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Sample records for term five-year survival

  1. Long term (five-year survival following radical surgical treatment plus adjuvant chemotherapy (FAM in advanced gastric cancer: a controlled study

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    Bresciani Cláudio

    2000-01-01

    Full Text Available Several drugs and their associations are being used for adjuvant or complementary chemotherapy with the aim of improving results of gastric cancer treatment. The objective of this study was to verify the impact of these drugs on nutrition and on survival rate after radical treatment of 53 patients with gastric cancer in stage III of the TNM classification. A control group including 28 patients who had only undergone radical resection was compared to a group of 25 patients who underwent the same operative technique followed by adjuvant polychemotherapy with FAM (5-fluorouracil, Adriamycin, and mitomycin C. In this latter group, chemotherapy toxicity in relation to hepatic, renal, cardiologic, neurological, hematologic, gastrointestinal, and dermatological functions was also studied. There was no significant difference on admission between both groups in relation to gender, race, macroscopic tumoral type of tumor according to the Borrmann classification, location of the tumor in the stomach, length of the gastric resection, or response to cutaneous tests on delayed sensitivity. Chemotherapy was started on average, 2.3 months following surgical treatment. Clinical and laboratory follow-up of all patients continued for 5 years. The following conclusions were reached: 1 The nutritional status and incidence of gastrointestinal manifestation were similar in both groups; 2 There was no occurrence of cardiac, renal, neurological, or hepatic toxicity or death due to the chemotherapeutic method per se; 3 Dermatological alterations and hematological toxicity occurred exclusively in patients who underwent polychemotherapy; 4 There was no significant difference between the rate and site of tumoral recurrence, the disease-free interval, or the survival rate of both study groups; 5 Therefore, we concluded, after a 5-year follow-up, chemotherapy with the FAM regimen did not increase the survival rate.

  2. Five year survival analysis of an oxidised zirconium total knee arthroplasty.

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    Holland, Philip; Santini, Alasdair J A; Davidson, John S; Pope, Jill A

    2013-12-01

    Zirconium total knee arthroplasties theoretically have a low incidence of failure as they are low friction, hard wearing and hypoallergenic. We report the five year survival of 213 Profix zirconium total knee arthroplasties with a conforming all polyethylene tibial component. Data was collected prospectively and multiple strict end points were used. SF12 and WOMAC scores were recorded pre-operatively, at three months, at twelve months, at 3 years and at 5 years. Eight patients died and six were "lost to follow-up". The remaining 199 knees were followed up for five years. The mean WOMAC score improved from 56 to 35 and the mean SF12 physical component score improved from 28 to 34. The five year survival for failure due to implant related reasons was 99.5% (95% CI 97.4-100). This was due to one tibial component becoming loose aseptically in year zero. Our results demonstrate that the Profix zirconium total knee arthroplasty has a low medium term failure rate comparable to the best implants. Further research is needed to establish if the beneficial properties of zirconium improve long term implant survival. Copyright © 2012 Elsevier B.V. All rights reserved.

  3. Long-term outcomes five years after selective dorsal rhizotomy

    Directory of Open Access Journals (Sweden)

    Lagergren Jan

    2008-12-01

    Full Text Available Abstract Background Selective dorsal rhizotomy (SDR is a well accepted neurosurgical procedure performed for the relief of spasticity interfering with motor function in children with spastic cerebral palsy (CP. The goal is to improve function, but long-term outcome studies are rare. The aims of this study were to evaluate long-term functional outcomes, safety and side effects during five postoperative years in all children with diplegia undergoing SDR combined with physiotherapy. Methods This study group consisted of 35 children, consecutively operated, with spastic diplegia, of which 26 were Gross Motor Function Classification System (GMFCS levels III–V. Mean age was 4.5 years (range 2.5–6.6. They were all assessed by the same multidisciplinary team at pre- and at 6, 12, 18 months, 3 and 5 years postoperatively. Clinical and demographic data, complications and number of rootlets cut were prospectively registered. Deep tendon reflexes and muscle tone were examined, the latter graded with the modified Ashworth scale. Passive range of motion (PROM was measured with a goniometer. Motor function was classified according to the GMFCS and measured with the Gross Motor Function Measure (GMFM-88 and derived into GMFM-66. Parent's opinions about the children's performance of skills and activities and the amount of caregiver assistance were measured with Pediatric Evaluation Disability Inventory (PEDI. Results The mean proportion of rootlets cut in S2-L2 was 40%. Muscle tone was immediately reduced in adductors, hamstrings and dorsiflexors (p Conclusion SDR is a safe and effective method for reducing spasticity permanently without major negative side effects. In combination with physiotherapy, in a group of carefully selected and systematically followed young children with spastic diplegia, it provides lasting functional benefits over a period of at least five years postoperatively.

  4. Five-year survival in 309 patients with colorectal liver metastases treated with radiofrequency ablation

    International Nuclear Information System (INIS)

    Gillams, A.R.; Lees, W.R.

    2009-01-01

    There is little published long-term survival data for patients with colorectal liver metastases treated with radiofrequency ablation (RFA). We present a multivariate analysis of 5-year survival in 309 patients (198 male, aged 64 (24-92)) treated at 617 sessions. Our standard protocol used internally cooled electrodes introduced percutaneously under combined US and CT guidance/monitoring. The number and size of liver metastases, the presence and location of extrahepatic disease, primary resection, clinical, chemotherapy and follow-up data were recorded. Data analysis was performed using SPSS v.10. On multivariate analysis, significant survival factors were the presence of extrahepatic disease (p < 0.001) and liver tumour volume (p = 0.001). For 123 patients with five or less metastases of 5 cm or less maximum diameter and no extrahepatic disease median survival was 46 and 36 months from liver metastasis diagnosis and ablation, respectively; corresponding 3- and 5-year survival rates were 63%, 34% and 49%, 24%. Sixty-nine patients had three or less tumours of below 3.5 cm in diameter and their 5-year survival from ablation was 33%. There were 23/617(3.7%) local complications requiring intervention. Five-year survival of 24-33% post ablation in selected patients is superior to any published chemotherapy data and approaches the results of liver resection. (orig.)

  5. Original signs and symptoms in patients surviving five years after atomic bomb exposure under 1000 meters

    Energy Technology Data Exchange (ETDEWEB)

    Lewis, J J; Patterson, H A

    1959-01-01

    Atomic bomb victims in Hiroshima who were exposed under 1000 meters and survived over five years were reinvestigated. There were 619 patients who comprised a total sample. Mechanical, blast, burn and radiation injuries were evaluated as to onset, duration, severity, body area affected and type of healing. The modal patient experienced severe radiation and mild trauma. Results were compared with similar earlier studies. The question emerges as to the possibility that patients exposed within 1000 meters with radiation and/or thermal injuries have been dying at a faster rate than those with mechanical or no injuries. A short history of the development of the Atomic Bomb Casualty Commission is included. 17 references, 11 tables.

  6. Challenging a dogma: five-year survival does not equal cure in all colorectal cancer patients.

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    Abdel-Rahman, Omar

    2018-02-01

    The current study tried to evaluate the factors affecting 10- to 20- years' survival among long term survivors (>5 years) of colorectal cancer (CRC). Surveillance, Epidemiology and End Results (SEER) database (1988-2008) was queried through SEER*Stat program.Univariate probability of overall and cancer-specific survival was determined and the difference between groups was examined. Multivariate analysis for factors affecting overall and cancer-specific survival was also conducted. Among node positive patients (Dukes C), 34% of the deaths beyond 5 years can be attributed to CRC; while among M1 patients, 63% of the deaths beyond 5 years can be attributed to CRC. The following factors were predictors of better overall survival in multivariate analysis: younger age, white race (versus black race), female gender, Right colon location (versus rectal location), earlier stage and surgery (P <0.0001 for all parameters). Similarly, the following factors were predictors of better cancer-specific survival in multivariate analysis: younger age, white race (versus black race), female gender, Right colon location (versus left colon and rectal locations), earlier stage and surgery (P <0.0001 for all parameters). Among node positive long-term CRC survivors, more than one third of all deaths can be attributed to CRC.

  7. Sustainable development: five structural milestones for the next five-year term

    International Nuclear Information System (INIS)

    Demailly, Damien; Treyer, Sebastien; Levai, David; Laurans, Yann; Rochette, Julien

    2017-05-01

    The energy transition, climate change, biodiversity, agriculture... the French President, the government and the new majority appointed by the 2017 elections will need to make some important decisions about sustainable development over the next five-year term. Their agenda will be marked in particular by five key events, not only in France, but also at the European and international levels. These five events will be opportunities to adapt the French economy to the major challenges of the 21. century, those of a regulated globalization, combining prosperity, social protection and environmental protection

  8. Five year growth and survival of Eucalyptus hybrid clones in coastal ...

    African Journals Online (AJOL)

    -urophylla i.e. GU hybrids) and three local landraces (E. camaldulensis, E. tereticornis and E. urophylla) were established in Gede, Sokoke and Msambweni in the Coast province of Kenya in 2002, to compare growth, survival and adaptability ...

  9. Chemoembolization With Doxorubicin-Eluting Beads for Unresectable Hepatocellular Carcinoma: Five-Year Survival Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Malagari, Katerina, E-mail: kmalag@otonet.gr [University of Athens, Second Department of Radiology (Greece); Pomoni, Mary [University of Athens, Imaging and Research Unit (Greece); Moschouris, Hippocrates, E-mail: hipmosch@gmail.com [Tzanion Hospital, Department of Radiology (Greece); Bouma, Evanthia [University of Athens, Imaging and Research Unit (Greece); Koskinas, John [Ippokration Hospital, University of Athens, Department of Internal Medicine and Hepatology (Greece); Stefaniotou, Aspasia [University of Athens, Imaging and Research Unit (Greece); Marinis, Athanasios [Tzanion Hospital, Department of Surgery (Greece); Kelekis, Alexios; Alexopoulou, Efthymia [University of Athens, Second Department of Radiology (Greece); Chatziioannou, Achilles [University of Athens, First Department of Radiology (Greece); Chatzimichael, Katerina [University of Athens, Second Department of Radiology (Greece); Dourakis, Spyridon [Ippokration Hospital, University of Athens, Department of Internal Medicine and Hepatology (Greece); Kelekis, Nikolaos [University of Athens, Second Department of Radiology (Greece); Rizos, Spyros [Tzanion Hospital, Department of Surgery (Greece); Kelekis, Dimitrios [University of Athens, Imaging and Research Unit (Greece)

    2012-10-15

    Purpose: The purpose of this study was to report on the 5-year survival of hepatocellular carcinoma (HCC) patients treated with DC Bead loaded with doxorubicin (DEB-DOX) in a scheduled scheme in up to three treatments and thereafter on demand. Materials and Methods: 173 HCC patients not suitable for curable treatments were prospectively enrolled (mean age 70.4 {+-} 7.4 years). Child-Pugh (Child) class was A/B (102/71 [59/41 %]), Okuda stage was 0/1/2 (91/61/19 [53.2/35.7/11.1 %]), and mean lesion diameter was 7.6 {+-} 2.1 cm. Lesion morphology was one dominant {<=}5 cm (22 %), one dominant >5 cm (41.6 %), multifocal {<=}5 (26 %), and multifocal >5 (10.4 %). Results: Overall survival at 1, 2, 3, 4, and 5 years was 93.6, 83.8, 62, 41.04, and 22.5 %, with higher rates achieved in Child class A compared with Child class B patients (95, 88.2, 61.7, 45, and 29.4 % vs. 91.5, 75, 50.7, 35.2, and 12.8 %). Mean overall survival was 43.8 months (range 1.2-64.8). Cumulative survival was better for Child class A compared with Child class B patients (p = 0.029). For patients with dominant lesions {<=}5 cm 1-, 2-, 3-, 4-, and 5-year survival rates were 100, 95.2, 71.4, 66.6, and 47.6 % for Child class A and 94.1, 88.2, 58.8, 41.2, 29.4, and 23.5 % for Child class B patients. Regarding DEB-DOX treatment, multivariate analysis identified number of lesions (p = 0.033), lesion vascularity (p < 0.0001), initially achieved complete response (p < 0.0001), and objective response (p = 0.046) as significant and independent determinants of 5-year survival. Conclusion: DEB-DOX results, with high rates of 5-year survival for patients, not amenable to curative treatments. Number of lesions, lesion vascularity, and local response were significant independent determinants of 5-year survival.

  10. Chemoembolization With Doxorubicin-Eluting Beads for Unresectable Hepatocellular Carcinoma: Five-Year Survival Analysis

    International Nuclear Information System (INIS)

    Malagari, Katerina; Pomoni, Mary; Moschouris, Hippocrates; Bouma, Evanthia; Koskinas, John; Stefaniotou, Aspasia; Marinis, Athanasios; Kelekis, Alexios; Alexopoulou, Efthymia; Chatziioannou, Achilles; Chatzimichael, Katerina; Dourakis, Spyridon; Kelekis, Nikolaos; Rizos, Spyros; Kelekis, Dimitrios

    2012-01-01

    Purpose: The purpose of this study was to report on the 5-year survival of hepatocellular carcinoma (HCC) patients treated with DC Bead loaded with doxorubicin (DEB-DOX) in a scheduled scheme in up to three treatments and thereafter on demand. Materials and Methods: 173 HCC patients not suitable for curable treatments were prospectively enrolled (mean age 70.4 ± 7.4 years). Child-Pugh (Child) class was A/B (102/71 [59/41 %]), Okuda stage was 0/1/2 (91/61/19 [53.2/35.7/11.1 %]), and mean lesion diameter was 7.6 ± 2.1 cm. Lesion morphology was one dominant ≤5 cm (22 %), one dominant >5 cm (41.6 %), multifocal ≤5 (26 %), and multifocal >5 (10.4 %). Results: Overall survival at 1, 2, 3, 4, and 5 years was 93.6, 83.8, 62, 41.04, and 22.5 %, with higher rates achieved in Child class A compared with Child class B patients (95, 88.2, 61.7, 45, and 29.4 % vs. 91.5, 75, 50.7, 35.2, and 12.8 %). Mean overall survival was 43.8 months (range 1.2–64.8). Cumulative survival was better for Child class A compared with Child class B patients (p = 0.029). For patients with dominant lesions ≤5 cm 1-, 2-, 3-, 4-, and 5-year survival rates were 100, 95.2, 71.4, 66.6, and 47.6 % for Child class A and 94.1, 88.2, 58.8, 41.2, 29.4, and 23.5 % for Child class B patients. Regarding DEB-DOX treatment, multivariate analysis identified number of lesions (p = 0.033), lesion vascularity (p < 0.0001), initially achieved complete response (p < 0.0001), and objective response (p = 0.046) as significant and independent determinants of 5-year survival. Conclusion: DEB-DOX results, with high rates of 5-year survival for patients, not amenable to curative treatments. Number of lesions, lesion vascularity, and local response were significant independent determinants of 5-year survival.

  11. Radiation therapy: A major factor in the five-year survival analysis of women with breast cancer in Lagos, Nigeria

    International Nuclear Information System (INIS)

    Makanjuola, Samira B.L.; Popoola, Abiodun O.; Oludara, Mobolaji A.

    2014-01-01

    Purpose: This retrospective study was carried out to examine five-year survival from breast cancer cases diagnosed between 2005 and May 2008 in Nigerian women. Material and methods: Two hundred and twenty-four patients were entered into the study. Five-year survival was evaluated using proportional hazard model proposed by Cox to assess variables such as age of diagnosis, menopausal status, and stage of the disease in the two treatment groups: surgery/chemotherapy or surgery/chemotherapy/radiotherapy. Results: Findings revealed that the different staging of disease and treatment are independent predictors of disease outcome whereas age of diagnosis and menopausal status although associated with low hazards, are not significant. TNM Stage I (Hazard Ratio = 0.153, 95% CI 0.45–0.51, P = 0.003), II (Hazard Ratio = 0.245, 95% CI 0.12–0.46, P = 0.0001), and III (Hazard Ratio = 0.449, 95% CI 0.31–0.46, P = 0.0001) showed significantly greater survival rates compared to TNM Stage IV for patients receiving surgery/chemotherapy. Similarly, for patients receiving surgery/chemotherapy/radiotherapy TNM Stage II (Hazard Ratio = 0.110, 95% CI 0.02–0.46, P = 0.003) and III (Hazard Ratio = 0.238, 95% CI 0.07–0.73, P = 0.012) also showed significantly greater survival rates compared to TNM Stage IV. Treatment had a significant impact on survival independent of stage, age, and menopausal status. Patients receiving surgery/chemotherapy/radiotherapy had a significant increase in survival outcome for TNM Stage (II, P = 0.045; III, P = 0.0001); age groups (40–49, P = 0.021; 50–59, P = 0.016; 60–69, P = 0.017; >70, P = 0.025); and menopausal status (premenopausal, P = 0.049; postmenopausal, P = 0.0001) compared to those receiving surgery/chemotherapy. Conclusion: The five-year breast cancer survival rate in Lagos, Nigeria 24.1% (54/224) is relatively poor compared to most countries in the world and needs to be improved. Poor survival rates are mainly attributed to late

  12. Risk factors for dental caries in childhood: a five-year survival analysis.

    Science.gov (United States)

    Lee, Hyo-Jin; Kim, Jin-Bom; Jin, Bo-Hyoung; Paik, Dai-Il; Bae, Kwang-Hak

    2015-04-01

    The purpose of this study was to examine the risk factors of dental caries at the level of an individual person with survival analysis of the prospective data for 5 years. A total of 249 first-grade students participated in a follow-up study for 5 years. All participants responded to a questionnaire inquiring about socio-demographic variables and oral health behaviors. They also received an oral examination and were tested for Dentocult SM and LB. Over 5 years, the participants received yearly oral follow-up examinations to determine the incidence of dental caries. The incidence of one or more dental caries (DC1) and four or more dental caries (DC4) were defined as one or more and four or more decayed, missing, and filled permanent teeth increments, respectively. Socio-demographic variables, oral health behaviors, and status and caries activity tests were assessed as risk factors for DC1 and DC4. The adjusted hazard ratios (HRs) of risk factors for DC1 and DC4 were calculated using Cox proportional hazard regression models. During the 5-year follow-up period, DC1 and DC4 occurred in 87 and 25 participants, respectively. In multivariate hazard models, five or more decayed, missing, and filled primary molar teeth [HR 1.93, 95% confidence interval (CI) 1.19-3.13], and Dentocult LB of two or three (HR 2.21, 95% CI 1.37-3.56) were independent risk factors of DC1. For DC4, only Dentocult LB of two or three was an independent risk factor (HR 2.95, 95% CI 1.11-7.79). Our results suggest that dental caries incidence at an individual level can be associated with the experience of dental caries in primary teeth and Dentocult LB based on the survival models for the 5-year prospective data. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  13. Twenty-Five Year Survival of Children with Intellectual Disability in Western Australia.

    Science.gov (United States)

    Bourke, Jenny; Nembhard, Wendy N; Wong, Kingsley; Leonard, Helen

    2017-09-01

    To investigate survival up to early adulthood for children with intellectual disability and compare their risk of mortality with that of children without intellectual disability. This was a retrospective cohort study of all live births in Western Australia between January 1, 1983 and December 31, 2010. Children with an intellectual disability (n = 10 593) were identified from the Western Australian Intellectual Disability Exploring Answers Database. Vital status was determined from linkage to the Western Australian Mortality database. Kaplan-Meier product limit estimates and 95% CIs were computed by level of intellectual disability. Hazard ratios (HRs) and 95% CIs were calculated from Cox proportional hazard regression models adjusting for potential confounders. After adjusting for potential confounders, compared with those without intellectual disability, children with intellectual disability had a 6-fold increased risk of mortality at 1-5 years of age (adjusted HR [aHR] = 6.0, 95%CI: 4.8, 7.6), a 12-fold increased risk at 6-10 years of age (aHR = 12.6, 95% CI: 9.0, 17.7) and a 5-fold increased risk at 11-25 years of age (aHR = 4.9, 95% CI: 3.9, 6.1). Children with severe intellectual disability were at even greater risk. No difference in survival was observed for Aboriginal children with intellectual disability compared with non-Aboriginal children with intellectual disability. Although children with intellectual disability experience higher mortality at all ages compared with those without intellectual disability, the greatest burden is for those with severe intellectual disability. However, even children with mild to moderate intellectual disability have increased risk of death compared with unaffected children. Copyright © 2017 Elsevier Inc. All rights reserved.

  14. Assessment of a five-year survival on hemodialysis in Brazil: a cohort of 3,082 incident patients

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    Jorge Paulo Strogoff de Matos

    2011-12-01

    Full Text Available Brazil has the third largest contingent of patients on maintenance hemodialysis (HD worldwide. However, little is known regarding survival rate and predictors of mortality risk in that population, which are the purposes of this study. A total of 3,082 patients incident on HD, from 2000 to 2004, at 25 dialysis facilities distributed among 7 out of 26 states of Brazil were followed-up until 2009. Patients were 52 ± 16 years-old, 57.8% men, and 20.4%, diabetics. The primary outcome was all causes of mortality. Data were censored at five years of follow-up. The global five-year survival rate was 58.2%. In the Cox proportional model, variables associated with risk of death were: age (hazard ratio - HR = 1.44 per decade, p < 0.0001, diabetes (HR = 1.51, p < 0.0001, serum albumin (HR = 0.76 per g/dL, p = 0.001, creatinine (HR = 0.92 per mg/dL, p < 0.0001, and phosphorus (HR = 1.06 per mg/dL, p = 0.04. The present results show that the mortality rate on HD in this Brazilian cohort was relatively low, but the population is younger and with a lower prevalence of diabetes than the ones reported for developed countries.

  15. Survival of all-ceramic restorations after a minimum follow-up of five years: A systematic review.

    Science.gov (United States)

    Araujo, Nara Santos; Moda, Mariana Dias; Silva, Ebele Adaobi; Zavanelli, Adriana Cristina; Mazaro, José Vitor Quinelli; Pellizzer, Eduardo Piza

    2016-01-01

    The purpose of this systematic review was to compare the survival and complication rates of all-ceramic restorations after a minimum follow-up time of 5 years. A comprehensive search of studies published from 2005 to November 2015 and listed in the PubMed/MEDLINE, Scopus, and Cochrane Library databases was performed in accordance with the PRISMA statement. Two reviewers independently analyzed the abstracts. Relevant studies were selected according to predetermined inclusion criteria. Twenty-nine studies were selected for the final analysis from an initial yield of 514. Only four studies fulfilled the requirement of having a randomized design, and 25 studies were prospective with a mean follow-up period of 5 to 16 years. Overall, the 5-year complication rates were low. The most frequent complications were secondary caries, endodontic problems, ceramic fractures, ceramic chipping, and loss of retention. This systematic review showed that all-ceramic restorations fabricated using the correct clinical protocol have an adequate clinical survival for at least 5 years of clinical service with very low complication rates. Minor ceramic chipping and debonding did not affect the longevity of the restorations. Long-term clinical performance of all-ceramic restorations manufactured using various ceramic systems provides clinical evidence of complications and long-term management of these restorations. Available evidence indicates the effectiveness of many ceramic systems for numerous clinical applications. Correct planning and a rigorous technical execution protocol increase clinical success. Studies of ceramic prostheses indicate more problems with ceramic failure and debonding.

  16. Radiotherapy alone for non-small cell lung carcinoma. Five-year disease-free survival and patterns of failure

    International Nuclear Information System (INIS)

    Koukourakis, M.; Skarlatos, J.; Kosma, L.; Yannakakis, D.; Giatromanolaki, A.

    1995-01-01

    One hundred and fifty-three patients with inoperable non-small cell lung cancer (NSCLC) treated with radiotherapy alone have been retrospectively analysed. Normalized Total Dose (NTD) as defined by Macejewski, TN-stage (AJC-system) and histology have been examined with respect to 5-year disease-free survival (DFS) and the patterns of failure so as to identify subgroups of patients that routinely should be treated with radical intent. The 5-year DFS for T1, 2-N0, 1 and T3-N0, 1 staged patients was 30% (7/23) and 25% (4/16) respectively when the tumor NTD (a/b=10 Gy) was 56-64 Gy vs. 12% (5/41) and 0% (0/10) when the NTD was 48-55 Gy. This difference was statistically significant for the squamous cell histology group. The higher doses significantly altered the patterns of death in N0, 1 staged squamous cell carcinoma and adenocarcinoma patients. Forty-five percent (22/55) and 41% (12/29) of squamous cell adenocarcinoma patients respectively, died from local relapse without evidence of distant metastases when NTD less than 55 Gy were given vs. 21% (9/42) and 13% (2/15) when the NTD delivered was 56-64 Gy (p<0.05). Although for N2, 3 staged patients or patients with direct extension of the tumor into the mediastinum death from local relapse occurred in 38% (10/26) of the high NTD treated patients vs. 51% (19/37) of the low-dose treated ones, the difference was not statistically significant. It is concluded that NSCLC patients should not a priori be considered as non-radiocurable. At least 30% of the patients with early local stages can be long-term disease-free survivors with readiation NTD up to 60 Gy and better results are to be expected with higher doses. Advanced T-stage without mediastinal involvement should be treated with radical intent since a high NTD could give cure rates of over 25%. The disappointing results for patients with mediastinal disease could perhaps be attributed to the low NTD delivered. For patients with good performance status

  17. Long term effect (more than five years) of intrathecal baclofen on impairment, disability, and quality of life in patients with severe spasticity of spinal origin

    NARCIS (Netherlands)

    Zahavi, A; Geertzen, JHB; Middel, B; Staal, M; Rietman, JS

    2004-01-01

    Objectives: To evaluate long term change in impairment, disability, and health related functional status in patients with severe spasticity who received intrathecal baclofen. Methods: A long term ( more than five years) observational longitudinal follow up study assessing 21 patients who received

  18. FIVE-YEAR OUTCOMES AFTER LONG-TERM OXANDROLONE ADMINISTRATION IN SEVERELY BURNED CHILDREN: A RANDOMIZED CLINICAL TRIAL.

    Science.gov (United States)

    Reeves, Patrick T; Herndon, David N; Tanksley, Jessica D; Jennings, Kristofer; Klein, Gordon L; Mlcak, Ronald P; Clayton, Robert P; Crites, Nancy N; Hays, Joshua P; Andersen, Clark; Lee, Jong O; Meyer, Walter; Suman, Oscar E; Finnerty, Celeste C

    2016-04-01

    Administration of oxandrolone, a nonaromatizable testosterone analog, to children for 12 months following severe burn injury has been shown to improve height, increase bone mineral content (BMC), reduce cardiac work, and augment muscle strength. Surprisingly, the increase in BMC persists well beyond the period of oxandrolone administration. This study was undertaken to determine if administration of oxandrolone for 2 years yields greater effects on long-term BMC and bone mineral density (BMD). Patients between 0 and 18 years of age with ≥30% of total body surface area burned were consented to an IRB-approved protocol and randomized to receive either placebo (n = 84) or 0.1 mg/kg oxandrolone orally twice daily for 24 months (n = 35). Patients were followed prospectively from the time of admission until 5 years postburn in a single-center, intent-to-treat setting. Height, weight, BMC, and BMD were recorded annually through 5 years postinjury. The long-term administration of oxandrolone for 16 ± 1 months postburn (range, 12.1-25.2 months) significantly increased whole-body (WB) BMC (p patients who were in growth spurt years (7-18 years). When adjusted for height, sex, and age, LS BMD was found to significantly increase with long-term oxandrolone administration (p patients receiving oxandrolone exhibited LS BMD z scores below -2.0 as compared with controls, indicating a significantly reduced risk for future fracture with oxandrolone administration. Long-term oxandrolone patients had significantly greater height velocity than controls throughout the first 2-year postburn (p patients receiving long-term oxandrolone to previously described patients receiving 12 months of oxandrolone revealed that long-term oxandrolone administration imparted significantly greater increases in WB-BMC, WB-BMD, and LS-BMD (p burned pediatric patients significantly improves WB BMC, LS BMC, LS BMD, and height velocity. The administration of long-term oxandrolone was more efficacious than

  19. FIVE-YEAR OUTCOMES AFTER LONG-TERM OXANDROLONE ADMINISTRATION IN SEVERELY BURNED CHILDREN: A RANDOMIZED CLINICAL TRIAL

    OpenAIRE

    Reeves, Patrick T; Herndon, David N; Tanksley, Jessica D; Jennings, Kristofer; Klein, Gordon L; Mlcak, Ronald P; Clayton, Robert P; Crites, Nancy N; Hays, Joshua P; Andersen, Clark; Lee, Jong O; Meyer, Walter; Suman, Oscar E; Finnerty, Celeste C

    2016-01-01

    Administration of oxandrolone, a non-aromatizable testosterone analog, to children for 12 months following severe burn injury has been shown to improve height, increase bone mineral content (BMC), reduce cardiac work, and augment muscle strength. Surprisingly, the increase in BMC persists well beyond the period of oxandrolone administration. This study was undertaken to determine if administration of oxandrolone for 2 years yields greater effects on long-term BMC and bone mineral density (BMD...

  20. Mid-term migration analysis of a femoral short-stem prosthesis: a five-year EBRA-FCA-study.

    Science.gov (United States)

    Freitag, Tobias; Fuchs, Michael; Woelfle-Roos, Julia V; Reichel, Heiko; Bieger, Ralf

    2018-05-01

    The objective of this study was to evaluate the mid-term migration pattern of a femoral short stem. Implant migration of 73 femoral short-stems was assessed by Ein-Bild-Roentgen-Analysis Femoral-Component-Analysis (EBRA-FCA) 5 years after surgery. Migration pattern of the whole group was analysed and compared to the migration pattern of implants "at risk" with a subsidence of more than 1.5 mm 2 years postoperative. Mean axial subsidence was 1.1 mm (-5.0 mm to 1.5 mm) after 60 months. There was a statistical significant axial migration until 2 years postoperative with settling thereafter. 2 years after surgery 18 of 73 Implants were classified "at risk." Nevertheless, all stems showed secondary stabilisation in the following period with no implant failure neither in the group of implants with early stabilisation nor the group with extensive early onset migration. In summary, even in the group of stems with more pronounced early subsidence, delayed settling occurred in all cases. The determination of a threshold of critical early femoral short stem subsidence is necessary because of the differing migration pattern described in this study with delayed settling of the Fitmore stem 2 years postoperatively compared to early settling within the first postoperative year described for conventional stems.

  1. Long-term changes in rocky intertidal macrobenthos during the five years after the Hebei Spirit oil spill, Taean, Korea

    Science.gov (United States)

    Jung, Yun-Hwan; Park, Henug-Sik; Yoon, Kon-Tak; Kim, Hyung-June; Shim, Won-Joon

    2017-03-01

    The Hebei Spirit oil spill reached the west coast of Taean County, Korea, on December 7, 2007. At that time, this was the largest oil spill that had occurred in the country. The incident devastated local marine ecosystems. In this study, we examined changes in these ecosystems and the recovery pattern on impacted rocky shores. Macrobenthos monitoring of polluted and control sites was performed seasonally from January 2008 through October 2013. At polluted sites, ecological indices increased gradually from 2009, thereby providing evidence of recovery. However, the mean density of macrobenthos was still less than 50% of the level at the control site, indicating that the ecological status of the polluted sites has still not recovered to that which prevailed before the oil spill. Although densities of the most dominant species were higher in the control site than in polluted sites, the densities of Lottia spp. and Odostomia aomori were higher in polluted sites. These two taxa were found in lower numbers at the control site, where they were out-competed by Chthamalus challengeri. Nonmetric multidimensional scaling ordination divided the macrobenthic community structure into three clusters according to differences in the abundance of dominant species over the 6 years after the oil spill. An ANOSIM test detected significant differences between the polluted and control sites. Consistent long-term differences indicate that complete recovery had not occurred during the duration of our study.

  2. Down-regulated E-cadherin expression is associated with poor five-year overall survival in bone and soft tissue sarcoma: results of a meta-analysis.

    Directory of Open Access Journals (Sweden)

    Ning Wang

    Full Text Available To conduct a meta-analysis to evaluate the prognostic role of E-cadherin expression in bone and soft tissue sarcomas.The PubMed, EMBASE, and Web of Science databases were searched using terms related to E-cadherin, sarcoma, and prognosis for all articles published in English before March 2014. Pooled effect was calculated from the available data to evaluate the association between negative E-cadherin expression and 5-year overall survival and tumor clinicopathological features in sarcoma patients. Pooled odds ratios (OR and risk ratios (RR with 95% confidence intervals (CI were calculated using a fixed-effects model.Eight studies met the selection criteria and reported on 812 subjects. A total of 496 subjects showed positive E-cadherin expression (59.9%. Negative E-cadherin expression in bone and soft tissue sarcomas was correlated with lower 5-year overall survival (OR = 3.831; 95% CI: 2.246-6.534, and was associated with higher clinical stage (RR = 1.446; 95% CI: 1.030-2.028 and with male sex (RR = 0.678; 95% CI: 0.493-0.933.In the E-cadherin negative group, 5-year overall survival was significantly worse than in the E-cadherin positive group. However, further studies are required to confirm these results.

  3. Early adherence to antiretroviral medication as a predictor of long-term HIV virological suppression: five-year follow up of an observational cohort.

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    Nathan Ford

    Full Text Available OBJECTIVE: Previous studies have demonstrated a cross-sectional relationship between antiretroviral adherence and HIV virological suppression. We assessed the predictive value of baseline adherence in determining long-term virological failure. DESIGN: We assessed baseline adherence via an adherence questionnaire between administered to all consenting patients attending antiretroviral clinics in Khayelitsha township, South Africa, between May 2002 and March 2004. Virological status was ascertained after five years of follow up and multivariate analysis used to model associations of baseline variables and medication adherence with time to viral suppression or failure. RESULTS: Our adherence cohort comprised 207 patients, among whom 72% were female. Median age was 30 years and median CD4 count at initiation was 55 cells/mm(3. We found no statistically significant differences between baseline characteristics and early adherence groups. Multivariate analysis adjusting for baseline CD4 and age found that patients with suboptimal baseline adherence had a hazard ratio of 2.82 (95% CI 1.19-6.66, p = 0.018 for progression to virological failure compared to those whose baseline adherence was considered optimal. CONCLUSIONS: Our longitudinal study provides further confirmation of adherence as a primary determinant of subsequent confirmed virological failure, and serves as a reminder of the importance of initial early investments in adherence counseling and support as an effective way to maximize long-term treatment success.

  4. Survival of ceramic veneers made of different materials after a minimum follow-up period of five years: a systematic review and meta-analysis.

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    Petridis, Haralampos P; Zekeridou, Alkisti; Malliari, Maria; Tortopidis, Dimitrios; Koidis, Petros

    2012-01-01

    The purpose of this systematic review was to compare the survival and complication rates of ceramic veneers produced with different techniques and materials after a minimum follow-up time of 5 years. A literature search was conducted, using electronic databases, relevant references, citations and journal researching, for clinical studies reporting on the survival of ceramic veneers fabricated with different techniques and materials with a mean followup time of at least 5 years. The search period spanned from January 1980 up to October 2010. Event rates were calculated for the following complications associated with ceramic veneers: fracture, debonding, marginal discoloration, marginal integrity, and caries. Summary estimates, and 5-year event rates were reported. Comparison between subgroups of different materials, as well as statistical significance, was calculated using a mixed effects model. Nine studies were selected for final analysis over an initial yield of 409 titles. No study directly compared the incidence of complications between ceramic veneers fabricated from different materials. Four of the included studies reported on the survival of ceramic veneers made out of feldspathic ceramics; four studies were on glass-ceramic veneers and one study included veneers fabricated from both materials. The mean observation time ranged between 5 and 10 years. Overall, the 5-year complication rates were low, with the exception of studies reporting on extended ceramic veneers. The most frequent complication reported was marginal discoloration (9% at 5 years), followed by marginal integrity (3.9-7.7% at 5 years). There was no statistically significant difference in the event rates between the subgroups of different materials (feldspathic vs. glass-ceramic). The results of this systematic review showed that ceramic veneers fabricated from feldspathic or glass-ceramics have an adequate clinical survival for at least 5 years of clinical service, with very low complication

  5. Five-Year Survival of 20,946 Unicondylar Knee Replacements and Patient Risk Factors for Failure: An Analysis of German Insurance Data.

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    Jeschke, Elke; Gehrke, Thorsten; Günster, Christian; Hassenpflug, Joachim; Malzahn, Jürgen; Niethard, Fritz Uwe; Schräder, Peter; Zacher, Josef; Halder, Andreas

    2016-10-19

    Improvements in implant design and surgical technique of unicondylar knee arthroplasty have led to reduced revision rates, but patient selection seems to be crucial for success of such arthroplasties. The purpose of the present study was to analyze the 5-year implant survival rate of unicondylar knee replacements in Germany and to identify patient factors associated with an increased risk of revision, including >30 comorbid conditions. Using nationwide billing data of the largest German health-care insurance for inpatient hospital treatment, we identified patients who underwent unicondylar knee arthroplasty between 2006 and 2012. Kaplan-Meier survival curves with revision as the end point and log-rank tests were used to evaluate 5-year implant survival. A multivariable Cox regression model was used to determine factors associated with revision. The risk factors of age, sex, diagnosis, comorbidities, type of implant fixation, and hospital volume were analyzed. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were calculated. During the study period, a total of 20,946 unicondylar knee arthroplasties were included. The number of unicondylar knee arthroplasties per year increased during the study period from 2,527 in 2006 to 4,036 in 2012. The median patient age was 64 years (interquartile range, 56 to 72 years), and 60.4% of patients were female. During the time evaluated, the 1-year revision rate decreased from 14.3% in 2006 to 8.7% in 2011. The 5-year survival rate was 87.8% (95% CI, 87.3% to 88.3%). Significant risk factors (p 74 years was used as the reference); female sex (HR, 1.18 [95% CI, 1.07 to 1.29]); complicated diabetes (HR, 1.47 [95% CI, 1.03 to 2.12]); depression (HR, 1.29 [95% CI, 1.06 to 1.57]); obesity, defined as a body mass index of ≥30 kg/m 2 (HR, 1.13 [95% CI, 1.02 to 1.26]); and low-volume hospitals, denoted as an annual hospital volume of ≤10 cases (HR, 1.60 [95% CI, 1.39 to 1.84]), 11 to 20 cases (HR, 1.47 [95% CI, 1.27 to 1

  6. Long-term impact of battle injuries; five-year follow-up of injured Dutch servicemen in Afghanistan 2006-2010.

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    Rigo Hoencamp

    Full Text Available OBJECTIVES: Units deployed to armed conflicts are at high risk for exposure to combat events. Many battle casualties (BCs have been reported in the recent deployment to Afghanistan. The long-term impact of these combat injuries, at their five-year end point, is currently unknown. To date, no systematic inventory has been performed of an identified group of BCs in comparison to non-injured service members from the same operational theatre. DESIGN: Observational cross-sectional cohort study. SETTING: Open online survey among Dutch BCs that deployed to Afghanistan (2006-2010. PARTICIPANTS: The Dutch BCs (n = 62 were compared to two control groups of non-injured combat groups (battle exposed [n = 53], and non-battle exposed [n = 73]. MAIN OUTCOME MEASURES: Participants rated their impact of trauma exposure (Impact of Events [IES], post deployment reintegration (Post Deployment Reintegration Scale [PDRS], general symptoms of distress (Symptom Checklist 90 [SCL-90], as well as their current perceived quality of life (EuroQol-6D [EQ-6D]. Also cost effectiveness (Short From health survey [SF-36] and care consumption were assessed (Trimbos/iMTA questionnaire. RESULTS: Over 90% of BCs were still in active duty. The mean scores of all questionnaires (IES, EQ-6D, SF-36, and SCL-90 of the BC group were significantly higher than in the control groups (p<0.05. The PDRS showed a significantly lower (p<0.05 outcome in the negative subscales. The mean consumption of care was triple that of both control groups. A lower score on quality of life was related to higher levels of distress and impact of trauma exposure. CONCLUSIONS: This study showed a clear long-term impact on a wide range of scales that contributes to a reduced quality of life in a group of BCs. Low perceived cost effectiveness matched with high consumption of care in the BC group in comparison to the control groups. These results warrant continuous monitoring of BCs.

  7. Beyond the five-year horizon: long-term outcome of high-risk and inoperable patients undergoing TAVR with first-generation devices.

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    Deutsch, Marcus-André; Erlebach, Magdalena; Burri, Melchior; Hapfelmeier, Alexander; Witt, Olivia Ganga; Ziegelmueller, Johannes Amadeus; Wottke, Michael; Ruge, Hendrik; Krane, Markus; Piazza, Nicolo; Bleiziffer, Sabine; Lange, Rüdiger

    2018-05-20

    We sought to determine the long-term outcome of high-risk patients who underwent transcatheter aortic valve replacement (TAVR) with first-generation devices with a focus on the identification of predictors for mortality and valve durability. Consecutive patients in our prospective single-centre registry undergoing TAVR with first-generation devices (n=214 CoreValve; n=86 SAPIEN) between 06/2007 and 07/2009 were retrospectively analysed (n=300, mean age 81.43±6.55 years, mean STS score 6.5±4.5%). Kaplan-Meier estimates of survival and the Cox proportional hazards model were used to identify independent predictors of all-cause-mortality. At 1, 5, and 7 years, estimated survival rates were 76.0%, 40.2%, and 23.2%, respectively. Age-adjusted baseline predictors of mortality included atrial fibrillation, impaired kidney function, peripheral artery disease, and mitral regurgitation (≥moderate). Baseline risk-adjusted procedure-related predictors for all-cause mortality included acute kidney injury, neurological events, major vascular complications, and major/life-threatening bleeding. At both five and six years, 78.2% of surviving patients were in NYHA Class I or II. PVL was ≤mild in the majority of patients at discharge and throughout follow-up. At seven years, the overall crude cumulative incidence of structural valve deterioration according to the 2017 EAPCI/ESC/EACTS definition was 14.9% (CoreValve 11.8% vs. SAPIEN 22.6%; p=0.01). Seven years after TAVR, 23.2% of high-risk patients were still alive. Independent predictors of all-cause mortality included both patient- and procedure-related factors. With a cumulative incidence of 14.9% at seven years, there is some suggestion that SVD post TAVR may become increasingly relevant during longer-term follow-up.

  8. A five year prospective investigation of anterior pituitary function after traumatic brain injury: is hypopituitarism long-term after head trauma associated with autoimmunity?

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    Tanriverdi, Fatih; De Bellis, Annamaria; Ulutabanca, Halil; Bizzarro, Antonio; Sinisi, Antonio A; Bellastella, Giuseppe; Amoresano Paglionico, Vanda; Dalla Mora, Liliana; Selcuklu, Ahmed; Unluhizarci, Kursad; Casanueva, Felipe F; Kelestimur, Fahrettin

    2013-08-15

    Traumatic brain injury (TBI) has been recently recognized as a common cause of pituitary dysfunction. However, there are not sufficient numbers of prospective studies to understand the natural history of TBI induced hypopituitarism. The aim was to report the results of five years' prospective follow-up of anterior pituitary function in patients with mild, moderate and severe TBI. Moreover, we have prospectively investigated the associations between TBI induced hypopituitarism and presence of anti-hypothalamus antibodies (AHA) and anti-pituitary antibodies (APA). Twenty five patients (20 men, five women) were included who were prospectively evaluated 12 months and five years after TBI, and 17 of them also had a third-year evaluation. Growth hormone (GH) deficiency is the most common pituitary hormone deficit at one, three, and five years after TBI. Although most of the pituitary hormone deficiencies improve over time, there were substantial percentages of pituitary hormone deficiencies at the fifth year (28% GH, 4% adrenocorticotropic hormone [ACTH], and 4% gonadotropin deficiencies). Pituitary dysfunction was significantly higher in strongly AHA- and APA-positive (titers ≥1/16) patients at the fifth year. In patients with mild and moderate TBI, ACTH and GH deficiencies may improve over time in a considerable number of patients but, although rarely, may also worsen over the five-year period. However in severe TBI, ACTH and GH status of the patients at the first year evaluation persisted at the fifth year. Therefore, screening pituitary function after TBI for five years is important, especially in patients with mild TBI. Moreover, close strong associations between the presence of high titers of APA and/or AHA and hypopituitarism at the fifth year were shown for the first time.

  9. Five-year follow-up of survival and relapse in patients who received cryotherapy during high-dose chemotherapy for stem cell transplantation shows no safety concerns.

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    Svanberg, A; Ohrn, K; Birgegård, G

    2012-11-01

    We have previously published a randomised controlled study of the efficacy of cryotherapy in preventing acute oral mucositis after high-dose chemotherapy for stem cell transplantation. The present study is a 5-year follow-up safety study of survival in these patients. In the previously published study oral cryotherapy (cooling of the oral cavity) during high-dose chemotherapy significantly reduced mucositis grade and opiate use in the treated group. All patients were followed up for at least 5 years with regard to relapse and death rates. Baseline data, transplant complications and mucositis data were compared. Significantly more patients (25/39) who received oral cryotherapy were alive after 5 years compared to 15/39 in the control group (P= 0.025). Relapse rates were similar. The only baseline difference was a lower proportion of patients in complete remission at transplantation in the control group (6 vs. 13, P= 0.047). This 5-year follow-up study gave no support for safety concerns with cryotherapy. © 2012 Blackwell Publishing Ltd.

  10. Columbine High: Five Years Later

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    Hurst, Marianne D.

    2004-01-01

    A few weeks before the fifth anniversary of the Columbine High School shootings on April 20, 1999, Principal Frank DeAngelis reflects on how his school has changed over the past five years. Much like the September 11, 2001 terrorist attacks against the United States, "Columbine" carries a chilling meaning that resonates across the…

  11. Five-year-old historian.

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    Morrison, Wynne

    2017-12-01

    In this poem, the author describes a doctor talking with a five-year-old child who has been brought to the hospital after being in a car accident with his/her mother and brother. The child is not able to remember the mother's name, but the doctor continues to talk with the child. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  12. Community re-integration and long-term need in the first five years after stroke: results from a national survey.

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    Walsh, Mary Elizabeth; Galvin, Rose; Loughnane, Cliona; Macey, Chris; Horgan, N Frances

    2015-01-01

    Acute stroke care continues to improve but the later stroke recovery phase remains less well understood. The aim of this study was to document self-reported need in relation to stroke recovery and community re-integration among community-dwelling persons up to five years post-stroke. A national survey was carried out in Ireland. Participants were recruited through stroke advocacy organisations and health professionals. Existing validated questionnaires were adapted with permission. The final questionnaire assessed respondents' perceptions of their community re-integration and on-going needs. A total of 196 stroke survivors, aged 24-89 years responded. Over 75% of respondents reported experiencing mobility, emotional, fatigue and concentration difficulties post-stroke. Emotional problems and fatigue demonstrated the highest levels of unmet need. Families provided much support with 52% of people needing help with personal care post-stroke. Forty-two per cent of respondents in a relationship felt that it was significantly affected by their stroke. In addition, 60% of respondents reported negative financial change. Only 23% of those <66 years had worked since their stroke, while 60% of drivers returned to driving. Stroke had a personal, social and economic impact. Emotional distress and fatigue were common and satisfaction with the help available for these problems was poor. Implications for Rehabilitation Professionals should recognise that family members provide high levels of support post-stroke while dealing with changes to personal relationships. Emotional, concentration and fatigue problems post-stroke require recognition by health professionals. A greater focus on return-to-work as part of stroke rehabilitation may be of value for patients of working age.

  13. Long term cause specific mortality among 34 489 five year survivors of childhood cancer in Great Britain: population based cohort study

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    Fidler, Miranda M; Reulen, Raoul C; Winter, David L; Kelly, Julie; Jenkinson, Helen C; Skinner, Rod; Frobisher, Clare

    2016-01-01

    Objective To determine whether modern treatments for cancer are associated with a net increased or decreased risk of death from neoplastic and non-neoplastic causes among survivors of childhood cancer. Design Population based cohort study. Setting British Childhood Cancer Survivor Study. Participants Nationwide population based cohort of 34 489 five year survivors of childhood cancer with a diagnosis from 1940 to 2006 and followed up until 28 February 2014. Main outcome measures Cause specific standardised mortality ratios and absolute excess risks are reported. Multivariable Poisson regression models were utilised to evaluate the simultaneous effect of risk factors. Likelihood ratio tests were used to test for heterogeneity or trend. Results Overall, 4475 deaths were observed, which was 9.1 (95% confidence interval 8.9 to 9.4) times that expected in the general population, corresponding to 64.2 (95% confidence interval 62.1 to 66.3) excess deaths per 10 000 person years. The number of excess deaths from all causes declined among those treated more recently; those treated during 1990-2006 experienced 30% of the excess number of deaths experienced by those treated before 1970. The corresponding percentages for the decline in excess deaths from recurrence or progression and non-neoplastic causes were 30% and 60%, respectively. Among survivors aged 50-59 years, 41% and 22% of excess deaths were attributable to subsequent primary neoplasms and circulatory conditions, respectively, whereas the corresponding percentages among those aged 60 years or more were 31% and 37%. Conclusions The net effects of changes in cancer treatments, and surveillance and management for late effects, over the period 1940 to 2006 was to reduce the excess number of deaths from both recurrence or progression and non-neoplastic causes among those treated more recently. Among survivors aged 60 years or more, the excess number of deaths from circulatory causes exceeds the excess number

  14. Long-term mortality benefits of air quality improvement during the twelfth five-year-plan period in 31 provincial capital cities of China

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    Liu, Tao; Cai, Yuanyuan; Feng, Baixiang; Cao, Ganxiang; Lin, Hualiang; Xiao, Jianpeng; Li, Xing; Liu, Sha; Pei, Lei; Fu, Li; Yang, Xinyi; Zhang, Bo; Ma, Wenjun

    2018-01-01

    The severe air pollution across China in the past several years has made the Chinese government recognize its significant impacts on public health and society, and take enormous efforts to improve the air quality all over the country, especially during the Twelfth Five-Year Plan (12th FYP). However, the overall effectiveness of these air pollution control policies remains unclear. In this study, we selected the 31 municipalities and provincial capital cities in mainland China as study settings. We collected the annual average population size, mortality rates (total mortality and mortality due to cardiovascular diseases, respiratory diseases, total cancer, lung cancer and breast cancer) and concentrations of air pollutants (PM10, PM2.5, SO2 and NO2) in each capital city from 2010 to 2015 from national or local Statistical Yearbooks. The effect sizes of air pollutants on mortality were obtained from previously published meta analyses or cohort studies. We first estimated the annual mortality rates attributed to the changes in air pollutant concentrations for every city in each year. Then, we further estimated the mortality benefits in the scenarios where the air quality had reached the grade II levels of Chinese Ambient Air Quality Standards (CAAQS) and World Health Organization (WHO) guidelines. In most capital cities, we observed dominant decreases in air pollutant concentrations during the 12th FYP, particularly from 2013 to 2015, which has led to significant mortality benefits for the public. A total of 121,658 deaths (0.441‰) have been prevented due to the decrease of PM2.5concentrations from 2013 to 2015 in all included cities. The morality benefits were larger in capital cities located in the key regions (the three main regions and ten city groups) than the other cities. In addition, more mortality benefits could be obtained in the future if the air quality reaches the grade II levels of Chinese Ambient Air Quality Standards (CAAQS) or WHO guidelines. We

  15. Civil partnerships five years on.

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    Ross, Helen; Gask, Karen; Berrington, Ann

    2011-01-01

    The Civil Partnership Act 2004, which came into force in December 2005 allowing same-sex couples in the UK to register their relationship for the first time, celebrated its fifth anniversary in December 2010. This article examines civil partnership in England and Wales, five years on from its introduction. The characteristics of those forming civil partnerships between 2005 and 2010 including age, sex and previous marital/civil partnership status are examined. These are then compared with the characteristics of those marrying over the same period. Further comparisons are also made between civil partnership dissolutions and divorce. The article presents estimates of the number of people currently in civil partnerships and children of civil partners. Finally the article examines attitudes towards same-sex and civil partner couples both in the UK and in other countries across Europe.

  16. TRIUMF: Five-year plan

    International Nuclear Information System (INIS)

    Anon.

    1995-01-01

    The Canadian government recently announced approval of a five-year-plan for TRIUMF, giving the Vancouver Laboratory assured funding until the year 2000. Besides continuation of the multidisciplinary cyclotron, this will allow construction of ISAC-1, a new on-line isotope separator. At the same time, TRIUMF will also be responsible for Canadian ''in-kind'' contributions to international science at CERN's LHC proton-proton collider (see page 1). The federal plan strengthens TRIUMF's role as a national facility, run by a consortium of universities across Canada. In addition, TRIUMF will have even stronger international links. The federal government has allocated a total of $166.6 million to TRIUMF over the next five years. In addition, the provincial British Columbia government, a long-time supporter of TRIUMF, has already agreed to provide approximately $10 million for conventional construction. The nature of the accelerator contributions to the LHC has not been finally decided, although two areas are under discussion - the upgrade of the accelerator chain, and construction of the two 'beam cleaning' insertions. The former would involve provision of various new systems (radiofrequency, magnets, power supplies, kickers, etc) for the Booster, PS and SPS synchrotrons; indeed activity is already underway in some areas, such as model studies for a new 40 MHz system for the PS. The acronym of the new facility, ISAC-1, is short for Isotope Separator & Accelerator. A prototype first stage already exists in TRIUMF. ISAC-1 will use the intense proton beam from the TRIUMF cyclotron to create powerful beams of exotic, short-lived, radioactive nuclei which will be accelerated in a new structure

  17. Sobrevida em cinco anos e fatores prognósticos em mulheres com câncer de mama em Santa Catarina, Brasil Five-year survival and prognostic factors in women with breast cancer in Santa Catarina State, Brazil

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    Ione Jayce Ceola Schneider

    2009-06-01

    Full Text Available Este estudo tem o objetivo de descrever a sobrevida em câncer de mama e os fatores associados à mesma. Caracteriza-se como uma coorte histórica de mulheres com diagnóstico de câncer de mama no período de 2000 a 2002, que foram catalogadas nos registros hospitalares de câncer do Centro de Pesquisas Oncológicas de Santa Catarina e Hospital de Caridade - Irmandade Nosso Senhor dos Passos, os dois localizados em Florianópolis, Santa Catarina, Brasil. Para a análise estatística foram utilizados o estimador de Kaplan-Meier e o modelo de Cox. A taxa de sobrevida geral em cinco anos foi de 76,2% (IC95%: 73,6-78,9. Os fatores independentes associados ao maior risco de óbito foram faixa etária menor de 30 anos (hazard ratio- HR = 3,09; IC95%: 1,25-7,67; as mulheres analfabetas (HR = 3,70; IC95%: 1,44-9,55; as com estadiamento III (HR = 5,27; IC95%: 2,56-10,82 e IV (HR = 14,07; IC95%: 6,81-29,06. Mulheres jovens são aquelas com piores taxas de sobrevida. Também existem muitas mulheres sendo diagnosticadas em estádios avançados, tendo uma sobrevida pior, demonstrando a necessidade de ações de diagnóstico precoce.The aim of this study was to analyze breast cancer survival and associated factors, based on a historical cohort of women with breast cancer diagnosis from 2000 to 2002 recorded in the hospital cancer registries at the Santa Catarina Center for Cancer Research and the Irmandade Nosso Senhor dos Passos Charity Hospital, both located in Florianópolis, Santa Catarina State, Brazil. The statistical analysis used the Kaplan-Meier estimator and Cox model. Overall five-year survival was 76.2% (95%CI: 73.6-78.9. Independent factors associated with increased risk of death were age less than 30 years (hazard ratio - HR = 3.09; 95%CI: 1.25-7.67; illiteracy (HR = 3.70; 95%CI: 1.44-9.55; and stages III (HR = 5.27; 95%CI: 2.56-10.82 and IV (HR = 14.07; 95%CI: 6.81-29.06. Young women had the worst survival rates. There were also many women

  18. Five-year field results and long-term effectiveness of 20 mg/kg liposomal amphotericin B (Ambisome for visceral leishmaniasis in Bihar, India.

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    Sakib Burza

    Full Text Available BACKGROUND: Visceral Leishmaniasis (VL; also known as Kala-azar is an ultimately fatal disease endemic in Bihar. A 2007 observational cohort study in Bihar of 251 patients with VL treated with 20 mg/Kg intravenous liposomal amphotericin B (Ambisome demonstrated a 98% cure rate at 6-months. Between July 2007 and August 2012, Médecins Sans Frontières (MSF and the Rajendra Memorial Research Institute (RMRI implemented a VL treatment project in Bihar, India-an area highly endemic for Leishmania donovani-using this regimen as first-line treatment. METHODS AND PRINCIPAL FINDINGS: Intravenous Ambisome 20 mg/kg was administered in four doses of 5 mg/kg over 4-10 days, depending on the severity of disease. Initial clinical cure at discharge was defined as improved symptoms, cessation of fever, and recession of spleen enlargement. This observational retrospective cohort study describes 8749 patients with laboratory-confirmed primary VL treated over a 5-year period: 1396 at primary healthcare centers, 7189 at hospital, and 164 at treatment camps. Initial clinical cure was achieved in 99.3% of patients (8692/8749; 0.3% of patients (26/8749 defaulted from treatment and 0.4% (31/8749 died. Overall, 1.8% of patients (161/8749 were co-infected with HIV and 0.6% (51/8749 with tuberculosis. Treatment was discontinued because of severe allergic reactions in 0.1% of patients (7/8749. Overall, 27 patients (0.3% were readmitted with post Kala-azar dermal leishmaniasis (PKDL. Risk factors for late presentation included female sex, age >15 years and being from a scheduled caste. In 2012, a long-term efficacy survey in the same area of Bihar determined relapse rates of VL after 5 years' intervention with Ambisome. Of 984 immunocompetent patients discharged between September 2010 and December 2011, 827 (84.0% were traced in order to determine their long-term outcomes. Of these, 20 patients (2.4% had relapsed or received further treatment for VL. Of those completing 6

  19. [Primary prevention of cardiovascular diseases: long term results of five year long preventive intervention in 12-year old boys (ten year prospective study)].

    Science.gov (United States)

    Rozanov, V B; Aleksandov, A A; Shugaeva, E N; Perova, N V; Maslennikova, G Ia; Smirnova, S G; Olfer'ev, A M

    2007-01-01

    In a longitudinal cohort (prevention group, n=213, comparison group, n=163) of 10-year prospective follow-up we addressed efficacy of 5-year-long multifactor preventive intervention, conducted in a sample of population of 12 year old boys. Preventive intervention was carried out both at populational level and among persons with risk factors of development of cardiovascular diseases with the use of group, individual, and partly family approaches, and was directed at rationalization of nutrition, elevation of physical activity and prevention of harmful habits. During first 3 years of prevention we succeeded to achieve stable statistically significant lowering of mean levels of total cholesterol, low density lipoprotein cholesterol, triglycerides, and atherogeneity index, as well as to affect fatty component of body mass (skinfold thickness). Long term effect of 5-year long preventive intervention manifested as significantly lower level of systolic blood pressure, lower prevalence of low levels of high density lipoprotein cholesterol, smaller increment of low density lipoprotein cholesterol and index of atherogeneity in the prevention group. These results evidence that prevention of main factors of risk of development of cardiovascular diseases (obesity, arterial hypertension, disorders of lipid composition of the blood, and low physical activity) in child and adolescent age in the period of active growth and development is feasible, effective, safe and is able to lead to decrease of levels of these factors in adults, but should last uninterruptedly until formation of stable habits of healthy life style.

  20. Effects of early maternal docosahexaenoic acid intake on neuropsychological status and visual acuity at five years of age of breast-fed term infants.

    Science.gov (United States)

    Jensen, Craig L; Voigt, Robert G; Llorente, Antolin M; Peters, Sarika U; Prager, Thomas C; Zou, Yali L; Rozelle, Judith C; Turcich, Marie R; Fraley, J Kennard; Anderson, Robert E; Heird, William C

    2010-12-01

    We previously reported better psychomotor development at 30 months of age in infants whose mothers received a docosahexaenoic acid (DHA) (22:6n-3) supplement for the first 4 months of lactation. We now assess neuropsychological and visual function of the same children at 5 years of age. Breastfeeding women were assigned to receive identical capsules containing either a high-DHA algal oil (∼200 mg/d of DHA) or a vegetable oil (containing no DHA) from delivery until 4 months postpartum. Primary outcome variables at 5 years of age were measures of gross and fine motor function, perceptual/visual-motor function, attention, executive function, verbal skills, and visual function of the recipient children at 5 years of age. There were no differences in visual function as assessed by the Bailey-Lovie acuity chart, transient visual evoked potential or sweep visual evoked potential testing between children whose mothers received DHA versus placebo. Children whose mothers received DHA versus placebo performed significantly better on the Sustained Attention Subscale of the Leiter International Performance Scale (46.5 ± 8.9 vs 41.9 ± 9.3, P DHA supplementation versus placebo for the first 4 months of breastfeeding performed better on a test of sustained attention. This, along with the previously reported better performance of the children of DHA-supplemented mothers on a test of psychomotor development at 30 months of age, suggests that DHA intake during early infancy confers long-term benefits on specific aspects of neurodevelopment. Copyright © 2010 Mosby, Inc. All rights reserved.

  1. Five years of Homo floresiensis.

    Science.gov (United States)

    Aiello, Leslie C

    2010-06-01

    Since Homo floresiensis was first described in October 2004 there has been a lively debate over its status. Is it a late surviving species of early Homo or merely a modern individual afflicted with disordered growth and one of the many syndromes resulting in microchephaly? Recently the discovery team has published a series of articles providing detailed descriptions of the hominin material, its geomorphological context, and the associated archaeology and faunal material (Morwood and Jungers: J Hum Evol 57 (2009) 437-648). In addition, other researchers have put forward new hypotheses for possible pathologies including Laron's Syndrome and Myxoedematous Endemic (ME) Cretinism. Here I review this new information and conclude that the evidence supports the hypothesis that Homo floresiensis is a late-surviving species of early Homo with its closest morphological affinities to early African pre-erectus/ergaster hominins. Although this hypothesis requires fundamental paradigm changes in our understanding of human evolution, it provides a more economical explanation for H. floresiensis than do the alternatives. None of the current explanations for microcephaly and disordered growth account for the range of features observed in H. floresiensis. Neither do they provide explanations for why a pathological condition in modern humans would mimic so closely the morphology observed in earlier hominins. This conclusion is based on the current evidence for H. floresiensis and on the particular pathological explanations that have appeared in the literature. There is no doubt that controversy over H. floresiensis will continue until new and conclusive evidence is available to settle the debate one way or another. Copyright 2010 Wiley-Liss, Inc.

  2. Idaho supplementation studies : five year report : 1992-1996

    International Nuclear Information System (INIS)

    Walters, Jody P.; Idaho. Dept. of Fish and Game; United States. Bonneville Power Administration. Division of Fish and Wildlife.

    1999-01-01

    In 1991, the Idaho Supplementation Studies (ISS) project was implemented to address critical uncertainties associated with hatchery supplementation of chinook salmon Oncorhynchus tshawytscha populations in Idaho. The project was designed to address questions identified in the Supplementation Technical Work Group (STWG) Five-Year-Workplan (STWG 1988). Two goals of the project were identified: (1) assess the use of hatchery chinook salmon to increase natural populations in the Salmon and Clearwater river drainages, and (2) evaluate the genetic and ecological impacts of hatchery chinook salmon on naturally reproducing chinook salmon populations. Four objectives to achieve these goals were developed: (1) monitor and evaluate the effects of supplementation on presmolt and smolt numbers and spawning escapements of naturally produced fish; (2) monitor and evaluate changes in natural productivity and genetic composition of target and adjacent populations following supplementation; (3) determine which supplementation strategies (broodstock and release stage) provide the quickest and highest response in natural production without adverse effects on productivity; and (4) develop supplementation recommendations. This document reports on the first five years of the long-term portion of the ISS project. Small-scale studies addressing specific hypotheses of the mechanisms of supplementation effects (e.g., competition, dispersal, and behavior) have been completed. Baseline genetic data have also been collected. Because supplementation broodstock development was to occur during the first five years, little evaluation of supplementation is currently possible. Most supplementation adults did not start to return to study streams until 1997. The objectives of this report are to: (1) present baseline data on production and productivity indicators such as adult escapement, redd counts, parr densities, juvenile emigrant estimates, and juvenile survival to Lower Granite Dam (lower Snake

  3. Sociohydrology: Where are we five years later?

    Science.gov (United States)

    Guneralp, I.; Weyand, S.; Guneralp, B.

    2017-12-01

    Studies exploring the nature of human-water systems and methodologies aiming to integrate social and biophysical cycles have existed long before the term `sociohydrology' was officially introduced in a 2012 article. Despite criticisms since this first publication, the term has promoted research towards a wholistic understanding of the dynamics of coupled human-water systems. The declaration of the 2013-2022 Scientific Decade as Panta Rhei - Everything Flows recognized the importance of interactions and feedbacks between hydrological and social systems: a call to broaden the horizons of sociohydrology. Five years have passed since the field began, and there is a need to analyze the growing body of literature and determine which steps to take next. This study will perform a meta-analysis of the literature pertaining to the field of sociohydrology from its coinage in 2012 until the present year. Our goal is to identify developing trends in the application of the sociohydrologic framework, study foci, criticisms, and the authors behind them. We have obtained 65 publications relating to `sociohydrology' or `socio-hydrology' and 34 additional publications identified solely by the "KeyWords PLUS" function on Web of Science. In addition to independent analyses, we will compare the two datasets for similarities and significant differences. Our interests include the areas of application - both geographically and in subject matter - and authorship diversity among others. These results will supplement the conversation on sociohydrology by discerning how the field has evolved over the past five years. The results will identify shortcomings in the scope of the current literature, potential prevailing biases, and criticisms of the field, in addition to unifying thought and novel application. It will finish by offering a direction for the research community to continue developing.

  4. Key Royale bridge five year evaluation.

    Science.gov (United States)

    2013-06-01

    This report describes the design, construction, instrumentation, and five-year evaluation of the Key Royale Bridge substructure. The primary focus was the evaluation of the implementation of highly reactive supplementary cementitious materials (SCM) ...

  5. Launching PPARC's five year strategy programme

    CERN Document Server

    2003-01-01

    "Over one hundred delegates from Parliament, Whitehall and Industry attended a reception on Tuesday night (25 November) to mark the launch the Particle Physics and Astronomy Research Council's (PPARC) Five Year Plan" (1 page).

  6. Long-term survival in acute leukemia in Japan. A study of 304 cases.

    Science.gov (United States)

    Kawashima, K; Suzuki, H; Yamada, K; Kato, Y; Watanabe, E; Morishima, Y; Takeyama, H; Kobayashi, M

    1980-04-15

    In a national survey of five-year survivors with acute leukemia, 233 of 304 cases were children under 14 years of age and 71 were adults. There were 107 myeloblastic, 10 promyelocytic, 142 lymphocytic, and 37 undifferentiated leukemias, Forty-five cases at age 3 represented the peak. These long-term survivors have shown a yearly increase in number. In 1972, the number of childhood ALL cases reached 38 with no great changes in ANLL cases. With respect to prognosis among long-term survivors, it seemed that neither type of leukemia nor age at diagnosis were factors influencing the future survival. CNS relapse occurring before the third year was an unfavorable complication for a prognosis beyond five years. Only 8 patients died of leukemia among 155 patients who reached five years in their initial complete remission; 49 of 90 patients who had relapse within five years after diagnosis died of leukemia. From these findings, it seems very important to follow patients for five years in their initial complete remission.

  7. The 2015 five-yearly review

    CERN Multimedia

    Staff Association

    2014-01-01

      This year CERN celebrates its 60th anniversary. On this occasion, throughout Europe — most recently on July 1st at the UNESCO headquarters in Paris — festivities are being organized to celebrate the Organization’s success as a flagship laboratory of high-energy physics. To ensure that CERN can remain a centre of excellence in the field of fundamental research, the Organization verifies every five years with the help of a five-yearly review procedure whether the financial and social conditions which it proposes to Staff Members allow it to recruit and retain Staff Members of the highest competence and integrity required for the execution of its mission from all its Member States. For Fellows these conditions should remain attractive compared with those in comparable research institutions, while for Associated members of personnel these conditions should allow it to host them in its research facilities taking into account the highest cost-of-living level in the local ...

  8. FIVE-YEAR RESULTS OF ADJUVANT RADIOTHER

    Science.gov (United States)

    Osa, Etin-Osa O.; DeWyngaert, Keith; Roses, Daniel; Speyer, James; Guth, Amber; Axelrod, Deborah; Kerimian, Maria Fenton; Goldberg, Judith D.; Formenti, Silvia C.

    2015-01-01

    Purpose/Objective A technique of prone breast radiotherapy delivered by a regimen of accelerated intensity modulated radiation therapy (IMRT) with a concurrent boost to the tumor bed, was developed at our institution. We report the five year results of this approach. Methods and Materials Between 2003–2006, 404 patients with Stage I–II breast cancer were prospectively enrolled into two consecutive protocols, institutional trials 03–30 and 05–181, that used the same regimen of 40.5Gy/15 fractions delivered to the index breast over 3 weeks, with a concomitant daily boost to the tumor bed of 0.5Gy (total dose=48Gy). All patients were treated after segmental mastectomy, had negative margins, and nodal assessment. Patients were set up prone: only if lung or heart volumes were in the field was a supine set-up attempted, and chosen if found to better spare these organs. Results 92% of patients were treated prone, 8% supine. 72% had stage I, 28% stage II invasive breast cancer. In-field lung volume ranged from 0 –228.27cc, mean: 19.65cc. In-field heart volume for left breast cancer patients ranged from 0–21.24cc, mean: 1.59cc. There was no heart in the field for right breast cancer patients. At a median follow-up of five years, the five-year cumulative incidence of isolated ipsilateral breast tumor recurrence was 0.82% (95% CI: 0.65–1.04). The five-year cumulative incidence of regional recurrence was 0.53% (95% CI:0.41–0.69) and the five-year overall cumulative death rate was 1.28% (95% CI: 0.48–3.38). 82% (95% CI: 77–85) of patients judged their final cosmetic result as excellent/good. Conclusions Prone accelerated IMRT with a concomitant boost results in excellent local control, optimal sparing of heart and lung, with good cosmesis. RTOG 10–05, a phase III, multi-institutional, randomized trial is ongoing and is evaluating the equivalence of a similar dose and fractionation approach to standard six weeks radiotherapy with a sequential boost. PMID

  9. Twenty-five years of simulator training

    International Nuclear Information System (INIS)

    Anon.

    2002-01-01

    The first training simulator for nuclear power plant personnel in Germany was commissioned twenty-five years ago. The strategy of training by simulators was developed and pursued consistently and continuously in order to ensure sound training of nuclear power plant personnel. The present thirteen simulators cover a broad range of plants. A systematic training concept also helps to ensure a high level of competence and permanent qualification of plant personnel. The anniversary was marked by a festive event at which Erich K. Steiner read a paper on 'The Importance of Simulator Training', and Professor Dr. Adolf Birkhofer spoke about 'Nuclear Technology Education and Training'. (orig.)

  10. Radiation curing - twenty five years on

    International Nuclear Information System (INIS)

    Garnett, J.L.

    1995-01-01

    Progress in UV/EB curing during the past twenty five years is briefly reviewed. During this time developments in unique polymer chemistry, novel equipment design and the introduction of relevant educational programmes has enabled radiation curing to become an established technology with specific strengths in certain industries. Possible reasons for the emergence of the technology in these niche markets are discussed. Despite the worldwide recession, radiation curing is shown to be expanding at 5% per annum with the prospect of higher growth with improving economic conditions. (Author)

  11. Five Years Survival on Hemodialysis Predicted by Artificial Neural ...

    African Journals Online (AJOL)

    Methods: The data of 93 patients who started HD at the Sheffield Kidney Institute between January 1997 and June 1998 were analyzed retrospectively. Potential risk predictors ... Conclusion: Integrated use of regression analysis and probabilistic models allow computation of individual risk of mortality in HD. This may help in ...

  12. Electricity supply alternatives : the next five years

    International Nuclear Information System (INIS)

    Oliver, W.J.

    1998-01-01

    Characteristics of the energy market for New England and the state of New York were summarized. It was predicted that in the next five years, virtually all proposals for electricity generation for New England and New York will be gas-fired combined cycle projects which are designed to meet new generation requirements and displace older steam units. The status of nuclear plants will influence project economics. It has been estimated that New England will need about 6,000-7,000 MW by 2004. This need is driven by the current deficiencies and increased shortfalls due to load growth and economic retirements of 2,000-4,000 MW. Market assumptions for new entrants, merchant plant economics, gas requirements in New England, pipeline capacity and power generation, and the challenges facing the natural gas industry were reviewed. A list of proposed combined cycle natural gas merchant power plants and their generating capacity was also provided. 1 tab., 5 figs

  13. Five years of operating experience with Phenix

    International Nuclear Information System (INIS)

    Conte, F.

    1980-01-01

    The construction of Phenix began at the end of 1968; the unit first went critical on August 31 st, 1973, and it was first connected to the grid of Electricite de France on 31st December 1973. It started operating industrially on July 14th, 1974. The balance sheet after five years of operations is as follows: Gross thermal capacity: 590 MW; Grosss electric capacity: 264 MW; Gross capacity factor of the power station: 45%; Gross electrical power produced by 30th september 1979: more than six billion kWh. In 1976 and 1977 the operation of the plant was affected by modifications made to the intermediate heat exchangers following leaks discovered in October 1976. Since 1976 the plants has been working at full capacity and the availability rate during the period July 1978 - July 1979 was more than 80% [fr

  14. Diffraction dissociation: thirty five years after

    International Nuclear Information System (INIS)

    Zotov, N.P.; Tsarev, V.A.

    1988-01-01

    Review of the basic results and stages of studying one of the most interesting phenomena in high energy physics-diffraction dissociation (DD) of hadrons is presented. The review contains complete information concerning the basic experimental results and the most ''set'' DD theoretical models. Though the discussion focuses primarily on considering a single nucleon DD, this still allows one to fully describe the basic features of the phenomenon under investigation. The last part of the review is devoted to the most notable results obtained during DD experimental investigation in the last five years, which have not been reflected in the earlier published reviews. Signs of excited system parton structure and pomeron are clearly found in the new experimental data. It is underlined that DD mechanism understanding is closely connected with the solution of the confinement problem in the strong interaction theory and requires further experimental and theoretical investigations

  15. Bon courage! (Five-Yearly Review)

    CERN Multimedia

    Association du personnel

    2006-01-01

    With these words of encouragement the Director General ended his long presentation to the staff on 12 January. And he is not wrong there…we certainly will need courage, not only to complete the LHC and other CERN projects, but also, unfortunately, to defend our employment conditions. Indeed, Mr. Aymar very (too) quickly presented us with his conclusions on the Five-Yearly Review, in a resolutely positive manner. In short, we can say that, beneath a deceptive exterior, a serious attack on our employment conditions is in preparation! Salary levels, careers, family…we are talking about your future! Last June, a huge majority of you approved the Staff Association's demands for this Review.

  16. The Chernobyl accident - five years later

    International Nuclear Information System (INIS)

    Mueck, K.

    1991-06-01

    At the fifth anniversary of the Chernobyl accident the initial situation at that time, the control of the consequences to Austria in the present light, as well as the knowledge gained from the accident and its consequences are described. A final estimate and appraisal of the total population dose by the accident alloted according to the individual exposure pathways and the dose reductions due to countermeasures by the authorities are given. The dose reduction in the following years is described. Five years later the external exposure was reduced to about 6 % of the values of the first year, the ingestion dose to about 5 % of the first-year-values. Finally, the current radiation situation is described and the dose contribution by foodstuff with elevated activity concentration is estimated. Also the consequences from the experience and knowledge obtained by the accident are described. (author)

  17. Twenty five years of fundamental theory

    International Nuclear Information System (INIS)

    Bell, J.S.

    1980-01-01

    In reviewing the last twenty five years in fundamental physics theory it is stated that there has been no revolution in this field. In the absence of gravitation, Lorentz invariance remains a requirement on fundamental laws. Einstein's theory of gravitation inspires increasing conviction on the astronomical scale. Quantum theory remains the framework for all serious effort in microphysics, and quantum electrodynamics remains the model of a fully articulated microphysical theory, completely successful in its domain. However,a number of ideas have appeared, of great theoretical interest and some phenomenological success, which may well contribute to the next decisive step. Recent work on the following topics is mentioned; gravitational radiation, singularites, black body radiation from black holes, gauge and hidden symmetry in quantum electrodynamics, the renormalization of electromagnetic and weak interaction theory, non-Abelian gauge theories, magnetic monopoles as the most striking example of solitons, and supersymmetry. (UK)

  18. Gender identity disorder in a five-year-old boy.

    OpenAIRE

    Herman, S. P.

    1983-01-01

    Markedly effeminate behavior in a young boy is a source of concern and confusion for parents, teachers, and the child. It also represents a therapeutic dilemma for the child psychiatrist. The case of a five-year-old boy with gender identity disorder of childhood is presented and the literature on hypotheses of etiology, treatment, and long-term follow-up is reviewed. The ethical and philosophical questions posed by such a case are discussed.

  19. The Scope of Numeracy after Five Years

    Directory of Open Access Journals (Sweden)

    H.L. Vacher

    2013-01-01

    Full Text Available The purpose of this editorial is to provide an efficient way for readers and potential authors to see (a what type of papers are published in this journal and (b what subjects are appropriate. The editorial consists mainly of about a dozen pages of tables including live links to the papers’ access/abstract pages to facilitate easy browsing. In the first table, the 85 papers that have been published in the journal’s first five years are classified into: review papers; research papers; case studies; essays; book reviews; columns; and editorials about the journal. In the second table, the papers are inventoried into overlapping sets on: assessment; QL and writing; the construct of QL; focused QL courses and curricula; QL across the curriculum; QL centers; algebra and calculus education; statistics education; intersections with science and engineering; intersections with social sciences; financial numeracy; health numeracy; math anxiety; and cognition. Browsing these links confirms what we said in the first editorial: the scope of Numeracy is huge.

  20. Acute and long-term survival in chronically critically ill surgical patients: a retrospective observational study.

    Science.gov (United States)

    Hartl, Wolfgang H; Wolf, Hilde; Schneider, Christian P; Küchenhoff, Helmut; Jauch, Karl-Walter

    2007-01-01

    Various cohort studies have shown that acute (short-term) mortality rates in unselected critically ill patients may have improved during the past 15 years. Whether these benefits also affect acute and long-term prognosis in chronically critically ill patients is unclear, as are determinants relevant to prognosis. We conducted a retrospective analysis of data collected from March 1993 to February 2005. A cohort of 390 consecutive surgical patients requiring intensive care therapy for more than 28 days was analyzed. The intensive care unit (ICU) survival rate was 53.6%. Survival rates at one, three and five years were 61.8%, 44.7% and 37.0% among ICU survivors. After adjustment for relevant covariates, acute and long-term survival rates did not differ significantly between 1993 to 1999 and 1999 to 2005 intervals. Acute prognosis was determined by disease severity during ICU stay and by primary diagnosis. However, only the latter was independently associated with long-term prognosis. Advanced age was an independent prognostic determinant of poor short-term and long-term survival. Acute and long-term prognosis in chronically critically ill surgical patients has remained unchanged throughout the past 12 years. After successful surgical intervention and intensive care, long-term outcome is reasonably good and is mainly determined by age and underlying disease.

  1. Virtual Knowledge Center Five Year Vision

    International Nuclear Information System (INIS)

    KENNY, N.E.

    2003-01-01

    The vision for Virtual Knowledge Center (VKC) is to make information accessible from one verifiable source, provide an environment for knowledge capture and sharing, and provide for automated business process management. VKC will be the foundation for management and integration of information activities at the Hanford Site for the next 5 years. It provides a distinctive solution that can increase return on investment, increase a facility's efficiency, and reduce a project's cost and schedule. This Five-Year Vision presents a clear path forward to support the U.S. Department of Energy and its contractors in their goals of achieving the Site's missions of preparing for the future, restoring the river corridor, and transitioning the central plateau. Diminishing funds and reduced availability of resources has created a direct obligation for the Hanford Site to be more innovative and resourceful in the use of its current information assets. The difficulty and, in some instances, the inability of current systems to effectively and efficiently meet evolving standards and directions, coupled with Hanford's geographical size, pose challenges to information acquisition, sharing, and use. An imbalance exists in the lifecycle process of information between locating information and executing work. The need to capture and retain workers' knowledge for future use was evaluated to identify cost effective alternatives. The VKC is comprised of a suite of technologies that enables seamless access to the information available through integration of databases and systems. The VKC uses web technology to provide the environment for gathering information from disparate data sources. The VKC makes information available to users; allowing them to search, access documents, retain enterprise knowledge, or interact with other users. The VKC provides a single path to electronic information; allows capture of knowledge at its source and makes data and information available for informed decision

  2. Geospatial Health: the first five years

    Directory of Open Access Journals (Sweden)

    Jürg Utzinger

    2011-11-01

    Full Text Available Geospatial Health is an international, peer-reviewed scientific journal produced by the Global Network for Geospatial Health (GnosisGIS. This network was founded in 2000 and the inaugural issue of its official journal was published in November 2006 with the aim to cover all aspects of geographical information system (GIS applications, remote sensing and other spatial analytic tools focusing on human and veterinary health. The University of Naples Federico II is the publisher, producing two issues per year, both as hard copy and an open-access online version. The journal is referenced in major databases, including CABI, ISI Web of Knowledge and PubMed. In 2008, it was assigned its first impact factor (1.47, which has now reached 1.71. Geospatial Health is managed by an editor-in-chief and two associate editors, supported by five regional editors and a 23-member strong editorial board. This overview takes stock of the first five years of publishing: 133 contributions have been published so far, primarily original research (79.7%, followed by reviews (7.5%, announcements (6.0%, editorials and meeting reports (3.0% each and a preface in the first issue. A content analysis of all the original research articles and reviews reveals that three quarters of the publications focus on human health with the remainder dealing with veterinary health. Two thirds of the papers come from Africa, Asia and Europe with similar numbers of contributions from each continent. Studies of more than 35 different diseases, injuries and risk factors have been presented. Malaria and schistosomiasis were identified as the two most important diseases (11.2% each. Almost half the contributions were based on GIS, one third on spatial analysis, often using advanced Bayesian geostatistics (13.8%, and one quarter on remote sensing. The 120 original research articles, reviews and editorials were produced by 505 authors based at institutions and universities in 52 countries

  3. Foreign Ownership and Long-term Survival

    DEFF Research Database (Denmark)

    Kronborg, Dorte; Thomsen, Steen

    2006-01-01

    probability. On average exit risk for domestic companies is 2.3 times higher than for foreign companies. First movers like Siemens, Philips, Kodak, Ford, GM or Goodyear have been active in the country for almost a century. Relative foreign survival increases with company age. However, the foreign survival...

  4. A case of long term survival with skeletal only metastatic breast cancer.

    Science.gov (United States)

    Kuechle, Joseph B; McGrath, Brian E; Khoury, Thaer; Mindell, Eugene R

    2015-01-01

    The prognosis of patients with metastatic breast cancer is very poor. Because of this, treatment of skeletal metastasis is often palliative with limited goals rather than cure. However, there are those patients, such as presented here, who survive for an extended time. This thirty-six year old female presented with lytic lesions to one ulna and rib five years after mastectomy for breast cancer. Despite radiation and chemotherapy, the ulnar lesion expanded and resulted in an elbow dislocation. The rib lesion was resected and the arm amputated above the elbow. She developed local recurrence in both her above elbow amputation stump and chest wall and a more proximal below shoulder amputation was performed with resection of chest wall lesion. Even though she had locally aggressive disease, she has survived for 31 years after diagnosis without any evidence of disease. Reports of metastatic breast cancer survival indicate the five year survival to be 15%. There have been few reports indicating that those patients with skeletal only or oligometastatic disease have improved prognosis. It is not clear what biological properties of these tumors results in the improved survival. This case highlights the challenges of giving patients the optimal treatment in the light of limited ability to predict prognosis. It also highlights the need to further investigate the phenotypes of breast cancer that can, despite metastatic disease and with modern treatment go on to long survival. In addition this case demonstrates the importance of long term followup. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  5. Population policy and the Five Year Plans.

    Science.gov (United States)

    Chandna, R C

    1989-01-01

    Population policy and the 5-year plans since 1951 in India are reivewed and evaluated in terms of limiting population growth. The family planning (FP) programs have not had a major impact on people's attitudes, practice of contraceptives, or the average fertility rate. Not enough attention has been paid to the interaction of demographic structure and economic and social development, and the implications for limiting population growth. Vital elements of a population policy are containing population growth, limiting births among the young and reproductive age groups, enhancing employment options for males and females, diversifying the economy, improving literacy and educational standards, improving urban/rural ratios, and balancing male/female ratios. Several approaches to FP programs are possible: long term measures to improve the social, economic, and demographic structure, and short term measures to immediately avert births. Long term approaches recognize the complexity of the problem. Rapid socioeconomic development is the best contraceptive for controlling India's population. A well conceived population education program can help, as will increasing the marriage age, preventing children from entering the labor market, increasing female education levels, providing old age pension and social security and other insurance, and providing maternity benefits for small families. Short term measures may provide temporary or permanent methods of averting births; i.e., contraceptives, sterilization, penalties and rewards for small families. However, it must not be a bureaucratic measure imposed from above. It must be a self generating process. The author suggests that simultaneous long and short term approaches are necessary. Research should be conducted to delineate which measures have the most impact on reducing fertility and policy be formulated in accordance with these answers. Compulsion is required, and government should not hesitate to step in. In rural areas

  6. Long-term survival in small-cell lung cancer

    DEFF Research Database (Denmark)

    Lassen, U; Osterlind, K; Hansen, M

    1995-01-01

    PURPOSE: To describe in patients with small-cell lung cancer (SCLC) the characteristics of those who survive for > or = 5 years, to identify long-term prognostic factors, to analyze survival data of 5-year survivors, and to study 10-year survival in patients entered before 1981. PATIENTS......, especially tobacco-related cancers and other tobacco-related diseases....

  7. 40 CFR 68.42 - Five-year accident history.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Five-year accident history. 68.42... (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Hazard Assessment § 68.42 Five-year accident history. (a) The owner or operator shall include in the five-year accident history all accidental releases from...

  8. Post-Operative Infection Is an Independent Risk Factor for Worse Long-Term Survival after Colorectal Cancer Surgery.

    Science.gov (United States)

    Kerin Povšič, Milena; Ihan, Alojz; Beovič, Bojana

    2016-12-01

    Colorectal cancer surgery is associated with a high incidence of post-operative infections, the outcome of which may be improved if diagnosed and treated early enough. We compared white blood cell (WBC) count, C-reactive protein (CRP), and procalcitonin (PCT) as predictors of post-operative infections and analyzed their impact on long-term survival. This retrospective study included 186 patients undergoing colorectal surgery. Post-operative values of WBC, CRP, and PCT were analyzed by the receiver operating characteristic (ROC) analysis. We followed infections 30 d after the surgery. A five-year survival was analyzed by Kaplan-Meier method and prognostic factors by Cox regression model. Fifty-five patients (29.5%) developed post-operative infection, the most frequent of which was surgical site infection (SSI). C-reactive protein on post-operative day three and PCT on post-operative day two demonstrated the highest diagnostic accuracy for infection (area under the curve [AUC] 0.739 and 0.735). C-reactive protein on post-operative day three was an independent predictor of infection. Five-year survival was higher in the non-infected group (70.8%), compared with the infected group (52.1%). The worst survival (40.9%) was identified in patients with organ/space SSI. Post-operative infection and tumor stage III-IV were independent predictors of a worse five-year survival. C-reactive protein on post-operative day three and PCT on post-operative day two may be early predictors of infection after colorectal cancer surgery. Post-operative infections in particular organ/space SSI have a negative impact on long-term survival.

  9. Hyperfunctioning thyroid cancer: a five-year follow-up.

    Science.gov (United States)

    Azevedo, Monalisa Ferreira; Casulari, Luiz Augusto

    2010-02-01

    Differentiated thyroid cancer rarely occurs in association with hyperfunctioning nodules. We describe a case of a 47-year-old woman who developed symptoms of hyperthyroidism associated with a palpable thyroid nodule. Thyroid scintigraphy showed an autonomous nodule, and fine-needle aspiration biopsy was suggestive of papillary carcinoma. Laboratorial findings were consistent with the diagnosis of hyperthyroidism. The patient underwent thyroidectomy and a papillary carcinoma of 3.0 x 3.0 x 2.0 cm, follicular variant, was described by histological examination. The surrounding thyroid tissue was normal. Postoperatively, the patient received 100 mCi of (131)I, and whole body scans detected only residual uptake. No evidence of metastasis was detected during five years of follow-up. Hot thyroid nodules rarely harbor malignancies, and this case illustrated that, when a carcinoma occurs the prognosis seems to be very good with no evidence of metastatic dissemination during a long-term follow-up.

  10. Long-term patient survival in ANCA-associated vasculitis

    DEFF Research Database (Denmark)

    Flossmann, Oliver; Berden, Annelies; de Groot, Kirsten

    2011-01-01

    Wegener's granulomatosis and microscopic polyangiitis are antineutrophil cytoplasm antibodies (ANCA)-associated vasculitides with significant morbidity and mortality. The long-term survival of patients with ANCA associated vasculitis treated with current regimens is uncertain.......Wegener's granulomatosis and microscopic polyangiitis are antineutrophil cytoplasm antibodies (ANCA)-associated vasculitides with significant morbidity and mortality. The long-term survival of patients with ANCA associated vasculitis treated with current regimens is uncertain....

  11. 40 CFR 68.168 - Five-year accident history.

    Science.gov (United States)

    2010-07-01

    ... 40 Protection of Environment 15 2010-07-01 2010-07-01 false Five-year accident history. 68.168 Section 68.168 Protection of Environment ENVIRONMENTAL PROTECTION AGENCY (CONTINUED) AIR PROGRAMS (CONTINUED) CHEMICAL ACCIDENT PREVENTION PROVISIONS Risk Management Plan § 68.168 Five-year accident history...

  12. The 2010 five-yearly review has started

    CERN Multimedia

    Association du personnel

    2009-01-01

    Every five years, the financial and social conditions of members of the personnel are examined according to the procedures defined in Annex A1 of the Staff Rules and Regulations (SR&R). This exercise is called the “five-yearly review” (5YR).

  13. Antioxidant defenses predict long-term survival in a passerine bird.

    Directory of Open Access Journals (Sweden)

    Nicola Saino

    2011-05-01

    Full Text Available Normal and pathological processes entail the production of oxidative substances that can damage biological molecules and harm physiological functions. Organisms have evolved complex mechanisms of antioxidant defense, and any imbalance between oxidative challenge and antioxidant protection can depress fitness components and accelerate senescence. While the role of oxidative stress in pathogenesis and aging has been studied intensively in humans and model animal species under laboratory conditions, there is a dearth of knowledge on its role in shaping life-histories of animals under natural selection regimes. Yet, given the pervasive nature and likely fitness consequences of oxidative damage, it can be expected that the need to secure efficient antioxidant protection is powerful in molding the evolutionary ecology of animals. Here, we test whether overall antioxidant defense varies with age and predicts long-term survival, using a wild population of a migratory passerine bird, the barn swallow (Hirundo rustica, as a model.Plasma antioxidant capacity (AOC of breeding individuals was measured using standard protocols and annual survival was monitored over five years (2006-2010 on a large sample of selection episodes. AOC did not covary with age in longitudinal analyses after discounting the effect of selection. AOC positively predicted annual survival independently of sex. Individuals were highly consistent in their relative levels of AOC, implying the existence of additive genetic variance and/or environmental (including early maternal components consistently acting through their lives.Using longitudinal data we showed that high levels of antioxidant protection positively predict long-term survival in a wild animal population. Present results are therefore novel in disclosing a role for antioxidant protection in determining survival under natural conditions, strongly demanding for more longitudinal eco-physiological studies of life-histories in

  14. Louisiana Airport System Plan Five-Year Capital Improvement Program.

    Science.gov (United States)

    1992-07-01

    The Louisiana Airport System Plan (LASP) Five-Year-Capital Improvement Program (CIP) is a development plan for all commercial service, reliever, and general aviation airports in Louisiana. It is a detailed listing of potential projects based on the a...

  15. General RMP Guidance - Chapter 3: Five-Year Accident History

    Science.gov (United States)

    This involves the reporting of significant accidental releases of one or more of the regulated toxic or flammable substances from a covered process in the five years prior to the submission of an initial or updated Risk Management Plan.

  16. FORMakademisk – Fem års jubileum - Five years anniversary

    Directory of Open Access Journals (Sweden)

    Janne Beate Reitan

    2013-01-01

    Full Text Available When we first published FORMakademisk five years ago, we stated in the very first editorial on page 1 in Volume 1, Issue 1 that:The aim of the journal is to provide a venue for research in design and design education, and thereby develop an interest and working community of scholars in the field. The editorial team perceives design as a generic term that includes creative and performing activities in the great span of the artefacts ‘from the spoon to the city’. The editorial team relates to design education as a field that includes the dissemination of design in society and the teaching of design at all levels general education, vocational preparation, professional education and research education—from kindergarten to doctorate.Since then we have published two issues every year, nine all together, with more than 50 articles. The editorial team saw that future contributors to FORMakademisk would mainly be recruited from researchers within the design disciplines, and their research interests would have their roots in creative and artistic design practice. At the same time, FORMakademisk has invited scientists from established academic disciplines, when their interest has been directed towards design issues.

  17. Breast sarcoma surgical management: a five-year multicentric study

    Directory of Open Access Journals (Sweden)

    Răzvan V. Scăunașu

    2016-11-01

    Full Text Available Background. Breast sarcomas are a heterogeneous group of breast neoplasms with a low incidence and a reserved prognosis. No treatment protocol has been yet established, a guideline similar to soft tissue sarcomas is used. Materials and Methods. Our study analyzed all the patients admitted with the diagnosis of malignant breast disease in two specialized centers on a five-year time frame. We compared long term results for the patients who underwent conservative treatment and mastectomy. Results. A total of 76 cases received surgical treatment with curative intent, 24 conservative procedures and 52 mastectomies. Incidence of local recurrence does not appear to be closely related to the type of surgical procedure. There were a number of five local recurrences for patients who received conservative treatment and 7 local recurrences where we used mastectomy. Kaplan-Meier analysis conducted shows no differences statistically significant (sig = 0.459 between the results of conservative treatment and mastectomy. Basically conservative surgery seems to get similar results, provided that R0 resection objective can be met. Conclusions. Treatment options are more limited for breast sarcomas than carcinomas, the role of surgery being more important to therapeutic success. The biological characteristic of the tumor including histological type and sub-type, play an important role in determining the results and the treatment should be tailored and adapted for each case.

  18. Fukushima five years after, a return to the abnormal

    International Nuclear Information System (INIS)

    Boilley, David

    2016-02-01

    After a synthetic presentation of the study which discusses how different issues have been and are still addressed in Fukushima (evacuated populations, protection against radiations, food contamination, future of evacuated lands, reluctance of inhabitants to come back), this report outlines that radioactive releases are still going on (discussion of source terms, continuing leakages, impact on sea, practices resulting in significant releases of radioactive dusts, a still threatening Fukushima plant). The author then addresses issues related to radioactive contamination and evacuation (evacuation sequence, number of displaced persons, situation after 5 years), discusses the reviewing of levels of protection after a nuclear accident (principles of radiation protection, evacuation policy, protection values and operational values, limits for food contamination). He proposes an assessment of food contamination five years after the accident (initial mistakes in food control, extended food controls, internal exposure of consumers, threats on some activities due to production restrictions), and comments the restoration of contaminated territories (restoring policy, limited effects of decontamination, production of a large quantity of wastes which are not well maintained nor secure). He finally comments the issue of population come-back (government decisions, reluctance of inhabitants, depopulation and ageing of contaminated areas, case of human right violation, suffering of elderly people)

  19. [Association between the use of blood components and the five-year mortality after liver transplant].

    Science.gov (United States)

    de Morais, Bruno Salomé; Sanches, Marcelo Dias; Ribeiro, Daniel Dias; Lima, Agnaldo Soares; de Abreu Ferrari, Teresa Cristina; Duarte, Malvina Maria de Freitas; Cançado, Guilherme Henrique Gomes Moreira

    2011-01-01

    Liver transplant (LT) surgery is associated with significant bleeding in 20% of cases, and several authors have demonstrated the risks related to blood components. The objective of the present study was to evaluate the impact of using blood components during hospitalization in five-year survival of patients undergoing LT. One hundred and thirteen patients were evaluated retrospectively. Several variables, including the use of blood components intraoperatively and throughout hospitalization, were categorized and evaluated by univariate analysis using Fisher's test. A level of significance of 5% was adopted. Results with p renal dysfunction, and longer stay in hospital and ICU are associated with greater five-year mortality after LT (p transplantation (p < 0.01). This study emphasizes the relationship between the use of blood components during hospitalization and increased mortality in five years after LT. 2011 Elsevier Editora Ltda. All rights reserved.

  20. Long-term survival and causes of death after stroke

    DEFF Research Database (Denmark)

    Brønnum-Hansen, Henrik; Davidsen, M; Thorvaldsen, P

    2001-01-01

    As part of the Danish contribution to the World Health Organization (WHO) MONICA (Monitoring Trends and Determinants in Cardiovascular Disease) Project, a register of patients with stroke was established in 1982. The purpose of the present study was to analyze long-term survival and causes of death...

  1. The deep, hot biosphere: Twenty-five years of retrospection.

    Science.gov (United States)

    Colman, Daniel R; Poudel, Saroj; Stamps, Blake W; Boyd, Eric S; Spear, John R

    2017-07-03

    Twenty-five years ago this month, Thomas Gold published a seminal manuscript suggesting the presence of a "deep, hot biosphere" in the Earth's crust. Since this publication, a considerable amount of attention has been given to the study of deep biospheres, their role in geochemical cycles, and their potential to inform on the origin of life and its potential outside of Earth. Overwhelming evidence now supports the presence of a deep biosphere ubiquitously distributed on Earth in both terrestrial and marine settings. Furthermore, it has become apparent that much of this life is dependent on lithogenically sourced high-energy compounds to sustain productivity. A vast diversity of uncultivated microorganisms has been detected in subsurface environments, and we show that H 2 , CH 4 , and CO feature prominently in many of their predicted metabolisms. Despite 25 years of intense study, key questions remain on life in the deep subsurface, including whether it is endemic and the extent of its involvement in the anaerobic formation and degradation of hydrocarbons. Emergent data from cultivation and next-generation sequencing approaches continue to provide promising new hints to answer these questions. As Gold suggested, and as has become increasingly evident, to better understand the subsurface is critical to further understanding the Earth, life, the evolution of life, and the potential for life elsewhere. To this end, we suggest the need to develop a robust network of interdisciplinary scientists and accessible field sites for long-term monitoring of the Earth's subsurface in the form of a deep subsurface microbiome initiative.

  2. Five-year workplace wellness intervention in the NHS.

    Science.gov (United States)

    Blake, Holly; Zhou, Dingyuan; Batt, Mark E

    2013-09-01

    Poor health and well-being has been observed among NHS staff and has become a key focus in current public health policy. The objective of this study was to deliver and evaluate a five-year employee wellness programme aimed at improving the health and well-being of employees in a large NHS workplace. A theory-driven multi-level ecological workplace wellness intervention was delivered including health campaigns, provision of facilities and health-promotion activities to encourage employees to make healthy lifestyle choices and sustained behaviour changes. An employee questionnaire survey was distributed at baseline (n = 1,452) and at five years (n = 1,134), including measures of physical activity, BMI, diet, self-efficacy, social support, perceived general health and mood, smoking behaviours, self-reported sickness absence, perceived work performance and job satisfaction. Samples were comparable at baseline and follow-up. At five years, significantly more respondents actively travelled (by walking or cycling both to work and for non-work trips) and more were active while at work. Significantly more respondents met current recommendations for physical activity at five years than at baseline. Fewer employers reported 'lack of time' as a barrier to being physically active following the intervention. Significantly lower sickness absence, greater job satisfaction and greater organisational commitment was reported at five years than at baseline. Improvements in health behaviours, reductions in sickness absence and improvements in job satisfaction and organisational commitment were observed following five years of a workplace wellness intervention for NHS employees. These findings suggest that health-promoting programmes should be embedded within NHS infrastructure.

  3. Power generation in the 12-th five-year plan

    International Nuclear Information System (INIS)

    Troitskij, A.A.

    1986-01-01

    The state of electric power generation in the 11-th five-year plan is summed up. Perspectives of development of heat and electric power generation in the 12-th five-year plan are considered. Thermal power generation of NPPs in 1990 will increase by a factor of 8.4 as compared with 1975. The NPP development will be mainly realized on the basis of the WWER-1000 type reactors. It is planned to commission fast reactors of up to 800 MW

  4. Twenty-five year outcome of sequential abdominopelvic radiotherapy and alkylating agent chemotherapy for ovarian carcinoma

    International Nuclear Information System (INIS)

    Bellairs, Ellen E.; Twiggs, Leo B.; Potish, Roger A.

    1997-01-01

    Purpose: A prospective study of sequential surgery, abdominopelvic radiotherapy and single agent alkylating chemotherapy was conducted to evaluate survival and toxicity in the management of ovarian carcinoma. Methods: From 1970-1976, 95 women with stage I-III epithelial ovarian carcinoma were scheduled to receive postoperative radiotherapy consisting of 20.0 Gy to the whole abdomen (1.0 Gy/day), a 29.75 Gy pelvic boost (1.75 Gy/day) and 10 subsequent courses of Melphalan (1 mg/kg/course). Endpoints were overall survival, disease-free survival(DFS), and acute and chronic toxicity. Results: The evaluable 94 patients included 19 stage I, 25 stage II, and 50 stage III. Of the latter, 21 had no palpable disease postoperatively (IIIN) and 29 had postoperative palpable disease (IIIP). Overall survival at 5, 10, 15 and 20 years was 42%, 30%, 23% and 22%. DFS for the entire group was 54% at 5 years and remained 50% from 10 to 25 years. All but two recurrences were noted within the first 27 months. No recurrence or treatment-related deaths occurred after 8 years. After 10 years, the survival of the study group became parallel to the general population. Prognostic factors were only related to stage (p<.001) and the presence of postoperative palpable disease(p<.001). DFS at 25 years was 95 % for stage I, 71% at 5 years and 66% from 10 to 25 years for stage II, and 17% at 5 years and 11% thereafter for stage III patients(p<.001). Although no stage IIIP patients were cured, 25% lived beyond 2 years. Five year DFS was significantly better in IIIN (45%) vs. IIIP (0%) patients (p<.001). The 65 patients without postoperative palpable disease, (stage I-IIIN) achieved DFS at 5 and 25 years of 69%, and 61%, respectively. Of 31 patients undergoing a second-look surgery, 84% were found to be free of tumor. Two recurred at 3.5 and 7 years after surgery. Acute tolerance was acceptable. Chronic toxicity included an 11.7% rate of small bowel obstruction requiring surgery and a 3% rate of

  5. Collaboration on DIII-D Five Year Plan

    International Nuclear Information System (INIS)

    Allen, S

    2003-01-01

    This document summarizes Lawrence Livermore National Laboratory's (LLNL) plan for fusion research on the DIII-D Tokamak, located at General Atomics (GA) in San Diego, California, in the time period FY04-FY08. This document is a companion document to the DIII-D Five-Year Program Plan; which hereafter will be referred to as the ''D3DPP''. The LLNL Collaboration on DIII-D is a task-driven program in which we bring to bear the full range of expertise needed to complete specific goals of plasma science research on the DIII-D facility. This document specifies our plasma performance and physics understanding goals and gives detailed plans to achieve those goals in terms of experimental leadership, code development and analysis, and diagnostic development. Our program is designed to be consistent with the long-term mission of the DIII-D program as documented in the D3DPP. The overall DIII-D Program mission is ''to establish the scientific basis for the optimization of the tokamak approach to fusion energy production''. LLNL Magnetic Fusion Energy (MFE) supports this mission, and we contribute to two areas of the DIII-D program: divertor physics and advanced tokamak (AT) physics. We lead or contribute to the whole cycle of research: experimental planning, diagnostic development, execution of experiments, and detailed analysis. We plan to continue this style in the next five years. DIII-D has identified three major research themes: AT physics, confinement physics, and mass transport. The LLNL program is part of the AT theme: measurement of the plasma current profile, and the mass transport theme: measurement and modeling of plasma flow. In the AT area, we have focused on the measurement and modeling of the current profile in Advanced Tokamak plasmas. The current profile, and it's effect on MHD stability of the high-β ''AT'' plasma are at the heart of the DIII-D program. LLNL has played a key role in the development of the Motional Stark Effect (MSE) diagnostic. Starting

  6. Goiania radiological accident: five years talking with the population

    International Nuclear Information System (INIS)

    Rozental, J.J.

    1993-01-01

    This article presents an overview five years after the Goiania radiological accident. It reviews from a number of important aspects the psychological impact and conflicting opinions, the public hearings and debates and, particularly describes the victims that still have difficulties to understand the accident and its consequences. (B.C.A.). 05 refs

  7. Five-Yearly Review: TREF avoids the worst!

    CERN Multimedia

    Staff Association

    2006-01-01

    In our last edition, we informed you about the Staff Council decision to reject the entire set of proposals for the five-yearly review, on the basis of the Director-General's revised proposals 2 and 10. We also indicated that a total failure could still be avoided at TREF on 4 and 5 October. To our relief, TREF avoided the worst!

  8. State of logistics - a five-year review

    CSIR Research Space (South Africa)

    Ittmann, HW

    2009-07-01

    Full Text Available The state of logistics survey makes it possible to analyse and show trends over the past five years. This relates to quantitative and qualitative logistics issues that were not possible when this survey started in 2004. The paper will show...

  9. Outcome of the 2015 five-yearly review: decision time

    CERN Multimedia

    Staff Association

    2015-01-01

    To ensure that CERN remains a centre of excellence in the field of fundamental research, the Organization verifies every five years with the help of a Five-yearly review procedure whether the financial and social conditions which it proposes to its staff allow it to recruit and retain Staff Members of the highest competence and integrity required for the execution of its mission and coming from all Member States. For Fellows these conditions should remain attractive compared with those in comparable research institutions, while for Associated members of personnel the conditions should allow it to host them in its research facilities taking into account the highest cost-of-living level in the local region of the Organization. Annex A1 of the CERN Staff Rules prescribes the principles of how to manage this Five-Yearly process. Getting ready In order to prepare the 2015 Five-yearly review and to help define the topics which had to be decided by the CERN Council in June 2014, the Staff Association has organized ...

  10. Annex A1: cornerstone of the five-yearly review

    CERN Multimedia

    Staff Association

    2016-01-01

    As a reminder; the purpose of the five-yearly review is to review the financial and social conditions of all CERN personnel whether employed (MPE) or associated (MPA)! In December 2015, the CERN Council approved the package proposed by the Management. Early this year, and as final act of the 2015 five-yearly review, the CERN Council may decide, if necessary and appropriate, to review the procedures defined in Annex A1 and applicable to future five-yearly reviews. At the meeting of TREF (TRipartite Employment Forum)  in early March 2016 discussions will take place between all stakeholders (representatives of Member States, Management and the Staff Association) and Council will take a decision in June 2016, on the basis of the Management's recommendations. What does Annex A1 say and where can I find it? Annex A1 (Article S V 1.02) is a part of the Staff Rules and Regulations. This annex defines: The five-yearly review of the financial and social conditions of the staff, fellows and MPA; The a...

  11. Five-yearly Review: What now? Is this the end?

    CERN Multimedia

    Association du personnel

    2006-01-01

    The CERN Staff Association has made every effort over the past months to devise and propose numerous solutions in the framework of the current five-yearly review. The Staff Association has done this in close collaboration with the staff members, through several polls which have all resulted in a massive rejection of the Management's position.

  12. The Five-Year Resume: A Career Planning Exercise

    Science.gov (United States)

    Laker, Dennis R.; Laker, Ruth

    2007-01-01

    For most college students, lack of career planning wastes time and resources and may result in years of "career drift." Lack of planning can also lead to deception once students begin seeking career-related employment. Faced with a competitive job market, some students inflate and exaggerate their resumes. The five-year resume exercise helps…

  13. An Explanation on the Tenth-Five-Year Plan of China’s Auto Industry

    Institute of Scientific and Technical Information of China (English)

    2002-01-01

    <正> The Tenth-Five-Year-Plan of the auto industry recently issued has made an analysis on the market demand, development environment and situation that the auto industry will face and advanced the idea for solving contractions and problems, taking the restructuring as motif. Compared with the previous medium-and-long-term programs, the plan is more macroscopic, strategical,

  14. Environmental restoration and waste management five-year plan, Fiscal years 1994--1998

    International Nuclear Information System (INIS)

    1993-01-01

    In March 1989, Secretary of Energy James D. Watkins outlined his vision for a changed Department of Energy (DOE) culture. This culture is one of environmental responsibility, increased knowledge and involvement in environmental management, a new openness to public input, and overall accountability to the Nation for its actions. Over the past three years, the Five Year Plan has evolved into the primary planning tool for the DOE Environmental Restoration and Waste Management Program, looking beyond the current three-year Federal budget horizon. The FY 1994--1998 Five-Year Plan demonstrates DOE's commitment to a culture based on the principles of openness, responsiveness, and accountability; reports on the progress made in carrying out DOE's environmental mission; identifies what must be accomplished during a five-year planning period; and describes strategies for achieving critical program objectives. The Five-Year Plan is not exclusively focused on near-term activities. It also expresses the DOE commitment to a 30-year goal for the cleanup of the 1989 inventory of inactive sites. This goal was established in response to recommendations from the State and Tribal Government Working Group (STGWG) that DOE define a specific end point for completing necessary remediation and restoration activities. The FY 1994--1998 Five-Year Plan reiterates the DOE commitment to meeting this and other important environmental goals

  15. Long-term survival and healthcare utilization outcomes attributable to sepsis and pneumonia

    Directory of Open Access Journals (Sweden)

    Dick Andrew

    2012-11-01

    Full Text Available Abstract Background Hospital associated infections are major problems, which are increasing in incidence and very costly. However, most research has focused only on measuring consequences associated with the initial hospitalization. We explored the long-term consequences of infections in elderly Medicare patients admitted to an intensive care unit (ICU and discharged alive, focusing on: sepsis, pneumonia, central-line-associated bloodstream infections (CLABSI, and ventilator-associated pneumonia (VAP; the relationships between the infections and long-term survival and resource utilization; and how resource utilization was related to impending death during the follow up period. Methods Clinical data and one year pre- and five years post-index hospitalization Medicare records were examined. Hazard ratios (HR and healthcare utilization incidence ratios (IR were estimated from state of the art econometric models. Patient demographics (i.e., age, gender, race and health status and Medicaid status (i.e., dual eligibility were controlled for in these models. Results In 17,537 patients, there were 1,062 sepsis, 1,802 pneumonia, 42 CLABSI and 52 VAP cases. These subjects accounted for 62,554 person-years post discharge. The sepsis and CLABSI cohorts were similar as were the pneumonia and VAP cohorts. Infection was associated with increased mortality (sepsis HR = 1.39, P  Conclusions The infections had significant and lasting adverse consequences among the elderly. Yet, many of these infections may be preventable. Investments in infection prevention interventions are needed in both community and hospitals settings.

  16. Elderly victims of abuse: a five year document analysis

    OpenAIRE

    Garbin,Cléa Adas Saliba; Joaquim,Renata Colturato; Rovida,Tânia Adas Saliba; Garbin,Artênio José Isper

    2016-01-01

    Objective To verify the occurrence of maltreatment of the elderly and its characteristics (location, type, reason, involvement of alcohol/drugs, profile and family relationship of victims and perpetrators) from the police records of a specialized police station over a five year period. Method A cross-sectional, descriptive and documentary analytical study was performed. The police reports of a medium-sized municipality in the northwest of São Paulo were analyzed from 2008 to 2012. The sociod...

  17. Twenty five years of clusters -- from Bochum to Strasbourg

    International Nuclear Information System (INIS)

    Betts, R.R.; Chicago Univ., IL

    1994-01-01

    Developments in the area of clustering aspects of nuclear structure and reactions over the past twenty-five years are reviewed. The viewpoint is that the nucleus is an assembly of clusters. The question is whether clusters actually exist in the nucleus. Although there is abundant evidence for this in light nuclei, the situation for more complex clusters in heavier nuclei is much worse. Differential cross sections for scattering of alpha particles and heavy ions are shown

  18. Computing for magnetic fusion energy research: The next five years

    International Nuclear Information System (INIS)

    Mann, L.; Glasser, A.; Sauthoff, N.

    1991-01-01

    This report considers computing needs in magnetic fusion for the next five years. It is the result of two and a half years of effort by representatives of all aspects of the magnetic fusion community. The report also factors in the results of a survey that was distributed to the laboratories and universities that support fusion. There are four areas of computing support discussed: theory, experiment, engineering, and systems

  19. Environmental restoration and waste management five year plan, fiscal years 1994--1998

    International Nuclear Information System (INIS)

    1993-01-01

    In March 1989, Secretary of Energy James D. Watkins outlined his vision for a changed Department of Energy (DOE) culture. This culture is one of envirorunental responsibility, increased knowledge and involvement in environmental management, a new openness to public input, and overall accountability to the Nation for its actions. Secretary Watkins also requested all the near-term activities necessary to bring DOEactivities into compliance with all applicable environmental requirements to be detailed in one plan. The Five-Year Plan was to be based on a ''bottom up'' approach to planning by using Activity Data Sheets to collect financial and technical information at the installation level. Over the past three years, the Five-Year Plan has evolved into the primary planning tool for the DOE Environmental Restoration and Waste Management Program, looking beyond the current three-year Federal budget horizon. The FY 1994--1998 Five-Year Plan demonstrates DOE's commitment to a culture based on the principles of openness, responsiveness, and accountability; reports on the progress made in carrying out DOE's environmental mission; identifies what must be accomplished during a five-year planning period; and describes strategies for achieving critical program objectives. This plan represents another step towards the implementation of the culture change Secretary Watkins envisioned. The Five-Year Plan is not exclusively focused on near-term activities. Italso expresses the DOE commitment to a 30-year goal for the cleanup of the 1989 inventory of inactive sites. The FY 1994--1998 Five-Year Plan reiterates the DOE commitment to meeting this and other important environmental goals

  20. Long-term Survival after Metastatic Childhood Melanoma

    DEFF Research Database (Denmark)

    Larsen, Anne Kristine; Bybjerg Jensen, Mette; Krag, Christen

    2014-01-01

    SUMMARY: Malignant melanoma in children is very rare and accounts for only 1-3% of all melanomas. A congenital melanocytic nevus depending on the size of the lesion is one of the risk factors for developing childhood melanoma because of the possible malignant transformation. Childhood malignant...... of malign melanoma must be in mind when evaluating a pigmented lesion in a pediatric patient. We present a case of a patient born with a congenital nevus diagnosed with metastatic childhood malignant scalp melanoma at the age of 6 years. The patient underwent surgical ablation and reconstruction and has...... survived 26 years without recurrence, thus representing an uplifting case of long-term survival of childhood melanoma....

  1. Five-year workplace wellness intervention in the NHS

    OpenAIRE

    Blake, Holly; Zhou, Dingyuan; Batt, Mark E.

    2013-01-01

    aims:\\ud Poor health and well-being has been observed among NHS staff and has become a key focus in current public health policy. The objective of this study was to deliver and evaluate a five-year employee wellness programme aimed at improving the health and well-being of employees in a large NHS workplace.\\ud method:\\ud A theory-driven multi-level ecological workplace wellness intervention was delivered including health campaigns, provision of facilities and health-promotion activities to e...

  2. Effects of bystander CPR following out-of-hospital cardiac arrest on hospital costs and long-term survival.

    Science.gov (United States)

    Geri, Guillaume; Fahrenbruch, Carol; Meischke, Hendrika; Painter, Ian; White, Lindsay; Rea, Thomas D; Weaver, Marcia R

    2017-06-01

    Bystander cardiopulmonary resuscitation (CPR) is associated with a greater likelihood of survival to hospital discharge after out-of-hospital cardiac arrest (OHCA). However the long-term survival benefits in relationship to cost have not been well-studied. We evaluated bystander CPR, hospital-based costs, and long-term survival following OHCA in order to assess the potential cost-effectiveness of bystander CPR. We conducted a retrospective cohort study of consecutive EMS-treated OHCA patients >=12years who arrested prior to EMS arrival and outside a nursing facility between 2001 and 2010 in greater King County, WA. Utstein-style information was obtained from the EMS registry, including 5-year survival. Costs from the OHCA hospitalization were obtained from the Washington State Comprehensive Hospital Abstract Reporting System. Cost effectiveness was based on hospital costs divided by quality-adjusted life years (QALYs) for a 5-year follow-up window. Of the 4448 eligible patients, 18.5% (n=824) were discharged alive from hospital and 12.1% (n=539) were alive at 5 years. Five-year survival was higher in patients who received bystander CPR (14.3% vs. 8.7%, pbystander CPR. The average (SD) total cost of the initial acute care hospitalization was USD 19,961 (40,498) for all admitted patients and USD 75,175 (52,276) for patients alive at year 5. The incremental cost-effectiveness ratio associated with bystander CPR was USD 48,044 per QALY. Based on this population-based investigation, bystander CPR was positively associated with long-term survival and appears cost-effective. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Outcomes and long-term survival of coronary artery surgery: The controversial role of opium as risk marker

    Science.gov (United States)

    Najafi, Mahdi; Jahangiry, Leila; Mortazavi, Seyedeh Hamideh; Jalali, Arash; Karimi, Abbasali; Bozorgi, Ali

    2016-01-01

    AIM To study survival in isolated coronary artery bypass graft (CABG) patients and to evaluate the impact of preoperative chronic opium consumption on long-term outcome. METHODS Cohort of 566 isolated CABG patients as Tehran Heart Center cardiac output measurement was conducted. Daily evaluation until discharge as well as 4- and 12-mo and 6.5-year follow-up information for survival status were fulfilled for all patients. Long-term 6.5-year overall and opium-stratified survival, adjusted survival curves based on opium consumption as well as possible predictors of all-cause mortality using multiple cox regression were determined by statistical analysis. RESULTS Six point five-year overall survival was 91.8%; 86.6% in opium consumers and 92.7% in non-opium consumers (P = 0.035). Patients with positive history of opium consumption significantly tended to have lower ejection fraction (EF), higher creatinine level and higher prevalence of myocardial infarction. Multiple predictors of all-cause mortality included age, body mass index, EF, diabetes mellitus and cerebrovascular accident. The hazard ratio (HR) of 2.09 for the risk of mortality in opium addicted patients with a borderline P value (P = 0.052) was calculated in this model. Further adjustment with stratification based on smoking and opium addiction reduced the HR to 1.20 (P = 0.355). CONCLUSION Simultaneous impact of smoking as a confounding variable in most of the patients prevents from definitive judgment on the role of opium as an independent contributing factor in worse long-term survival of CABG patients in addition to advanced age, low EF, diabetes mellitus and cerebrovascular accident. Meanwhile, our findings do not confirm any cardio protective role for opium to improve outcome in coronary patients with the history of smoking. Further studies are needed to clarify pure effect of opium and warrant the aforementioned findings. PMID:27957254

  4. Five-Year Risk of Interval-Invasive Second Breast Cancer

    Science.gov (United States)

    Buist, Diana S. M.; Houssami, Nehmat; Dowling, Emily C.; Halpern, Elkan F.; Gazelle, G. Scott; Lehman, Constance D.; Henderson, Louise M.; Hubbard, Rebecca A.

    2015-01-01

    Background: Earlier detection of second breast cancers after primary breast cancer (PBC) treatment improves survival, yet mammography is less accurate in women with prior breast cancer. The purpose of this study was to examine women presenting clinically with second breast cancers after negative surveillance mammography (interval cancers), and to estimate the five-year risk of interval-invasive second cancers for women with varying risk profiles. Methods: We evaluated a prospective cohort of 15 114 women with 47 717 surveillance mammograms diagnosed with stage 0-II unilateral PBC from 1996 through 2008 at facilities in the Breast Cancer Surveillance Consortium. We used discrete time survival models to estimate the association between odds of an interval-invasive second breast cancer and candidate predictors, including demographic, PBC, and imaging characteristics. All statistical tests were two-sided. Results: The cumulative incidence of second breast cancers after five years was 54.4 per 1000 women, with 325 surveillance-detected and 138 interval-invasive second breast cancers. The five-year risk of interval-invasive second cancer for women with referent category characteristics was 0.60%. For women with the most and least favorable profiles, the five-year risk ranged from 0.07% to 6.11%. Multivariable modeling identified grade II PBC (odds ratio [OR] = 1.95, 95% confidence interval [CI] = 1.15 to 3.31), treatment with lumpectomy without radiation (OR = 3.27, 95% CI = 1.91 to 5.62), interval PBC presentation (OR = 2.01, 95% CI 1.28 to 3.16), and heterogeneously dense breasts on mammography (OR = 1.54, 95% CI = 1.01 to 2.36) as independent predictors of interval-invasive second breast cancers. Conclusions: PBC diagnosis and treatment characteristics contribute to variation in subsequent-interval second breast cancer risk. Consideration of these factors may be useful in developing tailored post-treatment imaging surveillance plans. PMID:25904721

  5. The 2015 Five-yearly review: diversity in the spotlight

    CERN Multimedia

    Staff Association

    2014-01-01

    Introduction As mentioned in Echo 201, with the Council Decision of last June the CERN 2015 five-yearly review has formally begun. Following the procedure defined in Annex A1 of the Staff Rules and Regulations CERN will thus review its financial and social conditions that should enable it to recruit from all its Member States, and retain, staff of the highest competence and integrity necessary to perform its mission. In addition, these conditions should increase the attractiveness of CERN in all Member States and motivate staff of all ages and all occupations throughout their careers. Annex A1 stipulates that a five-yearly review must include basic salaries (stipends for Fellows and subsistence allowances for associated members of the personnel) and, optionally, may include any other financial or social conditions. For this optional part of the 2015 exercise, the CERN career structure and measures to improve diversity were chosen. Towards a better diversity policy The analysis of the 2013 Staff Associat...

  6. Parapneumonic effusions in children: five years’ experience

    Directory of Open Access Journals (Sweden)

    Atilla Cifci

    2017-12-01

    Full Text Available Aim: Most severe complication of respiratory tract infections that causing morbidity and mortality in children is parapneumonic effusion(PPE. PPE is a pleural exudate that is related with primary pneumonia. The early and appropriate antibiotic treatment is very important in follow-up of patients who are diagnosed as parapneumonic effusion and also the timing of interventional and surgical treatment is important to decrease morbidity and mortalitiy in whom clinical and laboratory findings are not cured enough. Materials and Methods: In this study, the clinical and laboratory findings of parapneumonic effusion one hundred patients applied to one center in five years time are discussed. Results: The mean age of patients were 52 months(1.5-156, 52 were male(52%.The 71% of patients were smaller than five years old. The mean duration of hospitalization of patients were 19.6 days(1-45 days. Most frequent spymptom in application was fever, most frequent sign were tachycardia and retractions, most frequent laboratory anormality was high white blood count. The most frequent microorganism in pleural fluid culture was S.aureus. Conclusion: The determination of pathogens causing parapneumonic effusions in our country is very important for starting most suitable treatment early and to decrease morbidity and mortality. [J Contemp Med 2017; 7(4.000: 340-347

  7. Does hospital readmission following colorectal cancer resection and enhanced recovery after surgery affect long term survival?

    Science.gov (United States)

    Curtis, N J; Noble, E; Salib, E; Hipkiss, R; Meachim, E; Dalton, R; Allison, A; Ockrim, J; Francis, N K

    2017-08-01

    Hospital readmission is undesirable for patients and care providers as this can affect short-term recovery and carries financial consequences. It is unknown if readmission has long-term implications. We aimed to investigate the impact of 30-day readmission on long-term overall survival (OS) following colorectal cancer resection within enhanced recovery after surgery (ERAS) care and explore the reasons for and the severity and details of readmission episodes. A dedicated, prospectively populated database was reviewed. All patients were managed within an established ERAS programme. Five-year OS was calculated using the Kaplan-Meier method. The number, reason for and severity of 30-day readmissions were classified according to the Clavien-Dindo (CD) system, along with total (initial and readmission) length of stay (LoS). Multivariate analysis was used to identify factors predicting readmission. A total of 1023 consecutive patients underwent colorectal cancer resection between 2002 and 2015. Of these, 166 (16%) were readmitted. Readmission alone did not have a significant impact on 5-year OS (59% vs 70%, P = 0.092), but OS was worse in patients with longer total LoS (20 vs 14 days, P = 0.04). Of the readmissions, 121 (73%) were minor (CD I-II) and 27 (16%) required an intervention of which 16 (10%) were returned to theatre. Gut dysfunction 32 (19%) and wound complications 23 (14%) were the most frequent reasons for readmission. Prolonged initial LoS, rectal cancer and younger age predicted for hospital readmission. Readmission does not have a significant impact on 5-year OS. A broad range of conditions led to readmission, with the majority representing minor complications. Colorectal Disease © 2017 The Association of Coloproctology of Great Britain and Ireland.

  8. Short Communication. Recruitment and early growth of Pinus pinaster seedlings over five years after a wildfire in NW Spain

    Directory of Open Access Journals (Sweden)

    L. Calvo

    2013-12-01

    Full Text Available Aim of study: The main aim of this study was to analyse the post-fire recruitment and growth of Pinus pinaster seedlings during the first five years after wildfire and also to analyse the effects of climatic conditions on the survival of P. pinaster seedlingsArea of study: The study area was located in a P. pinaster stand in León province (NW Spain burned in 1998.Material and Methods: Three sites in the burned area were selected. In each site three permanent transects of 20m x 1m were placed. In each transect, twenty 1m2 sampling units were marked and the number and height of each pine seedlings was recorded at 7, 8, 9, 10, 11, 12 months and 2, 3, 4 and 5 years after the wildfire. The soil of study area is Cambisol.Mean results: Mean Pinus regeneration densities varied between 33.2 seedlings/m2 after 7 months and 6 seedlings/m2 five years after wildfire. In this P. pinaster stand, maximum mortality appeared during the summer months in the first year of regeneration. There was a significant increase in seedling height associated with a decrease in density.Research highlights: The post-fire recruitment is considered enough to ensure good natural Pinus pinaster forest regeneration. In the short term post-fire management strategy in this type of forest could be the remaining branches with cones of burned trees that allow the dissemination of the seeds during the first few years after fire and ensure natural regeneration.Keywords: Fire effects; natural regeneration; León province (NW Spain; seedlings density; growth and survival.

  9. THE FIVE YEAR FERMI/GBM MAGNETAR BURST CATALOG

    Energy Technology Data Exchange (ETDEWEB)

    Collazzi, A. C. [SciTec, Inc., 100 Wall Street, Princeton, NJ 08540 (United States); Kouveliotou, C.; Horst, A. J. van der; Younes, G. A. [Department of Physics, The George Washington University, 725 21st Street NW, Washington, DC 20052 (United States); Kaneko, Y.; Göğüş, E. [Sabancı University, Orhanlı-Tuzla, İstanbul 34956 (Turkey); Lin, L. [François Arago Centre, APC, 10 rue Alice Domon et Léonie Duquet, F-75205 Paris (France); Granot, J. [Department of Natural Sciences, The Open University of Israel, 1 University Road, P.O. Box 808, Raanana 43537 (Israel); Finger, M. H. [Universities Space Research Association, NSSTC, 320 Sparkman Drive, Huntsville, AL 35805 (United States); Chaplin, V. L. [School of Medicine, Vanderbilt University, 1161 21st Avenue S, Nashville, TN 37232 (United States); Huppenkothen, D. [Center for Data Science, New York University, 726 Broadway, 7th Floor, New York, NY 10003 (United States); Watts, A. L. [Anton Pannekoek Institute, University of Amsterdam, Postbus 94249, 1090 GE Amsterdam (Netherlands); Kienlin, A. von [Max-Planck-Institut für extraterrestrische Physik, Giessenbachstrasse 1, D-85748 Garching (Germany); Baring, M. G. [Department of Physics and Astronomy, Rice University, MS-108, P.O. Box 1892, Houston, TX 77251 (United States); Gruber, D. [Planetarium Südtirol, Gummer 5, I-39053 Karneid (Italy); Bhat, P. N. [CSPAR, University of Alabama in Huntsville, 320 Sparkman Drive, Huntsville, AL 35899 (United States); Gibby, M. H., E-mail: acollazzi@scitec.com [Jacobs Technology, Inc., Huntsville, AL (United States); and others

    2015-05-15

    Since launch in 2008, the Fermi Gamma-ray Burst Monitor (GBM) has detected many hundreds of bursts from magnetar sources. While the vast majority of these bursts have been attributed to several known magnetars, there is also a small sample of magnetar-like bursts of unknown origin. Here, we present the Fermi/GBM magnetar catalog, providing the results of the temporal and spectral analyses of 440 magnetar bursts with high temporal and spectral resolution. This catalog covers the first five years of GBM magnetar observations, from 2008 July to 2013 June. We provide durations, spectral parameters for various models, fluences, and peak fluxes for all the bursts, as well as a detailed temporal analysis for SGR J1550–5418 bursts. Finally, we suggest that some of the bursts of unknown origin are associated with the newly discovered magnetar 3XMM J185246.6+0033.7.

  10. Five years of operating the TRIGA Mainz reactor

    International Nuclear Information System (INIS)

    Benedict, Georg

    1970-01-01

    Considerable obstacles had to be surmounted before TRIGA MAINZ, first TRIGA reactor built in Germany, reached initial criticality in 1965. Subsequent five years' operation did not raise any major problems. The facility has proven quite reliable and particularly well suited for the purposes of the nuclear chemistry research program pursued at Mainz University. Extensive use is made of the pulse mode of operation. As a result, fuel elements are obviously somewhat overstressed, even though most pulses performed are of the 1.50 dollar size. Maximum licensed steady state power of 100 kW till now has met the requirements of most experiments. However, efforts are in progress to improve irradiation conditions by increasing the reactor power to 300 kW. (author)

  11. AMBULATORY CARE - SENSITIVE CONDITIONS IN CHILDREN UNDER FIVE YEARS

    Directory of Open Access Journals (Sweden)

    Maria Aparecida Araújo Figueiredo

    2013-05-01

    Full Text Available Objective:analyzethe extent to which the incidence rate of primary care sensitivehospitalizations in children under five years is influenced by the percentage of coverage of theprimary care.Methods:This was a cross-sectional ecological study that combines coverage ofprimary careand theambulatorycare-sensitiveconditionsin 2000 and 2010. We used data from theHospital Information System (HIS and the Information System of Primary Care (SIAB.Results:The data revealed that the increased coverage providedprimary carereductionrateofhospitalization diseases studied. In 2000 the reduction was greater for gastroenteritis (51% inchildren under 01 years and 30% in children 01-04 years in 2010 for respiratory diseases (51% inchildren under 01years and 33% in children aged 01-04 years.Conclusion:we found an association between the coverage ofprimary careand admission rates, however seem to affect othervariables, suggesting the need for further studies.

  12. e+e- physics at PETRA - the first five years

    International Nuclear Information System (INIS)

    Sau Lan Wu

    1984-03-01

    PETRA (Positron-Electron Tandem Ring Accelerator) is located at DESY in Hamburg, Germany, and is the highest energy electron-positron storage ring in the world. This report gives a global review of the experimental investigations carried out at PETRA for the first five years of its operation beginning in 1978 by the five Collaborations CELLO, JADE, MARK J, PLUTO and TASSO. The physics objectives in the original proposals have largely been fullfilled. The emphasis of this review, based mainly on journal publications before July 15, 1983 (the fifth anniversary of the first successful storage on an electron beam at PETRA), is on the physics results, ranging over strong, electromagnetic and weak interactions. The topics covered include quark and gluon physics, inclusive particle production, electroweak interference, two-photon physics, and search for new particles. Although cited for comparison, no attempt has been made for any systematic coverage of the corresponding results from PEP of SLAC. (orig.)

  13. Decommissioning of AECL Whiteshell Laboratories: progress from first five years of legacy funding

    International Nuclear Information System (INIS)

    Swartz, R.S.; Bilinsky, D.M.; Harding, J.W.; Ridgway, W.R.

    2011-01-01

    In 2006, the Government of Canada adopted a new long-term strategy to deal with the nuclear legacy liabilities and initiated a five-year start-up phase. The objective is to safely and cost-effectively reduce these liabilities, and associated risks, based on sound waste management and environmental principles in the best interests of Canadians. AECL's Whiteshell Laboratories is part of the long-term strategy and decommissioning activities are underway. Several redundant non-nuclear buildings have been removed/decommissioned, and redundant nuclear facilities (hot cell facilities, radiochemical laboratories) are being decontaminated and prepared for demolition. This paper describes the progress in the first five-year funding period (2006 April to 2011 March). (author)

  14. Infectious Diseases of Poverty, the first five years.

    Science.gov (United States)

    Wang, Wei; Chen, Jin; Sheng, Hui-Feng; Wang, Na-Na; Yang, Pin; Zhou, Xiao-Nong; Bergquist, Robert

    2017-05-04

    Although the focus in the area of health research may be shifting from infectious to non-communicable diseases, the infectious diseases of poverty remain a major burden of disease of global health concern. A global platform to communicate and share the research on these diseases is needed to facilitate the translation of knowledge into effective approaches and tools for their elimination. Based on the "One health, One world" mission, a new, open-access journal, Infectious Diseases of Poverty (IDP), was launched by BioMed Central in partnership with the National Institute of Parasitic Diseases (NIPD), Chinese Center for Disease Control and Prevention (China CDC) on October 25, 2012. Its aim is to identify and assess research and information gaps that hinder progress towards new interventions for a particular public health problem in the developing world. From the inaugural IDP issue of October 25, 2012, a total of 256 manuscripts have been published over the following five years. Apart from a small number of editorials, opinions, commentaries and letters to the editor, the predominant types of publications are research articles (69.5%) and scoping reviews (21.5%). A total of 1 081 contributing authors divided between 323 affiliations across 68 countries, territories and regions produced these 256 publications. The journal is indexed in major international biomedical databases, including Web of Science, PubMed, Scopus and Embase. In 2015, it was assigned its first impact factor (4.11), which is now 2.13. During the past five years, IDP has received manuscripts from 90 countries, territories and regions across six continents with an annual acceptance rate of all contributions maintained at less than 40%. Content analysis shows that neglected tropical diseases (NTDs), followed by the "Big Three" (HIV/AIDS, malaria and tuberculosis) and infectious diseases in general comprise 88% of all publications. In addition, a series of 10 thematic issues, covering 118 publications

  15. AEC sets five year nuclear safety research program

    International Nuclear Information System (INIS)

    Anon.

    1976-01-01

    The research by the government for the establishment of means of judging the adequacy of safety measures incorporated in nuclear facilities, including setting safety standards and collecting documents of general criteria, and the research by the industry on safety measures and the promotion of safety-related technique are stated in the five year program for 1976-80 reported by subcommittees, Atomic Energy Commission (AEC). Four considerations on the research items incorporated in the program are 1) technical programs relating to the safety of nuclear facilities and the necessary criteria, 2) priority of the relevant items decided according to their impact on circumstances, urgency, the defence-indepth concept and so on, 3) consideration of all relevant data and documents collected, and research subjects necessary to quantify safety measurement, and 4) consideration of technological actualization, the capability of each research body, the budget and the time schedule. In addition, seven major themes decided on the basis of these points are 1) reactivity-initiated accident, 2) LOCA, 3) fuel behavior, 4) structural safety, 5) radioactive release, 6) statistical method of safety evaluation, and 7) seismic characteristics. The committee has deliberated the appropriate division of researches between the government and the industry. A set of tables showing the nuclear safety research plan for 1976-80 are attached. (Iwakiri, K.)

  16. Five-yearly review: where do we stand now?

    CERN Multimedia

    Staff Association

    2016-01-01

    A reminder The first issue of Echo in 2016 announced a year of changes with many challenges for the Staff Association and the staff it represents. Indeed, following the decision of the Council in December 2015 to approve all components of the five-yearly review, many changes were to be implemented in 2016. This is the case of the new career structure, the definition of benchmark jobs (BMJ), the redesign of the advancement and promotions process, etc. Looking back at 2015 and the various statements In December 2015, the CERN Council emphasized: the substantial effort made by the Staff Association and the Management, taking into account the difficult economic situation faced by some Member States, led to the creation of a package of measures as balanced as possible. It is clear however: that there was no alignment of CERN basic salaries with the comparison salaries; that in the new career system, staff will have their advancement prospects, and consequently the level of their pension, reduced with respect to ...

  17. Five years of successful CANDU-6 fuel manufacturing in Romania

    International Nuclear Information System (INIS)

    Galeriu, A.C.; Pascu, A.; Andrei, G.; Bailescu, A.

    1999-01-01

    This paper describes the evolution of CANDU-6 nuclear fuel manufacturing in Romania at FCN Pitesti, after the completion of the qualification in 1994. Commercial production was resumed early 1995 and fuel bundles produced were entirely delivered to Cernavoda Plant and charged in the reactor. More than 12,000 fuel bundles have been produced in the last five years and the fuel behaved very well. Defective bundles represents less than 0.06% from the total irradiated fuel, and the most defects are associated to the highest power positions. After qualification, FCN focused the effort to improve braze quality and also to maintain a low residual hydrogen content in graphite coated sheaths. The production capacity was increased especially for component manufacturing, appendages tack welding and brazing. A new graphite baking furnace with increased capacity, is under design. In the pelleting area, a rotating press will replace the older hydraulic presses used for pelleting. Plant development taken inter consideration the future demands for Cernavoda Unit 2. (author)

  18. Fuel quality control: Five years of activity in laboratories

    International Nuclear Information System (INIS)

    Bettinelli, M.; Cimini, G.; Durello, G.; Lucchesi, P.L.

    1991-01-01

    A description of how ENEL (Italian National Electricity Board) carries out the activity of fuel quality control is given, and the results of the Round Robin circuit which has been operating for five years in laboratories regulary performing the control analyses of these products are reported. The laboratories taking part in the Round Robin circuit are 41 (out of which 35 are ENEL laboratories and 6 are owned by external companies) and they are situated throughout Italy; the controlled parameters are the following: heat of combustion (PCS), sulphur (S), vanadium (V) and asphaltenes (ASF); the adopted methods are the official ASTM or IP ones. The statistical analysis of the results has permitted, for every parameter, the calculation of the repeatability and the reproducibility which, in most cases, have turned out to be in keeping with the values provided for in the regulations. Among the collateral initiatives promoted in the framework of this Round Robin, the following are reported: preparation of standards of fuel oil with a known content of a sulphur and vanadium; expediting visits to all the ENEL laboratories participating in the RRT; publication of a handbook of the adopted analysis methods (in Italian); definition of guide-lines on the right selection of new automatic equipment

  19. Vertigo/dizziness in pediatric emergency department: Five years' experience.

    Science.gov (United States)

    Raucci, Umberto; Vanacore, Nicola; Paolino, Maria Chiara; Silenzi, Romina; Mariani, Rosanna; Urbano, Antonella; Reale, Antonino; Villa, Maria Pia; Parisi, Pasquale

    2016-05-01

    Vertigo/Dizziness in childhood is not a rare cause of visits to the emergency department (ED). We analyzed a selected group with vertigo/dizziness to identify signs and symptoms that may help to guide the diagnostic approach and management. A total of 616 children admitted for vertigo to the ED over a five-year period were retrospectively reviewed. Their medical history, clinical characteristics, laboratory and neuroimaging tests, final diagnoses and management were analyzed. Migraine and syncope were the most frequent causes. Two patients were affected by life-threatening cardiac syncope, while structural life-threatening central nervous system diseases were found in 15 patients, none of whom presented with vertigo as an isolated clinical finding. Most cases of vertigo/dizziness in childhood that consist mainly of migraine and syncope are of benign origin. The prompt identification of neurological or cardiological signs or symptoms associated with vertigo in children is mandatory to rule out life-threatening conditions. © International Headache Society 2015.

  20. Five years of solar UV-radiation monitoring in Sweden

    Energy Technology Data Exchange (ETDEWEB)

    Josefsson, Weine

    1996-10-01

    A network of five stations measuring the solar UV-radiation has been operated for about five years. Data are presented as plotted time-series of monthly and yearly values for the sites. A general climatology can be deduced from these data. Daily and hourly maximum values are shown for each month as indicators of the potential extreme exposure levels. The large annual variation at high latitudes is easily seen in the data set. This illustrates the importance of the solar elevation on the level of the UV-irradiance. Influence of cloud variation and of larger changes in ozone is also detectable. A few examples of the daily variation also show the strong solar elevation dependence of the UV-irradiance. The quantity and unit of the UV-radiation in this presentation is CIE-weighted irradiance expressed as MED (minimum erythermal dose), where one MED equals 210 Jm{sup -2}. The values have been recomputed to refer to the international intercomparison of broad-band meters in Helsinki in 1995. In the following named WMO-STUK 1995 scale. As will be seen there are many sources of error and detailed studies are prevented by the large uncertainty connected with these data. Due to the short period of the record and the low accuracy no attempt to study trends is done. 6 refs, 27 figs, 4 tabs

  1. Five years of LRO laser altimetry at the Moon

    Science.gov (United States)

    Smith, David E.; Zuber, Maria T.

    After five years of near-continuous operation at the Moon, the Lunar Orbiter Laser Altimeter (LOLA) on LRO continues to collect altimetry, surface roughness, slope and normal reflectance data. LOLA has acquired over 6 billion altimeter measurements, all geodetically controlled to the center-of-mass of the Moon with a radial precision of around 10 cm and an accuracy of about 1 meter. The position of the measurements on the lunar surface is primarily limited by the knowledge of the position of the spacecraft in orbit and in the last few years the LRO orbit accuracy has improved significantly as a result of the accurate gravity model of the Moon developed by the GRAIL Discovery mission. Our present estimate of positional accuracy is less than 10 m rms but is only achievable with a GRAIL gravity model to at least degree and order 600 because of the perturbing gravitational effect of the Moon’s surface features. Significant improvements in the global shape and topography have assisted the Lunar Reconnaissance Orbiter Camera (LROC) stereo mapping program, and the identification of potential lunar landing sites for ESA and Russia, particularly in the high-latitude polar regions where 5- and 10-meter average horizontal resolution has been obtained. LOLA’s detailed mapping of these regions has improved the delineation of permanently-shadowed areas and assisted in the understanding of the LEND neutron data, and its relationship to surface slopes. Recently a global, calibrated LOLA normal albedo dataset at 1064 nm has been developed.

  2. Long-Term Survival in a Patient with Multiple Brain Metastases from Small-Cell Lung Cancer Treated with Gamma Knife Radiosurgery on Four Occasions: A Case Report

    Science.gov (United States)

    Elaimy, Ameer L.; Thumma, Sudheer R.; Lamm, Andrew F.; Mackay, Alexander R.; Lamoreaux, Wayne T.; Fairbanks, Robert K.; Demakas, John J.; Cooke, Barton S.; Lee, Christopher M.

    2012-01-01

    Brain metastases are the most common cancerous neoplasm in the brain. The treatment of these lesions is challenging and often includes a multimodality management approach with whole-brain radiation therapy, stereotactic radiosurgery, and neurosurgery options. Although advances in biomedical imaging technologies and the treatment of extracranial cancer have led to the overall increase in the survival of brain metastases patients, the finding that select patients survive several years remains puzzling. For this reason, we present the case of a 70-year-old patient who was diagnosed with multiple brain metastases from small-cell lung cancer five years ago and is currently alive following treatment with chemotherapy for the primary cancer and whole-brain radiation therapy and Gamma Knife radiosurgery on four separate occasions for the neurological cancer. Since the diagnosis of brain metastases five years ago, the patient's primary cancer has remained controlled. Furthermore, multiple repeat GKRS procedures provided this patient with high levels of local tumor control, which in combination with a stable primary cancer led to an extended period of survival and a highly functional life. Further analysis and clinical research will be valuable in assessing the durability of multiple GKRS for brain metastases patients who experience long-term survival. PMID:23091748

  3. Vitamin E diffused highly cross-linked polyethylene in total hip arthroplasty at five years

    DEFF Research Database (Denmark)

    Nebergall, Audrey K; Greene, M. E.; Laursen, M B

    2017-01-01

    Aims: The objective of this five-year prospective, blinded, randomised controlled trial (RCT) was to compare femoral head penetration into a Vitamin E diffused highly cross-linked polyethylene (HXLPE) liner with penetration into a medium cross-linked polyethylene control liner using......, ArComXL. This is the longest-term RCT comparing the wear performance and clinical outcome of Vitamin E diffused HXLPE with a previous generation of medium cross-linked polyethylene....... radiostereometric analysis. Patients and Methods: Patients scheduled for total hip arthroplasty (THA) were randomised to receive either the study E1 (32 patients) or the control ArComXL polyethylene (35 patients). The median age (range) of the overall cohort was 66 years (40 to 76). Results: The five-year median...

  4. Does television viewing predict dietary intake five years later in high school students and young adults?

    Directory of Open Access Journals (Sweden)

    Neumark-Sztainer Dianne

    2009-01-01

    Full Text Available Abstract Background Prior research has found that television viewing is associated with poor diet quality, though little is known about its long-term impact on diet, particularly during adolescence. This study examined the associations between television viewing behavior with dietary intake five years later. Methods Survey data, which included television viewing time and food frequency questionnaires, were analyzed for 564 middle school students (younger cohort and 1366 high school students (older cohort who had complete data available at Time 1 (1998–1999 and five years later at Time 2 (mean age at Time 2, 17.2 ± 0.6 and 20.5 ± 0.8 years, respectively. Regression models examined longitudinal associations between Time 1 television viewing behavior and Time 2 dietary intake adjusting for sociodemographic characteristics, Time 1 dietary intake, and Time 2 total daily energy intake. Results Respondents were categorized as limited television users (2 hours/daily, moderately high television viewers (2–5 hours/daily, and heavy television viewers (≥5 hours/daily. Among the younger cohort, Time 1 heavy television viewers reported lower fruit intake and higher sugar-sweetened beverage consumption than the other two groups. Among the older cohort, watching five or more hours of television per day at Time 1, predicted lower intakes of fruits, vegetables, whole grain and calcium-rich foods, and higher intakes of trans fat, fried foods, fast food menu items, snack products, and sugar-sweetened beverages (products commonly advertised on television five years later. Conclusion Television viewing in middle and high school predicted poorer dietary intake five years later. Adolescents are primary targets of advertising for fast food restaurants, snack foods, and sugar-sweetened beverages, which may influence their food choices. Television viewing, especially during high school, may have long-term effects on eating choices and contribute to poor eating

  5. Five years of an educational programme - Results and experiences

    International Nuclear Information System (INIS)

    Dufkova, Marie

    1998-01-01

    Full text: School teachers and pupils constitute an important group having the ability to listen, Understand and help to create positive ties between the public and a utility. Therefore, CEZ spends a part of its revenue arising from the sales of electricity on education. CEZ's information and education programme named 'Energy for everybody' has been used by Czech schools for five years now. The main part of this educational programme is devoted to nuclear energy. CEZ materials for schools include: printed information, supplements to textbooks, videotapes, computer programmes, CD ROMs, an educational set for experiments with ionizing radiation, posters and other assorted materials. Schools are invited to visit Czech power plants and other facilities of the power sector (for example the experimental reactor at the Prague Technical University). Seminars and workshops are organised for teachers. CEZ offers objective information on all activities associated with energy generation and uses and the relationships between man and nature. The prices of our informational materials are rather symbolic, they come to one-tenth to one-third of the actual cost. CEZ is the only industrial company offering such a large-scale educational programme for schools in the Czech Republic. Materials are distributed to nearly 7 000 primary and secondary schools and 30 university departments. We have agreements with several schools which have committed themselves to testing our materials. Several dissertations and studies have demonstrated the usefulness of our materials for education and the contribution this information has made to the better understanding of nuclear energy. We have organised polls in order to ascertain how the schools liked the materials, what additional things they wished and what their view of nuclear power plants and CEZ was. The outcome has been unexpectedly favourable. In my contribution I will present the results of these polls and examples of successful activities

  6. A Five-Year Review of Tag Rugby Hand Injuries.

    Science.gov (United States)

    Joyce, C W; Woods, J F C; Murphy, S; Bollard, S; Kelly, J L; Carroll, S M; O'Shaughnessy, M

    2016-10-01

    Tag rugby is one of the fastest growing sports in Ireland. It is a soft-contact team game that is loosely based on the rugby league format except players try to remove Velcro tags from their opponents' shorts rather than engage in a typical rugby tackle. The purpose of this study was to examine all tag rugby associated hand injuries over a five-year period in three large tertiary referral hospitals in Ireland. Using the patient corresponding system, 228 patients with hand injury related tag rugby injuries were observed from 2010 to 2015. There were 138 males and 90 females in the study and over 40% of patients required surgery. Most of the patients were young professionals with an average age of 30. Twenty-five patients worked in the financial services whilst there were 23 teachers. Fractures accounted for 124 of the 228 injuries and mallet injuries accounted for 53. Eighty percent of all injuries occurred during the tackle. The mean number of days missed from work was 9.1±13.8 days. These injuries resulted in an average of seven hospital appointments per patient. Considering it is a soft-contact sport, it is surprising the number of hand injuries that we have observed. Although safety measures have been introduced to decrease the number of hand injuries in recent years, there is a need for further improvements. Better player education about seeking prompt medical attention once an injury occurs, coupled with longer shorts worn by players may improve measures for the sport. Copyright © 2016. Published by Elsevier Ltd.

  7. Parotid tumor statistics for the past five years

    International Nuclear Information System (INIS)

    Yamaguchi, Soichi; Sueno, Kohei; Yamaguchi, Takeshi; Asano, Yukimi; Shiba, Kazutaka; Sekiguchi, Nao; Masuda, Takeshi

    2004-01-01

    We reviewed the case of 40 patients with parotid tumor who underwent an operation in the past five years. The patients included 23 (57.5%) males and 17 (42.5%) females. The average age was 53.4 years old with a range of 19 to 71 years. Thirty eight (95.0%) had benign tumor, and 2 (5.0%) had malignant tumor. Tc scintigraphy was performed in 37 out of the 40 patients, and 9 patients showed positive results. Six patients had warthin's tumor, and 3 had pleomorphic adenoma. In other words, 66.7% were positive for warthin's tumor. Ga scintigraphy was performed in 31 out of the 40 patients. Nine were positive out of the 10 benign tumor that showed a positive result. None of the cases had permanent facial palsy as a postoperative complication. Transient facial palsy was exhibited by 13 patients (32.5%), but they all improved 2 weeks to 6 months. In addition, we experienced 1 case of salivary fistula. Pleomorphic adenoma was noted in 63.2%, and warthin's tumor in 23.7%. There was no gender difference for pleomorphic adenoma, but 8 out of the 9 patients with warthin's tumor were men. The average age was 47.0 for pleomorphic adenoma and 58.7 for warthin's tumor which was in accordance with conventional reports. The Tc scintigraphy positive rate of warthin's tumor was low, 66.7%, in comparison with that in conventional reports. In addition, 90% of the tumors that showed positive results in Ga scintigraphy were preoperatively positive tumors, indicating the diagnostic usefulness of this. Transient facial palsy was a complication in 32.5% of the patients, which was similar to the rate in the conventional report. We experienced 1 case salivary fistula, which did not improve with conservative treatment. We opened the wounded area, and drained it by pressing. (author)

  8. Five-year risk of interval-invasive second breast cancer.

    Science.gov (United States)

    Lee, Janie M; Buist, Diana S M; Houssami, Nehmat; Dowling, Emily C; Halpern, Elkan F; Gazelle, G Scott; Lehman, Constance D; Henderson, Louise M; Hubbard, Rebecca A

    2015-07-01

    Earlier detection of second breast cancers after primary breast cancer (PBC) treatment improves survival, yet mammography is less accurate in women with prior breast cancer. The purpose of this study was to examine women presenting clinically with second breast cancers after negative surveillance mammography (interval cancers), and to estimate the five-year risk of interval-invasive second cancers for women with varying risk profiles. We evaluated a prospective cohort of 15 114 women with 47 717 surveillance mammograms diagnosed with stage 0-II unilateral PBC from 1996 through 2008 at facilities in the Breast Cancer Surveillance Consortium. We used discrete time survival models to estimate the association between odds of an interval-invasive second breast cancer and candidate predictors, including demographic, PBC, and imaging characteristics. All statistical tests were two-sided. The cumulative incidence of second breast cancers after five years was 54.4 per 1000 women, with 325 surveillance-detected and 138 interval-invasive second breast cancers. The five-year risk of interval-invasive second cancer for women with referent category characteristics was 0.60%. For women with the most and least favorable profiles, the five-year risk ranged from 0.07% to 6.11%. Multivariable modeling identified grade II PBC (odds ratio [OR] = 1.95, 95% confidence interval [CI] = 1.15 to 3.31), treatment with lumpectomy without radiation (OR = 3.27, 95% CI = 1.91 to 5.62), interval PBC presentation (OR = 2.01, 95% CI 1.28 to 3.16), and heterogeneously dense breasts on mammography (OR = 1.54, 95% CI = 1.01 to 2.36) as independent predictors of interval-invasive second breast cancers. PBC diagnosis and treatment characteristics contribute to variation in subsequent-interval second breast cancer risk. Consideration of these factors may be useful in developing tailored post-treatment imaging surveillance plans. © The Author 2015. Published by Oxford University Press. All rights reserved

  9. Adherence to vaccination guidelines post splenectomy: A five year follow up study.

    Science.gov (United States)

    Boam, Tristan; Sellars, Peter; Isherwood, John; Hollobone, Chloe; Pollard, Cristina; Lloyd, David M; Dennison, Ashley R; Garcea, Giuseppe

    Following a splenectomy patients are at increased risk of significant infections. In its most severe form, overwhelming post-splenectomy infection (OPSI) has a mortality rate of up to 80%. In this study we aim to establish the adherence to vaccination and antibiotic national guidelines in splenectomised patients. A retrospective study of 100 patients who underwent splenectomy (21 emergency, 79 elective), in two teaching hospitals was undertaken over a five-year period. Patients were followed up for five years. Hospital and GP records were reviewed for adherence to pre, intra and postoperative vaccination, thromboprophylaxis and antibiotic guidance. Eighty-six eligible patients (91.5%) received their Haemophilus influenzae B, meningococcal C and pneumococcus vaccinations peri-operatively. Eighty-one (86%) received post-operative antibiotics. Ninety-nine percent of patients received thromboprophylaxis treatment. Eighty-nine (95%) were treated with long-term antibiotic prophylaxis. Only 20 patients (23%) had an emergency supply of antibiotics. Ninety-five percent of patients were administered an annual influenza vaccination and 84% of eligible patients received a five-year pneumococcal booster vaccination. Improvement in the management of this patient cohort can be achieved by a multidisciplinary approach involving adherence to national guidelines, standardised trust protocols, patient information leaflets and advice detailing risk of infection, standardised GP letters and a splenectomy register to monitor and manage this vulnerable group of patients. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Assessment of China's renewable energy contribution during the 12th Five Year Plan

    International Nuclear Information System (INIS)

    Hong, Lixuan; Zhou, Nan; Fridley, David; Raczkowski, Chris

    2013-01-01

    In recent years, China has been ambitious in investing and developing renewable energy technologies, aiming to enhance its energy security, mitigate its energy-related CO 2 emissions and develop renewable energy industry. The 12th Five Year Plan (2011–2015) has set clear targets on installed capacities of different renewable energy technologies. This study aimed to assess the possible contribution of 12th Five Year Plan for China's future energy system and identify factors that might influence its impacts. First, current status of renewable energy development in China has been reviewed. Then several energy scenarios have been developed in an hourly simulation using an energy system analysis tool EnergyPLAN. It was identified that existing grid bottleneck would greatly reduce the potential contribution of renewable installations in terms of share of renewable electricity generation, share of non-fossil fuels in primary energy and system CO 2 emissions. In contrast, improving technical performance of renewable energy technologies and sectoral energy efficiency plays an important role in increasing the share of renewables and promoting China’s energy system transition. Finally, some policy suggestions were drawn to facilitate a better implementation of the renewable energy plan. - Highlights: • China's renewable energy contribution during the 12th Five Year Plan was assessed. • Non-fossil fuel targets in primary energy for 2015 and 2020 could be easily achieved. • Grid bottlenecks severely decrease the share of RES-E in electricity generation through the 12th Five Year Period. • Improved technical performance of renewable technologies and sectoral energy efficiency are extremely important for achieving higher RES-E share. • Several policy suggestions were drawn

  11. Twenty-Five Year Site Plan FY2013 - FY2037

    Energy Technology Data Exchange (ETDEWEB)

    Jones, William H. [Los Alamos National Laboratory

    2012-07-12

    Los Alamos National Laboratory (the Laboratory) is the nation's premier national security science laboratory. Its mission is to develop and apply science and technology to ensure the safety, security, and reliability of the United States (U.S.) nuclear stockpile; reduce the threat of weapons of mass destruction, proliferation, and terrorism; and solve national problems in defense, energy, and the environment. The fiscal year (FY) 2013-2037 Twenty-Five Year Site Plan (TYSP) is a vital component for planning to meet the National Nuclear Security Administration (NNSA) commitment to ensure the U.S. has a safe, secure, and reliable nuclear deterrent. The Laboratory also uses the TYSP as an integrated planning tool to guide development of an efficient and responsive infrastructure that effectively supports the Laboratory's missions and workforce. Emphasizing the Laboratory's core capabilities, this TYSP reflects the Laboratory's role as a prominent contributor to NNSA missions through its programs and campaigns. The Laboratory is aligned with Nuclear Security Enterprise (NSE) modernization activities outlined in the NNSA Strategic Plan (May 2011) which include: (1) ensuring laboratory plutonium space effectively supports pit manufacturing and enterprise-wide special nuclear materials consolidation; (2) constructing the Chemistry and Metallurgy Research Replacement Nuclear Facility (CMRR-NF); (3) establishing shared user facilities to more cost effectively manage high-value, experimental, computational and production capabilities; and (4) modernizing enduring facilities while reducing the excess facility footprint. Th is TYSP is viewed by the Laboratory as a vital planning tool to develop an effi cient and responsive infrastructure. Long range facility and infrastructure development planning are critical to assure sustainment and modernization. Out-year re-investment is essential for sustaining existing facilities, and will be re-evaluated on an annual

  12. Genetic Polymorphisms in Endothelin-1 as Predictors for Long-Term Survival and the Cardiac Index in Patients Undergoing On-Pump Cardiac Surgery.

    Directory of Open Access Journals (Sweden)

    Ashham Mansur

    Full Text Available Genetic variants within the endothelin-1 gene (EDN1 have been associated with several cardiovascular diseases and may act as genetic prognostic markers. Here, we explored the overall relevance of EDN1 polymorphisms for long-term survival in patients undergoing on-pump cardiac surgery. A prospectively collected cohort of 455 Caucasian patients who underwent cardiac surgery with cardiopulmonary bypass was followed up for 5 years. The obtained genotypes and inferred haplotypes were analyzed for their associations with the five-year mortality rate (primary endpoint. The EDN1 T-1370G and K198N genotype distributions did not deviate from Hardy-Weinberg equilibrium and the major allele frequencies were 83% and 77%, respectively. The cardiovascular risk factors were equally distributed in terms of the different genotypes and haplotypes associated with the two polymorphisms. The five-year mortality rate did not differ among the different EDN1 T-1370G and K198N genotypes and haplotypes. Haplotype analysis revealed that carriers of the G-T (compound EDN1 T-1370G G/K198N T haplotype had a higher cardiac index than did non-carriers (p = 0.0008; however, this difference did not reach significance after adjusting for multiple testing. The results indicate that common variations in EDN1 do not act as prognostic markers for long-term survival in patients undergoing on-pump cardiac surgery.

  13. Long-term survival of methotrexate in psoriatic arthritis

    Directory of Open Access Journals (Sweden)

    N. Battafarano

    2011-06-01

    Full Text Available Objective. The purpose of this study was to evaluate the long-term survival rate of Methotrexate (MTX in the peripheral joint involvement of psoriatic arthritis (PsA in a setting of everyday clinical practice. Methods. This was an observational restrospective study performed using the data from a dermatological-rheumatological PsA clinic. All of the patients evaluated at this clinic from March 1997 to December 2007 who were started on MTX alone, had a three-year follow-up time or had discontinued the therapy were included into the survey. Results. Of the 174 evaluable patients, 104 (59.8% were still taking MTX after three years of treament. The reasons of therapy discontinuation in the remaining 70 (40.2% patients were: 34 (19.5% lost-to-follow-up, 18 (10.3% adverse events, 14 (8% inefficacies, and 4 (2.3% deaths (none related to the therapy. MTX was effective in controlling joint inflammation but not in preventing their deterioration. Overall, adverse events were recorded in 43 patients (36.4% of the 114 patients with a three-year follow-up. No serious side effect occurred in the study population. Conclusions. The results of this study showed that, in a setting of clinical pratice, MTX had a good three-year performance in patients with peripheral PsA. Almost 60% of them were still taking this drug at the end of the study period and the toxicity was more than acceptable. In our opinion, MTX might be considered the non-biological DMARD of choice for the treatment of this condition. However it should be used earlier and at higher doses.

  14. SNL Five-Year Facilities & Infrastructure Plan FY2015-2019

    Energy Technology Data Exchange (ETDEWEB)

    Cipriani, Ralph J. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2014-12-01

    Sandia’s development vision is to provide an agile, flexible, safer, more secure, and efficient enterprise that leverages the scientific and technical capabilities of the workforce and supports national security requirements in multiple areas. Sandia’s Five-Year Facilities & Infrastructure Planning program represents a tool to budget and prioritize immediate and short-term actions from indirect funding sources in light of the bigger picture of proposed investments from direct-funded, Work for Others and other funding sources. As a complementary F&I investment program, Sandia’s indirect investment program supports incremental achievement of the development vision within a constrained resource environment.

  15. Thirty-five years of geochronology in Uruguay

    International Nuclear Information System (INIS)

    Bossi, J.; Campal, N; Hartmann, L.A; Schipilov, A.; Pineyro, D

    2001-01-01

    The radiometric ages obtained abroad have been systematically integrated with the field geology over the last thirty five years. The difference between the radiometric ages and their geochronology interpretation was realized rather early in the investigations. The few opportunities for radiometric determinations of rocks and minerals required careful regional geological mapping, based on models which were predominant at the time. Untial 1965, the pre-Devonian rocks in Uruguay were divided into Archean and Algonkian. The Archean units included medium metamorphic grade rocks and all the plutonic rocks. The Algonkian units were the low metamorphic grade supracrustal belts. The tectono-stratigraphic proposal presented at the International Geological Congress in India (1960) induced the division into two orogenic cycles and the radiometric dating with the techniques available at the time: K-Ar already in use and Rb-Sr isochrons, which were considered accurate and precise. The work of Hart (1966) resulted in ten ages, grouped in two geographically separated age sets: 600-500 Ma in the southeast and ca. 2000 Ma in the south and southwest. Bossi et al. (1967) identified two orogenic cycles based on geological mapping at the 1:250,000 scale, no intermediate ages. These cycles were recognized until 1991, although some improvements occurred in limits of units and cartography and some changes in nomenclature and integration of the Rb-Sr isotopic data by Umpierre and Halpern (1971), Soliani Jr. (1986), Renne (1991, pers. comm.). The proposal of a Trans-Amazonian craton in the west (Ciclo Orogenico Antiguo) and a mobile belt in the east (Ciclo Orogenico Moderno) was accepted for 25 years. Many Brazilian (e.g., Fragoso Cesar, 1980) and some Uruguayan authors included the 'Ciclo Orogenico Moderno in the Brasiliano Cycle of Almeida (1976). The consistency of this proposal has been accepted up to today, because 800-550 Ma granitic rocks are intruded in low metamorphic grade

  16. Long-term survival differences in gastric cancer after D2 lymphadenectomy and an improved assessment of resectability

    Directory of Open Access Journals (Sweden)

    Gabriel Dimofte

    2017-05-01

    Full Text Available Objective. The purpose of this work is to compare the long-term survival between a control group with mostly D1 lymphadenectomy and a study group with mostly D2 lymphadenectomy. Materials and Methods. We analyzed consecutive cases operated by a single surgeon performing mostly D2 lymphadenectomy and a control group of consecutive gastric cancer patients operated by a group of surgeons, performing mostly D1 lymphadenectomy, in a period when D2 lymphadenectomy was not the standard and was introduced as a new technique in our center. Results. We found 30,56% D2 lymphadenectomy in the control groups and 85,1% in the study group. At a five years interval from surgery the control group had no survivors, while the study group had 8 (20% survivors. Conclusions. The spleen and pancreas preserving D2 lymphadenectomy done by experienced surgeons, according to the current guidelines in order to select operable patients improves the overall survival of such gastric cancer patients.

  17. Long term survival with whole abdominopelvic irradiation (WAI) in platinum-refractory ovarian cancer

    International Nuclear Information System (INIS)

    Cmelak, Anthony J.; Cox, Richard S.; Kapp, Daniel S.

    1996-01-01

    Purpose: To evaluate the efficacy and toxicity of WAI in persistent or recurrent epithelial ovarian carcinoma after initial chemotherapy. Methods and Materials: Between 1970 and 1995, 41 women with persistent or recurrent ovarian carcinoma after initial surgical debulking and chemotherapy were treated with WAI. Median age was 57 years (range 27-75). Initial FIGO stages were I and II - 5 patients (12%), III - 26 (64%), and IV - 10 (24%). Tumor grade was 1 - 4 (10%), II - 16 (39%), and III - 20 (49%). Four to eighteen (median eight) cycles of chemotherapy had been given prior to WAI. Thirty-one patients had received platinum-based regimens, and 22 of these had failed within six months after completion of chemotherapy (platinum-refractory). Prior to WAI, 11 (27%) patients had microscopic residual disease, 21 (51%) had gross residual disease up to 1.5 cm, and 9 (22%) had tumors greater than 1.5 cm in maximal diameter. Median doses of 28 Gy to the abdomen and 48 Gy to the pelvis were delivered using an open-field technique with appropriate liver and kidney shielding. Results: With follow-up of 1 month to 16.5 years, the 5-year actuarial disease specific survival was 47% in all 41 patients, and 49% in 22 platinum-refractory patients. Both disease bulk at WAI (p -4 ) and initial stage (p=0.005) were of prognostic value. Five-year disease specific survivals were stage I and II - 100%, stage III - 55%, and stage IV - 27%. Five-year disease specific survival of all nonbulky (less than 1.5 cm) patients was 40%; 0% for patients with disease greater than 1.5 cm. Five-year disease specific survival for grade I - 66%, II - 59%, and III - 33%. Stage I, II, or III patients with residual disease bulk of 1.5 cm or less before WAI had a 10-year actuarial disease specific survival of 50%. Twelve patients (29%) failed to complete the planned course of WAI due to acute toxicity (most often due to prolonged thrombocytopenia). Late bowel toxicity included obstruction in one patient and

  18. The Long Game: Five Years of Simulating the Middle East

    Science.gov (United States)

    Hardy, Mat; Totman, Sally

    2017-01-01

    Scholarly literature attesting to the benefits of role play in teaching international relations or political science subjects is abundant and universally positive. However, despite many case studies presenting snapshots of single examples, long term data concerning a role play exercise is difficult to find. This study presents student feedback…

  19. Chernobyl five years after. WHO to spearhead international programme

    International Nuclear Information System (INIS)

    1991-01-01

    In April 1990, an agreement was signed between the WHO and the USSR Ministry of Health to set up a long-term international programme to assist the populations affected by the Chernobyl accident, as well as to increase the body of scientific knowledge about radiation effects. The programme will deal with monitoring and treatment of the affected populations and will carefully examine emergency prevention issues. Funding will come primarily from voluntary contributions from WHO Member States

  20. Five-Year Follow-Up of Concomitant Accelerated Hypofractionated Radiation in Advanced Squamous Cell Carcinoma of the Buccal Mucosa: A Retrospective Cohort Study

    Directory of Open Access Journals (Sweden)

    Hassan Iqbal

    2015-01-01

    Full Text Available In resource limited settings, induction chemotherapy with Gemcitabine and Cisplatinum and concurrent hypofractionated chemoradiation for locally advanced carcinoma of buccal mucosa (BMSCC are a cost effective option but remain under reported. The objective of this study was to report long term survival outcome after concurrent hypofractionated radiotherapy in locally advanced BMSCC. Between February 2005 and 2009, 63 patients received treatment. Induction chemotherapy (IC regimen consisted of two drugs: Gemcitabine and Cisplatin. All patients received 55 Gy of radiation in 20 fractions with concurrent single agent Cisplatin (75 mg/m2. Five-year overall survival (OS, disease-free survival (DFS, and progression-free survival (PFS were determined. Based on AJCC staging, 7 (11% patients were stage III, 31 (49% stage IV a, and 25 (40% stage IVb at presentation. After IC, 8 (18% patients had complete radiological response, 33 (73% had partial response, and 4 (9% had stable disease. After concurrent hypofractionated chemoradiation, thirty-nine (62% patients were complete responders and 24 (38% had stable disease. With a minimum follow-up of 60 months, 5-year OS, DFS, and PFS were 30%, 49%, and 30%, respectively. In locally advanced buccal mucosa squamous cell carcinoma, concurrent hypofractionated chemoradiation results in acceptable survival and regimen related toxicity.

  1. Mid-term Outcome of 100 Consecutive Ross Procedures: Excellent Survival, But Yet to Be a Cure.

    Science.gov (United States)

    Zimmermann, Corina; Attenhofer Jost, Christine; Prêtre, René; Mueller, Christoph; Greutmann, Matthias; Seifert, Burkhardt; Valsangiacomo Büchel, Emanuela; Kretschmar, Oliver; Dave, Hitendu Hasmukhlal; Weber, Roland

    2018-03-01

    The Ross procedure offers excellent short-term outcome but the long-term durability is under debate. Reinterventions and follow-up of 100 consecutive patients undergoing Ross Procedure at our centre (1993-2011) were analysed. Follow-up was available for 96 patients (97%) with a median duration of 5.3 (0.1-17.1) years. Median age of the patient cohort was 15.2 (0.04-58.4) years with 76 males. 93% had underlying congenital aortic stenosis. Root replacement technique was applied in all. The most common valved conduits used for reconstruction of the right ventricular outflow tract were homografts (66 patients) and bovine jugular vein (Contegra R ) graft (31 patients). Additional procedures included Ross-Konno procedure (14%), resection of subaortic stenosis/myectomy (11%) and reduction plasty of the ascending aorta (25%). One patient died within the first 30 days (1%). Late deaths occurred in 4 patients (4%) 0.5-4.5 years postoperatively: causes included pulmonary hypertension due to endocardial fibroelastosis (2), subarachnoid haemorrhage (1) and sudden cardiac death (1). Five-year survival was 93.6 (95% CI 88.1-99.1)%. Moderate or severe aortic (autograft) regurgitation needing reoperation occurred in 8 patients with a 5-year freedom from autograft reoperation of 98.5 (95.6-100)%. Five-year freedom from reintervention (surgery or catheter based) on the right ventricular outflow tract conduit was 91.5 (85.5-96.5)%. Univariate predictors of this reinterventions were smaller graft size (p = 0.03) and use of a Contegra R graft (p = 0.04). Ross procedure can be performed with low mortality and good survival in the long term. Most of the reinterventions are related to the neo-right ventricular outflow tract and may be partly attributed to the lack of growth. While the Ross Procedure remains an invaluable option for aortic valve disease in children, new solutions for the neo-pulmonary valve as well as for the less often occurring problems on the autograft are

  2. 78 FR 26616 - Draft NOAA Five Year Research and Development Plan

    Science.gov (United States)

    2013-05-07

    ... DEPARTMENT OF COMMERCE Draft NOAA Five Year Research and Development Plan AGENCY: National Oceanic and Atmospheric Administration (NOAA), Department of Commerce (DOC). ACTION: Draft NOAA Five Year Research and Development Plan for Public Review. SUMMARY: NOAA's draft Five Year Research and Development...

  3. 75 FR 34959 - Five-Year Review of Oil Pipeline Pricing Index

    Science.gov (United States)

    2010-06-21

    ...] Five-Year Review of Oil Pipeline Pricing Index June 15, 2010. AGENCY: Federal Energy Regulatory... comments on its five-year review of the oil pipeline pricing index established in Revisions to Oil Pipeline...-year review of the oil pricing index, the Commission adopted an index of PPI+1.3 for the five-year...

  4. 75 FR 80300 - Five-Year Review of Oil Pipeline Pricing Index

    Science.gov (United States)

    2010-12-22

    ...] Five-Year Review of Oil Pipeline Pricing Index Issued December 16, 2010. AGENCY: Federal Energy... five-year review of the oil pricing index, established in Order No. 561. After consideration of the... period commencing July 1, 2011. \\1\\ Five-Year Review of Oil Pipeline Pricing Index, 75 FR 34959 (June 21...

  5. 75 FR 75453 - Proposed Information Collection; Comment Request; Five-Year Records Retention Requirement for...

    Science.gov (United States)

    2010-12-03

    ... Request; Five-Year Records Retention Requirement for Export Transactions and Boycott Actions AGENCY... parties involved in export transactions and the U.S. party involved in a boycott action are required to... boycott documents and reports. The five-year record retention period corresponds with the five-year...

  6. Radiofrequency ablation of osteoid osteomas: five years experience.

    Science.gov (United States)

    Papathanassiou, Zafiria G; Petsas, Theodore; Papachristou, Dionysios; Megas, Panagiotis

    2011-12-01

    The purpose of this study is to retrospectively evaluate the efficacy of radiofrequency ablation as a curative treatment method for benign bone tumours. Twenty-nine osteoid osteomas were treated with radiofrequency ablation. Primary success rate was 89.6% and total secondary success rate was 93.1%. Mean clinical follow-up period was 26.7 months (range: 6-63 months). Statistical analysis of 25 cases of osteoid osteomas with CT follow-up revealed that post-treatment re-ossification does not correlate with clinical outcome (p = 0.14) but is strongly correlated with long-term (> or = 12 months) CT follow-up (p = 0.014). Percutaneous radiofrequency ablation was found to be an effective and safe treatment for osteoid osteomas. CT findings cannot solely differentiate between treatment successes and failures.

  7. Five years of simulator evaluation - a contribution to safety culture

    International Nuclear Information System (INIS)

    Engel, G.J.; Spindler, B.; Kruip, J.

    2001-01-01

    Simulator training has been an important component in education and advanced training at a high level of nuclear power plant personnel for more than 25 years. From the beginning of simulator training, checking on the objectives of learning and feedback have been part and parcel of the effort. In the course of the revision of the 1990 Directive on Expertise of Licensed Personnel in Nuclear Power Plants composed by the German Federal Ministry for the Environment (BMU), the type and organization of evaluations and the inclusion of qualified simulator trainers were expressed in even more concrete terms. Simulator evaluation serves the purpose of assessing, on the basis of the goals of practical exercises and courses established jointly with nuclear power plant operators, the performance and the behavior of individual participants so as to obtain information and guidance for further work. In addition, both simulator trainers, the Simulator Center, and the operators are to receive feedback with respect to the courses held and for checking against plans. First experience since the introduction of simulator evaluation has shown a basically positive assessment by all participants, i.e. attendees, operators, and the Simulator Center, expressing important aspects in support of training. As new simulators were commissioned in the mid-nineties, this met one of the major requests by course participants for a realistic model of their working environment. The experience accumulated also helps optimum training by means of simulators and thus ultimately also contributes to the safety culture in German nuclear technology. (orig.) [de

  8. Be well prepared for the next five-yearly review

    CERN Multimedia

    Staff Association

    2013-01-01

    2012: An excellent year for particle physics We’ve all been involved in the great endeavour of high-energy physics in 2012, the discovery of the famous Higgs-like particle, a missing piece of the Standard Model. In other areas 2012 has also been rich in exceptional results. The Director-General, his team and all CERN staff members can be proud of these extraordinary scientific and technological achievements. The Member States have shown their support to the Organization by approving the 2013 budget and the medium-term plan until 2017 during the official Committees in December 2012, despite a rather worrying economic situation. The Director-General, in his New Year speech of 9th January 2013, underlined that the Organization can positively consider its future, with the LHC re-start scheduled in early 2015, with an energy of 6.5 TeV. The consolidation of other infrastructure, necessary for proper functioning of the installations of the Organization, will take place in 2013 and 2014. The European St...

  9. Emotion regulation predicts symptoms of depression over five years.

    Science.gov (United States)

    Berking, Matthias; Wirtz, Carolin M; Svaldi, Jennifer; Hofmann, Stefan G

    2014-06-01

    Deficits in emotion regulation have been identified as an important risk and maintaining factor for depression. The aim of this study was to examine the long-term effects of emotion regulation on symptoms of depression. Moreover, we investigated which specific emotion regulation skills were associated with subsequent symptoms of depression. Participants were 116 individuals (78% women, average age 35.2 years) who registered for an online-based assessment of depression and its risk-factors and reported at least some symptoms of depression. Successful application of emotion regulation skills and depressive symptom severity were assessed twice over a 5-year period. We utilized cross-lagged panel analyses to assess whether successful skills application would be negatively associated with subsequent depressive symptom severity. Cross-lagged panel analyses identified successful skills application as a significant predictor for depressive symptom severity even when controlling for the effects of initial symptoms of depression. A comparison of the effect sizes for different emotion regulation skills on subsequent depressive symptoms suggests that most of the skills included have similar predictive value. These findings provide preliminary evidence for the hypotheses that deficits in emotion regulation may contribute to the development of depression and that interventions systematically enhancing adaptive emotion regulation skills may help prevent and treat depressive symptoms. Copyright © 2014 Elsevier Ltd. All rights reserved.

  10. Pre- and Posttransplant IgA Anti-Fab Antibodies to Predict Long-term Kidney Graft Survival.

    Science.gov (United States)

    Amirzargar, M A; Amirzargar, A; Basiri, A; Hajilooi, M; Roshanaei, G; Rajabi, G; Solgi, G

    2015-05-01

    Immunologic factors are reliable markers for allograft monitoring, because of their seminal role in rejection process. One of these factors is the immunoglobulin (Ig)A anti-Fab of the IgG antibody. This study aimed to evaluate the predictive value of pre- and posttransplant levels of this marker for kidney allograft function and survival. Sera samples of 59 living unrelated donor kidney recipients were collected before and after transplantation (days 7, 14, and 30) and investigated for IgA anti-Fab of IgG antibody levels using enzyme-linked immunosorbent assay in relation with allograft outcome. Among 59 patients, 15 cases (25%) including 10 with acute rejection and 5 with chronic rejection episodes showed graft failure during a mean of 5 years of follow-up. High posttransplant levels of IgA anti-Fab antibodies were observed more frequently in patients with stable graft function (SGF) compared with patients with graft failure (P = 2 × 10(-6)). None of patients with acute or chronic rejection episodes had high levels of IgA anti-Fab antibodies at day 30 posttransplant compared with the SGF group (P = 10(-6) and P = .01, respectively). In addition, high levels of IgA anti-Fab antibody correlated with lesser concentration of serum creatinine at 1 month posttransplantation (P = .01). Five-year graft survival was associated with high levels of pre- and posttransplant IgA anti-Fab antibodies (P = .02 and P = .003, respectively). Our findings indicate the protective effect of higher levels of IgA anti-Fab antibodies regarding to kidney allograft outcomes and long-term graft survival. Copyright © 2015 Elsevier Inc. All rights reserved.

  11. Long‐Term Post‐CABG Survival: Performance of Clinical Risk Models Versus Actuarial Predictions

    Science.gov (United States)

    Carr, Brendan M.; Romeiser, Jamie; Ruan, Joyce; Gupta, Sandeep; Seifert, Frank C.; Zhu, Wei

    2015-01-01

    Abstract Background/aim Clinical risk models are commonly used to predict short‐term coronary artery bypass grafting (CABG) mortality but are less commonly used to predict long‐term mortality. The added value of long‐term mortality clinical risk models over traditional actuarial models has not been evaluated. To address this, the predictive performance of a long‐term clinical risk model was compared with that of an actuarial model to identify the clinical variable(s) most responsible for any differences observed. Methods Long‐term mortality for 1028 CABG patients was estimated using the Hannan New York State clinical risk model and an actuarial model (based on age, gender, and race/ethnicity). Vital status was assessed using the Social Security Death Index. Observed/expected (O/E) ratios were calculated, and the models' predictive performances were compared using a nested c‐index approach. Linear regression analyses identified the subgroup of risk factors driving the differences observed. Results Mortality rates were 3%, 9%, and 17% at one‐, three‐, and five years, respectively (median follow‐up: five years). The clinical risk model provided more accurate predictions. Greater divergence between model estimates occurred with increasing long‐term mortality risk, with baseline renal dysfunction identified as a particularly important driver of these differences. Conclusions Long‐term mortality clinical risk models provide enhanced predictive power compared to actuarial models. Using the Hannan risk model, a patient's long‐term mortality risk can be accurately assessed and subgroups of higher‐risk patients can be identified for enhanced follow‐up care. More research appears warranted to refine long‐term CABG clinical risk models. doi: 10.1111/jocs.12665 (J Card Surg 2016;31:23–30) PMID:26543019

  12. Stereotactic body radiotherapy for low-risk prostate cancer: five-year outcomes

    Directory of Open Access Journals (Sweden)

    King Christopher R

    2011-01-01

    Full Text Available Abstract Purpose Hypofractionated, stereotactic body radiotherapy (SBRT is an emerging treatment approach for prostate cancer. We present the outcomes for low-risk prostate cancer patients with a median follow-up of 5 years after SBRT. Method and Materials Between Dec. 2003 and Dec. 2005, a pooled cohort of 41 consecutive patients from Stanford, CA and Naples, FL received SBRT with CyberKnife for clinically localized, low-risk prostate cancer. Prescribed dose was 35-36.25 Gy in five fractions. No patient received hormone therapy. Kaplan-Meier biochemical progression-free survival (defined using the Phoenix method and RTOG toxicity outcomes were assessed. Results At a median follow-up of 5 years, the biochemical progression-free survival was 93% (95% CI = 84.7% to 100%. Acute side effects resolved within 1-3 months of treatment completion. There were no grade 4 toxicities. No late grade 3 rectal toxicity occurred, and only one late grade 3 genitourinary toxicity occurred following repeated urologic instrumentation. Conclusion Five-year results of SBRT for localized prostate cancer demonstrate the efficacy and safety of shorter courses of high dose per fraction radiation delivered with SBRT technique. Ongoing clinical trials are underway to further explore this treatment approach.

  13. Foraminiferal survival after long term experimentally induced anoxia

    Science.gov (United States)

    Langlet, D.; Geslin, E.; Baal, C.; Metzger, E.; Lejzerowicz, F.; Riedel, B.; Zuschin, M.; Pawlowski, J.; Stachowitsch, M.; Jorissen, F. J.

    2013-06-01

    Anoxia has been successfully induced in four benthic chambers installed on the Northern Adriatic seafloor from 1 week to 10 months. To accurately determine whether benthic foraminifera can survive experimentally induced prolonged anoxia, the CellTrackerGreen method has been applied. Numerous individuals have been found living at all sampling times and at all sampling depths, showing that benthic foraminifera can survive up to 10 months of anoxia with co-occurring hydrogen sulphides. However, foraminiferal standing stocks decrease with sampling time in an irregular way. A large difference in standing stock between two cores samples in initial conditions indicates the presence of a large spatial heterogeneity of the foraminiferal faunas. An unexpected increase in standing stocks after 1 month is tentatively interpreted as a reaction to increased food availability due to the massive mortality of infaunal macrofaunal organisms. After this, standing stocks decrease again in a core sampled after 2 months of anoxia, to attain a minimum in the cores sampled after 10 months. We speculate that the trend of overall decrease of standing stocks is not due to the adverse effects of anoxia and hydrogen sulphides, but rather due to a continuous diminution of labile organic matter.

  14. Prognostic Factors and Decision Tree for Long-term Survival in Metastatic Uveal Melanoma.

    Science.gov (United States)

    Lorenzo, Daniel; Ochoa, María; Piulats, Josep Maria; Gutiérrez, Cristina; Arias, Luis; Català, Jaum; Grau, María; Peñafiel, Judith; Cobos, Estefanía; Garcia-Bru, Pere; Rubio, Marcos Javier; Padrón-Pérez, Noel; Dias, Bruno; Pera, Joan; Caminal, Josep Maria

    2017-12-04

    The purpose of this study was to demonstrate the existence of a bimodal survival pattern in metastatic uveal melanoma. Secondary aims were to identify the characteristics and prognostic factors associated with long-term survival and to develop a clinical decision tree. The medical records of 99 metastatic uveal melanoma patients were retrospectively reviewed. Patients were classified as either short (≤ 12 months) or long-term survivors (> 12 months) based on a graphical interpretation of the survival curve after diagnosis of the first metastatic lesion. Ophthalmic and oncological characteristics were assessed in both groups. Of the 99 patients, 62 (62.6%) were classified as short-term survivors, and 37 (37.4%) as long-term survivors. The multivariate analysis identified the following predictors of long-term survival: age ≤ 65 years (p=0.012) and unaltered serum lactate dehydrogenase levels (p=0.018); additionally, the size (smaller vs. larger) of the largest liver metastasis showed a trend towards significance (p=0.063). Based on the variables significantly associated with long-term survival, we developed a decision tree to facilitate clinical decision-making. The findings of this study demonstrate the existence of a bimodal survival pattern in patients with metastatic uveal melanoma. The presence of certain clinical characteristics at diagnosis of distant disease is associated with long-term survival. A decision tree was developed to facilitate clinical decision-making and to counsel patients about the expected course of disease.

  15. Guttate Psoriasis Following Streptococcal Vulvovaginitis in a Five-year-old Girl.

    Science.gov (United States)

    Hernandez, Melia; Simms-Cendan, Judith; Zendell, Kathleen

    2015-10-01

    Guttate psoriasis is frequently associated with a preceding pharyngeal or perianal streptococcal infection in children. Despite Group A beta-hemolytic streptococci (GABHS) being the most common cause of specific bacterial vulvovaginitis in prepubertal girls, there are no reports of streptococcal vulvovaginitis triggering guttate psoriasis. A five-year-old girl presented with guttate psoriasis following an episode of Streptococcal pyogenes vulvovaginitis. Following antibiotic treatment and bacterial eradication she developed vulvar psoriasis that resolved with high potency topical steroids. Identification of an antecedent streptoccocal infection can help predict the long term prognosis in children with guttate psoriasis. The vulvovaginal area should be considered as a source of GABHS infection in young girls with guttate psoriasis, and cultures should be considered if symptoms are present. Published by Elsevier Inc.

  16. Molecular profiling of short-term and long-term surviving patients identifies CD34 mRNA level as prognostic for glioblastoma survival

    DEFF Research Database (Denmark)

    Michaelsen, Signe Regner; Urup, Thomas; Olsen, Lars Rønn

    2018-01-01

    Despite extensive treatment, overall survival (OS) for glioblastoma (GBM) remains poor. A small proportion of patients present long survival over 3 years, but the underlying molecular background separating these long-term survivors (LTS) from short-term survivors (STS) are insufficiently understood....... Accordingly, study aim was to identify independent prognostic biomarkers for survival. Study cohort consisted of 93 primary GBM patients treated with radiation-, chemo- and bevacizumab therapy, among which 14 STS (OS ≤ 12 months) and 6 LTS (OS ≥ 36 months) were identified, all confirmed being IDH wild......-type. RNA expression levels in diagnostic tumor specimen for 792 genes were analyzed by NanoString technology. While no differences were found with regard to GBM subtype between LTS versus STS, comparative analysis of individual genes identified 14 significantly differently expressed candidate genes...

  17. Energy and climate policy in China's twelfth five-year plan: A paradigm shift

    International Nuclear Information System (INIS)

    Li Jun; Wang Xin

    2012-01-01

    The twelfth five-year plan (FYP) endorsed by the People's National Congress in March 2011 plays a crucial role in shaping China's development trajectory over the next decades , and especially for the fulfillment of the 40–45 carbon intensity reduction target by 2020. The plan will condition both the medium and long term perspectives of economic restructuring, rebalance between the inclusive economic growth and environmental objectives, which are compounded by multiple constraints faced by China such as aging population, natural resources depletion, energy supply security and environmental deterioration. This article investigates the major energy and climate targets and actions specified in the 12th FYP to gain insights into the nature and magnitude of challenges and difficulties with regard to the medium and long run economic and environmental policies. It points out that China should articulate sectoral policies with the global climate mitigation targets to avoid long term carbon lock-in. Based on an in-depth analysis of the objectives in the plan, it is argued that the implementation should include mainstreaming developments of appropriate instruments to support cost-effective energy efficiency improvements and carbon intensity reduction in the next five years. - Highlights: ► We investigate the major energy and climate targets and actions specified in the Chinese 12th FYP. ► It points out FYP's implications for energy policy and global climate stabilisation. ► Challenges and difficulties with regard to the medium and long run climate strategies. ► Shift from investment and export-led to consumption led sustainable and inclusive growth model.

  18. Long-Term Survival of Enteric Microorganisms in Frozen Wastewater

    Science.gov (United States)

    2002-10-01

    sewage.............31 Table 12. Percentage of cysts of Giardia muris recovered after one and three cycles of freezing and thawing...of Giardia muris and Giardia lamblia that had been subjected to one to three cycles of freezing at –16°C and thawing at 20°C. Examination Long-Term... Giardia muris recovered after one and three cycles of freezing and thawing. (From Erlandsen et al. 1990.)a Number of freeze–thaw cycles Initial

  19. Intrathoracic Anastomotic Leakage after Gastroesophageal Cancer Resection Is Associated with Reduced Long-term Survival

    DEFF Research Database (Denmark)

    Kofoed, Steen Christian; Calatayud, Dan; Jensen, Lone Susanne

    2014-01-01

    BACKGROUND: Most likely because of low statistical power, no previous studies have shown any significant association between long-term survival and anastomotic leakage in patients who have undergone gastroesophageal cancer resection. MATERIAL AND METHODS: The present study included, prospectively...

  20. Predicting long-term graft survival in adult kidney transplant recipients

    Directory of Open Access Journals (Sweden)

    Brett W Pinsky

    2012-01-01

    Full Text Available The ability to accurately predict a population′s long-term survival has important implications for quantifying the benefits of transplantation. To identify a model that can accurately predict a kidney transplant population′s long-term graft survival, we retrospectively studied the United Network of Organ Sharing data from 13,111 kidney-only transplants completed in 1988- 1989. Nineteen-year death-censored graft survival (DCGS projections were calculated and com-pared with the population′s actual graft survival. The projection curves were created using a two-part estimation model that (1 fits a Kaplan-Meier survival curve immediately after transplant (Part A and (2 uses truncated observational data to model a survival function for long-term projection (Part B. Projection curves were examined using varying amounts of time to fit both parts of the model. The accuracy of the projection curve was determined by examining whether predicted sur-vival fell within the 95% confidence interval for the 19-year Kaplan-Meier survival, and the sample size needed to detect the difference in projected versus observed survival in a clinical trial. The 19-year DCGS was 40.7% (39.8-41.6%. Excellent predictability (41.3% can be achieved when Part A is fit for three years and Part B is projected using two additional years of data. Using less than five total years of data tended to overestimate the population′s long-term survival, accurate prediction of long-term DCGS is possible, but requires attention to the quantity data used in the projection method.

  1. Significant achievements in '10th five-year plan' period and primary guidance in '11th five-year plan' period on uranium exploration

    International Nuclear Information System (INIS)

    Zhang Jindai; Li Youliang; Jian Xiaofei; Peng Xinjian; Jiang Deying

    2007-01-01

    During the '10th five-year-plane' period, uranium resource had attracted high attention and concentration from related organization of the CCPC and the central government because of the state's manifestation on the development goal for nuclear power, efforts on uranium research and exploration were intensified accordingly. In that five years, both uranium exploration, regional assessment and prognostication for the Mesozoic-Cenozoic basin in North China and research on uranium metallogeny theory and prospecting method had made fairly great progress and reached important fruits. Due to the improvement of prospecting theory and technology for ISL amenable sandstone hosted U-deposits, uranium exploration efficiency was great enhanced and had prompted the sustainable development for China's uranium exploration. This paper have briefly expounded the general deploy for the uranium geology research and exploration in the '11th five-year plan' period. (authors)

  2. Perioperative Outcomes and Long-term Survival in Clinically Early-stage Thymic 
Malignancies: Video-assisted Thoracoscopic Thymectomy versus Open Approaches

    Directory of Open Access Journals (Sweden)

    Hao WANG

    2016-07-01

    Full Text Available Background and objective Video-assisted thoracoscopic surgery (VATS theoretically offers advantages over open thymectomy for clinically early-stage (Masaoka-Koga stage I and II thymic malignancies. However, longterm outcomes have not been well studied. We compared the postoperative outcomes and survival from a cohort study based on the database of the Chinese Alliance for Research in Thymomas (ChART. Methods Between 1994 and 2012, data of 1,117 patients having surgery for clinically early-stage (Masaoka-Koga stage I and II tumors were enrolled for the study. Among them, 241 cases underwent VATS thymectomy (VATS group, while 876 cases underwent open thymectomy (Open group. Univariate analyses were used to compare the clinical character and perioperative outcomes between the two groups. And multivariate analysis was performed to determine the independent predictive factors for long-term survival. Results Compared with the Open group, the VATS group had higher percentage of total thymectomy (80.5% vs 73.9%, P=0.028, resection rate (98.8% vs 88.7%, P<0.001 and less recurrence (2.9% vs 16.0%, P<0.001. Five-year overall survival was 92% after VATS and 92% after open thymectomy, with no significant difference between the two groups (P=0.15. However, 5-year disease free survival were 92% in VATS group and 83% in Open group (P=0.011. Cox proportional hazards model revealed that WHO classification, Masaoka-Koga stage and adjuvant therapy were independent predictive factors for overall survival, while surgical approach had no significant impact on long-term outcome. Conclusion This study suggests that VATS thymectomy is an effective approach for clinically early-stage thymic malignancies. And it may offer better perioperative outcomes, as well as equal oncological survival.

  3. Five-Year Review of CERCLA Response Actions at the Idaho National Laboratory

    Energy Technology Data Exchange (ETDEWEB)

    W. L. Jolley

    2007-02-01

    This report summarizes the documentation submitted in support of the five-year review or remedial actions implemented under the Comprehensive Environmental Response, Compensation, and Liability Act Sitewide at the Idaho National Laboratory. The report also summarizes documentation and inspections conducted at the no-further-action sites. This review covered actions conducted at 9 of the 10 waste area groups at the Idaho National Laboratory, i.e. Waste Area Groups 1, 2, 3, 4, 5, 6, 7, 9, and 10. Waste Area Group 8 was not subject to this review, because it does not fall under the jurisdiction of the U.S. Department of Energy Idaho Operations Office. The review included past site inspections and monitoring data collected in support of the remedial actions. The remedial actions have been completed at Waste Area Groups 2, 4, 5, 6, and 9. Remedial action reports have been completed for Waste Area Groups 2 and 4, and remedial action reports are expected to be completed during 2005 for Waste Area Groups 1, 5, and 9. Remediation is ongoing at Waste Area Groups 3, 7, and 10. Remedial investigations are yet to be completed for Operable Units 3-14, 7-13/14, and 10-08. The review showed that the remedies have been constructed in accordance with the requirements of the Records of Decision and are functioning as designed. Immediate threats have been addressed, and the remedies continue to be protective. Potential short-term threats are being addressed though institutional controls. Soil cover and cap remedies are being maintained properly and inspected in accordance with the appropriate requirements. Soil removal actions and equipment or system removals have successfully achieved remedial action objectives identified in the Records of Decision. The next Sitewide five-year review is scheduled for completion by 2011.

  4. The external quality assessment scheme: Five years experience as a participating laboratory

    Directory of Open Access Journals (Sweden)

    Chaudhary Rajendra

    2010-01-01

    Full Text Available Background and Aim : Quality assurance in blood banking includes active participation in the external quality program. Such a program offers valuable benefits to patient care, their safety, and an overall quality of laboratory practices. In the year 2002, we participated in the External Quality Assessment Scheme (EQAS under the World Health Organization (WHO, Bureau of Laboratory Quality Standards, Thailand. Materials and Methods: In the current study we evaluated our EQAS test result of the past five years, from 2003 to 2007. Test results of all blood samples such as ABO grouping, D typing, antibody screening, antibody identification, and transfusion transmitted infection (TTI testing were analyzed and documented. Results: Discordant results in one or more instances were observed with antibody identification, weak D testing, and tests for anti-HIV1/2 and HBsAg. Twice we failed to detect the ′anti-Mia′ antibody in the issued sample and that could be attributed to the absence of the corresponding antigen in the used cell panel. HBsAg was missed due to its critically low titer in the serum and the comparatively low sensitivity of our Enzyme-Linked Immunosorbent Assay (ELISA test kit. Conclusion: All these failures in the last five years have helped us to significantly improve our transfusion service in terms of performance evaluation, patient care and safety issues, and the overall quality of laboratory practices. We therefore recommend all laboratories and hospitals to participate in the EQAS program, which will definitely help them to improve from what they learn.

  5. Depression and anxiety in women with early breast cancer: five year observational cohort study

    Science.gov (United States)

    Burgess, Caroline; Cornelius, Victoria; Love, Sharon; Graham, Jill; Richards, Michael; Ramirez, Amanda

    2005-01-01

    Objective To examine the prevalence of, and risk factors for, depression and anxiety in women with early breast cancer in the five years after diagnosis. Design Observational cohort study. Setting NHS breast clinic, London. Participants 222 women with early breast cancer: 170 (77%) provided complete interview data up to either five years after diagnosis or recurrence. Main outcome measures Prevalence of clinically important depression and anxiety (structured psychiatric interview with standardised diagnostic criteria) and clinical and patient risk factors, including stressful life experiences (Bedford College life events and difficulties schedule). Results Nearly 50% of the women with early breast cancer had depression, anxiety, or both in the year after diagnosis, 25% in the second, third, and fourth years, and 15% in the fifth year. Point prevalence was 33% at diagnosis, falling to 15% after one year. 45% of those with recurrence experienced depression, anxiety, or both within three months of the diagnosis. Previous psychological treatment predicted depression, anxiety, or both in the period around diagnosis (one month before diagnosis to four months after diagnosis). Longer term depression and anxiety, were associated with previous psychological treatment, lack of an intimate confiding relationship, younger age, and severely stressful non-cancer life experiences. Clinical factors were not associated with depression and anxiety, at any time. Lack of intimate confiding support also predicted more protracted episodes of depression and anxiety. Conclusion Increased levels of depression, anxiety, or both in the first year after a diagnosis of early breast cancer highlight the need for dedicated service provision during this time. Psychological interventions for women with breast cancer who remain disease free should take account of the broader social context in which the cancer occurs, with a focus on improving social support. PMID:15695497

  6. Five years database of landslides and floods affecting Swiss transportation networks

    Science.gov (United States)

    Voumard, Jérémie; Derron, Marc-Henri; Jaboyedoff, Michel

    2017-04-01

    Switzerland is a country threatened by a lot of natural hazards. Many events occur in built environment, affecting infrastructures, buildings or transportation networks and producing occasionally expensive damages. This is the reason why large landslides are generally well studied and monitored in Switzerland to reduce the financial and human risks. However, we have noticed a lack of data on small events which have impacted roads and railways these last years. This is why we have collect all the reported natural hazard events which have affected the Swiss transportation networks since 2012 in a database. More than 800 roads and railways closures have been recorded in five years from 2012 to 2016. These event are classified into six classes: earth flow, debris flow, rockfall, flood, avalanche and others. Data come from Swiss online press articles sorted by Google Alerts. The search is based on more than thirty keywords, in three languages (Italian, French, German). After verifying that the article relates indeed an event which has affected a road or a railways track, it is studied in details. We get finally information on about sixty attributes by event about event date, event type, event localisation, meteorological conditions as well as impacts and damages on the track and human damages. From this database, many trends over the five years of data collection can be outlined: in particular, the spatial and temporal distributions of the events, as well as their consequences in term of traffic (closure duration, deviation, etc.). Even if the database is imperfect (by the way it was built and because of the short time period considered), it highlights the not negligible impact of small natural hazard events on roads and railways in Switzerland at a national level. This database helps to better understand and quantify this events, to better integrate them in risk assessment.

  7. Long-term survival of adult trauma patients.

    Science.gov (United States)

    Davidson, Giana H; Hamlat, Christian A; Rivara, Frederick P; Koepsell, Thomas D; Jurkovich, Gregory J; Arbabi, Saman

    2011-03-09

    Inpatient trauma case fatality rates may provide an incomplete assessment for overall trauma care effectiveness. To date, there have been few large studies evaluating long-term mortality in trauma patients and identifying predictors that increase risk for death following hospital discharge. To determine the long-term mortality of patients following trauma admission and to evaluate survivorship in relationship with discharge disposition. Retrospective cohort study of 124,421 injured adult patients during January 1995 to December 2008 using the Washington State Trauma Registry linked to death certificate data. Kaplan-Meier and Cox proportional hazards models were used to evaluate long-term mortality following hospital admission for trauma. Of the 124,421 trauma patients, 7243 died before hospital discharge and 21,045 died following hospital discharge. Cumulative mortality at 3 years postinjury was 16% (95% confidence interval [CI], 15.8%-16.2%) compared with the expected population cumulative mortality of 5.9% (95% CI, 5.9%-5.9%). In-hospital mortality improved during the 14-year study period from 8% (n = 362) to 4.9% (n = 600), whereas long-term cumulative mortality increased from 4.7% (95% CI, 4.1%-5.4%) to 7.4% (95% CI, 6.8%-8.1%). After adjustments for confounders, patients who were older and those who were discharged to a skilled nursing facility had the highest risk of death. The adjusted hazard ratios (HRs) for death after discharge to a skilled nursing facility compared with that after discharge home were 1.41 (95% CI, 0.72-2.76) for patients aged 18 to 30 years, 1.92 (95% CI, 1.36-2.73) for patients aged 31 to 45 years, 2.02 (95% CI, 1.39-2.93) for patients aged 46 to 55 years, 1.93 (95% CI, 1.40-2.64) for patients aged 56 to 65 years, 1.49 (95% CI, 1.14-1.94) for patients aged 66 to 75 years, 1.54 (95% CI, 1.27-1.87) for patients aged 76 to 80 years, and 1.38 (95% CI, 1.09-1.74) for patients older than 80 years. Other significant predictors of mortality

  8. Risk Factors for Malnutrition Among Under-Five-Year olds in an ...

    African Journals Online (AJOL)

    Objectives: To identify risk factors associated with the development of malnutrition in the under-five-year olds in a homogeneous inner city community. Design: A community-based, case-control study. Materials and Methods: One hundred and thirty eight children (subjects and controls) aged less than five years living in the ...

  9. Five-year follow-up using a prostate stent as fiducial in image-guided radiotherapy of prostate cancer.

    Science.gov (United States)

    Carl, Jesper; Sander, Lotte

    2015-06-01

    To report results from the five-year follow-up on a previously reported study using image-guided radiotherapy (IGRT) of localized or locally advanced prostate cancer (PC) and a removable prostate stent as fiducial. Patients with local or locally advanced PC were treated using five-field 3D conformal radiotherapy (3DRT). The clinical target volumes (CTV) were treated to 78 Gy in 39 fractions using daily on-line image guidance (IG). Late genito-urinary (GU) and gastro-intestinal (GI) toxicities were scored using the radiotherapy oncology group (RTOG) score and the common toxicity score of adverse events (CTC) score. Urinary symptoms were also scored using the international prostate symptom score (IPSS). Median observation time was 5.4 year. Sixty-two of the 90 patients from the original study cohort were eligible for toxicity assessment. Overall survival, cancer-specific survival and biochemical freedom from failure were 85%, 96% and 80%, respectively at five years after radiotherapy. Late toxicity GU and GI RTOG scores≥2 were 5% and 0%. Comparing pre- and post-radiotherapy IPSS scores indicate that development in urinary symptoms after radiotherapy may be complex. Prostate image-guided radiotherapy using a prostate stent demonstrated survival data comparable with recently published data. GU and GI toxicities at five-year follow-up were low and comparable to the lowest toxicity rates reported. These findings support that the precision of the prostate stent technique is at least as good as other techniques. IPSS revealed a complex development in urinary symptoms after radiotherapy.

  10. The Effect of Talking Drawings on Five-Year-Old Turkish Children's Mental Models of the Water Cycle

    Science.gov (United States)

    Ahi, Berat

    2017-01-01

    The purpose of the current study is to determine the effect of talking drawings on Turkish preschool children's mental models of the water cycle. The study was conducted in the city of Kastamonu, located in the north-west of Turkey. A total of 40 five-year-old preschool children participated in the study in the spring term of the 2015-2016 school…

  11. The 1989 patterns of care study for prostate cancer: five-year outcomes

    International Nuclear Information System (INIS)

    Chuba, Paul J.; Moughan, Jennifer; Forman, Jeffrey D.; Owen, Jean; Hanks, Gerald

    2001-01-01

    Purpose: Five-year results from the 1989 patterns of care study (PCS) for prostate cancer are now ready for analysis. The PCS was initiated to determine national averages for treatments and examine outcomes prospectively; the 1989 prostate study is the first to have collected pre- and post-treatment serum PSA data. Methods and Materials: Six hundred patients treated with radiotherapy with curative intent for prostate cancer at 71 separate institutions in the year 1989 made up the study population. Three hundred ninety-one cases were fully analyzable. Pretreatment patient and tumor characteristics were as follows: of the 391 analyzable, 255 had pretreatment PSA values obtained, and 245 had a Gleason's sum (GS) reported. Three hundred fifty-eight were Caucasian, 24 African-American, and 3 Hispanic (also 6 unknown). One hundred three patients had PSA 20. Ninety-seven patients were from Radiation Therapy Oncology Group (RTOG), Community Cancer Centers (CCC), or teaching institutions; 141 patients were from other hospital-based, nonteaching institutions; and 153 were from freestanding radiation oncology facilities. Seventy-one patients were T1, 203 T2, and 100 T3/4. Twenty-four out of 391 patients also received neoadjuvant hormone therapy. Survival curves were constructed using Kaplan-Meier methods, and differences between groups were tested for significance using the log-rank test. For cumulative incidence curves, Gray's test was used to investigate failure distributions between groups. The variables entering Cox model for multivariate analysis included age, race, T stage, pretreatment PSA, and GS. A patient was considered a PSA failure if the treating radiation oncologist reported it as such. Results: With a median follow-up of 5.7 years, the 5-year biochemical no evidence of disease (bNED) and overall survival were 56% and 79% respectively for Stage T1, 52% and 81% for T2, and 36% and 63% for Stages T3 and T4 combined. As expected, higher pretreatment PSA, GS, and T

  12. Conditional long-term survival following minimally invasive robotic mitral valve repair: a health services perspective.

    Science.gov (United States)

    Efird, Jimmy T; Griffin, William F; Gudimella, Preeti; O'Neal, Wesley T; Davies, Stephen W; Crane, Patricia B; Anderson, Ethan J; Kindell, Linda C; Landrine, Hope; O'Neal, Jason B; Alwair, Hazaim; Kypson, Alan P; Nifong, Wiley L; Chitwood, W Randolph

    2015-09-01

    Conditional survival is defined as the probability of surviving an additional number of years beyond that already survived. The aim of this study was to compute conditional survival in patients who received a robotically assisted, minimally invasive mitral valve repair procedure (RMVP). Patients who received RMVP with annuloplasty band from May 2000 through April 2011 were included. A 5- and 10-year conditional survival model was computed using a multivariable product-limit method. Non-smoking men (≤65 years) who presented in sinus rhythm had a 96% probability of surviving at least 10 years if they survived their first year following surgery. In contrast, recent female smokers (>65 years) with preoperative atrial fibrillation only had an 11% probability of surviving beyond 10 years if alive after one year post-surgery. In the context of an increasingly managed healthcare environment, conditional survival provides useful information for patients needing to make important treatment decisions, physicians seeking to select patients most likely to benefit long-term following RMVP, and hospital administrators needing to comparatively assess the life-course economic value of high-tech surgical procedures.

  13. When palliative treatment achieves more than palliation: Instances of long-term survival after palliative radiotherapy

    Directory of Open Access Journals (Sweden)

    Madhup Rastogi

    2012-01-01

    Full Text Available Context: Palliative radiotherapy aims at symptom alleviation and improvement of quality of life. It may be effective in conferring a reasonable quantum of local control, as well as possibly prolonging survival on the short term. However, there can be rare instances where long-term survival, or even cure, results from palliative radiotherapy, which mostly uses sub-therapeutic doses. Aim: To categorize and characterize the patients with long-term survival and/or cure after palliative radiotherapy. Materials and Methods: This study is a retrospective analysis of hospital records of patients treated with palliative radiotherapy from 2001 to 2006 at the Regional Cancer Centre, Shimla. Results: Of the analyzed 963 patients who received palliative radiotherapy, 2.4% (n = 23 survived at least 5 years, with a large majority of these surviving patients (73.9%, n = 17 being free of disease. Conclusions: In addition to providing valuable symptom relief, palliative radiotherapy utilizing sub-therapeutic doses may, in a small proportion of patients, bestow long-term survival, and possibly cure. Rationally, such a favorable, but rare outcome cannot be expected with supportive care alone.

  14. Long-Term Survival, Quality of Life, and Quality-Adjusted Survival in Critically Ill Patients With Cancer.

    Science.gov (United States)

    Normilio-Silva, Karina; de Figueiredo, Adelaide Cristina; Pedroso-de-Lima, Antonio Carlos; Tunes-da-Silva, Gisela; Nunes da Silva, Adriana; Delgado Dias Levites, Andresa; de-Simone, Ana Tereza; Lopes Safra, Patrícia; Zancani, Roberta; Tonini, Paula Camilla; Vasconcelos de Andrade E Silva, Ulysses; Buosi Silva, Thiago; Martins Giorgi, Juliana; Eluf-Neto, José; Costa, Anderson; Abrahão Hajjar, Ludhmila; Biasi Cavalcanti, Alexandre

    2016-07-01

    To assess the long-term survival, health-related quality of life, and quality-adjusted life years of cancer patients admitted to ICUs. Prospective cohort. Two cancer specialized ICUs in Brazil. A total of 792 participants. None. The health-related quality of life before ICU admission; at 15 days; and at 3, 6, 12, and 18 months was assessed with the EQ-5D-3L. In addition, the vital status was assessed at 24 months. The mean age of the subjects was 61.6 ± 14.3 years, 42.5% were female subjects and half were admitted after elective surgery. The mean Simplified Acute Physiology Score 3 was 47.4 ± 15.6. Survival at 12 and 18 months was 42.4% and 38.1%, respectively. The mean EQ-5D-3L utility measure before admission to the ICU was 0.47 ± 0.43, at 15 days it was 0.41 ± 0.44, at 90 days 0.56 ± 0.42, at 6 months 0.60 ± 0.41, at 12 months 0.67 ± 0.35, and at 18 months 0.67 ± 0.35. The probabilities for attaining 12 and 18 months of quality-adjusted survival were 30.1% and 19.1%, respectively. There were statistically significant differences in survival time and quality-adjusted life years according to all assessed baseline characteristics (ICU admission after elective surgery, emergency surgery, or medical admission; Simplified Acute Physiology Score 3; cancer extension; cancer status; previous surgery; previous chemotherapy; previous radiotherapy; performance status; and previous health-related quality of life). Only the previous health-related quality of life and performance status were associated with the health-related quality of life during the 18-month follow-up. Long-term survival, health-related quality of life, and quality-adjusted life year expectancy of cancer patients admitted to the ICU are limited. Nevertheless, these clinical outcomes exhibit wide variability among patients and are associated with simple characteristics present at the time of ICU admission, which may help healthcare professionals estimate patients

  15. Priorities for the implementation of the energy transition for the current five-year term

    International Nuclear Information System (INIS)

    Berghmans, Nicolas; Ruedinger, Andreas

    2017-10-01

    This Policy Brief sets out six priorities to accelerate the energy transition in France based on learning from recent or ongoing studies at IDDRI: initiating large-scale energy efficiency retrofitting; anticipating and planning the transformation of the electricity system; shaping the transformation in the mobility sector through green objectives; integrating local energy management methods; mobilizing funding sources for the energy transition; placing the energy transition at the heart of the European and global agenda. Recommendations: A review of sectoral policies is necessary to set the country on track to achieving national energy policy objectives: overhauling incentive mechanisms to encourage large-scale energy efficiency retrofitting, smoothing the road for new renewable energy projects while outlining a clear strategy for a reduction of the installed capacity of nuclear, identifying and using levers addressing mobility needs within land use policy measures. A plan to tackle mobility-related vulnerability with a dedicated mechanism to support employees and regions vulnerable to economic restructuring due to the closing of industrial sites will help ensure a 'just' and inclusive transition. New modes of energy governance and interaction between local authorities and citizens could also be promoted so that they can become real tools for the facilitation of the transition at a regional and local level. In addition to the already-announced environmental fiscal reforms, some thought on the distribution channels for financial flows and their modalities would help in mobilizing the necessary funds and reinforcing the attractiveness of these mechanisms and the effectiveness of the public funds committed. The proposal for an Energy Union could play a major part in boosting the European Union and placing it at the forefront of strengthening ambition during international negotiations on climate. Having played a crucial role in the Paris Climate Agreement, France has a legitimate place in these discussions and could use its position to initiate stronger co-operation with neighbouring countries that share a commitment to ensuring a smooth and controlled transition at EU level

  16. A hands-on approach for fitting long-term survival models under the GAMLSS framework.

    Science.gov (United States)

    de Castro, Mário; Cancho, Vicente G; Rodrigues, Josemar

    2010-02-01

    In many data sets from clinical studies there are patients insusceptible to the occurrence of the event of interest. Survival models which ignore this fact are generally inadequate. The main goal of this paper is to describe an application of the generalized additive models for location, scale, and shape (GAMLSS) framework to the fitting of long-term survival models. In this work the number of competing causes of the event of interest follows the negative binomial distribution. In this way, some well known models found in the literature are characterized as particular cases of our proposal. The model is conveniently parameterized in terms of the cured fraction, which is then linked to covariates. We explore the use of the gamlss package in R as a powerful tool for inference in long-term survival models. The procedure is illustrated with a numerical example. Copyright 2009 Elsevier Ireland Ltd. All rights reserved.

  17. Differences between colon and rectal cancer in complications, short-term survival and recurrences.

    Science.gov (United States)

    van der Sijp, Max P L; Bastiaannet, Esther; Mesker, Wilma E; van der Geest, Lydia G M; Breugom, Anne J; Steup, Willem H; Marinelli, Andreas W K S; Tseng, Larissa N L; Tollenaar, Rob A E M; van de Velde, Cornelis J H; Dekker, J W T

    2016-10-01

    Many apparent differences exist in aetiology, genetics, anatomy and treatment response between colon cancer (CC) and rectal cancer (RC). This study examines the differences in patient characteristics, prevalence of complications and their effect on short-term survival, long-term survival and the rate of recurrence between RC and CC. For all stage II-III CC and RC patients who underwent resection with curative intent (2006-2008) in five hospitals in the Netherlands, occurrence of complications, crude survival, relative survival and recurrence rates were compared. A total of 767 CC and 272 RC patients underwent resection. Significant differences were found for age, gender, emergency surgery, T-stage and grade. CC patients experienced fewer complications compared to RC (p = 0.019), but CC patients had worse short-term mortality rates (1.5 versus 6.7 % for 30-day mortality, p = 0.001 and 5.2 versus 9.5 % for 90-day mortality, p = 0.032). The adjusted HR (overall survival) for CC patients with complications was 1.57 (1.23-2.01; p characteristics and clinical outcomes between CC and RC. CC patients have a significantly higher short-term mortality compared to RC patients due to a more severe effect of complications.

  18. RMP Guidance for Chemical Distributors - Chapter 3: Five-Year Accident History

    Science.gov (United States)

    A five year accident history must be completed for each covered process, and all accidental release events meeting specified criteria must be reported in the Risk Management Plan (RMP) for that process.

  19. The First Five Years of the Alpha Magnetic Spectrometer on the International Space Station

    CERN Multimedia

    CERN. Geneva

    2016-01-01

    In the five years since its installation on the International Space Station, it has collected more than 90 billion cosmic rays. Some of the unexpected results and their possible interpretations will be presented.

  20. Preventing Dental Caries in Children from Birth Through Age Five Years

    Science.gov (United States)

    Understanding Task Force Recommendations Preventing Dental Caries in Children from Birth Through Age Five Years The U.S. Preventive Services Task Force (Task Force) has issued a final recommendation statement ...

  1. Family accommodation in obsessive-compulsive and anxiety disorders: a five-year update.

    Science.gov (United States)

    Lebowitz, Eli R; Panza, Kaitlyn E; Bloch, Michael H

    2016-01-01

    Family accommodation describes changes that individuals make to their behavior, to help their relative who is dealing with a psychiatric and/or psychological disorder(s), avoid or alleviate distress related to the disorder. Research on family accommodation has advanced rapidly. In this update we aim to provide a synthesis of findings from the past five years. A search of available, peer-reviewed, English language papers was conducted through PubMed and PsycINFO, cross referencing psychiatric disorders with accommodation and other family-related terms. The resulting 121 papers were individually reviewed and evaluated and the main findings were discussed. Family accommodation is common in obsessive-compulsive disorder (OCD) and in anxiety disorders, and manifests similarly across these disorders. Family accommodation is associated with more severe psychopathology and poorer clinical outcomes. Treatments have begun to focus on the reduction of family accommodation as a primary therapeutic goal and finally, neurobiological underpinnings of family accommodation are beginning to be investigated.

  2. Public comments and responses to the 1989 Hanford cleanup five-year plan

    International Nuclear Information System (INIS)

    1991-06-01

    In April 1990 the US Department of Energy (DOE) issued a site- specific Five-Year Plan (DOE-RL 1989a) on Hanford's cleanup for public review and comment. The plan guides Hanford in carrying out DOE's national plan for environmental restoration and waste management. During the 90-day public comment period, DOE held nine public meetings to answer questions and gather comments on the plan. This report is in three main sections. The first presents consolidated public comments and responses. These were compiled from both verbal comments from public meetings and written comments. The second section contains comments not responded to in this plan. Those comments were outside this plan's scope, related to how we gathered public comments, or intended for and directed to DOE-Headquarters. In the appendixes are the written comment letters we received and a short glossary and list of special terms we use. The source of comments is shown in parentheses after the comment. The individual who made the comment, the city of the public meeting, or the organization name is generally used. When several sources gave the same comment, a source was not listed. 26 refs

  3. Five-year forward view: lessons from emergency care at the extremes of age.

    Science.gov (United States)

    Minhas, J S; Minhas, D; Coats, T; Banerjee, J; Roland, D

    2018-03-01

    Objective The progressive rise in demand on NHS emergency care resources is partly attributable to increases in attendances of children and older people. A quality gap exists in the care provision for the old and the young. The Five Year Forward View suggested new models of care but that the "answer is not one-size-fits-all". This article discusses the urgent need for person-centred outcome measures to bridge the gap that exists between demand and provision. Design This review is based on evidence gathered from literature searching across several platforms using a variety of search terms to account for the obvious heterogeneity, drawing on key 'think-tank' evidence. Settings Qualitative and quantitative studies examining approaches to caring for individuals at the extremes of age. Participants Individuals at the extremes of age (infants and older people). Main Outcome Measures Understanding similarities and disparities in the care of individuals at the extremes of age in an emergency and non-emergency context. Results There exists several similarities and disparities in the care of individuals at the extremes of age. The increasing burden of health disease on the economy must acknowledge the challenges that exist in managing patients in emergency settings at the extremes of age and build systems to acknowledge the traits these individuals exhibit. Conclusion Commissioners of services must optimise the models of care delivery by appreciating the similarities and differences between care requirements in these two large groups seeking emergency care.

  4. Longitudinal Impact of the Project PATHS on Adolescent Risk Behavior: What Happened after Five Years?

    Directory of Open Access Journals (Sweden)

    Daniel T. L. Shek

    2012-01-01

    Full Text Available The present study investigated the longitudinal impact of the Project PATHS, a large-scale curriculum-based positive youth development program in Hong Kong, on the development of adolescents’ risk behavior over a period of five years. Using a longitudinal randomized controlled design, eight waves of data were collected from 19 experimental schools in which students participated in the Project PATHS (=2,850 at Wave 8 and 24 control schools without joining the Project PATHS (=3,640 at Wave 8. At each wave, students responded to measures assessing their current risk behaviors, including delinquency, use of different types of drug, and their intentions of participating in risk behaviors in the future. Results demonstrated that adolescents receiving the program exhibited significantly slower increases in delinquent behaviors and substance use as compared to the control participants. During two years after the completion of the program, differences in youth risk behaviors in the two groups still existed. These results suggest that the Project PATHS has long-term effect in preventing adolescent problem behavior through promoting positive youth development.

  5. Consultant-based otolaryngology emergency service: a five-year experience.

    Science.gov (United States)

    Barnes, M L; Hussain, S S M

    2011-12-01

    To present our experience of running a consultant-based otolaryngology emergency care service for more than five years. In 2003, we developed a system of consultant-based emergency service: consultants spent a week on-call providing a dedicated emergency service, with routine commitments cancelled. Our new system had advantages over traditional working practices in terms of consultant involvement, trainee education, continuity and efficiency. It also reduced disruption to elective commitments for both consultants and registrars. This system was fundamental to the successful review of all urgent (and in future elective) cases within target periods. Only 31 per cent of new referrals to the consultant emergency clinics required a further appointment. Good teamwork and flexibility in working arrangements have been essential to the success of this service. Given that health service changes have reduced junior trainee working hours and numbers, and that patients increasingly expect to be treated by trained doctors, our new consultant-based emergency service has merit. Although implementation in other units may differ, we recommend this new service, for the above reasons.

  6. Five-Yearly Review 2010 : Confirmation that our salaries are going downhill

    CERN Multimedia

    Staff Association

    2010-01-01

    A general review of our financial and social conditions takes place every five years: “the five-yearly review”, whose principles and procedures are described in Annex A1 of the Staff Rules and Regulations. The purpose of the five-yearly review is to ensure that the financial and social conditions offered by the Organization allow it to recruit and retain from all its Member States staff members of the highest competence and integrity required for the execution of its mission. The five-yearly review must include basic remuneration (the basic salaries of staff members, the stipends of fellows, and the subsistence allowances of associated members of the personnel) and may include any other financial or social conditions. Start of the 2010 five-yearly review and data collection As we wrote in Echo no. 80, CERN Council approved the document CERN/2862 for the 2010 five-yearly review (hereinafter 2010 5YR) at its meeting on 19th June 2009. This was the Management’s proposal which...

  7. Interventions for increasing fruit and vegetable consumption in children aged five years and under.

    Science.gov (United States)

    Hodder, Rebecca K; O'Brien, Kate M; Stacey, Fiona G; Wyse, Rebecca J; Clinton-McHarg, Tara; Tzelepis, Flora; James, Erica L; Bartlem, Kate M; Nathan, Nicole K; Sutherland, Rachel; Robson, Emma; Yoong, Sze Lin; Wolfenden, Luke

    2018-05-17

    trials of various intervention approaches, the evidence for how to increase children's fruit and vegetable consumption remains limited. There was very low- and low-quality evidence respectively that child-feeding practice and multicomponent interventions may lead to very small increases in fruit and vegetable consumption in children aged five years and younger. It is uncertain whether parent nutrition education interventions are effective in increasing fruit and vegetable consumption in children aged five years and younger. Given that the quality of the evidence is very low or low, future research will likely change estimates and conclusions. Long-term follow-up is required and future research should adopt more rigorous methods to advance the field.This is a living systematic review. Living systematic reviews offer a new approach to review updating, in which the review is continually updated, incorporating relevant new evidence as it becomes available. Please refer to the Cochrane Database of Systematic Reviews for the current status of this review.

  8. Interventions for increasing fruit and vegetable consumption in children aged five years and under.

    Science.gov (United States)

    Hodder, Rebecca K; Stacey, Fiona G; O'Brien, Kate M; Wyse, Rebecca J; Clinton-McHarg, Tara; Tzelepis, Flora; James, Erica L; Bartlem, Kate M; Nathan, Nicole K; Sutherland, Rachel; Robson, Emma; Yoong, Sze Lin; Wolfenden, Luke

    2018-01-25

    vegetable intake. Thirteen trials examined the impact of parent nutrition education in increasing child fruit and vegetable intake. Eight studies examined the impact of multicomponent interventions (e.g. parent nutrition education and preschool policy changes) in increasing child fruit and vegetable intake. One study examined the effect of a nutrition intervention delivered to children in increasing child fruit and vegetable intake.We judged 14 of the 55 included trials as free from high risks of bias across all domains; performance, detection and attrition bias were the most common domains judged at high risk of bias for the remaining studies.Meta-analysis of trials examining child-feeding practices versus no intervention revealed a positive effect on child vegetable consumption (SMD 0.38, 95% confidence interval (CI) 0.15 to 0.61; n = 1509; 11 studies; very low-quality evidence), equivalent to a mean difference of 4.03 g of vegetables. There were no short-term differences in child consumption of fruit and vegetables in meta-analyses of trials examining parent nutrition education versus no intervention (SMD 0.11, 95% CI -0.05 to 0.28; n = 3023; 10 studies; very low-quality evidence) or multicomponent interventions versus no intervention (SMD 0.28, 95% CI -0.06 to 0.63; n = 1861; 4 studies; very low-quality evidence).Insufficient data were available to assess long-term effectiveness, cost effectiveness and unintended adverse consequences of interventions. Studies reported receiving governmental or charitable funds, except for three studies reporting industry funding. Despite identifying 55 eligible trials of various intervention approaches, the evidence for how to increase children's fruit and vegetable consumption remains sparse. There was very low-quality evidence that child-feeding practice interventions are effective in increasing vegetable consumption in children aged five years and younger, however the effect size was very small and long-term follow-up is required

  9. Long-Term Survival According to Histology and Radiologic Response to Preoperative Chemotherapy in 126 Patients Undergoing Resection of Non-GIST Sarcoma Liver Metastases.

    Science.gov (United States)

    Goumard, Claire; Marcal, Leonardo P; Wang, Wei-Lien; Somaiah, Neeta; Okuno, Masayuki; Roland, Christina L; Tzeng, Ching-Wei D; Chun, Yun Shin; Feig, Barry W; Vauthey, Jean-Nicolas; Conrad, Claudius

    2018-01-01

    Non-gastrointestinal stromal tumor sarcomas (NGSs) have heterogeneous histology, and this heterogeneity may lead to uncertainty regarding the prognosis of patients with liver metastases from NGS (NGSLM) and decision regarding their surgical management. Furthermore, the role of preoperative chemotherapy in treatment of NGSLM remains poorly defined. We investigated long-term survival and its correlation to response to preoperative chemotherapy in patients with NGSLM. Patients who underwent liver resection for NGSLM during 1998-2015 were identified. Clinical, histopathologic, and survival data were analyzed. Multivariate analysis was performed using a Cox proportional hazards model. 126 patients [62 (49%) with leiomyosarcoma] were included. Five-year overall survival (OS) and recurrence-free survival (RFS) rates were 49.3 and 14.9%, respectively. Survival did not differ by histologic subtype, primary tumor location, or use of preoperative or postoperative chemotherapy. NGSLM ≥ 10 cm and extrahepatic metastases at NGSLM diagnosis were the only independent risk factors for OS. In the 83 (66%) patients with metachronous NSGLM, disease-free interval > 6 months was associated with improved OS and RFS. Among the 65 patients (52%) who received preoperative chemotherapy, radiologic response according to Choi criteria specifically was associated with improved OS (p = 0.04), but radiologic response according to RECIST 1.1 criteria was not. Resection of NGSLM led to a 5-year OS rate of 49%, independent of histologic subtype and primary tumor location. Choi criteria (which take into account tumor density) are superior to RECIST 1.1 in assessing radiologic response and should be used to assess response to preoperative chemotherapy.

  10. Long-term graft and patient survival following renal transplantation in diabetic patients

    DEFF Research Database (Denmark)

    Rømming Sørensen, Vibeke; Schwartz Sørensen, Søren; Feldt-Rasmussen, Bo

    2006-01-01

    . The groups were similar with respect to age and sex. RESULTS: The patient survival rates (diabetic versus non-diabetic patients) were 88% vs 91% (p=NS) at 1 year, 68% vs 73% (p=NS) at 5 years and 31% vs 52% (pnon-diabetic patients) were 72% vs 72...... patients, 55% were smokers. Among the diabetic patients, graft and patient survival were independent of smoking habits, blood pressure, HbA1c and total cholesterol. CONCLUSIONS: Graft survival was similar in diabetic and non-diabetic patients. For the first 5 years following renal transplantation......OBJECTIVE: To study long-term graft and patient survival following renal transplantation in diabetic and non-diabetic patients. MATERIAL AND METHODS: Over the time period 1985-99, 498 transplantations in 399 non-diabetic patients and 68 transplantations in 62 diabetic patients were performed...

  11. Long-term survival in advanced melanoma patients using repeated therapies: successive immunomodulation improving the odds?

    Directory of Open Access Journals (Sweden)

    Coventry BJ

    2015-04-01

    Full Text Available Brendon J Coventry, Dominique Baume, Carrie Lilly Discipline of Surgery, Royal Adelaide Hospital, University of Adelaide, Adelaide, SA, Australia Background: Patients with advanced metastatic melanoma are often confronted with little prospect of medium- to longer-term survival by any currently available therapeutic means. However, most clinicians are aware of exceptional cases where survival defies the notion of futility. Prolonged survival from immunotherapies, including interleukin-2, vaccines and antibodies to cytotoxic lymphocyte antigen-4, and programmed death-1 receptor inhibitory monoclonal antibody, implies a role for immune system modulation. We aimed to identify cases where exceptional survival from advanced melanoma occurred prior to recent novel therapies to facilitate better understanding of this phenomenon. Methods: Cases of long-term survival of ≥3 years' duration (from diagnosis of metastatic disease were identified from the database of one clinician; these cases were treated before the availability of newer immunotherapies, and they were documented and examined. A literature search for reported outcome measures from published studies using older and recent therapies for advanced melanoma was conducted to enable the comparison of data. Results: Eighteen cases were identified that identified survival of ≥3 years' duration from metastatic disease (12 American Joint Committee on Cancer [AJCC] Stage IV cases; six AJCC III cases diagnosis. These were assessed and reported to detail the clinical course. Standard clinical prognostication methods predicted high risk of early mortality in those patients. No identifiable differences could be detected between these and other patients with similar patterns of disease. At evaluation, 17 patients (94% had survived ≥5 years, and eleven patients (61% had survived ≥10 years (range: 3–15 years. The median survival duration with metastatic disease was 11 years; 15 remained alive and three

  12. RECURRENCE RATE OF HELICOBACTER PYLORI IN PATIENTS WITH PEPTIC ULCER FIVE YEARS OR MORE AFTER SUCCESSFUL ERADICATION.

    Science.gov (United States)

    Fernandes, Yuri Costa Farago; Bonatto, Gabriel da Rocha; Bonatto, Mauro Willeman

    2016-01-01

    Infection with Helicobacter pylori is highly prevalent worldwide, especially in developing countries. Its presence in the gastroduodenal mucosa is related with development of peptic ulcer and other illnesses. The eradication of H. pylori improves mucosal histology in patients with peptic ulcers. This study was aimed to verify if H. pylori recurrence occurs five years or more after confirmed eradication in patients with peptic ulcer. Moreover, we sought to determine the recurrence rate. Retrospective and longitudinal, this study was based on a sample of 201 patients from western Paraná, Brazil. The patients were diagnosed with peptic ulcer disease, in the period of 1990-2000, and followed for five years or more after successful H. pylori eradication. Patients with early recurrence - prior to five years after eradication - were excluded from the sample. During an average follow-up of 8 years, 180 patients (89.55%) remained negative, and 21 (10.45%) became positive for H. pylori infection. New ulcers appeared in two-thirds of the patients with H. pylori recurrence. The recurrence of H. pylori in patients with peptic ulcer can occur in the long-term - even if the infection had been successfully eradicated and the patients had remained free of recurrence in the first years of follow-up.

  13. Health surveillance in milling, baking and other food manufacturing operations--five years' experience.

    Science.gov (United States)

    Smith, T A; Patton, J

    1999-04-01

    The objective of this study was to describe the incidence of allergic respiratory disease and its outcome in terms of symptoms and jobs, across different flour-using industries. It uses the findings of a health surveillance programme in a large food organization over a five-year period. The population under surveillance consisted of 3,450 employees with exposure to ingredient dusts, of whom 400 were in flour milling, 1,650 in bread baking, 550 in cake baking and 850 in other flour-using operations. A total of 66 employees with either asthma or rhinitis symptoms attributable to sensitization to allergens in the workplace were identified. The majority of these (48/66) had become symptomatic prior to the commencement of the health surveillance programme in 1993. The incidence rates (per million employees per year) for those who developed symptoms between 1993 and 1997 were 550 for flour milling, 1,940 for bread baking, 0 for cake baking and 235 for other flour-using operations. The agent believed to be responsible for symptoms was most commonly grain dust in flour millers and fungal amylase in bread bakers. Wheat flour appeared to have a weaker sensitizing potential than these other two substances. In terms of outcome, at follow-up 18% of symptomatically sensitized employees had left the company. Two of the ex-employees retired through ill health due to occupational asthma. Of those still in employment, 63% described an improvement in symptoms, 32% were unchanged and 4% were worse than when first diagnosed. Over half the cases still in employment were continuing to work in the same job as at the time of diagnosis.

  14. Five-year safety and performance results from the Argus II Retinal Prosthesis System clinical trial

    Science.gov (United States)

    da Cruz, Lyndon; Dorn, Jessy D.; Humayun, Mark S.; Dagnelie, Gislin; Handa, James; Barale, Pierre-Olivier; Sahel, José-Alain; Stanga, Paulo E.; Hafezi, Farhad; Safran, Avinoam B.; Salzmann, Joel; Santos, Arturo; Birch, David; Spencer, Rand; Cideciyan, Artur V.; de Juan, Eugene; Duncan, Jacque L.; Eliott, Dean; Fawzi, Amani; Olmos de Koo, Lisa C.; Ho, Allen C.; Brown, Gary; Haller, Julia; Regillo, Carl; Del Priore, Lucian V.; Arditi, Aries; Greenberg, Robert J.

    2016-01-01

    Purpose The Argus® II Retinal Prosthesis System (Second Sight Medical Products, Inc., Sylmar, CA) was developed to restore some vision to patients blind from retinitis pigmentosa (RP) or outer retinal degeneration. A clinical trial was initiated in 2006 to study the long-term safety and efficacy of the Argus II System in patients with bare or no light perception due to end-stage RP. Design The study is a prospective, multicenter, single-arm, clinical trial. Within-patient controls included the non-implanted fellow eye and patients' native residual vision compared to their vision when using the System. Subjects There were 30 subjects in 10 centers in the U.S. and Europe. Methods The worse-seeing eye of blind patients was implanted with the Argus II System. Patients wore glasses mounted with a small camera and a video processor that converted images into stimulation patterns sent to the electrode array on the retina. Main Outcome Measures The primary outcome measures were safety (the number, seriousness, and relatedness of adverse events) and visual function, as measured by three computer-based, objective tests. Secondary measures included functional vision performance on objectively-scored real-world tasks. Results Twenty-four out of 30 patients remained implanted with functioning Argus II Systems at 5 years post-implant. Only one additional serious adverse event was experienced since the 3-year time point. Patients performed significantly better with the System ON than OFF on all visual function tests and functional vision tasks. Conclusions The five-year results of the Argus II trial support the long-term safety profile and benefit of the Argus II System for patients blind from RP. The Argus II is the first and only retinal implant to have market approval in the European Economic Area, the United States, and Canada. PMID:27453256

  15. Long-term survival and function after suspected gram-negative sepsis.

    Science.gov (United States)

    Perl, T M; Dvorak, L; Hwang, T; Wenzel, R P

    1995-07-26

    To determine the long-term (> 3 months) survival of septic patients, to develop mathematical models that predict patients likely to survive long-term, and to measure the health and functional status of surviving patients. A large tertiary care university hospital and an associated Veterans Affairs Medical Center. From December 1986 to December 1990, a total of 103 patients with suspected gram-negative sepsis entered a double-blind, placebo-controlled efficacy trial of monoclonal antiendotoxin antibody. Of these, we followed up 100 patients for 7667 patient-months. Beginning in May 1992, we reviewed hospital records and contacted all known survivors. We measured the health status of all surviving patients. The determinants of long-term survival (up to 6 years) were identified through two Cox proportional hazard regression models: one that included patient characteristics identified at the time of sepsis (bedside model) and another that included bedside, infection-related, and treatment characteristics (overall model). Of the 60 patients in the cohort who died at a median interval of 30.5 days after sepsis, 32 died within the first month of the septic episode, seven died within 3 months, and four more died within 6 months. In the bedside multivariate model constructed to predict long-term survival, large hazard ratios (HRs) were associated with severity of underlying illness as classified by McCabe and Jackson criteria (for rapidly fatal disease, HR = 30.4, P respiratory distress syndrome (HR = 2.3; P = .02) predicted patients most likely to die. The Acute Physiology and Chronic Health Evaluation II score was not a significant predictor of outcome when either model included the simpler McCabe and Jackson classification of underlying disease severity. We compared the health status scores with norms for the general population and found that patients with resolved sepsis reported more physical dysfunction (P bedridden), suggesting that the patients' physical function

  16. Long-term survival in advanced melanoma patients using repeated therapies: successive immunomodulation improving the odds?

    International Nuclear Information System (INIS)

    Coventry, Brendon J; Baume, Dominique; Lilly, Carrie

    2015-01-01

    Patients with advanced metastatic melanoma are often confronted with little prospect of medium- to longer-term survival by any currently available therapeutic means. However, most clinicians are aware of exceptional cases where survival defies the notion of futility. Prolonged survival from immunotherapies, including interleukin-2, vaccines and antibodies to cytotoxic lymphocyte antigen-4, and programmed death-1 receptor inhibitory monoclonal antibody, implies a role for immune system modulation. We aimed to identify cases where exceptional survival from advanced melanoma occurred prior to recent novel therapies to facilitate better understanding of this phenomenon. Cases of long-term survival of ≥3 years’ duration (from diagnosis of metastatic disease) were identified from the database of one clinician; these cases were treated before the availability of newer immunotherapies, and they were documented and examined. A literature search for reported outcome measures from published studies using older and recent therapies for advanced melanoma was conducted to enable the comparison of data. Eighteen cases were identified that identified survival of ≥3 years’ duration from metastatic disease (12 American Joint Committee on Cancer [AJCC] Stage IV cases; six AJCC III cases) diagnosis. These were assessed and reported to detail the clinical course. Standard clinical prognostication methods predicted high risk of early mortality in those patients. No identifiable differences could be detected between these and other patients with similar patterns of disease. At evaluation, 17 patients (94%) had survived ≥5 years, and eleven patients (61%) had survived ≥10 years (range: 3–15 years). The median survival duration with metastatic disease was 11 years; 15 remained alive and three had died. Published studies of melanoma therapies were tabled for comparison. The fact that 18 cases of exceptional survival in advanced melanoma were identified is remarkable in itself

  17. Long-Term Survival in Young Women: Hazards and Competing Risks after Thyroid Cancer

    International Nuclear Information System (INIS)

    Stroup, A. M.; Harrell, C. J.; Herget, K. A.

    2012-01-01

    Differentiated thyroid cancers (DTCs) are one of the most common and survivable cancers diagnosed in women. We examine factors associated with long-term survival and competing risks of death in women diagnosed with DTC under the age of 40 (<40) and aged 40 and older (40+). Methods. SEER data was used to identify DTCs diagnosed in women from 1975 to 2009. We examined overall (OS), disease-specific (DSS), other cancer (OCS), and non-cancer-related (NCS) survival using multivariate Cox proportional hazards modeling. Results. Observed survival was 97.2% for <40 (n=14,540) and 82.5% for 40+ (n=20,513). Distant stage (HR=1.96, 95% CI 1.23-3.07), non-Hispanic Black (HR=2.04, 95% CI 1.45-2.87), being unmarried (HR=1.26, 95% 1.03-1.54), and subsequent primary cancers (HR=4.63, 95% CI 3.76-5.71) were significant for OS in women <40. Age was an effect modifier for all survival outcomes. Racial disparities in NCS were most pronounced for young non-Hispanic black women (HR=3.36, 95% CI 2.17-5.22). Women in both age groups were more likely to die from other causes. Conclusions. Age at diagnosis remains one of the strongest prognostic factors for thyroid cancer survival. More directed efforts to ensure effective care for co morbid conditions are needed to reduce mortality from other causes.

  18. Advanced gastric adenocarcinoma. Influence of preoperative radiation therapy on toxicity and long-term survival rates

    International Nuclear Information System (INIS)

    Malzoni, Carlos Eduardo

    1996-01-01

    The surgical treatment of gastric cancer has better long-term survival rates when performed in patients with early gastric cancer. Worse results are obtained in treatment of advanced gastric cancer. Most patients in west centers are treated in advanced stages. A great number of them go through a surgical treatment unable by itself to cure them. the frequent local recurrence caused by failure of the surgical treatment has been keeping poor survival rates in patients with advanced gastric cancer for decades. The desire of improving survival is the reason of the use of adjuvant therapies. This paper achieved the retrospective study of the influence of preoperative radiation therapy (2000 cGy) in long-term survival rates (120 months) of patients with advanced gastric cancer on stages IIIa, IIIb and IV. The possible injuries caused in the liver and kidney were observed also as well as first group was treated by surgical and radiation therapies and the second received surgical treatment only. There was no statistical difference between the two groups when sex, age, race, occurrence of other diseases, nutritional assessment, TNM stage, occurrence of obstruction or bleeding caused by tumor, surgical procedure and hepatic and renal function were considered. Survival rates and changes on hepatic and renal function were statistically compared. The results showed a statistic improvement on the long-term survival rates of stage IIIa patients treated by preoperative radiation therapy. No statistic difference was observed on hepatic or renal function between the groups. No adverse influence of radiation therapy method was detected by the used parameters. There was no statistical difference between the two groups when immediate surgical complications were considered. (author)

  19. Contrasting long-term survival of two outplanted Mojave Desert perennials for post-fire revegetation

    Science.gov (United States)

    Scoles-Sciulla, Sara J.; Defalco, Lesley A.; Esque, Todd C.

    2015-01-01

    Post-fire recovery of arid shrublands is typically slow, and planting greenhouse-raised seedlings may be a means of jump-starting this process. Recovery can be further accelerated by understanding the factors controlling post-planting survival. In fall 2007 and 2009, we outplanted seedlings of two contrasting native evergreen shrubs—fast-growing Nevada jointfir and slow-growing blackbrush—across five burned sites in the Mojave Desert. To increase soil moisture and optimize seedling survival, we experimentally applied and evaluated soil amendments and supplemental watering. We also evaluated two herbicides that reduce competitive invasive annual grasses and two types of herbivore protection. Survival of jointfir outplanted in 2007 was 61% after 43 months, and site largely influenced survival, while herbicide containing imazapic applied more than one year after outplanting reduced survival. Reduced survival of jointfir outplanted in 2009 coincided with delayed seasonal precipitation that intensified foliar damage by small mammals. In contrast, blackbrush survival was 4% after 43 months, and was influenced by site, type of herbivore protection, and greenhouse during the 2007 outplanting, and soil amendment during 2009. Counter to expectations, we found that supplemental watering and soil amendments did not influence long-term survival of either blackbrush or jointfir. Shrub species with rapid growth rates and broad environmental tolerances, such as jointfir, make ideal candidates for outplanting, provided that seedlings are protected from herbivores. Re-introduction of species with slow growth rates and narrow environmental tolerances, such as blackbrush, requires careful consideration to optimize pre- and post-planting conditions.

  20. Further investigation of confirmed urinary tract infection (UTI in children under five years: a systematic review

    Directory of Open Access Journals (Sweden)

    Cooper Julie

    2005-03-01

    Full Text Available Abstract Background Further investigation of confirmed UTI in children aims to prevent renal scarring and future complications. Methods We conducted a systematic review to determine the most effective approach to the further investigation of confirmed urinary tract infection (UTI in children under five years of age. Results 73 studies were included. Many studies had methodological limitations or were poorly reported. Effectiveness of further investigations: One study found that routine imaging did not lead to a reduction in recurrent UTIs or renal scarring. Diagnostic accuracy: The studies do not support the use of less invasive tests such as ultrasound as an alternative to renal scintigraphy, either to rule out infection of the upper urinary tract (LR- = 0.57, 95%CI: 0.47, 0.68 and thus to exclude patients from further investigation or to detect renal scarring (LR+ = 3.5, 95% CI: 2.5, 4.8. None of the tests investigated can accurately predict the development of renal scarring. The available evidence supports the consideration of contrast-enhanced ultrasound techniques for detecting vesico-ureteric reflux (VUR, as an alternative to micturating cystourethrography (MCUG (LR+ = 14.1, 95% CI: 9.5, 20.8; LR- = 0.20, 95%CI: 0.13, 0.29; these techniques have the advantage of not requiring exposure to ionising radiation. Conclusion There is no evidence to support the clinical effectiveness of routine investigation of children with confirmed UTI. Primary research on the effectiveness, in terms of improved patient outcome, of testing at all stages in the investigation of confirmed urinary tract infection is urgently required.

  1. Prevalence of Bilirubin Encephalopathy in Calabar, South-South Nigeria: A Five-year Review Study

    Directory of Open Access Journals (Sweden)

    Sunny Oteikwu Ochigbo

    2016-03-01

    Full Text Available Background: Bilirubin encephalopathy is a clinical syndrome, associated with bilirubin toxicity in the central nervous system, resulting in chronic and permanent sequelae. It has been estimated that approximately 60% and 80% of term and preterm newborns develop jaundice in the first week of life, respectively. In the present study, we aimed to determine the prevalence, morbidity, and mortality of bilirubin encephalopathy in the neonatal unit of the University of Calabar Teaching Hospital, Calabar, Nigeria. Methods: In this retrospective, descriptive review, medical records of all newborns, diagnosed with bilirubin encephalopathy over the past five years (from January 2010 to December 2014, were studied. Information retrieved from the medical records included age, sex, presence of fever, duration of disease, place of delivery, causes of the disease, and selected treatments. Variables such as hospital discharge, discharge against medical advice, and mortality were also evaluated. Results: Out of 2,820 newborns, 21 (0.74% cases were admitted on account of bilirubin encephalopathy. Among these affected cases, 17 (81% were male and 4 (19% were female (male-to-female ratio of 5:1. Based on the findings, 18 newborns (85.7% had pyrexia, while 8 (38.1% and 6 (28.6% cases were hypertonic and hypotonic, respectively upon admission. Only 33.3% of deliveries took place in healthcare facilities. The established factors responsible for jaundice included infection, i.e., septicemia (n=15, 71.4%, ABO incompatibility (n=4, 19.1%, and glucose-6-phosphate-dehydrogenase (G6PD deficiency (n=2, 9.5%. The mean maximum total bilirubin level in subjects was 321.3 μmol/L (range: 242.5–440.3 μmol/L. Also, mortality was reported in 4 (19% out of 21 cases. Conclusion: Based on the findings, neonatal septicemia is associated with bilirubin encephalopathy. Therefore, identification and prompt treatment are of utmost importance in preventing the associated morbidity and

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

    International Nuclear Information System (INIS)

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

    1998-01-01

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

  3. Does geographical variability influence five-year MACCE rates in the multicentre SYNTAX revascularisation trial?

    Science.gov (United States)

    Roy, Andrew K; Chevalier, Bernard; Lefèvre, Thierry; Louvard, Yves; Segurado, Ricardo; Sawaya, Fadi; Spaziano, Marco; Neylon, Antoinette; Serruys, Patrick A; Dawkins, Keith D; Kappetein, Arie Pieter; Mohr, Friedrich-Wilhelm; Colombo, Antonio; Feldman, Ted; Morice, Marie-Claude

    2017-09-20

    The use of multiple geographical sites for randomised cardiovascular trials may lead to important heterogeneity in treatment effects. This study aimed to determine whether treatment effects from different geographical recruitment regions impacted significantly on five-year MACCE rates in the SYNTAX trial. Five-year SYNTAX results (n=1,800) were analysed for geographical variability by site and country for the effect of treatment (CABG vs. PCI) on MACCE rates. Fixed, random, and linear mixed models were used to test clinical covariate effects, such as diabetes, lesion characteristics, and procedural factors. Comparing five-year MACCE rates, the pooled odds ratio (OR) between study sites was 0.58 (95% CI: 0.47-0.71), and countries 0.59 (95% CI: 0.45-0.73). By homogeneity testing, no individual site (X2=93.8, p=0.051) or country differences (X2=25.7, p=0.080) were observed. For random effects models, the intraclass correlation was minimal (ICC site=5.1%, ICC country=1.5%, p<0.001), indicating minimal geographical heterogeneity, with a hazard ratio of 0.70 (95% CI: 0.59-0.83). Baseline risk (smoking, diabetes, PAD) did not influence regional five-year MACCE outcomes (ICC 1.3%-5.2%), nor did revascularisation of the left main vs. three-vessel disease (p=0.241), across site or country subgroups. For CABG patients, the number of arterial (p=0.49) or venous (p=0.38) conduits used also made no difference. Geographic variability has no significant treatment effect on MACCE rates at five years. These findings highlight the generalisability of the five-year outcomes of the SYNTAX study.

  4. An Evaluation on Medical Education, Research and Development of AYUSH Systems of Medicine through Five Year Plans of India.

    Science.gov (United States)

    Samal, Janmejaya; Dehury, Ranjit Kumar

    2016-05-01

    Indian system of medicine has its origin in India. The system is currently renamed as AYUSH, an acronym for Ayurveda, Yoga & Naturopathy, Unani, Sidha and Homeopathy. These are the six Indian systems of medicine prevalent and practiced in India and in few neighboring Asian countries. The primary objective of this review was to gain insight in to the prior and existing initiatives which would enable reflection and assist in the identification of future change. A review was carried out based on the five year plan documents, obtained from the planning commission web portal of Govt. of India, on medical education, research and development of AYUSH systems of medicine. Post independence, the process of five year planning took its birth with the initiation of long term planning in India. The planning process embraced all the social and technology sectors in it. Since the beginning of five year planning, health and family welfare planning became imperative as a social sector planning. Planning regarding Indian Systems of Medicine became a part of health and family welfare planning since then. During the entire planning process a progressive path of development could be observed as per this evaluation. A relatively sluggish process of development was observed up to seventh plan however post eighth plan the growth took its pace. Eighth plan onwards several innovative development processes could be noticed. Despite the relative developments and growth of Indian systems of medicine these systems have to face lot of criticism and appraisal owing to their various characteristic features. In the beginning the system thrived with great degree of uncertainty, as described in 1(st) five year plan, however progressed ahead with a vision to be a globally accepted system, as envisaged in 11(th) five year plan. A very strong optimistic approach in spreading India's own medical heritage is the need of the hour. The efforts are neither completely insufficient nor sufficient enough; hence

  5. Long-term functional and survival outcomes after induction chemotherapy and risk-based definitive therapy for locally advanced squamous cell carcinoma of the head and neck.

    Science.gov (United States)

    Hutcheson, Katherine A; Lewin, Jan S; Holsinger, F Christopher; Steinhaus, Ganene; Lisec, Asher; Barringer, Denise A; Lin, Heather Y; Villalobos, Sandra; Garden, Adam S; Papadimitrakopoulou, Vali; Kies, Merrill S

    2014-04-01

    The purpose of this study was to evaluate long-term outcomes after induction chemotherapy followed by "risk-based" local therapy for locally-advanced squamous cell carcinoma of the head and neck (SCCHN). Forty-seven patients (stage IV; ≥N2b) were enrolled in a phase II trial. Baseline and 24-month functional measures included modified barium swallow (MBS) studies, oropharyngeal swallow efficiency (OPSE), and the MD Anderson Dysphagia Inventory (MDADI). Functional status was assessed at 5 years. Five-year overall survival (OS) was 89% (95% confidence interval [CI], 81% to 99%). A nonsignificant 13% average reduction in swallowing efficiency (OPSE) was observed at 24 months relative to baseline (p = .191). MDADI scores approximated baseline at 24 months. Among 42 long-term survivors (median, 5.9 years), 3 patients (7.1%) had chronic dysphagia. The rate of final gastrostomy dependence was 4.8% (2 of 42). Sequential chemoradiotherapy achieved favorable outcomes among patients with locally advanced SCCHN, mainly of oropharyngeal origin. MBS and MDADI scores found modest swallowing deterioration at 2 years, and chronic aspiration was uncommon in long-term survivors. Copyright © 2013 Wiley Periodicals, Inc.

  6. Chemotherapy increases long-term survival in patients with adult medulloblastoma

    DEFF Research Database (Denmark)

    Kocakaya, Selin; Beier, Christoph Patrick; Beier, Dagmar

    2016-01-01

    chemotherapy first-line survived significantly longer (mOS: 108 mo, 95% CI: 68.6-148.4) than patients treated with radiation alone (mOS: 57 mo, 95% CI: 39.6-74.4) or patients who received chemotherapy at tumor recurrence. This effect was not biased by tumor stage or decade of treatment. Importantly, (neo...... parts of treatment regimes; however, established prognostic factors and data clarifying the role of chemotherapy are missing. METHODS: We investigated 227 publications from 1969-2013, with 907 identifiable, individual patients being available for meta-analysis. Demographic data, risk stratification......)adjuvant chemotherapy also significantly increased the chance for long-term survival (>5 y) compared with radiotherapy alone or chemotherapy at tumor recurrence. CONCLUSIONS: This meta-analysis clarifies relevant prognostic factors and suggests that chemotherapy as part of first-line therapy improves overall survival...

  7. Survival, durable tumor remission, and long-term safety in patients with advanced melanoma receiving nivolumab.

    Science.gov (United States)

    Topalian, Suzanne L; Sznol, Mario; McDermott, David F; Kluger, Harriet M; Carvajal, Richard D; Sharfman, William H; Brahmer, Julie R; Lawrence, Donald P; Atkins, Michael B; Powderly, John D; Leming, Philip D; Lipson, Evan J; Puzanov, Igor; Smith, David C; Taube, Janis M; Wigginton, Jon M; Kollia, Georgia D; Gupta, Ashok; Pardoll, Drew M; Sosman, Jeffrey A; Hodi, F Stephen

    2014-04-01

    Programmed cell death 1 (PD-1) is an inhibitory receptor expressed by activated T cells that downmodulates effector functions and limits the generation of immune memory. PD-1 blockade can mediate tumor regression in a substantial proportion of patients with melanoma, but it is not known whether this is associated with extended survival or maintenance of response after treatment is discontinued. Patients with advanced melanoma (N = 107) enrolled between 2008 and 2012 received intravenous nivolumab in an outpatient setting every 2 weeks for up to 96 weeks and were observed for overall survival, long-term safety, and response duration after treatment discontinuation. Median overall survival in nivolumab-treated patients (62% with two to five prior systemic therapies) was 16.8 months, and 1- and 2-year survival rates were 62% and 43%, respectively. Among 33 patients with objective tumor regressions (31%), the Kaplan-Meier estimated median response duration was 2 years. Seventeen patients discontinued therapy for reasons other than disease progression, and 12 (71%) of 17 maintained responses off-therapy for at least 16 weeks (range, 16 to 56+ weeks). Objective response and toxicity rates were similar to those reported previously; in an extended analysis of all 306 patients treated on this trial (including those with other cancer types), exposure-adjusted toxicity rates were not cumulative. Overall survival following nivolumab treatment in patients with advanced treatment-refractory melanoma compares favorably with that in literature studies of similar patient populations. Responses were durable and persisted after drug discontinuation. Long-term safety was acceptable. Ongoing randomized clinical trials will further assess the impact of nivolumab therapy on overall survival in patients with metastatic melanoma.

  8. Does tumour location influence postoperative long-term survival in patients with oesophageal squamous cell carcinoma?

    Science.gov (United States)

    Shi, Hui; Zhang, Kun; Niu, Zhong-Xi; Wang, Wen-Ping; Gao, Qiang; Chen, Long-Qi

    2015-08-01

    The seventh edition of the American Joint Committee on Cancer (AJCC) staging system introduced tumour location for the first time as an determinant of stage grouping in pathological T2N0M0 and T3N0M0 (pT2-3N0M0) oesophageal squamous cell carcinoma (OSCC). However, the new modification remains controversial. The objective of this study was to investigate the correlation between tumour location and postoperative long-term survival in patients with OSCC in China. The clinicopathological data and over 10 years of follow-up results from a large cohort of 988 patients with OSCC undergoing radical-intent oesophagectomy from 1984 to 1995 without preoperative and postoperative chemoradiotherapy were reviewed, in which 632 patients were staged as pT2-3N0M0. Tumour location was redefined according to the seventh edition of the AJCC staging system. Survival was calculated by the Kaplan-Meier method; univariate log-rank and multivariate Cox proportional hazard models were used to further determine the impact of tumour location on long-term survival. Univariate analysis showed that OSCC tumour location was closely associated with long-term survival for the entire cohort of 988 patients (odds ratio [OR]: 0.82; 95% confidence interval [95% CI]: 0.67-0.99; P = 0.049), and for pT2-3N0M0 patients (OR: 0.63; 95% CI: 0.48-0.84; P = 0.001). The median survival times for patients with pT2-3N0M0 OSCC in the upper, middle and lower third of the oesophagus were 38.1, 46.6 and 66.0 months, respectively, with corresponding 5-year survival rates of 40.0, 51.8 and 66.2%, respectively. Overall survival rates among three categories of patients according to tumour location in the pT2-3N0M0 patients were statistically different (P = 0.004). Multivariate analysis demonstrated that tumour location was a significant independent predictor of long-term survival for pT2-3N0M0 patients (OR: 0.53; 95% CI: 0.42-0.67; P = 0.0001), but not for the entire cohort of 988 patients (OR: 0.99; 95% CI: 0.79-1.23; P

  9. Prognostic Factors Affecting Long-Term Survival after Resection for Noncolorectal, Nonneuroendocrine, and Nonsarcoma Liver Metastases

    Directory of Open Access Journals (Sweden)

    Fabio Uggeri

    2017-01-01

    Full Text Available Aim. To evaluate feasibility and long-term outcome after hepatic resection for noncolorectal, nonneuroendocrine, and nonsarcoma (NCNNNS liver metastases in a single center. Methods. We retrospectively reviewed our experience on patients who underwent surgery for NCNNNS liver metastases from 1995 to 2015. Patient baseline characteristics, tumor features, treatment options, and postoperative outcome were retrieved. Results. We included 47 patients. The overall 5-year survival (OS rate after hepatectomy was 27.6%, with a median survival of 21 months. Overall survival was significantly longer for patients operated for nongastrointestinal liver metastases when compared with gastrointestinal (41 versus 10 months; p=0.027. OS was significantly worse in patients with synchronous metastases than in those with metachronous disease (10 versus 22 months; p=0.021. The occurrence of major postoperative complication negatively affected long-term prognosis (OS 23.5 versus 9.0 months; p=0.028. Preoperative tumor characteristics (number and size of the lesions, intraoperative features (extension of resection, need for transfusions, and Pringle’s maneuver, and R0 at pathology were not associated with differences in overall survival. Conclusion. Liver resection represents a possible curative option for patients with NCNNNS metastases. The origin of the primary tumor and the timing of metastases presentation may help clinicians to better select which patients could take advantages from surgical intervention.

  10. Radiotherapy and chemotherapy in the treatment of head and neck cancer: results after five years of a randomized study

    Energy Technology Data Exchange (ETDEWEB)

    Santarelli, M.; Raffetto, N.; Torcia, P.; Vitturini, A.; Tombolini, V.; Maurizi Enrici, R. [Istituto di radiologia Universita Roma ' ' La Sapienza' ' , Rome (Italy)

    1999-11-01

    Purpose: this study was undertaken to evaluate the efficacy of two regimens of chemoradiotherapy in the treatment of locally advanced head and neck cancer. Methods: from 1992 to 1997, 127 patients with locally advanced head and neck cancer (stage III-IV) were randomized. Sixty-six patients (group a), 42 male and 24 female, with a median age of 48 years (range 40-72) received during radiotherapy two courses (1.-6. week) of chemotherapy with carbo-platin (300 mg/m{sup 2} day 1) and etoposide (60 mg/m{sup 2} days 1 to 3). Sixty-one patients (group b), 40 male and 21 female, with a median age of 51 years (range 42-69) received two cycles of chemotherapy with 5 FU (750 mg/m{sup 2} days 1 to 5) and MIT C ( 10 mg/m{sup 2} day 1). The median dose of radiotherapy was 60 Gy (range 55-66 Gy) 180 cGy /d 5w. Results: the actuarial five-year survival rate(Kaplan-Meier) was 38 % for group a (CBDCA+etoposide+RT) and 25 % for group b (5FU+MIT C+RT). The difference was statistically significant (p = 0.036). Toxicity group a: mucositis G III in 41 patients and G IV in 16; dysphagia G III in 46 patients and IV in 5; leukopenia in 24 patients; 28 patients required nutritional therapy. Toxicity group b: mucositis G III in 38 patients and G IV in 17; dysphagia G III in 48 patients and G IV in 3; leukopenia in 23 patients; 25 patients needed nutritional therapy. Conclusions: the data of the actuarial survival five-year rate suggest that concomitant chemotherapy in group a (CBDCA+etoposide+RT) is better than the concomitant chemotherapy in group b (5FU+MIT C+RT). (author)

  11. Radiotherapy and chemotherapy in the treatment of head and neck cancer: results after five years of a randomized study

    International Nuclear Information System (INIS)

    Santarelli, M.; Raffetto, N.; Torcia, P.; Vitturini, A.; Tombolini, V.; Maurizi Enrici, R.

    1999-01-01

    Purpose: this study was undertaken to evaluate the efficacy of two regimens of chemoradiotherapy in the treatment of locally advanced head and neck cancer. Methods: from 1992 to 1997, 127 patients with locally advanced head and neck cancer (stage III-IV) were randomized. Sixty-six patients (group a), 42 male and 24 female, with a median age of 48 years (range 40-72) received during radiotherapy two courses (1.-6. week) of chemotherapy with carbo-platin (300 mg/m 2 day 1) and etoposide (60 mg/m 2 days 1 to 3). Sixty-one patients (group b), 40 male and 21 female, with a median age of 51 years (range 42-69) received two cycles of chemotherapy with 5 FU (750 mg/m 2 days 1 to 5) and MIT C ( 10 mg/m 2 day 1). The median dose of radiotherapy was 60 Gy (range 55-66 Gy) 180 cGy /d 5w. Results: the actuarial five-year survival rate (Kaplan-Meier) was 38 % for group a (CBDCA+etoposide+RT) and 25 % for group b (5FU+MIT C+RT). The difference was statistically significant (p = 0.036). Toxicity group a: mucositis G III in 41 patients and G IV in 16; dysphagia G III in 46 patients and IV in 5; leukopenia in 24 patients; 28 patients required nutritional therapy. Toxicity group b: mucositis G III in 38 patients and G IV in 17; dysphagia G III in 48 patients and G IV in 3; leukopenia in 23 patients; 25 patients needed nutritional therapy. Conclusions: the data of the actuarial survival five-year rate suggest that concomitant chemotherapy in group a (CBDCA+etoposide+RT) is better than the concomitant chemotherapy in group b (5FU+MIT C+RT). (author)

  12. Progress in 11th Five Year and the geneal idea for 12th Five Year of uranium exploration and geological science and technology

    International Nuclear Information System (INIS)

    Zhang Jindai; Jian Xiaofei; Li Youliang; Du Jiannong; Guo Qinggen; Zhang Qiuying

    2011-01-01

    Since the 11th-Five Year, uranium exploration in China has retrieved obviously and some new resources have been identified. More detailed uranium exploration has been carried out in about 1 000 000 km 2 , exploration in large uranium resource bases, old orefields and focusing prospect areas has achieved important progress, several middle-large and extral-large deposits have been discovered, and one super-large deposit was submitted for the first time in China. In the science and technology of uranium exploration, the capability and platform of research has been reinforced, a number of key projects have been carried out such as national uranium potential evaluation, study of 'four types of uranium deposit', research for the enlargement of uranium resource bases, research of application foundation of uranium geology, research on exploratin techniques and method and technological standard. All these projects have obtained fruitful result and significantly raised the creative level in uranium science and technology. In the coming 12th Five Year, uranium exploration will follow the strategy of 'foundation research first with focus on resource base,systematical exploration and integral evaluation second' under the guideline of 'domestic foothold and oversea development' and set up large uranium resource bases, four major geological preosecting programs will be commence in the exploration for large uranium resource base, national uranium survey, regional evaluation of potential uranium resource and science and technology innovation of uranium geology, Ideas of 'Great uranium exploration system' should be set up to widely unite the localized prospecting teams and cooperate with the geologic research organization such as domestic and foreign university and college so as to make corespondent contribution to raise the supporting capability of uranium resources in China. (authors)

  13. Last Five Years Pakistan Economic Growth Rate GDP And Its Comparison With China India And Bangladesh

    Directory of Open Access Journals (Sweden)

    Abdul Rehman

    2015-01-01

    Full Text Available Abstract This paper formulates and reviews Pakistans last five years economic growth rate and its comparison with the growth rate of China India and Bangladesh. As growth rate the amount of increment of a specific variable has gained within a specific period of time and context. In fact economic growth rate provides general direction and magnitude of growth for overall economy.

  14. Prevalence of rotavirus among children under five years of age with ...

    African Journals Online (AJOL)

    2016-08-16

    Aug 16, 2016 ... acute diarrhea in children under five years in Kaduna State, Nige- ria. Hence the need to introduce the vaccines into the childhood immunization program in the country. Keywords: Prevalence, Rotavirus,. Children, Kaduna State, Nigeria. Introduction. Diarrheal disease kills 1.8 million children under five.

  15. Five years program execution outcome; Bilan d'execution du plan quinquenal

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1983-07-01

    This document presents realized activities during five years program in mine field and petroleum (1979-1983). It involves mining and petroleum researches and mining productions. [French] Le document presente les activites realisees dans le domaine des mines et du petrole pendant les 5 annees du plan quinquenal (1979-1983). Il s'agit des recherches minieres et petrolieres et des productions minieres.

  16. Transition to low carbon energy policies in China-from the Five-Year Plan perspective

    International Nuclear Information System (INIS)

    Yuan Xueliang; Zuo Jian

    2011-01-01

    Energy policy plays a critical role not only in the energy development, but also in the social and environmental aspects of a nation. Five-Year Plan for National Economic and Social Development is one of the most important government plans, which documents the national strategy during that period. This study presents a critical review of 12 Five-Year Plans that have been released by the Chinese central government in last 58 years. In particular, the recently released Twelfth Five-Year Plan is reviewed. The results clearly show a pattern of increasingly level of attention of Chinese government to energy efficiency improvement, air pollutant emission reduction, new and renewable energy development, carbon dioxide emission and climate change. - Highlights: → Critical review of the energy related contents in the 12 Five-Year Plans. → Energy policy of China is focusing on energy efficiency, new and renewable energy. → China is improving the capability of dealing with CO 2 emission and climate change. → China is on transition to low carbon energy policies for a sustainable development.

  17. Search for relativistic magnetic monopoles with five years of the ANTARES detector data

    NARCIS (Netherlands)

    Albert, A.; André, M.; Anghinolfi, M.; Anton, G.; Ardid, M.; Aubert, J.-J.; Avgitas, T.; Baret, B.; Barrios-Martí, J.; Basa, S.; Bertin, V.; Biagi, S.; Bormuth, R.; Bourret, S.; Bouwhuis, M.C.; Bruijn, R.; Brunner, J.; Busto, J.; Capone, A.; Caramete, L.; Carr, J.; Celli, S.; Chiarusi, T.; Circella, M.; Coelho, J.A.; Coleiro, A.; Coniglione, R.; Costantini, H.; Coyle, P.; Creusot, A.; Deschamps, A.; De Bonis, G.; Distefano, C.; Di Palma, I.; Domi, A.; Donzaud, C.; Dornic, D.; Drouhin, D.; Eberl, T.; El Bojaddaini, I.; Elsässer, D.; Enzenhöfer, A.; Felis, I.; Fusco, L.A.; Galatà, S.; Gay, P.; Giordano, V.; Glotin, H.; Grégoire, T.; Gracia-Ruiz, R.; Graf, K.; Hallmann, S.; van Haren, H.; Heijboer, A.J.; Hello, Y.; Hernandez-Rey, J.J.; Hößl, J.; Hofestädt, J.; Hugon, C.; Illuminati, G.; James, C.W.; de Jong, M.; Jongen, M.; Kadler, M.; Kalekin, O.; Katz, U.; Kießling, D.; Kouchner, A.; Kreter, M.; Kreykenbohm, I.; Kulikovskiy, V.; Lachaud, C.; Lahmann, R.; Lefevre, D.; Leonora, E.; Lotze, M.; Loucatos, S.; Marcelin, M.; Margiotta, A.; Marinelli, A.; Martinez-Mora, J.A.; Mele, R.; Melis, K.; Michael, T.; Migliozzi, P.; Moussa, A.; Navas, S.; Nezri, E.; Organokov, M.; Pavalas, G.E.; Pellegrino, C.; Perrina, C.; Piattelli, P.; Popa, V.; Pradier, T.; Quinn, L.; Racca, C.; Riccobene, G.; Sánchez-Losa, A.; Saldaña, M.; Salvadori, I.; Samtleben, D.F.E.; Sanguineti, M.; Sapienza, P.; Schüssler, F.; Sieger, C.; Spurio, M.; Stolarczyk, Th.; Taiuti, M.; Tayalati, Y.; Trovato, A.; Turpin, D.; Tönnis, C.; Vallage, B.; Van Elewyck, V.; Versari, F.; Vivolo, D.; Vizzoca, A.; Wilms, J.; Zornoza, J.D.; Zúñiga, J.

    2017-01-01

    A search for magnetic monopoles using five years of data recorded with the ANTARES neutrino telescope from January 2008 to December 2012 with a total live time of 1121 days is presented. The analysis is carried out in the range β > 0.6 of magnetic monopole velocities using a strategy based on

  18. North Dakota University System Five-Year Plan. Daring to Be Great: The NDUS Edge

    Science.gov (United States)

    North Dakota University System, 2017

    2017-01-01

    This report presents the 2017-19 edition of the State Board of Higher Education's strategic narrative. Contents include: (1) North Dakota University System (NDUS) colleges and locations; (2) Board Chair Neset's report; (3) Five-year goals; (4) Deliver degrees that are the best value in the nation; (5) Provide programs people want; (6) Equip…

  19. Esophageal adenocarcinoma five years after laparoscopic sleeve gastrectomy. A case report

    Directory of Open Access Journals (Sweden)

    Fernando Gabriel Wright

    2017-01-01

    Conclusion: We present a case of an esophageal adenocarcinoma five years after a laparoscopic sleeve gastrectomy for morbid obesity. There is need to better determine the relationship between sleeve gastrectomy and gastroesophageal reflux disease in order to prevent its related complications, such as esophageal adenocarcinoma.

  20. Patient demands, lack of reciprocity, and burnout: a five-year longitudinal study about general practitioners.

    NARCIS (Netherlands)

    Bakker, A.B.; Schaufeli, W.B.; Sixma, H.J.; Bosveld, W.; Dierendonck, D. van

    2000-01-01

    This study among a sample of 207 general practitioners (GPs) uses a five-year longitudinal design to test a process model of burnout. On the basis of social exchange and equity theory, it is hypothesized and found that demanding patient contacts produce a lack of reciprocity in the GP-patient

  1. Assessment of Peer-Led Team Learning in Calculus I: A Five-Year Study

    Science.gov (United States)

    Merkel, John Conrad; Brania, Abdelkrim

    2015-01-01

    This five-year study of the peer-led team learning (PLTL) paradigm examined its implementation in a Calculus I course at an all-male HBCU institution. For this study we set up a strong control group and measured the effect of PLTL in the teaching and learning of Calculus I through two points of measure: retention and success rates and learning…

  2. Key projects to be enforced during the 11th Five-year Plan

    Institute of Scientific and Technical Information of China (English)

    2009-01-01

    @@ Addressing major S&T issues of strategic importance to China's socioeconomic growth, national security and development sustainability, the key projects of CAS during the period of the 11th Five-year Plan (2006-2010) are large-scale research initiatives with an expectation to give rise to S&T breakthroughs.

  3. Development trends of remote sensing technology for uranium exploration in 12th Five Year

    International Nuclear Information System (INIS)

    Zhang Jielin

    2011-01-01

    This paper introduced the research status,application requirements, technique questions and development trends of remote sensing technology for uranium exploration in the 12th five year, and discussed the applicant prospects and potential of applied basic research innovation, thermal infrared hyperspectral and microwave remote sensing, 4D geological mapping and stereo exploration model in the uranium exploration. (authors)

  4. Southern Stalemate: Five Years without Public Education in Prince Edward County, Virginia

    Science.gov (United States)

    Bonastia, Christopher

    2012-01-01

    In 1959, Virginia's Prince Edward County closed its public schools rather than obey a court order to desegregate. For five years, black children were left to fend for themselves while the courts decided if the county could continue to deny its citizens public education. Investigating this remarkable and nearly forgotten story of local, state, and…

  5. A five year study on the susceptibility of isolates from various parts of ...

    African Journals Online (AJOL)

    tests. The various isolates for the five-year period were Staphylococcus aureus 1000, Klebsiella pneumoniae 340, Proteus mirabilis 38 Escherichia coli 295, Pseudomonas aeroginosa 240, Alcaligenes faecalis 200, Enterobacter aerogenes 175, Acinetobacter baumannii 150, Proteus vulgaris 110, Providencia stuartii 101, ...

  6. An appraisal of retained placentae in Ibadan: a five year review ...

    African Journals Online (AJOL)

    During the study period, 4980 deliveries took place at the University College Hospital, Ibadan and 106 cases of retained placenta were managed making the incidence 2.13 per cent of all births. Results: During the five year period, there were 106 patients with retained placenta; of these, 90 (84.9%) case notes were ...

  7. Career Decision Status as a Predictor of Resignation Behavior Five Years Later

    Science.gov (United States)

    Earl, Joanne K.; Minbashian, Amirali; Sukijjakhamin, Aun; Bright, Jim E. H.

    2011-01-01

    This paper extends earlier research exploring the relationship between career decision status and work outcomes by examining resignation behavior in a group of new graduates five years after initial appointment. On appointment various measures were collected including career decision status variables. Earlier research identified a significant…

  8. A Five-Year School Building and Future Sites Program 1966-1970.

    Science.gov (United States)

    1965

    Five-year school building and site needs and related financial requirements are summarized for Milwaukee's schools. Educational policies concerning the school building program are stated, and consideration is given to factors affecting school board needs such as birth rate, public housing projects, urban renewal, highways, and expressways. School…

  9. Still the One: Reflections on Sixty-Five Years of Resilience and Relevance

    Science.gov (United States)

    Adcock, Donald; Ballard, Susan

    2015-01-01

    2016 marks an important milestone for the American Association of School Librarians (AASL). Despite the ever-changing and always-challenging economic, political, and societal landscape, for nearly sixty-five years the association has grown and prospered within the structure of the American Library Association (ALA) and remains "the only…

  10. ANALYSIS ON THE EVOLUTION OF INSURANCE SYSTEMS IN ROMANIA - THE PAST FIVE YEARS

    Directory of Open Access Journals (Sweden)

    AURELIA PĂTRAȘCU

    2016-08-01

    Full Text Available The aim of this paper is to analyze the evolution of insurance systems in Romania in the past five years. Unlike other European countries, it can be seen that Romania does not have a well-established insurance tradition. Insurance companies are constantly adapting to the realities of the financial situation and the market structure in Romania.

  11. Nutrition and public hygiene among children under five years of age ...

    African Journals Online (AJOL)

    Objective: To determine the relationship between sanitation and malnutrition among children below five years. Design: A random sampling followed by an experimental design on microbiological analysis of food and water samples. Setting: Mukuru slums of Makadara division in Nairobi City. Subjects: Eighty food and thirty ...

  12. Use of insecticide-treated mosquito nets for children under five years ...

    African Journals Online (AJOL)

    2011-06-13

    Jun 13, 2011 ... Background: Insecticide-treated nets (ITNs) have proven to be one of the most effective means of reducing malaria morbidity and mortality in children and pregnant women. This study is carried out to determine the practice and determinants of ITN use for children under five years among care givers in an ...

  13. 47 CFR 22.947 - Five year build-out period.

    Science.gov (United States)

    2010-10-01

    ... authorized in the Gulf of Mexico Exclusive Zone, the licensee of the first cellular system authorized on each channel block in each cellular market is afforded a five year period, beginning on the date the initial authorization for the system is granted, during which it may expand the system within that market. (a) Exclusive...

  14. Double cervix in a five-year-old white Fulami cow | Ajala | African ...

    African Journals Online (AJOL)

    A case report of true double cervix in a five-year-old white Fulani cow is presented. The condition is known to cause infertility which might be the reason why the cow was brought to the slaughterhouse at this critical age. Keywords: Double cervix, cow ...

  15. Five-year activity (1981-1985) on the project ionizing and nonionizing radiation protection investigations

    International Nuclear Information System (INIS)

    Zaricj, M.

    1987-01-01

    The brief review of the work conducted during five year's period on the project is given. Some organization and financial questions are touched. In spite of the permanent difficulties, it may be concluded that past period was successful. (author) 3 refs

  16. Socio-economic factors predisposing under five-year-old children to ...

    African Journals Online (AJOL)

    Background: Malnutrition is one of the leading causes of morbidity and mortality in children aged five years and below. Risk factors for severe protein energy malnutrition (PEM) have been identified as ignorance, family size, mothers and fathers education, poverty, residence, chronic infections, and congenital defects or ...

  17. Letter to the Editor: Re: A Five-year Survey of Cesarean Delivery at a ...

    African Journals Online (AJOL)

    Letter to the Editor: Re: A Five-year Survey of Cesarean Delivery at a Nigerian Tertiary Hospital. VO Ajuzieogu, AO Amucheazi. Abstract. Letter to the editor - no abstract. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT. Article Metrics. Metrics Loading .

  18. Lenin nuclear reactor research institute in the tenth five-year plan

    International Nuclear Information System (INIS)

    Tsykanov, V.A.; Kulov, E.V.

    1980-01-01

    Main tasks and research results of Lenin Nuclear Reactor Reseach Institute in the 10-th Five-Year Plan are considered. Main research achievements are noted in nuclear power, radiation material testing, accumulation of transuranium elements and investigation of their physicochemical properties at VK-50, BOR-60, SM-2, RBT-6 and MIR reactor plants and in material testing laboratories

  19. Five Years of Cyclotron Radioisotope Production Experiences at the First PET-CT in Venezuela

    International Nuclear Information System (INIS)

    Colmenter, L.; Coelho, D.; Esteves, L. M.; Ruiz, N.; Morales, L.; Lugo, I.; Sajo-Bohus, L.; Liendo, J. A.; Greaves, E. D.; Barros, H.; Castillo, J.

    2007-01-01

    Five years operation of a compact cyclotron installed at PET-CT facility in Caracas, Venezuela is given. Production rate of 18 F labeled FDG, operation and radiation monitoring experience are included. We conclude that 18 FDG CT-PET is the most effective technique for patient diagnosis

  20. 78 FR 13380 - Silicomanganese From India, Kazakhstan, and Venezuela; Scheduling of Full Five-Year Reviews...

    Science.gov (United States)

    2013-02-27

    ... From India, Kazakhstan, and Venezuela; Scheduling of Full Five-Year Reviews Concerning the Antidumping Duty Orders on Silicomanganese From India, Kazakhstan, and Venezuela AGENCY: United States..., Kazakhstan, and Venezuela would be likely to lead to continuation or recurrence of material injury within a...

  1. Long-term survival from gastrocolic fistula secondary to adenocarcinoma of the transverse colon

    Directory of Open Access Journals (Sweden)

    Murali Kothandaraman

    2005-02-01

    Full Text Available Abstract Background Gastrocolic fistula is a rare presentation of both benign and malignant diseases of the gastrointestinal tract. Malignant gastrocolic fistula is most commonly associated with adenocarcinoma of the transverse colon in the Western World. Despite radical approaches to treatment, long-term survival is rarely documented. Case presentation We report a case of a 24-year-old woman who presented with the classic triad of symptoms associated with gastrocolic fistula. Radical en-bloc surgery and adjuvant chemotherapy were performed. She is still alive ten years after treatment. Conclusions Gastrocolic fistula is an uncommon presentation of adenocarcinoma of the transverse colon. Radical en-bloc surgery with adjuvant chemotherapy may occasionally produce long-term survival.

  2. Long-term survival in nasopharyngeal carcinoma and late complications of irradiation

    International Nuclear Information System (INIS)

    Furukawa, Mitsuru; Komori, Takashi; Ishiguro, Hideyo; Takimoto, Toru; Umeda, Ryozo

    1983-01-01

    Irradiation remains the mainstay of treatment of nasopharyngeal carcinoma in the primary site and the neck. We studied the long-term effects of irradiation in five patients who have survived ten or more years after treatment without recurrence of disease, and we were impressed by the rarity of disabling complications of the treatment. Minor complications were common, and especially troublesome were xerostomia, dental caries, postnasal crusting and neck weakness. (author)

  3. BAYESIAN ANALYSIS OF WHITE NOISE LEVELS IN THE FIVE-YEAR WMAP DATA

    International Nuclear Information System (INIS)

    Groeneboom, N. E.; Eriksen, H. K.; Gorski, K.; Huey, G.; Jewell, J.; Wandelt, B.

    2009-01-01

    We develop a new Bayesian method for estimating white noise levels in CMB sky maps, and apply this algorithm to the five-year Wilkinson Microwave Anisotropy Probe (WMAP) data. We assume that the amplitude of the noise rms is scaled by a constant value, α, relative to a pre-specified noise level. We then derive the corresponding conditional density, P(α | s, C l , d), which is subsequently integrated into a general CMB Gibbs sampler. We first verify our code by analyzing simulated data sets, and then apply the framework to the WMAP data. For the foreground-reduced five-year WMAP sky maps and the nominal noise levels initially provided in the five-year data release, we find that the posterior means typically range between α = 1.005 ± 0.001 and α = 1.010 ± 0.001 depending on differencing assembly, indicating that the noise level of these maps are biased low by 0.5%-1.0%. The same problem is not observed for the uncorrected WMAP sky maps. After the preprint version of this letter appeared on astro-ph., the WMAP team has corrected the values presented on their web page, noting that the initially provided values were in fact estimates from the three-year data release, not from the five-year estimates. However, internally in their five-year analysis the correct noise values were used, and no cosmological results are therefore compromised by this error. Thus, our method has already been demonstrated in practice to be both useful and accurate.

  4. Long-term effects of edaravone on survival of patients with amyotrophic lateral sclerosis

    Directory of Open Access Journals (Sweden)

    Masamitsu Okada

    2018-06-01

    Full Text Available Background and purpose: Oxidative stress has been implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS. Edaravone, a free radical scavenger, was approved as a therapeutic drug for ALS in 2015 in Japan. A phase 3 clinical trial demonstrated a smaller decline in ALS functional scale scores compared with placebo. However, the long-term effects of edaravone on ALS patients remain unclear. This study aimed to retrospectively investigate the long-term effects of edaravone on the survival of ALS patients. Methods: We retrospectively analyzed 27 consecutive patients with ALS who were treated with edaravone and 30 consecutive ALS patients who were not treated with edaravone between 2010 and 2016. Results: The differences of ALSFRS-R scores from baseline to 6 months was significantly reduced in the edaravone group, compared to the control group. The changes in serum creatinine, as a possible marker of ALS severity, from baseline to 6 and 12 months were significantly improved in the edaravone group, compared to the control group. The survival rate was significantly improved in the edaravone group compared with control patients. Conclusion: Our retrospective single-center analysis suggests slower progression and better prognosis of ALS patients with edaravone treatment. Further investigation, including prospective multicenter analysis, is warranted to confirm the usefulness of edaravone for a better prognosis of ALS. Keywords: Amyotrophic lateral sclerosis, Oxidative stress, Edaravone, Long-term effect, Survival

  5. Long-term monitoring of Sacramento Shade program trees: tree survival, growth and energy-saving performance

    Science.gov (United States)

    Yekang Ko; Jun-Hak Lee; E. Gregory McPherson; Lara A. Roman

    2015-01-01

    Long-term survival and growth of urban forests are critical to achieve the targeted benefits of urban tree planting programs, such as building energy savings from tree shade. However, little is known about how trees perform in the long-term, especially in residential areas. Given this gap in the literature, we monitored 22-years of post-planting survival, growth, and...

  6. Short-Term and Long-Term Survival and Virulence of Legionella pneumophila in the Defined Freshwater Medium Fraquil.

    Directory of Open Access Journals (Sweden)

    Nilmini Mendis

    Full Text Available Legionella pneumophila (Lp is the etiological agent responsible for Legionnaires' disease, a potentially fatal pulmonary infection. Lp lives and multiplies inside protozoa in a variety of natural and man-made water systems prior to human infection. Fraquil, a defined freshwater medium, was used as a highly reproducible medium to study the behaviour of Lp in water. Adopting a reductionist approach, Fraquil was used to study the impact of temperature, pH and trace metal levels on the survival and subsequent intracellular multiplication of Lp in Acanthamoeba castellanii, a freshwater protozoan and a natural host of Legionella. We show that temperature has a significant impact on the short- and long-term survival of Lp, but that the bacterium retains intracellular multiplication potential for over six months in Fraquil. Moreover, incubation in Fraquil at pH 4.0 resulted in a rapid decline in colony forming units, but was not detrimental to intracellular multiplication. In contrast, variations in trace metal concentrations had no impact on either survival or intracellular multiplication in amoeba. Our data show that Lp is a resilient bacterium in the water environment, remaining infectious to host cells after six months under the nutrient-deprived conditions of Fraquil.

  7. Five-Year Outcomes of High-Dose Single-Fraction Spinal Stereotactic Radiosurgery

    International Nuclear Information System (INIS)

    Moussazadeh, Nelson; Lis, Eric; Katsoulakis, Evangelia; Kahn, Sweena; Svoboda, Marek; DiStefano, Natalie M.; McLaughlin, Lily; Bilsky, Mark H.; Yamada, Yoshiya; Laufer, Ilya

    2015-01-01

    Purpose: To characterize local tumor control and toxicity risk in very long-term survivors (>5 years) after high-dose spinal image guided, intensity modulated radiation therapy delivered as single-dose stereotactic radiosurgery (SRS). Previously published spinal SRS outcome analyses have included a heterogeneous population of cancer patients, mostly with short survival. This is the first study reporting the long-term tumor control and toxicity profiles after high-dose single-fraction spinal SRS. Methods and Materials: The study population included all patients treated from June 2004 to July 2009 with single-fraction spinal SRS (dose 24 Gy) who had survived at least 5 years after treatment. The endpoints examined included disease progression, surgical or radiation retreatment, in-field fracture development, and radiation-associated toxicity, scored using the Radiation Therapy Oncology Group radiation morbidity scoring criteria and the Common Terminology Criteria for Adverse Events, version 4.0. Local control and fracture development were assessed using Kaplan-Meier analysis. Results: Of 278 patients, 31 (11.1%), with 36 segments treated for spinal tumors, survived at least 5 years after treatment and were followed up radiographically and clinically for a median of 6.1 years (maximum 102 months). The histopathologic findings for the 5-year survivors included radiation-resistant metastases in 58%, radiation-sensitive metastases in 22%, and primary bone tumors in 19%. In this selected cohort, 3 treatment failures occurred at a median of 48.6 months, including 2 recurrences in the radiation field and 1 patient with demonstrated progression at the treatment margins. Ten lesions (27.8%) were associated with acute grade 1 cutaneous or gastrointestinal toxicity. Delayed toxicity ≥3 months after treatment included 8 cases (22.2%) of mild neuropathy, 2 (5.6%) of gastrointestinal discomfort, 8 (22.2%) of dermatitides, and 3 (8.3%) of myalgias/myositis. Thirteen

  8. Five-Year Outcomes of High-Dose Single-Fraction Spinal Stereotactic Radiosurgery

    Energy Technology Data Exchange (ETDEWEB)

    Moussazadeh, Nelson [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York (United States); Lis, Eric [Department of Radiology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Katsoulakis, Evangelia [Department of Radiation Oncology, New York Methodist Hospital, Brooklyn, New York (United States); Kahn, Sweena; Svoboda, Marek; DiStefano, Natalie M.; McLaughlin, Lily [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Bilsky, Mark H. [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York (United States); Yamada, Yoshiya [Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Laufer, Ilya, E-mail: lauferi@mskcc.org [Division of Neurological Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York (United States); Department of Neurological Surgery, Weill Cornell Medical College, New York Presbyterian Hospital, New York, New York (United States)

    2015-10-01

    Purpose: To characterize local tumor control and toxicity risk in very long-term survivors (>5 years) after high-dose spinal image guided, intensity modulated radiation therapy delivered as single-dose stereotactic radiosurgery (SRS). Previously published spinal SRS outcome analyses have included a heterogeneous population of cancer patients, mostly with short survival. This is the first study reporting the long-term tumor control and toxicity profiles after high-dose single-fraction spinal SRS. Methods and Materials: The study population included all patients treated from June 2004 to July 2009 with single-fraction spinal SRS (dose 24 Gy) who had survived at least 5 years after treatment. The endpoints examined included disease progression, surgical or radiation retreatment, in-field fracture development, and radiation-associated toxicity, scored using the Radiation Therapy Oncology Group radiation morbidity scoring criteria and the Common Terminology Criteria for Adverse Events, version 4.0. Local control and fracture development were assessed using Kaplan-Meier analysis. Results: Of 278 patients, 31 (11.1%), with 36 segments treated for spinal tumors, survived at least 5 years after treatment and were followed up radiographically and clinically for a median of 6.1 years (maximum 102 months). The histopathologic findings for the 5-year survivors included radiation-resistant metastases in 58%, radiation-sensitive metastases in 22%, and primary bone tumors in 19%. In this selected cohort, 3 treatment failures occurred at a median of 48.6 months, including 2 recurrences in the radiation field and 1 patient with demonstrated progression at the treatment margins. Ten lesions (27.8%) were associated with acute grade 1 cutaneous or gastrointestinal toxicity. Delayed toxicity ≥3 months after treatment included 8 cases (22.2%) of mild neuropathy, 2 (5.6%) of gastrointestinal discomfort, 8 (22.2%) of dermatitides, and 3 (8.3%) of myalgias/myositis. Thirteen

  9. Ten Years Back, Five Years Forward: The Data Seal of Approval

    Directory of Open Access Journals (Sweden)

    Ingrid Dillo

    2015-02-01

    Full Text Available If we want to share data, the long-term storage of those data in a trustworthy digital archive is an essential condition. Trust is the basis of storing and sharing data. That trust must be present in the various stakeholders involved. Certification of digital archives can make an important contribution to the confidence of these stakeholders in the digital archives.Ten years ago DANS was assigned the task of developing a Seal of Approval for digital data to ensure that archived data can still be found, understood and used in the future. In 2009 this Data Seal of Approval (DSA was transferred to an international body, the DSA Board, which has managed and further developed the guidelines and the peer review process ever since.The objectives of the DSA are to safeguard data, ensure high quality and guide reliable management of data for the future without requiring implementation of new standards, regulations or heavy investments. The DSA contains 16 guidelines for applying and verifying quality aspects concerning the creation, storage, use and reuse of digital data.Based on feedback from data archives that applied for a DSA and different case studies we have gained some insight into the benefits of DSA. Still, the impact of having the Seal is not easy to measure. Seal holders usually refer to qualitative benefits in the form of increased awareness of the value of their repositories to their communities, funders and publishers.Ten years down the line we can safely state that the Data Seal of Approval has proven its added value. If we try to look five years into the future, what can we expect? There are different developments: a growing interest in DSA among European research infrastructures, the collaboration between DSA and the ISCU World Data System under the umbrella of the RDA (Research Data Alliance and the European Commission is showing a growing interest in certification services.The success of DSA also provides the challenge to further

  10. Impact of diabetes on treatment outcomes and long-term survival in multidrug-resistant tuberculosis.

    Science.gov (United States)

    Kang, Young Ae; Kim, Song Yee; Jo, Kyung-Wook; Kim, Hee Jin; Park, Seung-Kyu; Kim, Tae-Hyung; Kim, Eun Kyung; Lee, Ki Man; Lee, Sung Soon; Park, Jae Seuk; Koh, Won-Jung; Kim, Dae Yun; Shim, Tae Sun

    2013-01-01

    Few studies have investigated the impact of diabetes mellitus (DM), a globally increasing metabolic disease, on treatment outcomes and long-term survival in patients with multidrug-resistant forms of tuberculosis (MDR-TB). We analyzed outcomes in a large cohort to assess the impact of DM on treatment outcomes of patients with MDR-TB. MDR-TB patients newly diagnosed or retreated between 2000 and 2002 and followed for 8-11 years were retrospectively analyzed with respect to the effect of DM as a comorbidity on their treatment outcome and long-term survival. Of 1,407 patients with MDR-TB, 239 (17.0%) had coexisting DM. The mean age and body mass index were higher in MDR-TB patients with DM [MDR-TBDM(+)] than in those without DM [MDR-TBDM(-)]. Patients with MDR-TB and a comorbidity of DM had a significantly lower treatment success rate than those without a history of DM (36.0 vs. 47.2%, p = 0.002). In addition, DM was the negative predictor for MDR-TB treatment success in multivariate analyses [odds ratio 0.51, 95% confidence interval (CI) 0.26-0.99]. Mean survival times were also lower in MDR-TBDM(+) than in MDR-TBDM(-) patients (102 vs. 114 months, p = 0.001), with DM as a significant predictor of poor long-term survival in multivariate analyses (hazard ratio 1.59, 95% CI 1.01-2.50). Among MDR-TB patients, DM was a relatively common comorbidity. In patients undergoing treatment for MDR-TB and followed for 8-11 years, it was found to be independently associated with an increased risk of both treatment failure and death. Copyright © 2013 S. Karger AG, Basel.

  11. Preoperative White Matter Lesions Are Independent Predictors of Long-Term Survival after Internal Carotid Endarterectomy

    Directory of Open Access Journals (Sweden)

    Niku Oksala

    2014-06-01

    Full Text Available Background: Cerebral white matter lesions (WMLs predict long-term survival of conservatively treated acute stroke patients with etiology other than carotid stenosis. In carotid endarterectomy patients, WMLs are associated with severe carotid stenosis and unstable plaques, with the risk of perioperative complications and with increased 30-day perioperative risk of death. However, no data exist on their effect on postoperative long-term survival, a factor important when considering the net benefit from carotid endarterectomy. Whether this effect is independent of classical risk factors and indications for surgery is not known either. We hypothesized that WMLs could be evaluated from preoperative routine computed tomography (CT scans and are predictors of postoperative survival, independent of classical cardiovascular risk factors, indication category and degree of carotid stenosis. Methods: A total of 353 of 481 (73.4% consecutive patients subjected to carotid endarterectomy due to different indications, i.e. asymptomatic stenosis (n = 28, 7.9%, amaurosis fugax (n = 52, 14.7%, transient ischemic attack (n = 135, 38.2% or ischemic stroke (n = 138, 39.1%, from prospective vascular registries during the years 2001-2010 with digital preoperative CT scans, were included in the study. WMLs were rated by a radiologist (Wahlund criteria in a blinded fashion. Internal carotid artery (ICA stenoses were angiographically graded (Results: WML severity could be assessed with a substantial intraobserver agreement (Spearman's rho 0.843, p Conclusions: WMLs in a preoperative CT scan provide a substantially reliable estimate of postoperative long-term survival of carotid endarterectomy patients independent of currently used criteria, i.e. cardiovascular risk factors, indication category and degree of ipsilateral ICA stenosis.

  12. A thermal control system for long-term survival of scientific instruments on lunar surface.

    Science.gov (United States)

    Ogawa, K; Iijima, Y; Sakatani, N; Otake, H; Tanaka, S

    2014-03-01

    A thermal control system is being developed for scientific instruments placed on the lunar surface. This thermal control system, Lunar Mission Survival Module (MSM), was designed for scientific instruments that are planned to be operated for over a year in the future Japanese lunar landing mission SELENE-2. For the long-term operations, the lunar surface is a severe environment because the soil (regolith) temperature varies widely from nighttime -200 degC to daytime 100 degC approximately in which space electronics can hardly survive. The MSM has a tent of multi-layered insulators and performs a "regolith mound". Temperature of internal devices is less variable just like in the lunar underground layers. The insulators retain heat in the regolith soil in the daylight, and it can keep the device warm in the night. We conducted the concept design of the lunar survival module, and estimated its potential by a thermal mathematical model on the assumption of using a lunar seismometer designed for SELENE-2. Thermal vacuum tests were also conducted by using a thermal evaluation model in order to estimate the validity of some thermal parameters assumed in the computed thermal model. The numerical and experimental results indicated a sufficient survivability potential of the concept of our thermal control system.

  13. A thermal control system for long-term survival of scientific instruments on lunar surface

    International Nuclear Information System (INIS)

    Ogawa, K.; Iijima, Y.; Tanaka, S.; Sakatani, N.; Otake, H.

    2014-01-01

    A thermal control system is being developed for scientific instruments placed on the lunar surface. This thermal control system, Lunar Mission Survival Module (MSM), was designed for scientific instruments that are planned to be operated for over a year in the future Japanese lunar landing mission SELENE-2. For the long-term operations, the lunar surface is a severe environment because the soil (regolith) temperature varies widely from nighttime −200 degC to daytime 100 degC approximately in which space electronics can hardly survive. The MSM has a tent of multi-layered insulators and performs a “regolith mound”. Temperature of internal devices is less variable just like in the lunar underground layers. The insulators retain heat in the regolith soil in the daylight, and it can keep the device warm in the night. We conducted the concept design of the lunar survival module, and estimated its potential by a thermal mathematical model on the assumption of using a lunar seismometer designed for SELENE-2. Thermal vacuum tests were also conducted by using a thermal evaluation model in order to estimate the validity of some thermal parameters assumed in the computed thermal model. The numerical and experimental results indicated a sufficient survivability potential of the concept of our thermal control system

  14. A thermal control system for long-term survival of scientific instruments on lunar surface

    Energy Technology Data Exchange (ETDEWEB)

    Ogawa, K., E-mail: ogawa@astrobio.k.u-tokyo.ac.jp [Department of Complexity Science and Engineering, The University of Tokyo, 5-1-5 Kashiwanoha, Kashiwa, Chiba (Japan); Iijima, Y.; Tanaka, S. [Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency, 3-1-1 Yoshinodai, Chuo, Sagamihara, Kanagawa (Japan); Sakatani, N. [The Graduate University for Advanced Studies, Shonan Village, Hayama, Kanagawa (Japan); Otake, H. [JAXA Space Exploration Center, Japan Aerospace Exploration Agency, 3-1-1 Yoshinodai, Chuo, Sagamihara, Kanagawa (Japan)

    2014-03-15

    A thermal control system is being developed for scientific instruments placed on the lunar surface. This thermal control system, Lunar Mission Survival Module (MSM), was designed for scientific instruments that are planned to be operated for over a year in the future Japanese lunar landing mission SELENE-2. For the long-term operations, the lunar surface is a severe environment because the soil (regolith) temperature varies widely from nighttime −200 degC to daytime 100 degC approximately in which space electronics can hardly survive. The MSM has a tent of multi-layered insulators and performs a “regolith mound”. Temperature of internal devices is less variable just like in the lunar underground layers. The insulators retain heat in the regolith soil in the daylight, and it can keep the device warm in the night. We conducted the concept design of the lunar survival module, and estimated its potential by a thermal mathematical model on the assumption of using a lunar seismometer designed for SELENE-2. Thermal vacuum tests were also conducted by using a thermal evaluation model in order to estimate the validity of some thermal parameters assumed in the computed thermal model. The numerical and experimental results indicated a sufficient survivability potential of the concept of our thermal control system.

  15. Brain tumors in children: long-term survival after radiation treatment

    Energy Technology Data Exchange (ETDEWEB)

    Jenkin, Derek; Greenberg, Mark; Hoffman, Harold; Hendrick, Bruce; Humphreys, Robin; Vatter, Annette

    1995-02-01

    Purpose: To determine the cause of death in children who survive more than 5 years after radiation treatment of a brain tumor. Methods and Material: Nine hundred and twelve consecutive children with a primary brain tumor irradiated at the Princess Margaret Hospital or Toronto-Bayview Regional Cancer Center from 1958 to 1991, were evaluated for long-term outcome. Results: Overall 10- and 20-year survival rates were 44% and 37%. Subsequent survival of 377 5-year survivors was, at an additional 10 and 20 years, 78% and 67%. Most (83%) deaths that occurred more than 5 years from diagnosis were a result of relapse of the original tumor. The 10-year survival rate subsequent to relapse was 9% when the first relapse occurred less than one year from diagnosis, 17% for 1-2 years, and 31% when the time to relapse was 3 years or greater. The cumulative actuarial incidence of, and death from, second malignant tumors at 30 years from diagnosis was 18% and 13%, respectively. Conclusions: Death later than 5 years from diagnosis of a brain tumor in children is common and is usually due to progressive disease in slowly evolving low grade tumors. Death from a second malignant tumor becomes more frequent than death from the original tumor after 15 years from diagnosis.

  16. Five year prognosis in patients with angina identified in primary care: incident cohort study.

    LENUS (Irish Health Repository)

    Buckley, Brian S

    2009-01-01

    OBJECTIVE: To ascertain the risk of acute myocardial infarction, invasive cardiac procedures, and mortality among patients with newly diagnosed angina over five years. DESIGN: Incident cohort study of patients with primary care data linked to secondary care and mortality data. SETTING: 40 primary care practices in Scotland. PARTICIPANTS: 1785 patients with a diagnosis of angina as their first manifestation of ischaemic heart disease, 1 January 1998 to 31 December 2001. MAIN OUTCOME MEASURES: Adjusted hazard ratios for acute myocardial infarction, coronary artery bypass grafting, percutaneous transluminal coronary angioplasty, death from ischaemic heart disease, and all cause mortality, adjusted for demographics, lifestyle risk factors, and comorbidity at cohort entry. RESULTS: Mean age was 62.3 (SD 11.3). Male sex was associated with an increased risk of acute myocardial infarction (hazard ratio 2.01, 95% confidence interval 1.35 to 2.97), death from ischaemic heart disease (2.80, 1.73 to 4.53), and all cause mortality (1.82, 1.33 to 2.49). Increasing age was associated with acute myocardial infarction (1.04, 1.02 to 1.06, per year of age increase), death from ischaemic heart disease (1.09, 1.06 to 1.11, per year of age increase), and all cause mortality (1.09, 1.07 to 1.11, per year of age increase). Smoking was associated with subsequent acute myocardial infarction (1.94, 1.31 to 2.89), death from ischaemic heart disease (2.12, 1.32 to 3.39), and all cause mortality (2.11, 1.52 to 2.95). Obesity was associated with death from ischaemic heart disease (2.01, 1.17 to 3.45) and all cause mortality (2.20, 1.52 to 3.19). Previous stroke was associated with all cause mortality (1.78, 1.13 to 2.80) and chronic kidney disease with death from ischaemic heart disease (5.72, 1.74 to 18.79). Men were more likely than women to have coronary artery bypass grafting or percutaneous transluminal coronary angioplasty after a diagnosis of angina; older people were less likely to

  17. A Randomised Controlled Treatment Trial of Two Forms of Family Therapy in Adolescent Anorexia Nervosa: A Five-Year Follow-Up

    Science.gov (United States)

    Eisler, Ivan; Simic, Mima; Russell, Gerald F. M.; Dare, Christopher

    2007-01-01

    Background: There is growing evidence that family therapy is an effective treatment for adolescent anorexia nervosa. This study aimed to ascertain the long-term impact of two forms of outpatient family intervention previously evaluated in a randomised controlled trial (RCT). Method: A five-year follow-up was conducted on a cohort of 40 patients…

  18. The effect of retraining of nurses on cardiopulmonary resuscitationsuccess rate and short-term and long-term survival in patients revived

    Directory of Open Access Journals (Sweden)

    Dahi M

    2015-02-01

    Full Text Available Background and Objective: Cardiopulmonary resuscitation (CPR is performed in order to restore the functioning of two most important body organs the heart and brain. The present study was performed to investigate the effect of retraining of nurses on CPR success rate and short-term and long-term CPR survival. Materials and Method: The study population of the present quasi-experimental study consisted of all nurses of Taleghani Hospital affiliated with Shahid Beheshti University, Tehran, Iran, in 2011. The study subjects (n = 400 were selected using convenience and purposive sampling method. The patient survival rate during the first 24 hours (short-term survival and discharge from the hospital (long-term survival after CPR were reported. Then, the study subjects, in groups of 20, participated in CPR training courses. Short-term (24 hours and long-term (discharge from hospital in good mental status survival subsequent to CPR were reevaluated and compared with pre-training results. Data were analyzed using SPSS software version 20, and t-test and chi-square test. Results: Retraining promoted CPR success rates. This increase in the short-term success rate was not significant, but the increase in long-term success rate was statistically significant (P = 0.007. Conclusion: Periodic retraining of nurses may improve CPR success rate particularly long-term survival or discharge from hospital. Therefore, further studies on long-term success of CPR considering confounding factors are recommended

  19. Glaucoma-related adverse events in the first five years after unilateral cataract removal in the Infant Aphakia Treatment Study

    Science.gov (United States)

    Freedman, Sharon F.; Lynn, Michael J.; Beck, Allen D.; Bothun, Erick D.; Orge, Faruk H.; Lambert, Scott R.

    2015-01-01

    are common and increase between one and five years in infants after unilateral cataract removal at 1–6 months of age; primary IOL placement does not mitigate their risk, but surgery at a younger age increases the risk. Longer follow-up of these children may further characterize risk factors, long-term outcomes, potential differences between eyes having primary IOL vs. aphakia, and optimal timing of unilateral congenital cataract removal. PMID:25996491

  20. Long-term survival in an adolescent with widely metastatic renal cell carcinoma with rhabdoid features.

    Science.gov (United States)

    Ettinger, L J; Goodell, L A; Javidian, P; Hsieh, Y; Amenta, P

    2000-01-01

    Renal cell carcinoma is rarely seen in children and adolescents. Patients with widespread disease at diagnosis have a particularly poor survival rate. Currently, all known chemotherapy has been ineffective in improving the median survival in patients with advanced disease. A 13-year-old black boy with stage IV renal cell carcinoma with rhabdoid features is a long-term disease-free survivor after aggressive multiagent chemotherapy. After the initial evaluation and histologic diagnosis of renal cell carcinoma, the patient received three courses of an aggressive chemotherapy regimen consisting of vincristine, doxorubicin, cyclophosphamide with mesna uroprotection, granulocyte colony-stimulating factor and erythropoietin (Epogen). After an almost complete response, a radical nephrectomy was performed and results demonstrated a solitary small nodule with viable tumor. After surgery, he received floxuridine infusion for 14 days by circadian schedule at 28-day intervals for a total of 1 year. The patient is well and free of disease 5 years after initial presentation. The dramatic response to treatment and long-term disease-free survival of this patient suggest this chemotherapeutic approach warrants additional investigation.

  1. Biologically-equivalent dose and long-term survival time in radiation treatments

    International Nuclear Information System (INIS)

    Zaider, Marco; Hanin, Leonid

    2007-01-01

    Within the linear-quadratic model the biologically-effective dose (BED)-taken to represent treatments with an equal tumor control probability (TCP)-is commonly (and plausibly) calculated according to BED(D) = -log[S(D)]/α. We ask whether in the presence of cellular proliferation this claim is justified and examine, as a related question, the extent to which BED approximates an isoeffective dose (IED) defined, more sensibly, in terms of an equal long-term survival probability, rather than TCP. We derive, under the assumption that cellular birth and death rates are time homogeneous, exact equations for the isoeffective dose, IED. As well, we give a rigorous definition of effective long-term survival time, T eff . By using several sets of radiobiological parameters, we illustrate potential differences between BED and IED on the one hand and, on the other, between T eff calculated as suggested here or by an earlier recipe. In summary: (a) the equations currently in use for calculating the effective treatment time may underestimate the isoeffective dose and should be avoided. The same is the case for the tumor control probability (TCP), only more so; (b) for permanent implants BED may be a poor substitute for IED; (c) for a fractionated treatment schedule, interpreting the observed probability of cure in terms of a TCP formalism that refers to the end of the treatment (rather than T eff ) may result in a miscalculation (underestimation) of the initial number of clonogens

  2. Im. A. F. Zasyad'ko coal mine during the eleventh five year plan

    Energy Technology Data Exchange (ETDEWEB)

    Zvyagil' skii, E.L.

    1985-08-01

    The achievements of this mine are chronicled, which began production in December 1958, throughout the eleventh five year plan, showing how the annual targets for coal output, roadway drivage, savings in energy and materials, output per manshift and cost price of coal were met and improved upon in each of the five years. The factors which made possible these achievements in productivity and efficiency are described and include: use of modern equipment and systems, increased mechanization, on-site education and training, improved discipline, reduced absenteeism, incentive schemes and, above all, the full involvement of the coal mine in the program of socialist competition. The social infrastructure supporting the coal mine and its workforce is also described.

  3. Mathematical descriptions of a one- and five-year old child for use in dosimetry calculations

    Energy Technology Data Exchange (ETDEWEB)

    Hwang, J.M.L.; Shoup, R.L.; Warner, G.G.; Poston, J.W.

    1976-03-01

    Mathematical representations for estimating the absorbed radiation dose from external and internal radiation sources of a one-year old and a five-year old human have been designed. The phantoms used consist of head, trunk and leg regions with a skeletal system and twenty-two internal organs, each. The mathematical descriptions of these phantoms have been coded into Fortran computer language for use with a Monte-Carlo photon transport code. This computer code was used to calculate absorbed fractions of energy deposited in different targets organs from a radionuclide deposited uniformly in a source organ. Absorbed dose calculations were performed for two /sup 99m/Tc-labeled pharmaceuticals. Photon absorbed fraction estimates for the pediatric phantoms from Monte-Carlo calculations were combined with biological data to estimate dose distributions in one-year old and five-year old children. (CH)

  4. Rural Transformation and Planning Tactics in the 13th Five-Year Plan Period

    Institute of Scientific and Technical Information of China (English)

    Luo; Xiaolong; Xu; Xiao; Li; Min

    2016-01-01

    Rural development has long been the focus of China’s central and local governments. Since the late 2000 s, rural areas have presented new transformation features and development trends. To stimulate rural transformation and development in the 13 th Five-Year Plan period, this paper reviews major ideas on rural development in related disciplines. This study also summarizes main rural transformation features, including the aging population, hollow villages, changes in the allocation of land resource, semi-urbanization, and regional differences in rural development. Finally, it also provides suggestions for planning tactics in the 13 th Five-Year Plan period, such as making differentiated rural development strategies, exploring new methods to stimulate rural stock land planning and use, and enforcing relevant policy and management reforms.

  5. Rural Transformation and Planning Tactics in the 13th Five-Year Plan Period

    Institute of Scientific and Technical Information of China (English)

    Luo Xiaolong; Xu Xiao; Li Min

    2016-01-01

    Rural development has long been the focus of China's central and local governments.Since the late 2000s,rural areas have presented new transformation features and development trends.To stimulate rural transformation and development in the 13th Five-Year Plan period,this paPer reviews major ideas on rural development in related disciplines.This study also summarizes main rural transformation features,including the aging population,hollow villages,changes in the allocation of land resource,semi-urbanization,and regional differences in rural development.Finally,it also provides suggestions for planning tactics in the 13th Five-Year Plan period,such as making differentiated rural development strategies,exploring new methods to stimulate rural stock land planning and use,and enforcing relevant policy and management reforms.

  6. Chief Financial Officer FY 1997 status report and five-year plan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-10-01

    The Chief Financial Officers Act of 1990 (CFO Act) establishes the legal framework for improved Federal financial management. The Act requires the agency CFO to prepare, and annually revise, a plan to implement the Office of Management and Budget (OMB) Federal Financial Management Status Report and Five-Year Plan. This is the sixth Status Report and Five-Year Plan submission to OMB by the Department of Energy (DOE). Financial management at the Department operates in an environment of Government-wide efforts to improve financial management and implements legislation and administrative provisions which stress the need for change. This report sets forth the Department`s plans for financial management improvements in the coming years. It also highlights several new initiatives completed or currently underway that will significantly improve the overall effectiveness of financial management at the Department of Energy.

  7. Mathematical descriptions of a one- and five-year old child for use in dosimetry calculations

    International Nuclear Information System (INIS)

    Hwang, J.M.L.; Shoup, R.L.; Warner, G.G.; Poston, J.W.

    1976-03-01

    Mathematical representations for estimating the absorbed radiation dose from external and internal radiation sources of a one-year old and a five-year old human have been designed. The phantoms used consist of head, trunk and leg regions with a skeletal system and twenty-two internal organs, each. The mathematical descriptions of these phantoms have been coded into Fortran computer language for use with a Monte-Carlo photon transport code. This computer code was used to calculate absorbed fractions of energy deposited in different targets organs from a radionuclide deposited uniformly in a source organ. Absorbed dose calculations were performed for two /sup 99m/Tc-labeled pharmaceuticals. Photon absorbed fraction estimates for the pediatric phantoms from Monte-Carlo calculations were combined with biological data to estimate dose distributions in one-year old and five-year old children

  8. Five-Year NRHP Re-Evaluation of Historic Buildings Assessment

    Energy Technology Data Exchange (ETDEWEB)

    Ullrich, R A; Heidecker, K R

    2011-09-12

    The Lawrence Livermore National Laboratory (LLNL) 'Draft Programmatic Agreement among the Department of Energy and the California State Historic Preservation Officer Regarding Operation of Lawrence Livermore National Laboratory' requires a review and re-evaluation of the eligibility of laboratory properties for the National Register of Historic Places (NRHP) every five years. The original evaluation was published in 2005; this report serves as the first five-year re-evaluation. This re-evaluation includes consideration of changes within LLNL to management, to mission, and to the built environment. it also determines the status of those buildings, objects, and districts that were recommended as NRHP-eligible in the 2005 report. Buildings that were omitted from the earlier building list, those that have reached 50 years of age since the original assessment, and new buildings are also addressed in the re-evaluation.

  9. A Study Of Universal Immunization Coverage During Last Five Years In Resettlement Colonies Of Delhi

    Directory of Open Access Journals (Sweden)

    Salhotra V S

    1999-01-01

    Full Text Available Research Question: Is there any difference in immunization coverage in resettlement colonies of Delhi during past five years? Objectives: 1. To study the immunization coverage levels of children over a period of five years. 2. To observe changes in the coverage levels of different years, if any. Study design: Cross-sectional study. Setting: Khichripur, Kalyanpuri, Kalyanpuri, Trilokpuri and Himmatpuri- four resettlement colonies of trans-Yamuna area of Delhi. Participants: 1500 children belonging to five age-groups i.e. birth-1 yr., 1-2 yrs., 2-3 yrs, and 4-5 yrs. Methods: Verification of child’s immunization from immunization card and interview of mother if immunization car was not available. Study period: May1997 to March1998 Results: Immunization with individual vaccines and immunization status of the children peaked in 1995-96 but started falling thereafter due to fall in ICE activities.

  10. Causal inference for long-term survival in randomised trials with treatment switching: Should re-censoring be applied when estimating counterfactual survival times?

    OpenAIRE

    Latimer, N.R.; White, I.R.; Abrams, K.R.; Sieburt, U.

    2017-01-01

    Treatment switching often has a crucial impact on estimates of effectiveness and cost-effectiveness of new oncology treatments. Rank preserving structural failure time models (RPSFTM) and two-stage estimation (TSE) methods estimate ‘counterfactual’ (i.e. had there been no switching) survival times and incorporate re-censoring to guard against informative censoring in the counterfactual dataset. However, re-censoring causes a loss of longer term survival information which is problematic when e...

  11. System of optimization computations of five year plans in the coal industry. [USSR

    Energy Technology Data Exchange (ETDEWEB)

    Goyzman, E I; Korenev, V G

    1980-01-01

    A system of optimization computations of five year plans is set forth which was developed over a number of years at the Central Scientific Research Institute of Economics and Scientific-Technical Information of the Coal Industry. Basic principles of design and methodological approaches are given which were used in development of the systemas well as levels of administration and information links between them. The report analyzes the characteristics of problems of planning which arise at different stages of formation of the five year plans and discusses possibilities of taking into account these characteristics in optimized models. Economic formulations of problems of optimization of five year plans are given as applied to two levels of administration: at the branch level and at the level of production associations. Economic-mathematical models of optimization of five year plans are developed for each of the levels and their characteristic features described. The primary methodological principles, on the basis of which optimization models were developed are examined. An economic-mathematical model with continuous variables was developed for the branch level of planning. Volumes of recovery according to a group of shafts in the stage of normal operation (stable group) of each production enterprise are adopted as model variables. A system of limitations which includes limitations on volumes and distinguishable resources is formulated. The minimum of operating expenses, minimum of capital investments and maximum of recovery volumes for the planned period can be used as the optimization criteria. An economic-mathematical model which uses integral variable was developed for the production association level.

  12. The U.S.-Singapore Free Trade Agreement: Effects After Five Years

    Science.gov (United States)

    2010-03-26

    U.S. service providers in Singapore under the FTA , Citibank has been able to expand its operations there (it has 50% of the credit card market...failing to comply with a collection of information if it does not display a currently valid OMB control number. 1. REPORT DATE 26 MAR 2010 2. REPORT...U.S.-Singapore Free Trade Agreement: Effects After Five Years Congressional Research Service Summary The U.S.-Singapore Free Trade Agreement ( FTA

  13. The covered distance for twenty five years of the Manche waste storage 1969 - 1994

    International Nuclear Information System (INIS)

    Gourden, J.M.

    2001-01-01

    The twenty five years of the Manche plant,are narrated with the difficulties of the beginning, the problems coming from leaks or runoff that have led to improvement in the knowledge of radioactive waste behaviour and the solutions that have been brought. It is from the building of the plant until the radioactive waste management that is related in this book. (N.C.)

  14. Risk Factors of Diarrhea in Children Under Five Years in Urban Slums

    Directory of Open Access Journals (Sweden)

    Balakrishna Kalakheti

    2016-12-01

    Full Text Available Introduction: Diarrhea is a leading cause of mortality in children in developing countries and the condition is worse in slums. In order to provide effective preventive and management strategies, it is important to identify factors associated with the disease. This study was carried out to investigate the risk factors of diarrhea in  children under five years of age in urban slums. Methods: Parents of all children under five years from the urban slums of Tansen municipality, Palpa, Nepal were interviewed using a standardized pretested questionnaire and proforma. Parental variables, environmental factors, and presence of diarrhea in those children in past three months were collected by trained enumerators and the data were analyzed with statistical software SPSS-10. Results: A total of 450 under five years children were enrolled in the study. There were 216 (48% male and 234 (52% female children with F:M ratio of 1.08:1. Occurrence of diarrhea was lower if the children were breast-fed for more than six months, well-nourished, used fountain water for drinking, or used boiled or treated water. Similarly, diarrhea prevalence was lower if father had a regular job, daily income in the family was more than one US dollar, there was a toilet in the house, practice of hand washing was followed before feeding or preparing food, or there was no child suffering from diarrhea in the neighborhood. Conclusion: There are a few variables that are significantly related to diarrhea in children under five years of age. In order to decrease the diarrheal episodes in children in the slums of the developing countries, priority could be given in the improvement of those variables.

  15. Review of the Main Activities Carried out by the CSN in the Last Five Years

    International Nuclear Information System (INIS)

    2006-01-01

    Nearing the time to finalise a new phase for the Consejo de Seguridad Nuclear, it is time to make a brief account of the main activities carried out over the past five years. During this period, one in which the CSN celebrated its 25th Anniversary, the organisation has served a social demand in a modernisation and adjustment process, followed by the continuous improvement process which throughout its history the former management, teams have carried out with great stamina and dedication. (Author)

  16. Five years' experience of the new SAPs: overview and way forward

    International Nuclear Information System (INIS)

    Pape, R.P.

    1998-01-01

    This paper gives an overview of the five years' experience gained in applying the new safety assessment principles (SAPs). Beginning with a brief history of SAPs, it goes on to discuss their structure and their relevance to safety matters. It develops some of the more basic issues which users have to bear in mind and also considers how SAPs are used by NII. Finally, there is a look forward to future developments in SAPs usage and application. (author)

  17. Five years after Fukushima, it's time to seize new nuclear opportunities

    Energy Technology Data Exchange (ETDEWEB)

    Shephers, John [nuclear24, Redditch (United Kingdom)

    2016-05-15

    In March of this year, we marked a painful chapter in the history of the world's civil nuclear energy industry as we reflected on the earthquake and tsunami that struck Japan five years ago - leading to the nuclear accident at Fukushima-Daiichi. In moving on, the nuclear industry needs to absorb the lessons learned from Fukushima and there are now clear signals for going on with nuclear.

  18. A National Study of the Prevalence of Autism among Five-Year-Old Children in Iran

    Science.gov (United States)

    Samadi, Sayyed Ali; Mahmoodizadeh, Ameneh; McConkey, Roy

    2012-01-01

    In Iran, more than 1.3 million five-year olds have been screened for autism over three academic years, with the Social Communication Questionnaire (SCQ). The Autism Diagnostic Interview-Revised (ADI-R) is used to confirm a diagnosis of typical autism. The resulting prevalence of 6.26 per 10,000 for typical autism is in line with rates for certain…

  19. Retrospective Evaluation of the Five-Year and Ten-Year CSEP-Italy Earthquake Forecasts

    OpenAIRE

    Werner, M. J.; Zechar, J. D.; Marzocchi, W.; Wiemer, S.

    2010-01-01

    On 1 August 2009, the global Collaboratory for the Study of Earthquake Predictability (CSEP) launched a prospective and comparative earthquake predictability experiment in Italy. The goal of the CSEP-Italy experiment is to test earthquake occurrence hypotheses that have been formalized as probabilistic earthquake forecasts over temporal scales that range from days to years. In the first round of forecast submissions, members of the CSEP-Italy Working Group presented eighteen five-year and ten...

  20. Policy recommendations for improvement and strengthening of future provincial environmental five years plans in China

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-11-15

    Since the Eleventh Five-Year Plan (2006-2010) started, the environmental protection plan has been playing a more and more important role in the implementation of Chinas national environmental protection strategy as well as promoting and carrying out the 'three historical transitions' in environmental protection, and enhancing the functions of environmental protection for macroscopic adjustment and control and optimizing economic growth.(auth)

  1. Taking out 1 billion tons of CO2: The magic of China's 11th Five-Year Plan?

    International Nuclear Information System (INIS)

    Lin Jiang; Zhou Nan; Levine, Mark; Fridley, David

    2008-01-01

    China's 11th Five-Year Plan (FYP) sets an ambitious target for energy-efficiency improvement: energy intensity of the country's gross domestic product (GDP) should be reduced by 20% from 2005 to 2010 [National Development and Reform Commission (NDRC), 2006. Overview of the 11th Five Year Plan for National Economic and Social Development. NDRC, Beijing]. This is the first time that a quantitative and binding target has been set for energy efficiency, and signals a major shift in China's strategic thinking about its long-term economic and energy development. The 20% energy-intensity target also translates into an annual reduction of over 1.5 billion tons of CO 2 by 2010, making the Chinese effort one of the most significant carbon mitigation efforts in the world today. While it is still too early to tell whether China will achieve this target, this paper attempts to understand the trend in energy intensity in China and to explore a variety of options toward meeting the 20% target using a detailed end-use energy model

  2. Five-Year Wilkinson Microwave Anisotropy Probe Observations: Beam Maps and Window Functions

    Science.gov (United States)

    Hill, R. S.; Weiland, J. L.; Odegard, N.; Wollack, E.; Hinshaw, G.; Larson, D.; Bennett, C. L.; Halpern, M.; Page, L.; Dunkley, J.; Gold, B.; Jarosik, N.; Kogut, A.; Limon, M.; Nolta, M. R.; Spergel, D. N.; Tucker, G. S.; Wright, E. L.

    2009-02-01

    Cosmology and other scientific results from the Wilkinson Microwave Anisotropy Probe (WMAP) mission require an accurate knowledge of the beam patterns in flight. While the degree of beam knowledge for the WMAP one-year and three-year results was unprecedented for a CMB experiment, we have significantly improved the beam determination as part of the five-year data release. Physical optics fits are done on both the A and the B sides for the first time. The cutoff scale of the fitted distortions on the primary mirror is reduced by a factor of ~2 from previous analyses. These changes enable an improvement in the hybridization of Jupiter data with beam models, which is optimized with respect to error in the main beam solid angle. An increase in main-beam solid angle of ~1% is found for the V2 and W1-W4 differencing assemblies. Although the five-year results are statistically consistent with previous ones, the errors in the five-year beam transfer functions are reduced by a factor of ~2 as compared to the three-year analysis. We present radiometry of the planet Jupiter as a test of the beam consistency and as a calibration standard; for an individual differencing assembly, errors in the measured disk temperature are ~0.5%. WMAP is the result of a partnership between Princeton University and NASA's Goddard Space Flight Center. Scientific guidance is provided by the WMAP Science Team.

  3. Does life satisfaction predict five-year mortality in community-living older adults?

    Science.gov (United States)

    St John, Philip D; Mackenzie, Corey; Menec, Verena

    2015-01-01

    Depression and depressive symptoms predict death, but it is less clear if more general measures of life satisfaction (LS) predict death. Our objectives were to determine: (1) if LS predicts mortality over a five-year period in community-living older adults; and (2) which aspects of LS predict death. 1751 adults over the age of 65 who were living in the community were sampled from a representative population sampling frame in 1991/1992 and followed five years later. Age, gender, and education were self-reported. An index of multimorbidity and the Older American Resource Survey measured health and functional status, and the Terrible-Delightful Scale assessed overall LS as well as satisfaction with: health, finances, family, friends, housing, recreation, self-esteem, religion, and transportation. Cox proportional hazards models examined the influence of LS on time to death. 417 participants died during the five-year study period. Overall LS and all aspects of LS except finances, religion, and self-esteem predicted death in unadjusted analyses. In fully adjusted analyses, LS with health, housing, and recreation predicted death. Other aspects of LS did not predict death after accounting for functional status and multimorbidity. LS predicted death, but certain aspects of LS are more strongly associated with death. The effect of LS is complex and may be mediated or confounded by health and functional status. It is important to consider different domains of LS when considering the impact of this important emotional indicator on mortality among older adults.

  4. Five-year change in morale is associated with negative life events in very old age.

    Science.gov (United States)

    Näsman, Marina; Niklasson, Johan; Saarela, Jan; Nygård, Mikael; Olofsson, Birgitta; Conradsson, Mia; Lövheim, Hugo; Gustafson, Yngve; Nyqvist, Fredrica

    2017-10-27

    The objectives were to study changes in morale in individuals 85 years and older, and to assess the effect of negative life events on morale over a five-year follow-up period. The present study is based on longitudinal data from the Umeå85+/GERDA-study, including individuals 85 years and older at baseline (n = 204). Morale was measured with the Philadelphia Geriatric Center Morale Scale (PGCMS). Negative life events were assessed using an index including 13 negative life events occurring during the follow-up period. Linear regression was used for the multivariate analyses. The majority of the sample (69.1%) had no significant changes in morale during the five-year follow-up. However, the accumulation of negative life events was significantly associated with a greater decrease in PGCMS. A higher baseline PGCMS score did not attenuate the adverse effect negative life events had on morale. Morale seemed to be mainly stable in a five-year follow-up of very old people. It seems, nonetheless, that individuals are affected by negative life events, regardless of level of morale. Preventing negative life events and supporting individuals who experience multiple negative life events could have important implications for the care of very old people.

  5. Public comments and responses to the 1993 Hanford cleanup five-year plan

    International Nuclear Information System (INIS)

    1993-08-01

    In March 1993, the US Department of Energy, Richland Operations Office (DOE-RL) published its annual Site-Specific Five-Year Plan. The Site-Specific Plan is published to inform the public about the background, status, and plans for Environmental Restoration (ER) and Waste Management (WM) activities at the Hanford site. It is the only document that seeks to bring all ER and WM elements together in one document. The Site-Specific Plan is a companion document to the National Five-Year Plan that deals with all the sites within the DOE complex on a summary level. This Response to Comments document does not try to address every question or concern raised during the public comment period. Some questions were outside the scope of the Five-Year Plan, some we could not decipher, others were variations of the same question. The initial round of public meetings was held in Portland, Oregon, and Seattle, Pasco, and Olympia, Washington. At the request of the Oregon Department of Energy (ODOE) and the Washington State Department of Ecology (Ecology), a second round of meetings was held in Portland and Olympia. Both agencies felt that the first two meetings were held with too little advance notice, and before the Plan could be distributed. Once the public meetings were over and the comment period closed, we then compiled the public comments, largely from audio tapes of the meetings. Individual functions within Hanford were asked to consider and respond to the comments

  6. Suicide rates in five-year age-bands after the age of 60 years

    DEFF Research Database (Denmark)

    Shah, Ajit; Bhat, Ravi; Zarate-Escudero, Sofia

    2016-01-01

    -79 years) and the oldest old (80+ years) age groups. METHODS: Data on the number of suicides (International Classification of Diseases - ICD-10 codes, X60-84) in each of the eight five-year age-bands between the age-bands 60-64 years and 95-99 years in both gender for as many years as possible from 2000...... were ascertained from three sources: colleagues with access to national data, national statisics office websites and email contact with the national statistics offices. The population size for the corresponding years and age-bands was estimated for each country using data provided by the United Nations......BACKGROUND: There is paucity of studies examining suicide rates in narrow five-year age-bands after the age of 60 years. This study examined suicide rates in eight five-year age-bands between the age of 60 and 99 years because this will allow more precise comparison between the young old (60...

  7. Long-term kinetics of Salmonella Typhimurium ATCC 14028 survival on peanuts and peanut confectionery products.

    Directory of Open Access Journals (Sweden)

    Maristela S Nascimento

    Full Text Available Due to recent large outbreaks, peanuts have been considered a product of potential risk for Salmonella. Usually, peanut products show a low water activity (aw and high fat content, which contribute to increasing the thermal resistance and survival of Salmonella. This study evaluated the long-term kinetics of Salmonella survival on different peanut products under storage at 28°C for 420 days. Samples of raw in-shell peanuts (aw = 0.29, roasted peanuts (aw = 0.39, unblanched peanut kernel (aw = 0.54, peanut brittle (aw = 0.30, paçoca (aw = 0.40 and pé-de-moça (aw = 0.68 were inoculated with Salmonella Typhimurium ATCC 14028 at two inoculum levels (3 and 6 log cfu/ g. The Salmonella behavior was influenced (p420 days, especially in products with aw around 0.40.

  8. Conventional chemotherapy and long-term survival in multiple myeloma patients

    International Nuclear Information System (INIS)

    Kraj, M; Poglod, R.; Sokolowska, U.; Kruk, B.; Maj, S.

    2010-01-01

    Objectives. The study was especially focused on the estimation of real frequency of long-term survivals in patients with multiple myeloma and finding common clinical and laboratory features present in long-term surviving patients as possible good prognostic factors. Material and methods. The survey was carried out on 600 multiple myeloma patients diagnosed before the year 2000 and treated with conventional chemotherapy in the Institute of Hematology and Transfusion Medicine in Warsaw in the years 1962-2009. All patients who had fulfilled the requirement of more than seven years of survival from the diagnosis and beginning of treatment for myeloma were included into the study group. Results. Out of 600 studied patients with multiple myeloma 88 (14.7%) survived over 7 years including 45 (7.5%) over 10 years, 11 (1.8 %) over 15 years and 7 (1.1%) over 20 years from the disease diagnosis and beginning of antitumor treatment. Patients with long survival were younger (median age 55 years) at the time of diagnosis than the whole studied group and had normal serum creatinine, calcium and beta2-microglobulin levels. Sixty eight percent of these patients had stage I or II clinical progression, 60% presented with IgG monoclonal protein and 58% with osteolysis. Treatment with melphalan only was given to 18 patients, 30 were treated with melphalan, followed by vincristine, cyclophosphamide, BCNU, doxorubicin and prednisone or dexamethasone. Polychemotherapy was given from the time of the diagnosis to 16 patients, 15 received radiotherapy or 60C o irradiation besides chemotherapy and 9 received new agents: thalidomide, bortezomib, lenalidomide. In 66% of the evaluated cases response to treatment was good and in another 34% stabilization of the proliferative process was achieved. The mean duration of treatment till the achievement of partial response was 10 months, range: 2 - 89 months. The mean duration of good therapeutic response was 70 months. Twelve patients are alive and

  9. Impact of obesity on long-term survival after aortic valve replacement with a small prosthesis.

    Science.gov (United States)

    Wang, Biao; Yang, Hongyang; Wang, Tao; Zhang, Xiquan; Zhu, Wenjie; Cao, Guangqing; Wu, Shuming

    2013-07-01

    Although many studies have evaluated the impact of obesity on various medical treatments, it is not known whether obesity is related to late mortality with implantation of small aortic prostheses. This study evaluated the effect of obesity on the late survival of patients after aortic valve replacement (AVR) with implantation of a small aortic prosthesis (size ≤ 21 mm). From January 1998 to December 2008, 307 patients in our institution who underwent primary AVR with smaller prostheses survived 30 days after surgery. Patients were categorized as normal weight if body mass index (BMI) was prosthesis. Obesity or/and overweight may also affect the NYHA classification, even in the longer term. EOAI should be improved where possible, as it may reduce late mortality and improve quality of life in obese or overweight patients.

  10. Use of Antithrombotic Therapy and Long-Term Clinical Outcome Among Patients Surviving Intracerebral Hemorrhage

    DEFF Research Database (Denmark)

    Ottosen, Tobias Pilgaard; Grijota, Miriam; Hansen, Morten Lock

    2016-01-01

    inhibitors was not related to statistically significantly improved clinical outcome. CONCLUSIONS: Approximately 1 of 2 patients surviving intracerebral hemorrhage had a high risk of thromboembolism. Postdischarge use of oral anticoagulation therapy was associated with a lower risk of all-cause mortality......BACKGROUND AND PURPOSE: The effectiveness and safety of antithrombotic therapy (AT) among patients with a history of intracerebral hemorrhage remain uncertain. We therefore determined the prevalence of indication for AT among patients hospitalized with first-time intracerebral hemorrhage...... and examined the impact of subsequent AT use on the long-term clinical outcome. METHODS: We performed a population-based cohort study using nationwide Danish medical registries. Patients with risk of thromboembolism surviving the first 30 days after hospitalization because of intracerebral hemorrhage were...

  11. FBLN4 as candidate gene associated with long-term and short-term survival with primary glioblastoma

    Directory of Open Access Journals (Sweden)

    Li F

    2017-01-01

    Full Text Available Fubin Li,1,* Yiping Li,1,* Kewei Zhang,1,* Ye Li,1,* Ping He,1,* Yujia Liu,1,* Hongyan Yuan,2,* Honghua Lu,1,* Jinxiang Liu,1,* Songtian Che,3,* Zhenju Li,4,* Li Bie1,5 1Department of Neurosurgery of the First Clinical Hospital, 2Department of Immunology, Norman Bethune College of Medicine, 3Department of Neurosurgery of the Second Clinical Hospital, 4Department of Neurosurgery of the Fourth Clinical Hospital, Jilin University, Changchun, People’s Republic of China; 5Department of Pathology and Laboratory Medicine, School of Medicine, University of California – Irvine, Irvine, CA, USA *These authors contributed equally to this work Background: Glioblastoma multiforme (GBM is the most common malignant and lethal type of primary central nervous system tumor in humans. In spite of its high lethality, a small percentage of patients have a relatively good prognosis, with median survival times of 36 months or longer. The identification of clinical subsets of GBM associated with distinct molecular genetic profiles has made it possible to design therapies tailored to treat individual patients. Methods: We compared microarray data sets from long-term survivors (LTSs and short-term survivors (STSs to screen for prognostic biomarkers in GBM patients using the WebArrayDB platform. We focused on FBLN4, IGFBP-2, and CHI3L1, all members of a group of 10 of the most promising, differentially regulated gene candidates. Using formalin-fixed paraffin-embedded GBM samples, we corroborated the relationship between these genes and patient outcomes using methylation-specific polymerase chain reaction (PCR for MGMT methylation status and quantitative reverse transcription PCR for expression of these genes. Results: Expression levels of the mRNAs of these 3 genes were higher in the GBM samples than in normal brain samples and these 3 genes were significantly upregulated in STSs compared to the levels in LTS samples (P<0.01. Furthermore, Kaplan–Meier analysis

  12. Insurance and education predict long-term survival after orthotopic heart transplantation in the United States.

    Science.gov (United States)

    Allen, Jeremiah G; Weiss, Eric S; Arnaoutakis, George J; Russell, Stuart D; Baumgartner, William A; Shah, Ashish S; Conte, John V

    2012-01-01

    Insurance status and education are known to affect health outcomes. However, their importance in orthotopic heart transplantation (OHT) is unknown. The United Network for Organ Sharing (UNOS) database provides a large cohort of OHT recipients in which to evaluate the effect of insurance and education on survival. UNOS data were retrospectively reviewed to identify adult primary OHT recipients (1997 to 2008). Patients were stratified by insurance at the time of transplantation (private/self-pay, Medicare, Medicaid, and other) and college education. All-cause mortality was examined using multivariable Cox proportional hazard regression incorporating 15 variables. Survival was modeled using the Kaplan-Meier method. Insurance for 20,676 patients was distributed as follows: private insurance/self-pay, 12,298 (59.5%); Medicare, 5,227 (25.3%); Medicaid, 2,320 (11.2%); and "other" insurance, 831 (4.0%). Educational levels were recorded for 15,735 patients (76.1% of cohort): 7,738 (49.2%) had a college degree. During 53 ± 41 months of follow-up, 6,125 patients (29.6%) died (6.7 deaths/100 patient-years). Survival differed by insurance and education. Medicare and Medicaid patients had 8.6% and 10.0% lower 10-year survival, respectively, than private/self-pay patients. College-educated patients had 7.0% higher 10-year survival. On multivariable analysis, college education decreased mortality risk by 11%. Medicare and Medicaid increased mortality risk by 18% and 33%, respectively (p ≤ 0.001). Our study examining insurance and education in a large cohort of OHT patients found that long-term mortality after OHT is higher in Medicare/Medicaid patients and in those without a college education. This study points to potential differences in the care of OHT patients based on education and insurance status. Copyright © 2012 International Society for Heart and Lung Transplantation. Published by Elsevier Inc. All rights reserved.

  13. Timely disclosure of progress in long-term cancer survival: the boomerang method substantially improved estimates in a comparative study.

    Science.gov (United States)

    Brenner, Hermann; Jansen, Lina

    2016-02-01

    Monitoring cancer survival is a key task of cancer registries, but timely disclosure of progress in long-term survival remains a challenge. We introduce and evaluate a novel method, denoted "boomerang method," for deriving more up-to-date estimates of long-term survival. We applied three established methods (cohort, complete, and period analysis) and the boomerang method to derive up-to-date 10-year relative survival of patients diagnosed with common solid cancers and hematological malignancies in the United States. Using the Surveillance, Epidemiology and End Results 9 database, we compared the most up-to-date age-specific estimates that might have been obtained with the database including patients diagnosed up to 2001 with 10-year survival later observed for patients diagnosed in 1997-2001. For cancers with little or no increase in survival over time, the various estimates of 10-year relative survival potentially available by the end of 2001 were generally rather similar. For malignancies with strongly increasing survival over time, including breast and prostate cancer and all hematological malignancies, the boomerang method provided estimates that were closest to later observed 10-year relative survival in 23 of the 34 groups assessed. The boomerang method can substantially improve up-to-dateness of long-term cancer survival estimates in times of ongoing improvement in prognosis. Copyright © 2016 Elsevier Inc. All rights reserved.

  14. Biochemical Mechanisms and Energy Strategies of Geobacter sulfurreducens for Long- Term Survival

    Science.gov (United States)

    Helmus, R. A.; Liermann, L. J.; Brantley, S. L.; Tien, M.

    2008-12-01

    Numerous species of bacteria have been observed to exhibit a growth advantage in stationary phase (GASP) phenotype, indicating that microorganisms starved of an energy source may adapt to allow for long-term survival. Understanding how Geobacter sulfurreducens persists using various metal forms as energy sources and whether a GASP phenotype develops during long-term growth are important for efficient application of this bacterium to sites requiring engineered bioremediation of soluble metals. Thus, we investigated the growth kinetics and survival of G. sulfurreducens. The growth rate of G. sulfurreducens was highest when cultured with soluble iron and generally higher on iron oxide than manganese oxide, suggesting that soluble metal forms are more readily utilized as energy sources by G. sulfurreducens. By monitoring the abundance of G. sulfurreducens in batch cultures for >6 months, distinct growth, stationary, and prolonged starvation phases were observed and a cell density of 105- 106 cells/mL persisted under long-term starvation conditions. The outgrowth of an aged G. sulfurreducens strain co-cultured with a young strain was monitored as a measure of the existence of the GASP phenotype. As the strains aged, the rpoS gene was cloned and sequenced at different stages of growth to identify mutations corresponding to a growth advantage. The results of these studies provide insight into the use of various metal forms for growth by G. sulfurreducens and its ability to persist when starved of energy sources.

  15. Effect of donor age on long-term survival following cardiac transplantation.

    Science.gov (United States)

    Topkara, Veli K; Cheema, Faisal H; Kesavaramanujam, Satish; Mercando, Michelle L; Forster, Catherine S; Argenziano, Michael; Esrig, Barry C; Oz, Mehmet C; Naka, Yoshifumi

    2006-01-01

    The current shortage of donor hearts has forced the criteria of organ procurement to be extended, leading to increased use of older donor hearts to bridge the gap between demand and availability. Our objective was to analyze the effect of donor age on outcomes after cardiac transplantation. We retrospectively studied 864 patients who underwent cardiac transplantation at New York Presbyterian Hospital - Columbia University between 1992 and 2002. Patients were divided into two groups; donor age or =40 years (Group B, n = 264). Characteristics including gender, body mass index, and cytomegalovirus (CMV) status were significantly different between the two donor age groups. Race, CMV status, toxoplasmosis status, left ventricular assist device prior to transplant, diabetes mellitus, and retransplantation were similar in both the recipient groups, while age, gender, and BMI were different. Early mortality was lower in Group A, 5%, versus 9.5% in Group B. Multivariate analysis revealed recipient female gender (odd ratio (OR) = 1.71), retransplantation (OR = 1.63), and increased donor age (OR = 1.02) as significant predictors of poor survival in the recipient population. Actuarial survival at 1 year (86.7% vs 81%), 5 years (75% vs 65%), and 10 years (56% vs 42%) was significantly different as well with a log rank p = 0.002. These findings suggest that increased donor age is an independent predictor of long-term survival. However, the shortage of organs makes it difficult to follow strict guidelines when placing hearts; therefore, decisions need to be made on a relative basis.

  16. An Assessment of Student Learning in an Online Oceanography Course: Five Years After Implementation

    Science.gov (United States)

    Reed, D. L.

    2002-12-01

    The results of assessing student learning in an online oceanography class offered over the past five years are compiled to reveal several general trends. In order to understand the context of these trends, it is important to first note that SJSU has a two-tiered general education program consisting of a category of core courses for frosh and sophomores and an advanced category for juniors and seniors, most of whom are community college transfers. The course described in this study is in the latter category and therefore composed largely of seniors. Enrollments in the course have exploded from 6 students in a pilot section offered during the 1998 fall semester to over 170 students in the summer semester of 2002. The course is now offered in both semesters of the academic year with four sections offered during 2002 summer session as part of a system-wide conversion to year-round operation. No other course, be it classroom, hybrid or online, in the general education category has experienced the level of student demand as this online course. All sections of the online course reach enrollment limits in the first days of registration with an equal or greater number of students turned away each semester. More female, students of color, returning students and K-12 in-service teachers enroll in the online sections than in the equivalent classroom sections of the course. Students enroll in the online section for the convenience of self-paced learning since attending a classroom section is not a viable option. Enrollments in concurrent classroom sections have not been negatively impacted by the addition of online sections. Enrollment attrition is higher in the first few days of the online course, but similar to that experienced in the classroom sections, once the class is underway. However, student requests for incompletes tend to be somewhat higher in the online course, especially during the summer offerings. Learning outcomes are reviewed at the beginning of the course and

  17. Taking out one billion tones of carbon: the magic of China's 11thFive-Year Plan

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Jiang; Zhou, Nan; Levine, Mark D.; Fridley, David

    2007-05-01

    China's 11th Five-Year Plan (FYP) sets an ambitious targetfor energy-efficiency improvement: energy intensity of the country sgross domestic product (GDP) should be reduced by 20 percent from 2005 to2010 (NDRC, 2006). This is the first time that a quantitative and bindingtarget has been set for energy efficiency, and signals a major shift inChina's strategic thinking about its long-term economic and energydevelopment. The 20 percent energy intensity target also translates intoan annual reduction of over one billion tons of CO2 by 2010, making theChinese effort one of most significant carbon mitigation effort in theworld today. While it is still too early to tell whether China willachieve this target, this paper attempts to understand the trend inenergy intensity in China and to explore a variety of options towardmeeting the 20 percent target using a detailed endues energymodel.

  18. How Did You Survive in the First Five Years? Secrets to Success Described by Apparel New Ventures in China

    OpenAIRE

    Li Zhao; Jung Ha-Brookshire

    2014-01-01

    The study explored the secrets of success described by Chinese apparel new ventures. Barney's (1991) resource-based view of the firm helped the researchers understand secrets to success from the firm's internal perspective, and the social network theory informed key secrets from the external perspective (Ahuja, 2000). In-depth interviews with open-ended questions were employed with sixteen top apparel companies in China. Results revealed that having the first successful store is the symbol of...

  19. CO2 emissions and economic development: China's 12th five-year plan

    International Nuclear Information System (INIS)

    Meng Ming; Niu Dongxiao; Shang Wei

    2012-01-01

    For the period of the 12th Five-Year Plan (2011–2015), the Chinese government has decided to reconsider and adjust its policies on economic development because of the pressures of CO 2 emissions and fossil energy consumption. The current paper adopts the logarithmic Stochastic Impacts by Regression on Population, Affluence, and Technology (STIRPAT) model to simulate the relationship between CO 2 emissions and other economic development factors in China. Three groups of outliers are found using samples from 1989 to 2008 and the Partial Least Square (PLS) regularity test method. The outlier analysis reveals three important areas for CO 2 reduction: (a) decreasing the share of coal to the total energy consumption and replacing it with non-fossil energies; (b) controlling vehicles used in the cities as well as (c) adjusting industrial structure. Furthermore, based on the social and economic realities of China, the current paper designs six feasible development scenarios for the period covered by the 12th Five-Year Plan and predicts the values of each factor in each scenario. The values can test the implementation of China's CO 2 control development concept. The experiences obtained by outlier analysis can be of significant reference value for realizing the predicted scenarios. - Highlights: ► Using STIRPAT to analyze China's CO 2 emissions and economic development factors. ► Using the PLS outlier test method, three groups of outliers are found. ► Outlier analysis reveals three important areas on reducing CO 2 emissions. ► We design six feasible scenarios for the period covered by the 12th Five-Year Plan. ► We predict the values of each factor in each scenario.

  20. Chagas disease: national survey of seroprevalence in children under five years of age conducted in 2008.

    Science.gov (United States)

    Russomando, Graciela; Cousiño, Blanca; Sanchez, Zunilda; Franco, Laura X; Nara, Eva M; Chena, Lilian; Martínez, Magaly; Galeano, María E; Benitez, Lucio

    2017-05-01

    Since the early 1990s, programs to control Chagas disease in South America have focused on eradicating domiciliary Triatoma infestans, the main vector. Seroprevalence studies of the chagasic infection are included as part of the vector control programs; they are essential to assess the impact of vector control measures and to monitor the prevention of vector transmission. To assess the interruption of domiciliary vector transmission of Chagas disease by T. infestans in Paraguay by evaluating the current state of transmission in rural areas. A survey of seroprevalence of Chagas disease was carried out in a representative sample group of Paraguayans aged one to five years living in rural areas of Paraguay in 2008. Blood samples collected on filter paper from 12,776 children were tested using an enzyme-linked immunosorbent assay. Children whose serology was positive or undetermined (n = 41) were recalled to donate a whole blood sample for retesting. Their homes were inspected for current triatomine infestation. Blood samples from their respective mothers were also collected and tested to check possible transmission of the disease by a congenital route. A seroprevalence rate of 0.24% for Trypanosoma cruzi infection was detected in children under five years of age among the country's rural population. Our findings indicate that T. cruzi was transmitted to these children vertically. The total number of infected children, aged one to five years living in these departments, was estimated at 1,691 cases with an annual incidence of congenital transmission of 338 cases per year. We determined the impact of vector control in the transmission of T. cruzi, following uninterrupted vector control measures employed since 1999 in contiguous T. infestans-endemic areas of Paraguay, and this allowed us to estimate the degree of risk of congenital transmission in the country.

  1. New developments in Indian space policies and programmes—The next five years

    Science.gov (United States)

    Sridhara Murthi, K. R.; Bhaskaranarayana, A.; Madhusudana, H. N.

    2010-02-01

    Over past four decades Indian space programme has systematically acquired capabilities in space technologies and implemented its programmes with a high level of focus on societal applications. It is developed into a multi-dimensional programme where its strategy is directed towards diverse stake holders and actors such as government, users and beneficiaries including general public, industrial suppliers as well as customers, academia and other space agencies/international organisations. Over the next five years, the Indian space programme has charted an ambitious set of policies and programmes that aim to enhance impacts on society. The major task is to enlarge and diversify the services delivered to a large section of population affected by income, connectivity and digital divides. While efficacy of application of space based systems have been proven in several fields such as tele-education, water resources management, improving productivity of land and out reaching quality health services and others, the crux of the problem is to evolve sustainable and scalable delivery mechanisms on a very large scale and extending over large geographical areas. Essentially the problem shifts from being predominately a technology problem to one of a composite of economic, cultural and social problems. Tackling such problems would need renewal of policies relating to commercial as well as public service systems. Major programmatic initiatives are planned in the next five years involving new and upgraded technologies to expand services from space to fill the gaps and to improve economic efficiency. Thrust is also given to science and exploration mission beyond Chandrayaan-1 and some initial steps for the participation in human space flight. This paper discusses the policy and strategy perspectives of the programmes planned by Indian Space Research Organisation over next five years.

  2. Chagas disease: national survey of seroprevalence in children under five years of age conducted in 2008

    Directory of Open Access Journals (Sweden)

    Graciela Russomando

    Full Text Available BACKGROUND Since the early 1990s, programs to control Chagas disease in South America have focused on eradicating domiciliary Triatoma infestans, the main vector. Seroprevalence studies of the chagasic infection are included as part of the vector control programs; they are essential to assess the impact of vector control measures and to monitor the prevention of vector transmission. OBJECTIVE To assess the interruption of domiciliary vector transmission of Chagas disease by T. infestans in Paraguay by evaluating the current state of transmission in rural areas. METHODS A survey of seroprevalence of Chagas disease was carried out in a representative sample group of Paraguayans aged one to five years living in rural areas of Paraguay in 2008. Blood samples collected on filter paper from 12,776 children were tested using an enzyme-linked immunosorbent assay. Children whose serology was positive or undetermined (n = 41 were recalled to donate a whole blood sample for retesting. Their homes were inspected for current triatomine infestation. Blood samples from their respective mothers were also collected and tested to check possible transmission of the disease by a congenital route. FINDINGS A seroprevalence rate of 0.24% for Trypanosoma cruzi infection was detected in children under five years of age among the country’s rural population. Our findings indicate that T. cruzi was transmitted to these children vertically. The total number of infected children, aged one to five years living in these departments, was estimated at 1,691 cases with an annual incidence of congenital transmission of 338 cases per year. MAIN CONCLUSION We determined the impact of vector control in the transmission of T. cruzi, following uninterrupted vector control measures employed since 1999 in contiguous T. infestans-endemic areas of Paraguay, and this allowed us to estimate the degree of risk of congenital transmission in the country.

  3. Academic substance and location: The national technical university of Athens' five-year program

    DEFF Research Database (Denmark)

    Spyrou, Kostas J.; Psaraftis, Harilaos N.

    2014-01-01

    The National Technical University of Athens (NTUA) established a small Department of Naval Architecture and Marine Engineering in 1969, within the School of Mechanical and Electrical Engineering. Today, it is organized in four divisions, ship design and maritime transport, ship and marine...... hydrodynamics, marine structures, and marine engineering. To be awarded an engineering diploma in Greece, one has to spend a minimum of five years. The program at NTUA has also 10 semesters, out of which nine are dedicated to course study while the tenth is spend on the writing of a thesis. There is no tuition...

  4. Caries in five-year-old children and associations with family-related factors.

    Science.gov (United States)

    Mattila, M L; Rautava, P; Sillanpää, M; Paunio, P

    2000-03-01

    It is generally understood that the teeth of pre-school-aged children are healthy, but the improvement in the dmft index has halted in the industrialized countries. Those few children who have caries have more of it than before. Little is known of the family-related factors which are associated with this polarization of caries. A representative population-based sample consisted of 1443 mothers expecting their first child. The children were followed at well-baby clinics and public dental health clinics for over five years. The objective was to study the prevalence of dental caries and its predictors in five-year-old children and to assess children's own dental health habits and the meaning of family-related factors in dental health. The findings were based on questionnaire data from parents and on clinical dental examinations of the five-year-old children as completed by 101 public health dentists. In firstborn five-year-old children, dental health was found to be good in 72%, fair in 20%, and poor in 8% of the cases. The final multivariate analysis illustrated that the dmft index > 0 was independently associated with the mother's irregular toothbrushing (OR 2.2; 95% CI 1.4-3.5), annual occurrence of several carious teeth in the father (OR 2.6; 95% CI 1.9-3.6), daily sugar consumption at the age of 18 months (OR 2.4; 95% CI 1.4-4.1), occurrence of child's headaches (OR 3.7; 95% CI 1.5-8.8), parents' cohabitation (OR 3.3; 95% CI 1.5-7.6), rural domicile (OR 2.4; 95% CI 1.2-4.5), and mother's young age (OR 5.0; 95% CI 1.3-19.8). The findings indicated that attention should be paid not only to the child's dental health care but also to that of the whole family. Parents should be supported in their upbringing efforts and encouraged to improve their children's dental health habits. In everyday life, parents function as role models for their children, and therefore, parents' own dental hygiene habits are very meaningful.

  5. Environmental restoration and waste management five-year plan, Fiscal years 1994--1998

    International Nuclear Information System (INIS)

    1993-01-01

    The US Department of Energy (DOE) understands that cleaning up the Nation's nuclear-related sites and facilities affects many different segments of the public, ranging from communities near DOE facilities to engineers concerned with developing new technologies to clean up the environment. In an effort to make the Environmental Restoration and Waste Management Five-Year Plan for Fiscal Years (FY) 1994--1998 more responsive to your concerns, DOE invites your comments on the plan. Volume II contains 37 Installation Summaries that provide a synopsis of past, present and future activities of each major installation, and Progress Charts

  6. Five years of opening the electricity market in Germany: an assessment

    International Nuclear Information System (INIS)

    Feder, A.

    2004-01-01

    In 1998, the German federal government decided to transpose in national law the principle of competition in the sector of electricity. To set up an electricity market, the new law has more or less dismantled the former system of the juxtaposed monopolies of approximately nine hundred local energy firms. The author tries to answer the following questions: How were the new market's legal and institutional modalities determined? What political choices underlie them? What benefits will consumers draw from this liberalization? What assessment has Germany made about these past five years ? What are the hopes and fears for coming years? (author)

  7. [A five-year-old girl with epilepsy showing forced normalization due to zonisamide].

    Science.gov (United States)

    Hirose, Mieko; Yokoyama, Hiroyuki; Haginoya, Kazuhiro; Iinuma, Kazuie

    2003-05-01

    A case of forced normalization in childhood is presented. When zonisamide was administered to a five-year-old girl with intractable epilepsy, disappearance of seizures was accompanied by severe psychotic episodes such as communication disturbance, personal relationship failure, and stereotyped behavior, which continued after the withdrawal of zonisamide. These symptoms gradually improved by administration of fluvoxamine, however epileptic attacks reappeared. Although most patients with forced normalization are adult and teenager, attention should be paid to this phenomenon as adverse psychotic effects of zonisamide even in young children. Fluvoxamine may be effective for the symptoms.

  8. Twenty-five years of post-Bretton Woods experience: some lessons

    Directory of Open Access Journals (Sweden)

    H. ASKARI

    1999-03-01

    Full Text Available In 1971 many academic economists were predicting that the Bretton Woods system of fixed parities would collapse. Some, most notably Milton Friedman, became excited about the possibility of a floating system because the benefits of international capital mobility can only be achieved through the flexibility in the exchange rate. These economists argued that a floating exchange rate system can ensure positive results more than the fixed parities system. Twenty-five years later, however, there is still no consensus on the matter. The author reviews the post-Bretton Woods experience to highlight some policies and approaches that might be helpful for the future.

  9. Long-term effects of edaravone on survival of patients with amyotrophic lateral sclerosis.

    Science.gov (United States)

    Okada, Masamitsu; Yamashita, Satoshi; Ueyama, Hidetsugu; Ishizaki, Masatoshi; Maeda, Yasushi; Ando, Yukio

    2018-06-01

    Oxidative stress has been implicated in the pathogenesis of amyotrophic lateral sclerosis (ALS). Edaravone, a free radical scavenger, was approved as a therapeutic drug for ALS in 2015 in Japan. A phase 3 clinical trial demonstrated a smaller decline in ALS functional scale scores compared with placebo. However, the long-term effects of edaravone on ALS patients remain unclear. This study aimed to retrospectively investigate the long-term effects of edaravone on the survival of ALS patients. We retrospectively analyzed 27 consecutive patients with ALS who were treated with edaravone and 30 consecutive ALS patients who were not treated with edaravone between 2010 and 2016. The differences of ALSFRS-R scores from baseline to 6 months was significantly reduced in the edaravone group, compared to the control group. The changes in serum creatinine, as a possible marker of ALS severity, from baseline to 6 and 12 months were significantly improved in the edaravone group, compared to the control group. The survival rate was significantly improved in the edaravone group compared with control patients. Our retrospective single-center analysis suggests slower progression and better prognosis of ALS patients with edaravone treatment. Further investigation, including prospective multicenter analysis, is warranted to confirm the usefulness of edaravone for a better prognosis of ALS.

  10. Long-term survival of an urban fruit bat seropositive for Ebola and Lagos bat viruses.

    Directory of Open Access Journals (Sweden)

    David T S Hayman

    2010-08-01

    Full Text Available Ebolaviruses (EBOV (family Filoviridae cause viral hemorrhagic fevers in humans and non-human primates when they spill over from their wildlife reservoir hosts with case fatality rates of up to 90%. Fruit bats may act as reservoirs of the Filoviridae. The migratory fruit bat, Eidolon helvum, is common across sub-Saharan Africa and lives in large colonies, often situated in cities. We screened sera from 262 E. helvum using indirect fluorescent tests for antibodies against EBOV subtype Zaire. We detected a seropositive bat from Accra, Ghana, and confirmed this using western blot analysis. The bat was also seropositive for Lagos bat virus, a Lyssavirus, by virus neutralization test. The bat was fitted with a radio transmitter and was last detected in Accra 13 months after release post-sampling, demonstrating long-term survival. Antibodies to filoviruses have not been previously demonstrated in E. helvum. Radio-telemetry data demonstrates long-term survival of an individual bat following exposure to viruses of families that can be highly pathogenic to other mammal species. Because E. helvum typically lives in large urban colonies and is a source of bushmeat in some regions, further studies should determine if this species forms a reservoir for EBOV from which spillover infections into the human population may occur.

  11. The NEA co-operative programme on decommissioning. Twenty-five years of progress; the last five years - 2006 through 2010

    International Nuclear Information System (INIS)

    2011-01-01

    The Co-operative Programme for the Exchange of Scientific and Technical Information Concerning Nuclear Installation Decommissioning (CPD) is a joint undertaking according to Article 5 of the Statute of the NEA. Concluded in 1985, the Agreement constituting the CPD has been continuously extended, although modified in 2003, with the current programme period lasting until the end of 2013. This report provides information about the participants, structure and achievements of the Co-operative Programme and the projects involved. The projects in the Programme have a broad range of characteristics and cover various types of reactors and fuel facilities. The number of projects in the programme has grown from 42 to 59 over the past five years. The Programme now covers 35 reactor related projects and 24 fuel related projects representing a wide selection of facility types in each category. Also, all phases of decommissioning - from active dismantling to safe store and to completed decommissioning back to 'green field conditions' - are represented. Over the 25 years of experience of the Co-operative Programme on Decommissioning, and in particular through the information exchange and review within the TAG, it has become evident that: - decommissioning can and has been done in a safe, cost-effective and environmentally friendly manner; - the evolution of technologies have demonstrated their effectiveness in performance improvements in all aspects of conducting decommissioning projects; - the upkeep and maintenance of design, construction and operational records can significantly enhance performance through all stages of a decommissioning project; - in the absence of waste disposal facilities, interim waste storage facilities with integrated waste processing facilities can effectively be used to keep all levels of waste streams moving and avoid delays to project schedules; - cleanup of material for recycle and reuse or disposal as conventional waste is cost

  12. Long-term disease-free survival in advanced melanomas treated with nitrosoureas: mechanisms and new perspectives.

    Science.gov (United States)

    Durando, Xavier; Thivat, Emilie; D'Incan, Michel; Sinsard, Anne; Madelmont, Jean-Claude; Chollet, Philippe

    2005-11-15

    Median survival of metastatic malignant melanoma is 6.0 to 7.5 months, with a 5-year survival of approximately 6.0%. Although long-term complete remissions are rare, few reports describe cases after chemotherapy. Fifty-three patients with metastatic melanoma were treated with Cystemustine, a chloroethyl nitrosourea (CENU) (60 or 90 mg/m2). We describe 5 cases, presenting with complete response with long-term disease-free survival of long-term remission of 14, 12, 9, 7 and 6 years after Cystemustine therapy alone. Long-term survival has already been described in literature, but in all cases they have been obtained after chemotherapy associated with or followed by surgery. But despite these noteworthy and encouraging but also rare results, it appears essential to increase Cystemustine efficiency.

  13. Long-term disease-free survival in advanced melanomas treated with nitrosoureas: mechanisms and new perspectives

    Directory of Open Access Journals (Sweden)

    Sinsard Anne

    2005-11-01

    Full Text Available Abstract Background Median survival of metastatic malignant melanoma is 6.0 to 7.5 months, with a 5-year survival of ~6.0%. Although long-term complete remissions are rare, few reports describe cases after chemotherapy. Fifty-three patients with metastatic melanoma were treated with Cystemustine, a chloroethyl nitrosourea (CENU (60 or 90 mg/m2. Case presentation We describe 5 cases, presenting with complete response with long-term disease-free survival of long-term remission of 14, 12, 9, 7 and 6 years after Cystemustine therapy alone. Conclusion Long-term survival has already been described in literature, but in all cases they have been obtained after chemotherapy associated with or followed by surgery. But despite these noteworthy and encouraging but also rare results, it appears essential to increase cystemustine efficiency.

  14. Predicting short-term mortality and long-term survival for hospitalized US patients with alcoholic hepatitis.

    Science.gov (United States)

    Cuthbert, Jennifer A; Arslanlar, Sami; Yepuri, Jay; Montrose, Marc; Ahn, Chul W; Shah, Jessica P

    2014-07-01

    No study has evaluated current scoring systems for their accuracy in predicting short and long-term outcome of alcoholic hepatitis in a US population. We reviewed electronic records for patients with alcoholic liver disease (ALD) admitted to Parkland Memorial Hospital between January 2002 and August 2005. Data and outcomes for 148 of 1,761 admissions meeting pre-defined criteria were collected. The discriminant function (DF) was revised (INRdf) to account for changes in prothrombin time reagents that could potentially affect identification of risk using the previous DF threshold of >32. Admission and theoretical peak scores were calculated by use of the Model for End-stage Liver Disease (MELD). Analysis models compared five different scoring systems. INRdf was closely correlated with the old DF (r (2) = 0.95). Multivariate analysis of the data showed that survival for 28 days was significantly associated with a scoring system using a combination of age, bilirubin, coagulation status, and creatinine (p short-term mortality (p 50 % mortality at four weeks and >80 % mortality at six months without specific treatment.

  15. Long-term survival, prevalence, and cure of cancer: a population-based estimation for 818 902 Italian patients and 26 cancer types

    Science.gov (United States)

    Dal Maso, L.; Guzzinati, S.; Buzzoni, C.; Capocaccia, R.; Serraino, D.; Caldarella, A.; Dei Tos, A. P.; Falcini, F.; Autelitano, M.; Masanotti, G.; Ferretti, S.; Tisano, F.; Tirelli, U.; Crocetti, E.; De Angelis, R.; Virdone, S.; Zucchetto, A.; Gigli, A.; Francisci, S.; Baili, P.; Gatta, G.; Castaing, M.; Zanetti, R.; Contiero, P.; Bidoli, E.; Vercelli, M.; Michiara, M.; Federico, M.; Senatore, G.; Pannozzo, F.; Vicentini, M.; Bulatko, A.; Pirino, D. R.; Gentilini, M.; Fusco, M.; Giacomin, A.; Fanetti, A. C.; Cusimano, R.

    2014-01-01

    Background Persons living after a cancer diagnosis represent 4% of the whole population in high-income countries. The aim of the study was to provide estimates of indicators of long-term survival and cure for 26 cancer types, presently lacking. Patients and methods Data on 818 902 Italian cancer patients diagnosed at age 15–74 years in 1985–2005 were included. Proportions of patients with the same death rates of the general population (cure fractions) and those of prevalent patients who were not at risk of dying as a result of cancer (cure prevalence) were calculated, using validated mixture cure models, by cancer type, sex, and age group. We also estimated complete prevalence, conditional relative survival (CRS), time to reach 5- and 10-year CRS >95%, and proportion of patients living longer than those thresholds. Results The cure fractions ranged from >90% for patients aged cancers to cancers of all ages. Five- or 10-year CRS >95% were both reached in cancers of the stomach, colon–rectum, pancreas, corpus and cervix uteri, brain, and Hodgkin lymphoma. For breast cancer patients, 5- and 10-year CRSs reached >95% after 19 and 25 years, respectively, and in 15 and 18 years for prostate cancer patients. Five-year CRS remained 25 years after cancer diagnosis in patients with liver and larynx cancers, non-Hodgkin lymphoma, myeloma, and leukaemia. Overall, the cure prevalence was 67% for men and 77% for women. Therefore, 21% of male and 31% of female patients had already reached 5-year CRS >95%, whereas 18% and 25% had reached 10-year CRS >95%. Conclusions A quarter of Italian cancer patients can be considered cured. This observation has a high potential impact on health planning, clinical practice, and patients' perspective. PMID:25149707

  16. Error identification in a high-volume clinical chemistry laboratory: Five-year experience.

    Science.gov (United States)

    Jafri, Lena; Khan, Aysha Habib; Ghani, Farooq; Shakeel, Shahid; Raheem, Ahmed; Siddiqui, Imran

    2015-07-01

    Quality indicators for assessing the performance of a laboratory require a systematic and continuous approach in collecting and analyzing data. The aim of this study was to determine the frequency of errors utilizing the quality indicators in a clinical chemistry laboratory and to convert errors to the Sigma scale. Five-year quality indicator data of a clinical chemistry laboratory was evaluated to describe the frequency of errors. An 'error' was defined as a defect during the entire testing process from the time requisition was raised and phlebotomy was done until the result dispatch. An indicator with a Sigma value of 4 was considered good but a process for which the Sigma value was 5 (i.e. 99.977% error-free) was considered well controlled. In the five-year period, a total of 6,792,020 specimens were received in the laboratory. Among a total of 17,631,834 analyses, 15.5% were from within hospital. Total error rate was 0.45% and of all the quality indicators used in this study the average Sigma level was 5.2. Three indicators - visible hemolysis, failure of proficiency testing and delay in stat tests - were below 5 on the Sigma scale and highlight the need to rigorously monitor these processes. Using Six Sigma metrics quality in a clinical laboratory can be monitored more effectively and it can set benchmarks for improving efficiency.

  17. Personality disorder features as predictors of symptoms five years post-treatment.

    Science.gov (United States)

    Jansson, Irene; Hesse, Morten; Fridell, Mats

    2008-01-01

    Personality disorders are associated with dysfunction in a variety of areas. Recent longitudinal research has shown that personality disorders are also predictive of problems later in life, as well as of poor response to treatment of depression and anxiety. This study assessed whether personality disorder features were associated with psychiatric symptoms in a cohort of women treated for substance abuse in Sweden. Patients were diagnosed with personality disorders using the Structured Clinical Interview for DSM-IV (SCID-II) personality questionnaire and SCID-II interview, and were then administered a self-report questionnaire designed to measure symptoms of psychiatric illness, the Symptoms Checklist-90 (SCL-90), during and five years after treatment. Concurrently, features of all personality disorders, except histrionic, were associated with SCL-90 score. At five-year follow-up, most personality disorders remained associated with SCL-90 score, with the exception of paranoid and schizoid personality disorder. After controlling for baseline score on the SCL-90, conduct disorder, borderline personality disorder, and narcissistic personality disorder remained significantly associated with symptoms at follow-up. After controlling for abstinence and baseline score, only borderline personality disorder features remained associated with SCL-90 score at follow-up. Patients with personality disorders should be monitored after treatment for psychiatric symptoms.

  18. Acceptance of family planning methods by induced abortion seekers: An observational study over five years.

    Science.gov (United States)

    Kathpalia, S K

    2016-01-01

    Prior to legalization of abortion, induced abortions were performed in an illegal manner and that resulted in many complications hence abortion was legalized in India in 1971 and the number of induced abortions has been gradually increasing since then. One way of preventing abortions is to provide family planning services to these abortion seekers so that same is not repeated. The study was performed to find out the acceptance of contraception after abortion. A prospective study was performed over a period of five years from 2010 to 2014. The study group included all the cases reporting for abortion. A proforma was filled in detail to find out the type of contraception being used before pregnancy and acceptance of contraception after abortion. The existing facilities were also evaluated. 1228 abortions were performed over a period of five years. 94.5% of abortions were during the first trimester. 39.9% had not used any contraceptive before, contraceptives used were natural and barrier which had high failure. The main indication for seeking abortion was failure of contraception and completion of family. 39.6% of patients accepted sterilization as a method of contraception. The existing post abortion family planning services are inadequate. Post abortion period is one which is important to prevent subsequent abortions and family planning services after abortion need to be strengthened.

  19. Patients' knowledge of Diabetes five years after the end of an educational program

    Directory of Open Access Journals (Sweden)

    Izabel Alves das Chagas

    2013-10-01

    Full Text Available We present a cross-sectional study that aims to describe the sociodemographic and clinical conditions of individuals with diabetes mellitus and to analyze their knowledge of treatment five years after the end of an educational program in which they took part. In 2010, 40 individuals who had participated in a diabetes educational program for 12 months in 2005 at a primary care service were interviewed. A form was used for data collection that included their knowledge of the notion, physiopathology, and treatment of the disease; exercise; nutrition; foot care; self-monitoring of capillary blood glucose at home; hypoglycemia; chronic complications; special situations; and family support. The results showed that the volunteers incorporated the information about the notion, physiopathology, and treatment of the disease; exercise; foot care; self-monitoring; care associated with hypoglycemia; chronic complications; and special situations. In contrast, nutrition and family support require further reinforcement. It is concluded that five years after the end of the educational program, the participants kept most of the information provided.

  20. Five-year trajectories of social networks and social support in older adults with major depression.

    Science.gov (United States)

    Voils, Corrine I; Allaire, Jason C; Olsen, Maren K; Steffens, David C; Hoyle, Rick H; Bosworth, Hayden B

    2007-12-01

    Research with nondepressed adults suggests that social networks and social support are stable over the life course until very late age. This may not hold true for older adults with depression. We examined baseline status and trajectories of social networks and social support at the group and individual levels over five years. The sample consisted of 339 initially depressed adults aged 59 or older (M = 69 years) enrolled in a naturalistic study of depression. Measures of social ties, including social network size, frequency of interaction, instrumental support, and subjective support, were administered at baseline and yearly for five years. Latent growth curve models were estimated for each aspect of social ties. On average, social network size and frequency of interaction were low at baseline and remained stable over time, whereas subjective and instrumental support were high at baseline yet increased over time. There was significant variation in the direction and rate of change over time, which was not predicted by demographic or clinical factors. Because increasing social networks may be ineffective and may not be possible for a portion of people who already receive maximal support, interventions to increase social support may only work for a portion of older depressed adults.

  1. [Epidemiologic behavior of malignant digestive tract tumors over a five year period in Veracruz, Mexico].

    Science.gov (United States)

    Roesch-Dietlen, F; Jiménez-García, V A; Remes-Troche, J M; Rubio-Arce, J F; López-Salinas, A; Ruiz-Juárez, I; Grube-Pagola, P; Silva-Cañetas, C F

    2012-01-01

    Tumors of the digestive system are considered to be a public health problem because of their elevated mortality rate. In Mexico, gastric cancer and colon cancer rank fourth and fifth, respectively, following tracheal, bronchial, and lung cancer, and there has been an increase in their frequency in the last few years. However, there are no specific studies that have evaluated their epidemiologic behavior in Veracruz. To determine the frequency of digestive system cancer in five health institutions in the city of Veracruz and to describe its epidemiologic behavior over a five-year period. Annual statistics from the following hospitals were reviewed: the Instituto Mexicano del Seguro Social, the Secretaría de Salud, the Instituto de Seguridad y Servicios Sociales de los Trabajadores del Estado, Petróleos Mexicanos, and the Secretaría de la Defensa Nacional within the time frame of January 2005 to December 2009. Diagnoses based on histopathology were recorded, along with patient age and sex. A total of 1803 cases of digestive tract cancers were detected: 52% were men and 48% were women. A yearly increase in the number of cases was observed with colon cancer being in first place, followed by stomach cancer and rectal cancer. The increase in digestive system cancer cases over the last five years in Veracruz underlines the need to evaluate the implementation of screening programs for the at-risk population and to study the different etiologic factors involved in its manifestation.

  2. Five-year trends of selected halogenated flame retardants in the atmosphere of Northeast China

    Energy Technology Data Exchange (ETDEWEB)

    Li, Wen-Long; Liu, Li-Yan; Song, Wei-Wei; Zhang, Zi-Feng; Qiao, Li-Na [International Joint Research Center for Persistent Toxic Substances (IJRC-PTS), State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin 150090 (China); Ma, Wan-Li, E-mail: mawanli002@163.com [International Joint Research Center for Persistent Toxic Substances (IJRC-PTS), State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin 150090 (China); Li, Yi-Fan, E-mail: ijrc_pts_paper@yahoo.com [International Joint Research Center for Persistent Toxic Substances (IJRC-PTS), State Key Laboratory of Urban Water Resource and Environment, Harbin Institute of Technology, Harbin 150090 (China); IJRC-PTS-NA, Toronto M2N 6X9 (Canada)

    2016-01-01

    This study collected 227 pairs of gas phase and particle phase air samples in a typical urban city of Northeast China from 2008 to 2013. Four alternative halogenated flame retardants for polybrominated diphenyl ethers (PBDEs) were analyzed, namely 2-ethylhexyl 2,3,4,5-tetrabromobenzoate (EHTBB), bis (2-ethylhexyl) tetrabromophthalate (BEHTBP), syn-dechlorane plus (syn-DP) and anti-dechlorane plus (anti-DP). The average concentrations for EHTBB and BEHTBP were 5.2 ± 20 and 30 ± 200 pg/m{sup 3}, respectively, while for syn-DP and anti-DP were 1.9 ± 5.1 and 5.8 ± 18 pg/m{sup 3}, respectively. Generally, they were frequently detected in the particle phase, and the gas/particle partitioning suggested they were the maximum partition chemicals. The fractional abundance of EHTBB (f{sub EHTBB}) and syn-DP (f{sub syn}) were comparable with those in other studies. Strong local sources were identified based on the air parcel backward trajectories and the potential source contribution function. The concentrations of these chemicals were significantly increased during this sampling campaign, possibly suggesting their increasing usages from 2008 to 2013 in China. - Highlights: • Five-year air samples were analyzed for four alternative HFRs. • BEHTBP and DP were frequently detected in the particle phase. • Local and nearby city sources of these HFRs were suggested. • Concentrations of these HFRs were significantly increased in the five-year period.

  3. Anisotropies in the cosmic neutrino background after Wilkinson Microwave Anisotropy Probe five-year data

    International Nuclear Information System (INIS)

    De Bernardis, Francesco; Pagano, Luca; Melchiorri, Alessandro; Serra, Paolo; Cooray, Asantha

    2008-01-01

    We search for the presence of cosmological neutrino background (CNB) anisotropies in recent Wilkinson Microwave Anisotropy Probe (WMAP) five-year data using their signature imprinted on modifications to the cosmic microwave background (CMB) anisotropy power spectrum. By parameterizing the neutrino background anisotropies with the speed viscosity parameter c vis , we find that the WMAP five-year data alone provide only a weak indication for CNB anisotropies with c vis 2 >0.06 at the 95% confidence level. When we combine CMB anisotropy data with measurements of galaxy clustering, the SN-Ia Hubble diagram, and other cosmological information, the detection increases to c vis 2 >0.16 at the same 95% confidence level. Future data from Planck, combined with a weak lensing survey such as the one expected with DUNE from space, will be able to measure the CNB anisotropy parameter at about 10% accuracy. We discuss the degeneracy between neutrino background anisotropies and other cosmological parameters such as the number of effective neutrinos species and the dark energy equation of state

  4. Five years of monitoring bird strike potential at a mountain-top wind turbine, Yukon Territory

    Energy Technology Data Exchange (ETDEWEB)

    Mossop, D.H. [Yukon College, Whitehorse, YT (Canada)

    1997-12-31

    A five-year study was conducted to determine if birds were at risk of collision with an experimental wind turbine on a 1,500 metre mountain near the major Shakwak migration corridor used by many thousands of birds. More than 100 ground searches at the turbine site and about 80 hours of migration watch were conducted. In five years, six birds hit the control tower, none hit the turbine tower. All strikes were in winter and none of the birds killed were in migration. Waterfowl were found to navigate in the valley centre about 1,000 feet below the turbine. Small birds were rarely found at the altitude where the turbine was located. Raptors were the most common birds found near the site, but they were able to avoid the tower. It was concluded that birds using the migration corridor near Whitehorse were not at great risk of collision with towers above 1,200 metre altitude. 7 refs., 3 tabs., 6 figs.

  5. Five years' experience of classical swine fever polymerase chain reaction ring trials in France.

    Science.gov (United States)

    Po, F; Le Dimna, M; Le Potier, M F

    2011-12-01

    Since 2004, the French National Reference Laboratory for classical swine fever (CSF) has conducted an annual proficiency test (PT) to evaluate the ability of local veterinary laboratories to perform real-time polymerase chain reaction (PCR) for CSF virus. The results of five years of testing (2004-2008) are described here. The PT was conducted under blind conditions on 20 samples. The same batch of samples was used for all five years. The number of laboratories that analysed the samples increased from four in 2004 to 13 in 2008. The results of the PT showed the following: cross-contamination between samples and deficiencies in RNA preparation can occur even in experienced laboratories; sample homogeneity should be checked carefully before selection; samples stored at-80 degrees C for several years remain stable; and poor shipment conditions do not damage the samples with regard to detection of CSF virus genome. These results will enable redesign of the panel to improve the overall quality of the PT, which will encourage laboratories to check and improve their PCR procedures and expertise. This is an excellent way to determine laboratory performance.

  6. In vivo studies of the long-term 51Cr red cell survival of serologically incompatible red cell units

    International Nuclear Information System (INIS)

    Baldwin, M.L.; Ness, P.M.; Barrasso, C.; Kickler, T.S.; Drew, H.; Tsan, M.F.; Shirey, R.S.

    1985-01-01

    The long-term survival of serologically incompatible red cell units was measured in five patients with antibodies to high-frequency antigens. Initially, the survival of 1 ml of 51 Cr-labeled incompatible red cells was measured over 1 hour. After demonstrating that the 1-hour survival times were successful (greater than 70%), each patient then received 5 ml of the same 51 Cr-labeled red cells followed by the transfusion of the remainder of the red cell unit. The long-term T 1/2Cr survival for each case was patient 1 (anti-McCa), 15 days; patient 2 (anti-JMH), 12 days; patient 3 (anti-Kna), 31 days; patient 4 (anti-McCa), 12 days; and patient 5 (anti-Hya), 14 days. Each antibody tested in an in vitro homologous macrophage assay showed less than 5 percent phagocytosis. Anti-JMH was the only antibody to react with IgG subclass antisera and was determined to be IgG4. The macrophage assay, IgG subclass testing, and short-term (1 hour, 1 ml) 51 Cr survival studies all indicated that the short-term survival was good. However, only the measurement of long-term survival with transfused units of serologically incompatible red cells was able to determine the actual survival, and clinical significance of the alloantibodies. Determining the actual long-term survival by the method described here can be of importance for patients requiring chronic red cell transfusion

  7. Pathologic complete response predicts long-term survival following preoperative radiation therapy for rectal cancer

    International Nuclear Information System (INIS)

    Ahmad, Neelofur R.; Nagle, Deborah A.; Topham, Allan

    1997-01-01

    Purpose: The finding of a pathologic complete response (pCR) after preoperative radiation therapy (RT) for rectal cancer is frequently used as a surrogate endpoint for treatment outcome. In most reported series, the pCR rate ranges from 10 to 25%. An underlying assumption is that pCR relates to favorable long-term patient outcome; however, such results are rarely reported. The purpose of this study was to determine the long-term outcome of patients having pCR's following preoperative RT and surgery for rectal cancer. Materials and Methods: Between 1978 and 1993, 49 of 315 patients (16%) were found to have pCR's following 40 to 65 Gy of preoperative RT for rectal cancer (median RT dose 55.8 Gy). Six complete responders also received concurrent 5-FU chemotherapy with RT. Follow-up time ranged from 7 to 224 months (median 52 months). Actuarial overall survival (OS), disease-free survival (DFS), and local control (LC) rates were calculated. Patient outcome was analyzed with respect to pretreatment clinical stage (mobile vs. tethered/fixed on digital exam), tumor level in the rectum as measured from the anorectal ring (0-3 cm vs. >3 cm), type of surgery (local excision, APR, or other), and use of concurrent chemotherapy vs. RT alone. Results: Prior to treatment, clinical stage tumor stage was 43% mobile ((21(49))) and 35% tethered/fixed ((17(49))). Twenty-two percent ((11(49))) did not have palpable tumor at presentation to our institution due to prior local excision of an invasive cancer. Tumor level in the rectum was 74% 0-3 cm, 16% >3 to 6 cm, and 10% > 6 cm. Surgical procedures were 12% APR, 24% LAR, 6% combined abdominal transsacral resection (CATS), 27% coloanal anastamosis, and 31% full thickness local excision. Overall, 2 of 49 patients (4%) developed a local tumor recurrence, and 4 of 49 (8%) developed distant metastases. The overall 5- and 10-year actuarial survival rates were 91% and 86%, respectively. The 5- and 10-year actuarial DFS rate was 85%, and the

  8. Short-term azithromycin treatment promotes cornea allograft survival in the rat.

    Science.gov (United States)

    Wacker, Katrin; Denker, Sophy; Hildebrand, Antonia; Eberwein, Philipp; Reinhard, Thomas; Schwartzkopff, Johannes

    2013-01-01

    Any inflammatory response following corneal transplantation may induce rejection and irreversible graft failure. The purpose of this study is to analyze the anti-inflammatory effect of azithromycin (AZM) following experimental keratoplasty in rats. Corneal transplants were performed between Fisher-donor and Lewis-recipient rats. Recipients were postoperatively treated three times daily with AZM, miglyol, ofloxacin or dexamethasone eye drops. As an additional control, AZM was applied following syngeneic keratoplasty. Furthermore, short-term treatments with AZM for seven days perioperatively or with AZM only three days prior to the transplantation were compared to appropriate controls. All transplants were monitored clinically for opacity, edema, and vascularization. Infiltrating CD45(+), CD4(+), CD8(+), CD25(+), CD161(+) and CD163(+) cells were quantified via immunohistochemistry. AZM significantly promoted corneal graft survival compared with miglyol or ofloxacin treatment. This effect was comparable to topical dexamethasone. No adverse AZM effect was observed. Histology confirmed a significant reduction of infiltrating leukocytes. The short-term application of AZM for three days prior to transplantation or for seven days perioperatively reduced corneal graft rejection significantly compared with the controls. Along with antibiotic properties, topical AZM has a strong anti-inflammatory effect. Following keratoplasty, this effect is comparable to topical dexamethasone without the risk of steroid-induced adverse effects. Short-term treatment with AZM three days prior to the transplantation was sufficient to promote graft survival in the rat keratoplasty model. We therefore suggest further assessing the anti-inflammatory function of topical AZM following keratoplasty in humans.

  9. Short-term azithromycin treatment promotes cornea allograft survival in the rat.

    Directory of Open Access Journals (Sweden)

    Katrin Wacker

    Full Text Available Any inflammatory response following corneal transplantation may induce rejection and irreversible graft failure. The purpose of this study is to analyze the anti-inflammatory effect of azithromycin (AZM following experimental keratoplasty in rats.Corneal transplants were performed between Fisher-donor and Lewis-recipient rats. Recipients were postoperatively treated three times daily with AZM, miglyol, ofloxacin or dexamethasone eye drops. As an additional control, AZM was applied following syngeneic keratoplasty. Furthermore, short-term treatments with AZM for seven days perioperatively or with AZM only three days prior to the transplantation were compared to appropriate controls. All transplants were monitored clinically for opacity, edema, and vascularization. Infiltrating CD45(+, CD4(+, CD8(+, CD25(+, CD161(+ and CD163(+ cells were quantified via immunohistochemistry.AZM significantly promoted corneal graft survival compared with miglyol or ofloxacin treatment. This effect was comparable to topical dexamethasone. No adverse AZM effect was observed. Histology confirmed a significant reduction of infiltrating leukocytes. The short-term application of AZM for three days prior to transplantation or for seven days perioperatively reduced corneal graft rejection significantly compared with the controls.Along with antibiotic properties, topical AZM has a strong anti-inflammatory effect. Following keratoplasty, this effect is comparable to topical dexamethasone without the risk of steroid-induced adverse effects. Short-term treatment with AZM three days prior to the transplantation was sufficient to promote graft survival in the rat keratoplasty model. We therefore suggest further assessing the anti-inflammatory function of topical AZM following keratoplasty in humans.

  10. Effect of BRCA1/2 mutation on short-term and long-term breast cancer survival: a systematic review and meta-analysis.

    Science.gov (United States)

    Lee, Eun-Ha; Park, Sue K; Park, Boyoung; Kim, Sung-Won; Lee, Min Hyuk; Ahn, Sei Hyun; Son, Byung Ho; Yoo, Keun-Young; Kang, Daehee

    2010-07-01

    Reports of BRCA genetic mutations and risk of death or recurrence are inconsistent. This study aimed to compare overall and disease-free breast cancer survival rates between BRCA1/2 mutation carriers and non-carriers for short-term and long-term outcomes separately. We searched the PUBMED and EMBASE databases and retrieved 452 articles using keywords that included breast cancer, BRCA mutation, and survival. Seventeen articles were selected for systematic review and among them 11 were included in our meta-analysis. We used the random-effects model to calculate the summary hazard ratio and corresponding 95% confidence interval. BRCA1 mutation carriers had significantly lower short-term and long-term overall survival rates (OSR) relative to non-carriers (HR = 1.92 [95% CI = 1.45-2.53]; 1.33 [1.12-1.58], respectively), while both short-term and long-term OSR of BRCA2 carriers did not differ from non-carriers (HR = 1.30 [95% CI = 0.95-1.76]; 1.12 [95% CI = 0.86-1.45], respectively). For short-term progression-free survival rate (PFSR), BRCA1 mutation carriers had a significantly lower rate than non-carriers (HR = 1.54 [95% CI = 1.12-2.12]), while BRCA2 mutation carriers had a similar PFSR (HR = 1.23 [95% CI = 0.96-1.58]). For long-term PFSRs, we found no significant results. Our results suggest that BRCA1 mutation decreases short-term and long-term OSRs and short-term PFSR, however, BRCA2 mutation does not affect either short-term or long-term survival rate, which is attributed to the different carcinogenic pathways for BRCA1 and BRCA2.

  11. Long-Term Survival of Individuals Born Small and Large for Gestational Age.

    Directory of Open Access Journals (Sweden)

    E Christina M Wennerström

    Full Text Available Little is known on long-term survival and causes of death among individuals born small or large for gestational age. This study investigates birth weight in relation to survival and causes of death over time.A national cohort of 1.7 million live-born singletons in Denmark was followed during 1979-2011, using the Danish Civil Registration System, the Medical Birth Registry and the Cause of Death Registry. Cox proportional hazards were estimated for the impact of small (SGA and large (LGA gestation weight and mortality overall, by age group and birth cohort.Compared to normal weight children, SGA children were associated with increased risk of dying over time. Though most of the deaths occurred during the first year of life, the cumulative mortality risk was increased until 30 years of age. The hazard ratios [HR] for dying among SGA children ages <2 years were: 3.47 (95% CI, 3.30-3.64 and 1.06 (95% CI, 0.60-1.87 in 30 years and older. HR for dying among SGA adults (20-29 years were: 1.20 (95% CI, 0.99-1.46 in years 1979-1982 and 1.61 (95% CI, 1.04-2.51 in years 1989-1994. The SGA born had increased risk of dying from infection, heart disease, respiratory disease, digestive disease, congenital malformation, perinatal conditions, and accidents, suicide, and homicide. Individuals born LGA were associated with decreased mortality risk, but with increased risk of dying from malignant neoplasm.Survival has improved independently of birth weight the past 30 years. However, children born SGA remain at significantly increased risk of dying up till they turn 30 years of age. Individuals born LGA have lower mortality risk but only in the first two years of life.

  12. Traditional Chinese medicine as adjunctive therapy improves the long-term survival of lung cancer patients.

    Science.gov (United States)

    Liao, Yueh-Hsiang; Li, Chia-Ing; Lin, Cheng-Chieh; Lin, Jaung-Geng; Chiang, Jen-Huai; Li, Tsai-Chung

    2017-12-01

    Traditional Chinese medicine is one of the popular alternative treatments for cancer, mainly enhancing host immune response and reducing adverse effect of chemotherapy. This study first explored traditional Chinese medicine treatment effect on long-term survival of lung cancer patients. This study evaluated whether traditional Chinese medicine combined with conventional cancer treatment improved overall survival of lung cancer patients. We had conducted a retrospective cohort study on 111,564 newly diagnosed lung cancer patients in 2000-2009 from National Health Insurance Program database. A total of 23,803 (21.31%) patients used traditional Chinese medicine for lung cancer care. Eligible participants were followed up until 2011 with a mean follow-up period of 1.96 years (standard deviation 2.55) for non-TCM users and 3.04 years (2.85) for traditional Chinese medicine users. Patients with traditional Chinese medicine utilization were significantly more likely to have a 32% decreased risk of death [hazard ratio = 0.62; 95% confidence interval = 0.61-0.63], compared with patients without traditional Chinese medicine utilization after multivariate adjustment. We also observed a similar significant reduction risk across various subgroups of chronic lung diseases. Qing Zao Jiu Fei Tang was the most effective traditional Chinese medicine agent for mortality reduction both in the entire lung cancer (0.81; 0.72-0.91) and matched populations (0.86; 0.78-0.95). This study demonstrated adjunctive therapy with traditional Chinese medicine may improve overall survival of lung cancer patients. This study also suggested traditional Chinese medicine may be used as an adjunctive therapy for cancer treatment. These observational findings need being validated by future randomized controlled trials to rule out the possibility of effect due to holistic care.

  13. Long-term survival of hydrated resting eggs from Brachionus plicatilis.

    Science.gov (United States)

    Clark, Melody S; Denekamp, Nadav Y; Thorne, Michael A S; Reinhardt, Richard; Drungowski, Mario; Albrecht, Marcus W; Klages, Sven; Beck, Alfred; Kube, Michael; Lubzens, Esther

    2012-01-01

    Several organisms display dormancy and developmental arrest at embryonic stages. Long-term survival in the dormant form is usually associated with desiccation, orthodox plant seeds and Artemia cysts being well documented examples. Several aquatic invertebrates display dormancy during embryonic development and survive for tens or even hundreds of years in a hydrated form, raising the question of whether survival in the non-desiccated form of embryonic development depends on pathways similar to those occurring in desiccation tolerant forms. To address this question, Illumina short read sequencing was used to generate transcription profiles from the resting and amictic eggs of an aquatic invertebrate, the rotifer, Brachionus plicatilis. These two types of egg have very different life histories, with the dormant or diapausing resting eggs, the result of the sexual cycle and amictic eggs, the non-dormant products of the asexual cycle. Significant transcriptional differences were found between the two types of egg, with amictic eggs rich in genes involved in the morphological development into a juvenile rotifer. In contrast, representatives of classical "stress" proteins: a small heat shock protein, ferritin and Late Embryogenesis Abundant (LEA) proteins were identified in resting eggs. More importantly however, was the identification of transcripts for messenger ribonucleoprotein particles which stabilise RNA. These inhibit translation and provide a valuable source of useful RNAs which can be rapidly activated on the exit from dormancy. Apoptotic genes were also present. Although apoptosis is inconsistent with maintenance of prolonged dormancy, an altered apoptotic pathway has been proposed for Artemia, and this may be the case with the rotifer. These data represent the first transcriptional profiling of molecular processes associated with dormancy in a non-desiccated form and indicate important similarities in the molecular pathways activated in resting eggs compared

  14. Long-term survival of hydrated resting eggs from Brachionus plicatilis.

    Directory of Open Access Journals (Sweden)

    Melody S Clark

    Full Text Available Several organisms display dormancy and developmental arrest at embryonic stages. Long-term survival in the dormant form is usually associated with desiccation, orthodox plant seeds and Artemia cysts being well documented examples. Several aquatic invertebrates display dormancy during embryonic development and survive for tens or even hundreds of years in a hydrated form, raising the question of whether survival in the non-desiccated form of embryonic development depends on pathways similar to those occurring in desiccation tolerant forms.To address this question, Illumina short read sequencing was used to generate transcription profiles from the resting and amictic eggs of an aquatic invertebrate, the rotifer, Brachionus plicatilis. These two types of egg have very different life histories, with the dormant or diapausing resting eggs, the result of the sexual cycle and amictic eggs, the non-dormant products of the asexual cycle. Significant transcriptional differences were found between the two types of egg, with amictic eggs rich in genes involved in the morphological development into a juvenile rotifer. In contrast, representatives of classical "stress" proteins: a small heat shock protein, ferritin and Late Embryogenesis Abundant (LEA proteins were identified in resting eggs. More importantly however, was the identification of transcripts for messenger ribonucleoprotein particles which stabilise RNA. These inhibit translation and provide a valuable source of useful RNAs which can be rapidly activated on the exit from dormancy. Apoptotic genes were also present. Although apoptosis is inconsistent with maintenance of prolonged dormancy, an altered apoptotic pathway has been proposed for Artemia, and this may be the case with the rotifer.These data represent the first transcriptional profiling of molecular processes associated with dormancy in a non-desiccated form and indicate important similarities in the molecular pathways activated in

  15. Association of perioperative blood pressure with long-term survival in rectal cancer patients.

    Science.gov (United States)

    Yu, Hui-Chuan; Luo, Yan-Xin; Peng, Hui; Wang, Xiao-Lin; Yang, Zi-Huan; Huang, Mei-Jin; Kang, Liang; Wang, Lei; Wang, Jian-Ping

    2016-04-11

    Several studies suggested that hypertension is positively related to cancer incidence and mortality. In this study, we investigated the association between perioperative blood pressure (BP) and long-term survival outcomes in patients with rectal cancer. This study included a cohort of 358 patients with stages I-III rectal cancer who underwent a curative resection between June 2007 and June 2011. Both pre- and postoperative BPs were measured, by which patients were grouped (low BP: cancer-specific survival (CSS). Univariate analysis showed that patients with high preoperative systolic BP had lower 3-year DFS (67.2% vs. 82.1%, P = 0.041) and CSS rates (81.9% vs. 94.8%, P = 0.003) than patients with low preoperative systolic BP, and the associations remained significant in the Cox multivariate analysis, with the adjusted hazard ratios equal to 1.97 [95% confidence interval (CI) = 1.08-3.60, P = 0.028] and 2.85 (95% CI = 1.00-8.25, P = 0.050), respectively. Similarly, in postoperative evaluation, patients with high systolic BP had significantly lower 3-year CSS rates than those with low systolic BP (78.3% vs. 88.9%, P = 0.032) in univariate analysis. Moreover, high pre- and/or postoperative systolic BP presented as risk factors for CSS in the subgroups of patients who did not have a history of hypertension, with and/or without perioperative administration of antihypertensive drugs. High preoperative systolic BP was an independent risk factor for both CSS and DFS rates, and high postoperative systolic BP was significantly associated with a low CSS rate in rectal cancer patients. Additionally, our results suggest that rectal cancer patients may get survival benefit from BP control in perioperative care. However, further studies should be conducted to determine the association between BP and CSS and targets of BP control.

  16. Five-year mortality after acute poisoning treated in ambulances, an emergency outpatient clinic and hospitals in Oslo.

    Science.gov (United States)

    Lund, Cathrine; Bjornaas, Mari A; Sandvik, Leiv; Ekeberg, Oivind; Jacobsen, Dag; Hovda, Knut E

    2013-08-21

    The long-term mortality after prehospital treatment for acute poisoning has not been studied previously. Thus, we aimed to estimate the five-year mortality and examine the causes of death and predictors of death for all acutely poisoned patients treated in ambulances, the emergency outpatient clinic, and hospitals in Oslo during 2003-2004. A prospective cohort study included all adults (≥16 years; n=2045, median age=35 years, male=58%) who were discharged after treatment for acute poisoning in ambulances, the emergency outpatient clinic, and the four hospitals in Oslo during one year. The patients were observed until the end of 2008. Standardized mortality rates (SMRs) were calculated and multivariate Cox regression analysis was applied. The study comprised 2045 patients; 686 treated in ambulances, 646 treated in the outpatient clinic, and 713 treated in hospitals. After five years, 285 (14%) patients had died (four within one week). The SMRs after ambulance, outpatient, and hospital treatment were 12 (CI 9-14), 10 (CI 8-12), and 6 (CI 5-7), respectively. The overall SMR was 9 (CI 8-10), while the SMR after opioid poisoning was 27 (CI 21-32). The most frequent cause of death was accidents (38%). In the regression analysis, opioids as the main toxic agents (HR 2.3, CI 1.6-3.0), older age (HR 1.6, CI 1.5-1.7), and male sex (HR 1.4, CI 1.1-1.9) predicted death, whereas the treatment level did not predict death. The patients had high mortality compared with the general population. Those treated in hospital had the lowest mortality. Opioids were the major predictor of death.

  17. Five years of Project META - An all-sky narrow-band radio search for extraterrestrial signals

    Science.gov (United States)

    Horowitz, Paul; Sagan, Carl

    1993-01-01

    We have conducted a five-year search of the northern sky (delta between 30 and 60 deg) for narrow-band radio signals near the 1420 MHz line of neutral hydrogen, and its second harmonic, using an 8.4 x 10 exp 6 channel Fourier spectrometer of 0.05 Hz resolution and 400 kHz instantaneous bandwidth. The observing frequency was corrected both for motions with respect to three astronomical inertial frames, and for the effect of Earth's rotation, which provides a characteristic changing Doppler signature for narrow-band signals of extraterrestrial origin. Among the 6 x 10 exp 13 spectral channels searched, we have found 37 candidate events exceeding the average detection threshold of 1.7 x 10 exp -23 W/sq m, none of which was detected upon reobservation. The strongest of these appear to be dominated by rare processor errors. However, the strongest signals that survive culling for terrestrial interference lie in or near the Galactic plane. We describe the search and candidate events, and set limits on the prevalence of supercivilizations transmitting Doppler-precompensated beacons at H I or its second harmonic. We conclude with recommendations for future searches, based upon these findings, and a description of our next-generation search system.

  18. Ecological Responses to Five Years of Experimental Nitrogen Application in an Upland Jack-pine Stand

    Science.gov (United States)

    Melaschenko, N.; Berryman, S.; Straker, J.; Berg, K.; McDonough, A.; Watmough, S. A.

    2016-12-01

    A five-year experimental study was conducted to evaluate the response of an upland jack-pine (Pinus banksiana) forest to elevated levels of nitrogen (N) deposition in Northern Alberta. N deposition in the region is expected to increase with industrial expansion of oil sands activity, and there is regional interest to set N critical loads for sensitive ecosystems. In this study, N was applied as NH4NO3 above a jack-pine canopy via helicopter, annually for five years (2010-2015) at dosages equivalent to 5, 10, 15, 20 and 25 kg N ha-1 yr-1. Approximately 35% of the applied N was retained in the canopy while 65% reached understory vegetation dominated by lichens and mosses. We measured a significant increase in tissue N concentrations of common ground lichens (Cladonia mitis and C. stellaris) and ground moss (Pleurozium schreberi) as well as epiphytic lichens (Hypogymnia physodes and Evernia mesomorpha). On an annual basis, the applied N was primarily captured in the lichen and moss understory, dominated by C. mitis. In the highest treatments, N concentrations in C. mitis were 1.5-2.5 times greater than pre-treatment values. Peak N concentrations in the ground moss Pleurozium schreberi (1.4%) indicate that a threshold of N saturation was reached by year 3. We observed no changes in community composition of vascular and non-vascular plants, or changes in vascular plant tissue N. Chlorophyll levels in C. mitis increased with N treatment, but there was no indication of toxicity or changes to decomposition and growth. After five years of N application, only Peltigera polydactylon, a ground cyanolichen, appeared to be negatively impacted where the thalli showed necrosis at deposition loads >10kg N ha-1 yr-1. No changes to biomass or N ecosystem processes were observed. Based on these observations, we provide evidence that the first adverse ecological effects of N deposition in jack-pine stands occurred at deposition rates of 10 kg N ha-1 yr-1.

  19. Permanent vascular access survival in children on long-term chronic hemodialysis.

    Science.gov (United States)

    Briones, Liliana; Diaz Moreno, Alexia; Sierre, Sergio; Lopez, Laura; Lipsich, José; Adragna, Marta

    2010-09-01

    The aim of this study is to report a single-center experience regarding the management and outcome of permanent vascular accesses (VA) in children on chronic hemodialysis (HD). We analyzed the survival of permanent VA in 79 pediatric patients with end-stage renal disease patients on chronic HD between January 2000 and December 2008. One hundred and thirty-seven VA [89 native fistulas (AVFs) and 48 grafts (AVGs)] were created in 79 children. The creation of AVFs was significantly more frequent in children weighing >25 kg and AVGs in children weighing <25 kg (p = 0.003). The 1-year primary patency rate was 50% for AVF and 30% for AVG. The secondary patency rates at 1, 2, and 3 years for AVFs were 73, 50, and 20% and for AVGs were 64, 36, and 20%, respectively. The total number of surgical and endovascular interventions was significantly higher in AVGs (p term HD access in pediatrics. Surveillance and radiologic procedures are necessary for early detection and treatment of access complications in order to extend access survival.

  20. Colorectal cancer patients in a tertiary referral centre in Malaysia: a five year follow-up review.

    Science.gov (United States)

    Rashid, Mohd Radzniwan A; Aziz, Aznida Firzah Abdul; Ahmad, Saharuddin; Shah, Shamsul Azhar; Sagap, Ismail

    2009-01-01

    Colorectal cancer (CRC) is one of the major malignancies in the world. In Malaysia, CRC is fast becoming the commonest cause of cancer death. Its etiology is complex, involving both environmental and genetic factors. This study looked at the profile and outcome of five-year follow-up of patients with CRC. Retrospective case review study done on CRC patients at University Kebangsaan Malaysia Medical Centre (UKMMC), Kuala Lumpur, Malaysia. Patientsandapos; socio-demographic characteristics, modalities of treatment, cancer characteristics and outcome at 5-year follow up were extracted from the case records. A total of 107 case records of patients were analyzed. Peak age of CRC presentation was 40-69 years (71.1%). Male to female ratio was 1.2:1 with Chinese predominance (52.3%). Anaemia and its related symptoms including per rectal bleeding was the commonest clinical presentation. The median duration of clinical presentation was 13 weeks (IQR 21.8). More than two-thirds presented as non-emergency cases (69.2%). Most patients presented with Dukes C stage (40.2%). The overall 5-year survival rate was 40% with local recurrence rate of 19.6%. Metastasis after curative-intend treatment (surgery with adjuvant therapy) developed in 26% of patients. Lower recurrence (p = 0.016, OR = 0.205) and metastatic disease (p = 0.02, OR = 0.24) found among the Chinese patients. Almost half of the patients defaulted follow up care (43%), most often within the first year of treatment (22.4%) and the Chinese were the least likely to default (p= 0.04, OR = 0.45). Socio-demographic profile of CRC patients in UKMMC is comparable to Asia pacific region. Apparent delay in seeking treatment gives rise to poor overall survival and local recurrence rates.

  1. Follow up assessment of very preterm infants at five years of age

    NARCIS (Netherlands)

    Kleine, Martin de

    2005-01-01

    Simultaneous with the improved survival of very preterm and low birth weight infants, the awareness increased that not all survive without sequelae. Mild developmental disturbances that interfere with the acquisition of everyday skills and normal learning appeared to be very frequent and were not

  2. Risk Factors for Suicide Ideation Among Adolescents: Five-Year National Data Analysis.

    Science.gov (United States)

    Im, Yeojin; Oh, Won-Oak; Suk, Minhyun

    2017-06-01

    This study identified risk factors for suicide ideation among adolescents through a secondary analysis using data collected over five years from the 5th-9th Korea Youth Risk Behavior Survey. We analyzed 370,568 students' responses to questions about suicidality. The risk factors for suicide ideation included demographic characteristics, such as gender (girls), low grades, low economic status, and not living with one or both parents. Behavioral and mental health risk factors affecting suicide ideation were depression, low sleep satisfaction, high stress, alcohol consumption, smoking, and sexual activity. Health care providers should particularly target adolescents manifesting the above risk factors when developing suicide prevention programs for them. Copyright © 2017 Elsevier Inc. All rights reserved.

  3. Twenty-five years of the common market in coal, 1953--1978. [genesis and growth

    Energy Technology Data Exchange (ETDEWEB)

    1978-01-01

    Twenty-five years have passed since the European Coal and Steel commmunity was established. An attempt is made to show what economic integration is, what problems have arisen, and how the community has tried to overcome them. Three phases can be distinguished during the period under review--a first phase of growth in the coal industry between 1953 and 1957; a second phase marked by a plentiful supply of cheap hydrocarbons and a rapid reduction in coal output despite exceptional growth, linked with a parallel increase in overall energy requirements; and a third phase from 1973, marked by sharp price increases by the oil producing countries with repercussions on the world market in coal.

  4. Wood mouse and box turtle populations in an area treated annually with DDT for five years

    Science.gov (United States)

    Stickel, L.F.

    1951-01-01

    A 117-acre area of dense woodland on the Patuxent Research Refuge received an aerial application of DDT in oil at the rate of 2 pounds per acre gnnually for five years. DDT reached ground level in a much smaller amount (thousandths to hundredths of a pound per acre). Treatment was made during the first week of June of each year from 1945 through 1949. Field studies of the wood mouse population in DDT and check areas showed no significant differences in the two areas before and after the 1949 DDT treatment. There was no significant difference between trapping samples taken in DDT and check areas in 1945 and those taken in 1949. Field studies of the box turtles in DDT and check areas in 1945 and 1949 showed no significant difference in population size. Growth of the four young turtles taken in the DDT area in both 1945 and 1949 appeared to be normal in comparison with growth of check area turtles.

  5. Five years on the bumpy road delivering well chemicals for zero harmful discharge

    Energy Technology Data Exchange (ETDEWEB)

    Selle, Olav M.; Paltiel, Sten; Saeten, Jens O.; Nasvik, Haavard

    2006-03-15

    This is a summary of five years development work to qualify environmentally acceptable well chemicals for Heidrun. We will describe the situation as we started the work, what strategy we followed and the ups and downs we experienced as we went along. The focus is on scale inhibitors, scale dissolvers, acid formulations, viscosified fluids and chemicals for zonal isolation/shut-off purposes. The challenge has been to develop biodegradable and low toxic chemicals with equal or better effectiveness and with a reasonable prize compare to {sup b}est in class{sup -}products. The impact this has provided for zero harmful discharge to sea at Haltenbanken will be presented, to show the status as we are entering into year 2005. (Author)

  6. A Chinese-style energy transition: the new five-year plan for energy

    International Nuclear Information System (INIS)

    Cornot-Gandolphe, Sylvie

    2013-01-01

    After having recalled the six major problems identified by Chinese leaders as they assessed the past evolution of the energy market (constraints on resources, environmental and ecologic degradations due to intensive consumption, an energy efficiency to be improved, an inadequate energy infrastructure, a weak capacity of the energy industry for technological innovation, and required deeper and quicker reforms of the energy market), the author presents and comments the content of the last five-year plan for energy (some data are provided in appendix). The addressed issues are: energy consumption revised downwards and controlled, definition of ambitious objectives for the transformation of the electric system (for the coal sector, the gas sector, the oil sector, electricity production, production location and international cooperation)

  7. Behind the shine: An appraisal of five years of Danish CCTV trials

    DEFF Research Database (Denmark)

    Ulrich, Clara; Dalskov, Jørgen; Egekvist, Josefine

    2014-01-01

    Denmark has been the first nation in Europe to promote the use of Fully Documented Fisheries (FDF) through Remote Electronic Monitoring (REM) and CCTV camera systems, and some pilot schemes for monitoring cod catches have been in place since 2008. In theory, such a scheme could supplement and even...... potentially replace expensive control and monitoring programs; and, when associated to a Catch Quota management system, incentivize positive changes in fishing patterns in a results-based management approach. However, in practice, the technical and institutional challenges remain important hurdles to overcome...... for the system to be beneficial and reliable. In this paper we investigate the added value on catch information gained over the last five years, and discuss the future of REM as a monitoring program in the context of the future discards ban...

  8. The Geothermal Data Repository: Five Years of Open Geothermal Data, Benefits to the Community: Preprint

    Energy Technology Data Exchange (ETDEWEB)

    Weers, Jonathan D [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Taverna, Nicole [National Renewable Energy Laboratory (NREL), Golden, CO (United States); Anderson, Arlene [U.S. Department of Energy

    2018-04-02

    In the five years since its inception, the Department of Energy's (DOE) Geothermal Data Repository (GDR) has grown from the simple idea of storing public data in a centralized location to a valuable tool at the center of the DOE open data movement where it is providing a tangible benefit to the geothermal scientific community. Throughout this time, the GDR project team has been working closely with the community to refine the data submission process, improve the quality of submitted data, and embrace modern proper data management strategies to maximize the value and utility of submitted data. This paper explores some of the motivations behind various improvements to the GDR over the last 5 years, changes in data submission trends, and the ways in which these improvements have helped to drive research, fuel innovation, and accelerate the adoption of geothermal technologies.

  9. 2015 Five-Yearly Review : one last formal step, with the implementation to follow

    CERN Multimedia

    Staff Association

    2015-01-01

    Taking into account the arbitration by the Director General the Staff Council decided that it did not oppose the Management proposals for the 2015 Five-Yearly Review (see Echo 234). Consequently, at the TREF meeting of Thursday 26 November, Management presented its consolidated proposals taking into account the outcome of the arbitration. The Staff Association was invited to express its point of view (the text of our declaration follows). After the Member States’ delegates got satisfactory answers to their questions for clarification, none of the 14 delegations represented opposed the proposals nor were there any abstentions. The Chair of TREF, B. Dormy, will thus report to Finance Committee and Council on 16 and 17 December that TREF recommends that these committees approve the Management proposals. A huge amount of work by many CERN colleagues, representatives of the Management, the Sectors, and the Staff Association has come to a successful conclusion. Now we move into the important implementati...

  10. Characterization of automotive shredder residues before and five years after landfill disposal

    Directory of Open Access Journals (Sweden)

    Lucian Ionel Cioca

    2015-04-01

    Full Text Available The paper illustrates the results of an extensive analytical characterization study of automotive shredder residues (ASR, also known as "fluff”. The analyses concerned material fractions and their content, with special reference to heavy metals (e.g. Cd, Cr, Hg, Pb, Cu and arsenic. Elution tests on the original materials were also conducted. Moreover, chemical concentrations of ASR samples after about five years' landfill residence was assessed, in order to verify possible changes resulting from both in-situ leaching and organic matter degradation phenomena. Results show that lead seems to be the most critical element in view of possible ASR acceptance in non-hazardous waste landfills because of its high concentration in raw waste and, especially, of its proven leachability characteristics.

  11. Sentinel node biopsy in breast cancer: five years experience from Denmark

    DEFF Research Database (Denmark)

    Christiansen, Peter; Balslev, E.; Jensen, D.

    2008-01-01

    INTRODUCTION: Danish experience from the first five years with sentinel lymph node biopsy (SLNB) as a routine staging procedure in early breast cancer is reported. METHODS: During the period January 1, 2002 to December 31, 2006, 14 923 patients were diagnosed at Danish breast surgical centers...... certified for the sentinel node method. SLNB was performed in 8 338 patients (55.9%). The fraction increased steadily from 43% in 2002 to 67% in 2006. The median follow-up was 1.7 year (range 0-5.2 years). RESULTS: Patients staged with SLNB were younger, had more often BCS, had smaller tumor size, were more...... often hormone receptor positive, and had lower grade, than patients staged with lymph node dissection (ALND). Blue dye and radio colloid were used in combination in 82%. Lymphoscintigraphy was performed in 61%, and frozen section was performed in 87%. Originally, peritumoral injection of tracer was most...

  12. Five years of beach drainage survey on a macrotidal beach (Quend-Plage, northern France)

    Science.gov (United States)

    Bain, Olivier; Toulec, Renaud; Combaud, Anne; Villemagne, Guillaume; Barrier, Pascal

    2016-07-01

    A drainage system was installed in 2008 on the macrotidal beach of Quend-Plage, close to Abbeville (Somme, northern France), following a period of significant erosion of recreational areas. The "Direction départementale des territoires et de la mer" (French Coastal Department Authority) has requested a biannual survey in order to validate the beach drainage setup and its efficiency. This paper presents the methodology used for this survey, and the response of the coastal system to this soft engineering method for preventing erosion. These five years of drainage operation have strongly modified the morphology of the beach. Three main modifications occurred: (i) accretion of the upper beach and foredune, (ii) erosion of the lower and middle beach and (iii) a slight shift in directions of the beach bars and troughs. These morphological changes finally led to the stabilization of the beach.

  13. Improvement in QA protocol for TLD based personnel monitoring laboratory in last five year

    International Nuclear Information System (INIS)

    Rakesh, R.B.

    2018-01-01

    The Quality Assurance (QA) in Personnel monitoring (PM) is a tool to assess the performance of PM laboratories and reliability of dose estimation with respect to standards laid down by international agencies such as IAEA (ISO trumpet curve), IEC, ANSI etc. Reliable personal dose estimation is a basic requirement for radiation protection planning as well as decision making continuous improvement in radiation protection is inherent in radiation protection practices which is highly dependent on accuracy and reliability of the monitoring data. Experience based evolution of Quality control (QC) measures as well as Quality assurance (QA) protocol are two important aspects towards continuous improvement in accuracy and reliability of personnel monitoring results. The paper describes improvement in QC measures and QA protocols initiated during the last five years which led to improvement in the quality of PM services

  14. Patient function, long-term survival, and use of surgery in patients with kidney cancer.

    Science.gov (United States)

    Tan, Hung-Jui; Chamie, Karim; Daskivich, Timothy J; Litwin, Mark S; Hu, Jim C

    2016-12-15

    Beyond age and comorbidity, functionality can shape the long-term survival potential of patients with cancer. Accordingly, herein the authors compared mortality and receipt of cancer-directed surgery according to patient function among older adults with kidney cancer. Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data from 2000 through 2009, the authors studied 28,326 elderly subjects with primary kidney cancer. Patient function was quantified using function-related indicators, claims indicative of dysfunction and disability. Adjusting for patient and cancer characteristics, competing risk regression was used to assess the relationship between function-related indicator count and cause-specific mortality and then generalized estimating equations were used to quantify the probability of surgery. A total of 13,619 adult patients (48.1%) with at least 1 function-related indicator were identified. A higher indicator category was associated with older age, greater comorbidity, female sex, unmarried status, lower socioeconomic status, and higher stage of disease (Pkidney cancer mortality varied minimally with patient function. Patients with ≥ 2 indicators received cancer-directed surgery less often than those without disability (odds ratio, 0.61; 95% CI, 0.56-0.66), although treatment probabilities remained high for patients with locoregional disease and low for those with metastatic cancer. Among older adults with kidney cancer, functional health stands as a significant predictor of long-term survival. However, receipt of cancer-directed surgery appears largely determined by cancer stage. Patient function should be considered more heavily when determining treatment for older adults with kidney cancer. Cancer 2016;122:3776-3784. © 2016 American Cancer Society. © 2016 American Cancer Society.

  15. Five-year follow-up of cognitive impairment in older adults with bipolar disorder.

    Science.gov (United States)

    Schouws, Sigfried N T M; Comijs, Hannie C; Dols, Annemieke; Beekman, Aartjan T F; Stek, Max L

    2016-03-01

    To date, cognitive impairment has been thought to be an integral part of bipolar disorder. In clinical staging models, cognitive impairment is one of the hallmarks to define the clinical stage and it plays an important role in identifying the risk factors for progression to later stages of the illness. It is important to examine neurocognitive performance over longer periods to test the hypothesis of neuroprogression of bipolar disorder. A comprehensive neuropsychological test battery was applied at baseline and five years later to 56 euthymic older outpatients with bipolar disorder (mean age = 68.35 years, range: 60-90 years) and to a demographically matched sample of 44 healthy subjects. A group-by-time repeated measures multivariate analysis of variance was performed to measure changes over time for the two groups. The impact of baseline illness characteristics on the intra-individual change in neurocognitive performance within the bipolar disorder group was studied by using logistic regression analysis. At baseline and at follow-up, patients with bipolar disorder performed worse on all neurocognitive measures compared to the matched healthy subjects. However, there was no significant group-by-time interaction between the patients with bipolar disorder and the comparison group. Although older patients with bipolar disorder had worse cognitive function than healthy subjects, they did not have greater cognitive decline over a five-year period. The change in acquired cognitive impairment of patients with bipolar disorder might parallel the cognitive development as seen in normal aging. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  16. Nutritional profile in children under five years of Afro-descendant communities in Paraguay

    Directory of Open Access Journals (Sweden)

    Susana Sánchez-Bernal

    2015-12-01

    Full Text Available Background: In Paraguay, little is known about the Afro-descendant population. It is important to know about their nutritional status, mainly in childhood, to guide appropriate action. Objective: To determine the nutritional profile of children under five years from the African descendants’ communities in Paraguay and its associated factors. Material and methods: A cross-sectional and observational design with analytical component was developed. It involved healthy male and female children under five years old, with at least one African descendant as immediate family. Dietary habits and nutritional status (WHO criteria were assessed. WHO Anthro and SPSS 16.0 software were used. Results: 150 children were included. The median of age was 26.9 months (1.2-59.9 m, and 50.7% were males. The median maternal age was 28.3 years (16-49 years. Children with Exclusive Breast Feeding (EBF, n=119 had a mean duration of 3.5±1.8 months (1-7m. 26.9% were exclusively breastfed during six months. The starting of complementary feeding was on average 5.2 months. The underweight prevalence (UW, zP/E 0.05. Children with UW had a lower average of age of onset of complementary feeding (1.7 vs 4.9 months, p˂0.0001 compare with their pairs without malnutrition. Conclusion: Chronic malnutrition was the most prevalent chronic disease affecting over 1 in 10 children. Early initiation of complementary feeding could be a risk factor for malnutrition.

  17. FAMILY’S ECONOMIC LEVEL AND CULTURE CORRELATE WITH NUTRITIONAL STATUS OF CHILDREN UNDER FIVE YEARS

    Directory of Open Access Journals (Sweden)

    Abdul Muhith

    2017-01-01

    Full Text Available Introduction: Nutrition is an important thing for human life. Variety in family’s economic level and culture have effect on family’s eating habit. Family with higher economic status have big opportunity to met under fi ve year’s nutrition. Cultural diversity on each family has an impact on the difference of raw food selection, processing methods, and presentation of food. The purpose of this study was to determine the correlation between family’s economic level and culture with nutritional status of children under fi ve year. Method: Research design was observational analytic with cross sectional approach. The population were mother and their children under fi ve years at Desa Jatigono Kunir, Kabupaten Lumajang. Sampel were 184 respondents, taken by using cluster sampling. Independent variables were family’s economic level and culture. Dependent variable was nutritional status of children under fi ve years. Data were collected by using questionnaire and observational sheet. Then, data were analyzed by using Spearman Rho Test with α<0.05. Result: The results showed that 140 (76.1% respondents have low economic level, 105 (57.1% respondents have negative culture in children’s nutrition, and 89 (48% respondents have good nutritional status. The result of Spearman-rho test showed that family’s economic level (p=0.000 and culture (0.019 have correlated with nutritional status of children under five years. Discussion: It can be concluded that family’s economic level and culture have correlated with nutritional status of children under fi ve years. Nurses should develop health education and counseling to improve family’s knowledge about nutrition, so children will have good nutritional status. Keywords: economic level, family’s culture, nutritional status, children under five years

  18. Revisiting restored river reaches - Assessing change of aquatic and riparian communities after five years.

    Science.gov (United States)

    Lorenz, Armin W; Haase, Peter; Januschke, Kathrin; Sundermann, Andrea; Hering, Daniel

    2018-02-01

    Hydromorphological restructuring of river sections, i.e. river restoration measures, often has little effects on aquatic biota, even in case of strong habitat alterations. It is often supposed that the biotic response is simply delayed as species require additional time to recolonize the newly generated habitats and to establish populations. To identify and specify the supposed lag time between restoration and biotic response, we investigated 19 restored river reaches twice in a five-year interval. The sites were restored one to ten years prior to the first sampling. We sampled three aquatic (fish, benthic invertebrates, macrophytes) and two riparian organism groups (ground beetles and riparian vegetation) and analyzed changes in assemblage composition and biotic metrics. With the exception of ground beetle assemblages, we observed no significant changes in richness and abundance metrics or metrics used for biological assessment. However, indicator taxa for near-natural habitat conditions in the riparian zone (indicators for regular inundation in plants and river bank specialists in beetles) improved significantly in the five-year interval. Contrary to general expectations in river restoration planning, we neither observed a distinct succession of aquatic communities nor a general trend towards "good ecological status" over time. Furthermore, multiple linear regression models revealed that neither the time since restoration nor the morphological status had a significant effect on the biological metrics and the assessment results. Thus, the stability of aquatic assemblages is strong, slowing down restoration effects in the aquatic zone, while riparian assemblages improve more rapidly. When defining restoration targets, the different timelines for ecological recovery after restoration should be taken into account. Furthermore, restoration measures should not solely focus on local habitat conditions but also target stressors acting on larger spatial scales and take

  19. Dietary quality and its structural relationships among equivalent income, emotional well-being, and a five-year subjective health in Japanese middle-aged urban dwellers.

    Science.gov (United States)

    Kodama, Sayuri; Fujii, Nobuya; Furuhata, Tadashi; Sakurai, Naoko; Fujiwara, Yoshinori; Hoshi, Tanji

    2015-01-01

    Although dietary quality in middle-age and the prime age of a person's work career might be determined by positive emotional well-being based on socioeconomic status (SES), causation among determinants of dietary quality still remains unclear. Our purpose was to elucidate the structural relationships among five-year prior dietary quality, equivalent income, emotional well-being, and a five-year subjective health by sex and age group separately. In 2003, 10,000 middle-aged urban dwellers aged 40-64 years, who lived in ward A in the Tokyo metropolitan area, were randomly selected and a questionnaire survey was conducted by mail. In 2008, we made a follow-up survey for dwellers, and were able to gather their survival status. A total of 2507, middle-aged men (n = 1112) and women (n = 1395), were examined at baseline. We created three latent variables for a structural equation modeling (SEM), five-year subjective health reported in 2003 and in 2008, dietary quality of principle food groups diversity and eating behavior in 2003, and emotional well-being constructed by enjoyment & ikigai (meaning of life) and by close people in 2003. Equivalent income in 2003 was calculated as SES indicator. In the SEM analysis of both men and women, there was an indirect effect of the equivalent income on dietary quality and on five-year subjective health, via emotional well-being explained by ikigai and having comforting people close to the individuals, significantly. There tended to be a larger direct effect of emotional well-being on the dietary quality in men than in women, and also a larger effect accompanying with aging. In women, there was a large direct effect of equivalent income on dietary quality than in men. When examined comprehensively, there appeared to be a larger effect of five-year prior equivalent income on subjective health during five-year in men than in women. This study suggests that it is necessary to support the improvement of dietary quality in middle

  20. Decayed, missing and filled teeth and dental anomalies in long term survived leukemic children: a prospective controlled study

    OpenAIRE

    Lauritano, D; Petruzzi, M; Baldoni, M

    2012-01-01

    Objective: The aim of this prospective controlled study is the comparison between long-term children survived leukaemia and a control group in terms of the decayed, missing or filled permanent teeth (DMFT) and dental anomalies. Study design: Fifty-two long term children survived leukaemia, aged from 8 to 15 years (27 females, 25 males; mean age 11.5 years) were evaluated for the possible effects of the anti-leukaemic therapy on dental development and compared to a control group of 52 healthy ...

  1. Etude Climat no. 38 'The economic tools of Chinese climate and energy policy at the time of the at the time of the 12. five-year plan'

    International Nuclear Information System (INIS)

    Zhou, Di; Delbosc, Anais

    2013-01-01

    Among the publications of CDC Climat Research, 'Climate Reports' offer in-depth analyses on a given subject. This issue addresses the following points: The largest developing country and the main source of GHG emissions in the world, China has undertaken in its 12. five-year plan (2011-2015) to strengthen the strategy initiated in the 11. five-year plan. It proposes making the Chinese economy more flexible - hence its change of name to five-year 'guide'-, particularly through increased use of market instruments. This change applies across all fields, including energy and climate policies. Economic instruments are especially expected to help achieve the 2020 strategic energy and climate objectives which China committed to at the Copenhagen Conference in 2009. The five-year plan forms a programmatic document requiring translation into law to develop details of the measures required to achieve the objectives set out. Following the publication of the 12. five-year plan, the Chinese central government therefore introduced a series of regulations to promote energy conservation and reduction of greenhouse gas (GHG) emissions, including at a regional and sectoral level. Local governments are particularly expected to participate, by incorporating progress in achieving their climate and energy policy objectives into the system of administrative appraisal. In relation to energy policy, the economic tools put in place exist side by side with pre-existing administrative tools and remain subject to very strong administrative control. They concern the adjustment of both the production pattern - reinforcement of exchanges of production rights and renewable energy production quotas - and the structure of energy consumption - market for energy savings certificates coordinated at a regional level. In terms of climate policy, the Chinese government is testing a range of instruments, including market and taxation mechanisms. The 12. five-year plan notably includes the development of a

  2. Long-Term Survival after Stroke: 30 Years of Follow-Up in a Cohort, the Copenhagen City Heart Study

    DEFF Research Database (Denmark)

    Boysen, G.; Marott, J.L.; Gronbaek, M.

    2009-01-01

    in the Copenhagen City Heart Study who experienced a first-ever stroke from 1978 to the end of 2001 were followed to the end of 2007. Stroke events were validated using the World Health Organization's definition of stroke. Linkage to the Danish Civil Registration System enabled identification of participants who...... died before the end of 2007. The National Register of Causes of Death provided cause of death. Survival in stroke patients was compared with survival in participants in the Copenhagen City Heart Study who did not suffer a stroke, and with survival in the general Danish population. Cox regression......-stroke controls. Long-term survival improved steadily over time. Life expectancy after stroke increased up to 4 years from 1978 to the end of 2001, exceeding the increase of life expectancy in the general population. Slightly longer survival was found in women than in men when adjusted for age at stroke onset...

  3. Predicting long-term risk for relationship dissolution using nonparametric conditional survival trees.

    Science.gov (United States)

    Kliem, Sören; Weusthoff, Sarah; Hahlweg, Kurt; Baucom, Katherine J W; Baucom, Brian R

    2015-12-01

    Identifying risk factors for divorce or separation is an important step in the prevention of negative individual outcomes and societal costs associated with relationship dissolution. Programs that aim to prevent relationship distress and dissolution typically focus on changing processes that occur during couple conflict, although the predictive ability of conflict-specific variables has not been examined in the context of other factors related to relationship dissolution. The authors examine whether emotional responding and communication during couple conflict predict relationship dissolution after controlling for overall relationship quality and individual well-being. Using nonparametric conditional survival trees, the study at hand simultaneously examined the predictive abilities of physiological (systolic and diastolic blood pressure, heart rate, cortisol) and behavioral (fundamental frequency; f0) indices of emotional responding, as well as observationally coded positive and negative communication behavior, on long-term relationship stability after controlling for relationship satisfaction and symptoms of depression. One hundred thirty-six spouses were assessed after participating in a randomized clinical trial of a relationship distress prevention program as well as 11 years thereafter; 32.5% of the couples' relationships had dissolved by follow up. For men, the only significant predictor of relationship dissolution was cortisol change score (p = .012). For women, only f0 range was a significant predictor of relationship dissolution (p = .034). These findings highlight the importance of emotional responding during couple conflict for long-term relationship stability. (c) 2015 APA, all rights reserved).

  4. Long-term survival in inoperable squamous cell carcinoma of the lung

    International Nuclear Information System (INIS)

    Ono, Ryosuke; Egawa, Sunao

    1988-01-01

    Radiotherapy is the first treatment of choice in cases of inoperable lung cancer. This paper reported the indications and limitations of radiotherapy for squamous cell carcinoma of the lung, based on the results of long-term survivors among non-resected squamous cell carcinoma. Materials consisted of 372 cases of squamous cell carcinoma of the lung treated with radiotherapy at the National Cancer Center Hospital between May 1962 and December 1980. Histopathological diagnosis was confirmed by biopsy in all cases. Among the 372 cases, 8 survived more than 5 years. Analyzing these 8 cases according to the TNM classification of the UICC, 7 were stage I, 1 was stage II, and there were no long-term survivors with stage III or IV. Of the 8 cases only one is alive. Analyzing 7 the fatal cases, 2 succumbed due to hepatic or brain metatasis following local recurrence and one had double primary cancer of the pancreas. The remaining 4 cases did not show recurrence or metastasis and succumbed due to pneumonia or myocardial infarct. (author)

  5. Functional Gain After Inpatient Stroke Rehabilitation: Correlates and Impact on Long-Term Survival.

    Science.gov (United States)

    Scrutinio, Domenico; Monitillo, Vincenzo; Guida, Pietro; Nardulli, Roberto; Multari, Vincenzo; Monitillo, Francesco; Calabrese, Gianluigi; Fiore, Pietro

    2015-10-01

    Prediction of functional outcome after stroke rehabilitation (SR) is a growing field of interest. The association between SR and survival still remains elusive. We sought to investigate the factors associated with functional outcome after SR and whether the magnitude of functional improvement achieved with rehabilitation is associated with long-term mortality risk. The study population consisted of 722 patients admitted for SR within 90 days of stroke onset, with an admission functional independence measure (FIM) score of stroke onset to rehabilitation admission (PStroke Scale score at rehabilitation admission (P<0.001), and aphasia (P=0.021) were independently associated with FIM gain. The R2 of the model was 0.275. During a median follow-up of 6.17 years, 36.9% of the patients died. At multivariable Cox analysis, age (P<0.0001), coronary heart disease (P=0.018), atrial fibrillation (P=0.042), total cholesterol (P=0.015), and total FIM gain (P<0.0001) were independently associated with mortality. The adjusted hazard ratio for death significantly decreased across tertiles of increasing FIM gain. Several factors are independently associated with functional gain after SR. Our findings strongly suggest that the magnitude of functional improvement is a powerful predictor of long-term mortality in patients admitted for SR. © 2015 American Heart Association, Inc.

  6. Long term survival with the combination of interferon and chemotherapy in metastatic melanoma

    International Nuclear Information System (INIS)

    Karagoz, B.; Bilgi, O.; Ozgun, A.; Emirzeoglu, L.; Celika, S.; Ozet, A.

    2015-01-01

    The prognosis of metastatic melanoma is poor. Pre-targeted treatment era, the combination of interferon-α (IF-α) plus chemotherapy had been used and have generally short response duration. Herein, we present a metastatic melanoma case that achieved long-term durable complete response (CR) IF-α plus chemotherapy and IF-α maintenance therapy and had lower Regulatory T (Treg) cells. A fifty-year old woman was admitted to the hospital with metastatic melanoma. Lactate dehydrogenase (LDH) level was 660 U/L. The percentage of CD4+CD25+ Treg cells was 2.4% in CD4+ lymphocytes. The IF-α plus chemotherapy and IF-α maintenance were administered. After six courses of chemotherapy, CR was achieved. Vitiligo and hypothyroidism occurred. The patient has remained in CR for approximately 7 years until second pleural metastases were detected and death. The patient has positive prognostic factors such as induction of auto immunity, small tumor volume, mild elevated LDH level, and lower Treg cell percentage. She survived long term with CR after IF-α treatment with concurrent chemotherapy and maintenance. IF-α plus chemotherapy may be a treatment option for metastatic melanoma in selected cases who cannot reach new targeted drugs

  7. Preoperative atrial fibrillation and long-term survival after open heart surgery in a rural tertiary heart institute.

    Science.gov (United States)

    O'Neal, Wesley T; Efird, Jimmy T; Davies, Stephen W; Choi, Yuk Ming; Anderson, Curtis A; Kindell, Linda C; O'Neal, Jason B; Ferguson, T Bruce; Chitwood, W Randolph; Kypson, Alan P

    2013-01-01

    Preoperative atrial fibrillation (AF) is associated with increased morbidity and mortality after open heart surgery. However, the impact of preoperative AF on long-term survival after open heart surgery has not been widely examined in rural populations. Patients from rural regions are less likely to receive treatment for cardiac conditions and to have adequate medical insurance coverage. To examine the influence of preoperative AF on long-term survival following open heart surgery in rural eastern North Carolina. Long-term survival was compared in patients with and without preoperative AF after coronary artery bypass grafting (CABG) and CABG plus valve (CABG + V) surgery between 2002 and 2011. Hazard ratios (HR) and 95% confidence intervals (CI) were computed using a Cox regression model. The study population consisted of 5438 patients. A total of 263 (5%) patients had preoperative AF. Preoperative AF was an independent predictor of long-term survival (open heart surgery: adjusted HR = 1.6, 95% CI = 1.3-2.0; CABG: adjusted HR = 1.6, 95% CI = 1.3-2.1; CABG + V: adjusted HR = 1.6, 95% CI = 1.1-2.3). Preoperative AF is an important predictor of long-term survival after open heart surgery in this rural population. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. The impact of vegan diet on B-12 status in healthy omnivores: five-year prospective study.

    Science.gov (United States)

    Mądry, Edyta; Lisowska, Aleksandra; Grebowiec, Philip; Walkowiak, Jarosław

    2012-04-02

    There are no long-term prospective studies assessing the impact of the vegan diet on vitamin B-12 (B-12) status. Many vegans take B-12 supplements irregularly or refuse to adopt them at all, considering them to be "unnatural" products. The use of B-12 fortified food may be an alternative. Therefore, we aimed to estimate the long-term effect of a vegan diet on serum B-12 concentrations in healthy omnivore adults, comparing the influence of natural products consumption and B-12 fortified food. A five year prospective study was carried out comprising 20 omnivore healthy adult subjects, who moved to strict vegan diet for 5 years. Ten volunteers followed vegan diet based entirely on natural products, while the remaining ten subjects consumed food fortified in B-12. In all subjects serum vitamin B-12 concentration was determined before and 6, 12, 24 and 60 months after the implementation of the diet. A significant decrease (p vegan diet. However, observed changes were in fact limited to the subgroup consuming exclusively natural products (p vegan diet is associated with the risk of vitamin B-12 deficiency. B-12 fortified products might constitute a valuable alternative in vegans refusing to take vitamin supplements.

  9. Long-term survival with unfavourable outcome: a qualitative and ethical analysis.

    Science.gov (United States)

    Honeybul, Stephen; Gillett, Grant R; Ho, Kwok M; Janzen, Courtney; Kruger, Kate

    2015-12-01

    To assess the issue of 'retrospective consent' among a cohort of patients who had survived with unfavourable outcome and to assess attitudes among next of kin regarding their role as surrogate decision makers. Twenty patients who had survived for at least 3 years with an unfavourable outcome following a decompressive craniectomy for severe traumatic brain injury were assessed with their next of kin. During the course of a semistructured interview, participants were asked whether they would have provided consent if they had known their eventual outcome. They were also asked for general comments regarding all aspects of the clinical journey. Eighteen patients had next of kin who were available for interview. For two patients, there was no longer any family involvement. Of the 20 patients, 13 were able to provide a response and 11 felt that they would have provided consent even if they had known their eventual outcome. Of the 18 next of kin who were able to express an opinion, 10 felt that they would have provided retrospective consent. Many patients appeared to have adapted to a level of disability that competent individuals might deem unacceptable. This does not necessarily mean that such outcomes should be regarded as 'favourable', nor that decompressive craniectomy must be performed for patients with predicted poor outcome. Nevertheless, those burdened with the initial clinical decisions and thereafter the long-term care of these patients may draw some support from the knowledge that unfavourable may not necessarily be unacceptable. 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/

  10. Long-term survival after acute myocardial infarction is lower in more deprived neighborhoods.

    Science.gov (United States)

    Tonne, Cathryn; Schwartz, Joel; Mittleman, Murray; Melly, Steve; Suh, Helen; Goldberg, Robert

    2005-06-14

    As part of the Worcester Heart Attack Study, a community-wide study examining changes over time in the incidence and long-term case-fatality rates of greater Worcester, Mass, residents hospitalized with confirmed acute myocardial infarction (AMI), we investigated the hypothesis that census tract-level socioeconomic position is an important predictor of survival after hospital discharge for AMI, after adjusting for demographic and clinical characteristics. Data were available for 3423 confirmed cases of AMI among metropolitan Worcester residents during the 4 study years of 1995, 1997, 1999, and 2001 who were followed up through the end of 2002. The mean age among patients was 69 years, and 58% were men. Using a multilevel Cox proportional hazards regression model, we estimated a 30% higher death rate after AMI for patients living in census tracts with the most residents living below the poverty line compared with patients living in the wealthiest census tracts (relative risk=1.30; 95% CI, 1.08 to 1.56). Similarly, patients living in census tracts with the highest proportion of residents with less than a high school education experienced a 47% higher death rate than patients living in census tracts with the lowest proportion of residents with less than a high school education (relative risk=1.47; 95% CI, 1.15 to 1.88). Within a medium-sized urban area, there are important variations in survival after hospital discharge for AMI that are associated with socioeconomic position. These associations persist after adjustment for demographic and clinical characteristics. Reasons for these differences warrant further investigation.

  11. Five-year results of a randomized clinical trial comparing total mastectomy and segmental mastectomy with or without radiation in the treatment of breast cancer

    International Nuclear Information System (INIS)

    Fisher, B.; Bauer, M.; Margolese, R.

    1985-01-01

    In 1976 the authors began a randomized trial to evaluate breast conservation by a segmental mastectomy in the treatment of State I and II breast tumors less than or equal to 4 cm in size. The operation removes only sufficient tissue to ensure that margins of resected specimens are free of tumor. Women were randomly assigned to total mastectomy, segmental mastectomy alone, or segmental mastectomy followed by breast irradiation. All patients had auxillary dissections, and patients with positive nodes received chemotherapy. Life-tables estimates based on data from 1843 women indicated that treatment by segmental mastectomy, with or without breast irradiation, resulted in disease-free, distant-disease-free, and overall survival at five years that was no worse than that after total breast removal. In fact, disease-free survival after segmental mastectomy plus radiation was better than disease-free survival after total mastectomy, and overall survival after segmental mastectomy, with or without radiation, was better than overall survival after total mastectomy. A total of 92.3% of women treated with radiation remained free of breast tumor at five years, as compared with 72.1% of those receiving no radiation. Among patients with positive nodes 97.9% of women treated with radiation and 63.8% of those receiving no radiation remained tumor-free, although both groups received chemotherapy. They conclude that segmental mastectomy, followed by breast irradiation in all patients and adjuvant chemotherapy in women with positive nodes, is appropriate therapy for Stage I and II breast tumors less than or equal to 4 cm, provided that margins of resected specimens are free of tumor. 23 references, 4 figures, 6 tables

  12. U.S. Department of Energy clean cities five-year strategic plan.

    Energy Technology Data Exchange (ETDEWEB)

    Cambridge Concord Associates

    2011-02-15

    Clean Cities is a government-industry partnership sponsored by the U.S. Department of Energy's (DOE) Vehicle Technologies Program, which is part of the Office of Energy Efficiency and Renewable Energy. Working with its network of about 100 local coalitions and more than 6,500 stakeholders across the country, Clean Cities delivers on its mission to reduce petroleum consumption in on-road transportation. In its work to reduce petroleum use, Clean Cities focuses on a portfolio of technologies that includes electric drive, propane, natural gas, renewable natural gas/biomethane, ethanol/E85, biodiesel/B20 and higher-level blends, fuel economy, and idle reduction. Over the past 17 years, Clean Cities coalitions have displaced more than 2.4 billion gallons of petroleum; they are on track to displace 2.5 billion gallons of gasoline per year by 2020. This Clean Cities Strategic Plan lays out an aggressive five-year agenda to help DOE Clean Cities and its network of coalitions and stakeholders accelerate the deployment of alternative fuel and advanced technology vehicles, while also expanding the supporting infrastructure to reduce petroleum use. Today, Clean Cities has a far larger opportunity to make an impact than at any time in its history because of its unprecedented $300 million allocation for community-based deployment projects from the American Recovery and Reinvestment Act (ARRA) (see box below). Moreover, the Clean Cities annual budget has risen to $25 million for FY2010 and $35 million has been requested for FY2011. Designed as a living document, this strategic plan is grounded in the understanding that priorities will change annually as evolving technical, political, economic, business, and social considerations are woven into project decisions and funding allocations. The plan does not intend to lock Clean Cities into pathways that cannot change. Instead, with technology deployment at its core, the plan serves as a guide for decision-making at both the

  13. Treatment choices for fevers in children under-five years in a rural Ghanaian district

    Directory of Open Access Journals (Sweden)

    Gyapong Margaret

    2010-06-01

    Full Text Available Abstract Background Health care demand studies help to examine the behaviour of individuals and households during illnesses. Few of existing health care demand studies examine the choice of treatment services for childhood illnesses. Besides, in their analyses, many of the existing studies compare alternative treatment options to a single option, usually self-medication. This study aims at examining the factors that influence the choices that caregivers of children under-five years make regarding treatment of fevers due to malaria and pneumonia in a rural setting. The study also examines how the choice of alternative treatment options compare with each other. Methods The study uses data from a 2006 household socio-economic survey and health and demographic surveillance covering caregivers of 529 children under-five years of age in the Dangme West District and applies a multinomial probit technique to model the choice of treatment services for fevers in under-fives in rural Ghana. Four health care options are considered: self-medication, over-the-counter providers, public providers and private providers. Results The findings indicate that longer travel, waiting and treatment times encourage people to use self-medication and over-the-counter providers compared to public and private providers. Caregivers with health insurance coverage also use care from public providers compared to over-the-counter or private providers. Caregivers with higher incomes use public and private providers over self-medication while higher treatment charges and longer times at public facilities encourage caregivers to resort to private providers. Besides, caregivers of female under-fives use self-care while caregivers of male under-fives use public providers instead of self-care, implying gender disparity in the choice of treatment. Conclusions The results of this study imply that efforts at curbing under-five mortality due to malaria and pneumonia need to take into

  14. Long-term Survival of Six Patients with Glioblastoma Multiforme: Case Series and Review of the Literature

    Directory of Open Access Journals (Sweden)

    Shapour Omidvari

    2012-04-01

    Full Text Available The median overall survival in glioblastoma multiforme is usually less than one year. Long-term survival is rare and is seen in only 3%-6% of GBM patients. The present study reports the characteristics and treatment outcomes of six cases of glioblastoma multiforme with long-term survival. A literature review is also presented.Between 1990 and 2008, 217 glioblastoma multiforme patients have been treated at our center of which six cases (four males survived for three years or longer. The mean age of the six cases was 25.7 years. All patients received postoperative radiotherapy with a mean dose of 55 gray and four patients received nitrosourea-based chemotherapy.Patients' mean survival was 5.2 years. The results of this study and review of the literature have indicated that long-term (more than three years survival is exceptional and mainly observed in younger patients with good performance status and following complete surgical tumor resection.

  15. Perioperative Mortality and Long-Term Survival in 80 Dogs and 32 Cats Undergoing Excision of Thymic Epithelial Tumors.

    Science.gov (United States)

    Garneau, Mark S; Price, Lori Lyn; Withrow, Stephen J; Boston, Sarah E; Ewing, Patty J; McClaran, Janet Kovak; Liptak, Julius M; Berg, John

    2015-07-01

    To examine perioperative mortality, long-term survival, causes of death, and prognostic factors for dogs and cats undergoing surgical excision of thymic epithelial tumors (TETs). Multi-institutional case series. Eighty dogs and 32 cats. Follow-up information was obtained for dogs and cats that underwent surgical excision of a TET between 2001 and 2012. Perioperative mortality was 20% in dogs and 22% in cats. No independent risk factors for perioperative mortality were identified. The estimated median survival time for all dogs was 1.69 years (95% CI 0.56-4.32) and the 1- and 4-year survival rates were 55% (95% CI 44-67) and 44% (95% CI 32-56). The estimated median survival time for all cats was 3.71 years (95% CI 0.56-unestimatable) and the 1- and 4-year survival rates were 70% (95% CI 53-87) and 47% (95% CI 0-100). Of animals that survived to discharge, 42% of dogs and 20% of cats eventually died of TET-related causes. The presence of paraneoplastic syndromes (hazard ratio [HR] 5.78, 95% CI 1.64-20.45, P = .007) or incomplete histologic margins (HR 6.09, 95% CI 1.50-24.72, P = .01) were independently associated with decreased survival in dogs. No significant predictors of survival were identified in cats. Conclusions regarding the effect of chemotherapy or radiation therapy could not be made. While there is substantial risk of perioperative death in dogs and cats undergoing surgery for TETs, many animals that survive to discharge have prolonged survival. Survival is significantly decreased in dogs with paraneoplastic syndromes or incomplete histologic margins. © Copyright 2014 by The American College of Veterinary Surgeons.

  16. Management of gestational trophoblastic tumours: a five-year clinical experience

    International Nuclear Information System (INIS)

    Rauf, B.; Hassan, L.; Ahmed, S.

    2004-01-01

    Objective: An analysis of a 5-year clinical experience in the management of gestational trophobIastic tumours in a tertiary care hospital. Patients and Methods: A total of 30 cases were managed and a detailed analysis of these patients were done. Of these 13 followed Hydatidiform Mole, 10 after abortion and 7 after a term pregnancy. Results: Out of 30 cases of gestational trophobIastic tumour, 63.3% were between 21 and 38 years of age. Ninety percent of the patients presented with vaginal bleeding, while life-threatening hemorrhage occurred in 23.3% of the cases. 43.3% of the patients had hydatidiform mole as an antecedent pregnancy and 36.7% of the patients presented within four months of the antecedent pregnancy. Blood groups O and B were most frequently encountered i.e. in 40% and 33.3% of the cases. Metastatic disease was present in 46.6% of the cases, of which 8 were high risk and one was of medium risk group. Major sites of metastasis were lungs (33.3%) and vagina (30%). Serum BHCG of 40,000 miu/ml and above was present in 53.3% of the cases (P=0.016) and number of metastasis >8 were found in 16.7% cases (P=0.001). Prior chemotherapy was given in only 2 patients and both of them died due to resistance. Chemotherapy was given to 100% of patients; survival was 100% in low-risk group and 50% in high-risk group (P=0.004). Overall mortality was 20% i.e. 6 patients died of the disease. Major side effects of chemotherapy were stomatitis (66.6%), alopecia (56.6%), low hemoglobin (60%), weight loss and recurrent infection. Conclusion: Late diagnosis, previously failed chemotherapy and high WHO prognostic scores are major risk factors affecting outcome in these patients. Hence every female in reproductive age group with unexplained bleeding per vaginum should be investigated with serum BHCG (Beta human chorionic gonadotrophin). (author)

  17. Very slow lava extrusion continued for more than five years after the 2011 Shinmoedake eruption observed from SAR interferometry

    Science.gov (United States)

    Ozawa, T.; Miyagi, Y.

    2017-12-01

    Shinmoe-dake located to SW Japan erupted in January 2011 and lava accumulated in the crater (e.g., Ozawa and Kozono, EPS, 2013). Last Vulcanian eruption occurred in September 2011, and after that, no eruption has occurred until now. Miyagi et al. (GRL, 2014) analyzed TerraSAR-X and Radarsat-2 SAR data acquired after the last eruption and found continuous inflation in the crater. Its inflation decayed with time, but had not terminated in May 2013. Since the time-series of inflation volume change rate fitted well to the exponential function with the constant term, we suggested that lava extrusion had continued in long-term due to deflation of shallow magma source and to magma supply from deeper source. To investigate its deformation after that, we applied InSAR to Sentinel-1 and ALOS-2 SAR data. Inflation decayed further, and almost terminated in the end of 2016. It means that this deformation has continued more than five years from the last eruption. We have found that the time series of inflation volume change rate fits better to the double-exponential function than single-exponential function with the constant term. The exponential component with the short time constant has almost settled in one year from the last eruption. Although InSAR result from TerraSAR-X data of November 2011 and May 2013 indicated deflation of shallow source under the crater, such deformation has not been obtained from recent SAR data. It suggests that this component has been due to deflation of shallow magma source with excess pressure. In this study, we found the possibility that long-term component also decayed exponentially. Then this factor may be deflation of deep source or delayed vesiculation.

  18. Centre-based day care for children younger than five years of age in high-income countries.

    Science.gov (United States)

    van Urk, Felix C; Brown, Taylor W; Waller, Rebecca; Mayo-Wilson, Evan

    2014-09-23

    A large proportion of children younger than five years of age in high-income countries experience significant non-parental care. Centre-based day care services may influence the development of children and the economic situation of parents. To assess the effects of centre-based day care without additional interventions (e.g. psychological or medical services, parent training) on the development and well-being of children and families in high-income countries (as defined by the World Bank 2011). In April 2014, we searched CENTRAL, Ovid MEDLINE, EMBASE, PsycINFO, the Education Resources Information Center (ERIC) and eight other databases. We also searched two trials registers and the reference lists of relevant studies. We included randomised and quasi-randomised controlled trials of centre-based day care for children younger than five years of age. We excluded studies that involved co-interventions not directed toward children (e.g. parent programmes, home visits, teacher training). We included the following outcomes: child cognitive development (primary outcome), child psychosocial development, maternal and family outcomes and child long-term outcomes. Two review authors independently assessed the risk of bias and extracted data from the single included study. We contacted investigators to obtain missing information. We included in the review one trial, involving 120 families and 143 children. Risk of bias was high because of contamination between groups, as 63% of control group participants accessed day care services separate from those offered within the intervention. No evidence suggested that centre-based day care, rather than no treatment (care at home), improved or worsened children's cognitive ability (Griffiths Mental Development Scale, standardised mean difference (SMD) 0.34, 95% confidence interval (CI) -0.01 to 0.69, 127 participants, 1 study, very low-quality evidence) or psychosocial development (parental report of abnormal development, risk ratio (RR

  19. Risk Factors Associated with High Blood Pressure in Two-to Five-Year-Old Children

    Science.gov (United States)

    Crispim, Paula Azevedo Aranha; Peixoto, Maria do Rosário Gondim; Jardim, Paulo César Brandão Veiga

    2014-01-01

    Background Over recent decades, the prevalence of high blood pressure (BP) has increased among children. Several risk factors are involved in the genesis of high BP during childhood, and their early identification can prevent the development of that disease. Objectives To assess the prevalence of high BP and associated factors in children. Methods Cross-sectional, population-based study, carried out at the household. This study included 276 two- to five-year-old children in the city of Goiânia, state of Goiás, and assessed their BP, sociodemographic characteristics, birth weight, high BP family history, passive smoking, maternal breastfeeding, dietary habits, sedentary lifestyle and nutritional status. Poisson regression was used to assess the association between risk factors and high BP. Results Their mean age was 3.1 ± 0.79 years, and high BP and overweight were observed in 19.9% and 11.2% of the children, respectively. Direct association of high BP was identified with age [prevalence ratio (PR) = 2.3; 95%CI: 1.2 - 4.8; p = 0.017] and overweight (PR = 2.0; 95%CI: 1.2 - 3.6; p = 0.014). No other variable associated with high BP. Conclusions The prevalence of high BP in children was high. Overweight and younger children had greater prevalence of high BP. PMID:24263779

  20. Revised Fifth Five Year Economic and Social Development Plan, 1984-1986.

    Science.gov (United States)

    1987-01-01

    This document contains provisions of chapter 6 (Promoting Social Development) of the Revised Fifth Five-Year Economic and Social Development Plan (1984-86) of the Republic of Korea. The plan calls for the efficient control of population growth by targeting intensive efforts to women 20-30 years old, eradicating the traditional preference for male children, providing incentives to foster a small family norm, and discouraging couples from having too many children. Family planning (FP) programs will be expanded to increase the contraceptive prevalence rate and improve the quality of contraceptive services. Emphasis will be placed on women 34 years or younger residing in poor urban and remote rural areas. The emphasis of the evaluations of FP guidance and evaluation teams will be on the actual prevention of birth rather than on the contraceptive use ratio, and the FP program will be linked to other health and medical schemes. Families with 2 children or less will receive extended medical services and free kindergarten tuition. Families with 3 or more children may face discriminatory policy measures. The Family Law will be amended to allow daughters to inherit, the Medical Insurance Law will be changed to allow family members dependent upon female workers to be insured, and social institutions hindering female participation in the work force will be banned. The dissemination of FP information and population education will be expanded.

  1. The U.S. Department of Energy Environmental Restoration and Waste Management Five-Year Plan

    International Nuclear Information System (INIS)

    Grimm, P.

    1990-01-01

    Within the first month after being confirmed as this country's sixth secretary of energy, Admiral James D. Watkins (US Navy, Retired) promised Congress that he would deliver a comprehensive plan that outlines specific actions to undertake over the next 5 yr to achieve compliance with US environmental laws and to begin to clean up and restore those sites that we have contaminated over the past 40 yr. The Environmental Restoration and Waste Management Five-Year Plan was published in August 1989. As the admiral committed, the plan established and documented an agenda for compliance and cleanup against which progress in the area of environmental restoration and waste management would be measured and specifically identified actions and commitments to achieve this progress. In November 1989, an additional chapter identifying the applied research, development, demonstration, testing, and evaluation (RDDT and E) activities that would support the implementation of the plan was published. Last June, the US Department of Energy (DOE) issued the first annual update of the 5-yr plan. This update covers the years 1992-1996, notes the progress achieved during the past year, and incorporates the scope of both the original plan and the RDDT and E plan. The plan is divided into five sections: corrective activities, environmental restoration, waste operations, technology development, and transportation. Each section explains DOE's overall policies and plans for achieving compliance and cleanup at DOE's nuclear-related facilities

  2. International radiation protection recommendations. Five years experience of ICRP Publication 26

    International Nuclear Information System (INIS)

    Lindell, B.; Beninson, D.; Sowby, F.D.

    1983-01-01

    The International Commission on Radiological Protection has issued radiation protection recommendations since 1928. The latest set of basic recommendations was adopted by the Commission on 17 January 1977, and subsequently published as ICRP Publication 26. This document has met with a wider interest than any of the previous ICRP recommendations. It has been considered to mark a radical change in the protection policy advocated by ICRP. It is not often appreciated that recommendations which are believed to be 'new' in ICRP Publication 26 had already been made in ICRP Publication 9 more than ten years earlier. In any event, ICRP Publication 26 has had a substantial impact on regulatory work in countries all over the world. It forms the basis for the Basic Safety Standards of the international organizations IAEA, ILO, OECD/NEA and WHO. The paper refers to the experience gained in using the new ICRP recommendations over the five years that have passed since ICRP Publication 26 was adopted and discusses some of the problems that have arisen in the practical application of the new recommendations in various countries. (author)

  3. Environmental impact analysis: the first five years of the National Environmental Policy Act in the USA

    Energy Technology Data Exchange (ETDEWEB)

    Thorold, O

    1975-11-01

    The National Environmental Policy Act (NEPA) of 1969 was the first comprehensive law to subject decisions to an assessment of total environmental consequence and instill environmental attitudes throughout government. All agencies must submit impact projections of proposed as well as alternative actions. Twenty-one states have passed similar legislation. A review of the Act's provisions for oversight, court action, timing, content, and commenting procedures is followed by a five-year evaluation. Because NEPA is generally felt to be a realistic approach to decision making and not a substitute for other kinds of environmental control, Mr. Thorold feels the American experience has been positive and is worth modifying for other countries. The Act lacked a ''grandfather clause,'' which caused a difficult transition period while agencies coped with both new and existing projects and developed standards for identifying and reviewing impacts. As agencies recognized that delays from lawsuits often resulted from inadequate impact statements, the quality improved to meet the strict guidelines of the Council on Environmental Quality. Joint efforts of agencies, universities, consulting firms, and private groups have cooperated to improve environmental forecasting and promote full communication. The costs of preparing statements and those of abandoned projects are felt to be conservative when compared to the costs of pursuing inappropriate projects. (21 references) (DCK)

  4. [Five years of ROM in substance abuse treatment centres in the Netherlands].

    Science.gov (United States)

    Oudejans, S C C; Schippers, G M; Spits, M E; Stollenga, M; van den Brink, W

    2012-01-01

    Three substance abuse treatment centres set up a benchmarking project for routine outcome management (ROM) of structured cognitive behavioral treatments for outpatients with a substance use disorder. To present the results of five years benchmarking. All patients were included at intake and the follow-up assessment was performed by a call-center nine months later. Twice a year aggregated data were fed back to management and treatment teams. Since 2005, clinical outcome data, including substance abuse data, have been collected for more than half of all 15.786 treated patients. At follow-up, nine months after intake, 23% was abstinent, 28% reported moderate substance use and 49% reported excessive substance use. The Dutch centres for the treatment of substance abuse were successful in setting up ROM projects to monitor and compare the development and the effects of outpatient addiction treatments. The clinical results are acceptable and correspond to the results of the American project called match. It is not yet clear whether the biannual feedback of aggregated outcomes to management and treatment teams has contributed to the creation of learning organisations, but it has provided transparency and has made it possible for teams to learn from the outcomes.

  5. Five years post whiplash injury: Symptoms and psychological factors in recovered versus non-recovered

    Directory of Open Access Journals (Sweden)

    Stålnacke Britt-Marie

    2010-07-01

    Full Text Available Abstract Background Few studies have focused on the differences between persons who are recovered after whiplash injury and those who suffer from persistent disability. The primary aim of this study was therefore to examine differences in symptoms, psychological factors and life satisfaction between subjects classified as recovered and those with persistent disability five years after whiplash injury based on the Neck Disability Index (NDI. Methods A set of questionnaires was answered by 158 persons (75 men, 83 women to assess disability (NDI, pain intensity (VAS, whiplash-related symptoms (Rivermead Post-Concussion Symptoms Questionnaire, RPQ, post-traumatic stress (Impact of Event Scale, IES, depression (Beck's depression inventory, BDI and life satisfaction (LiSat-11. The participants were divided into three groups based on the results of the NDI: recovered (34.8%, mild disability (37.3% and moderate/severe disability (27.3%. Results The moderate/severe group reported significantly higher VAS, BDI and IES scores and lower level of physical health and psychological health compared to the mild and the recovered groups. Less significant differences were reported between the mild and the recovered groups. Conclusions The group with the highest disability score reported most health problems with pain, symptoms, depression, post-traumatic stress and decreased life satisfaction. These findings indicate that classifying these subjects into subgroups based on disability levels makes it possible to optimize the management and treatment after whiplash injury.

  6. Five-year follow-up of Community Pediatrics Training Initiative.

    Science.gov (United States)

    Minkovitz, Cynthia S; Goldshore, Matt; Solomon, Barry S; Guyer, Bernard; Grason, Holly

    2014-07-01

    To compare community involvement of pediatricians exposed to enhanced residency training as part of the Dyson Community Pediatrics Training Initiative (CPTI) with involvement reported by a national sample of pediatricians. A cross-sectional analyses compared 2008-2010 mailed surveys of CPTI graduates 5 years after residency graduation with comparably aged respondents in a 2010 mailed national American Academy of Pediatrics survey of US pediatricians (CPTI: n = 234, response = 56.0%; national sample: n = 243; response = 59.9%). Respondents reported demographic characteristics, practice characteristics (setting, time spent in general pediatrics), involvement in community child health activities in past 12 months, use of ≥1 strategies to influence community child health (eg, educate legislators), and being moderately/very versus not at all/minimally skilled in 6 such activities (eg, identify community needs). χ(2) statistics assessed differences between groups; logistic regression modeled the independent association of CPTI with community involvement adjusting for personal and practice characteristics and perspectives regarding involvement. Compared with the national sample, more CPTI graduates reported involvement in community pediatrics (43.6% vs 31.1%, P .05). Differences in involvement remained in adjusted analyses with greater involvement by CPTI graduates (adjusted odds ratio 2.4, 95% confidence interval 1.5-3.7). Five years after residency, compared with their peers, more CPTI graduates report having skills and greater community pediatrics involvement. Enhanced residency training in community pediatrics may lead to a more engaged pediatrician workforce. Copyright © 2014 by the American Academy of Pediatrics.

  7. Seroepizootology of Q fever in Bulgaria during the last five years.

    Science.gov (United States)

    Martinov, S P; Pandarov, S; Popov, G V

    1989-12-01

    The work presents results of investigations on Q fever seroepizootology in Bulgaria during the last five years. These data are compared with the preceding period from 1950 to 1983. The basic method for investigation is Complement fixation test. Also used are immunofluorescence, agglutination reaction, cultivation and direct Electron microscopy. In general 15,814 samples were tested. Q fever positivity was foundin 10.08% of cattle, 20.44% of sheep, 10.17% of goats, 59.25% of dogs, 26.66% of magpies, 11.11% of wood-pigeons, 7.40% of mouflons, 7.14% of foxes and 5.82% of hens. These data confirm the results of our preceding investigations for the wide dissemination of C. burnetti among domestic animals. Positive data for the significant spread of C. burnetti among the wild animals and birds also exists. The disease manifests itself clinically in abortions in sheep and cattle and mastitis in sheep. The inapparent form, however, is much more frequent. The infected dogs represent a special interest. The control measures are based on the wide use of tetracyclines. The presented data testify to the continuing importance of the problem of Q fever in Bulgaria.

  8. Public comments and responses to the 1991 Hanford Cleanup Five-Year Plan

    International Nuclear Information System (INIS)

    1992-05-01

    The Department of Energy (DOE) Richland Field Office (RL) updated its Site-Specific Plan (DOE-RL 1991a) dealing with cleanup and operation of the Hanford Site in September 1991. The plan provides direction as to how DOE will carry out the national strategy for managing and cleaning up the Hanford Site wastes resulting from production of nuclear weapons. The plan is updated annually. We asked the public to comment on the plan during its 60-day public comment period. This report presents the comments and provides responses. The introduction explains how the comments were gathered and how we responded. This report is in four main sections: (1) comments and responses addressed locally; (2) comments forwarded to DOE-Headquarters for their response (these responses will appear in the National Five-Year Plan [DOE 1991a]); (3) comments we did not respond to here because they were outside the scope, or about how we gathered the public's comments; and (4) the appendices, which include a glossary, a list of acronyms used in the document, and the letters and cards we received reproduced in their entirety

  9. [Prevalence of overwight and obesity among children under five years in Peru 2007-2010].

    Science.gov (United States)

    Pajuelo-Ramírez, Jaime; Miranda-Cuadros, Marianella; Campos-Sánchez, Miguel; Sánchez-Abanto, José

    2011-06-01

    To estimate the prevalence of overweight and obesity in children under five in Peru in the years 2007-2010 and to describe according to geographical areas, poverty levels, maternal education, breastfeeding, child age, sex and birth weight. continuous (repeated cross-sectional) multistage, random sampling survey from the universe of children under five-years and pregnant women living in Peru, divided into five geographical areas. Out of 3,669 children, 50.3% were males (Lima N=680, Remaining Coast N=763, Urban Sierra N=719, Rural Sierra N=699, Jungle N=808) having their weight and height measured according to international standards. The national prevalence of overweight and obesity was 6.9%, with Metropolitan Lima (10.1%) as the highest and in the Jungle (2.6%) as the lowest. Age, sex, geographical area and birth weight were identified as risk factors through multiple logistic regression. overweight and obesity are higher in Lima, during the first year of age and when birth weight is more than 2.5 Kg.

  10. Associated factors of malnutrition among African children under five years old, Bom Jesus, Angola

    Directory of Open Access Journals (Sweden)

    Ema Cândida Branco FERNANDES

    Full Text Available ABSTRACT Objective: To identify the determinants of wasting and stunting in children under five years old in the commune of Bom Jesus, Angola Methods: A population-based cross-sectional study was conducted with 742 children in 2010, and nutritional deficits were defined by World Health Organization criteria. Prevalence ratios and associated factors of wasting and stunting were estimated using Poisson regression with robust variance, using a conceptual hierarchical model Results: For both deficits, there were significant differences in the prevalence ratios according to the children's neighborhood and age. Boys and those children living in households whose water supply came from the river or lake, as well those with recent expulsion of parasites and infections were more likely to present stunting. Children of fathers with higher number of children or that which the fathers were not living at home and whose mothers were 25-34 years old were less likely to have wasting Conclusion: It was identified independent variables from different levels of determination of malnutrition, standing out the basic sanitation conditions and family structure as important predictors of the nutritional deficits. The knowledge of the associated factors of malnutrition may contribute for subside public policies in planning interventions to improve the childhood nutrition status in Bom Jesus and communes with similar characteristics in Angola.

  11. Results of five years to open exposure of the Zn22Al2Cu alloy

    International Nuclear Information System (INIS)

    Hernandez, L.S.; Miranda, J.M.; Narvaez, L.

    1998-01-01

    It was studied the behavior of the Zn 2 2Al 2 Cu alloy within urban environment (ISO C3) and it is compared with that of galvanized steel (zinc) and aluminium at the same environment. The exposure included three annual exposures and other until for five years. The corrosion damage was evaluated by weight losses. The results confirm a greater corrosion for the ternary alloy compared with the galvanized steel. However, the obtained results through the Polarization resistance technique (Rp), utilizing a 0.1 M Na 2 SO 4 solution, indicated greater values for the corrosion products layer over the alloy with respect to galvanized. The formed corrosion products over the exposed samples by different periods were characterized by different techniques to estimate the protective properties out in the open. By means of X-ray diffraction were identified zinc and aluminium sulfates also alumina in the ternary alloy. The presence of alumina was confirmed by Raman spectroscopy. Through polarization curves and punctual analysis by X-ray dispersive energies (EDX) it was confirmed the enrichment of the aluminium surface by the preferential dissolution of zinc. (Author)

  12. Retrospective evaluation of the five-year and ten-year CSEP-Italy earthquake forecasts

    Directory of Open Access Journals (Sweden)

    Stefan Wiemer

    2010-11-01

    Full Text Available On August 1, 2009, the global Collaboratory for the Study of Earthquake Predictability (CSEP launched a prospective and comparative earthquake predictability experiment in Italy. The goal of this CSEP-Italy experiment is to test earthquake occurrence hypotheses that have been formalized as probabilistic earthquake forecasts over temporal scales that range from days to years. In the first round of forecast submissions, members of the CSEP-Italy Working Group presented 18 five-year and ten-year earthquake forecasts to the European CSEP Testing Center at ETH Zurich. We have considered here the twelve time-independent earthquake forecasts among this set, and evaluated them with respect to past seismicity data from two Italian earthquake catalogs. We present the results of the tests that measure the consistencies of the forecasts according to past observations. As well as being an evaluation of the time-independent forecasts submitted, this exercise provides insight into a number of important issues in predictability experiments with regard to the specification of the forecasts, the performance of the tests, and the trade-off between robustness of results and experiment duration. We conclude with suggestions for the design of future earthquake predictability experiments.

  13. Five Year Retrospective Study of the Financial Situation of Northern Foods Plc., United Kingdom

    Directory of Open Access Journals (Sweden)

    Louie DACOSTA

    2016-09-01

    Full Text Available This study was conducted as a retrospective analysis of Northern Foods Plc., once a major player in FTSE 350 Food Sector, to evaluate its financial situation over a five year period. The ex post factor research design was used for this study. Annual reports and databases on Northern Foods Plc., and Associated British Foods Plc., were used to perform a series of ratio analyses. The results revealed that Northern Foods Plc.’s performance has been declining as evidenced in the profitability ratios calculated. Also, financial strength was weak and working capital has not been effectively managed, hence affecting its cash and profit generation potentials. The company was limited in its ability to grow and expand as it needed to regularly fund its pension deficit, and finance its high levels of debt. The study concludes that Northern Foods was not in a very strong financial position, yet it was not making the required investments to improve, hence its takeover though this paper will not rule out non-financial issues. Furthermore, the study prescribed five generic points to improve the financial health of any organisation.

  14. Corrosion study of steels exposed over five years to the humid tropical atmosphere of Panama

    Energy Technology Data Exchange (ETDEWEB)

    Jaén, Juan A., E-mail: juan.jaen@up.ac.pa [Departamento de Química Física, Edificio de Laboratorios Científicos-VIP (Panama); Iglesias, Josefina [Laboratorio de Análisis Industriales y Ciencias Ambientales (Panama)

    2017-11-15

    The results of assessing five-year corrosion of low-carbon and conventional weathering steels exposed to the Panamanian tropical atmosphere is presented. Two different test sites, one in Panama City: 5 km from the shoreline of the Pacific Ocean, and another in the marine environment of Fort Sherman, Caribbean coast of Panama; namely, Fort Sherman Coastal site: 100 m from coastline. The corrosion products, formed in the skyward and earthward faces in the studied tropical environment, were mainly identified using room temperature and low temperature (15 K) Mössbauer spectroscopy, and ATR-FTIR. In all samples, lepidocrocite (γ-FeOOH) and goethite (α-FeOOH) were the main constituents. Some maghemite (γ-Fe{sub 2}O{sub 3}), was also identified in Tocumen by Mössbauer spectroscopy and traces of feroxyhyte (δ-FeOOH) using ATR-FTIR. The corrosion rate values obtained are discussed in light of the atmospheric exposure conditions and atmospheric pollutants.

  15. CYTOLOGICAL EVALUATION OF MALE BREAST LESIONS IN GREATER GWALIOR : A FIVE YEAR RETROSPECTIVE STUDY

    Directory of Open Access Journals (Sweden)

    Jagannath

    2015-03-01

    Full Text Available BACKGROUNDS: Fine needle aspiration cytology is an effective modality for diagnosis of breast lesions. Usually male breast lesions are benign and affect the young male. Most common lesion is gynaecomastia. Male breast cancer accounts for a small proportion of breast cancers. Male breast cancer usually presents at an advanced age. OBJECTIVE: The aim of this study was to examine the nature of male breast lesions and to determine the cytomorphologic patterns of these lesions. MET HODS: five year retrospective study was conducted in our institution and in that 112 patients underwent fine needle aspiration cytology of the palpable breast lump after thorough physical examination. The cytological diagnosis was classified as benign, inf lammatory, malignant and others. RESULTS: In 112 male patients diagnosed with breast lesions, the most common lesion was gynecomastia (103/112, 91.9%, followed by breast cancer (6/112, 5.4%, inflammatory (2/112, 1.8% and apocrine metaplasia (01/112, 0.9 %. Gynecomastia was commonly found in male patients less than 40 years of age, while breast cancer is seen in male patients over 40 years of age

  16. Treatment-resistant, five-year long, postpartum-onset Capgras episode resolving after electroconvulsive therapy.

    Science.gov (United States)

    Rapinesi, Chiara; Kotzalidis, Georgios D; Del Casale, Antonio; Ferri, Vittoria Rachele; Di Pietro, Simone; Scatena, Paola; Serata, Daniele; Danese, Emanuela; Sani, Gabriele; Koukopoulos, Alexia E; Angeletti, Gloria; Girardi, Paolo

    2015-01-01

    Postpartum psychosis, which rarely presents with Capgras syndrome (delusional misidentification), requires rapid symptom resolution. First-line drugs have important drawbacks, such as delayed onset of clinical response and secretion in breast milk. In this report, we report successful treatment of a treatment-resistant woman presenting with treatment-resistant Capgras syndrome, with onset during postpartum. A 36-year-old woman had presented with Capgras syndrome during postpartum. For more than five years, she believed her son and other family members were substituted by impostors. All adequately administrated treatments were unsuccessful. We suggested electroconvulsive therapy to overcome treatment resistance. After six electroconvulsive therapy sessions, delusions of doubles subsided and other symptoms improved. She was discharged two weeks later with a mood stabilizer and low-dose atypical antipychotic combination and is well at the one-and-a-half-year follow-up. Electroconvulsive therapy followed by a mood stabilizer-antipsychotic drug combination showed rapid, permanent, and effective control of long-standing Capgras syndrome in a young woman. © The Author(s) 2015 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. Kratom abuse in Ramathibodi Poison Center, Thailand: a five-year experience.

    Science.gov (United States)

    Trakulsrichai, Satariya; Tongpo, Achara; Sriapha, Charuwan; Wongvisawakorn, Sunun; Rittilert, Panee; Kaojarern, Sming; Wananukul, Winai

    2013-01-01

    Kratom (Mitragyna speciosa Korth), a native tree in Southeast Asia, is misused as an abuse drug and becomes legally widespread to several countries. Currently, it is available through the online market or by some shops. The clinical manifestations of Kratom's effects are not well-defined and the clinical studies are limited. This study was designed to identify the characteristics of Kratom poisoning and withdrawal cases from Kratom exposure cases in Ramathibodi Poison Center (RPC), Thailand, during a five-year period. We used a retrospective review of Kratom exposure cases from the RPC toxic surveillance system. A total of 52 Kratom exposure cases were identified. The trend of case consultations has been increasing. There were Kratom poisoning cases (76.9%) and withdrawal cases (23.1%). Common presenting symptoms in the poisoning group were palpitation (22.5%), followed by seizure (17.5%). For the withdrawal group, the common presenting symptoms were myalgia (33.3%), insomnia (16.67%), fatigue (16.67%), and chest discomfort (16.67%). There was a baby with withdrawal symptoms who was delivered from a chronic Kratom-abusing mother, suggesting possible exposure via the transplacental route. There were no deaths in either group. Kratom abuse can cause either poisoning or withdrawal. Most cases in both groups had good prognostic outcome.

  18. Five Years of Experimental Warming Increases the Biodiversity and Productivity of Phytoplankton

    Science.gov (United States)

    Yvon-Durocher, Gabriel; Allen, Andrew P.; Cellamare, Maria; Dossena, Matteo; Gaston, Kevin J.; Leitao, Maria; Montoya, José M.; Reuman, Daniel C.; Woodward, Guy; Trimmer, Mark

    2015-01-01

    Phytoplankton are key components of aquatic ecosystems, fixing CO2 from the atmosphere through photosynthesis and supporting secondary production, yet relatively little is known about how future global warming might alter their biodiversity and associated ecosystem functioning. Here, we explore how the structure, function, and biodiversity of a planktonic metacommunity was altered after five years of experimental warming. Our outdoor mesocosm experiment was open to natural dispersal from the regional species pool, allowing us to explore the effects of experimental warming in the context of metacommunity dynamics. Warming of 4°C led to a 67% increase in the species richness of the phytoplankton, more evenly-distributed abundance, and higher rates of gross primary productivity. Warming elevated productivity indirectly, by increasing the biodiversity and biomass of the local phytoplankton communities. Warming also systematically shifted the taxonomic and functional trait composition of the phytoplankton, favoring large, colonial, inedible phytoplankton taxa, suggesting stronger top-down control, mediated by zooplankton grazing played an important role. Overall, our findings suggest that temperature can modulate species coexistence, and through such mechanisms, global warming could, in some cases, increase the species richness and productivity of phytoplankton communities. PMID:26680314

  19. Burlington Bottoms wildlife mitigation site : five-year habitat management plan, 2001-2005

    International Nuclear Information System (INIS)

    Beilke, Susan G.

    2001-01-01

    Historically the lower Columbia and Willamette River Basins were ecologically rich in both the habitat types and the species diversity they supported. This was due in part to the pattern of floods and periodic inundation of bottomlands that occurred, which was an important factor in creating and maintaining a complex system of wetland, meadow, and riparian habitats. This landscape has been greatly altered in the past 150 years, primarily due to human development and agricultural activities including cattle grazing, logging and the building of hydroelectric facilities for hydropower, navigation, flood control and irrigation in the Columbia and Willamette River Basins. The Burlington Bottoms (BB) wetlands contains some of the last remaining bottomlands in the area, supporting a diverse array of native plant and wildlife species. Located approximately twelve miles northwest of Portland and situated between the Tualatin Mountains to the west and Multnomah Channel and Sauvie Island to the east, the current habitats are remnant of what was once common throughout the region. In order to preserve and enhance this important site, a five-year habitat management plan has been written that proposes a set of actions that will carry out the goals and objectives developed for the site, which includes protecting, maintaining and enhancing wildlife habitat for perpetuity

  20. Treatment of winery wastewater in a conventional municipal activated sludge process: five years of experience.

    Science.gov (United States)

    Bolzonella, D; Zanette, M; Battistoni, P; Cecchi, F

    2007-01-01

    A full-scale wastewater treatment plant where municipal and winery wastewaters were co-treated was studied for five years. The experimental results showed that suspended solids, COD, nitrogen and phosphorous were effectively removed both during the treatment of municipal wastewater and the cotreatment of municipal and winery wastewater. The sludge production increase from 4 tons to 5.5 tons per day during the harvesting and wine making period. In any case the specific sludge production was 0.2 kgMLVSS per kgCOD(removed) despite the organic loading increasing. About 70% of the COD was removed through respiration. Also the energy demand increased from 6,000 to 7,000 kWh per day. The estimated costs for the treatment of the winery wastewater was 0.2-0.3 Euros per m3 of treated wastewater. With reference to the process efficiency, the nitrogen removal was just 20%. The co-treatment of municipal and winery wastewater in conventional activated sludge processes can be a feasible solution for the treatment of these streams at relatively low costs.

  1. Clinical anatomy e-cases: a five-year follow-up of learning analytics.

    Science.gov (United States)

    Perumal, Vivek; Butson, Russell; Blyth, Phil; Daniel, Ben

    2017-01-27

    This article explores the development and user experiences of a supplementary e-learning resource (clinical anatomy e-cases) for medical students, across a five-year teaching period. A series of online supplementary e-learning resources (the clinical anatomy e-cases) were developed and introduced to the regional and clinical anatomy module of the medicine course. Usage analytics were collected online from a cohort of third-year medical students and analysed to gain a better understanding of how students utilised these resources. Key results showed that the students used the supplementary learning resource during and outside regular teaching hours that includes a significant access during holidays. Analysis also suggested that the resources were frequently accessed during examination periods and during subsequent clinical study years (fourth or fifth years of medicine course). Increasing interest and positive feedback from students has led to the development of a further series of e-cases. Tailor-made e-learning resources promote clinical anatomy learning outside classroom hours and make supplementary learning a 24/7 task.

  2. Hemivertebrectomy and fixation with titanium cable for congenital scoliosis in children younger than five years

    International Nuclear Information System (INIS)

    Arango, Luis Alberto; Meneses, David; Montero, Carlos; Naquira, Luis Felipe

    2004-01-01

    A retrospective study was performed. The general objective was to describe the results and behavior of patients with congenital scoliosis secondary to hemivertebrae, treated with hemivertebral resection and fixation with titanium cable. There are different types of treatment: anterior fusion, posterior fusion, hemiepiphyseodesis and hemivertebral resection with or without instrumentation. Instrumentation in young children less than five years is difficult because of the pediatric spine devices are still big for this patient group. Between January 1999 and December 2003, 11 hemivertebrae resection in ten children were evaluated clinically and radiologically at admission, after surgery and at mean follow up of 12 months. The mean deformity angle before surgery was 40.8 degrades, 20.4 degrades alter surgery and 12.4 degrades at final follow up. There was one superficial infection and one of two cables rupture. The mean surgical time for double approach was 7.1 hours and for posterior approach was 3.6 hours. The bleeding for double approach was 656cc and for posterior approach was 186cc. The hemivertebral resection with titanium cable fixation is safe and success alternative for treating congenital scoliosis secondary hemivertebrae in young children

  3. Etorphine-halothane anaesthesia in two five-year-old African elephants (Loxodonta africana : clinical communication

    Directory of Open Access Journals (Sweden)

    G.F. Stegmann

    1999-07-01

    Full Text Available Anaesthesia of 2 five-year-old femaleAfrican elephants (Loxodonta africana was required for dental surgery. The animals were each premedicated with 120 mg of azaperone 60 min before transportation to the hospital. Before offloading, 1 mg etorphine was administered intramuscularly (i.m. to each elephant to facilitate walking them to the equine induction / recovery room. For induction, 2 mg etorphine was administered i.m. to each animal. Induction was complete within 6 min. Surgical anaesthesia was induced with halothane-in-oxygen after intubation of the trunk. During surgery the mean heart rate was 61 and 45 beats / min respectively. Systolic blood pressures increased to 27.5 and 25.6 kPa respectively, and were treated with intravenous azaperone. Blood pressure decreased thereafter to a mean systolic pressure of 18.1 and 19.8 kPa, respectively. Rectal temperature was 35.6 and 33.9 oC at the onset of surgery, and decreased to 35.3 and 33.5 oC, respectively, at the end of anaesthesia. Etorphine anaesthesia was reversed with 5mg diprenorphine at the completion of 90 min of surgery.

  4. The safeguards on-site laboratory at Sellafield. Five years operational experience

    Energy Technology Data Exchange (ETDEWEB)

    Duinslaeger, L.; Belle, P. van; Mayer, K.; Casteleyn, K.; Abousahl, S.; Daures, P.; Eberle, H.; Enright, T.; Guiot, A.; Hild, M.; Horta Domenech, J.; Lajarge, P.; Laurent, P.; Le Terrier, A.; Lynch, B.; Marucci, M.; Millet, S.; Ottmar, H.; Richir, P.; Street, S.; Vallet, P.; Zuleger, E. [European Commission, Karlsruhe (Germany). Inst. for Transuranium Elements

    2004-06-01

    The start of operation of the large reprocessing facilities led Euratom Safeguards to a new approach for verification analysis of samples taken at the facility: the installation of on-site laboratories. The availability of analytical capabilities for independent verification measurements at the site of these facilities offers obvious advantages in view of timeliness of results. The 'On-Site Laboratory' (OSL) at the BNFL Sellafield site was the first ever and entered into operation in 1999. For almost five years, the Institute for Transuranium Elements (ITU) has been operating the laboratory under routine conditions. During this period, more than one thousand safeguards samples were analysed. The experience gained in the management, logistics and operation of the OSL allow a critical review based on a significant period in time. This includes also aspects of training of staff, maintenance of equipment, flow of information, and improvements in the efficiency. The analytical issues are of key importance: based on the operational experience, the measurement methods were adapted (changing boundary conditions), the distribution of samples according to material type changed (start up of MOS fabrication plant), and the cutback in resources triggered a further streamlining of the analytical efforts. (orig.)

  5. Improving the Agronomy of Alyssum murale for Extensive Phytomining: A Five-Year Field Study.

    Science.gov (United States)

    Bani, Aida; Echevarria, Guillaume; Sulçe, Sulejman; Morel, Jean Louis

    2015-01-01

    Large ultramafic areas exist in Albania, which could be suitable for phytomining with native Alyssum murale. We undertook a five-year field experiment on an ultramafic Vertisol, aimed at optimizing a low-cost Ni-phytoextraction crop of A. murale which is adapted to the Balkans. The following aspects were studied on 18-m2 plots in natural conditions: the effect of (i) plant phenology and element distribution, (ii) plant nutrition and fertilization, (iii) plant cover and weed control and (iv), planting technique (natural cover vs. sown crop). The optimal harvest time was set at the mid-flowering stage when Ni concentration and biomass yield were highest. The application of N, P, and K fertilizers, and especially a split 100-kg ha(-1) N application, increased the density of A. murale against all other species. It significantly increased shoot yield, without reducing Ni concentration. In natural stands, the control of graminaceous weeds required the use of an anti-monocots herbicide. However, after the optimization of fertilization and harvest time, weed control procured little benefit. Finally, cropping sown A. murale was more efficient than enhancing native stands and gave higher biomass and phytoextraction yields; biomass yields progressively improved from 0.3 to 9.0 t ha(-1) and phytoextracted Ni increased from 1.7 to 105 kg ha(-1).

  6. Five years audit for presence of toxic agents/drug of abuse at autopsy

    International Nuclear Information System (INIS)

    Ali, S.M.A.; Khalil, I.R.; Saeed, A.; Hussain, Z.

    2003-01-01

    Objective: To know the frequency of fatal poisoning in Peshawar regarding the toxic agents mostly involved and year wise percentage. To know the age group and the gender that is most vulnerable to fatal poisoning. Results: Poisoning was the cause of death in 1.48% of the total autopsies conducted during the five years. Males were more involved than the females, 90.38%. Suicidal poisoning was present in 17.30% of the total cases and accidental poisoning was found in 80.72% cases, while homicidal cases were 1.29% only. Diacetylmorphine (heroin) was the most commonly involved agent, 65.38%, of the total cases. The incidence of poisoning was more during the third and fourth decades of life. Conclusion: Diacetylmorphine (heroin) was the main causative agent involved in young males due to accidental over-dosage. Accidental and suicidal deaths should not be considered as inevitable. More elaborative studies are required in this area of recent research to adopt appropriate and adequate measures to save precious lives.(author)

  7. Pacific Northwest and Alaska Regional Bioenergy Program : Five Year Report, 1985-1990.

    Energy Technology Data Exchange (ETDEWEB)

    Pacific Northwest and Alaska Bioenergy Program (U.S.)

    1991-02-01

    This five-year report describes activities of the Pacific Northwest and Alaska Regional Bioenergy Program between 1985 and 1990. Begun in 1979, this Regional Bioenergy Program became the model for the nation's four other regional bioenergy programs in 1983. Within the time span of this report, the Pacific Northwest and Alaska Regional Bioenergy Program has undertaken a number of applied research and technology projects, and supported and guided the work of its five participating state energy programs. During this period, the Regional Bioenergy Program has brought together public- and private-sector organizations to promote the use of local biomass and municipal-waste energy resources and technologies. This report claims information on the mission, goals and accomplishments of the Regional Bioenergy Program. It describes the biomass projects conducted by the individual states of the region, and summarizes the results of the programs technical studies. Publications from both the state and regional projects are listed. The report goes on to consider future efforts of the Regional Bioenergy Program under its challenging assignment. Research activities include: forest residue estimates; Landsat biomass mapping; woody biomass plantations; industrial wood-fuel market; residential space heating with wood; materials recovery of residues; co-firing wood chips with coal; biomass fuel characterization; wood-boosted geothermal power plants; wood gasification; municipal solid wastes to energy; woodstove study; slash burning; forest depletion; and technology transfer. 9 figs., 6 tabs.

  8. The effect of five years versus two years of specialised assertive intervention for first episode psychosis - OPUS II: study protocol for a randomized controlled trial

    DEFF Research Database (Denmark)

    Melau, Marianne; Jeppesen, Pia; Thorup, Anne

    2011-01-01

    . Based on our sample size estimation, 400 patients treated in OPUS for two years will be randomized to further three years of OPUS treatment versus standard treatment. The specialized assertive OPUS treatment consists of three core elements: assertive community treatment, psycho-educational family...... treatment, and social skills training. Discussion It has been hypothesized that there is a critical period from onset up to five years, which represents a window of opportunity where a long-term course can be influenced. Extending the specialized assertive OPUS treatment up to five years may allow...... the beneficial effects to continue beyond the high-risk period, through consolidation of improved social and functional outcome. Trial registration Clinical Trial.gov NCT00914238...

  9. Effect of PS-K on long-term survival of primary lung cancer patients treated with radiation

    International Nuclear Information System (INIS)

    Okazaki, Atsushi; Nakajima, Nobuaki; Hayakawa, Kazushige; Saito, Yoshihiro; Mitomo, Osamu; Niibe, Hideo

    1984-01-01

    The effect of PS-K on long-term survival of primary lung cancer patients irradiated over 60 Gy through 1977 to 1982 was studied. PS-K was administrated orally 3.0 g, daily or intermittently in the pattern of 2 weeks per a month on patients of positive PPD skin test. All cases irradiated over 60 Gy were 174 (Group A) containing 62 cases with PS-K (Group B) and 112 cases without PS-K (Group C). Of group B, 44 cases were administrated within a month after curative irradiation (Group B1), 7 cases were administrated on time maintaining long-term good condition after irradiation (Group B2) and 11 cases were administrated after recognition of recurrence or metastasis (Group B3). Following results were obtained. 1. Obvious prolongation of survivals was recognized in the patients with PS-K after irradiation. (1) The cumulative 5 years survival rates of Group A, B 1 and C were 11.0%, 28.8% and 4.8%, respectively. (2) The cumulative 5 years survival rates of stage I,11 were 45.7% with PS-K and 10.7% without PS-K. (3) The cumulative 5 years survival rates of 21 cases matched age, sex, stage, histological type and tumor dose with and without PS-K were 37.8% and 7.2%. (4) In Group B 2, 5 cases out of 7 cases have been alived, but in Group B 3, satisfactory long-term survivals ware not obtained. 2. The necessary conditions which obtain long-term survival with PS-K were thought to be follows. One is that the tumor is brought almost to vanish by irradiation. Another is that the condition of host is superior to that of tumor in host-tumor relationship. 3. The possibility of intermittent administration of PS-K was suggested. (author)

  10. Practice patterns and long-term survival for early-stage rectal cancer.

    Science.gov (United States)

    Stitzenberg, Karyn B; Sanoff, Hanna K; Penn, Dolly C; Meyers, Michael O; Tepper, Joel E

    2013-12-01

    Standard of care treatment for most stage I rectal cancers is total mesorectal excision (TME). Given the morbidity associated with TME, local excision (LE) for early-stage rectal cancer has been explored. This study examines practice patterns and overall survival (OS) for early-stage rectal cancer. All patients in the National Cancer Data Base diagnosed with rectal cancer from 1998 to 2010 were initially included. Use of LE versus proctectomy and use of adjuvant radiation therapy were compared over time. Adjusted Cox proportional hazards models were used to compare OS based on treatment. LE was used to treat 46.5% of patients with T1 and 16.8% with T2 tumors. Use of LE increased steadily over time (P OS than those treated with proctectomy alone or multimodality therapy. Guideline-concordant adoption of LE for treatment of low-risk stage I rectal cancer is increasing. However, use of LE is also increasing for higher-risk rectal cancers that do not meet guideline criteria for LE. Treatment with LE alone is associated with poorer long-term OS. Additional studies are warranted to understand the factors driving increased use of LE.

  11. Quality of life and salivary output in patients with head-and-neck cancer five years after radiotherapy

    International Nuclear Information System (INIS)

    Braam, Pètra M; Roesink, Judith M; Raaijmakers, Cornelis PJ; Busschers, Wim B; Terhaard, Chris HJ

    2007-01-01

    To describe long-term changes in time of quality of life (QOL) and the relation with parotid salivary output in patients with head-and-neck cancer treated with radiotherapy. Forty-four patients completed the EORTC-QLQ-C30(+3) and the EORTC-QLQ-H&N35 questionnaires before treatment, 6 weeks, 6 months, 12 months, and at least 3.5 years after treatment. At the same time points, stimulated bilateral parotid flow rates were measured. There was a deterioration of most QOL items after radiotherapy compared with baseline, with gradual improvement during 5 years follow-up. The specific xerostomia-related items showed improvement in time, but did not return to baseline. Global QOL did not alter significantly in time, although 41% of patients complained of moderate or severe xerostomia at 5 years follow-up. Five years after radiotherapy the mean cumulated parotid flow ratio returned to baseline but 20% of patients had a flow ratio <25%. The change in time of xerostomia was significantly related with the change in flow ratio (p = 0.01). Most of the xerostomia-related QOL scores improved in time after radiotherapy without altering the global QOL, which remained high. The recovery of the dry mouth feeling was significantly correlated with the recovery in parotid flow ratio

  12. Results of the radiologic emergencies response in the state of Sao Paulo during the last five years

    International Nuclear Information System (INIS)

    Boni-Mitake, Malvina; Suzuki, Fabio F.; Nicolau, Jose R.A.; Rodrigues, Demerval L.

    2001-01-01

    Radiation is often associated with bombs, diseases, and destruction rather than with the many benefits of nuclear technology that are present in the daily life. The radiation risk symbol still frightens the population. In addition, small risks related to nuclear area are overestimated. So, when there is a radiological accident, a prompt response is necessary because some of its major deleterious impacts are not quantified just in terms of radiation dose, but they are related to the risk perceived, and in many cases, wrong information or just lack of information induces fear or anxiety. In case of unusual situations involving radiation sources in Sao Paulo State, the people can contact IPEN-CNEN/SP Nuclear and Radiological Emergency Response Team by telephone. The objective of this paper is to show the results obtained in the last five years. In this period, there were 89 calls. About half of those calls were performed by intervening organizations, as Fire Department or Civil Defense. Most of the situations presented low potential risks and some did not involve radiation sources. The results indicate that arrangements should be made for training the intervening organization personnel, which usually are the first ones that arrive at the emergency scene, in fundamentals of radiological protection, including both theoretical and practical aspects. Moreover, major efforts should be intended to divulge and clarify the public about the peaceful uses of nuclear technology, focusing the safety requirements and the regulatory control over the radiation sources. (author)

  13. Taking out 1 billion tons of CO2: The magic of China's 11th Five-Year Plan?

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Nan; Lin, Jiang; Zhou, Nan; Levine, Mark; Fridley, David

    2007-07-01

    China's 11th Five-Year Plan (FYP) sets an ambitious target for energy-efficiency improvement: energy intensity of the country's gross domestic product (GDP) should be reduced by 20% from 2005 to 2010 (NDRC, 2006). This is the first time that a quantitative and binding target has been set for energy efficiency, and signals a major shift in China's strategic thinking about its long-term economic and energy development. The 20% energy intensity target also translates into an annual reduction of over 1.5 billion tons of CO2 by 2010, making the Chinese effort one of most significant carbon mitigation effort in the world today. While it is still too early to tell whether China will achieve this target, this paper attempts to understand the trend in energy intensity in China and to explore a variety of options toward meeting the 20% target using a detailed end-use energy model.

  14. Capitation of public mental health services in Colorado: a five-year follow-up of system-level effects.

    Science.gov (United States)

    Bloom, Joan R; Wang, Huihui; Kang, Soo Hyang; Wallace, Neal T; Hyun, Jenny K; Hu, Teh-wei

    2011-02-01

    Capitated Medicaid mental health programs have reduced costs over the short term by lowering the utilization of high-cost inpatient services. This study examined the five-year effects of capitated financing in community mental health centers (CMHCs) by comparing not-for-profit with for-profit programs. Data were from the Medicaid billing system in Colorado for the precapitation year (1994) and a shadow billing system for the postcapitation years (1995-1999). In a panel design, a random-effect approach estimated the impact of two financing systems on service utilization and cost while adjusting for all the covariates. Consistent with predictions, in both the for-profit and the not-for-profit CMHCs, relative to the precapitation year, there were significant reductions in each postcapitation year in high-cost treatments (inpatient treatment) for all but one comparison (not-for-profit CMHCs in 1999). Also consistent with predictions, the for-profit programs realized significant reductions in cost per user for both outpatient services and total services. In the not-for-profit programs, there were no significant changes in cost per user for total services; a significant reduction in cost per user for outpatient services was found only in the first two years, 1995 and 1996). The evidence suggests that different strategies were used by the not-for-profit and for-profit programs to control expenditures and utilization and that the for-profit programs were more successful in reducing cost per user.

  15. [Long term effect of hepatitis B and C virus infection on the survival of kidney transplant patients].

    Science.gov (United States)

    Corrêa, José Roberto Missel; Rocha, Fabrício Domingos; Peres, Alessandro Afonso; Gonçalves, Luiz Felipe; Manfro, Roberto Ceratti

    2003-01-01

    To evaluate the impact of HCV (hepatitis C virus) and HBV (hepatitis B virus) infection on long-term graft and patient survival in renal transplantation. One hundred and nine kidney allograft recipients were evaluated regarding the presence of antibodies against HCV and hepatitis B surface antigen. Patients were divided into four groups according to their serologic status and followed for ten years for survival analysis. Age, gender, renal failure etiology, length of previous dialysis and post transplantation periods were evaluated. Length on dialysis time was significantly longer in the anti-HCV positive group. There was also a higher number of patients with re-transplants in the HBV and HCV groups. There were no significant differences in 10-year patient survival in the anti-HCV positive group (71.0%; relative risk: 1.13; CI: 0.86-1.47) and in the HBV infected group (77.8%; relative risk: 1.03; CI: 0.7-1.5) compared to the not infected group (80%). However, the group of patients infected with both viruses presented a significantly lower 10-year patient survival (37.5%; relative risk: 2.13; CI: 0.86-5.28) compared to the index group. There were no significant differences on graft survival among the groups. In the present study renal transplant patients infected concomitantly with HBV and HCV present a significantly lower long-term patient survival.

  16. Development of a cell-based treatment for long-term neurotrophin expression and spiral ganglion neuron survival.

    Science.gov (United States)

    Zanin, M P; Hellström, M; Shepherd, R K; Harvey, A R; Gillespie, L N

    2014-09-26

    Spiral ganglion neurons (SGNs), the target cells of the cochlear implant, undergo gradual degeneration following loss of the sensory epithelium in deafness. The preservation of a viable population of SGNs in deafness can be achieved in animal models with exogenous application of neurotrophins such as brain-derived neurotrophic factor (BDNF) and neurotrophin-3. For translation into clinical application, a suitable delivery strategy that provides ongoing neurotrophic support and promotes long-term SGN survival is required. Cell-based neurotrophin treatment has the potential to meet the specific requirements for clinical application, and we have previously reported that Schwann cells genetically modified to express BDNF can support SGN survival in deafness for 4 weeks. This study aimed to investigate various parameters important for the development of a long-term cell-based neurotrophin treatment to support SGN survival. Specifically, we investigated different (i) cell types, (ii) gene transfer methods and (iii) neurotrophins, in order to determine which variables may provide long-term neurotrophin expression and which, therefore, may be the most effective for supporting long-term SGN survival in vivo. We found that fibroblasts that were nucleofected to express BDNF provided the most sustained neurotrophin expression, with ongoing BDNF expression for at least 30 weeks. In addition, the secreted neurotrophin was biologically active and elicited survival effects on SGNs in vitro. Nucleofected fibroblasts may therefore represent a method for safe, long-term delivery of neurotrophins to the deafened cochlea to support SGN survival in deafness. Copyright © 2014 IBRO. Published by Elsevier Ltd. All rights reserved.

  17. Incidence, recurrence, and long-term survival of ischemic stroke subtypes: A population-based study in the Middle East.

    Science.gov (United States)

    Saber, Hamidreza; Thrift, Amanda G; Kapral, Moira K; Shoamanesh, Ashkan; Amiri, Amin; Farzadfard, Mohammad T; Behrouz, Réza; Azarpazhooh, Mahmoud Reza

    2017-10-01

    Background Incidence, risk factors, case fatality and survival rates of ischemic stroke subtypes are unknown in the Middle East due to the lack of community-based incidence stroke studies in this region. Aim To characterize ischemic stroke subtypes in a Middle Eastern population. Methods The Mashad Stroke Incidence Study is a community-based study that prospectively ascertained all cases of stroke among the 450,229 inhabitants of Mashhad, Iran between 2006 and 2007. We identified 512 cases of first-ever ischemic stroke [264 men (mean age 65.5 ± 14.4) and 248 women (mean age 64.14 ± 14.5)]. Subtypes of ischemic stroke were classified according to the TOAST criteria. Incidence rates were age standardized to the WHO and European populations. Results The proportion of stroke subtypes was distributed as follows: 14.1% large artery disease, 15% cardioembolic, 22.5% small artery disease, 43.9% undetermined and 4.5% other. The greatest overall incidence rates were attributed to undetermined infarction (49.97/100,000) followed by small artery disease (25.54/100,000). Prevalence of hypertension, diabetes and atrial fibrillation differed among ischemic stroke subtypes. Overall, there were 268 (52.34%) deaths and 73 (14.25%) recurrent strokes at five years after incident ischemic stroke, with the greatest risk of recurrence seen in the large artery disease (35.6%) and cardioembolic (35.5%) subgroups. Survival was similar in men and women for each stroke subtype. Conclusions We observed markedly greater incidence rates of ischemic stroke subtypes than in other countries within the Mashad Stroke Incidence Study after age standardization. Our findings should be considered when planning prevention and stroke care services in this region.

  18. Twenty-five years of transient counting experience in French PWR units

    Energy Technology Data Exchange (ETDEWEB)

    Barthelet, B. [Electricite de France (EDF DPN), 93 - Saint-Denis (France); Savoldelli, D.; Fritz, R. [Electricite de France (EDF DPN), 93 - Noisy le Grand (France)

    2001-07-01

    For nearly twenty five years, EDF has been checking that the actual operating transients are neither more severe nor more numerous than the design basis transients. This activity of transient cycle counting and bookkeeping has enabled EDF to own a database of more than 800 reactor.years for the PWR units. The current method of transient cycle counting is presented. In the paper, we will point out the main results of transient cycle counting and lessons learned. In general, the frequencies of transients are lower than the design frequencies. In few cases, they are higher, such as the transient frequencies of the RCS lines connected to auxiliary systems often due to operating procedures or particular periodic testing. Few periodic tests were not taken into account in the design basis transient file ; they have been detected thanks to the transient cycle counting. In the last 1980's, we achieved the first updating of the design basis transient file for the PWR 900 MWe series. In the early 1990's, we updated the design basis transient file of the PWR 1300 MWe series. In fact, since design and start-up, the operating conditions have been modified (fuel cycle with stretch-out, modification of the hot leg and cold leg temperatures for the PWR 1300 MWe,...). This was the cause of many unclassified transients. In the new design basis transient file, we have created new transients and increased the frequencies of some of them. This has enabled to consider the updated design basis transient file more representative of actual operating transients. For some years, we have increasingly associated the operators with the transient cycle counting concern. We noticed progress (decreased frequencies of most transients). (authors)

  19. Nutrition profile of under-five year rural children and correlates of undernutrition in central India

    Directory of Open Access Journals (Sweden)

    Venkaiah Kodavalla

    2015-12-01

    Full Text Available Background: High prevalence of undernutrition in Madhya Pradesh contributing to high mortality and morbidities among young children. Aims & objectives: to assess prevalence of undernutrition and its co-relates among under 5 year children in Madhya Pradesh. Materials & Methods: It was a community based cross- sectional study carried out in all the districts of Madhya Pradesh, India using systematic random sampling. Results: A total of 22,895 children (Boys:12379, Girls:10516, mean age 26.1 months, SD 15.9, were covered. The overall prevalence of underweight, stunting and wasting was about 52%, 49% and 26% respectively. The prevalence was significantly (p<0.01 higher among boys as compared to girls. The risk of underweight, stunting and wasting was significantly higher among children belonging to SC+ST communities (OR: 1.36, 1.21 & 1.23 as compared to others, among children of illiterate parents and landless labourers (OR: 1.27, 1.32 & 1.15. The risk of stunting was significantly higher among children living in HHs without electricity (OR: 1.41 and HHs not using sanitary latrine (OR: 1.29. Similarly, the risk of wasting was significantly higher among households not having access to safe drinking water, mothers not cleaning their hands before feeding and among children with history of morbidity during preceding fortnight. Prevalence of underweight (28%, stunting (17% and wasting (34% was significantly (p<0.01 lower among children who were exclusively breast fed up to 6 months. Conclusions: Multiple risk factors are associated with childhood undernutrition and needs multi-pronged and multi-sector approach to tackle the problem. The results will help planners to develop and implement appropriate intervention strategies, for effective control and prevention of undernutrition among under-five year children in Madhya Pradesh

  20. Perceived affordability of health insurance and medical financial burdens five years in to Massachusetts health reform.

    Science.gov (United States)

    Zallman, Leah; Nardin, Rachel; Sayah, Assaad; McCormick, Danny

    2015-10-29

    Under the Massachusetts health reform, low income residents (those with incomes below 150 % of the Federal Poverty Level [FPL]) were eligible for Medicaid and health insurance exchange-based plans with minimal cost-sharing and no premiums. Those with slightly higher incomes (150 %-300 % FPL) were eligible for exchange-based plans that required cost-sharing and premium payments. We conducted face to face surveys in four languages with a convenience sample of 976 patients seeking care at three hospital emergency departments five years after Massachusetts reform. We compared perceived affordability of insurance, financial burden, and satisfaction among low cost sharing plan recipients (recipients of Medicaid and insurance exchange-based plans with minimal cost-sharing and no premiums), high cost sharing plan recipients (recipients of exchange-based plans that required cost-sharing and premium payments) and the commercially insured. We found that despite having higher incomes, higher cost-sharing plan recipients were less satisfied with their insurance plans and perceived more difficulty affording their insurance than those with low cost-sharing plans. Higher cost-sharing plan recipients also reported more difficulty affording medical and non-medical health care as well as insurance premiums than those with commercial insurance. In contrast, patients with low cost-sharing public plans reported higher plan satisfaction and less financial concern than the commercially insured. Policy makers with responsibility for the benefit design of public insurance available under health care reforms in the U.S. should calibrate cost-sharing to income level so as to minimize difficulty affording care and financial burdens.

  1. Type distribution of lymphomas in Lebanon: five-year single institution experience.

    Science.gov (United States)

    Sader-Ghorra, Claude; Rassy, Marc; Naderi, Samah; Kourie, Hampig Raphael; Kattan, Joseph

    2014-01-01

    Lymphomas represent the fifth most frequent cancer in Lebanon. However, little is known concerning epidemiologic characteristics and distribution of lymphoid neoplasms according to the 2008 WHO classification. We conducted a retrospective study of lymphoma cases diagnosed from 2008 till 2012 at Hotel-Dieu de France University Hospital. A total of 502 new cases of lymphoma were diagnosed at our institution during a five year period: 119 cases (24%) were Hodgkin lymphomas (HL) and 383 cases (76%) were non-Hodgkin lymphomas (NHL). HLs were equally distributed in both sexes with a mean age at diagnosis of 30 years. Among NHL, 87% (332 cases) were B cell lymphomas, 9% (34 cases) were T cell lymphomas and 4%(17 cases) were classified as precursor lymphoid neoplasms. Among B cell lymphomas, 44% (147 cases) were diffuse large B cell lymphomas (DLBCL), 20% (65 cases) follicular lymphomas and 8% (27 cases) mantle cell lymphomas. DLBCL were equally distributed in both sexes with a mean age of 58 years. Follicular lymphomas were characterized by a male predominance (57%) and a mean age of 60 years. Mantle cell lymphomas showed a pronounced male predominance (85%) with a mean age of 60 years in men and 70 years in women. Some 72% of patients having T cell lymphomas were men, with a mean age of 57 years in men and 45 years in women, while 65% of patients having precursor lymphoid neoplasms were women with a mean age of 22 years in women and 30 years in men. The lymphoma subtype distribution in Lebanon is unique when compared to other countries from around the world. In fact, Hodgkin and follicular lymphomas are more frequent than in most Far Eastern, European and American countries, while T-cell lymphomas and DLBCL are less frequent.

  2. Temporal artery biopsies in south-east Scotland: a five year review.

    Science.gov (United States)

    Gajree, S; Borooah, S; Dhillon, N; Goudie, C; Smith, C; Aspinall, P; Dhillon, B

    2017-06-01

    Temporal artery biopsy is the gold standard investigation for the diagnosis of giant cell arteritis. The aim of this retrospective study was to investigate the use of temporal artery biopsy in diagnosing giant cell arteritis in south-east Scotland over a five-year period. We aimed to quantify success rates, and predictive factors for a positive biopsy, as well as compare the different specialities performing the biopsies. The data should enable the development of better criteria for referral for investigation of giant cell arteritis. Methods Patients were identified using a database of temporal artery biopsies generated by the pathology department in NHS Lothian (south east Scotland), for all biopsies examined between January 2010 and December 2015. An electronic patient record was used to retrospectively examine the records of patients in the database. Results A total of 715 biopsies were included in the study, of which 250 (35.0%) showed features of giant cell arteritis. The main predictors for a positive biopsy were age at biopsy, specialty performing biopsy, erythrocyte sedimentation rate, jaw claudication/pain, and ophthalmic symptoms. The most important predictor of a positive biopsy was erythrocyte sedimentation rate. The length of biopsy was not found to be a predictor of positive biopsy; however, diameter of biopsy was predictive. Conclusions We have shown that many temporal artery biopsies are negative, and finding ways to reduce the number of patients unnecessarily undergoing biopsy will be essential in reducing workload and streamlining services. This study demonstrates some key predictive factors for patients with positive biopsies. The study also shows that a large proportion of biopsies taking place do not result in the recommended length of specimen, but this does not necessarily reduce the likelihood of a positive biopsy.

  3. Employment status and sick-leave following obesity surgery: a five-year prospective cohort study.

    Science.gov (United States)

    Andersen, John Roger; Hernæs, Ulrikke J V; Hufthammer, Karl Ove; Våge, Villy

    2015-01-01

    Background. Severe obesity is a risk factor for lower participation in paid work, but whether employment increases and sick leave decreases after obesity surgery is not well documented. Methods. We assessed 224 Norwegian patients with severe obesity (mean age: 40; mean BMI: 49; 61% female) regarding employment status (working versus not working) and the number of days of sick leave during the preceding 12 months, before and five years after obesity surgery (75% follow-up rate). Logistic regression analysis was used to study preoperative predictors of employment status after surgery. Results. There were no change in the employment rate over time (54% versus 58%), but the number of days of sick leave per year was significantly reduced, from a mean of 63 to a mean of 26, and from a median of 36 to a median of 4. Most of this change was attributable to patients with zero days of sick leave, which increased from 25% to 41%. Being female, older, having low education level, receiving disability pension and not being employed before obesity surgery were important risk factors for not being employed after obesity surgery. The type of obesity surgery, BMI and marital status were not useful predictors. Conclusions. Our findings suggest that undergoing obesity surgery is not associated with a higher rate of employment, although it may reduce the number of days of sick leave. Additional interventions are likely needed to influence the employment status of these patients. The significant preoperative predictors of not being employed in this study provide suggestions for further research.

  4. Employment status and sick-leave following obesity surgery: a five-year prospective cohort study

    Directory of Open Access Journals (Sweden)

    John Roger Andersen

    2015-09-01

    Full Text Available Background. Severe obesity is a risk factor for lower participation in paid work, but whether employment increases and sick leave decreases after obesity surgery is not well documented.Methods. We assessed 224 Norwegian patients with severe obesity (mean age: 40; mean BMI: 49; 61% female regarding employment status (working versus not working and the number of days of sick leave during the preceding 12 months, before and five years after obesity surgery (75% follow-up rate. Logistic regression analysis was used to study preoperative predictors of employment status after surgery.Results. There were no change in the employment rate over time (54% versus 58%, but the number of days of sick leave per year was significantly reduced, from a mean of 63 to a mean of 26, and from a median of 36 to a median of 4. Most of this change was attributable to patients with zero days of sick leave, which increased from 25% to 41%. Being female, older, having low education level, receiving disability pension and not being employed before obesity surgery were important risk factors for not being employed after obesity surgery. The type of obesity surgery, BMI and marital status were not useful predictors.Conclusions. Our findings suggest that undergoing obesity surgery is not associated with a higher rate of employment, although it may reduce the number of days of sick leave. Additional interventions are likely needed to influence the employment status of these patients. The significant preoperative predictors of not being employed in this study provide suggestions for further research.

  5. Five Years of Women in Nuclear at Texas A&M University

    International Nuclear Information System (INIS)

    Dromgoole, L.

    2015-01-01

    Texas A&M University Women in Nuclear (WiN–TAMU) seeks to provide professional development opportunities for its members while also reaching out to the public both on the university campus and the surrounding local community. The purpose of this poster is to share best practices and learning experiences promoting the career development and education of women in nuclear-related fields acquired over five years of existence as a chapter. Since its reestablishment in 2010, WiN–TAMU has hosted events for women in disciplines related to nuclear technology, including presentations from experts in the nuclear field, Q&A sessions with nuclear engineering faculty, workshops on communicating technical issues about nuclear to the public, public screenings of nuclear films, technical tours of nuclear power plants, medical facilities and regulatory bodies, and socials to build camaraderie among members. WiN–TAMU collaborates with the Nuclear Power Institute (NPI) by interacting with high school students in NPI’s POWER SET programmes. POWER SET (Powerful Opportunities forWomen Eager and Ready for Science, Engineering, and Technology) provides young women with the educational tools and support to pursue education and careers in science, technology, engineering, and math (STEM). The POWER SET students also interact with members of WiN at Texas’s two nuclear power plants, Comanche Peak and South Texas Project. This tiered approach provides the students with the perspectives of WiN members at various stages in their education and careers. As of the end of the 2014 school year, 81% of the students self-identified that they will pursue STEM course of study (as opposed to the U.S. average of 15–17%). The POWER SET model has recently been implemented internationally in the Philippines with a new programme of 50 young women and is being considered for implementation at the Vienna International School as well. (author)

  6. Therapeutic apheresis in the Republic of Macedonia - our five years experience (2000-2004).

    Science.gov (United States)

    Milovanceva-Popovska, M; Stojkovski, Lj; Grcevska, L; Dzikova, S; Ristovska, V; Gogovska, L; Polenakovic, M

    2006-07-01

    Membrane plasma exchange (PE) is a mode of extracorporeal blood purification. Since 1985 membrane PE has been in regular use at the Department of Nephrology, Medical Faculty of Skopje, R.Macedonia. In this paper we report on five years (2000-2004) of single centre plasma exchange activity. We performed 540 PE treatments (108 PE/per year) on 99 patients. The M/F ratio was 40/48. The patients underwent a median of 5.45 procedures (range, 1-16). The treated patients were from different Departments. Protocols for PE depend on the disease and its severity. PE were performed 2-4 times weekly using Gambro PF 2000 N filters with an adaptation of the Gambro AK10 dialysis machine or with the Gambro Prizma machine (2 cases). Blood access was achieved through femoral vein. Substitution was made with fresh frozen plasma and/or with 20% human albumin combined with Ringer's solution. An average amount of 2150 ml plasmafiltrate per treatment (respectively 30 to 40 ml plasmafiltrate/kg body weight) was eliminated. Most therapeutic procedures were performed on patients from the Department of Neurology. 63.6% of all patients were referred for Myasthenia gravis and the Guillian Barre syndrome. The total number of procedures per year has remained fairly stable, corresponding to a median of 5.4 treatments/100 000 inhabitants. We observed hypocalcaemia in 8% of the patients, urticarial reactions in 7.3%, pruritic reactions in 12%, and hypotension/headache in 6.8%. No major procedural complications were seen.

  7. The UK Government's global partnership programme - Its achievements over the past five years and challenges ahead

    International Nuclear Information System (INIS)

    Heyes, Alan

    2007-01-01

    Through the Global Partnership the UK continues to make a significant contribution to improve national and global security. Over the past year the UK has continued to implement a wide range of projects across the breadth of its Global Partnership Programme. As well as ensuring the Programme is robust and capable of dealing with new challenges, the UK has cooperated with other donor countries to help them progress projects associated with submarine dismantling, scientist redirection, enhancing nuclear security and Chemical Weapons Destruction. The Global Partnership, although only five years old, has already achieved a great deal. Some 23 states, plus the European Union, are now working closer together under the Global Partnership, and collectively have enhanced global regional and national security by reducing the availability of Weapons of Mass Destruction (WMD) materials and expertise to both states of concern and terrorists. Considerable progress has already been made in, for example: - Improving the security of fissile materials, dangerous biological agents and chemical weapons stocks; - Reducing the number of sites containing radioactive materials; - Working towards closure of reactors still producing weapon-grade plutonium; - Improving nuclear safety to reduce the risks of further, Chernobyl style accidents; - Constructing facilities for destroying Chemical Weapons stocks, and starting actual destruction; - Providing sustainable employment for former WMD scientists to reduce the risk that their expertise will be misused by states or terrorists. By contributing to many of these activities, the UK has helped to make the world safer. This paper reports on the UK's practical and sustainable contribution to the Global Partnership and identifies a number of challenges that remain if it is to have a wider impact on reducing the threats from WMD material. (authors)

  8. NASA SMD Science Education and Public Outreach Forums: A Five-Year Retrospective

    Science.gov (United States)

    Smith, Denise A.; Peticolas, Laura; Schwerin, Theresa; Shipp, Stephanie

    2014-06-01

    NASA’s Science Mission Directorate (SMD) created four competitively awarded Science Education and Public Outreach Forums (Astrophysics, Heliophysics, Planetary Science, Earth Science) in 2009. The objective is to enhance the overall coherence of SMD education and public outreach (E/PO), leading to more effective, efficient, and sustainable use of SMD science discoveries and learning experiences. We summarize progress and next steps towards achieving this goal with examples drawn from Astrophysics and cross-Forum efforts. Over the past five years, the Forums have enabled leaders of individual SMD mission and grant-funded E/PO programs to work together to place individual science discoveries and learning resources into context for audiences, conveying the big picture of scientific discovery based on audience needs. Forum-organized collaborations and partnerships extend the impact of individual programs to new audiences and provide resources and opportunities for educators to engage their audiences in NASA science. Similarly, Forum resources support scientists and faculty in utilizing SMD E/PO resources. Through Forum activities, mission E/PO teams and grantees have worked together to define common goals and provide unified professional development for educators (NASA’s Multiwavelength Universe); build partnerships with libraries to engage underserved/underrepresented audiences (NASA Science4Girls and Their Families); strengthen use of best practices; provide thematic, audience-based entry points to SMD learning experiences; support scientists in participating in E/PO; and, convey the impact of the SMD E/PO program. The Forums have created a single online digital library (NASA Wavelength, http://nasawavelength.org) that hosts all peer-reviewed SMD-funded education materials and worked with the SMD E/PO community to compile E/PO program metrics (http://nasamissionepometrics.org/). External evaluation shows the Forums are meeting their objectives. Specific examples

  9. Prenatal mercury exposure, maternal seafood consumption and associations with child language at five years.

    Science.gov (United States)

    Vejrup, Kristine; Brandlistuen, Ragnhild Eek; Brantsæter, Anne Lise; Knutsen, Helle Katrine; Caspersen, Ida Henriette; Alexander, Jan; Lundh, Thomas; Meltzer, Helle Margrete; Magnus, Per; Haugen, Margaretha

    2018-01-01

    Methyl mercury (MeHg) is a well-known neurotoxin and evidence suggests that also low level exposure may affect prenatal neurodevelopment. Uncertainty exists as to whether the maternal MeHg burden in Norway might affect child neurodevelopment. To evaluate the association between prenatal mercury exposure, maternal seafood consumption and child language and communication skills at age five. The study sample comprised 38,581 mother-child pairs in the Norwegian Mother and Child Cohort Study. Maternal mercury blood concentration in gestational week 17 was analysed in a sub-sample of 2239 women. Prenatal mercury exposure from maternal diet was calculated from a validated FFQ answered in mid-pregnancy. Mothers reported children's language and communications skills at age five by a questionnaire including questions from the Ages and Stages Questionnaire (ASQ), the Speech and Language Assessment Scale (SLAS) and the Twenty Statements about Language-Related Difficulties (language 20). We performed linear regression analyses adjusting for maternal characteristics, nutritional status and socioeconomic factors. Median maternal blood mercury concentration was 1.03μg/L, dietary mercury exposure was 0.15μg/kgbw/wk, and seafood intake was 217g/wk. Blood mercury concentrations were not associated with any language and communication scales. Increased dietary mercury exposure was significantly associated with improved SLAS scores when mothers had a seafood intake below 400g/wk in the adjusted analysis. Sibling matched analysis showed a small significant adverse association between those above the 90th percentile dietary mercury exposure and the SLAS scores. Maternal seafood intake during pregnancy was positively associated with the language and communication scales. Low levels of prenatal mercury exposure were positively associated with language and communication skills at five years. However, the matched sibling analyses suggested an adverse association between mercury and child

  10. Twenty-five years of transient counting experience in French PWR units

    International Nuclear Information System (INIS)

    Barthelet, B.; Savoldelli, D.; Fritz, R.

    2001-01-01

    For nearly twenty five years, EDF has been checking that the actual operating transients are neither more severe nor more numerous than the design basis transients. This activity of transient cycle counting and bookkeeping has enabled EDF to own a database of more than 800 reactor.years for the PWR units. The current method of transient cycle counting is presented. In the paper, we will point out the main results of transient cycle counting and lessons learned. In general, the frequencies of transients are lower than the design frequencies. In few cases, they are higher, such as the transient frequencies of the RCS lines connected to auxiliary systems often due to operating procedures or particular periodic testing. Few periodic tests were not taken into account in the design basis transient file ; they have been detected thanks to the transient cycle counting. In the last 1980's, we achieved the first updating of the design basis transient file for the PWR 900 MWe series. In the early 1990's, we updated the design basis transient file of the PWR 1300 MWe series. In fact, since design and start-up, the operating conditions have been modified (fuel cycle with stretch-out, modification of the hot leg and cold leg temperatures for the PWR 1300 MWe,...). This was the cause of many unclassified transients. In the new design basis transient file, we have created new transients and increased the frequencies of some of them. This has enabled to consider the updated design basis transient file more representative of actual operating transients. For some years, we have increasingly associated the operators with the transient cycle counting concern. We noticed progress (decreased frequencies of most transients). (authors)

  11. 'Twenty-five years after Chernobyl accident: Safety for the future'. 2011 National report of Ukraine

    International Nuclear Information System (INIS)

    Imanaka, Tetsuji; Shindo, Mahito

    2016-02-01

    This is the Japanese translation of the Ukrainian National Report 'Twenty-five Years after Chernobyl Accident: Safety for the Future', published by the Ministry of Ukraine of Emergencies in 2011 (in Ukrainian and English). This Japanese translation is published as an outcome of the KAKENHI research project on liquidations of Nuclear Disasters in the World (headed by Tetsuji Imanaka), in which Shindo participates, and as a KUR report of the Research Reactor Institute at Kyoto University. The objective of publishing this Japanese translation is to provide basic information on how to overcome the consequences of a large-scale Nuclear Disaster for the wide range of public, including decision-makers and administrative staff. By doing so, this publication aims at invigorating discussions over measures to be applied for overcoming the consequences of the TEPCO Nuclear Disaster (started in 11th March 2011 at Fukushima), and at forming proper schemes to minimise the consequences on current and future generations. The original text of this translation tightly summarised the whole picture of the Chernobyl Nuclear Disaster, which had been the only large-scale Nuclear Disaster until 11th March 2011. More importantly, it describes all sorts of measures and schemes taken in Ukraine from 1986 to 2011 in order to overcome the consequences of the Chernobyl Nuclear Disaster, in a quite well structured manner. In other words, from the contents of this text, Japanese readers are able to learn a lot about the very problems currently facing with. Therefore, I wish many Japanese readers will read this text, and utilise the knowledge written here effectively to overcome the consequences of the TEPCO Nuclear Disaster. (J.P.N.)

  12. THE CONCEPTION OF FISHERIES DEVELOPMENT IN DNIPROPETROVS’K REGION FOR THE NEXT FIVE YEARS

    Directory of Open Access Journals (Sweden)

    O. Fedonenko

    2015-03-01

    Full Text Available Purpose. To analyse the current state of fisheries in Dnipropetrovs’k region and elaborate a strategy of their development for the period of 2015–2019. Methodology. We used the summarized results of hydrobiological, ichthyological and toxicological studies carried out during 2010–2014. Data were collected in the Zaporizhzhia reservoir and small water bodies with standard sampling gears. A set of control gears (gill nets with mesh size of 30–120 mm was used to investigate the fish fauna. Juvenile fish were caught in the third decade of July – first decade of August with 10 m beach seine. Findings. The analysis of fisheries in Dnipropetrovs’k region for the past five years showed that the disorder and absence of scientifically-based approach to fisheries processes as well as the low level of professional training of aquatic resource users resulted in low fish productivity in the majority of reservoirs, which ranged within 25–30 kg/ha that was several times less than the real potential fish productivity. The proposed Conception of fisheries development provides a set of coordinated measures aimed at ensuring sustainable use, effective protection and restoration of aquatic biological resources, fisheries management based on natural, economic and environmental conditions of different types of water bodies. The developed practical measures allow increasing the amounts of fish product supply to the internal consumer market by at least 5 times without any environmental damage, expanding its assortment and reducing the costs by 25–30%. Originality. For the first time, the Conceptual approaches to the regional management of aquatic biological resources in the conditions of specific human impact were introduced. They are aimed at implementing the scientific rationale of the measures for their rational use, artificial restoration, reclamation, etc. Practical value. The proposed Conception is to provide the food requirements of the population

  13. UNAVCO's Education and Community Engagement Program: Evaluating Five years of Geoscience Education and Community Outreach

    Science.gov (United States)

    Charlevoix, D. J.; Dutilly, E.

    2017-12-01

    In 2013, UNAVCO, a facility co-sponsored by the NSF and NASA, received a five-year award from the NSF: Geodesy Advancing Geosciences and EarthScope (GAGE). Under GAGE, UNAVCO's Education and Community Engagement (ECE) program conducts outreach and education activities, in essence broader impacts for the scientific community and public. One major challenge of this evaluation was the breadth and depth of the dozens of projects conducted by the ECE program under the GAGE award. To efficiently solve this problem of a large-scale program evaluation, we adopted a deliberative democratic (DD) approach that afforded UNAVCO ECE staff a prominent voice in the process. The evaluator directed staff members to chose the projects they wished to highlight as case studies of their finest broader impacts work. The DD approach prizes inclusion, dialogue, and deliberation. The evaluator invited ECE staff to articulate qualities of great programs and develop a case study of their most valuable broader impacts work. To anchor the staff's opinion in more objectivity than opinion, the evaluator asked each staff member to articulate exemplary qualities of their chosen project, discuss how these qualities fit their case study, and helped staff to develop data collection systems that lead to an evidence-based argument in support of their project's unique value. The results of this evaluation show that the individual ECE work areas specialized in certain kinds of projects. However, when viewed at the aggregate level, ECE projects spanned almost the entire gamut of NSF broader impacts categories. Longitudinal analyses show that since the beginning of the GAGE award, many projects grew in impact from year 1 to year 5. While roughly half of the ECE projects were prior work projects, by year five at least 33% of projects were newly developed under GAGE. All selected case studies exemplified how education and outreach work can be productively tied to UNAVCO's core mission of promoting geodesy.

  14. Branch Development of Five-Year-Old Betula alnoides Plantations in Response to Planting Density

    Directory of Open Access Journals (Sweden)

    Chun-Sheng Wang

    2018-01-01

    Full Text Available Branch development in the lower part of stem is critical to both early stem growth and wood quality of the most valuable section of tree, and its regulation through planting density has always been greatly concerned. Here the effect of planting density on branch development was examined in a five-year-old plantation of Betula alnoides with six planting densities (625, 833, 1111, 1250, 1667, and 2500 stems per hectare (sph in Guangdong Province, South China. Branch quantity (number, proportion, and density, morphology (diameter, length, and angle, position (height and orientation, and branch status (dead or alive were investigated for 54 dominant or co-dominant trees under six treatments of planting density after the growth of each tree was measured. Factors influencing branch development were also explored by mixed modelling. The results showed that the mean tree heights of 1250 and 1667 sph treatments were higher than those of other planting density treatments. The quantity of live branches decreased with increasing planting density. However, planting density had no significant effect on the number of all branches, and there existed no remarkable difference in branch number and proportion among four orientations. As for branch morphology, only the largest branch diameter had a significantly negative correlation with planting density. In addition, high planting density significantly increased the height of the largest branch within the crown. Mixed effects models indicated that branch diameter, length, and angle were closely correlated with each other, and they were all in positively significant correlation to the branch height at the stem section below six meters. It was concluded that properly increasing planting density will promote natural pruning, improve early branch control, and be beneficial for wood production from the most valuable section of the stem.

  15. Predictors of long-term survival among first-ever ischemic and hemorrhagic stroke in a Brazilian stroke cohort.

    Science.gov (United States)

    Goulart, Alessandra C; Fernandes, Tiotrefis G; Santos, Itamar S; Alencar, Airlane P; Bensenor, Isabela M; Lotufo, Paulo A

    2013-05-24

    Few studies have examined both ischemic and hemorrhagic stroke to identify prognostic factors associated to long-term stroke survival. We investigated long-term survival and predictors that could adversely influence ischemic and hemorrhagic first-ever stroke prognosis. We prospectively ascertained 665 consecutive first-ever ischemic and hemorrhagic stroke cases from "The Study of Stroke Mortality and Morbidity" (The EMMA Study) in a community hospital in São Paulo, Brazil. We evaluated cardiovascular risk factors and sociodemographic characteristics (age, gender, race and educational level). We found a lower survival rate among hemorrhagic cases compared to ischemic stroke cases at the end of 4 years of follow-up (52% vs. 44%, p = 0.04). The risk of death was two times higher among people with ischemic stroke without formal education. Also, we found consistently higher risk of death for diabetics with ischemic stroke (HR = 1.45; 95% CI = 1.07-1.97) compared to no diabetics. As expected, age equally influenced on the high risk of poor survival, regardless of stroke subtype. For ischemic stroke, the lack of formal education and diabetes were significant independent predictors of poor long-term survival.

  16. Association Among Blood Transfusion, Sepsis, and Decreased Long-term Survival After Colon Cancer Resection.

    Science.gov (United States)

    Aquina, Christopher T; Blumberg, Neil; Becerra, Adan Z; Boscoe, Francis P; Schymura, Maria J; Noyes, Katia; Monson, John R T; Fleming, Fergal J

    2017-08-01

    To investigate the potential additive effects of blood transfusion and sepsis on colon cancer disease-specific survival, cardiovascular disease-specific survival, and overall survival after colon cancer surgery. Perioperative blood transfusions are associated with infectious complications and increased risk of cancer recurrence through systemic inflammatory effects. Furthermore, recent studies have suggested an association among sepsis, subsequent systemic inflammation, and adverse cardiovascular outcomes. However, no study has investigated the association among transfusion, sepsis, and disease-specific survival in postoperative patients. The New York State Cancer Registry and Statewide Planning and Research Cooperative System were queried for stage I to III colon cancer resections from 2004 to 2011. Propensity-adjusted survival analyses assessed the association of perioperative allogeneic blood transfusion, sepsis, and 5-year colon cancer disease-specific survival, cardiovascular disease-specific survival, and overall survival. Among 24,230 patients, 29% received a transfusion and 4% developed sepsis. After risk adjustment, transfusion and sepsis were associated with worse colon cancer disease-specific survival [(+)transfusion: hazard ratio (HR) 1.19, 95% confidence interval (CI) 1.09-1.30; (+)sepsis: HR 1.84, 95% CI 1.44-2.35; (+)transfusion/(+)sepsis: HR 2.27, 95% CI 1.87-2.76], cardiovascular disease-specific survival [(+)transfusion: HR 1.18, 95% CI 1.04-1.33; (+)sepsis: HR 1.63, 95% CI 1.14-2.31; (+)transfusion/(+)sepsis: HR 2.04, 95% CI 1.58-2.63], and overall survival [(+)transfusion: HR 1.21, 95% CI 1.14-1.29; (+)sepsis: HR 1.76, 95% CI 1.48-2.09; (+)transfusion/(+)sepsis: HR 2.36, 95% CI 2.07-2.68] relative to (-)transfusion/(-)sepsis. Additional analyses suggested an additive effect with those who both received a blood transfusion and developed sepsis having even worse survival. Perioperative blood transfusions are associated with shorter survival

  17. Sex differences in lung cancer survival: long-term trends using population-based cancer registry data in Osaka, Japan.

    Science.gov (United States)

    Kinoshita, Fukuaki Lee; Ito, Yuri; Morishima, Toshitaka; Miyashiro, Isao; Nakayama, Tomio

    2017-09-01

    Several studies of sex differences in lung cancer survival have been reported. However, large-size population-based studies based on long-term observation are scarce. We investigated long-term trends in sex differences in lung cancer survival using population-based cancer registry data from Osaka, Japan. We analyzed 79 330 cases from the Osaka Cancer Registry (OCR) diagnosed between 1975 and 2007. We calculated 5-year relative survival in the six periods (1975-1980, 1981-1986, 1987-1992, 1993-1997, 1998-2002 and 2003-2007). To estimate the trends in sex differences in lung cancer survival throughout the study period, we applied a multivariate excess hazard model to control for confounders. The proportion of adenocarcinoma (ADC) and 5-year relative relative survival have increased for both sexes. Sex differences in lung cancer survival have widened over the period, especially in ADC and since the late 1990s. The excess hazard ratio of death within 5 years for males was 1.19 (95% CI: 1.16-1.21), adjusting for period at diagnosis, histologic type, stage, age group and treatment. We reported that females have better prognosis in lung cancer than males and the sex differences in lung cancer survival have become wider in Osaka, Japan. This can be partly explained by the sex differences in the proportions of histologic type and stage. Further studies considering other factors that influence sex differences in lung cancer survival are needed. © The Author 2017. Published by Oxford University Press. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com

  18. Survival in Malnourished Older Patients Receiving Post-Discharge Nutritional Support; Long-Term Results of a Randomized Controlled Trial.

    Science.gov (United States)

    Neelemaat, F; van Keeken, S; Langius, J A E; de van der Schueren, M A E; Thijs, A; Bosmans, J E

    2017-01-01

    Previous analyses have shown that a post-discharge individualized nutritional intervention had positive effects on body weight, lean body mass, functional limitations and fall incidents in malnourished older patients. However, the impact of this intervention on survival has not yet been studied. The objective of this randomized controlled study was to examine the effect of a post-discharge individualized nutritional intervention on survival in malnourished older patients. Malnourished older patients, aged ≥ 60 years, were randomized during hospitalization to a three-months post-discharge nutritional intervention group (protein and energy enriched diet, oral nutritional supplements, vitamin D3/calcium supplement and telephone counseling by a dietitian) or to a usual care regimen (control group). Survival data were collected 4 years after enrollment. Survival analyses were performed using intention-to-treat analysis by Log-rank tests and Cox regression adjusted for confounders. The study population consisted of 94 men (45%) and 116 women with a mean age of 74.5 (SD 9.5) years. There were no statistically significant differences in baseline characteristics. Survival data was available in 208 out of 210 patients. After 1 and 4 years of follow-up, survival rates were respectively 66% and 29% in the intervention group (n=104) and 73% and 30% in the control group (n=104). There were no statistically significant differences in survival between the two groups 1 year (HR= 0.933, 95% CI=0.675-1.289) and 4 years after enrollment (HR=0.928, 95% CI=0.671-1.283). The current study failed to show an effect of a three-months post-discharge multi-component nutritional intervention in malnourished older patients on long-term survival, despite the positive effects on short-term outcome such as functional limitations and falls.

  19. Repair or Replacement for Isolated Tricuspid Valve Pathology? Insights from a Surgical Analysis on Long-Term Survival

    Science.gov (United States)

    Farag, Mina; Arif, Rawa; Sabashnikov, Anton; Zeriouh, Mohamed; Popov, Aron-Frederik; Ruhparwar, Arjang; Schmack, Bastian; Dohmen, Pascal M.; Szabó, Gábor; Karck, Matthias; Weymann, Alexander

    2017-01-01

    Background Long-term follow-up data concerning isolated tricuspid valve pathology after replacement or reconstruction is limited. Current American Heart Association guidelines equally recommend repair and replacement when surgical intervention is indicated. Our aim was to investigate and compare operative mortality and long-term survival in patients undergoing isolated tricuspid valve repair surgery versus replacement. Material/Methods Between 1995 and 2011, 109 consecutive patients underwent surgical correction of tricuspid valve pathology at our institution for varying structural pathologies. A total of 41 (37.6%) patients underwent tricuspid annuloplasty/repair (TAP) with or without ring implantation, while 68 (62.3%) patients received tricuspid valve replacement (TVR) of whom 36 (53%) were mechanical and 32 (47%) were biological prostheses. Results Early survival at 30 days after surgery was 97.6% in the TAP group and 91.1% in the TVR group. After 6 months, 89.1% in the TAP group and 87.8% in the TVR group were alive. In terms of long-term survival, there was no further mortality observed after one year post surgery in both groups (Log Rank p=0.919, Breslow p=0.834, Tarone-Ware p=0.880) in the Kaplan-Meier Survival analysis. The 1-, 5-, and 8-year survival rates were 85.8% for TAP and 87.8% for TVR group. Conclusions Surgical repair of the tricuspid valve does not show survival benefit when compared to replacement. Hence valve replacement should be considered generously in patients with reasonable suspicion that regurgitation after repair will reoccur. PMID:28236633

  20. Effect of a long-term high-protein diet on survival, obesity development, and gut microbiota in mice

    NARCIS (Netherlands)

    Kiilerich, Pia; Myrmel, Lene Secher; Fjære, Even; Hao, Qin; Hugenholtz, Floor; Sonne, Si Brask; Derrien, Muriel; Pedersen, Lone Møller; Petersen, Rasmus Koefoed; Mortensen, Alicja; Licht, Tine Rask; Rømer, Maria Unni; Vogel, Ulla Birgitte; Waagbø, Linn Jeanette; Giallourou, Natasa; Feng, Qiang; Xiao, Liang; Liu, Chuan; Liaset, Bjørn; Kleerebezem, Michiel; Wang, Jun; Madsen, Lise; Kristiansen, Karsten

    2016-01-01

    Female C57BL/6J mice were fed a regular low-fat diet or high-fat diets combined with either high or low protein-to-sucrose ratios during their entire lifespan to examine the long-term effects on obesity development, gut microbiota, and survival. Intake of a high-fat diet with a low

  1. Effect of a long-term high-protein diet on survival, obesity development, and gut microbiota in mice

    NARCIS (Netherlands)

    Kiilerich, Pia; Myrmel, Lene Secher; Fjære, Even; Hao, Qin; Hugenholtz, Floor; Sonne, Si Brask; Derrien, Muriel; Pedersen, Lone Møller; Petersen, Rasmus Koefoed; Mortensen, Alicja; Licht, Tine Rask; Rømer, Maria Unni; Vogel, Ulla Birgitte; Waagbø, Linn Jeanette; Giallourou, Natasa; Feng, Qiang; Xiao, Liang; Liu, Chuan; Liaset, Bjørn; Kleerebezem, Michiel; Wang, Jun; Madsen, Lise; Kristiansen, Karsten

    2016-01-01

    Female C57BL/6J mice were fed a regular low-fat diet or high-fat diets combined with either high or low protein-to-sucrose ratios during their entire lifespan to examine the long-term effects on obesity development, gut microbiota, and survival. Intake of a high-fat diet with a low protein/sucrose

  2. Predictive value of the Status Epilepticus Severity Score (STESS) and its components for long-term survival

    DEFF Research Database (Denmark)

    Aukland, Preben; Lando, Martin; Vilholm, Ole

    2016-01-01

    BACKGROUND: The "Status Epilepticus Severity Score" (STESS) is the most important clinical score to predict in-hospital mortality of patients with status epilepticus (SE), but its prognostic relevance for long-term survival is unknown. This study therefore examined if STESS and its components...

  3. Bayesian Gaussian regression analysis of malnutrition for children under five years of age in Ethiopia, EMDHS 2014.

    Science.gov (United States)

    Mohammed, Seid; Asfaw, Zeytu G

    2018-01-01

    The term malnutrition generally refers to both under-nutrition and over-nutrition, but this study uses the term to refer solely to a deficiency of nutrition. In Ethiopia, child malnutrition is one of the most serious public health problem and the highest in the world. The purpose of the present study was to identify the high risk factors of malnutrition and test different statistical models for childhood malnutrition and, thereafter weighing the preferable model through model comparison criteria. Bayesian Gaussian regression model was used to analyze the effect of selected socioeconomic, demographic, health and environmental covariates on malnutrition under five years old child's. Inference was made using Bayesian approach based on Markov Chain Monte Carlo (MCMC) simulation techniques in BayesX. The study found that the variables such as sex of a child, preceding birth interval, age of the child, father's education level, source of water, mother's body mass index, head of household sex, mother's age at birth, wealth index, birth order, diarrhea, child's size at birth and duration of breast feeding showed significant effects on children's malnutrition in Ethiopia. The age of child, mother's age at birth and mother's body mass index could also be important factors with a non linear effect for the child's malnutrition in Ethiopia. Thus, the present study emphasizes a special care on variables such as sex of child, preceding birth interval, father's education level, source of water, sex of head of household, wealth index, birth order, diarrhea, child's size at birth, duration of breast feeding, age of child, mother's age at birth and mother's body mass index to combat childhood malnutrition in developing countries.

  4. Characteristics of individuals receiving disability benefits in the Netherlands and predictors of leaving the disability benefit scheme: a retrospective cohort study with five-year follow-up.

    Science.gov (United States)

    Louwerse, Ilse; Huysmans, Maaike A; van Rijssen, H Jolanda; van der Beek, Allard J; Anema, Johannes R

    2018-01-18

    Today, work disability is one of the greatest social and labour market challenges for policy makers in most OECD countries, where on average, about 6% of the working-age population relies on disability benefits. Understanding of factors associated with long-term work disability may be helpful to identify groups of individuals at risk for disability benefit entitlement or continuing eligibility, and to develop effective interventions for these groups. The purpose of this study is to provide insight into the main diagnoses of workers who qualify for disability benefits and how these diagnoses differ in age, gender and education. Using a five-year follow-up, we examined the duration of disability benefits and how durations differ among individuals with various characteristics. We performed a cohort study of 31,733 individuals receiving disability benefits from the Dutch Social Security Institute (SSI) with a five-year follow-up. Data were collected from SSI databases. Information about disorders was assessed by an insurance physician upon benefit application. These data were used to test for significant relationships among socio-demographics, main diagnoses and comorbidity, and disability benefit entitlement and continuing eligibility. Mental disorders were the most frequent diagnosis for individuals claiming work disability. Diagnoses differed among age groups and education categories. Mental disorders were the main diagnosis for work disability for younger and more highly educated individuals, and physical disorders (generally musculoskeletal, cardiovascular and cancer) were the main diagnosis for older and less educated individuals. In 82% of the claims, the duration of disability benefit was five years or more after approval. Outflow was lowest for individuals with (multiple) mental disorders and those with comorbidity of mental and physical disorders, and highest for individuals with (multiple) physical disorders. The main diagnosis for persons entitled to

  5. [Chest Injury and its Surgical Treatment in Polytrauma Patients. Five-Year Experience].

    Science.gov (United States)

    Vodička, J; Doležal, J; Vejvodová, Š; Šafránek, J; Špidlen, V; Třeška, V

    2016-01-01

    PURPOSE OF THE STUDY Thoracic trauma, one of the most frequent injuries in patients with multiple traumata, is found in 50 to 80% of these patients and it is crucial for the patient's prognosis. It accounts for 25% of all death from polytraumatic injuries. The aim of this retrospective study was an analysis of the occurrence of chest injuries in polytrauma patients and their surgical treatment in the Trauma Centre or Department of Surgery of the University Hospital Pilsen in a five-year period. MATERIAL AND METHODS Patients with injuries meeting the definition of polytrauma and an Injury Severity Score (ISS) ≥16 were included. The demographic characteristics, mechanism of multiple trauma, ISS value and chest injury were recorded in each patient. The number of injured patients in each year of the study was noted. In the patients with chest injury, the type of injury and method of treatment were assessed. The therapy was further analysed including its timing. The number of deaths due to polytrauma involving chest injury, the cause of death and its time in relation to the patient's admission to the Trauma Centre were evaluated. RESULTS In the period 2010-14, 513 polytrauma patients were treated; of them 371 (72.3%) were men with an average age of 40.5 years. The most frequent cause of injury was a traffic accident (74%). The average ISS of the whole group was 35 points. Chest injury was diagnosed in 469 patients (91.4%) of whom only five (1.1%) had penetrating injury. Pulmonary contusion was most frequent (314 patients; 67%). A total of 212 patients with chest injury underwent surgery (45.2%); urgent surgery was performed in 143 (67.5%), acute surgery in 49 (23.1%) and delayed surgery in 63 (29.7%) patients. Chest drainage was the major surgical procedure used in the whole group. Of 61 patients who died, 52 had chest injury. In this subgroup the most frequent cause of death was decompensated traumatic shock (26 patients; 50%). In the whole group, 32 polytrauma

  6. Twenty-five years of modeling multiphase flow and heat transfer

    International Nuclear Information System (INIS)

    Lyczkowski, R.W.

    1999-01-01

    This presentation will cover some of the highlights of multiphase modeling in collaboration with Professor Dimitri Gidaspow (DG) over the last roughly twenty-five years. It all started in 1972 in Idaho Falls with Charles Solbrig, who planned and initiated a project for the former USAEC to develop a computer code to replace RELAP4 to analyze the loss of coolant accident (LOCA). DG spent his sabbatical on the project in 1973. One highlight was the discovery of complex characteristics, the implications of which are still pondered by some. Fluidization research began in 1978 when the author collaboratively developed a step-by-step building-block approach to understanding the hydrodynamics of fluidized beds, an approach closely coupled to validation experiments. A grant from the USDOE to study solids circulation around a jet in a fluidized bed was awarded to DG in 1978. Following that, grants from GRI, NSF, and a contract from Westinghouse Electric Corp. allowed the early work to continue. Progress was slow since computer costs were high. Subsequent continuing support from the USDOE, NSF, EPRI, and industry has allowed research to continue, as has his collaboration. A highlight of this collaboration was the development of the monolayer energy dissipation (MED) erosion model. Multiphase flow and fluidization theory took quantum leaps with the publication of DG's Multiphase Flow and Fluidization: Continuum and Kinetic Theory Descriptions (MFF), Academic Press, San Diego (1994), for which there is essentially no competition. Only the late Professor S.L. Soo's Particulates and Continuum: Multiphase Fluid Dynamics, Hemisphere Publishing Corp., New York (1989), a textbook version of the classic monograph Multiphase Fluid Dynamics, Science Press, Beijing, China (1990), comes close. In MFF, the kinetic theory of granular flow has evolved as a potentially viable adjunct to the continuum multiphase theory, of which fluidization is one important manifestation. It must be

  7. ROMANIA’S FIRST FIVE YEARS IN THE EUROPEAN UNION. A SHORT ASSESSMENT

    Directory of Open Access Journals (Sweden)

    VADASAN Ioana

    2012-12-01

    Full Text Available It’s been more than 5 years since our country has joined the European Union, on January the 1st 2007. It’s been a long road, as fulfilling the Copenhagen criteria had not been an easy task. But was it all worth it? Are we better off today, five years after? Did we know how to take advantage of European Union membership? Did we know what to do and how to do it, in order to benefit from (all the advantages of the Single Market? These are some questions we will try to answer in this paper. In this paper, we will present data regarding: the evolution of Romania’s foreign trade, overall, as well as with the rest of the European Union countries; the evolution of Romania’s economic growth, in comparison with European Union’s average economic growth; the evolution of foreign direct investments in Romania; the absorption degree of structural and cohesion funds, in comparison with other countries of the European Union. We will analyze these data, and we will make comparisons between Romania and the European Union, in order to see the similarity between Romania’s evolution and EU’s evolution. We will also analyze the structural and cohesion funds absorption degree, in comparison with other European Union countries. Finally, we will try to assess whether we knew how to take advantage of our European Union membership, as being member implies both advantages and disadvantages. Knowing how to fully benefit from the advantages and how to diminish the disadvantages is the winning strategy. Did Romania know how to maximize its advantages? As we will see in the conclusions of this paper, the answers to these questions are not always in our advantage. There are still some lessons to be learned, especially regarding the absorption of structural and cohesion funds, and attracting foreign direct investments.

  8. WMAP five-year constraints on lepton asymmetry and radiation energy density: implications for Planck

    International Nuclear Information System (INIS)

    Popa, L A; Vasile, A

    2008-01-01

    In this paper we set bounds on the radiation content of the Universe and neutrino properties by using the WMAP (Wilkinson microwave anisotropy probe) five-year CMB (cosmic microwave background) measurements complemented with most of the existing CMB and LSS (large scale structure) data (WMAP5+All), imposing also self-consistent BBN (big bang nucleosynthesis) constraints on the primordial helium abundance. We consider lepton asymmetric cosmological models parametrized by the neutrino degeneracy parameter ξ ν and the variation of the relativistic degrees of freedom, ΔN eff oth , due to possible other physical processes occurring between BBN and structure formation epochs. We get a mean value of the effective number of relativistic neutrino species of N eff = 2.98  2.27 3.60   1.65 4.37 , providing an important improvement over the similar result obtained from WMAP5+BAO+SN+HST (BAO: baryonic acoustic oscillations; SN: supernovae; HST: Hubble Space Telescope) data (Komatsu et al (WMAP Collaboration), 2008 Astrophys. J. Suppl. submitted [0803.0547]). We also find a strong correlation between Ω m h 2 and z eq , showing that we observe N eff mainly via the effect of z eq , rather than via neutrino anisotropic stress as claimed by the WMAP team (Komatsu et al (WMAP Collaboration), 2008 Astrophys. J. Suppl. submitted [0803.0547]). WMAP5+All data provide a strong bound on the helium mass fraction of Y p = 0.2486 ± 0.0085 (68% CL), that rivals the bound on Y p obtained from the conservative analysis of the present data on helium abundance. For the neutrino degeneracy parameter we find a bound of −0.216≤ξ ν ≤0.226 (68% CL), which represents an important improvement over the similar result obtained by using the WMAP three-year data. The inclusion in the analysis of LSS data reduces the upper limit of the neutrino mass to m ν ν and Y p down to σ(ξ ν )≅0.089 (68% CL) and σ(Y p ) = 0.013 (68% CL) respectively, values fully consistent with the BBN bounds on

  9. Evaluation of a five-year Bloomberg Global Road Safety Program in Turkey.

    Science.gov (United States)

    Gupta, S; Hoe, C; Özkan, T; Lajunen, T J; Vursavas, F; Sener, S; Hyder, A A

    2017-03-01

    Turkey was included in the Bloomberg Philanthropies funded Global Road Safety Program (2010-14) with Ankara and Afyonkarahisar (Afyon) selected for interventions to manage speed and encourage seat-belt use. The objectives of this study are to present the monitoring and evaluation findings of seat-belt use and speed in Afyon and Ankara over the five years and to assess overall impact of the program on road traffic injury, and death rates in Turkey. Quasi-experimental before after without comparison. In collaboration with the Middle East Technical University, roadside observations and interviews were coupled with secondary data to monitor changes in risk factors and outcomes at the two intervention sites. The percentage of seat-belt use among drivers and front-seat passengers in Afyon and Ankara increased significantly between 2010 and 2014 with increased self-reported use and preceded by an increase in tickets (fines) for not using seat belts. There were uneven improvements in speed reduction. In Afyon, the average speed increased significantly from 46.3 km/h in 2012 to about 52.7 km/h in 2014 on roads where the speed limits were 50 km/h. In Ankara, the average speed remained less than 55 km/h during the program period (range: 50-54 km/h; P < 0.005) for roads where the speed limits were 50 km/h; however, the average speed on roads with speed limits of 70 km/h decreased significantly from 80.6 km/h in 2012 to 68.44 km/h in 2014 (P < 0.005). The program contributed to increase in seat-belt use in Afyon and Ankara and by drawing political attention to the issue can contribute to improvements in road safety. We are optimistic that the visible motivation within Turkey to substantially reduce road traffic injuries will lead to increased program implementation matched with a robust evaluation program, with suitable controls. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

  10. Five-year Treatment Outcomes in the Ahmed Baerveldt Comparison Study

    Science.gov (United States)

    Budenz, Donald L.; Barton, Keith; Gedde, Steven J.; Feuer, William J.; Schiffman, Joyce; Costa, Vital P.; Godfrey, David G.; Buys, Yvonne M.

    2014-01-01

    Purpose To compare the five year outcomes of the Ahmed FP7 Glaucoma Valve (AGV) and the Baerveldt 101-350 Glaucoma Implant (BGI) for the treatment of refractory glaucoma. Design Multicenter randomized controlled clinical trial. Participants 276 patients, including 143 in the AGV group and 133 in the BGI group. Methods Patients 18 to 85 years of age with previous intraocular surgery or refractory glaucoma and intraocular pressure (IOP) of ≥ 18 mmHg in whom glaucoma drainage implant surgery was planned were randomized to implantation of either an AGV or BGI. Main Outcome Measures IOP, visual acuity, use of glaucoma medications, complications, and failure (IOP > 21 mmHg or not reduced by 20% from baseline, IOP ≤ 5 mmHg, reoperation for glaucoma, removal of implant, or loss of light perception). Results At 5 years, IOP (mean ± SD) was 14.7 ± 4.4 mmHg in the AGV group and 12.7 ± 4.5 mmHg in the BGI group (p = 0.012). The number of glaucoma medications in use at 5 years (mean ± SD) was 2.2 ± 1.4 in the AGV group and 1.8 ± 1.5 in the BGI group (p = 0.28). The cumulative probability of failure during 5 years of follow-up was 44.7% in the AGV group and 39.4% in the BGI group (p = 0.65). The number of subjects failing due to inadequately controlled IOP or reoperation for glaucoma was 46 in the AGV group (80% of AGV failures) and 25 in the BGI group (53% of BGI failures, p=0.003). Eleven AGV eyes (20% of AGV failures) experienced persistent hypotony, explantation of implant, or loss of light perception compared to 22 (47% of failures) in the BGI group. The 5-year cumulative reoperation rate for glaucoma was 20.8% in the AGV group compared to 8.6% in the BGI group (p=0.010). Change in logMAR Snellen visual acuity (mean ± SD) at 5 years was 0.42 ± 0.99 in the AGV group and 0.43 ± 0.84 in the BGI group (p=0.97). Conclusions Similar rates of surgical success were observed with both implants at 5 years. BGI implantation produced greater IOP reduction and a lower rate

  11. An appraisal of retained placentae in ibadan: a five year review.

    Science.gov (United States)

    Obajimi, G O; Roberts, A O; Aimakhu, C O; Bello, F A; Olayemi, O

    2009-06-01

    To determine the frequency of retained placenta at the University College Hospital Ibadan (UCH). and to describe the socio-demographic characteristics of the patients and examine the risk factors predisposing to retained placenta. This is a descriptive study covering a period of 5 years from January 1(st) 2002 to December 31(st) 2006. During the study period, 4980 deliveries took place at the University College Hospital, Ibadan and 106 cases of retained placenta were managed making the incidence 2.13 per cent of all births. During the five year period, there were 106 patients with retained placenta; of these, 90 (84.9%) case notes were available for analysis. The mean age was 29.37 ± 4.99 years. First and second Para accounted for 52 per cent of the patients. Majority of the patient were unbooked for antenatal care in UCH with booked patients accounting for 27.8 per cent of the cases. The mean gestational age at delivery was 34.29 ± 6.02. Three patients presented to the hospital in shock of which 2 died on account of severe haemorrhagic shock. Fifty-eight patients (64.8%) presented with anaemia (packed cell volume less than 30 per cent) and 35 patients (38.8%) had blood transfusion ranging between 1-4 pints. 1 patient required hysterectomy on account of morbidly adherent placenta. Eleven patients (12.2%) had placenta retention in the past, 28 patients (31%) had a previous dilatation and curettage, 14 patients (15.5%) had previous caesarean sections and 47 patients (41.3%) had no known predisposing factors. Retained placenta still remains a potentially life threatening condition in the tropics due to the associated haemorrhage, and other complications related to its removal. The incidence and severity may be decreased by health education, women empowerment and the provision of facilities for essential obstetric services by high skilled health care providers in ensuring a properly conducted delivery with active management of the third stage of labour.

  12. [Email in a dedicated headache clinic: experience gained over a five-year period].

    Science.gov (United States)

    Pedraza, M Isabel; Herrero-Velázquez, Sonia; López-Mesonero, Luis; Ruiz-Piñero, Marina; Posadas, Javier; Guerrero-Peral, Ángel L

    2015-06-16

    The use of email can facilitate communication between the different levels of an organisation. Our primary care physicians have had an email service in the dedicated headache clinic (DHC) since November 2009, and our aim is therefore to analyse the use of email over that five-year period. Data concerning the emails sent up until October 2014 were collected prospectively. The questions were classified as need for referral to the DHC (group 1), progress made by the cases seen in the DHC (group 2), training in headaches (group 3) or the treatment of the headaches suffered by primary care physicians themselves as patients (group 4). A total of 274 email messages were analysed. Monthly consultations have increased (from 1.5 per month during the first year to 7.5 per month during the fifth). Findings showed that 10.2% of the email messages came from rural health centres and 89.8% were sent from urban health centres. Replies were sent within 2 ± 2.8 days (range: 0-24 days). Altogether 130 consultations were classified as belonging to group 1 (47.4%), in which referral through the normal channel was recommended in 60 cases (46.2%), via the preferential channel in 47 (36.2%) and non-referral was suggested in 23 cases (17.6%). Group 2 included 125 emails (45.7%) and in 80 cases there was no need to make a new appointment or to bring forward the existing one (64%). Thirteen visits (4.7%) were classified into group 3 and six (2.2%) in group 4. Our primary care physicians are using the email of the DHC on an increasingly more frequent basis. Its use makes it possible to detect patients whose appointment -whether the first or a follow-up- needs to be brought forward, as well as allowing issues to be solved without the need for referral. It is effective for the treatment of physicians who themselves have headaches and as a tool for continuing education.

  13. Five Years of Analyses of Volatiles, Isotopes and Organics in Gale Crater Materials

    Science.gov (United States)

    McAdam, A.; Mahaffy, P. R.; Andrejkovicova, S. C.; Archer, P. D., Jr.; Atreya, S. K.; Buch, A.; Coll, P. J.; Conrad, P. G.; Eigenbrode, J. L.; Farley, K. A.; Flesch, G.; Franz, H. B.; Freissinet, C.; Glavin, D. P.; Hogancamp, J. V.; House, C. H.; Knudson, C. A.; Lewis, J. M.; Malespin, C.; Martin, P. M.; Millan, M.; Ming, D. W.; Morris, R. V.; Navarro-Gonzalez, R.; Steele, A.; Stern, J. C.; Summons, R. E.; Sutter, B.; Szopa, C.; Teinturier, S.; Trainer, M. G.; Webster, C. R.; Wong, G. M.

    2017-12-01

    Over the last five years, the Curiosity rover has explored a variety of fluvial, lacustrine and aeolian sedimentary rocks, and soils. The Sample Analysis at Mars (SAM) instrument has analysed 3 soil and 12 rock samples, which exhibit significant chemical and mineralogical diversity in over 200 meters of vertical section. Here we will highlight several key insights enabled by recent measurements of the chemical and isotopic composition of inorganic volatiles and organic compounds detected in Gale Crater materials. Until recently samples have evolved O2 during SAM evolved gas analyses (EGA), attributed to the thermal decomposition of oxychlorine phases. A lack of O2 evolution from recent mudstone samples may indicate a difference in the composition of depositional or diagenetic fluids, and can also have implications for the detection of organic compounds since O2 can combust organics to CO2 in the SAM ovens. Recent mudstone samples have also shown little or no evolution of NO attributable to nitrate salts, possibly also as a result of changes in the chemical composition of fluids [1]. Measurements of the isotopic composition of sulfur, hydrogen, nitrogen, chlorine, and carbon in methane evolved during SAM pyrolysis are providing constraints on the conditions of possible paleoenvironments [e.g., 2, 3]. There is evidence of organic C from both EGA and GCMS measurements of Gale samples [e.g., 4, 5]. Organic sulfur volatiles have been detected in several samples, and the first opportunistic derivatization experiment produced a rich dataset indicating the presence of several organic compounds [6, 7]. A K-Ar age has been obtained from the Mojave mudstone, and the age of secondary materials formed by aqueous alteration is likely history and habitability. [1] Sutter et al. (2017) LPSC 3009. [2] Franz et al., this mtg. [3] Stern et al., this mtg. [4] Ming et al. (2014) Science 343. [5] Freissinet et al. (2015) JGR 120. [6] Eigenbrode et al. (2016) AGU P21D-08. [7] Freissinet

  14. Firework injuries at a major trauma and burn center: A five-year prospective study.

    Science.gov (United States)

    Wang, Cheng; Zhao, Ran; Du, Wei-Li; Ning, Fang-Gang; Zhang, Guo-An

    2014-03-01

    In China, fireworks are an integral part of the celebration of the annual Spring Festival, but the number of injuries associated with their private use seen in emergency rooms increases dramatically. To raise awareness and help guide future prevention practices in this city, we investigated the epidemiology of firework-related injuries presented at our trauma and burn center in Beijing during the Spring Festivals of 2007-2011. Patients were interviewed using a pre-coded questionnaire to elicit information regarding age, gender, causes, injured body part, type of injury, diagnosis, and disposition. From 2007 to 2011, during the Spring Festivals 734 patients with fire-work related injuries were seen at our trauma and burn center in Beijing, the median patients of the five year were 140(136-150). The mean age of the patients was 26±15.3 years (range, 1-95 years). Of the 734 patients, the highest proportion of injuries were the 5-14 year-old age group The majority of the patients were male (87.9%), the overall male:female ratio was 7.41:1, and males were predominant in all age groups. For all 5 years, the incidence of firework-related injuries during the Spring Festival Holidays peaked specifically on the first, fifth, and last days, respectively. Injuries were mainly due to improper handling (415/610, 68.0%) or setting off illegal fireworks (195/610, 32.0%). The most frequently injured body parts were the hands and fingers (32.0%), head or face except eyes (28.3%), and trunk (22.4%). Burns were the most common type of injury (65.7%), most of the burned patients (437/453) were between 1% and 10%, and the most common region burned were hands and fingers (218/754). Contusions or lacerations were the second common type of injury (34.3%). Most of the patients (642, 87.5%) were treated and released, while 37 (5%) were treated and transferred, and 55 (7.5%) were admitted for advanced treatment. The private use of fireworks during the Spring Festival Holidays is associated

  15. Long-term survival of transplanted allogeneic cells engineered to express a T cell chemorepellent.

    Science.gov (United States)

    Papeta, Natalia; Chen, Tao; Vianello, Fabrizio; Gererty, Lyle; Malik, Ashish; Mok, Ying-Ting; Tharp, William G; Bagley, Jessamyn; Zhao, Guiling; Stevceva, Liljana; Yoon, Victor; Sykes, Megan; Sachs, David; Iacomini, John; Poznansky, Mark C

    2007-01-27

    Alloantigen specific T cells have been shown to be required for allograft rejection. The chemokine, stromal cell derived factor-1 (SDF-1) at high concentration, has been shown to act as a T-cell chemorepellent and abrogate T-cell infiltration into a site of antigen challenge in vivo via a mechanism termed fugetaxis or chemorepulsion. We postulated that this mechanism could be exploited therapeutically and that allogeneic cells engineered to express a chemorepellent protein would not be rejected. Allogeneic murine insulinoma beta-TC3 cells and primary islets from BALB/C mice were engineered to constitutively secrete differential levels of SDF-1 and transplanted into allogeneic diabetic C57BL/6 mice. Rejection was defined as the permanent return of hyperglycemia and was correlated with the level of T-cell infiltration. The migratory response of T-cells to SDF-1 was also analyzed by transwell migration assay and time-lapse videomicroscopy. The cytotoxicity of cytotoxic T cell (CTLs) against beta-TC3 cells expressing high levels of SDF-1 was measured in standard and modified chromium-release assays in order to determine the effect of CTL migration on killing efficacy. Control animals rejected allogeneic cells and remained diabetic. In contrast, high level SDF-1 production by transplanted cells resulted in increased survival of the allograft and a significant reduction in blood glucose levels and T-cell infiltration into the transplanted tissue. This is the first demonstration of a novel approach that exploits T-cell chemorepulsion to induce site specific immune isolation and thereby overcomes allograft rejection without the use of systemic immunosuppression.

  16. Suicide rates in five-year age-bands after the age of 60 years: the international landscape.

    Science.gov (United States)

    Shah, Ajit; Bhat, Ravi; Zarate-Escudero, Sofia; DeLeo, Diego; Erlangsen, Annette

    2016-01-01

    There is paucity of studies examining suicide rates in narrow five-year age-bands after the age of 60 years. This study examined suicide rates in eight five-year age-bands between the age of 60 and 99 years because this will allow more precise comparison between the young old (60-79 years) and the oldest old (80+ years) age groups. Data on the number of suicides (International Classification of Diseases - ICD-10 codes, X60-84) in each of the eight five-year age-bands between the age-bands 60-64 years and 95-99 years in both gender for as many years as possible from 2000 were ascertained from three sources: colleagues with access to national data, national statisics office websites and email contact with the national statistics offices. The population size for the corresponding years and age-bands was estimated for each country using data provided by the United Nations website. In men, suicide rates continued to increase for each of the seven five-year age-bands from 60-64 years to 90-94 years age-band, and then declined slightly for the 95-99 year age-band. In women, suicide rates continued to increase for each of the six five-year age-bands from 60-64 years to 85-89 years age-bands, and then declined slightly for the 90-94 years and 95-99 years age-bands. The overall global suicide rates for each of the eight five-year age-bands are sufficiently large for them to constitute a public health concern. This is especially important given the ongoing rise in the elderly population size and the paucity of data on risk and protective factors for suicide in the five-year age-bands after the age of 60 years.

  17. Relationship Between Mothers’ Role and Knowledge in Recurrence Prevention of Food Allergy for Children Under Five Years-Old

    Directory of Open Access Journals (Sweden)

    Fitria Rinawarti

    2017-04-01

    Full Text Available There are 30-40% of people with allergies world wide in 2011, this is based on data from the Center for Disease Control and Prevention (CDC more than tripled from 1993 to 2006. Parents play an important role in overcoming the recurrence of allergies in children in order of recurrence allergies and more severe recurrence. The goal of the study is to analyze association mothers’s role and knowledge in recurrence prevention of food allergy in children under five years-old. The study is an analytic observational research with cross sectional design. Method of sampling usedis simple random sampling. The samples were 39 mothers who have children under five years-old with food allergy in Rumah Sakit Islam Jemursari Surabaya. Analysis used chi-square test with α = 0.05 significance level.The results revealed the knowledge of mothers’ with allergy recurrance is 15 person (38,5% have a good knowledge in prevention of food allergy in children under five years-old, while mothers’s role in recurrence prevention of food allergy in children under five years-old is 26 person (66,7% have a role unfavorable. The statistical test by using chi-square revealed there were association between mothers’role (ρ=0,030 and mother’s of knowledge (ρ=0,00001in recurrence prevention of food allergy for children under five years-old.The conclusions of the results this study is mothers’s role with unfavorable to have children under five years-old with an allergy recurrence of severe allergy, while mothers with good knowledge to have children under five years-old with an allergy reccurrance of mild allergy. Keywords: recurrence allergies, mother’s role, mother’s knowledge

  18. Effect of Thoracic Surgeons on Lung Cancer Patients’ Survival

    Directory of Open Access Journals (Sweden)

    Ning LI

    2018-02-01

    Full Text Available Background and objective Surgeons are the direct decision-makers and performers in the surgical treatment of patients with lung cancer. Whether the differences among doctors affect the survival of patients is unclear. This study analyzed the five-year survival rates of different thoracic surgeries in patients undergoing surgery to assess the physician's impact and impact. Methods A retrospective analysis of five years between 2002-2007 in the Department of Thoracic Surgery, Cancer Hospital, Chinese Academy of Medical Sciences, for surgical treatment of lung cancer patients. According to different surgeons grouping doctors to compare the basic information of patients, surgical methods, short-term results and long-term survival differences. Results A total of 712 patients treated by 11 experienced thoracic surgeons were included in this study. The patients have nosignificant difference with gender, age, smoking, pathological type between groups. There were significant differences in clinical staging, surgery type, operation time, blood transfusion rate, number of lymph node dissection, palliative resection rate, postoperative complications and perioperative mortality. There was a significant difference in five-year survival rates among patients treated by different doctors. This difference can be seen in all clinical stage analyzes with consistency. In the multivariate analysis, it was suggested that surgeon was an independent factor influencing the prognosis of patients. Conclusion Thoracic surgeon has a significant effect on the therapeutic effect of lung cancer patients.

  19. Long-term survival outcomes in patients with surgically treated oropharyngeal cancer and defined human papilloma virus status.

    Science.gov (United States)

    Dale, O T; Sood, S; Shah, K A; Han, C; Rapozo, D; Mehanna, H; Winter, S C

    2016-11-01

    This study investigated long-term survival outcomes in surgically treated oropharyngeal cancer patients with known human papilloma virus status. A case note review was performed of all patients undergoing primary surgery for oropharyngeal cancer in a single centre over a 10-year period. Human papilloma virus status was determined via dual modality testing. Associations between clinicopathological variables and survival were identified using a log-rank test. Of the 107 cases in the study, 40 per cent (n = 41) were human papilloma virus positive. The positive and negative predictive values of p16 immunohistochemistry for human papilloma virus status were 57 per cent and 100 per cent, respectively. At a mean follow up of 59.5 months, 5-year overall and disease-specific survival estimates were 78 per cent and 69 per cent, respectively. Human papilloma virus status (p = 0.014), smoking status (p = 0.021) and tumour stage (p = 0.03) were significant prognostic indicators. The long-term survival rates in surgically treated oropharyngeal cancer patients were comparable to other studies. Variables including human papilloma virus status and tumour stage were associated with survival in patients treated with primary surgery; however, nodal stage and presence of extracapsular spread were non-prognostic.

  20. Radiobiological effects of tritiated water short-term exposure on V79 clonogenic cell survival

    DEFF Research Database (Denmark)

    Siragusa, Mattia; Fredericia, Nina Pil Møntegaard; Jensen, Mikael

    2018-01-01

    We set out to improve the accuracy of absorbed dose calculations for in-vitro measurements of the Relative Biological Effectiveness (RBE) of tritiated water (HTO) for the clonogenic cell survival assay, also considering the influence of the end-of-track Linear Energy Transfer (LET) of low-energy...... in suspension are usually comparable to those for adherent cells. RBEs calculated at the 10% survival fraction through the use of the average energy are almost similar to those obtained with the beta-spectrum. For adherent cells, an RBE of 1.6 was found when HTO cell survival curves were compared to acute γ...

  1. MID TERM RESULTS AFTER OPEN HEART SURGERY IN HEMODIALYSIS PATIENTS AWAITING KIDNEY TRANSPLANT: DOES CARDIOVASCULAR SURGICAL INTERVENTION PRIOR TO TRANSPLANTATION PROLONG SURVIVAL?

    Science.gov (United States)

    Ozbek, C; Sever, K; Demirhan, O; Mansuroglu, D; Kurtoglu, N; Ugurlucan, M; Sevmis, S; Karakayali, H

    2015-12-01

    The aim of this study was to compare the mid and long term postoperative outcomes between the hemodialysis-dependent patients awaiting kidney transplantat who underwent open heart surgery in our department during the last five years, and those who did not receive a renal transplant, to determine the predictors of mortality, and assess the possible contribution of post heart surgery kidney transplantation to survival. The patients were separated into two groups: those who underwent a transplantation after open heart surgery were included in the Tp+ group, and those who did not in the Tp- group Between June 2008 and December 2012, 127 dialysis dependent patients awaiting kidney transplant and who underwent open heart surgery were separated into two groups. Those who underwent transplantation after open heart surgery were determined as Tp+ (n=33), and those who did not as Tp- (n=94). Both groups were compared with respect to preoperative paramaters including age, sex, diabetes mellitus (DM), hypertension (HT), hyperlipidemia (HL), obesity, smoking, chronic obstructive pulmonary disease (COPD), peripheral vascular disease (PVD), left ventricle ejection fraction (EF), Euroscore; operative parameters including cross clamp time, perfusion time, number of grafts, use of internal mammary artery (IMA); postoperative parameters including revision, blood transfusion, ventilation time, use of inotropic agents, length of stay in the intensive care unit and hospital, and follow up findings. Problems encountered during follow up were recorded. Predictors of mortality were determined and the survival was calculated. Among the preoperative parameters, when compared with the Tp- group, the Tp+ group had significantly lower values in mean age, presence of DM, obesity, PVD, and Euroscore levels, and higher EF values. Assessment of postoperative values showed that blood transfusion requirement and length of hospital stay were significantly lower in the Tp+ group compared to the Tp

  2. Chemotherapy increases long-term survival in patients with adult medulloblastoma--a literature-based meta-analysis.

    Science.gov (United States)

    Kocakaya, Selin; Beier, Christoph Patrick; Beier, Dagmar

    2016-03-01

    Adult medulloblastoma is a potentially curable malignant entity with an incidence of 0.5-1 per million. Valid data on prognosis, treatment, and demographics are lacking, as most current knowledge stems from retrospective studies. Surgical resection followed by radiotherapy are accepted parts of treatment regimes; however, established prognostic factors and data clarifying the role of chemotherapy are missing. We investigated 227 publications from 1969-2013, with 907 identifiable, individual patients being available for meta-analysis. Demographic data, risk stratification, and treatment of these patients were similar to previous cohorts. The median overall survival (mOS) was 65 months (95% CI: 54.6-75.3) , the 5-year overall survival was 50.9% with 16% of the patients dying more than 5 years after diagnosis. Incomplete resection, clinical and radiological signs for brainstem infiltration, and abstinence from radiotherapy were predictive of worse outcome. Metastatic disease at tumor recurrence was identified as a new prognostic factor, while neither metastasis at initial diagnosis nor desmoplastic/classic histology was correlated with survival. Patients receiving chemotherapy first-line survived significantly longer (mOS: 108 mo, 95% CI: 68.6-148.4) than patients treated with radiation alone (mOS: 57 mo, 95% CI: 39.6-74.4) or patients who received chemotherapy at tumor recurrence. This effect was not biased by tumor stage or decade of treatment. Importantly, (neo)adjuvant chemotherapy also significantly increased the chance for long-term survival (>5 y) compared with radiotherapy alone or chemotherapy at tumor recurrence. This meta-analysis clarifies relevant prognostic factors and suggests that chemotherapy as part of first-line therapy improves overall survival and increases the proportion of patients with long-term survival. © The Author(s) 2015. Published by Oxford University Press on behalf of the Society for Neuro-Oncology. All rights reserved. For permissions

  3. Sarcopenia is an Independent Predictor of Severe Postoperative Complications and Long-Term Survival After Radical Gastrectomy for Gastric Cancer

    Science.gov (United States)

    Zhuang, Cheng-Le; Huang, Dong-Dong; Pang, Wen-Yang; Zhou, Chong-Jun; Wang, Su-Lin; Lou, Neng; Ma, Liang-Liang; Yu, Zhen; Shen, Xian

    2016-01-01

    Abstract Currently, the association between sarcopenia and long-term prognosis after gastric cancer surgery has not been investigated. Moreover, the association between sarcopenia and postoperative complications remains controversial. This large-scale retrospective study aims to ascertain the prevalence of sarcopenia and assess its impact on postoperative complications and long-term survival in patients undergoing radical gastrectomy for gastric cancer. From December 2008 to April 2013, the clinical data of all patients who underwent elective radical gastrectomy for gastric cancer were collected prospectively. Only patients with available preoperative abdominal CT scan within 30 days of surgery were considered for analysis. Skeletal muscle mass was determined by abdominal (computed tomography) CT scan, and sarcopenia was diagnosed by the cut-off values obtained by means of optimum stratification. Univariate and multivariate analyses evaluating risk factors of postoperative complications and long-term survival were performed. A total of 937 patients were included in this study, and 389 (41.5%) patients were sarcopenic based on the diagnostic cut-off values (34.9 cm2/m2 for women and 40.8 cm2/m2 for men). Sarcopenia was an independent risk factor for severe postoperative complications (OR = 3.010, P sarcopenia did not show significant association with operative mortality. Moreover, sarcopenia was an independent predictor for poorer overall survival (HR = 1.653, P sarcopenia remained an independent risk factor for overall survival and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I. Sarcopenia is an independent predictive factor of severe postoperative complications after radical gastrectomy for gastric cancer. Moreover, sarcopenia is independently associated with overall and disease-free survival in patients with TNM stage II and III, but not in patients with TNM stage I. PMID:27043677

  4. Short-term survival and mortality rates in a retrospective study of colic in 1588 Danish horses

    DEFF Research Database (Denmark)

    Christophersen, Mogens Teken; Dupont, Nana Hee; Berg-Sørensen, Kristina S.

    2014-01-01

    Background: Outcomes of colic treatment are of great interest to clinicians, horse owners and insurers. One commonly used criterion of success is the overall short-term survival rate. This is used as to compare treatments and to measure quality of veterinary care, but may be biased by demographic...... the countries, which may bias the outcomes. This study indicates that qualitative interview studies on owners ’ attitudes towards animal suffering and euthanasia need to be conducted. Our opinion is that survival rates are not valid as sole indicators of quality of care in colic treatment due to selection bias...

  5. Important prognostic factors for the long-term survival of lung cancer subjects in Taiwan

    International Nuclear Information System (INIS)

    Chiang, Tai-An; Chen, Ping-Ho; Wu, Pei-Fen; Wang, Tsu-Nai; Chang, Po-Ya; Ko, Albert Min-Shan; Huang, Ming-Shyan; Ko, Ying-Chin

    2008-01-01

    This study used a large-scale cancer database in determination of prognostic factors for the survival of lung cancer subjects in Taiwan. Total of 24,910 subjects diagnosed with lung cancer was analysed. Survival estimates by Kaplan-Meier methods. Cox proportional-hazards model estimated the death risk (hazard ratio (HR)) for various prognostic factors. The prognostic indicators associated with a higher risk of lung cancer deaths are male gender (males versus females; HR = 1.07, 95% confidence intervals (CI): 1.03–1.11), males diagnosed in later periods (shown in 1991–1994 versus 1987–1990; HR = 1.13), older age at diagnosis, large cell carcinoma (LCC)/small cell carcinoma (SCC), and supportive care therapy over chemotherapy. The overall 5-year survival rate for lung cancer death was significantly poorer for males (21.3%) than females (23.6%). Subjects with squamous cell carcinoma (SQCC) and treatment by surgical resection alone had better prognosis. We find surgical resections to markedly increase 5-year survival rate from LCC, decreased risk of death from LCC, and no improved survival from SCC. Gender and clinical characteristics (i.e. diagnostic period, diagnostic age, histological type and treatment modality) play important roles in determining lung cancer survival

  6. Long-term survival among Hodgkin's lymphoma patients with gastrointestinal cancer: a population-based study

    Science.gov (United States)

    Youn, P.; Li, H.; Milano, M. T.; Stovall, M.; Constine, L. S.; Travis, L. B.

    2013-01-01

    Background The increased risk of gastrointestinal (GI) cancers after Hodgkin's lymphoma (HL) is well established. However, no large population-based study has described the actuarial survival after subsequent GI cancers in HL survivors (HL-GI). Patients and methods For 209 patients with HL-GI cancers (105 colon, 35 stomach, 30 pancreas, 21 rectum, and 18 esophagus) and 484 165 patients with first primary GI cancers (GI-1), actuarial survival was compared, accounting for age, gender, race, GI cancer stage, radiation for HL, and other variables. Results Though survival of HL patients who developed localized stage colon cancer was similar to that of the GI-1 group, overall survival (OS) of HL patients with regional or distant stage colon cancer was reduced [hazard ratio, (HR) = 1.46, P = 0.01]. The HL survivors with regional or distant stage colon cancer in the transverse segment had an especially high risk of mortality (HR: 2.7, P = 0.001 for OS). For localized stomach cancer, OS was inferior among HL survivors (HR = 3.46, P = 0.006). Conclusions The HL patients who develop GI cancer experience significantly reduced survival compared with patients with a first primary GI cancer. Further research is needed to explain the inferior survival of HL patients and to define selection criteria for cancer screening in HL survivors. PMID:22855552

  7. Dexamethasone and long-term outcome of tuberculous meningitis in Vietnamese adults and adolescents.

    Directory of Open Access Journals (Sweden)

    M Estée Török

    Full Text Available Dexamethasone has been shown to reduce mortality in patients with tuberculous meningitis but the long-term outcome of the disease is unknown.Vietnamese adults and adolescents with tuberculous meningitis recruited to a randomised, double-blind, placebo-controlled trial of adjunctive dexamethasone were followed-up at five years, to determine the effect of dexamethasone on long-term survival and neurological disability.545 patients were randomised to receive either dexamethasone (274 patients or placebo (271 patients. 50 patients (9.2% were lost to follow-up at five years. In all patients two-year survival, probabilities tended to be higher in the dexamethasone arm (0.63 versus 0.55; p = 0.07 but five-year survival rates were similar (0.54 versus 0.51, p = 0.51 in both groups. In patients with grade 1 TBM, but not with grade 2 or grade 3 TBM, the benefit of dexamethasone treatment tended to persist over time (five-year survival probabilities 0.69 versus 0.55, p = 0.07 but there was no conclusive evidence of treatment effect heterogeneity by TBM grade (p = 0.36. The dexamethasone group had a similar proportion of severely disabled patients among survivors at five years as the placebo group (17/128, 13.2% vs. 17/116, 14.7% and there was no significant association between dexamethasone treatment and disability status at five years (p = 0.32.Adjunctive dexamethasone appears to improve the probability of survival in patients with TBM, until at least two years of follow-up. We could not demonstrate a five-year survival benefit of dexamethasone treatment which may be confined to patients with grade 1 TBM.ClinicalTrials.gov NCT01317654.

  8. Nutritional Status of Children under five years and it’s determinants in Vakarai, Sri Lanka

    International Nuclear Information System (INIS)

    Jayathissa, Renuka; Peiris, Dilka

    2014-01-01

    Full text: Vakarai area was heavily affected during the conflicts. After cessation of the war it's decided to identify the nutritional problems to support with appropriate interventions. Study aimed to determine the nutrition status of children under five years of age and it’s determinants to make the recommendations. Cross sectional study done in 389 children identified using cluster sampling. Interviewer administered questionnaire to and anthropometric measurements were taken. WHO standards were used. Prevalence of wasting was 24.7% (CI;20.4-28.9%), of which 20.5% (CI;16.5-24.5%) moderate and 4.2% (CI;2.2-6.2%) severe wasting. Prevalence of stunting and underweight 16.2% (CI;12.5-19.8%) and 33.4% (CI;28.7-38.1%) respectively. National estimates of moderate and severe wasting was 11.7% and 1.9% respectively. Low birth weight in the sample was 28.8% higher than national estimates (28.8%;18.1%). Immediate causes indicated 63.1% and 4.4% of children had respiratory tract infections and diarrhoea. 10.9% of children in the age group up to 6 months were given any items other than breast milk within first 3 days of life. Among those in the age group 6 – 23 months, water was the commonest item given (97.3%) and 77.4 % was given rice, bread and rice flour preparations. As age increased more of the children were given a variety of food items. 32.4% children aged 6-23 months has received a minimum acceptable diet, which was lower among girls compared to boys. Among the breastfed children the percentage having minimum meal frequency was higher (30.1%) than the non-breastfed children (14.3%). 96% had a Child Health Development Record and 95.8% had age appropriate immunization. 35.5% children were given de worming tablets within the previous 6 months with the percentage received a vitamin A was 69.8%. Rice and other cereals and coconut have been consumed almost on all days during the preceding week. Meat and pulses consumption was less frequent and 51.2% of the households

  9. Remotely Operated Vehicles under sea ice - Experiences and results from five years of polar operations

    Science.gov (United States)

    Katlein, Christian; Arndt, Stefanie; Lange, Benjamin; Belter, Hans Jakob; Schiller, Martin; Nicolaus, Marcel

    2016-04-01

    The availability of advanced robotic technologies to the Earth Science community has largely increased in the last decade. Remotely operated vehicles (ROV) enable spatially extensive scientific investigations underneath the sea ice of the polar oceans, covering a larger range and longer diving times than divers with significantly lower risks. Here we present our experiences and scientific results acquired from ROV operations during the last five years in the Arctic and Antarctic sea ice region. Working under the sea ice means to have all obstacles and investigated objects above the vehicle, and thus changes several paradigms of ROV operations as compared to blue water applications. Observations of downwelling spectral irradiance and radiance allow a characterization of the optical properties of sea ice and the spatial variability of the energy partitioning across the atmosphere-ice-ocean boundary. Our results show that the decreasing thickness and age of the sea ice have led to a significant increase in light transmission during summer over the last three decades. Spatially extensive measurements from ROV surveys generally provide more information on the light field variability than single spot measurements. The large number of sampled ice conditions during five cruises with the German research icebreaker RV Polarstern allows for the investigations of the seasonal evolution of light transmittance. Both, measurements of hyperspectral light transmittance through sea ice, as well as classification of upward-looking camera images were used to investigate the spatial distribution of ice-algal biomass. Buoyant ice-algal aggregates were found to be positioned in the stretches of level ice, rather than pressure ridges due to a physical interaction of aggregate-buoyancy and under-ice currents. Synchronous measurements of sea ice thickness by upward looking sonar provides crucial additional information to put light-transmittance and biological observations into context

  10. Long-term survival of 42 patients with resected N2 non-small-cell lung cancer: the impact of 2-(18)F-fluoro-2-deoxy-D-glucose positron emission tomogram mediastinal staging.

    Science.gov (United States)

    Barnett, Stephen; Baste, Jean-Marc; Murugappan, Kowsi; Tog, Check; Berlangieri, Salvatore; Scott, Andrew; Seevanayagam, Siven; Knight, Simon

    2011-01-01

    Prognostic information known preoperatively allows stratification of patients to surgery; induction therapy and surgery; or definitive chemoradiotherapy and may prevent a futile thoracotomy. Attention has focussed on the standard uptake value (SUV) of the primary tumour but less has been described regarding the 18F-fluoro-2-deoxy-D-glucose (18F-FDG) avidity of mediastinal nodes. We aimed, in a group of surgically resected cN0-1 but pN2 tumours, to compare the survival of patients with and without 18F-FDG avid mediastinal nodes. Retrospective review of a surgical database identified cN0-1 non-small-cell lung cancer (NSCLC) patients with pN2 disease after resection. Survival of non-FDG avid N2 versus FDG avid N2 groups was compared after stratification according to variables found on univariate analysis to affect survival. From January 1993 to December 2006, 42 patients were identified; 27 (64%) had non-FDG avid N2 disease. Five-year and median survival were better in the non-FDG avid N2 disease group, 25% versus 0% and 30 (16-44) versus 13 (10-16) months, respectively (p=0.02). After 1998, the difference in survival was 41% versus 0% and 35 (14-56) versus 12 (16-18) months, respectively (p=0.02). After resection, patients with non-FDG avid N2 disease have better survival than patients with FDG avid N2 disease. Exploratory thoracotomy alone (after frozen section analysis) cannot be advocated in patients with non-FDG avid N2 disease as survival after resection appears at least equivalent to alternate therapeutic approaches in this group. This assertion may be tempered if right pneumonectomy is required or R0 resection is unachievable. Mediastinal nodal avidity may improve stratification in future studies of long-term survival in NSCLC. Crown Copyright © 2010. Published by Elsevier B.V. All rights reserved.

  11. Minimal access surgery compared with medical management for gastro-oesophageal reflux disease: five year follow-up of a randomised controlled trial (REFLUX)

    Science.gov (United States)

    Cotton, S C; Boachie, C; Ramsay, C R; Krukowski, Z H; Heading, R C; Campbell, M K

    2013-01-01

    Objectives To determine the long term clinical effectiveness of laparoscopic fundoplication as an alternative to drug treatment for chronic gastro-oesophageal reflux disease (GORD). Design Five year follow-up of multicentre, pragmatic randomised trial (with parallel non-randomised preference groups). Setting Initial recruitment in 21 UK hospitals. Participants Responders to annual questionnaires among 810 original participants. At entry, all had had GORD for >12 months. Intervention The surgeon chose the type of fundoplication. Medical therapy was reviewed and optimised by a specialist. Subsequent management was at the discretion of the clinician responsible for care, usually in primary care. Main outcome measures Primary outcome measure was self reported quality of life score on disease-specific REFLUX questionnaire. Other measures were health status (with SF-36 and EuroQol EQ-5D questionnaires), use of antireflux medication, and complications. Results By five years, 63% (112/178) of patients randomised to surgery and 13% (24/179) of those randomised to medical management had received a fundoplication (plus 85% (222/261) and 3% (6/192) of those who expressed a preference for surgery and for medical management). Among responders at 5 years, 44% (56/127) of those randomised to surgery were taking antireflux medication versus 82% (98/119) of those randomised to medical management. Differences in the REFLUX score significantly favoured the randomised surgery group (mean difference 8.5 (95% CI 3.9 to 13.1), Preflux-related operations—most often revision of the wrap. Long term rates of dysphagia, flatulence, and inability to vomit were similar in the two randomised groups. Conclusions After five years, laparoscopic fundoplication continued to provide better relief of GORD symptoms than medical management. Adverse effects of surgery were uncommon and generally observed soon after surgery. A small proportion had re-operations. There was no evidence of long term adverse

  12. Audit in radiation therapy: long-term survival and cost of treatment

    International Nuclear Information System (INIS)

    Stevens, G.; Firth, I.

    1997-01-01

    In order to determine the cost of radiation treatment and the survival rate of a cohort of patients treated in a 6 month period in 1988, estimates of the capital and recurrent costs of this service were made for the calendar year 1988, expressed as $A(1988). Data collected prospectively included workload statistics (including number of attendances), field treated and complexity of treatment. Patient and tumour-related data included tumour site, intent of treatment and survival. The survival rate of patients during this period was determined in June 1995. The cost per field in 1988 was estimated at $A44.32. The 1988 costs of courses of definitive, adjuvant and palliative radiation therapy were estimated at $A2545, $A2482 and $A929, respectively. The major contributor to the cost of salaries and consumables within the Radiation Oncology Department (81.6%), with capital costs accounting for 13.5%, overheads accounting for 4.5% of the costs and planned admissions accounting for 0.2%. The median survival time of 580 patients with malignant disease treated during this period in 1988 was 12.4 months. The overall 5 year survival rate was 27%. For 105 patients treated definitively with radiation therapy, the median and 5 year survival rate figures were 26.0 months and 40%. For 149 patients treated with adjuvant radiation therapy, the 5 year survival rate was 62% (median survival rate not reached). For 279 patients treated palliatively, median and 5 year survival rate figures were 5.2 months and 3%. The cost per month of survival for all patients with malignancy was $A67; the figures for definitive , adjuvant and palliative treatments being $A74, $A48 and $A105, respectively. A sensitivity analysis indicated that these figures were robust. The cost of radiation treatment per field was comparable to reports for other centres and emphasizes the utility of radiation therapy as a cost-effective cancer treatment modality. 7 refs., 6 tabs., 2 figs

  13. Five-year longitudinal assessment of the downstream impact on schistosomiasis transmission following closure of the Three Gorges Dam.

    Directory of Open Access Journals (Sweden)

    Darren J Gray

    Full Text Available Schistosoma japonicum is a major public health concern in the Peoples' Republic of China (PRC, with about 800,000 people infected and another 50 million living in areas at risk of infection. Based on ecological, environmental, population genetic and molecular factors, schistosomiasis transmission in PRC can be categorised into four discrete ecosystems or transmission modes. It is predicted that, long-term, the Three Gorges Dam (TGD will impact upon the transmission of schistosomiasis in the PRC, with varying degree across the four transmission modes.We undertook longitudinal surveillance from 2002 to 2006 in sentinel villages of the three transmission modes below the TGD across four provinces (Hunan, Jiangxi, Hubei and Anhui to determine whether there was any immediate impact of the TGD on schistosomiasis transmission. Eight sentinel villages were selected to represent both province and transmission mode. The primary end point measured was human incidence. Here we present the results of this five-year longitudinal cohort study. Results showed that the incidence of human S. japonicum infection declined considerably within individual villages and overall mode over the course of the study. This is also reflected in the yearly odds ratios (adjusted for infection risk that showed significant (P<0.01 downward trends in all modes over the follow-up period.The decrease in human S. japonicum incidence observed across all transmission modes in this study can probably be attributed to the annual human and bovine PZQ chemotherapy. If an increase in schistosome transmission had occurred as a result of the TGD, it would be of negligible size compared to the treatment induced decline seen here. It appears therefore that there has been virtually no immediate impact of the TGD on schistosomiasis transmission downstream of the dam.

  14. Multidisciplinary therapy for the treatment of malocclusion in a patient with chronic periodontitis with a five-year follow-up: A case report.

    Science.gov (United States)

    Zhang, Dongmei; Lin, Li; Tang, Xiaoling; Li, Chen; Liu, Jingbo; Wang, Hongyang; Pan, Yaping

    2017-10-01

    Multidisciplinary therapy is essential in dental practice to achieve optimized outcomes. The present case report describes the application of periodontal surgery with a five-year follow-up in a patient with malocclusion and chronic periodontitis. In the presence of periodontal inflammation, orthodontic therapy may result in further periodontal breakdown due to plaque accumulation. In order to prevent this progression, scaling and root planning with a periodontal endoscope was applied, and continuous clinical monitoring and risk assessment was performed every 3 months using a Florida Probe. This combined treatment supports the long-term maintenance of periodontal conditions, functional occlusion and harmony of the facial profile.

  15. Higher morale is associated with lower risk of depressive disorders five years later among very old people.

    Science.gov (United States)

    Niklasson, Johan; Näsman, Marina; Nyqvist, Fredrica; Conradsson, Mia; Olofsson, Birgitta; Lövheim, Hugo; Gustafson, Yngve

    The aim of this study was to investigate whether higher morale, i.e. future-oriented optimism, at baseline was associated with lower risk of depressive disorders five years later among very old people.Methods The Umeå85+/GErontological Regional Database, a population-based study with a longitudinal design, recruited participants in Sweden and Finland aged 85, 90 and ≥95 years. The sample in the present study included 647 individuals (89.1±4.4 years (Mean±SD), range 85-103). After five years, 216 were alive and agreed to a follow-up (92.6±3.4 years, range 90-104). The Philadelphia Geriatric Center Morale Scale (PGCMS) was used to assess morale. The depressive disorder diagnosis was determined according to DSM-IV based on medical records and interview data including assessment scales for depressive disorders. A number of sociodemographic, functional and health-related variables were analysed as possible confounders.Results For those with no depressive disorders at baseline, the only baseline variable significantly associated with depressive disorders five years later was the PGCMS score. A logistic regression model showed lower risk of depressive disorders five years later with higher baseline PGCMS scores (odds ratio 0.779 for one point increase in PGCMS, pfive years later).Conclusion Our results indicate that the higher the morale, the lower the risk of depressive disorders five years later among very old people. The PGCMS seems to identify those very old individuals at increased risk of depressive disorders five years later. Preventive measures could befocused on this group. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. The randomized shortened dental arch study: tooth loss over five years.

    Science.gov (United States)

    Walter, M H; Hannak, W; Kern, M; Mundt, T; Gernet, W; Weber, A; Wöstmann, B; Stark, H; Werner, D; Hartmann, S; Range, U; Jahn, F; Passia, N; Pospiech, P; Mitov, G; Brückner, J; Wolfart, S; Busche, E; Luthardt, R G; Heydecke, G; Marré, B

    2013-04-01

    The study was designed to provide clinical outcome data for two treatments of the shortened dental arch (SDA). In a multicenter randomized controlled clinical trial, patients with complete molar loss in one jaw were provided with either a partial removable dental prosthesis (PRDP) retained with precision attachments or treated according to the SDA concept preserving or restoring a premolar occlusion. No implants were placed. The primary outcome was tooth loss. Of 152 treated patients, 132 patients reached the 5-year examination. Over 5 years, 38 patients experienced tooth loss. For the primary outcome tooth loss, the Kaplan-Meier survival rates at 5 years were 0.74 (95% CI 0.64, 0.84) in the PRDP group and 0.74 (95% CI 0.63, 0.85) in the SDA group. For tooth loss in the study jaw, the survival rates at 5 years were 0.88 (95% CI 0.80, 0.95) in the PRDP group and 0.84 (95% CI 0.74, 0.93) in the SDA group. The differences were not significant. No Cox regression models of appropriate fit explaining tooth loss on the patient level could be found. The overall treatment goals of a sustainable oral rehabilitation and the avoidance of further tooth loss over longer periods were not reliably achievable. The influence of the type of prosthetic treatment on tooth loss might have been overestimated. Regarding our results, the patient's view will gain even more importance in the clinical decision between removable and fixed restorations in SDAs.

  17. Twenty-Five-Year Experience With Radical Chemoradiation for Anal Cancer

    Energy Technology Data Exchange (ETDEWEB)

    Tomaszewski, Jonathan M., E-mail: jonathan.tomaszewski@petermac.org [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Link, Emma [Centre for Biostatistics and Clinical Trials, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Leong, Trevor [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); University of Melbourne, Parkville, Victoria (Australia); Heriot, Alexander [University of Melbourne, Parkville, Victoria (Australia); Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Vazquez, Melisa [Research Division, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Chander, Sarat; Chu, Julie; Foo, Marcus; Lee, Mark T. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Lynch, Craig A. [Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Mackay, John [University of Melbourne, Parkville, Victoria (Australia); Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Michael, Michael [University of Melbourne, Parkville, Victoria (Australia); Department of Medical Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Tran, Phillip [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); Ngan, Samuel Y. [Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria (Australia); University of Melbourne, Parkville, Victoria (Australia)

    2012-06-01

    Purpose: To evaluate the prognostic factors, patterns of failure, and late toxicity in patients treated with chemoradiation (CRT) for anal cancer. Methods and Materials: Consecutive patients with nonmetastatic squamous cell carcinoma of the anus treated by CRT with curative intent between February 1983 and March 2008 were identified through the institutional database. Chart review and telephone follow-up were undertaken to collect demographic data and outcome. Results: Two hundred eighty-four patients (34% male; median age 62 years) were identified. The stages at diagnosis were 23% Stage I, 48% Stage II, 10% Stage IIIA, and 18% Stage IIIB. The median radiotherapy dose to the primary site was 54 Gy. A complete clinical response to CRT was achieved in 89% of patients. With a median follow-up time of 5.3 years, the 5-year rates of locoregional control, distant control, colostomy-free survival, and overall survival were 83% (95% confidence interval [CI] 78-88), 92% (95% CI, 89-96), 73% (95% CI, 68-79)