibody (ANA), more specific antibodies associated with connective tissue disease and nail-fold capillaroscopy in all children presenting with Raynaud's syndrome as data suggests these can be risk factors for evolution into a connective tissue disease. The frequency of follow-up recommended depends on presence of these risk factors with the aim to detect evolving connective tissue disease early in high risk individuals. Those with no abnormalities on capillaroscopy and negative autoantibodies were deemed low risk of progression, whereas those with ANA positivity, specific autoantibodies and/or nailfold capillary changes were deemed high risk and more frequent follow-up was recommended. Recommendations, primarily based on consensus opinion, were agreed regarding investigation and monitoring of children who present with Raynaud's syndrome. Further prospective studies are needed to better define the risk factors for progression to connective tissue disease.
Traboulsi, Elias I
The clinical and molecular genetic classification of syndromes with congenital limitation of eye movements and evidence of cranial nerve dysgenesis continues to evolve. This monograph details clinical and molecular genetic data on a number of families and isolated patients with congenital fibrosis of the extraocular muscles (CFEOM) and related disorders, and presents an overview of the mechanisms of abnormal patterns of motor and sensory cranial nerve development in these rare syndromes. Clinical examination of one patient with CFEOM1, one family with clinical features of CFEOM2, one family with recessive CFEOM3, one family with horizontal gaze palsy and progressive scoliosis (HGPPS), and four patients with various combinations of congenital cranial nerve abnormalities. Genotyping of families with CFEOM and HGPPS for polymorphic markers in the regions of the three known CFEOM loci and in the HGPPS region, and mutation analysis of the ARIX and KIF21A genes in patients with CFEOM were performed according to standard published protocols. The patient with CFEOM1 had the second most common mutation in KIF21A, a 2861 G>A mutation that resulted in an R954Q substitution. The family with CFEOM2 phenotype did not map to the CFEOM2 locus. The family with recessive CFEOM3 did not map to any of the known loci. The HGPPS family mapped to 11q23-q25. One patient had optic nerve hypoplasia and fifth nerve dysfunction. Two patients had the rare combination of Möbius syndrome and CFEOM. One patient had Möbius syndrome and fifth nerve dysfunction. There is genetic heterogeneity in CFEOM2 and CFEOM3. Abnormalities in sensory nerves can also accompany abnormalities of motor nerves, further substantiating the effect of individual mutations on developing motor as well as sensory cranial nerve nuclei.
Ridner, Sheila H; Bonner, Candace M; Doersam, Jennifer K; Rhoten, Bethany A; Schultze, Benjamin; Dietrich, Mary S
A significant percentage of breast cancer survivors are at risk for lymphedema for which lifelong self-care is required. Previous studies suggest that less than 50% of breast cancer survivors with lymphedema (BCS-LE) perform prescribed self-care tasks and that even wearing a compression sleeve, the most commonly reported self-care activity, is done irregularly. Reasons for poor self-care adherence include perceived lack of results from self-care (no available arm volume data) and perceived inability to manage the condition. A two-part pilot study was conducted to: 1) develop and determine the feasibility of a self-measurement protocol using a single frequency bioelectrical impedance device; and 2) examine daily variation in extracellular volume in healthy and lymphedematous limbs. Healthy and BCS-LE volunteers were recruited to refine and test a self-measurement protocol. Volunteers were trained in the use of the device and measured for 5 consecutive days in a laboratory setting. They were then given the device to use at home for an additional 5 consecutive days of self-measurement. All volunteers completed each scheduled home measurement. Daily variability in both groups was noted. Home self-measurement using bioelectrical impedance is feasible, acceptable, and captures change. This has implications for both self-care support and for the possibility of incorporating self-measurement using bioelectrical impedance in future clinical trials examining effectiveness of lymphedema treatment.
Marschik, Peter B.; Einspieler, Christa; Oberle, Andreas; Laccone, Franco; Prechtl, Heinz F. R.
The subject of the present study is the development of a girl with the preserved speech variant of Rett disorder. Our data are based on detailed retrospective and prospective video analyses. Despite achieving developmental milestones, movement quality was already abnormal during the girl's first half year of life. In addition, early hand…
Folić, Nevena; Folić, Marko; Marković, Slavica; Andjelković, Marija; Janković, Slobodan
High prevalence of metabolic syndrome (MetS) in children and adolescents is a great concern of the modern society. bjective: Our aim was to determine the influence of previously investigated, but also and potentially novel risk factors for the development of metabolic syndrome in children and adolescents. Observational case-control clinical study was conducted involving children and adolescents with obesity/metabolic syndrome, treated on inpatient basis from January 2008 to January 2012 at the Pediatric Clinic of the Clinical Centre Kragujevac, Kragujevac, Serbia. The group of"cases"(n=28) included patients aged 10-16 years with the diagnosis of metabolic syndrome according to the International Diabetes Federation (IDF) criteria, while the control group included twice as many obese patients (n=56) matched to the compared group. Presence of maternal gestational diabates (ORadjusted: 39.426; 95% Cl: 1.822-853.271; p=0.019), and/or lack of breastfeeding in the first six months of life (ORadjusted: 0.079; 95% CI: 0.009-0.716; p=0.024) were significant predictors for developing MetS. Also, microalbuminuria is associated with MetS in obese children and adolescants (ORadjusted: 1.686; 95% Cl: 1.188-2.393; p=0.003) CONCLUSION: Presence of maternal gestational diabetes and/or lack of infant breastfeeding are considered as relevant factors that may contribute to the increased risk of developing MetS syndrome, while microalbuminuria is frequently associated with MetS in obese children and adolescents.
Hatori, Takayuki; Sugiyama, Yohei; Yamashita, Shinichiro; Hirakubo, Yuka; Nonaka, Kazuhito; Ichihashi, Ko
In a patient with cardiofaciocutaneous syndrome complicated by intractable infantile spasms (West syndrome), cardiac hypertrophy developed during adrenocorticotropic hormone treatment. Various types of antiepileptic drugs, intravenous immunoglobulin, thyrotropin releasing hormone, and a ketogenic diet were ineffective in this case. However, vigabatrin both decreased clinical seizures and improved electroencephalogram findings. Although vigabatrin has not been approved for use in Japan, the results in the present case suggest that this drug should be considered as an alternative therapy for cases of infantile spasms associated with syndromes involving cardiomyopathy or its potential risk factors, such as cardiofaciocutaneous syndrome.
Núñez-Nava, Jefersson; Orozco-Sánchez, Paola A; López, Diego M; Ceron, Jesus D; Alvarez-Rosero, Rosa E
According to the International Diabetes Federation (IDF), a quarter of the world's population has Metabolic Syndrome (MS). To develop (and assess the users' degree of satisfaction of) an online social network for patients who suffer from Metabolic Syndrome, based on the recommendations and requirements of the Human-Centered Design. Following the recommendations of the ISO 9241-210 for Human-Centered Design (HCD), an online social network was designed to promote physical activity and healthy nutrition. In order to guarantee the active participation of the users during the development of the social network, a survey, an in-depth interview, a focal group, and usability tests were carried out with people suffering from MS. The study demonstrated how the different activities, recommendations, and requirements of the ISO 9241-210 are integrated into a traditional software development process. Early usability tests demonstrated that the user's acceptance and the effectiveness and efficiency of the social network are satisfactory.
Pastora-Bernal, Jose-Manuel; Martín-Valero, Rocío; Barón-López, Francisco Javier; García-Gómez, Oscar
Shoulder pain is common in society, with high prevalence in the general population. Shoulder impingement syndrome (SIS) is the most frequent cause. Patients suffer pain, muscle weakness and loss of movement in the affected joint. Initial treatment is predominantly conservative. The surgical option has high success rates and is often used when conservative strategy fails. Traditional physiotherapy and post-operative exercises are needed for the recovery of joint range, muscle strength, stability and functionality. Telerehabilitation programmes have shown positive results in some orthopaedic conditions after surgery. Customized telerehabilitation intervention programmes should be developed to recover shoulder function after SIS surgery. The objective of this study is to evaluate the feasibility and effectiveness of a telerehabilitation intervention compared with usual care in patients after subacromial decompression surgery. We will compare an intervention group receiving videoconferences and a telerehabilitation programme to a control group receiving traditional physiotherapy intervention in a single-blind, randomized controlled non-inferiority trial study design. Through this study, we will further develop our preliminary data set and practical experience with the telerehabilitation programmes to evaluate their effectiveness and compare this with traditional intervention. We will also explore patient satisfaction and cost-effectiveness. Patient enrolment is ongoing. ClinicalTrials.gov, NCT02909920 . 14 September 2016.
Coffey, Sean; Lewandowski, Adam J; Garratt, Steve; Meijer, Rudy; Lynum, Steven; Bedi, Ram; Paterson, James; Yaqub, Mohammad; Noble, J Alison; Neubauer, Stefan; Petersen, Steffen E; Allen, Naomi; Sudlow, Cathie; Collins, Rory; Matthews, Paul M; Leeson, Paul
Background Ultrasound imaging is able to quantify carotid arterial wall structure for the assessment of cerebral and cardiovascular disease risks. We describe a protocol and quality assurance process to enable carotid imaging at large scale that has been developed for the UK Biobank Imaging Enhancement Study of 100,000 individuals. Design An imaging protocol was developed to allow measurement of carotid intima-media thickness from the far wall of both common carotid arteries. Six quality assurance criteria were defined and a web-based interface (Intelligent Ultrasound) was developed to facilitate rapid assessment of images against each criterion. Results and conclusions Excellent inter and intra-observer agreements were obtained for image quality evaluations on a test dataset from 100 individuals. The image quality criteria then were applied in the UK Biobank Imaging Enhancement Study. Data from 2560 participants were evaluated. Feedback of results to the imaging team led to improvement in quality assurance, with quality assurance failures falling from 16.2% in the first two-month period examined to 6.4% in the last. Eighty per cent had all carotid intima-media thickness images graded as of acceptable quality, with at least one image acceptable for 98% of participants. Carotid intima-media thickness measures showed expected associations with increasing age and gender. Carotid imaging can be performed consistently, with semi-automated quality assurance of all scans, in a limited timeframe within a large scale multimodality imaging assessment. Routine feedback of quality control metrics to operators can improve the quality of the data collection.
Abdominal obesity and its associated insulin resistance play a key role in the clustering of vascular risk factors, known as Metabolic Syndrome. Subjects with Metabolic Syndrome are at increased risk for the development of both type 2 diabetes and cardiovascular disease. Type 2 diabetes and
Scott, Fiona J.; Baron-Cohen, Simon; Bolton, Patrick; Brayne, Carol
This article describes a pilot and follow-up study of the development of a screening test for Asperger Syndrome (AS) and relates social and communication conditions in children aged 4-11. Results suggest that the Childhood Asperger Syndrome Test may be useful for identifying children at risk for AS and related conditions, in a mainstream…
Waite, Jane; Beck, Sarah R.; Heald, Mary; Powis, Laurie; Oliver, Chris
Working memory (WM) impairments might amplify behavioural difference in genetic syndromes. Murine models of Rubinstein-Taybi syndrome (RTS) evidence memory impairments but there is limited research on memory in RTS. Individuals with RTS and typically developing children completed WM tasks, with participants with RTS completing an IQ assessment and…
Darragh, Michael; Traynor, Victoria; Joyce-McCoach, Joanne
What interventions are the most effective for the development of leadership skills for nurses?The review objective is to systematically review the evidence to identify the effectiveness of interventions for the development of leadership skills among nurses. Centre for Evidence-based Initiatives in Health Care - University of Wollongong: an Affiliate Center of the Joanna Briggs Institute.
Kirkham, Jamie J; Gorst, Sarah; Altman, Douglas G; Blazeby, Jane; Clarke, Mike; Devane, Declan; Gargon, Elizabeth; Williamson, Paula R
Core outcome sets can increase the efficiency and value of research and, as a result, there are an increasing number of studies looking to develop core outcome sets (COS). However, the credibility of a COS depends on both the use of sound methodology in its development and clear and transparent reporting of the processes adopted. To date there is no reporting guideline for reporting COS studies. The aim of this programme of research is to develop a reporting guideline for studies developing COS and to highlight some of the important methodological considerations in the process. The study will include a reporting guideline item generation stage which will then be used in a Delphi study. The Delphi study is anticipated to include two rounds. The first round will ask stakeholders to score the items listed and to add any new items they think are relevant. In the second round of the process, participants will be shown the distribution of scores for all stakeholder groups separately and asked to re-score. A final consensus meeting will be held with an expert panel and stakeholder representatives to review the guideline item list. Following the consensus meeting, a reporting guideline will be drafted and review and testing will be undertaken until the guideline is finalised. The final outcome will be the COS-STAR (Core Outcome Set-STAndards for Reporting) guideline for studies developing COS and a supporting explanatory document. To assess the credibility and usefulness of a COS, readers of a COS development report need complete, clear and transparent information on its methodology and proposed core set of outcomes. The COS-STAR guideline will potentially benefit all stakeholders in COS development: COS developers, COS users, e.g. trialists and systematic reviewers, journal editors, policy-makers and patient groups.
Marshall, Mallory R; Coe, Dawn P; Pivarnik, James M
The purpose of this study was to develop a prediction model based on a submaximal workload during the Bruce treadmill protocol to estimate peak oxygen consumption (VO2(peak)) in adolescent girls. Adolescent girls (N = 116, M(age) = 13.2 +/- 2.0 years) performed a Bruce Treadmill Test to exhaustion. Expired respiratory gases and heart rate (HR) were collected and measured continuously via indirect calorimetry and telemetry. To be included in the analysis, each participant met 2 of 3 criteria: attain 95% of age-predicted HR(peak), respiratory exchange ratio > 1.05, or plateau of VO2. VO2 and HR at Stage 1 and Stage 2 of the Bruce test were entered into a regression model to predict VO2(peak). A regression model, constructed using the predicted sum of squares statistic, was developed using VO2 (VO(2)2) and HR (HR2) attained at the 2nd 3-min stage of the Bruce treadmill protocol: VO2(peak) = 46.77 - (0.2854155 x HR2) + (1.46732912 x VO(2)2). Actual average (+/- SD) VO2(peak) was 36.2 +/- 6.9 ml x kg(-1) x min(-1) (range = 22.9-55.9). Predicted VO2(peak) was 36.2 +/- 5.5 ml x kg(-1) x min(-1) (range = 24.3-56.2). The correlation between actual and predicted VO2(peak) was r = .80, standard error of estimate = 4.2 ml x kg(-1) x min(-1), with no bias relative to participant aerobic fitness. Based on this model, the VO2(peak) of healthy adolescent girls can be predicted within 4.2 ml x kg(-1) x min(-1) using submaximal Bruce data.
Malene W Skår
Full Text Available In recent years, use of lumpfish (Cyclopterus lumpus L. as cleaner-fish to remove sea-lice have been chosen by many salmon farmers in Europe and Canada as an alternative to medical treatment, which has led to large scale production of lumpfish. At present, there is limited knowledge of how lumpfish respond upon anaesthesia, which anaesthetics and concentrations that are efficient and conditions for euthanasia. We have therefore tested and developed protocols for bath immersion for three commonly used anaesthetics metacaine (Finquel, buffered tricaine methanesulfonate, MS-222 and Tricaine Pharmaq, benzocaine (Benzoak vet and isoeugenol (Aqui-S, determined concentration for normal and fast anaesthesia and evaluated safety margin for each condition. Also, a behavioral matrix has been developed. We have examined the effect of fish size (10-20 g, 200-400 g and 600-1300 g and sea water temperature (6°C and 12°C. We found that 200 mg L-1 metacaine is an efficient dose for deep narcosis independently for fish size and temperature due to good safety margins with regards to both exposure times and doses. However, for many tasks lighter anaesthesia is sufficient, and then 100 mg L-1 metacaine can be used. Benzocaine is less efficient than metacaine, but can be used as anaesthetic of fish 600 g, benzocaine is not suitable. Isoeugenol cannot be recommended for full anesthesia of lumpfish. The conditions for lethal doses varied with chosen anaesthetic, fish size and temperature. For small fish (10-20 g, exposure to 1600 mgL-1 of metacaine in 10 minutes it lethal. Guided protocols for non-lethal anaesthesia will contribute to ensure safe treatment of lumpfish according to an ethical standard for good fish welfare.
van Gijn, Daniel Richard; Tucker, Abigail S; Cobourne, Martyn T
The human face and skull are an elegant example of the anatomical sophistication that results from the interplay between the molecular cascades and the tissue interactions that are necessary for the proper development of the craniofacial complex. When it fails to develop normally the consequences can have life-long implications for the biological, psychological, and aesthetic wellbeing of an affected person. Among the many syndromes that affect the region, understanding of the biology that underlies Treacher Collins syndrome has advanced in the last decade, particularly concerning the causative TCOF1 gene that encodes TREACLE protein, a serine/alanine-rich nucleolar phosphoprotein with an essential function during ribosome biogenesis in cranial neural crest cells. Abnormal growth and differentiation of these cells affect much of the craniofacial skeleton. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.
Radiation accidents associated with the use of nuclear power, radiation devices and industrial applications have resulted in a number of individuals with significant partial or total body exposures, in a limited number with lethal outcome. Such exposures generally result in life-threatening suppression of bone marrow and immune functions and may be accompanied by high doses to the skin and underlying tissues. In recent years, new methods of diagnosis and treatment of such patients have entered development, while experience with relatively large-scale accidents, such as the Chernobyl cases, have clearly demonstrated the limitations of previous approaches. In particular bone marrow transplantation has met with limited success, mostly due to the inhomogeneous nature of accidental exposures as well as the frequent occurrence of other injuries other man bone marrow damage. Present day technology allows for direct estimates of the number of residual bone marrow stem cells to enable a rapid decision on the type of treatment indicated, while some twenty-five recombinant hemopoietic growth factors are under investigation to accelerate the recovery of white blood cells and platelets, as well as immune functions. If applied appropriately, such growth factor treatment will successfully replace bone marrow transplantation in the majority of accident cases. Advances in hemopoietic stem cell biology, both in terms of source of stem cells as well as their isolation, will on the other hand make stem cell infusion a much less risky operation than bone marrow transplantation has been in the past
Witteman, Holly O; Dansokho, Selma Chipenda; Colquhoun, Heather; Coulter, Angela; Dugas, Michèle; Fagerlin, Angela; Giguere, Anik Mc; Glouberman, Sholom; Haslett, Lynne; Hoffman, Aubri; Ivers, Noah; Légaré, France; Légaré, Jean; Levin, Carrie; Lopez, Karli; Montori, Victor M; Provencher, Thierry; Renaud, Jean-Sébastien; Sparling, Kerri; Stacey, Dawn; Vaisson, Gratianne; Volk, Robert J; Witteman, William
Providing patient-centered care requires that patients partner in their personal health-care decisions to the full extent desired. Patient decision aids facilitate processes of shared decision-making between patients and their clinicians by presenting relevant scientific information in balanced, understandable ways, helping clarify patients' goals, and guiding decision-making processes. Although international standards stipulate that patients and clinicians should be involved in decision aid development, little is known about how such involvement currently occurs, let alone best practices. This systematic review consisting of three interlinked subreviews seeks to describe current practices of user involvement in the development of patient decision aids, compare these to practices of user-centered design, and identify promising strategies. A research team that includes patient and clinician representatives, decision aid developers, and systematic review method experts will guide this review according to the Cochrane Handbook and PRISMA reporting guidelines. A medical librarian will hand search key references and use a peer-reviewed search strategy to search MEDLINE, EMBASE, PubMed, Web of Science, the Cochrane Library, the ACM library, IEEE Xplore, and Google Scholar. We will identify articles across all languages and years describing the development or evaluation of a patient decision aid, or the application of user-centered design or human-centered design to tools intended for patient use. Two independent reviewers will assess article eligibility and extract data into a matrix using a structured pilot-tested form based on a conceptual framework of user-centered design. We will synthesize evidence to describe how research teams have included users in their development process and compare these practices to user-centered design methods. If data permit, we will develop a measure of the user-centeredness of development processes and identify practices that are likely
Kumar, Anand; Rao, Gayathri M.; Shetty, Beena V.
Infantile tremor syndrome is seen worldwide more commonly in the developing countries. Although various protein energy malnutrition awareness programme being run in many of these countries including India yet there is persistence of this disease. Here we present a case of 13?month old female child who visited RAPCC paediatrics OPD of Govt. Wenlock Hospital Mangaluru with history of respiratory distress, fever, tremor in limbs and loss of milestones. On examination she had pallor, hyper pigmen...
Vos-Vromans, D.C.; Smeets, R.J.P.; Rijnders, L.J.; Gorrissen, R.R.; Pont, M.; Koke, A.J.; Hitters, M.W.; Evers, S.M.; Knottnerus, A.J.
ABSTRACT: BACKGROUND: Patients with chronic fatigue syndrome experience extreme fatigue, which often leads to substantial limitations of occupational, educational, social and personal activities. Currently, there is no consensus regarding the treatment. Patients try many different therapies to
Postema, Floor A M; Hopman, Saskia M J; De Borgie, Corianne A J M; Hammond, Peter; Hennekam, Raoul C.; Merks, Johannes H M; Aalfs, Cora M.; Anninga, Jakob K.; Berger, Lieke P V; Bleeker, Fonnet E.; De Bont, Eveline S J M; Dommering, Charlotte J.; Van Eijkelenburg, Natasha K A; Van Den Heuvel-Eibrink, Marry M.; Jongmans, Marjolijn C J; Kors, Wijnanda A.; Letteboer, Tom G W; Loeffen, Jan L C M; Olderode-Berends, Maran J W; Wagner, Anja
Introduction: Recognising a tumour predisposition syndrome (TPS) in patients with childhood cancer is of significant clinical relevance, as it affects treatment, prognosis and facilitates genetic counselling. Previous studies revealed that only half of the known TPSs are recognised during standard
Butts, Ian A.E.; Mokdad, A.; Trippel, E.A.
Populations of Redside Dace Clinostomus elongatus have declined in many areas across the species’North American range. Therefore, the development of sperm cryopreservation technology would provide an invaluable means of preserving genetic diversity in populations that are in imminent danger...
Elsman, E.B.M.; Leerlooijer, J.N.; Beek, ter J.; Duijzer, G.; Jansen, S.C.; Hiddink, G.J.; Feskens, E.J.M.; Haveman-Nies, A.
Background Although lifestyle interventions have shown to be effective in reducing the risk for type 2 diabetes mellitus, maintenance of achieved results is difficult, as participants often experience relapse after the intervention has ended. This paper describes the systematic development of a
Duijm, N.J.; Carissimo, B.; Mercer, A.; Bartholome, C.; Giesbrecht, H.
In order to improve the quality (i.e. fitness-for-purpose) of models used to describe the atmospheric dispersion of heavy gas, an evaluation methodology has been developed and tested through a small evaluation exercise. This activity was carried out by the Heavy Gas Dispersion Expert Group, which
Rice, William R; Friberg, Urban; Gavrilets, Sergey
We recently synthesized and reinterpreted published studies to advance an epigenetic model for the development of homosexuality (HS). The model is based on epigenetic marks laid down in response to the XX vs. XY karyotype in embryonic stem cells. These marks boost sensitivity to testosterone in XY fetuses and lower it in XX fetuses, thereby canalizing sexual development. Our model predicts that a subset of these canalizing epigenetic marks stochastically carry over across generations and lead to mosaicism for sexual development in opposite-sex offspring--the homosexual phenotype being one such outcome. Here, we begin by outlining why HS has been under-appreciated as a commonplace phenomenon in nature, and how this trend is currently being reversed in the field of neurobiology. We next briefly describe our epigenetic model of HS, develop a set of predictions, and describe how epigenetic profiles of human stem cells can provide for a strong test of the model. © 2013 The Authors. Bioessays published by WILEY Periodicals, Inc.
Beaton, Kara H.; Chappell, Steven P.; Bekdash, Omar S.; Gernhardt, Michael L.
The NASA Next Space Technologies for Exploration Partnerships (NextSTEP) program is a public-private partnership model that seeks commercial development of deep space exploration capabilities to support extensive human spaceflight missions around and beyond cislunar space. NASA first issued the Phase 1 NextSTEP Broad Agency Announcement to U.S. industries in 2014, which called for innovative cislunar habitation concepts that leveraged commercialization plans for low Earth orbit. These habitats will be part of the Deep Space Gateway (DSG), the cislunar space station planned by NASA for construction in the 2020s. In 2016, Phase 2 of the NextSTEP program selected five commercial partners to develop ground prototypes. A team of NASA research engineers and subject matter experts have been tasked with developing the ground test protocol that will serve as the primary means by which these Phase 2 prototype habitats will be evaluated. Since 2008, this core test team has successfully conducted multiple spaceflight analog mission evaluations utilizing a consistent set of operational products, tools, methods, and metrics to enable the iterative development, testing, analysis, and validation of evolving exploration architectures, operations concepts, and vehicle designs. The purpose of implementing a similar evaluation process for the NextSTEP Phase 2 Habitation Concepts is to consistently evaluate the different commercial partner ground prototypes to provide data-driven, actionable recommendations for Phase 3.
Ariana Aparecida Nascimento dos Santos
Full Text Available Considering the difficulties and limitations that Down’s Syndrome individuals have and taking into account historic-cultural theory’s contributions to understand the voluntary memory as fundamental to human development, it has been investigated the role played by dance, as a body language that allows the symbolic expressions on the memory’s building and development in Down’s Syndrome individuals. Therefore, a single group with three Down individuals was formed, aged between 9 and 12 years old, regularly enrolled in a APAE. It has been held 20 intervention meetings in order to identify and analyze, if there were changes in the subjects’s actions, from their movements, body and oral expressions throughout the intervention process. Thinking about the whole process of conducting this research, we’ve noticed that one of the consistent findings we’ve got is that, when we point out the subjects’s biological difficulties and we’ve agreed on them, we could, despite of the contradictions imposed by the social and educational reality, say that subject’s biological laws can be overcome from the social relations that one establishes in the course of his life, since the Down’s Syndrome subjects own the capacity to develop their psychic ability, even if slowly, and therefore, proceed from the interventions allowed by the physical education teacher, to propose the dance as an educational ctivity.
Full Text Available The prevalence of metabolic syndrome and obesity has been increasing. Pre-natal environment has been suggested as a factor influencing the risk of metabolic syndrome in adulthood. Both observational and experimental studies showed that maternal diet is a major modifier of the development of regulatory systems in the offspring in utero and post-natally. Both protein content and source in maternal diet influence pre- and early post-natal development. High and low protein dams’ diets have detrimental effect on body weight, blood pressure191 and metabolic and intake regulatory systems in the offspring. Moreover, the role of the source of protein in a nutritionally adequate maternal diet in programming of food intake regulatory system, body weight, glucose metabolism and blood pressure in offspring is studied. However, underlying mechanisms are still elusive. The purpose of this review is to examine the current literature related to the role of proteins in maternal diets in development of characteristics of the metabolic syndrome in offspring.
Khodyakov, Dmitry; Kinnett, Kathi; Grant, Sean; Lucas, Ann; Martin, Ann; Denger, Brian; Peay, Holly; Coulter, Ian; Fink, Arlene
guideline development process. We will solicit input on these best practice from Duchenne patients, caregivers, and clinicians by conducting a series of round-table discussions and making a presentation at an annual conference on Duchenne. The study protocol was reviewed by RAND's Human Subjects Protection Committee, which determined it to be exempt from review. Interviews with RAM experts have been completed. The projected study completion date is May 2020. We expect that the new method will make it easier to engage large numbers of patients and caregivers in the process of guideline development in a rigorous and culturally appropriate manner that is consistent with the way clinicians participate in guideline development. Moreover, this project will develop best practices that could help involve patients and caregivers in the clinical guideline development process in other clinical areas, thereby facilitating the work of guideline developers. ©Dmitry Khodyakov, Kathi Kinnett, Sean Grant, Ann Lucas, Ann Martin, Brian Denger, Holly Peay, Ian Coulter, Arlene Fink. Originally published in JMIR Research Protocols (http://www.researchprotocols.org), 28.04.2017.
Short course daily prednisolone therapy during an upper respiratory tract infection in children with relapsing steroid-sensitive nephrotic syndrome (PREDNOS 2): protocol for a randomised controlled trial
Background Relapses of childhood steroid-sensitive nephrotic syndrome (SSNS) are treated with a 4- to 8-week course of high-dose oral prednisolone, which may be associated with significant adverse effects. There is a clear association between upper respiratory tract infection (URTI) and relapse development. Previous studies in developing nations have suggested that introducing a 5- to 7-day course of daily prednisolone during an URTI may prevent a relapse developing and the need for a treatment course of high-dose prednisolone. The aim of PREDNOS 2 is to evaluate the effectiveness of a 6-day course of daily prednisolone therapy during an URTI in reducing the development of a subsequent relapse in a developed nation. Methods/design The subjects will be 300 children with relapsing SSNS (≥2 relapses in preceding year), who will be randomised to receive either a 6-day course of daily prednisolone or no change to their current therapy (with the use of placebo to double blind) each time they develop an URTI over 12 months. A strict definition for URTI will be used. Subjects will be reviewed at 3, 6, 9 and 12 months to capture data regarding relapse history, ongoing therapy and adverse effect profile, including behavioural problems and quality of life. A formal health economic analysis will also be performed. The primary end point of the study will be the incidence of URTI-related relapse (3 days of Albustix +++) following the first infection during the 12-month follow-up period. DNA and RNA samples will be collected to identify a potential genetic cause for the disease. Subjects will be recruited from over 100 UK centres with the assistance of the Medicines for Children Research Network. PREDNOS 2 is funded by the National Institute for Health Research Health Technology Assessment Programme (11/129/261). Discussion We propose that PREDNOS 2 will be a pivotal study that will inform the future standard of care for children with SSNS. If it is possible to reduce the
Short course daily prednisolone therapy during an upper respiratory tract infection in children with relapsing steroid-sensitive nephrotic syndrome (PREDNOS 2): protocol for a randomised controlled trial.
Webb, Nicholas J A; Frew, Emma; Brettell, Elizabeth A; Milford, David V; Bockenhauer, Detlef; Saleem, Moin A; Christian, Martin; Hall, Angela S; Koziell, Ania; Maxwell, Heather; Hegde, Shivram; Finlay, Eric R; Gilbert, Rodney D; Booth, Jenny; Jones, Caroline; McKeever, Karl; Cook, Wendy; Ives, Natalie J
Relapses of childhood steroid-sensitive nephrotic syndrome (SSNS) are treated with a 4- to 8-week course of high-dose oral prednisolone, which may be associated with significant adverse effects. There is a clear association between upper respiratory tract infection (URTI) and relapse development. Previous studies in developing nations have suggested that introducing a 5- to 7-day course of daily prednisolone during an URTI may prevent a relapse developing and the need for a treatment course of high-dose prednisolone. The aim of PREDNOS 2 is to evaluate the effectiveness of a 6-day course of daily prednisolone therapy during an URTI in reducing the development of a subsequent relapse in a developed nation. The subjects will be 300 children with relapsing SSNS (≥2 relapses in preceding year), who will be randomised to receive either a 6-day course of daily prednisolone or no change to their current therapy (with the use of placebo to double blind) each time they develop an URTI over 12 months. A strict definition for URTI will be used. Subjects will be reviewed at 3, 6, 9 and 12 months to capture data regarding relapse history, ongoing therapy and adverse effect profile, including behavioural problems and quality of life. A formal health economic analysis will also be performed. The primary end point of the study will be the incidence of URTI-related relapse (3 days of Albustix +++) following the first infection during the 12-month follow-up period. DNA and RNA samples will be collected to identify a potential genetic cause for the disease. Subjects will be recruited from over 100 UK centres with the assistance of the Medicines for Children Research Network.PREDNOS 2 is funded by the National Institute for Health Research Health Technology Assessment Programme (11/129/261). We propose that PREDNOS 2 will be a pivotal study that will inform the future standard of care for children with SSNS. If it is possible to reduce the disease relapse rate effectively and
Sugg, Holly Victoria Rose; Richards, David A; Frost, Julia
The aim of this paper is to showcase best practice in intervention development by illustrating a systematic, iterative, person-based approach to optimising intervention acceptability and feasibility, as applied to the cross-cultural adaptation of Morita therapy for depression and anxiety. We developed the UK Morita therapy outpatient protocol over four stages integrating literature synthesis and qualitative research. Firstly, we conducted in-depth interviews combining qualitative and cognitive interviewing techniques, utilising vignettes of Morita therapy being delivered and analysed using Framework analysis to investigate potential patients and therapists' perceptions of Morita therapy. Secondly, we developed qualitative themes into recommendations for optimising Morita therapy and synthesised Morita therapy literature in line with these to develop a draft protocol. Thirdly, we conducted repeat interviews with therapists to investigate their views of the protocol. Finally, we responded to these qualitative themes through protocol modification and tailoring our therapist training programme. As a consequence of literature describing Morita therapy and participants' perceptions of the approach, we developed both a therapy protocol and therapist training programme which were fit for purpose in proceeding to a UK-based Morita therapy feasibility study. As per our key qualitative findings and resulting recommendations, we structured our protocol according to the four-phased model of Morita therapy, included detailed guidance and warning points, and supported therapists in managing patients' expectations of the approach. Our systematic approach towards optimising intervention acceptability and feasibility prioritises the perspectives of those who will deliver and receive the intervention. Thus, we both showcase best practice in intervention development and demonstrate the application of this process to the careful cross-cultural adaptation of an intervention in which
Lee, Mi-Young; Cho, Dae-Yeon; Won, Hye-Sung; Hwang, Ah Reum; Jeong, Bada; Kim, Jihun; Oh, Mijin
Objective To evaluate the performance of Momguard, non-invasive prenatal test (NIPT) for detecting trisomy (T) 21, T18, T13, and sex-chromosome abnormalities recently developed in Korea. Methods This preliminary study formed part of a large prospective cohort study conducted at Asan Medical Center, Seoul, Korea. Only pregnant women who underwent both NIPT and confirmatory karyotyping were included in this study. NIPT results were compared with those of karyotype analyses. Results Among 93 eli...
Wilson, Damali; Gross, Deborah; Hodgkinson, Stacy; Deater‐Deckard, Kirby
ABSTRACT Children born to teen mothers may experience less responsive and supportive parenting and are at heightened risk for a range of social, developmental, and health issues. There is literature to support the positive impact of grandmothers on teen parents and their children. However, what if the teen's mother is also limited in her parenting capacities? How do parenting capacities across these two generations of mothers affect the developing child? In this ongoing study we are examining...
Matvienko-Sikar, Karen; Byrne, Molly; Kelly, Colette; Toomey, Elaine; Hennessy, Marita; Devane, Declan; Heary, Caroline; Harrington, Janas; McGrath, Niamh; Queally, Michelle; Kearney, Patricia M
Childhood obesity is a significant public health challenge that affects approximately one in five children worldwide. Infant feeding practices are implicated in the aetiology of childhood obesity. Infant feeding interventions for childhood obesity are increasingly popular but outcome reporting is inconsistent across trials. Lack of standardisation limits examination of intervention effects and mechanisms of change. The aim of the current project is to develop a core set of infant feeding outcomes for children ≤ 1 year old, to be evaluated in childhood obesity intervention trials. This project will use similar methodology to previous core outcome development research. An infant feeding core outcome set (COS) will be developed in four stages: (1) a systematic review of the literature, (2) discussion and clarification of outcomes in a meeting involving multiple stakeholder perspectives, (3) prioritisation of outcomes using the Delphi technique with an expert panel of stakeholders, and (4) achieving consensus on the COS using the nominal group technique (NGT) consensus meeting. An online Delphi survey will be conducted following the NGT meeting to prioritise outcomes identified in the systematic review. An NGT meeting will be conducted with groups of health professionals, non-clinician researchers, and parents of infants ≤ 1 year old, to achieve final consensus on the infant feeding COS. This study aims to develop a core outcome set of infant feeding outcomes for randomised infant feeding studies to prevent childhood obesity. This research will improve examination and syntheses of the outcomes of such studies to prevent and reduce childhood obesity.
van Heerden, Cherié; Kritzinger, Alta
Key findings of emergent literacy research conclude that emergent literacy experiences correlate with later reading success and that emergent literacy intervention for children with special needs is essential. As a group with special needs, children with Down syndrome require emergent literacy intervention. They may attain functional literacy skills and their language development determines their reading ability. Speech-language therapists have an important role to play in emergent literacy programme development in South Africa. As a first step towards programme development and emergent literacy intervention goal selection, the aim of this study was to determine the applicability of a self-administered questionnaire to describe parental perceptions and practices regarding the emergent literacy development of their young children with Down syndrome. A quantitative research approach was used within a cross-sectional descriptive survey. Fifteen literate parents, with preschool children with Down syndrome aged between two and five years were selected as participants. Data were collected via email and/or facsimile. The results showed that all participants valued emergent literacy development. They appeared to have knowledge about book-reading but not about the broad spectrum of emergent literacy experiences to which they might expose their children. Participants were actively promoting emergent literacy development of their children, but they had certain needs that could potentially be addressed by speech-language therapists working in early communication intervention. The questionnaire proved to be applicable, but changes are required for application with illiterate parents and those with low literacy skills. Based on the results a framework with guidelines for emergent literacy goal selection is provided.
Kinoshita, Akihide; Takizawa, Ryu; Yahata, Noriaki; Homae, Fumitaka; Hashimoto, Ryuichiro; Sakakibara, Eisuke; Kawasaki, Shingo; Nishimura, Yukika; Koike, Shinsuke; Kasai, Kiyoto
Neurofeedback has been studied with the aim of controlling cerebral activity. Near-infrared spectroscopy is a non-invasive neuroimaging technique used for measuring hemoglobin concentration changes in cortical surface areas with high temporal resolution. Thus, near-infrared spectroscopy may be useful for neurofeedback, which requires real-time feedback of repeated brain activation measurements. However, no study has specifically targeted neurofeedback, using near-infrared spectroscopy, in the frontal pole cortex. We developed an original near-infrared spectroscopy neurofeedback system targeting the frontal pole cortex. Over a single day of testing, each healthy participant (n = 24) received either correct or incorrect (Sham) feedback from near-infrared spectroscopy signals, based on a crossover design. Under correct feedback conditions, significant activation was observed in the frontal pole cortex (P = 0.000073). Additionally, self-evaluation of control and metacognitive beliefs were associated with near-infrared spectroscopy signals (P = 0.006). The neurofeedback system developed in this study might be useful for developing control of frontal pole cortex activation. © 2016 The Authors. Psychiatry and Clinical Neurosciences © 2016 Japanese Society of Psychiatry and Neurology.
Geisler, Martin Joakim Bittel
with a variant of the classic BGW protocol. The protocol is secure against a semi-honest adversary. In Chapter 4 we describe a new protocol for VIFF that is secure against malicious adversaries. The protocol guarantees termination if the adversary allows a preprocessing phase to terminate, in which...... systems hosted by an untrusted provider. It guarantees atomic read and write operations on the shared data when the service is correct and preserves fork-linearizability when the service is faulty. A prototype has been implemented on top of the Subversion revision control system; benchmarks show...
The Deepwater Horizon (DWH) accident, one of the largest oil spills in U.S. history, contaminated several beaches located along the Gulf of Mexico (GOM) shoreline. The residues from the spill still continue to be deposited on some of these beaches. Methods to track and monitor the fate of these residues require approaches that can differentiate the DWH residues from other types of petroleum residues. This is because, historically, the crude oil released from sources such as natural seeps and anthropogenic discharges have also deposited other types of petroleum residues on GOM beaches. Therefore, identifying the origin of these residues is critical for developing effective management strategies for monitoring the long-term environmental impacts of the DWH oil spill. Advanced fingerprinting methods that are currently used for identifying the source of oil spill residues require detailed laboratory studies, which can be cost-prohibitive. Also, most agencies typically use untrained workers or volunteers to conduct shoreline monitoring surveys and these worker will not have access to advanced laboratory facilities. Furthermore, it is impractical to routinely fingerprint large volumes of samples that are collected after a major oil spill event, such as the DWH spill. In this study, we propose a simple field testing protocol that can identify DWH oil spill residues based on their unique physical characteristics. The robustness of the method is demonstrated by testing a variety of oil spill samples, and the results are verified by characterizing the samples using advanced chemical fingerprinting methods. The verification data show that the method yields results that are consistent with the results derived from advanced fingerprinting methods. The proposed protocol is a reliable, cost-effective, practical field approach for differentiating DWH residues from other types of petroleum residues. PMID:29329313
Mao, Hui-Fen; Chang, Ling-Hui; Tsai, Athena Yi-Jung; Huang, Wen-Ni; Wang, Jye
Because resources for long-term care services are limited, timely and appropriate referral for rehabilitation services is critical for optimizing clients' functions and successfully integrating them into the community. We investigated which client characteristics are most relevant in predicting Taiwan's community-based occupational therapy (OT) service referral based on experts' beliefs. Data were collected in face-to-face interviews using the Multidimensional Assessment Instrument (MDAI). Community-dwelling participants (n = 221) ≥ 18 years old who reported disabilities in the previous National Survey of Long-term Care Needs in Taiwan were enrolled. The standard for referral was the judgment and agreement of two experienced occupational therapists who reviewed the results of the MDAI. Logistic regressions and Generalized Additive Models were used for analysis. Two predictive models were proposed, one using basic activities of daily living (BADLs) and one using instrumental ADLs (IADLs). Dementia, psychiatric disorders, cognitive impairment, joint range-of-motion limitations, fear of falling, behavioral or emotional problems, expressive deficits (in the BADL-based model), and limitations in IADLs or BADLs were significantly correlated with the need for referral. Both models showed high area under the curve (AUC) values on receiver operating curve testing (AUC = 0.977 and 0.972, respectively). The probability of being referred for community OT services was calculated using the referral algorithm. The referral protocol facilitated communication between healthcare professionals to make appropriate decisions for OT referrals. The methods and findings should be useful for developing referral protocols for other long-term care services.
Xu, Michael; Tam, Benjamin; Thabane, Lehana; Fox-Robichaud, Alison
Multiple early warning scores (EWS) have been developed and implemented to reduce cardiac arrests on hospital wards. Case-control observational studies that generate an area under the receiver operator curve (AUROC) are the usual validation method, but investigators have also generated EWS with algorithms with no prior clinical knowledge. We present a protocol for the validation and comparison of our local Hamilton Early Warning Score (HEWS) with that generated using decision tree (DT) methods. A database of electronically recorded vital signs from 4 medical and 4 surgical wards will be used to generate DT EWS (DT-HEWS). A third EWS will be generated using ensemble-based methods. Missing data will be multiple imputed. For a relative risk reduction of 50% in our composite outcome (cardiac or respiratory arrest, unanticipated intensive care unit (ICU) admission or hospital death) with a power of 80%, we calculated a sample size of 17,151 patient days based on our cardiac arrest rates in 2012. The performance of the National EWS, DT-HEWS and the ensemble EWS will be compared using AUROC. Ethics approval was received from the Hamilton Integrated Research Ethics Board (#13-724-C). The vital signs and associated outcomes are stored in a database on our secure hospital server. Preliminary dissemination of this protocol was presented in abstract form at an international critical care meeting. Final results of this analysis will be used to improve on the existing HEWS and will be shared through publication and presentation at critical care meetings. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.
Han, Yuling; Clement, T Prabhakar
The Deepwater Horizon (DWH) accident, one of the largest oil spills in U.S. history, contaminated several beaches located along the Gulf of Mexico (GOM) shoreline. The residues from the spill still continue to be deposited on some of these beaches. Methods to track and monitor the fate of these residues require approaches that can differentiate the DWH residues from other types of petroleum residues. This is because, historically, the crude oil released from sources such as natural seeps and anthropogenic discharges have also deposited other types of petroleum residues on GOM beaches. Therefore, identifying the origin of these residues is critical for developing effective management strategies for monitoring the long-term environmental impacts of the DWH oil spill. Advanced fingerprinting methods that are currently used for identifying the source of oil spill residues require detailed laboratory studies, which can be cost-prohibitive. Also, most agencies typically use untrained workers or volunteers to conduct shoreline monitoring surveys and these worker will not have access to advanced laboratory facilities. Furthermore, it is impractical to routinely fingerprint large volumes of samples that are collected after a major oil spill event, such as the DWH spill. In this study, we propose a simple field testing protocol that can identify DWH oil spill residues based on their unique physical characteristics. The robustness of the method is demonstrated by testing a variety of oil spill samples, and the results are verified by characterizing the samples using advanced chemical fingerprinting methods. The verification data show that the method yields results that are consistent with the results derived from advanced fingerprinting methods. The proposed protocol is a reliable, cost-effective, practical field approach for differentiating DWH residues from other types of petroleum residues.
Carroll, Herbert B.; Johnson, William I.
Procedures and protocols were developed for the determination of the status of oil, gas, and other mineral operations on the Osage Mineral Reservation Estate. The strategy for surveying Osage County, Oklahoma, was developed and then tested in the field. Two Osage Tribal Council members and two Native American college students (who are members of the Osage Tribe) were trained in the field as a test of the procedures and protocols developed in Task 1. Active and inactive surface mining operations, industrial sites, and hydrocarbon-producing fields were located on maps of the county, which was divided into four more or less equal areas for future investigation. Field testing of the procedures, protocols, and training was successful. No significant damage was found at petroleum production operations in a relatively new production operation and in a mature waterflood operation.
Nurliyana, Abdul Razak; Mohd Shariff, Zalilah; Mohd Taib, Mohd Nasir; Gan, Wan Ying; Tan, Kit-Aun
The first 2 years of life is a critical period of rapid growth and brain development. During this period, nutrition and environmental factors play important roles in growth and cognitive development of a child. This report describes the study protocol of early nutrition, growth and cognitive development of infants from birth to 2 years of age. This is a prospective cohort study of mothers and infants recruited from government health clinics in Seremban district in Negeri Sembilan, Malaysia. Infants are followed-up at 6, 12, 18 and 24 months of age. Pre-natal factors that include mother's pre-pregnancy body mass index, gestational weight gain, blood glucose and blood pressure during pregnancy, infant's gestational age, birth weight and head circumference at birth are obtained from patient card. Post-natal factors assessed at each follow-up are feeding practices, dietary intake, anthropometric measurements and cognitive development of infants. Iron status is assessed at 6 months, while infant temperament and home environment are assessed at 12 months. Maternal intelligence is assessed at 18 months. Early life nutritional programming is of current interest as many longitudinal studies are actively being conducted in developed countries to investigate this concept. The concept however is relatively new in developing countries such as Malaysia. This study will provide useful information on early nutrition and infant development in the first two years of life which can be further followed up to identify factors that track into childhood and contribute to growth and cognitive deviations.
Kumar S., A. Ajith; Simonsen, Kent Inge
Model-Driven Software Engineering (MDSE) is a promising approach for the development of applications, and has been well adopted in the embedded applications domain in recent years. Wireless Sensor Actuator Networks consisting of resource constrained hardware and platformspecific operating system...... induced due to manual translations. With the use of formal semantics in the modeling approach, we can further ensure the correctness of the source model by means of verification. Also, with the use of network simulators and formal modeling tools, we obtain a verified and validated model to be used...
Denehy, Mel; Crawford, Gemma; Leavy, Justine; Nimmo, Lauren; Jancey, Jonine
Worldwide, children under the age of 5 years are at particular risk of drowning. Responding to this need requires the development of evidence-informed drowning prevention strategies. Historically, drowning prevention strategies have included denying access, learning survival skills and providing supervision, as well as education and information which includes the use of mass media. Interventions underpinned by behavioural theory and formative evaluation tend to be more effective, yet few practical examples exist in the drowning and/or injury prevention literature. The Health Belief Model and Social Cognitive Theory will be used to explore participants' perspectives regarding proposed mass media messaging. This paper describes a qualitative protocol to undertake formative research to develop theory-based messages for a child drowning prevention campaign. The primary data source will be focus group interviews with parents and caregivers of children under 5 years of age in metropolitan and regional Western Australia. Qualitative content analysis will be used to analyse the data. This study will contribute to the drowning prevention literature to inform the development of future child drowning prevention mass media campaigns. Findings from the study will be disseminated to practitioners, policymakers and researchers via international conferences, peer and non-peer-reviewed journals and evidence summaries. The study was submitted and approved by the Curtin University Human Research Ethics Committee. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
Lenard, James; Badea-Romero, Alexandro; Danton, Russell
An increasing proportion of new vehicles are being fitted with autonomous emergency braking systems. It is difficult for consumers to judge the effectiveness of these safety systems for individual models unless their performance is evaluated through track testing under controlled conditions. This paper aimed to contribute to the development of relevant test conditions by describing typical circumstances of pedestrian accidents. Cluster analysis was applied to two large British databases and both highlighted an urban scenario in daylight and fine weather where a small pedestrian walks across the road, especially from the near kerb, in clear view of a driver who is travelling straight ahead. For each dataset a main test configuration was defined to represent the conditions of the most common accident scenario along with test variations to reflect the characteristics of less common accident scenarios. Some of the variations pertaining to less common accident circumstances or to a minority of casualties in these scenarios were proposed as optional or supplementary test elements for an outstanding performance rating. Many considerations are incorporated into the final design and implementation of an actual testing regime, such as cost and the state of development of technology; only the representation of accident data lay within the scope of this paper. It would be desirable to ascertain the wider representativeness of the results by analysing accident data from other countries in a similar manner. Copyright © 2014 Elsevier Ltd. All rights reserved.
Wilson, Damali; Gross, Deborah; Hodgkinson, Stacy; Deater-Deckard, Kirby
Children born to teen mothers may experience less responsive and supportive parenting and are at heightened risk for a range of social, developmental, and health issues. There is literature to support the positive impact of grandmothers on teen parents and their children. However, what if the teen's mother is also limited in her parenting capacities? How do parenting capacities across these two generations of mothers affect the developing child? In this ongoing study we are examining two important aspects of parenting capacities, attachment quality and executive functioning, in teen mothers (TM) and their biological, co- residing mothers or grandmothers (GM or GGM). Both are essential components of effective parenting, but little is known about their impact on young children's development when raised by two generations of parents. In a cross- sectional, descriptive design, a convenience sample of 50 TM/GM dyads with children 1 to 3 years old is being recruited from two urban teen-tot clinics. Participants complete a paper-and-pencil measure of attachment quality and a computerized measure of multiple aspects of executive function (working memory, inhibitory control, cognitive flexibility). A standardized maternal report measure is used to assess child developmental status. The biggest challenges of the study thus far include recruitment and transience of the study population. Progress to date and experiences from recruitment and data collection are discussed, as well as successful strategies to address challenges. © 2017 The Authors. Research in Nursing & Health Published by Wiley Periodicals, Inc.
Than, Martin; Flaws, Dylan; Sanders, Sharon; Doust, Jenny; Glasziou, Paul; Kline, Jeffery; Aldous, Sally; Troughton, Richard; Reid, Christopher; Parsonage, William A.; Frampton, Christopher; Greenslade, Jaimi H.; Deely, Joanne M.; Hess, Erik; Sadiq, Amr Bin; Singleton, Rose; Shopland, Rosie; Vercoe, Laura; Woolhouse-Williams, Morgana; Ardagh, Michael; Bossuyt, Patrick; Bannister, Laura; Cullen, Louise
Risk scores and accelerated diagnostic protocols can identify chest pain patients with low risk of major adverse cardiac event who could be discharged early from the ED, saving time and costs. We aimed to derive and validate a chest pain score and accelerated diagnostic protocol (ADP) that could
In this dissertation, the author examined the capabilities of Internet Protocol version 6 (IPv6) in regard to replacing Internet Protocol version 4 (IPv4) as the internetworking technology for Medium-sized Businesses (MBs) in the Information Systems (IS) field. Transition to IPv6 is inevitable, and, thus, organizations are adopting this protocol…
Sanders, Emma; Hill, Catherine Mary; Evans, Hazel Jean; Tuffrey, Catherine
Obstructive sleep apnea is a condition which affects an estimated 50% of children with Down syndrome, particularly in their early years. It can cause serious sequelae in affected children but may not be recognized by parents or health professionals. Routine screening has been recommended in some countries, but is not standard practice. There are no validated questionnaire-based tools available to screen this population of children for this particular sleep-related disorder. Using existing validated sleep questionnaire items, we have developed a questionnaire to screen children with Down syndrome up to 6 years of age for obstructive sleep apnea, which corresponds with the recommendations made in UK national guidelines. This paper describes these first steps in demonstrating content validity for a new questionnaire, which will be subject to further in-depth psychometric analysis. Relevance, clarity, and age appropriateness were rated for 33 items using a content review questionnaire by a group of 18 health professionals with expertise in respiratory pediatrics, neurodevelopmental pediatrics, and sleep physiology. The content validity index was calculated for individual items and contributed to decisions about item inclusion. Scale level content validity index for the modified questionnaire of 14 items was at an accepted level of 0.78. Two parents of children with Down syndrome took part in cognitive interviews after completing the modified questionnaire. We describe the development of this 14 item questionnaire to screen for OSA in children with DS from infancy to 6 years.
Full Text Available Obstructive sleep apnoea is a condition which affects an estimated 50% of children with Down syndrome, particularly in their early years. It can cause serious sequelae in affected children but may not be recognised by parents or health professionals. Routine screening has been recommended in some countries but is not standard practice. There are no validated questionnaire based tools available to screen this population of children for this particular sleep-related disorder. Using existing validated sleep questionnaire items, we have developed a questionnaire to screen children with Down syndrome up to 6 years of age for obstructive sleep apnoea, which corresponds with the recommendations made in UK national guidelines. This paper describes these first steps in demonstrating content validity for a new questionnaire which will be subject to further in-depth psychometric analysis. Relevance, clarity and age-appropriateness was rated for 33 items using a content review questionnaire by a group of 18 health professionals with expertise in respiratory paediatrics, neurodevelopmental paediatrics and sleep physiology. The content validity index was calculated for individual items and contributed to decisions about item inclusion. Scale level content validity index for the modified questionnaire of 14 items was at an accepted level of 0.78. Two parents of children with Down syndrome took part in cognitive interviews after completing the modified questionnaire. We describe the development of this 14 item questionnaire to screen for OSA in children with DS from infancy to 6 years.
Cohn, Gabriel M; Morin, Isabelle; Whiteman, David A H
The Hunter Outcome Survey (HOS), an international, long-term observational registry of patients with Hunter syndrome, was used to develop a simple mnemonic screening tool (HUNTER) to aid in the diagnosis of Hunter syndrome. Data regarding the prediagnosis prevalence of ten specific signs and symptoms present in individual patients enrolled in the HOS were used to develop the HUNTER mnemonic screening tool. A total score of 6 or greater using a weighting scheme in which certain manifestations were assigned a weight of 2 (facial dysmorphism, nasal obstruction or rhinorrhea, enlarged tongue, enlarged liver, enlarged spleen, joint stiffness) and others assigned a weight of 1 (hernia, hearing impairment, enlarged tonsils, airway obstruction or sleep apnea) correctly identified 95 % of patients who had no family history of Hunter syndrome or who were not diagnosed prenatally. No association between age at diagnosis and HUNTER score was found. The HUNTER mnemonic appears to be a useful screening tool. Further validation in the clinical setting will be necessary to confirm its utility.
Sund, Kristen Lipscomb; Roelker, Stephanie; Ramachandran, Vijaya; Durbin, Lisa; Benson, D Woodrow
Mutations identified in a cohort of patients with atrioventricular septal defects as a part of Ellis van Creveld syndrome (EvC syndrome) led us to study the role of two non-homologous genes, EVC and LBN, in heart development and disease pathogenesis. To address the cause of locus heterogeneity resulting in an indistinguishable heart-hand phenotype, we carried out in situ hybridization and immunofluorescence and identified co-localization of Evc and Lbn mRNA and protein. In the heart, expression was identified to be strongest in the secondary heart field, including both the outflow tract and the dorsal mesenchymal protrusion, but was also found in mesenchymal structures of the atrial septum and the atrioventricular cushions. Finally, we studied the transcriptional hierarchy of EVC and LBN but did not find any evidence of direct transcriptional interregulation between the two. Due to the locus heterogeneity of human mutations predicted to result in a loss of protein function, a bidirectional genomic organization and overlapping expression patterns, we speculate that these proteins function coordinately in cardiac development and that loss of this coordinate function results in the characteristics of EvC syndrome.
Lin, Shengxuan; Zhou, Xuedong; Ge, Liya; Ng, Sum Huan; Zhou, Xiaodong; Chang, Victor Wei-Chung
Heavy metals and some metalloids are the most significant inorganic contaminants specified in toxicity characteristic leaching procedure (TCLP) in determining the safety of landfills or further utilization. As a consequence, a great deal of efforts had been made on the development of miniaturized analytical devices, such as Microchip Electrophoresis (ME) and μTAS for on-site testing of heavy metals and metalloids to prevent spreading of those pollutants or decrease the reutilization period of waste materials such as incineration bottom ash. However, the bottleneck lied in the long and tedious conventional TCLP that requires 18 h of leaching. Without accelerating the TCLP process, the on-site testing of the waste material leachates was impossible. In this study, therefore, a new accelerated leaching method (ALM) combining ultrasonic assisted leaching with tumbling was developed to reduce the total leaching time from 18 h to 30 min. After leaching, the concentrations of heavy metals and metalloids were determined with ICP-MS or ICP-optical emission spectroscopy. No statistical significance between ALM and TCLP was observed for most heavy metals (i.e., cobalt, manganese, mercury, molybdenum, nickel, silver, strontium, and tin) and metalloids (i.e., arsenic and selenium). For the heavy metals with statistical significance, correlation factors derived between ALM and TCLP were 0.56, 0.20, 0.037, and 0.019 for barium, cadmium, chromium, and lead, respectively. Combined with appropriate analytical techniques (e.g., ME), the ALM can be applied to rapidly prepare the incineration bottom ash samples as well as other environmental samples for on-site determination of heavy metals and metalloids. © 2016 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.
Rose, Tanith C; Adams, Natalie; Taylor-Robinson, David C; Barr, Benjamin; Hawker, Jeremy; O'Brien, Sarah; Violato, Mara; Whitehead, Margaret
The association between low socioeconomic status (SES) and poor health is well documented in the existing literature. Nonetheless, evidence on the relationship between SES and gastrointestinal (GI) infections is limited, and the mechanisms underlying this relationship are not well understood with published studies pointing to conflicting results. This review aims to identify studies that investigate the relationship between SES and GI infections in developed countries, in order to assess the direction of the association and explore possible explanations for any differences in the risk, incidence or prevalence of GI infections across socioeconomic groups. Three systematic methods will be used to identify relevant literature: electronic database, reference list and grey literature searching. The databases MEDLINE, Scopus and Web of Science Core Collection will be searched using a broad range of search terms. Screening of the results will be performed by two reviewers using pre-defined inclusion and exclusion criteria. The reference lists of included studies will be searched, and Google will be used to identify grey literature. Observational studies reporting quantitative results on the prevalence or incidence of any symptomatic GI infections by SES, in a representative population sample from a member country of the Organisation for Economic Co-operation and Development (OECD), will be included. Data will be extracted using a standardised form. Study quality will be assessed using the Liverpool University Quality Assessment Tools (LQAT). A narrative synthesis will be performed including tabulation of studies for comparison. This systematic review will consolidate the existing knowledge on the relationship between SES and GI infections. The results will help to identify gaps in the literature and will therefore provide an evidence base for future empirical studies to deepen the understanding of the relationship, including effective study design and appropriate data
Full Text Available Abstract Background Practice guidelines can improve health care delivery and outcomes but several issues challenge guideline adoption, including their intrinsic attributes, and whether and how they are implemented. It appears that guideline format may influence accessibility and ease of use, which may overcome attitudinal barriers of guideline adoption, and appear to be important to all stakeholders. Guideline content may facilitate various forms of decision making about guideline adoption relevant to different stakeholders. Knowledge and attitudes about, and incentives and capacity for implementation on the part of guideline sponsors may influence whether and how they develop guidelines containing these features, and undertake implementation. Examination of these issues may yield opportunities to improve guideline adoption. Methods The attributes hypothesized to facilitate adoption will be expanded by thematic analysis, and quantitative and qualitative summary of the content of international guidelines for two primary care (diabetes, hypertension and institutional care (chronic ulcer, chronic heart failure topics. Factors that influence whether and how guidelines are implemented will be explored by qualitative analysis of interviews with individuals affiliated with guideline sponsoring agencies. Discussion Previous research examined guideline implementation by measuring rates of compliance with recommendations or associated outcomes, but this produced little insight on how the products themselves, or their implementation, could be improved. This research will establish a theoretical basis upon which to conduct experimental studies to compare the cost-effectiveness of interventions that enhance guideline development and implementation capacity. Such studies could first examine short-term outcomes predictive of guideline utilization, such as recall, attitude toward, confidence in, and adoption intention. If successful, then long-term objective
Collings, Sunny; Mathieson, Fiona; Dowell, Anthony; Stanley, James; Hatcher, Simon; Goodyear-Smith, Felicity; Lane, Brigitte; Munsterman, Amy
Although mild to moderate mental health problems are common and often debilitating, treatment options in primary care settings in New Zealand are often severely limited for patients with these conditions. Previously, we developed an ultra-brief intervention (UBI) to address mild to moderate psychological concerns, designed to be delivered by primary care clinicians. Recent feasibility testing, including an adaptation for Māori individuals (the indigenous people of New Zealand), showed that the brief intervention was feasible and acceptable to both clinicians and their patients. This protocol describes a large pragmatic randomized controlled trial of our UBI in primary care settings across the greater Wellington region, compared with practice as usual. We are using a two-arm cluster randomized controlled trial, with primary care practices randomized to exclusively deliver either the UBI or practice as usual to all their recruited participants. The structured, guided self-help UBI is delivered in three brief general practitioner (GP) appointments over a five week period. Participants are invited into the study based on partner primary health organization access criteria (youth, people with low income, or people with Māori or Pacific Island heritage). Improvements in mental health from baseline to post-treatment will be compared between the intervention and control groups using a mixed-models application of analysis of covariance. Data analysis will be on an intention-to-treat basis, to increase the real-world relevance of UBI and to meet the study's objective of releasing UBI to primary care clinicians nationwide. The UBI is a first-line intervention tool for GPs that models the stepped care approach advocated in New Zealand, against a background of limited access to treatments for often-overlooked patient groups. It is proposed to be accessible to clinicians and patients alike, with the potential to be relevant to primary care clinicians across New Zealand
Full Text Available Abstract Background Preterm birth is a major cause of neonatal mortality, responsible for 28% of neonatal deaths overall. The administration of antenatal corticosteroids to women at high risk of preterm birth is a powerful perinatal intervention to reduce neonatal mortality in resource rich environments. The effect of antenatal steroids to reduce mortality and morbidity among preterm infants in hospital settings in developed countries with high utilization is well established, yet they are not routinely used in developing countries. The impact of increasing antenatal steroid use in hospital or community settings with low utilization rates and high infant mortality among premature infants due to lack of specialized services has not been well researched. There is currently no clear evidence about the safety of antenatal corticosteroid use for community-level births. Methods We hypothesize that a multi country, two-arm, parallel cluster randomized controlled trial to evaluate whether a multifaceted intervention to increase the use of antenatal corticosteroids, including components to improve the identification of pregnancies at high risk of preterm birth and providing and facilitating the appropriate use of steroids, will reduce neonatal mortality at 28 days of life in preterm newborns, compared with the standard delivery of care in selected populations of six countries. 102 clusters in Argentina, Guatemala, Kenya, India, Pakistan, and Zambia will be randomized, and around 60,000 women and newborns will be enrolled. Kits containing vials of dexamethasone, syringes, gloves, and instructions for administration will be distributed. Improving the identification of women at high risk of preterm birth will be done by (1 diffusing recommendations for antenatal corticosteroids use to health providers, (2 training health providers on identification of women at high risk of preterm birth, (3 providing reminders to health providers on the use of the kits, and
Althabe, Fernando; Belizán, José M; Mazzoni, Agustina; Berrueta, Mabel; Hemingway-Foday, Jay; Koso-Thomas, Marion; McClure, Elizabeth; Chomba, Elwyn; Garces, Ana; Goudar, Shivaprasad; Kodkany, Bhalchandra; Saleem, Sarah; Pasha, Omrana; Patel, Archana; Esamai, Fabian; Carlo, Waldemar A; Krebs, Nancy F; Derman, Richard J; Goldenberg, Robert L; Hibberd, Patricia; Liechty, Edward A; Wright, Linda L; Bergel, Eduardo F; Jobe, Alan H; Buekens, Pierre
Preterm birth is a major cause of neonatal mortality, responsible for 28% of neonatal deaths overall. The administration of antenatal corticosteroids to women at high risk of preterm birth is a powerful perinatal intervention to reduce neonatal mortality in resource rich environments. The effect of antenatal steroids to reduce mortality and morbidity among preterm infants in hospital settings in developed countries with high utilization is well established, yet they are not routinely used in developing countries. The impact of increasing antenatal steroid use in hospital or community settings with low utilization rates and high infant mortality among premature infants due to lack of specialized services has not been well researched. There is currently no clear evidence about the safety of antenatal corticosteroid use for community-level births. We hypothesize that a multi country, two-arm, parallel cluster randomized controlled trial to evaluate whether a multifaceted intervention to increase the use of antenatal corticosteroids, including components to improve the identification of pregnancies at high risk of preterm birth and providing and facilitating the appropriate use of steroids, will reduce neonatal mortality at 28 days of life in preterm newborns, compared with the standard delivery of care in selected populations of six countries. 102 clusters in Argentina, Guatemala, Kenya, India, Pakistan, and Zambia will be randomized, and around 60,000 women and newborns will be enrolled. Kits containing vials of dexamethasone, syringes, gloves, and instructions for administration will be distributed. Improving the identification of women at high risk of preterm birth will be done by (1) diffusing recommendations for antenatal corticosteroids use to health providers, (2) training health providers on identification of women at high risk of preterm birth, (3) providing reminders to health providers on the use of the kits, and (4) using a color-coded tape to measure
Perfect, Michelle M; Beebe, Dean; Levine-Donnerstein, Deborah; Frye, Sara S; Bluez, Grai P; Quan, Stuart F
Findings from type 2 diabetes research indicate that sleep is both a predictor of onset and a correlate of disease progression. However, the role sleep plays in glucose regulation and daytime functioning in youth with type 1 diabetes mellitus (T1DM) has not been systematically investigated. Nonetheless, preliminary findings have supported that various sleep parameters are strongly correlated to health-related and neurobehavioral outcomes in youth with T1DM. This suggests that improving sleep might reduce morbidity. A critical step in developing evidence-based guidelines regarding sleep in diabetes management is to first determine that sleep modification in natural settings is possible (i.e., instructing youth to have a healthy sleep opportunity leads to more total sleep time) and that an increased sleep duration impacts disease and psychosocial outcomes in these youth. This article describes the background, design, and feasibility of an ongoing randomized clinical trial that aims to examine if increasing sleep relative to youth's own sleep routines affects glucose control and daytime functioning.
Urquidi, Jacob, E-mail: email@example.com; Brar, Ramaninder K. [X-ray and Neutron Science Laboratory, Department of Physics, New Mexico State University, Las Cruces, NM (United States); Rodriguez, Stacy; Hansen, Immo [Molecular Vector Physiology Lab, Department of Biology, New Mexico State University, Las Cruces, NM (United States)
Control of insect species for the protection of crops, livestock, and prevention of disease such as dengue fever and malaria is a high priority in today’s global economy. Traditional methods such as pesticides have fallen out of favor because its effects are indiscriminate as well as adverse and unpredictable impacts on the environment. Modern novel techniques such as genetic modification have had trouble gaining traction due to ethics concerns and the potential for unforeseen side effects. One approach that has gained traction and has proven its efficacy is the use of ionizing radiation to affect sterility in insect species in order to scale back their population. Known as Sterile Insect Technique (SIT), it has proven very effective in eradicating certain dipteran insect populations. However, when standard sterilization methods developed for dipertans are applied to mosquito populations significant complications arise, such as an inability to compete with non-irradiated males and high mortality rates. We have investigated the effect of treatment with x-rays of different wavelengths on x-ray sterilized mosquito males. Our results have demonstrated that longer wavelength x-rays have a significant effect on the outcome of the sterile males’ longevity as well as an increase on the efficacy of sterilization while employing a substantially lower dose.
Urquidi, Jacob; Brar, Ramaninder K.; Rodriguez, Stacy; Hansen, Immo
Control of insect species for the protection of crops, livestock, and prevention of disease such as dengue fever and malaria is a high priority in today's global economy. Traditional methods such as pesticides have fallen out of favor because its effects are indiscriminate as well as adverse and unpredictable impacts on the environment. Modern novel techniques such as genetic modification have had trouble gaining traction due to ethics concerns and the potential for unforeseen side effects. One approach that has gained traction and has proven its efficacy is the use of ionizing radiation to affect sterility in insect species in order to scale back their population. Known as Sterile Insect Technique (SIT), it has proven very effective in eradicating certain dipteran insect populations. However, when standard sterilization methods developed for dipertans are applied to mosquito populations significant complications arise, such as an inability to compete with non-irradiated males and high mortality rates. We have investigated the effect of treatment with x-rays of different wavelengths on x-ray sterilized mosquito males. Our results have demonstrated that longer wavelength x-rays have a significant effect on the outcome of the sterile males' longevity as well as an increase on the efficacy of sterilization while employing a substantially lower dose.
Urquidi, Jacob; Brar, Ramaninder K.; Rodriguez, Stacy; Hansen, Immo
Control of insect species for the protection of crops, livestock, and prevention of disease such as dengue fever and malaria is a high priority in today’s global economy. Traditional methods such as pesticides have fallen out of favor because its effects are indiscriminate as well as adverse and unpredictable impacts on the environment. Modern novel techniques such as genetic modification have had trouble gaining traction due to ethics concerns and the potential for unforeseen side effects. One approach that has gained traction and has proven its efficacy is the use of ionizing radiation to affect sterility in insect species in order to scale back their population. Known as Sterile Insect Technique (SIT), it has proven very effective in eradicating certain dipteran insect populations. However, when standard sterilization methods developed for dipertans are applied to mosquito populations significant complications arise, such as an inability to compete with non-irradiated males and high mortality rates. We have investigated the effect of treatment with x-rays of different wavelengths on x-ray sterilized mosquito males. Our results have demonstrated that longer wavelength x-rays have a significant effect on the outcome of the sterile males’ longevity as well as an increase on the efficacy of sterilization while employing a substantially lower dose
Lee, Mi-Young; Cho, Dae-Yeon; Won, Hye-Sung; Hwang, Ah Reum; Jeong, Bada; Kim, Jihun; Oh, Mijin
To evaluate the performance of Momguard, non-invasive prenatal test (NIPT) for detecting trisomy (T) 21, T18, T13, and sex-chromosome abnormalities recently developed in Korea. This preliminary study formed part of a large prospective cohort study conducted at Asan Medical Center, Seoul, Korea. Only pregnant women who underwent both NIPT and confirmatory karyotyping were included in this study. NIPT results were compared with those of karyotype analyses. Among 93 eligible cases, NIPT results could not be obtained in one case due to a low fetal cell-free DNA fraction. Based on NIPT, eight cases of fetal aneuploidies, including T21 (n=5), T18 (n=2), and T13 (n=1), were identified. For T21 and T18, the sensitivity and specificity of NIPT were both 100%, with a false-positive and false-negative rate of 0% and a positive-predictive value of 100%. One patient classified as having intermediate risk for T13 by NIPT was confirmed to have T13 by karyotyping, and there were no false-negative cases. No cases of sex-chromosome anomalies were detected by NIPT or karyotyping during the study period. Momguard is a reliable screening tool for detecting T21 and T18. For T13 and sex-chromosome anomalies, further prospective studies are necessary to confirm its utility.
Wang, Jy-An John [ORNL; Liu, Ken C [ORNL; Naus, Dan J [ORNL
The Spiral Notch Torsion Fracture Toughness Test (SNTT) was developed recently to determine the intrinsic fracture toughness (KIC) of structural materials. The SNTT system operates by applying pure torsion to uniform cylindrical specimens with a notch line that spirals around the specimen at a 45 pitch. KIC values are obtained with the aid of a three-dimensional finite-element computer code, TOR3D-KIC. The SNTT method is uniquely suitable for testing a wide variety of materials used extensively in pressure vessel and piping structural components and weldments. Application of the method to metallic, ceramic, and graphite materials has been demonstrated. One important characteristic of SNTT is that neither a fatigue precrack or a deep notch are required for the evaluation of brittle materials, which significantly reduces the sample size requirement. In this paper we report results for a Portland cement-based mortar to demonstrate applicability of the SNTT method to cementitious materials. The estimated KIC of the tested mortar samples with compressive strength of 34.45 MPa was found to be 0.19 MPa m.
Full Text Available Background: For TDM of mycophenolate acid (MPA, the Roche Total Mycophenolic AcidÂ® assay based on the inhibition of recombinant inosine monophosphate dehydrogenase (IMPDH has been shown to be a simple and reliable alternative to chromatographic methods. We have adapted this assay on the ABX Pentra 400 analyzer (HORIBA. Objective: To investigate the analytical performances of the Roche Total Mycophenolic AcidÂ® assay on the ABX Pentra 400 and to compare it to an LC-MS method using samples from children with nephrotic syndrome treated with mycophenolate mofetil (MMF. Material and methods: Configuration of the open-channel on the ABX Pentra 400 was based on the Roche MPA assay package insert. Precision was determined as described in the CLSI protocol EP5-A2. Comparison with the LC-MS method was performed using 356 plasma samples from 42 children with nephrotic syndrome (8Â h pharmacokinetic profiles. Results: The enzymatic assay demonstrated high precision. The %CV for Within Run Imprecision ranged from 5.5% at 1.2Â mg/L to 1.5% at 14.1Â mg/L and Total Imprecision ranged from 9.3% to 2.5%. The method comparison with plasma samples from children yielded overall a good correlation and a good agreement between both methods. The Passing Bablok regression analysis showed the following results: [Roche MPA assay]=1.058 [MPA LC-MS] â0.06; rho=0.996. Conclusion: The Roche Total Mycophenolic AcidÂ® assay is adaptable to the ABX Pentra 400 analyzer, and demonstrates accurate and precise measurement of MPA in plasma obtained from children with nephrotic syndrome. Keywords: Enzyme assay, Inosine monophosphate dehydrogenase, Mycophenolic acid, Nephrotic syndrome
Yasuda, Hideto; Nishimura, Tetsuro; Kamo, Tetsuro; Sanui, Masamitsu; Nango, Eishu; Abe, Takayuki; Takebayashi, Toru; Lefor, Alan Kawarai; Hashimoto, Satoru
Lower tidal volume ventilation in patients with acute respiratory distress syndrome (ARDS) is a strategy to reduce the plateau pressure and driving pressure to limit ventilator-induced lung injury (VILI). Several randomised controlled trials (RCTs) and meta-analyses showed that limiting both the plateau pressure and the tidal volume decreased mortality, but the optimal plateau pressure to demonstrate a benefit is uncertain. The aim of this systematic review is to investigate the optimal upper limit of plateau pressure in patients with ARDS to prevent VILI and improve clinical outcomes using meta-analysis with and without meta-regression. RCTs comparing two mechanical ventilation strategies will be included, with lower plateau pressure and with higher plateau pressure, among patients with ARDS and acute lung injury. Data sources include MEDLINE via the NCBI Entrez system, Cochrane Central Register of Controlled Trials (CENTRAL), EMBASE and Ichushi, a database of papers in Japanese. Two of three physicians will independently screen trials obtained by search for eligibility, and extract data from included studies onto standardised data recording forms. For each included trial, the risk of bias and the quality of evidence will be evaluated using the Grading of Recommendation Assessment Development and Evaluation system. This study does not require ethical approval. The results of this systematic review and meta-analysis with and without meta-regression will be disseminated through conference presentation and publication in a peer-reviewed journal. CRD42016041924. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.
Chatterjee, Pranab; Bhaumik, Soumyadeep; Chauhan, Abhimanyu Singh; Kakkar, Manish
Zoonotic and emerging infectious diseases (EIDs) represent a public health threat that has been acknowledged only recently although they have been on the rise for the past several decades. On an average, every year since the Second World War, one pathogen has emerged or re-emerged on a global scale. Low/middle-income countries such as India bear a significant burden of zoonotic and EIDs. We propose that the creation of a database of published, peer-reviewed research will open up avenues for evidence-based policymaking for targeted prevention and control of zoonoses. A large-scale systematic mapping of the published peer-reviewed research conducted in India will be undertaken. All published research will be included in the database, without any prejudice for quality screening, to broaden the scope of included studies. Structured search strategies will be developed for priority zoonotic diseases (leptospirosis, rabies, anthrax, brucellosis, cysticercosis, salmonellosis, bovine tuberculosis, Japanese encephalitis and rickettsial infections), and multiple databases will be searched for studies conducted in India. The database will be managed and hosted on a cloud-based platform called Rayyan. Individual studies will be tagged based on key preidentified parameters (disease, study design, study type, location, randomisation status and interventions, host involvement and others, as applicable). The database will incorporate already published studies, obviating the need for additional ethical clearances. The database will be made available online, and in collaboration with multisectoral teams, domains of enquiries will be identified and subsequent research questions will be raised. The database will be queried for these and resulting evidence will be analysed and published in peer-reviewed journals. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise
Full Text Available Although it has been demonstrated that visceral adipose tissue content and serum levels of adiponectin are associated with metabolic syndrome, their predictive potential for the development of metabolic syndrome remains to be elucidated.We studied 1,130 participants of the Seoul Metabolic Syndrome cohort. A total of 337 subjects without metabolic syndrome underwent the follow-up evaluation and finally analyzed. Visceral fat area (VFA was measured using dual bioelectrical impedance analysis. We compared the 1-year incidence rate of metabolic syndrome among four different groups: Group 1 (high adiponectin level and low VFA, Group 2 (low adiponectin level and low VFA, Group 3 (high adiponectin level and high VFA and Group 4 (low adiponectin level and high VFA.Median follow-up duration was 17 months. Cut-off points of adiponectin level and VFA for metabolic syndrome were 7.34 ng/ml and 84 cm2 for men, and 12.55 and 58 cm2 ng/ml for women, respectively. The incidence of metabolic syndrome was the highest in Group 4 (Group 1; 16.47%, Group 2; 22.08%, Group 3; 25%, and Group 4; 46.15%, p<0.001. Adjusted logistic regression analyses for metabolic syndrome prediction demonstrated that Group 4 exhibited the highest odds ratio compared with Group 1 (4.918 [2.05-11.795], which was predominantly affected by waist circumference and serum triglyceride levels. Notably, triglyceride/high-density lipoprotein cholesterol (TG/HDL ratio was significantly higher in Group 4 (p = 0.017.Incidence rate of metabolic syndrome was the highest in subjects with low serum adiponectin levels and high visceral fat area. Higher TG/HDL ratio in these subjects suggested insulin resistance may contribute to the development of metabolic syndrome.
Full Text Available Background: Congenital talipes equinovarus (CTEV or clubfoot is a common pediatric congenital foot deformity that occurs 1 in 1,000 live births. Clubfoot is characterized by four types of foot deformities: hindfoot equinus; midfoot cavus; forefoot adductus; and hindfoot varus. A structured assessment method for clubfoot is essential for quantifying the initial severity of clubfoot deformity and recording the progress of clubfoot intervention.Aim: This study aims to develop a three-dimensional (3D assessment method to evaluate the initial severity of the clubfoot and monitor the structural changes of the clubfoot after each casting intervention. In addition, this study explores the relationship between the thermophysiological changes in the clubfoot at each stage of the casting intervention and in the normal foot.Methods: In this study, a total of 10 clubfoot children who are <2 years old will be recruited. Also, the data of the unaffected feet of a total of 10 children with unilateral clubfoot will be obtained as a reference for normal feet. A Kinect 3D scanner will be used to collect the 3D images of the clubfoot and normal foot, and an Infrared thermography camera (IRT camera will be used to collect the thermal images of the clubfoot. Three-dimensional scanning and IR imaging will be performed on the foot once a week before casting. In total, 6–8 scanning sessions will be performed for each child participant. The following parameters will be calculated as outcome measures to predict, monitor, and quantify the severity of the clubfoot: Angles cross section parameters, such as length, width, and the radial distance; distance between selected anatomical landmarks, and skin temperature of the clubfoot and normal foot. The skin temperature will be collected on selected areas (forefoot, mid foot, and hindfoot to find out the relationship between the thermophysiological changes in the clubfoot at each stage of the casting treatment and in the
Durham, Justin; Breckons, Matthew; Araujo-Soares, Vera; Exley, Catherine; Steele, Jimmy; Vale, Luke
Pain affecting the face or mouth and lasting longer than three months ("chronic orofacial pain", COFP) is relatively common in the UK. This study aims to describe and model current care pathways for COFP patients, identify areas where current pathways could be modified, and model whether these changes would improve outcomes for patients and use resources more efficiently. The study takes a prospective operations research approach. A cohort of primary and secondary care COFP patients (n = 240) will be recruited at differing stages of their care in order to follow and analyse their journey through care. The cohort will be followed for two years with data collected at baseline 6, 12, 18, and 24 months on: 1) experiences of the care pathway and its impacts; 2) quality of life; 3) pain; 4) use of health services and costs incurred; 5) illness perceptions. Qualitative in-depth interviews will be used to collect data on patient experiences from a purposive sub-sample of the total cohort (n = 30) at baseline, 12 and 24 months. Four separate appraisal groups (public, patient, clincian, service manager/commissioning) will then be given data from the pathway analysis and asked to determine their priority areas for change. The proposals from appraisal groups will inform an economic modelling exercise. Findings from the economic modelling will be presented as incremental costs, Quality Adjusted Life Years (QALYs), and the incremental cost per QALY gained. At the end of the modelling a series of recommendations for service change will be available for implementation or further trial if necessary. The recent white paper on health and the report from the NHS Forum identified chronic conditions as priority areas and whilst technology can improve outcomes, so can simple, appropriate and well-defined clinical care pathways. Understanding the opportunity cost related to care pathways benefits the wider NHS. This research develops a method to help design efficient systems built
Vandenplas, Yvan; Szajewska, Hania; Benninga, Marc; Di Lorenzo, Carlo; Dupont, Christophe; Faure, Christophe; Miqdadi, Mohamed; Osatakul, Seksit; Ribes-Konickx, Carmen; Saps, Miguel; Shamir, Raanan; Staiano, Annamaria
The Bristol Stool Form Scale (BSS) which consists of 7 photographs of different stool forms allows assessment of stool consistency (scale 1 for hard lumps to scale 7 for watery stools), in an objective manner in adults. The BSS is also sometimes used to characterise the stools of infants and young children. Despite its use, there is general agreement among paediatric gastroenterologists that the BSS is not adequate to be used in infants and young children who wear diapers; thus, a new scale specifically designed for this population is needed. Our aim is to develop a paediatric stool scale, the Brussels Infant and Toddler Stool Scale ('BITSS'), and to evaluate the interobserver agreement of stool assessment with the BITSS between the patient's parent and healthcare providers (physicians and nurses). This study has two phases. In the first phase, 11 key-opinion leaders in the field of paediatric gastroenterology representing different areas of the world selected seven coloured photographs of infants and/or young children wearing diapers to match the original descriptors of the BSS. The selected photographs were used to create a new scale in which the drawings of stools of the BSS were replaced by infant/toddlers stool photographs. In phase II, we aim at demonstrating that parents, nurses and primary healthcare physicians interpret the stool-pictures of the BITSS with a high degree of consensus and that the agreement is independent of whether it is a parent or a healthcare provider. Interobserver variability of stool assessment with the BITSS between the patient's parent and healthcare providers will be assessed. The study will be approved by the Ethics Committee of the participating centres. The findings of this study will be submitted to a peer-reviewed journal. Abstracts will be submitted to national and international conferences. NCT02913950. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go
Lane, Christopher A; Parker, Thomas D; Cash, Dave M; Macpherson, Kirsty; Donnachie, Elizabeth; Murray-Smith, Heidi; Barnes, Anna; Barker, Suzie; Beasley, Daniel G; Bras, Jose; Brown, David; Burgos, Ninon; Byford, Michelle; Jorge Cardoso, M; Carvalho, Ana; Collins, Jessica; De Vita, Enrico; Dickson, John C; Epie, Norah; Espak, Miklos; Henley, Susie M D; Hoskote, Chandrashekar; Hutel, Michael; Klimova, Jana; Malone, Ian B; Markiewicz, Pawel; Melbourne, Andrew; Modat, Marc; Schrag, Anette; Shah, Sachit; Sharma, Nikhil; Sudre, Carole H; Thomas, David L; Wong, Andrew; Zhang, Hui; Hardy, John; Zetterberg, Henrik; Ourselin, Sebastien; Crutch, Sebastian J; Kuh, Diana; Richards, Marcus; Fox, Nick C; Schott, Jonathan M
Increasing age is the biggest risk factor for dementia, of which Alzheimer's disease is the commonest cause. The pathological changes underpinning Alzheimer's disease are thought to develop at least a decade prior to the onset of symptoms. Molecular positron emission tomography and multi-modal magnetic resonance imaging allow key pathological processes underpinning cognitive impairment - including β-amyloid depostion, vascular disease, network breakdown and atrophy - to be assessed repeatedly and non-invasively. This enables potential determinants of dementia to be delineated earlier, and therefore opens a pre-symptomatic window where intervention may prevent the onset of cognitive symptoms. This paper outlines the clinical, cognitive and imaging protocol of "Insight 46", a neuroscience sub-study of the MRC National Survey of Health and Development. This is one of the oldest British birth cohort studies and has followed 5362 individuals since their birth in England, Scotland and Wales during one week in March 1946. These individuals have been tracked in 24 waves of data collection incorporating a wide range of health and functional measures, including repeat measures of cognitive function. Now aged 71 years, a small fraction have overt dementia, but estimates suggest that ~1/3 of individuals in this age group may be in the preclinical stages of Alzheimer's disease. Insight 46 is recruiting 500 study members selected at random from those who attended a clinical visit at 60-64 years and on whom relevant lifecourse data are available. We describe the sub-study design and protocol which involves a prospective two time-point (0, 24 month) data collection covering clinical, neuropsychological, β-amyloid positron emission tomography and magnetic resonance imaging, biomarker and genetic information. Data collection started in 2015 (age 69) and aims to be completed in 2019 (age 73). Through the integration of data on the socioeconomic environment and on physical
Full Text Available In recent years the impact of animal disease on human societies has had an extremely high profile, with the spread of diseases such as Bovine Spongiform Encephalopathy (BSE and foot and mouth among animal populations, as well as the transmission of diseases such as Human Immunodeficiency Virus (HIV, Ebola and Severe Acute Respiratory Syndrome (SARS from animal to human populations. The social and economic impact of such illnesses has been profound. However, studies on the effect of animal disease in past human populations have been widely neglected. This is partly due to the inconsistent manner in which instances of animal disease (palaeopathology are recorded, diagnosed and interpreted which, together with the typically low incidence of specimens per site, has precluded detailed studies of regional or temporal trends. This article outlines the archaeological rationale behind developing a generic methodology to enable the consistent recognition, recording and description of animal palaeopathological data. Furthermore, the experience of palaeopathologists concerned with human populations has been drawn upon to develop a downloadable, stand-alone recording system to facilitate the recording of animal palaeopathological data and enable questions concerning past animal health and disease to be better explored in future.
Gómez-Puerta, José A; Martín, Helena; Amigo, Mary-Carmen; Aguirre, Maria A; Camps, Maria T; Cuadrado, Maria J; Hughes, Graham R V; Khamashta, Munther A
We retrospectively studied a large cohort of patients with primary antiphospholipid syndrome (APS) from 4 different referral centers to analyze the clinical and serologic features and, specifically, to determine the number of patients going on to develop systemic lupus erythematosus (SLE) or other autoimmune disease after long-term follow-up. The study included 128 unselected patients with primary APS who fulfilled the Sapporo International Criteria from 4 different tertiary hospitals in the United Kingdom, Mexico, and Spain. The patients had attended the referral centers between January 1987 and July 2001. We reviewed clinical and serologic characteristics according to a pre-established protocol. We used univariate analysis with the chi-squared or Fisher exact test and logistic regression to analyze possible factors related to the coexistence of SLE and APS. Ninety-seven female and 31 male patients fulfilled the criteria, with a median age of 42 +/- 12 years (range, 16-79 yr), and with a mean follow-up of 9 +/- 3 years (range, 2-15 yr). The main manifestations included deep vein thrombosis in 62 patients (48%), arterial thrombosis in 63 (49%) patients, pregnancy loss in 177/320 (55%) cases, and pulmonary embolism in 37 (30%) patients. Other clinical manifestations were migraine in 51 (40%) patients, thrombocytopenia in 48 (38%), livedo reticularis in 47 (37%), and valvular disease in 27 (21%). Serologic findings were anticardiolipin antibodies (aCL) IgG positive in 110 (86%) patients, aCL IgM in 36 (39%), lupus anticoagulant in 71 (65%), antinuclear antibodies in 47 (37%), and positive Coombs test in 5 (4%) patients. During the follow-up and after a median disease duration of 8.2 years (range, 1-14 yr), 11 (8%) patients developed SLE, 6 (5%) developed lupus-like disease, and 1 (1%) developed myasthenia gravis. The remaining 110 patients (86%) continued to have primary APS. After the univariate analysis, a family history of lupus, the presence of Raynaud phenomenon
Jaqueline Brito Vidal Batista
Full Text Available This study aimed to investigate the understanding of medical teaching professionals about Burnout Syndrome. This is a qualitative, exploratory study, consisting of ten teaching physicians, who work at the hospital of a higher education institution. The data were collected from May to June 2013, through a form with questions pertinent to the proposed research objective, after approval by the Research Ethics Committee (Protocol No. 84022, and analyzed qualitatively, through the content analysis technique (Bardin. Among the 10 participants in the study, eight had adequate knowledge about Burnout Syndrome, while others showed insufficient knowledge. From the empirical material analysis, five thematic categories emerged: Syndrome characterized by physical and psychological exhaustion due to work stress; Physical and psychological signs and symptoms of Burnout Syndrome; Burnout syndrome and its implications for the worker’s health; The most vulnerable workers who develop Burnout Syndrome and Relation of Burnout Syndrome to the work of the teaching physician. The study showed that most participants in the research adequately understand Burnout Syndrome, but the subject is still little explored in academia. Therefore, intervention measures are necessary with the professionals of the risk group and new studies that contribute to expand the knowledge about that syndrome, aiming to improve the quality of life of the workers. Keywords: Worker’s Health; Professional Exhaustion; Doctors; Professors; Work Conditions. DOI: http://dx.doi.org/10.3823/2397
Zhang, Xinghe; Guo, Taipin; Zhu, Bowen; Gao, Qing; Wang, Hourong; Tai, Xiantao; Jing, Fujie
Preterm infants are babies born alive before 37 weeks. Many survived infants concomitant with defects of growth and development, a lifetime of disability usually as following when insufficient intervention. In early intervention of preterm infants, pediatric Tuina shows good effect in many Chinese and some English clinical trials. This systematic review is aimed to evaluate the efficacy and safety of pediatric Tuina for promoting growth and development of preterm infants. The electronic databases of Cochrane Library, MEDLINE, EBASE, Web of Science, Springer, World Health Organization International Clinical Trials Registry Platform, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, Wan-fang database, Chinese Scientific Journal Database, and other databases will be searched from establishment to April 1, 2018. All published randomized controlled trials (RCTs) about this topic will be included. Two independent researchers will operate article retrieval, screening, quality evaluation, and data analyses by Review Manager (V.5.3.5). Meta-analyses, subgroup analysis, and/or descriptive analysis will be performed based on included data conditions. High-quality synthesis and/or descriptive analysis of current evidence will be provided from weight increase, motor development, neuropsychological development, length of stay, days of weight recovery to birthweight, days on supplemental oxygen, daily sleep duration, and side effects. This study will provide the evidence of whether pediatric Tuina is an effective early intervention for preterm infants. There is no requirement of ethical approval and informed consent, and it will be in print or published by electronic copies. This systematic review protocol has been registered in the PROSPERO network (No. CRD42018090563).
Bodei, Chiara; Buchholtz, Mikael; Degano, Pierpablo
We perform a systematic expansion of protocol narrations into terms of a process algebra in order to make precise some of the detailed checks that need to be made in a protocol. We then apply static analysis technology to develop an automatic validation procedure for protocols. Finally, we...
Oliveira, Renata Maria Souza; Franceschini, Sylvia do Carmo Castro; Rosado, Gilberto Paixão; Priore, Silvia Eloiza
The increase in the prevalence of excess weight among people of increasingly younger age groups may lead to the early development of cardiovascular risks. To investigate the prevalence of the metabolic syndrome among young adults and the impact of birth conditions and nutritional status during adolescence on this disorder. One hundred individuals were evaluated at three different stages of life. By consulting the database of people enlisted in the army reserve military service, data were collected on weight, height, and waist circumference of all draftees of 1996, 1997, and 1999 in order to analyze their nutritional status during adolescence. Using the same database, information was sought at the maternity on their birth conditions and the adult individuals were identified. Anthropometric and biochemical data were obtained from these adults. The Metabolic Syndrome (MS) was classified according to ATP III NCEP. Body fat percentage was assessed with bioelectrical impedance and the statistical analysis was performed using the Sigma Stat 2.0 software. Prevalence of the MS was detected in 13% of the individuals. The birth conditions showed no relationship with the syndrome. In adolescence, those individuals diagnosed with MS had greater values for weight (11 kg; p =<0.001), WC (8 cm; p < 0.001), and BMI (2.5 kg/m(2); p= 0.002). A significant part of the risk factors for cardiovascular conditions starts during childhood and adolescence, and is likely to persist throughout life; therefore, primary prevention measures are critical in the context of cardiovascular disease.
Borhan Haghighi, A; Khosropanah, H; Vahidnia, F; Esmailzadeh, S; Emami, Z
Carpal tunnel syndrome (CTS) is an important cause of work disability. There is controversy over the relation between carpal tunnel syndrome and occupation. The aim of this study was to assess the relationship between the time-span of practicing dentistry and the role of dominant hands in the development of carpal tunnel syndrome. In this descriptive cross sectional study, 40 dentists and dental students (15 women and 25 men) undertook the electroneuro-diagnostic test in both hands by an electromyogram (EMG) and they were also evaluated in terms of self- reported clinical symptoms. 17.5% of participants were diagnosed to have decreased nerve conduction velocity while10% had reported clinical symptoms of CTS. Both dominant and non-dominant hands were involved. Within cases who were diagnosed as having median nerve neuropathy, 87.5% worked more than 20 hours per week. 57% had 17-23 years of dental practice experience and 14.2% of cases had10-16 years of practice in dentistry. The high rate of CTS symptoms, in both dominant and non-dominant hand among dental practitioners with more years of dental practice, indicates a prequisite for particular attention, then sufficient education on the major risk factors causing this problem. Early diagnosis of these symptoms may improve the future management of the disease.
Pontari, Michel; Giusto, Laura
To describe new developments in the diagnosis and treatment of chronic prostatitis/chronic pelvic pain syndrome (CPPS). Symptoms in men with chronic prostatitis/CPPS appear to cluster into a group with primarily pelvic or localized disease, and a group with more systemic symptoms. Several other chronic pain conditions can be associated with chronic prostatitis/CPPS, including irritable bowel syndrome, fibromyalgia, and chronic fatigue syndrome. Markers of neurologic inflammation and autoimmune disease parallel changes in symptoms after treatment. Treatment options include new alpha-blockers, psychological intervention, and prostate-directed therapy. The areas of acupuncture and pelvic floor physical therapy/myofascial release have received increased recent attention and appear to be good options in these patients. Future therapy may include antibodies to mediators of neurogenic inflammation and even treatment of bacteria in the bowel. The diagnosis of chronic prostatitis/CPPS must include conditions traditionally outside the scope of urologic practice but important for the care of men with chronic pelvic pain. The treatment is best done using multiple simultaneous therapies aimed at the different aspects of the condition.
Fatigue Intervention by Nurses Evaluation – The FINE Trial. A randomised controlled trial of nurse led self-help treatment for patients in primary care with chronic fatigue syndrome: study protocol. [ISRCTN74156610
Full Text Available Abstract Background Chronic fatigue syndrome, also known as ME (CFS/ME, is a condition characterised primarily by severe, disabling fatigue, of unknown origin, which has a poor prognosis and serious personal and economic consequences. Evidence for the effectiveness of any treatment for CFS/ME in primary care, where most patients are seen, is sparse. Recently, a brief, pragmatic treatment for CFS/ME, based on a physiological dysregulation model of the condition, was shown to be successful in improving fatigue and physical functioning in patients in secondary care. The treatment involves providing patients with a readily understandable explanation of their symptoms, from which flows the rationale for a graded rehabilitative plan, developed collaboratively with the therapist. The present trial will test the effectiveness and cost-effectiveness of pragmatic rehabilitation when delivered by specially trained general nurses in primary care. We selected a client-centred counselling intervention, called supportive listening, as a comparison treatment. Counselling has been shown to be as effective as cognitive behaviour therapy for treating fatigue in primary care, is more readily available, and controls for supportive therapist contact time. Our control condition is treatment as usual by the general practitioner (GP. Methods and design This study protocol describes the design of an ongoing, single-blind, pragmatic randomized controlled trial of a brief (18 week self-help treatment, pragmatic rehabilitation, delivered by specially trained nurse-therapists in patients' homes, compared with nurse-therapist delivered supportive listening and treatment as usual by the GP. An economic evaluation, taking a societal viewpoint, is being carried out alongside the clinical trial. Three adult general nurses were trained over a six month period to deliver the two interventions. Patients aged over 18 and fulfilling the Oxford criteria for CFS are assessed at baseline
Fatigue Intervention by Nurses Evaluation--the FINE Trial. A randomised controlled trial of nurse led self-help treatment for patients in primary care with chronic fatigue syndrome: study protocol. [ISRCTN74156610].
Wearden, A J; Riste, L; Dowrick, C; Chew-Graham, C; Bentall, R P; Morriss, R K; Peters, S; Dunn, G; Richardson, G; Lovell, K; Powell, P
Chronic fatigue syndrome, also known as ME (CFS/ME), is a condition characterised primarily by severe, disabling fatigue, of unknown origin, which has a poor prognosis and serious personal and economic consequences. Evidence for the effectiveness of any treatment for CFS/ME in primary care, where most patients are seen, is sparse. Recently, a brief, pragmatic treatment for CFS/ME, based on a physiological dysregulation model of the condition, was shown to be successful in improving fatigue and physical functioning in patients in secondary care. The treatment involves providing patients with a readily understandable explanation of their symptoms, from which flows the rationale for a graded rehabilitative plan, developed collaboratively with the therapist. The present trial will test the effectiveness and cost-effectiveness of pragmatic rehabilitation when delivered by specially trained general nurses in primary care. We selected a client-centred counselling intervention, called supportive listening, as a comparison treatment. Counselling has been shown to be as effective as cognitive behaviour therapy for treating fatigue in primary care, is more readily available, and controls for supportive therapist contact time. Our control condition is treatment as usual by the general practitioner (GP). This study protocol describes the design of an ongoing, single-blind, pragmatic randomized controlled trial of a brief (18 week) self-help treatment, pragmatic rehabilitation, delivered by specially trained nurse-therapists in patients' homes, compared with nurse-therapist delivered supportive listening and treatment as usual by the GP. An economic evaluation, taking a societal viewpoint, is being carried out alongside the clinical trial. Three adult general nurses were trained over a six month period to deliver the two interventions. Patients aged over 18 and fulfilling the Oxford criteria for CFS are assessed at baseline, after the intervention, and again one year later
... that contain aspirin. Some hospitals and medical facilities conduct newborn screenings for fatty acid oxidation disorders to determine which children are at greater risk of developing Reye's syndrome. ...
... See More About Research The NINDS supports and conducts research on neurogenetic disorders such as Angelman syndrome, to develop techniques to diagnose, treat, ... Publications Definition Angelman ...
Full Text Available Abstract Background Down syndrome is a chromosomal disorder caused by the presence of three copies of chromosome 21. The mechanisms by which this aneuploidy produces the complex and variable phenotype observed in people with Down syndrome are still under discussion. Recent studies have demonstrated an increased transcript level of the three-copy genes with some dosage compensation or amplification for a subset of them. The impact of this gene dosage effect on the whole transcriptome is still debated and longitudinal studies assessing the variability among samples, tissues and developmental stages are needed. Results We thus designed a large scale gene expression study in mice (the Ts1Cje Down syndrome mouse model in which we could measure the effects of trisomy 21 on a large number of samples (74 in total in a tissue that is affected in Down syndrome (the cerebellum and where we could quantify the defect during postnatal development in order to correlate gene expression changes to the phenotype observed. Statistical analysis of microarray data revealed a major gene dosage effect: for the three-copy genes as well as for a 2 Mb segment from mouse chromosome 12 that we show for the first time as being deleted in the Ts1Cje mice. This gene dosage effect impacts moderately on the expression of euploid genes (2.4 to 7.5% differentially expressed. Only 13 genes were significantly dysregulated in Ts1Cje mice at all four postnatal development stages studied from birth to 10 days after birth, and among them are 6 three-copy genes. The decrease in granule cell proliferation demonstrated in newborn Ts1Cje cerebellum was correlated with a major gene dosage effect on the transcriptome in dissected cerebellar external granule cell layer. Conclusion High throughput gene expression analysis in the cerebellum of a large number of samples of Ts1Cje and euploid mice has revealed a prevailing gene dosage effect on triplicated genes. Moreover using an enriched cell
L.G. Jiskoot (Geranne); S.H. Benneheij (Sofie); A. Beerthuizen (Annemerle); J.E. de Niet; C. de Klerk (Cora); R. Timman (Reinier); J.J. van Busschbach (Jan); J.S.E. Laven (Joop)
textabstractBackground: Obesity in women with polycystic ovary syndrome (PCOS) negatively affects all clinical features, and a 5 to 10% weight loss has shown promising results on reproductive, metabolic and psychological level. Incorporating a healthy diet, increasing physical activity and changing
Schijvens, A. M.; Dorresteijn, E. M.; Roeleveld, N.; ter Heine, R.; van Wijk, J. A. E.; Bouts, A. H. M.; Keijzer-Veen, M. G.; van de Kar, N. C. A. J.; van den Heuvel, L. P. W. J.; Schreuder, M. F.
Introduction Oral corticosteroids are the first-line treatment for idiopathic childhood nephrotic syndrome. Most children experience several relapses, needing repeated courses of corticosteroid therapy. This exposes them to side effects and long-term complications. For most patients, long-term
Schijvens, A M; Dorresteijn, Eiske M.; Roeleveld, N.; ter Heine, R.; van Wijk, Joanna A E; Bouts, Antonia H M; Keijzer-Veen, M G; van de Kar, Nicole C A J; van den Heuvel, L P W J; Schreuder, M F
INTRODUCTION: Oral corticosteroids are the first-line treatment for idiopathic childhood nephrotic syndrome. Most children experience several relapses, needing repeated courses of corticosteroid therapy. This exposes them to side effects and long-term complications. For most patients, long-term
Schijvens, A.M.; Dorresteijn, E.M.; Roeleveld, N.; Heine, R. ter; Wijk, J.A. van; Bouts, A.H.M.; Keijzer-Veen, M.G.; Kar, N.C.A.J. van de; Heuvel, L.P.W.J. van den; Schreuder, M.F.
INTRODUCTION: Oral corticosteroids are the first-line treatment for idiopathic childhood nephrotic syndrome. Most children experience several relapses, needing repeated courses of corticosteroid therapy. This exposes them to side effects and long-term complications. For most patients, long-term
Watson, Dennis P; Young, Jeani; Ahonen, Emily; Xu, Huiping; Henderson, Macey; Shuman, Valery; Tolliver, Randi
There is currently a lack of scientifically designed and tested implementation strategies. Such strategies are particularly important for highly complex interventions that require coordination between multiple parts to be successful. This paper presents a protocol for the development and testing of an implementation strategy for a complex intervention known as the Housing First model (HFM). Housing First is an evidence-based practice for chronically homeless individuals demonstrated to significantly improve a number of outcomes. Drawing on practices demonstrated to be useful in implementation and e-learning theory, our team is currently adapting a face-to-face implementation strategy so that it can be delivered over a distance. Research activities will be divided between Chicago and Central Indiana, two areas with significantly different barriers to HFM implementation. Ten housing providers (five from Chicago and five from Indiana) will be recruited to conduct an alpha test of each of four e-learning modules as they are developed. Providers will be requested to keep a detailed log of their experience completing the modules and participate in one of two focus groups. After refining the modules based on alpha test results, we will test the strategy among a sample of four housing organizations (two from Chicago and two from Indiana). We will collect and analyze both qualitative and quantitative data from administration and staff. Measures of interest include causal factors affecting implementation, training outcomes, and implementation outcomes. This project is an important first step in the development of an evidence-based implementation strategy to increase scalability and impact of the HFM. The project also has strong potential to increase limited scientific knowledge regarding implementation strategies in general.
Muhammad Amjad Nawaz
Full Text Available Extraction of deoxyribose nucleic acid (DNA from plants is preliminary step in molecular biology. Fast and cost effective genomic DNA isolation from Glycine species for downstream application is a major bottleneck. Here we report a high throughput and trouble free method for genomic DNA extraction from leaf and seeds of Glycine species with high quality and quantity. Protocol reports the optimization by employing different concentrations of CTAB and PVP in extraction buffer. Efficiency of optimized protocol was compared with frequently used DNA extraction methods. Wide adoptability and utility of this protocol was confirmed by DNA extraction from leaves as well as seeds of G. max, G. soja, G. tomentella and G. latifolia. Extracted DNA was successfully subjected to PCR amplification of five microsatellite markers and four putative glycosyltransferase genes. DNA extraction protocol is reproducible, trouble free, rapid and can be adopted for plant molecular biology applications.
Evaluating a community-based early childhood education and development program in Indonesia: study protocol for a pragmatic cluster randomized controlled trial with supplementary matched control group
Pradhan, M.; Brinkman, S.A.; Beatty, A.; Maika, A.; Satriawan, E.; de Ree, J.; Hasan, A.
Background This paper presents the study protocol for a pragmatic cluster randomized controlled trial (RCT) with a supplementary matched control group. The aim of the trial is to evaluate a community-based early education and development program launched by the Government of Indonesia. The program
Evaluating a community-based early childhood education and development program in Indonesia: study protocol for a pragmatic cluster randomized controlled trial with supplementary matched control group
Pradhan, M.P.; Brinkman, S.A.; Beatty, A.; Maika, A.; Satriawan, E.; de Ree, J.; Hasan, A.
Background: This paper presents the study protocol for a pragmatic cluster randomized controlled trial (RCT) with a supplementary matched control group. The aim of the trial is to evaluate a community-based early education and development program launched by the Government of Indonesia. The program
The present status of the toxicity assessment of industrial products in Latin America is well below North America/EC standards. As an example, most of Latin America regulatory laws regarding effluent discharge are still based upon concentration limits of certain major pollutants, and BOD/COD measurements; no reference is made to the necessity of aquatic bioassay toxicity data. Aware of this imperative need, the Venezuelan Petroleum Industry (PDVSA), through its R ampersand D Corporative branch (INTEVEP) gave priority to the development of standardized acute/sublethal toxicity test protocols as sound means of evaluating their products and wastes. Throughout this presentation, the Venezuelan case will be studied, showing strategies undertaken to accelerate protocol development. Results will show the assessment of 14 different protocols encompassing a variety of species of aquatic/terrestrial organisms, and a series of toxicity test endpoints including mortality, reproductive, biological and immunological measurements, most of which are currently in use or being developed. These protocols have already yielded useful results in numerous cases where toxicity assessment was required, including evaluations of effluent, oil dispersants, drilling fluids, toxic wastes, fossil fuels and newly developed products. The Venezuelan case demonstrates that the integration of Industry, Academia and Government, which is an essential part of SETAC's philosophy, is absolutely necessary for the successful advancement of environmental scientific/regulatory issues
Conclusions: We ensure that cryopreservation technology provided useful cell survivability, tissue and organ preservation in a proper way. Although it varies according to different laboratory conditions, it is certainly beneficial for patient′s treatment and research. Further studies are needed for standardization and development of new protocol.
Chrystiane Maria Veras Pôrto
Full Text Available Objective: To assess the effect of aquatic environment while an occupational therapeutic scenario in the development of body scheme of a child with Down Syndrome, considering the therapeutic properties of water. Description of the case: An interventionist research, with a qualitative and descriptive approach, conducted in an adapted pool of the Núcleo de Atenção Médica Integrada (NAMI of Fortaleza University (UNIFOR, Ceara, during the period of March to May, 2005. The subject of the study was a female child, aged 10 years old, diagnosed with Down Syndrome. Data collection had as instruments an interview guide for anamnesis, an evaluation form of psychomotor development, besides a field diary to record clinical observations during the sessions. This information was organized and analyzed based on clinical reasoning of occupational therapists and then described as a case study. We observed an evolution in the development of skills related to body scheme, such as the perception of fine parts of her own body, as well as large parts in someone else’s body, the imitation of positions, finishing with more active participation in activities of daily living. Final Considerations: We verified the effectiveness of occupational therapeutic activities conducted in aquatic environment for the development of the body scheme of the child in the study. This may be useful for conducting further research on the subject – whose literature is scarce – and contributing to the crescent update of occupational therapy practices.
Kirschner, A K T; Rameder, A; Schrammel, B; Indra, A; Farnleitner, A H; Sommer, R
Open cooling towers are frequent sources of infections with Legionella pneumophila. The gold standard for the detection of Leg. pneumophila is based on cultivation lasting up to 10 days and detecting only culturable cells. Alternative fluorescence in situ hybridization (FISH) protocols have been proposed, but they result in faint fluorescence signals and lack specificity because of cross-hybridization with other Legionella species. Our aim was thus to develop a new FISH protocol for rapid and specific detection of Leg. pneumophila in water samples. A novel catalysed reporter deposition FISH (CARD-FISH) protocol for the detection of Leg. pneumophila was developed, which significantly enhanced signal intensity as well as specificity of the probe through the use of a novel competitor probe. The developed protocol was compared with the culture method for monitoring the seasonal development of culturable and nonculturable Leg. pneumophila in two hospital cooling tower systems. Seasonal fluctuations of Leg. pneumophila concentrations detected via CARD-FISH were related to the development of the total bacterial community in both cooling towers, with temperature and biocide as the main factors controlling this development. Our results clearly showed that the majority of the Leg. pneumophila cells were in a nonculturable state. Thus, detection of Leg. pneumophila with culture methods may underestimate the total numbers of Leg. pneumophila present. Rapid, sensitive and specific detection and quantification of Leg. pneumophila in water systems is prerequisite for reliable risk estimation. The new protocol significantly improves current methodology and can be used to monitor and screen for Leg. pneumophila concentrations in cooling towers or other water systems. © 2012 The Authors. Journal of Applied Microbiology © 2012 The Society for Applied Microbiology.
Jung, Hee-Kyoung; Chung, EunJung; Lee, Byoung-Hee
[Purpose] To compare function, activity, participation, and quality of life of Down syndrome children and typically developing children according to age. [Subjects and Methods] A total of 16 Down syndrome children and 20 children with typical development were included as subjects for this study. International Classification of Functioning, Disability, and Health (ICF) Child and Youth version (CY) developed by the World Health Organization (WHO) and a questionnaire were used to measure children's functioning, activity, and participation. To measure quality of life, KIDSCREEN 52-HRQOL questionnaire was used in this study. [Results] ICF-CY function, activity, participation, and quality of life showed statistically significant differences between Down syndrome children and typically developing children. Down syndrome children with higher functions showed higher activities and participation. Higher function, activity and participation features were correlated with better quality of life. Higher function resulted in better quality of life. [Conclusion] Function, activity, participation, quality of life, and several common factors of Down syndrome children depend on the ability of children. Function of Down syndrome children affects their activity, participation, and quality of life. Activities and participations also affect quality of life. Therefore, children's functional aspect is the foundation for quality of life.
Patchett, C L; Srinivasan, V; Waterhouse, P J
To produce a working clinical protocol for pulp therapy techniques in the extensively carious primary molar. The International Agency for Research on Cancer has recently classified formaldehyde as carcinogenic to human beings. As such, a medicament that can be used to replace formocresol in clinical practice should be identified. Part I of this paper explored the currently available alternative interventions and materials to formocresol in the form of a narrative review following an extensive literature search. Part II now presents the formation of a specialist group to establish an evidence-based protocol, for the management of the extensively carious primary molar. A protocol and key points document have been developed to assist clinicians in their treatment planning. Areas for further postgraduate training are identified.
Jiskoot, G; Benneheij, S H; Beerthuizen, A; de Niet, J E; de Klerk, C; Timman, R; Busschbach, J J; Laven, J S E
Obesity in women with polycystic ovary syndrome (PCOS) negatively affects all clinical features, and a 5 to 10% weight loss has shown promising results on reproductive, metabolic and psychological level. Incorporating a healthy diet, increasing physical activity and changing dysfunctional thought patterns in women with PCOS are key points in losing weight. The biggest challenge in weight management programs is to achieve a reasonable and sustainable weight loss. The aim of this study is to explore whether Cognitive Behavioural Therapy (CBT) by a mental health professional, working in a multidisciplinary team with a dietician and a physical therapist (a three-component intervention), is more effective for weight loss in the long term, within 12 months. We will also explore whether mobile phone applications are effective in supporting behavioural change and sustainable weight loss. The present study is a longitudinal randomized controlled trial (RCT) to study the effectiveness of a three-component 1-year cognitive-behavioural lifestyle intervention in overweight/obese women with PCOS. A total of 210 participants are randomly assigned to three groups: 1) CBT provided by the multidisciplinary team or; 2) CBT provided by the multidisciplinary team and Short Message Service (SMS) or; 3) usual care: encourage weight loss through publicly available services (control group). The primary aim of the 12-month intervention is to explore whether a three-component 1-year cognitive-behavioural lifestyle intervention is effective to decrease weight, when compared to usual care. Secondary outcomes include: the effect of the intervention on the PCOS phenotype, waist circumference, waist to hip ratio, ovulation rates, total testosterone, SHBG, free androgen index (FAI), AMH, hirsutism, acne, fasting glucose, blood pressure and all psychological parameters. Additionally, we assessed time to pregnancy, ongoing pregnancies, clinical pregnancies, miscarriages and birth weight. All
The First Protocol Additional to the Geneva Conventions of 1949 and relating to the Protection of Victims of International Armed Conflicts contains provisions prohibiting indiscriminate attacks. Nuclear warfare as such is not mentioned in the Protocol. It has been asserted that the Protocol does not apply to nuclear weapons for several reasons. However, close analysis shows that the rules governing the application of means and methods of warfare cannot exempt the nuclear weapons. If nuclear weapons are applied in a manner not consistent with article 51 of Protocol I, their use is forbidden by this article even in situations in which general international law might grant an exception from the ban on nuclear weapons, as in the case of reprisal. (orig./HSCH) [de
Nishi, Fernanda Ayache; de Motta Maia, Flávia Oliveira; de Lopes Monteiro da Cruz, Dina Almeida
The objective of this review is to assess the sensitivity and specificity of the Manchester Triage System in the evaluation of adult patients with acute coronary syndrome in emergency departments. Acute coronary syndrome (ACS) is a group of clinical conditions that include myocardial infarction with or without elevation of the ST segment and unstable angina. The term acute myocardial infarction (AMI) can be applied when there is evidence of myocardium necrosis with a clinical sign compatible with myocardial ischaemia. Acute myocardial infarction can be identified using clinical methods including electrocardiography (ECG), elevation in myocardium necrosis biomarkers, and imaging. Acute myocardial infarction is one of the leading causes of death and disability worldwide, and may be the first manifestation of coronary artery disease.Estimating the prevalence of coronary diseases in the general population is quite a complex task. In 2010, the prevalence of coronary diseases was reported as 6.4% among the general population in the United States.One of the main manifestations of ACS is chest pain. However, even in the presence of this typical symptom, early diagnosis of ACS is a challenge for health care professionals who initially attend to these patients. Several authors have indicated the importance and difficulty of recognizing chest pain of cardiac origin, where immediate medical attention is required.Triage, or risk classification, is a clinical management tool used in emergency services to guide patient flow when the need for medical attention exceeds that available. The Manchester Triage Group was developed in 1994 in the United Kingdom. The aim was to establish a consensus among physicians and nurses in the emergency room by creating a triage pattern focused on the development of the following:Thus, the Manchester Triage System (MTS) was created. The MTS simplifies the clinical management of each patient, and consequently, the whole service, by utilizing a
Song, Yue-Fan; Qu, Yi; Cao, Xu-Peng; Zhang, Wei
Sponges (Porifera), as the best known source of bioactive marine natural products in metazoans, play a significant role in marine drug discovery and development. As sessile filter-feeding animals, a considerable portion of the sponge biomass can be made of endosymbiotic and associated microorganisms. Understanding the cellular origin of targeted bioactive compounds from sponges is therefore important not only for providing chemotaxonomic information but also for defining the bioactive production strategy in terms of sponge aquaculture, cell culture, or fermentation of associated bacteria. The two alkaloids debromohymenialdisine (DBH) and hymenialdisine (HD), which are cyclin-dependent kinase inhibitors with pharmacological activities for treating osteoarthritis and Alzheimer's disease, have been isolated from the sponge Axinella sp. In this study, the cellular localization of these two alkaloids was determined through the quantification of these alkaloids in different cell fractions by high-performance liquid chromatography (HPLC). First, using a differential centrifugation method, the dissociated cells were separated into different groups according to their sizes. The two bioactive alkaloids were mainly found in sponge cells obtained from low-speed centrifugation. Further cell purifications were accomplished by a newly developed multi-step protocol. Four enriched cell fractions (C1, C2, C3, and C4) were obtained and subjected to light and transmission electron microscopy, cytochemical staining, and HPLC quantification. Compared to the low concentrations in other cell fractions, DBH and HD accounted for 10.9% and 6.1%, respectively, of dry weight in the C1 fraction. Using the morphological characteristics and cytochemical staining results, cells in the C1 fraction were speculated to be spherulous cells. This result shows that DBH and HD in Axinella sp. are located in sponge cells and mostly stored in spherulous cells.
Wattanapisit, Apichai; Vijitpongjinda, Surasak; Saengow, Udomsak; Amaek, Waluka; Thanamee, Sanhapan; Petchuay, Prachyapan
Physical activity (PA) is important in promoting health, as well as in the treatment and prevention of diseases. However, insufficient PA is still a global health problem and it is also a problem in medical schools. PA training in medical curricula is still sparse or non-existent. There is a need for a comprehensive understanding of the extent of PA in medical schools through several indicators, including people, places and policies. This study includes a survey of the PA prevalence in a medical school and development of a tool, the Medical School Physical Activity Report Card (MSPARC), which will contain concise and understandable infographics and information for exploring, monitoring and reporting information relating to PA prevalence. This mixed methods study will run from January to September 2017. We will involve the School of Medicine, Walailak University, Thailand, and its medical students (n=285). Data collection will consist of both primary and secondary data, divided into four parts: general information, people, places and policies. We will investigate the PA metrics about (1) people: the prevalence of PA and sedentary behaviours; (2) place: the quality and accessibility of walkable neighbourhoods, bicycle facilities and recreational areas; and (3) policy: PA promotion programmes for medical students, education metrics and investments related to PA. The MSPARC will be developed using simple symbols, infographics and short texts to evaluate the PA metrics of the medical school. This study has been approved by the Human Research Ethics Committee of Walailak University (protocol number: WUEC-16-005-01). Findings will be published in peer-reviewed journals and presented at national or international conferences. The MSPARC and full report will be disseminated to relevant stakeholders, policymakers, staff and clients. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is
Al-Bagdady, Mohammad; Murphy, Paul J; Woodhouse, J Margaret
Previous studies have described the emmetropisation process as inactive in Down's syndrome (DS). However, these studies investigated only a small age range of children-either young children or teenagers. The present study aims to describe refractive error development and distribution in DS throughout childhood and early teenage years. Subjects were recruited from the Cardiff University Down's Syndrome Vision Research cohort. Refractive error was measured using Mohindra retinoscopy. Subjects were grouped into 15 yearly age groups to allow a cross-sectional assessment of refractive error distribution (n=182). Longitudinal refractive development was observed in 12 children with DS whose refractive error had been monitored throughout their childhood and teenage years. Children were hypermetropic, on average, at all ages, albeit with a wide variation in refractive errors. Change in power vector components, M, J(0) and J(45), and the presence of significant astigmatism (≥1.00 D) was assessed with age. There were no statistically significant difference in M and J(0) across age groups. However, there was a significant difference in J(45). Prevalence of significant oblique astigmatism increased with age and was highly prevalent (45%) in teenage years. Longitudinally, no significant change in refractive error was reported with regards to the spherical component. The results provide further evidence of the failure in the emmetropisation process in children with DS. Change in spherical refractive error is minimal throughout childhood and early adulthood. The children show a specific development of oblique astigmatism that may be suggestive of a mechanical induction through eyelids.
Chen, Li; Mullegama, Sureni V; Alaimo, Joseph T; Elsea, Sarah H
Smith-Magenis syndrome (SMS) is a complex genetic disorder characterized by sleep disturbance, multiple developmental anomalies, psychiatric behavior, and obesity. It is caused by a heterozygous 17p11.2 microdeletion containing the retinoic acid-induced 1 (RAI1) gene or mutation within RAI1. Sleep disorder is one of the most penetrant features of SMS. Molecular genetic studies indicate that RAI1 regulates circadian rhythm genes and when haploinsucient, causes a distorted molecular circadian network that may be the cause of the sleep disturbance and the inverted rhythm of melatonin present in most individuals with SMS. RAI1 also regulates genes involved in development, neurobehavior, and lipid metabolism. Sleep debt, daytime melatonin secretion, and environmental stress often contribute to negative behavior in persons with SMS, and food entrained circadian rhythm also influences food intake behavior and humoral signals, which also affect development and neurobehavior. The cross-talk between circadian rhythm, development, metabolism and behaviors affect the multiple phenotypic outcomes in Smith-Magenis syndrome. These findings shed light on possible effective and personalized drug treatments for SMS patients in the future.
Full Text Available Background. Common cold is one of the most frequently occurring illnesses in primary healthcare services and represents considerable disease burden. Common cold of Qi-deficiency syndrome (CCQDS is an important but less addressed traditional Chinese medicine (TCM pattern. We designed a protocol to explore the efficacy, safety, and optimal dose of Shen Guo Lao Nian Granule (SGLNG for treating CCQDS. Methods/Design. This is a multicenter, randomized, double-blind, placebo-controlled, phase II clinical trial. A total of 240 eligible patients will be recruited from five centers. Patients are randomly assigned to high-dose group, middle-dose group, low-dose group, or control group in a 1 : 1 : 1 : 1 ratio. All drugs are required to be taken 3 times daily for 5 days with a 5-day follow-up period. Primary outcomes are duration of all symptoms, total score reduction on Jackson’s scale, and TCM symptoms scale. Secondary outcomes include every single TCM symptom duration and score reduction, TCM main symptoms disappearance rate, curative effects, and comparison between Jackson’s scale and TCM symptom scale. Ethics and Trial Registration. This study protocol was approved by the Ethics Committee of Clinical Trials and Biomedicine of West China Hospital of Sichuan University (number IRB-2014-12 and registered with the Chinese Clinical Trial Registry (ChiCTR-IPR-15006349.
... it? Share Facebook Twitter Pinterest Email Print What causes Rett syndrome? Most cases of Rett syndrome are ... in the MECP2 gene represent the most prevalent causes of Rett syndrome. The development and severity of ...
Lorusso, M. L.; Galli, R.; Libera, L.; Gagliardi, C.; Borgatti, R.; Hollebrandse, B.
It is a matter of debate whether the development of theory of mind (ToM) depends on linguistic development or is, rather, an expression of cognitive development. The study of genetic syndromes, which are characterized by intellectual impairment as well as by different linguistic profiles, may
Lorusso, M. L.; Galli, R.; Libera, L.; Gagliardi, C.; Borgatti, R.; Hollebrandse, B.
It is a matter of debate whether the development of theory of mind (ToM) depends on linguistic development or is, rather, an expression of cognitive development. The study of genetic syndromes, which are characterized by intellectual impairment as well as by different linguistic profiles, may provide useful information with respect to this issue.…
Full Text Available AIM: A potential link between infectious agents and atherosclerosis has been suggested. Data obtained from several seroepidemiological studies have suggested that infection with Chlamydophila pneumoniae, Helicobacter pylori, and Cytomegalovirus can initiate or maintain the atherosclerotic process. Aim of this study is to evaluate the probable relationship between serum titers of some various infectious agents and the development of acute coronary syndrome and to investigate the relationship between these infectious agents and other risk factors of acute coronary syndrome (smoking, hypertension, dyslipidemia, diabetes, and family history of CVD. METHOD: This is a hospital based case- control study was conducted on two groups: patients group included 86 patients, cases were collected from patients admitted to Cardiac Care Unit (CCU of Cleopatra hospital, and Ain Shams University hospital with acute myocardial infarction between January 2010 and June 2010 and control group included 86 apparently healthy individuals. A questionnaire was designed to determine conventional coronary artery risk factors. The sero-prevalence of Chlamydia pneumoniae (C. pneumoniae, Cytomegalovirus and Helicobacter pylori (H. pylori IgG antibodies were evaluated using quantitative enzyme-linked immunosorbent assay (ELISA. RESULTS: The results showed that there was an increased level of serum IgG antibodies of C. pneumoniae, Cytomegalovirus and Helicobacter pylori among patients with acute coronary syndrome compared to control subjects CONCLUSION: C. pneumoniae, Cytomegalovirus and Helicobacter pylori were expected to be predictors for the development of coronary artery disease, as there was significant elevation of the serum level of IgG antibodies against them. [TAF Prev Med Bull 2011; 10(6.000: 715-722
Jiskoot, G.; Benneheij, S.H.; Beerthuizen, A.; de Niet, J.E.; de Klerk, C.; Timman, R.; Busschbach, J.J.; Laven, J.S.E
textabstractBackground: Obesity in women with polycystic ovary syndrome (PCOS) negatively affects all clinical features, and a 5 to 10% weight loss has shown promising results on reproductive, metabolic and psychological level. Incorporating a healthy diet, increasing physical activity and changing dysfunctional thought patterns in women with PCOS are key points in losing weight. The biggest challenge in weight management programs is to achieve a reasonable and sustainable weight loss. The ai...
Wee, B.; Car, N.; Percivall, G.; Allen, D.; Fitch, P. G.; Baumann, P.; Waldmann, H. C.
The Belmont Forum E-Infrastructure and Data Management Cooperative Research Agreement (CRA) is designed to foster a global community to collaborate on e-infrastructure challenges. One of the deliverables is an implementation plan to address global data infrastructure interoperability challenges and align existing domestic and international capabilities. Work package three (WP3) of the CRA focuses on the harmonization of global data infrastructure for sharing environmental data. One of the subtasks under WP3 is the development of user scenarios that guide the development of applicable deliverables. This paper describes the proposed protocol for user scenario development. It enables the solicitation of user scenarios from a broad constituency, and exposes the mechanisms by which those solicitations are evaluated against requirements that map to the Belmont Challenge. The underlying principle of traceability forms the basis for a structured, requirements-driven approach resulting in work products amenable to trade-off analyses and objective prioritization. The protocol adopts the ISO Reference Model for Open Distributed Processing (RM-ODP) as a top level framework. User scenarios are developed within RM-ODP's "Enterprise Viewpoint". To harmonize with existing frameworks, the protocol utilizes the conceptual constructs of "scenarios", "use cases", "use case categories", and use case templates as adopted by recent GEOSS Architecture Implementation Project (AIP) deliverables and CSIRO's eReefs project. These constructs are encapsulated under the larger construct of "user scenarios". Once user scenarios are ranked by goodness-of-fit to the Belmont Challenge, secondary scoring metrics may be generated, like goodness-of-fit to FutureEarth science themes. The protocol also facilitates an assessment of the ease of implementing given user scenario using existing GEOSS AIP deliverables. In summary, the protocol results in a trac