WorldWideScience

Sample records for terms publication types

  1. The Long-Term Public Health Benefits of Breastfeeding.

    Science.gov (United States)

    Binns, Colin; Lee, MiKyung; Low, Wah Yun

    2016-01-01

    Breastfeeding has many health benefits, both in the short term and the longer term, to infants and their mothers. There is an increasing number of studies that report on associations between breastfeeding and long-term protection against chronic disease. Recent research evidence is reviewed in this study, building on previous authoritative reviews. The recent World Health Organization reviews of the short- and long-term benefits of breastfeeding concluded that there was strong evidence for many public health benefits of breastfeeding. Cognitive development is improved by breastfeeding, and infants who are breastfed and mothers who breastfeed have lower rates of obesity. Other chronic diseases that are reduced by breastfeeding include diabetes (both type 1 and type 2), obesity, hypertension, cardiovascular disease, hyperlipidemia, and some types of cancer. © 2015 APJPH.

  2. Comparing types of local public health agencies in North Carolina.

    Science.gov (United States)

    Markiewicz, Milissa; Moore, Jill; Foster, Johanna H; Berner, Maureen; Matthews, Gene; Wall, Aimee

    2013-01-01

    Some states are considering restructuring local public health agencies (LPHAs) in hopes of achieving long-term efficiencies. North Carolina's experience operating different types of LPHAs, such as county health departments, district health departments, public health authorities, and consolidated human services agencies, can provide valuable information to policy makers in other states who are examining how best to organize their local public health system. To identify stakeholders' perceptions of the benefits and challenges associated with different types of LPHAs in North Carolina and to compare LPHA types on selected financial, workforce, and service delivery measures. Focus groups and key informant interviews were conducted to identify stakeholders' perceptions of different LPHA types. To compare LPHA types on finance, workforce, and service delivery measures, descriptive statistical analyses were performed on publicly available quantitative data. North Carolina. Current and former state and local public health practitioners, county commissioners, county managers, assistant managers, state legislators, and others. In addition to identifying stakeholders' perceptions of LPHA types, proportion of total expenditures by funding source, expenditures per capita by funding source, full-time equivalents per 1000 population, and percentage of 127 tracked services offered were calculated. Stakeholders reported benefits and challenges of all LPHA types. LPHA types differ with regard to source of funding, with county health departments and consolidated human services agencies receiving a greater percentage of their funding from county appropriations than districts and authorities, which receive a comparatively larger percentage from other revenues. Types of LPHAs are not entirely distinct from one another, and LPHAs of the same type can vary greatly from one another. However, stakeholders noted differences between LPHA types-particularly with regard to district health

  3. Romanian public marketing in terms of necessity, collaboration and mix

    OpenAIRE

    Grigorescu, Adriana

    2010-01-01

    The paper carries out a short literature review on public sector and public marketing terms. The findings of the paper’s study shows that the Romanian public sector should give more importance to marketing activities, as 87% of the respondents sustained when asked about their necessity. Within a public institution, the marketing specialists should cooperate with research& development, sales and financial departments. The study results reaffirm the importance of the 4 P of the marketing mix wh...

  4. Predicting the long-term citation impact of recent publications

    NARCIS (Netherlands)

    Stegehuis, Clara; Litvak, Nelli; Waltman, Ludo

    2015-01-01

    A fundamental problem in citation analysis is the prediction of the long-term citation impact of recent publications. We propose a model to predict a probability distribution for the future number of citations of a publication. Two predictors are used: The impact factor of the journal in which a

  5. Predicting the long-term citation impact of recent publications

    NARCIS (Netherlands)

    Stegehuis, Clara; Litvak, Nelli; Waltman, Ludo

    A fundamental problem in citation analysis is the prediction of the long-term citation impact of recent publications. We propose a model to predict a probability distribution for the future number of citations of a publication. Two predictors are used: the impact factor of the journal in which a

  6. Transformational Leadership Type in Public and Private Organizations

    Directory of Open Access Journals (Sweden)

    Mihaela Rus

    2012-05-01

    Full Text Available The issue concerning leadership is a very complex one, that is why taking into the account theplurity of styles already existent many times it was asked the questions: „What type of leadership isnecessary?”. By asking this question, we are thinking of a person responsible with organizing or coordinatingwork or the ones hired to do this, to think of what people want, to solve the management problems in group.This study is intended as a comparison of the two types of leadership (transformational vs. transactional interms of employee performance in public and private organizations. To measure performance and chose twoindicators: satisfaction and productivity. This study falls into the category of research studies the type ofdriving through subordinates with both theoretical and practical implications. The efficiency of this type ofleadership has been demonstrated by studies especially in the political and military and very few studies havebeen made in industrial .Type of transformational leadership is better than transactional perceived astransformational leaders are closer to the needs of employees and continuously investigate these necessities.This paper presents a practical validity as advising managers to develop a transformational type of leadership,both public and private organizations, leads to better performance. Also open new avenues of research,among which we can mention: study the impact of organizational culture on the adoption of transformationaltype vs transactional type; decision-making mechanisms in the type of transformational leadership; initiatetraining programs to develop a transformational type of leadership.

  7. Long-term mortality and retinopathy in type 1 diabetes

    DEFF Research Database (Denmark)

    Grauslund, Jakob

    2010-01-01

    The incidence of type 1 diabetes is increasing in Denmark as well as the rest of the world. Due to diabetes-related micro- and macrovascular complications, the morbidity and the mortality is higher among type 1 diabetic patients. The aim of this thesis was to examine a population-based cohort...... of 727 type 1 diabetic patients from Fyn County, Denmark, with an onset of diabetes before 1 July 1973 in order to: (1) Evaluate the all-cause mortality rates and the influence of sex, duration of diabetes and calendar year of diagnosis in a 33-year follow-up (Paper I). (2) Examine glycaemic regulation...... of DR was graded higher in the digital photos. Among these, PDR was detected in three eyes using digital photos but remained undetected on all films. This suggests that digital photos with wide fields are the best way to detect DR in long-term type 1 diabetic patients. Overall, it is concluded...

  8. The public appeal as the through criminal term: statement of a question

    Directory of Open Access Journals (Sweden)

    Микола Анатолійович Рубащенко

    2017-09-01

    Full Text Available The author of the article supports the introduction of  «the through criminal legal concepts» into the science of criminal law. It is more expedient to use the phrase «the through terms», wherein the through terms have such signs: they are used in the law two or more times; they denote the same concept. The research is based on the fact that the Criminal Code of Ukraine provides for criminal liability for public appeals for various criminal acts: encroachment of the territorial integrity of the state (Art. 110 of the CC, seizure of state power or overthrow of constitutional order (Art. 109 of the CC, terrorist act (art. 258-2 CC, mass riots (Art. 295 of the CC, cruelty to animals (Art. 299 of the CC, act of aggression (Art. 436 of the CC, genocide (Art. 442 of the CC. In legal practice, all these articles are interpreted and applied in different. The necessity of researching public appeals and related acts as through terms is grounded. The through nature of public appeals, the spreading of materials with appeals, the making and storage of materials with appeals are argued. It is proposed to investigate through terms taking into account the context and taking into account systemic links with other criminal legal terms. The recognition that the investigated concept are through, opens a promising direction for the synthesis and application of inductive reasoning. This means the moving from knowledge about public appeals, as separate types of crimes, to knowledge of public appeals, as a generic act common to all of their species.

  9. Private Placements as Sources of Long Term Funds for publicly ...

    African Journals Online (AJOL)

    Thereafter, an overview of the concept of private placement is given to enable a better appreciation of its unique role in raising funds for organizations that are not publicly quoted in a registered stock exchange. It concludes with an exposition of the problems of allowing private placements for publicly quoted firms.

  10. Functional Interpretation of Neighborhood Public Spaces in Terms of Identity

    Directory of Open Access Journals (Sweden)

    Hamid Majedi

    2015-03-01

    Full Text Available The aim of this article is to evaluate the effect of neighborhood public space transformation due to rapid urbanization in Tehran since 1960s, on the formation of neighborhood identity. In order to find the role of public spaces in enhancing neighborhood identities, two middle class neighborhoods with different spatial organizations are compared with each other: Nazi Abad a planned neighborhood and Mehran a typical unplanned neighborhood which developed through rapid urbanization.   Next, the effect of neighborhood public spaces on neighborhood inhabitants is evaluated from two perspectives: Perceptual dimension and social dimension. The findings indicate that planned spatial organization and various neighborhood public spaces result in stronger neighborhood identity. It enhances both perceptual dimension of neighborhood identity(place attachment and its social dimension (sense of community. In contrast unplanned spatial organization which is the typical feature of Tehran neighborhoods leads to weak neighborhood identity.

  11. Columbia Public Health Core Curriculum: Short-Term Impact.

    Science.gov (United States)

    Begg, Melissa D; Fried, Linda P; Glover, Jim W; Delva, Marlyn; Wiggin, Maggie; Hooper, Leah; Saxena, Roheeni; de Pinho, Helen; Slomin, Emily; Walker, Julia R; Galea, Sandro

    2015-12-01

    We evaluated a transformed core curriculum for the Columbia University, Mailman School of Public Health (New York, New York) master of public health (MPH) degree. The curriculum, launched in 2012, aims to teach public health as it is practiced: in interdisciplinary teams, drawing on expertise from multiple domains to address complex health challenges. We collected evaluation data starting when the first class of students entered the program and ending with their graduation in May 2014. Students reported being very satisfied with and challenged by the rigorous curriculum and felt prepared to integrate concepts across varied domains and disciplines to solve public health problems. This novel interdisciplinary program could serve as a prototype for other schools that wish to reinvigorate MPH training.

  12. Does long-term coffee intake reduce type 2 diabetes mellitus risk?

    Directory of Open Access Journals (Sweden)

    Pimentel Gustavo D

    2009-09-01

    Full Text Available Abstract This review reports the evidence for a relation between long-term coffee intake and risk of type 2 diabetes mellitus. Numerous epidemiological studies have evaluated this association and, at this moment, at least fourteen out of eighteen cohort studies revealed a substantially lower risk of type 2 diabetes mellitus with frequent coffee intake. Moderate coffee intake (≥4 cups of coffee/d of 150 mL or ≥400 mg of caffeine/d has generally been associated with a decrease in the risk of type 2 diabetes mellitus. Besides, results of most studies suggest a dose-response relation, with greater reductions in type 2 diabetes mellitus risk with higher levels of coffee consumption. Several mechanisms underlying this protective effect, as well as the coffee components responsible for this association are suggested. Despite positive findings, it is still premature to recommend an increase in coffee consumption as a public health strategy to prevent type 2 diabetes mellitus. More population-based surveys are necessary to clarify the long-term effects of decaffeinated and caffeinated coffee intake on the risk of type 2 diabetes mellitus.

  13. Radiation protection glossary. Selected basic terms used in IAEA publications

    Energy Technology Data Exchange (ETDEWEB)

    1986-01-01

    The glossary is intended to be used as a terminology standard for IAEA documentation on radiation protection. An effort has been made to use definitions contained in internationally accepted publications such as recommendations of the International Commission on Radiological Protection (ICRP), standards of the International Organization for Standardization (ISO) and of the International Electrotechnical Commission (IEC), reports of the International Commission on Radiation Units and Measurements (ICRU), with only slight modifications in order to tailor them more closely to IAEA needs. The glossary is restricted to ionizing radiation.

  14. The Public Health Responsibility Deal: brokering a deal for public health, but on whose terms?

    Science.gov (United States)

    Panjwani, Clare; Caraher, Martin

    2014-02-01

    Coalitions of multinational food and drink businesses have pledged to reformulate their products and to market them responsibly. Largely business-led and self-regulated, the integrity of these voluntary initiatives has been questioned. The Public Health Responsibility Deal in England is an example of a voluntary initiative that is government-led. Does this approach provide evidence that with public leadership there is potential for voluntary actions to deliver meaningful results for public health? The subject of the research is the calorie reduction initiative of the Responsibility Deal. Source material was obtained primarily through a series of UK Freedom of Information requests and comprises previously unpublished Department of Health documentation relating to relevant meetings held during 2011 and 2012. The Responsibility Deal approach to calorie reduction deliberately involves the food industry in the specification of the measures it is to implement (reformulation and portion control). Finding the common ground between private and public interests has resulted in the deflection of public health objectives and the preclusion of adequate monitoring and evaluation. The Responsibility Deal approach is fundamentally flawed in its expectation that industry will take voluntary actions that prioritise public health interests above its own. Being government-led counts for little in the absence of sanctions to drive compliance. Instead the initiative affords private interests the opportunity to influence in their favour the public health policies and strategies that affect their products. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  15. THE PROGNOSIS OF TOTAL PUBLIC EXPENDITURES AND TYPES OF EXPENDITURES IN ROMANIA

    Directory of Open Access Journals (Sweden)

    ANA-PETRINA STANCIU

    2012-12-01

    Full Text Available The purpose of the paper is to provide a prognosis of total public expenditure and types of expenditures, starting from the evolution in time of total public expenditure and spending on public services, defense, public order and safety, economic affairs, environmental protection, housing and community amenities, health, recreation, culture and religion, education and social protection.

  16. The Observation of Bahasa Indonesia Official Computer Terms Implementation in Scientific Publication

    Science.gov (United States)

    Gunawan, D.; Amalia, A.; Lydia, M. S.; Muthaqin, M. I.

    2018-03-01

    The government of the Republic of Indonesia had issued a regulation to substitute computer terms in foreign language that have been used earlier into official computer terms in Bahasa Indonesia. This regulation was stipulated in Presidential Decree No. 2 of 2001 concerning the introduction of official computer terms in Bahasa Indonesia (known as Senarai Padanan Istilah/SPI). After sixteen years, people of Indonesia, particularly for academics, should have implemented the official computer terms in their official publications. This observation is conducted to discover the implementation of official computer terms usage in scientific publications which are written in Bahasa Indonesia. The data source used in this observation are the publications by the academics, particularly in computer science field. The method used in the observation is divided into four stages. The first stage is metadata harvesting by using Open Archive Initiative - Protocol for Metadata Harvesting (OAI-PMH). Second, converting the harvested document (in pdf format) to plain text. The third stage is text-preprocessing as the preparation of string matching. Then the final stage is searching the official computer terms based on 629 SPI terms by using Boyer-Moore algorithm. We observed that there are 240,781 foreign computer terms in 1,156 scientific publications from six universities. This result shows that the foreign computer terms are still widely used by the academics.

  17. Induced WZW-type term in dual field theory

    International Nuclear Information System (INIS)

    Nielsen, N.K.

    1990-01-01

    One-loop quantum equivalence is investigated by proper time regularization for a nonlinear σ-model in two dimensions on a group manifold and its dual theory constructed by Fradkin and Tseytlin. The one-loop effective actions are found to deviate by a finite local counterterm with a structure similar to that of a Wess-Zumino-Witten term

  18. Long term review of research on light water reactor types

    International Nuclear Information System (INIS)

    Sumiya, Yutaka

    1982-01-01

    In Japan, 24 nuclear power plants of 17.18 million kWe capacity are in operation, and their rate of operation has shown the good result of more than 60% since 1980. One of the research on the development of light water reactors is the electric power common research, which was started in 1976, and 272 researches were carried out till 1982. It contributed to the counter-measures to stress corrosion cracking, thermal fatigue and the thinning of steam generator tubes, to the reduction of crud generation and the remote control and automation of inspection and maintenance, and to the verification of safety. The important items for the future are the cost down of nuclear power plant construction, the development of robots for nuclear power plants, the improvement of the ability to follow load variation, and the development of light water reactors of new types. It is necessary to diversify the types of reactors to avoid the effect of a serious trouble which may occur in one type of reactors. Tokyo Electric Power Co., Inc., thinks that the Japanese type PWRs having the technical features of KWU type PWRs are desirable for the future development. The compatibility with the condition of installation permission in Japan, the required design change and the economy of the standard design PWRs of KWU (1.3 million kW) have been studied since October, 1981, by KWU and three Japanese manufacturers. (Kako, I.)

  19. Dominant Personality Types in Public Accounting: Selection Bias or Indoctrinated?

    Science.gov (United States)

    Burton, Hughlene; Daugherty, Brian; Dickins, Denise; Schisler, Dan

    2016-01-01

    Prior studies concerning the personality type and preferences of accountants generally draw conclusions based upon the reports of either practicing accountants, or accounting students, at a single point in time. So while much is known about the personality type of accountants in general, left unexplored is the question of whether public…

  20. Non-Public Schools in Durham County by Type

    Data.gov (United States)

    City and County of Durham, North Carolina — A list and the locations along with contact phone numbers of private schools within Durham County. The School Type field is either "religious" or independant....

  1. Urban revitalization and displacement: types, causes, and public policy

    Energy Technology Data Exchange (ETDEWEB)

    Feagin, J.R.

    1981-05-01

    The policy research report reviews the scholarly and print media literatures on urban revitalization. The extent of revitalization; the incumbent or occupant upgrading; gentrification (displacement of low- and moderate-income households by better-off households); gentrification and displacement from all causes; and the role of powerful actors in revitalization are discussed. Public policy dealing with land use and development in urban areas is discussed. Future research needs are indicated.

  2. Fuel consumption: short term and long term price impacts per population type

    International Nuclear Information System (INIS)

    2011-01-01

    This report presents assessments of the price sensitivity of household fuel consumption. After a literature review on price-elasticity assessments and the use of pseudo-panels, the investigation analyses the deciding factors of the household fuel expense and its evolution between 1985 and 2006. It proposes a short term price-elasticity assessment based on the most recent survey, and also proposes price-elasticity assessments for sub-populations, notably in terms of income level or location (rural or urban areas)

  3. Low prevalence of long-term breastfeeding among women with type 2 diabetes

    DEFF Research Database (Denmark)

    Herskin, Camilla W; Stage, Edna; Barfred, Charlotte

    2016-01-01

    OBJECTIVE: To investigate the prevalence of long-term breastfeeding among women with type 2 diabetes compared to women with type 1 diabetes and to identify predictors of long-term breastfeeding for women with pre-gestational diabetes. METHODS: In total, 149 women with diabetes were interviewed ab...

  4. Eye Complications and Markers of Morbidity and Mortality in Long-term Type 1 Diabetes

    DEFF Research Database (Denmark)

    Grauslund, Jakob

    2011-01-01

    The incidence of type 1 diabetes is rising all over the world. Furthermore, the increased life-expectancy of type 1 diabetic patients is likely to cause a higher number of diabetes-related micro- and macrovascular complications in the years to come. In order to examine the level of long......-term complications in type 1 diabetes as well as potential markers of micro- and macroangiopathy, a population-based cohort of Danish type 1 diabetic patients was examined in order to achieve the following aims: 1  To evaluate diabetic retinopathy as a long-term marker of all-cause mortality in type 1 diabetes...... (Paper I). 2  To estimate the long-term incidence and associated risk factors of blindness (Paper II) and cataract surgery (Paper III) in type 1 diabetes. 3  To use retinal vascular analyses in order to investigate the associations of long-term micro- and macrovascular complications and retinal vascular...

  5. Vacuum technology; acceptance specifications for mass spectrometer-type leak-detector, terms

    International Nuclear Information System (INIS)

    1976-03-01

    The terms are for the better understanding in specialist talks, dealings and acceptance regulations, as well as publications and company catalogues. For international information, the specialist terms in the anglo-saxon and french language sphere are given. They are not part of the standard. (orig./LH) [de

  6. U.S.-Based Short-Term Public Health Cultural Immersion Experience for Chinese Undergraduate Students

    Science.gov (United States)

    Powell, Dorothy Lewis; Biederman, Donna J.

    2017-01-01

    A U.S. and Chinese university developed a short-term student exchange program in public/community health. The program--which consisted of lectures, seminars, field trips, cross-cultural experiences, and a synthesis excursion--resulted in high levels of program satisfaction, increased intrapersonal awareness, and skill acquisition. Program content…

  7. 77 FR 12227 - Long Term 2 Enhanced Surface Water Treatment Rule: Uncovered Finished Water Reservoirs; Public...

    Science.gov (United States)

    2012-02-29

    ... Water Treatment Rule: Uncovered Finished Water Reservoirs; Public Meeting AGENCY: Environmental... review of the uncovered finished water reservoir requirement in the Long Term 2 Enhanced Surface Water... uncovered finished water reservoir requirement and the agency's Six Year Review process. EPA also plans to...

  8. Regional aspects of long-term public sector psychiatric care in the ...

    African Journals Online (AJOL)

    such as clinical, geographic and socio-demographic) influencing the use of public sector long-term psychiatric services in the Eastern Cape. This is important in improving service delivery, to assist policy developers with evidence-based research ...

  9. Terminology of the public relations field: corpus — automatic term recognition — terminology database

    Directory of Open Access Journals (Sweden)

    Nataša Logar Berginc

    2013-12-01

    Full Text Available The article describes an analysis of automatic term recognition results performed for single- and multi-word terms with the LUIZ term extraction system. The target application of the results is a terminology database of Public Relations and the main resource the KoRP Public Relations Corpus. Our analysis is focused on two segments: (a single-word noun term candidates, which we compare with the frequency list of nouns from KoRP and evaluate termhood on the basis of the judgements of two domain experts, and (b multi-word term candidates with verb and noun as headword. In order to better assess the performance of the system and the soundness of our approach we also performed an analysis of recall. Our results show that the terminological relevance of extracted nouns is indeed higher than that of merely frequent nouns, and that verbal phrases only rarely count as proper terms. The most productive patterns of multi-word terms with noun as a headword have the following structure: [adjective + noun], [adjective + and + adjective + noun] and [adjective + adjective + noun]. The analysis of recall shows low inter-annotator agreement, but nevertheless very satisfactory recall levels.

  10. Gauging the Purported Costs of Public Data Archiving for Long-Term Population Studies.

    Science.gov (United States)

    Evans, Simon Robin

    2016-04-01

    It was recently proposed that long-term population studies be exempted from the expectation that authors publicly archive the primary data underlying published articles. Such studies are valuable to many areas of ecological and evolutionary biological research, and multiple risks to their viability were anticipated as a result of public data archiving (PDA), ultimately all stemming from independent reuse of archived data. However, empirical assessment was missing, making it difficult to determine whether such fears are realistic. I addressed this by surveying data packages from long-term population studies archived in the Dryad Digital Repository. I found no evidence that PDA results in reuse of data by independent parties, suggesting the purported costs of PDA for long-term population studies have been overstated.

  11. Most Common Publication Types in Radiology Journals:: What is the Level of Evidence?

    Science.gov (United States)

    Rosenkrantz, Andrew B; Pinnamaneni, Niveditha; Babb, James S; Doshi, Ankur M

    2016-05-01

    This study aimed to assess the most common publication types in radiology journals, as well as temporal trends and association with citation frequency. PubMed was searched to extract all published articles having the following "Publication Type" indices: "validation studies," "meta-analysis," "clinical trial," "comparative study," "evaluation study," "guideline," "multicenter study," "randomized study," "review," "editorial," "case report," and "technical report." The percentage of articles within each category published within clinical radiology journals was computed. Normalized percentages for each category were also computed on an annual basis. Citation counts within a 2-year window following publication were obtained using Web of Science. Overall trends were assessed. Publication types with the highest fraction in radiology journals were technical reports, evaluation studies, and case reports (4.8% to 5.8%). Publication types with the lowest fraction in radiology journals were randomized trials, multicenter studies, and meta-analyses (0.8% to 1.5%). Case reports showed a significant decrease since 1999, with accelerating decline since 2007 (P = 0.002). Publication types with highest citation counts were meta-analyses, guidelines, and multicenter studies (8.1 ± 10.7 to 12.9 ± 5.1). Publication types with lowest citation counts were case reports, editorials, and technical reports (1.4 ± 2.4 to 2.9 ± 4.3). The representation in radiology journals and citation frequency of the publication types showed weak inverse correlation (r = -0.372). Radiology journals have historically had relatively greater representation of less frequently cited publication types. Various strategies, including methodological training, multidisciplinary collaboration, national support networks, as well as encouragement of higher level of evidence by funding agencies and radiology journals themselves, are warranted to improve the impact of radiological research

  12. Fuel consumption: short term and long term price impacts per population type; Consommation de carburant: effets des prix a court et a long termes par type de population

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2011-07-01

    This report presents assessments of the price sensitivity of household fuel consumption. After a literature review on price-elasticity assessments and the use of pseudo-panels, the investigation analyses the deciding factors of the household fuel expense and its evolution between 1985 and 2006. It proposes a short term price-elasticity assessment based on the most recent survey, and also proposes price-elasticity assessments for sub-populations, notably in terms of income level or location (rural or urban areas)

  13. Marketing, advertisement and publicity – a study of terms in Brazil

    Directory of Open Access Journals (Sweden)

    Miguel Arantes Normanha Filho

    2007-12-01

    Full Text Available The main objective of this research consists in contributing with empirical verification of several interpretations done on marketing and advertisement, advertisement and publicity, in a special form used as if they were synonyms. In business context, this can lead companies into financial loss. The research is part of the observation that treats the terms marketing and advertisement as not being the same [semantically], but the concept: advertisement is a specific instrument and marketing is a business philosophy. The wrong interpretation of this terms can induces businessmen [executives] to make strategic mistakes that can influence the cash flow and, consequently, affect the company’s financial economical health.

  14. Long-term associations between serum lipids and panretinal photocoagulation in type 1 diabetes

    DEFF Research Database (Denmark)

    Jørgensen, Jesper Skovlund; Mejnert Jørgensen, Trine; Green, Anders

    2013-01-01

    To examine the predictive value of serum lipids on the need for panretinal photocoagulation (PRP) treatment in a long-term follow-up of a cohort of Danish type 1 diabetic patients.......To examine the predictive value of serum lipids on the need for panretinal photocoagulation (PRP) treatment in a long-term follow-up of a cohort of Danish type 1 diabetic patients....

  15. Survey of public definitions of the term ?overdiagnosis? in the UK

    OpenAIRE

    Ghanouni, Alex; Meisel, Susanne F; Renzi, Cristina; Wardle, Jane; Waller, Jo

    2016-01-01

    Objectives To determine how ?overdiagnosis? is currently conceptualised among adults in the UK in light of previous research, which has found that the term is difficult for the public to understand and awareness is low. This study aimed to add to current debates on healthcare in which overdiagnosis is a prominent issue. Design An observational, web-based survey was administered by a survey company. Setting Participants completed the survey at a time and location of their choosing. Participant...

  16. Locally Rotationally Symmetric Bianchi Type-I Model with Time Varying Λ Term

    International Nuclear Information System (INIS)

    Tiwari, R. K.; Jha, Navin Kumar

    2009-01-01

    We investigate the locally rotationally symmetric (LRS) Bianchi type-I cosmological model for stiff matter and a vacuum solution with a cosmological term proportional to R −m (R is the scale factor and m is a positive constant). The cosmological term decreases with time. We obtain that for both the cases the present universe is accelerating with a large fraction of cosmological density in the form of a cosmological term

  17. Impaired vascular function during short-term poor glycaemic control in Type 1 diabetic patients

    DEFF Research Database (Denmark)

    Sørensen, V.R.; Mathiassen, E.R.; Clausen, P.

    2005-01-01

    AIM: To study the effects of short-term poor glycaemic control on vascular function in Type 1 diabetic patients. METHODS: Ten Type 1 diabetic patients, with diabetes duration of less than 10 years and normal urinary albumin excretion and ophthalmoscopy, were studied. All patients were examined af...

  18. Chaos in long-term behavior of some Bianchi-type VIII models

    Energy Technology Data Exchange (ETDEWEB)

    Halpern, P

    1987-01-01

    The long-term behavior of Bianchi-type VIII models with three different types of stress-energy tensors are examined and compared. The vacuum model, a matter-filled model, and a model with an electromagnetic field are considered. In each case the existence of chaotic behavior and transitions to chaotic behavior are discussed.

  19. Botulinum toxin type A in simple motor tics: short-term and long-term treatment-effects.

    Science.gov (United States)

    Rath, Judith J G; Tavy, Dénes L J; Wertenbroek, Agnes A A C M; van Woerkom, Theodoor C A M; de Bruijn, Sebastiaan F T M

    2010-08-01

    To determine the short-term and long-term treatment-effects of botulinum toxin type A in simple motor tics, we analyzed 15 consecutive patients (18 tics) with simple motor tics that were treated every 3 months with injections of BTX-A. Efficacy (rated on a 4-level scale) and duration of effect of the first 2 and last 2 (if treated 5 times or more) treatments were recorded, as well as latency of response, changes of premonitory urges (PMUs) and possible side effects. Total number of treatments for each tic varied from 2 to 50 (mean 11, median 6). In 16 of 18 tics (89%) short-term efficacy was reported successful (good or moderate). Long-term efficacy was reported in 12 tics of which 11 showed similar or even increased beneficial effects. Premonitory urge (PMU) was reported in 8 patients (53%). PMU, if present, lessened or disappeared after treatment with BTX-A. A permanent remission of the treated tic was seen in 3 patients with a maximum follow-up of 10 years. BTX-A appears a safe and effective treatment for simple motor tics and retains its efficacy after long-term treatment. BTX may also induce permanent remission of the treated tics and effects of BTX are not restricted to merely motor behaviour.

  20. Public long-term care insurance for the elderly in Korea: design, characteristics, and tasks.

    Science.gov (United States)

    Seok, Jae Eun

    2010-03-01

    This paper examines the design and issues of the long-term care scheme in Korea: coverage, eligibility, benefit types, financing, delivery system, and role sharing of state, family, and market in long-term care. It also aims to examine the radical change and impacts on service financing, provision, and governance from the introduction of the long-term care insurance for the elderly in Korea. The first noteworthy change is that the long-term care service has transformed from the very selective service applicable only to low-income groups to a universal service for all income groups. The second notable change is that the service provision method has been changed from the provision by nonprofit organizations entrusted by the state under a monopolistic commission arrangement in the past to a new open-service provision arrangement in which free competition among service providers in service market and consumers' choice will be emphasized.

  1. Two Modified Three-Term Type Conjugate Gradient Methods and Their Global Convergence for Unconstrained Optimization

    Directory of Open Access Journals (Sweden)

    Zhongbo Sun

    2014-01-01

    Full Text Available Two modified three-term type conjugate gradient algorithms which satisfy both the descent condition and the Dai-Liao type conjugacy condition are presented for unconstrained optimization. The first algorithm is a modification of the Hager and Zhang type algorithm in such a way that the search direction is descent and satisfies Dai-Liao’s type conjugacy condition. The second simple three-term type conjugate gradient method can generate sufficient decent directions at every iteration; moreover, this property is independent of the steplength line search. Also, the algorithms could be considered as a modification of the MBFGS method, but with different zk. Under some mild conditions, the given methods are global convergence, which is independent of the Wolfe line search for general functions. The numerical experiments show that the proposed methods are very robust and efficient.

  2. Application of Interval Type-2 Fuzzy Logic System in Short Term Load Forecasting on Special Days

    Directory of Open Access Journals (Sweden)

    Agus Dharma

    2011-05-01

    Full Text Available This paper presents the application of Interval Type-2 fuzzy logic systems (Interval Type-2 FLS in short term load forecasting (STLF on special days, study case in Bali Indonesia. Type-2 FLS is characterized by a concept called footprint of uncertainty (FOU that provides the extra mathematical dimension that equips Type-2 FLS with the potential to outperform their Type-1 counterparts. While a Type-2 FLS has the capability to model more complex relationships, the output of a Type-2 fuzzy inference engine needs to be type-reduced. Type reduction is used by applying the Karnik-Mendel (KM iterative algorithm. This type reduction maps the output of Type-2 FSs into Type-1 FSs then the defuzzification with centroid method converts that Type-1 reduced FSs into a number. The proposed method was tested with the actual load data of special days using 4 days peak load before special days and at the time of special day for the year 2002-2006. There are 20 items of special days in Bali that are used to be forecasted in the year 2005 and 2006 respectively. The test results showed an accurate forecasting with the mean average percentage error of 1.0335% and 1.5683% in the year 2005 and 2006 respectively.

  3. Effectiveness of short-term psychodynamic group therapy in a public outpatient psychotherapy unit

    DEFF Research Database (Denmark)

    Jensen, Hans Henrik; Mortensen, Erik Lykke; Lotz, Martin

    2010-01-01

    BACKGROUND: Short-term psychodynamic group therapy in heterogeneous patient groups is common in the public Danish psychiatric system but is in need of evaluation. AIM: To investigate improvement in 39-session psychodynamic group therapy using three criteria: 1) effect size (Cohen's d), 2...... compared with Danish norms. Clinical implications: Patients referred to public outpatient treatment settings may need alternative or longer treatment than 39 sessions of psychodynamic group therapy over 3 months.......) and subscales. Analyses were conducted on the total sample and after exclusion of 32 GSI pre-treatment no-cases. RESULTS: The total sample GSI effect size was 0.74 indicating a moderate to large effect size (ranging from 0.67 in depressed to 0.74 in neurotic and personality disorder patients), which increased...

  4. Double Crowding-Out Effects of Means-Tested Public Provision for Long-Term Care

    Directory of Open Access Journals (Sweden)

    Christophe Courbage

    2015-02-01

    Full Text Available Publicly provided long-term care (LTC insurance with means-tested benefits is suspected to crowd out either private saving or informal care. This contribution predicts crowding-out effects for both private saving and informal care for policy measures designed to relieve the public purse from LTC expenditure such as more stringent means testing and increased taxation of inheritance. These effects result from the interaction of a parent who decides on the amount of saving in retirement and a caregiver who decides on the effort devoted to informal care which lowers the probability of admission to a nursing home. Double crowding-out effects are also found to be the consequence of exogenous influences, notably a higher opportunity cost of caregiving.

  5. Public and private schoolteachers' differences in terms of job attitudes in Albania.

    Science.gov (United States)

    Buka, Migena; Bilgiç, Reyhan

    2010-06-01

    In the present study, the attitudinal differences between public and private schoolteachers in Albania were investigated. Since the type of the organization varies, one would expect different climates for the emergence of job attitudes--mainly job satisfaction, job involvement, and organizational commitment, the most frequently studied job attitudes in the industrial and organizational psychology literature. It was hypothesized that the private schoolteachers would be more satisfied than public schoolteachers, especially due to high levels of payment and other desirable conditions. However, the public schoolteachers will be more involved than the private schoolteachers since they have to justify their continued work under the undesirable conditions. The commitment level of the private schoolteachers will be higher than the public schoolteachers since there is usually high correlation between job satisfaction and organizational commitment. Data were gathered from a total of 429 teachers working in public (n = 254) and private (n = 175) schools in Albania, in high and middle schools. The data were analyzed using multivariate analysis of covariance with age as a covariate. The results indicated that the private schoolteachers were more satisfied, as expected, revealed a weaker job involvement and were more committed to their school than their colleagues in the public sector. The results were found to be in line with previous studies conducted in the west. However, this study is believed to have a potential contribution to the literature in general, and to the Albanian local literature in particular. To the knowledge of the authors, there has been no similar study in Albania. Discussion is provided along with the limitations of the study and suggestions for future research.

  6. Finite volume schemes with equilibrium type discretization of source terms for scalar conservation laws

    International Nuclear Information System (INIS)

    Botchorishvili, Ramaz; Pironneau, Olivier

    2003-01-01

    We develop here a new class of finite volume schemes on unstructured meshes for scalar conservation laws with stiff source terms. The schemes are of equilibrium type, hence with uniform bounds on approximate solutions, valid in cell entropy inequalities and exact for some equilibrium states. Convergence is investigated in the framework of kinetic schemes. Numerical tests show high computational efficiency and a significant advantage over standard cell centered discretization of source terms. Equilibrium type schemes produce accurate results even on test problems for which the standard approach fails. For some numerical tests they exhibit exponential type convergence rate. In two of our numerical tests an equilibrium type scheme with 441 nodes on a triangular mesh is more accurate than a standard scheme with 5000 2 grid points

  7. Racial Mismatch and School Type: Teacher Satisfaction and Retention in Charter and Traditional Public Schools

    Science.gov (United States)

    Renzulli, Linda A.; Parrott, Heather Macpherson; Beattie, Irenee R.

    2011-01-01

    Studies of teacher satisfaction suggest that satisfaction is related to both the racial composition and the organizational structure of the schools in which teachers work. In this article, the authors draw from theories of race and organizations to examine simultaneously the effects of school type (traditional public vs. charter) and racial…

  8. A Systematic Review of Global Publication Trends Regarding Long-Term Outcomes of ADHD

    Science.gov (United States)

    Hodgkins, Paul; Arnold, L. Eugene; Shaw, Monica; Caci, Hervé; Kahle, Jennifer; Woods, Alisa G; Young, Susan

    2012-01-01

    There is increased global recognition of attention deficit hyperactivity disorder (ADHD) as a serious medical condition with long-term consequences. Although originally conceived of as a childhood disorder, ADHD is being increasingly recognized in adults. Individual geographic regions may have specific interests and objectives for the study of ADHD. A systematic review of long-term outcomes (LTOs) in ADHD was conducted to evaluate research on ADHD LTOs on a global scale. Studies that were at least 2 years in duration were examined. A total of 351 studies were identified in the final analysis. We identified nine outcomes of interest and classified studies by specific geographical regions, age groups studied and study design by region and over time. Published studies of LTOs in ADHD have increased in all geographical regions over the past three decades, with a peak number of 42 publications in 2008. This rise in publications on ADHD LTOs may reflect a rise in global interest and recognition of consequences and impairment associated with ADHD. Although many world regions have published on ADHD LTOs, the majority of studies have emerged from the US and Canada, followed by Europe. While investigators in the US and Canada were predominantly interested in drug addiction as a LTO, European researchers were more interested in antisocial behavior, and Eastern Asian investigators focused on both of these LTOs as well as self-esteem. Geographical differences in the focus of ADHD LTO studies may reflect regional variations in cultural values. Proportionally fewer prospective longitudinal studies and proportionally more retrospective and cross-sectional studies have been published in more recent decades. Finally, more studies focusing on ADHD in adolescents and adults have been conducted in recent years, and particularly adolescents in Eastern Asia. These changes in basic study design may reflect an increase in the recognition that ADHD is a lifetime chronic disorder. This

  9. A systematic review of global publication trends regarding long-term outcomes of ADHD.

    Science.gov (United States)

    Hodgkins, Paul; Arnold, L Eugene; Shaw, Monica; Caci, Hervé; Kahle, Jennifer; Woods, Alisa G; Young, Susan

    2011-01-01

    There is increased global recognition of attention deficit hyperactivity disorder (ADHD) as a serious medical condition with long-term consequences. Although originally conceived of as a childhood disorder, ADHD is being increasingly recognized in adults. Individual geographic regions may have specific interests and objectives for the study of ADHD. A systematic review of long-term outcomes (LTOs) in ADHD was conducted to evaluate research on ADHD LTOs on a global scale. Studies that were at least 2 years in duration were examined. A total of 351 studies were identified in the final analysis. We identified nine outcomes of interest and classified studies by specific geographical regions, age groups studied and study design by region and over time. Published studies of LTOs in ADHD have increased in all geographical regions over the past three decades, with a peak number of 42 publications in 2008. This rise in publications on ADHD LTOs may reflect a rise in global interest and recognition of consequences and impairment associated with ADHD. Although many world regions have published on ADHD LTOs, the majority of studies have emerged from the US and Canada, followed by Europe. While investigators in the US and Canada were predominantly interested in drug addiction as a LTO, European researchers were more interested in antisocial behavior, and Eastern Asian investigators focused on both of these LTOs as well as self-esteem. Geographical differences in the focus of ADHD LTO studies may reflect regional variations in cultural values. Proportionally fewer prospective longitudinal studies and proportionally more retrospective and cross-sectional studies have been published in more recent decades. Finally, more studies focusing on ADHD in adolescents and adults have been conducted in recent years, and particularly adolescents in Eastern Asia. These changes in basic study design may reflect an increase in the recognition that ADHD is a lifetime chronic disorder. This

  10. Retinal vascular fractals predict long-term microvascular complications in type 1 diabetes mellitus

    DEFF Research Database (Denmark)

    Broe, Rebecca; Rasmussen, Malin L; Frydkjaer-Olsen, Ulrik

    2014-01-01

    : We included 180 patients with type 1 diabetes in a 16 year follow-up study. In baseline retinal photographs (from 1995), all vessels in a zone 0.5-2.0 disc diameters from the disc margin were traced using Singapore Institute Vessel Assessment-Fractal image analysis software. Artefacts were removed......AIMS/HYPOTHESIS: Fractal analysis of the retinal vasculature provides a global measure of the complexity and density of retinal vessels summarised as a single variable: the fractal dimension. We investigated fractal dimensions as long-term predictors of microvasculopathy in type 1 diabetes. METHODS....... Retinal fractal analysis therefore is a potential tool for risk stratification in type 1 diabetes....

  11. Survey of public definitions of the term 'overdiagnosis' in the UK.

    Science.gov (United States)

    Ghanouni, Alex; Meisel, Susanne F; Renzi, Cristina; Wardle, Jane; Waller, Jo

    2016-04-06

    To determine how 'overdiagnosis' is currently conceptualised among adults in the UK in light of previous research, which has found that the term is difficult for the public to understand and awareness is low. This study aimed to add to current debates on healthcare in which overdiagnosis is a prominent issue. An observational, web-based survey was administered by a survey company. Participants completed the survey at a time and location of their choosing. 390 consenting UK adults aged 50-70 years. Quota sampling was used to achieve approximately equal numbers in three categories of education and equal numbers of men and women. Participants were asked whether they had seen or heard the term 'overdiagnosis'. If they had, they were then invited to explain in a free-text field what they understood it to mean. If they had not previously encountered it, they were invited to say what they thought it meant. Responses were coded and interpreted using content analysis and descriptive statistics. Data from 390 participants were analysed. Almost a third (30.0%) of participants reported having previously encountered the term. However, their responses often indicated that they had no knowledge of its meaning. The most prevalent theme consisted of responses related to the diagnosis itself. Subthemes indicated common misconceptions, including an 'overly negative or complicated diagnosis', 'false-positive diagnosis' or 'misdiagnosis'. Other recurring themes consisted of responses related to testing (ie, 'too many tests'), treatment (eg, 'overtreatment') and patient psychology (eg, 'overthinking'). Responses categorised as consistent with 'overdiagnosis' (defined as detection of a disease that would not cause symptoms or death) were notably rare (n=10; 2.6%). Consistent with previous research, public awareness of 'overdiagnosis' in the UK is low and its meaning is often misunderstood or misinterpreted. Published by the BMJ Publishing Group Limited. For permission to use (where not

  12. Survey of public definitions of the term ‘overdiagnosis’ in the UK

    Science.gov (United States)

    Ghanouni, Alex; Meisel, Susanne F; Renzi, Cristina; Wardle, Jane; Waller, Jo

    2016-01-01

    Objectives To determine how ‘overdiagnosis’ is currently conceptualised among adults in the UK in light of previous research, which has found that the term is difficult for the public to understand and awareness is low. This study aimed to add to current debates on healthcare in which overdiagnosis is a prominent issue. Design An observational, web-based survey was administered by a survey company. Setting Participants completed the survey at a time and location of their choosing. Participants 390 consenting UK adults aged 50–70 years. Quota sampling was used to achieve approximately equal numbers in three categories of education and equal numbers of men and women. Primary outcome measures Participants were asked whether they had seen or heard the term ‘overdiagnosis’. If they had, they were then invited to explain in a free-text field what they understood it to mean. If they had not previously encountered it, they were invited to say what they thought it meant. Responses were coded and interpreted using content analysis and descriptive statistics. Results Data from 390 participants were analysed. Almost a third (30.0%) of participants reported having previously encountered the term. However, their responses often indicated that they had no knowledge of its meaning. The most prevalent theme consisted of responses related to the diagnosis itself. Subthemes indicated common misconceptions, including an ‘overly negative or complicated diagnosis’, ‘false-positive diagnosis’ or ‘misdiagnosis’. Other recurring themes consisted of responses related to testing (ie, ‘too many tests’), treatment (eg, ‘overtreatment’) and patient psychology (eg, ‘overthinking’). Responses categorised as consistent with ‘overdiagnosis’ (defined as detection of a disease that would not cause symptoms or death) were notably rare (n=10; 2.6%). Conclusions Consistent with previous research, public awareness of ‘overdiagnosis’ in the UK is low and its

  13. Long-term clinical outcomes in type 1 Gaucher disease following 10 years of imiglucerase treatment

    NARCIS (Netherlands)

    Weinreb, Neal J.; Goldblatt, Jack; Villalobos, Jacobo; Charrow, Joel; Cole, J. Alexander; Kerstenetzky, Marcelo; vom Dahl, Stephan; Hollak, Carla

    2013-01-01

    We studied the effect of long-term alglucerase/imiglucerase (Ceredase®/Cerezyme®, Genzyme, a Sanofi company, Cambridge, MA, USA) treatment on hematological, visceral, and bone manifestations of Gaucher disease type 1 (GD1). The International Collaborative Gaucher Group (ICGG) Gaucher Registry

  14. Existence of smooth solutions of multi-term Caputo-type fractional differential equations

    OpenAIRE

    Sin, Chung-Sik; Cheng, Shusen; Ri, Gang-Il; Kim, Mun-Chol

    2017-01-01

    This paper deals with the initial value problem for the multi-term fractional differential equation. The fractional derivative is defined in the Caputo sense. Firstly the initial value problem is transformed into a equivalent Volterra-type integral equation under appropriate assumptions. Then new existence results for smooth solutions are established by using the Schauder fixed point theorem.

  15. Long-term effects on nursing alumni: Assessing a course in public and global health.

    Science.gov (United States)

    Palmer, Sheri P; Lundberg, Karen; de la Cruz, Karen; Corbett, Cheryl; Heaston, Sondra; Reed, Shelly; Williams, Mary

    The impact of a cultural awareness course among nursing students may affect the particular person for years to come. Cultural awareness can be taught via many methods, often requiring study abroad and/or extreme investment of time, money and effort. There is little research on sustained effects on nursing alumni from such a course. The purpose of this descriptive survey study was to determine the long term outcomes of a cultural awareness course and 2) compare the long term effects between alumni who went abroad and those who chose to complete the course locally. One hundred and twenty-one nursing alumni completed the International Education Survey (IES) (Zorn, 1996) with additional open-ended questions. Quantitative and qualitative results concluded: 1) nursing alumni were influenced long term by a course dedicated to public and global health and 2) all alumni had statistically significant IES scores but alumni who studied abroad had the greatest increase. Copyright © 2017 Elsevier Inc. All rights reserved.

  16. Long-term Hyperglycemia Naturally Induces Dental Caries but Not Periodontal Disease in Type 1 and Type 2 Diabetic Rodents.

    Science.gov (United States)

    Nakahara, Yutaka; Ozaki, Kiyokazu; Matsuura, Tetsuro

    2017-11-01

    Periodontal disease (PD) in patients with diabetes is described as the sixth complication of diabetes. We have previously shown that diabetes increases dental caries, and carious inflammation might have a strong effect on the adjacent periodontal tissue in diabetic rodent models. However, the possibility that hyperglycemia may induce PD in diabetic animals could not be completely eliminated. The goal of this study was to confirm the presence of PD in diabetic animal models by preventing carious inflammation with fluoride administration. F344 rats injected with alloxan (type 1 diabetic model) and db/db mice (type 2 diabetic model) were given either tap water alone or tap water containing fluoride. A cariostatic effect of fluoride was evident in the diabetic animals. Meanwhile, fluoride treatment drastically attenuated periodontal inflammation in addition to preventing dental caries. Furthermore, with fluoride treatment, periodontitis was notably nonexistent in the periodontal tissue surrounding the normal molars, whereas the caries-forming process was clearly observed in the teeth that were enveloped with persistent periodontitis, suggesting that enhanced periodontal inflammation might have been derived from the dental caries in the diabetic rodents rather than from the PD. In conclusion, long-term hyperglycemia naturally induces dental caries but not PD in type 1 and type 2 diabetic rodents. © 2017 by the American Diabetes Association.

  17. Long-term earthquake forecasts based on the epidemic-type aftershock sequence (ETAS model for short-term clustering

    Directory of Open Access Journals (Sweden)

    Jiancang Zhuang

    2012-07-01

    Full Text Available Based on the ETAS (epidemic-type aftershock sequence model, which is used for describing the features of short-term clustering of earthquake occurrence, this paper presents some theories and techniques related to evaluating the probability distribution of the maximum magnitude in a given space-time window, where the Gutenberg-Richter law for earthquake magnitude distribution cannot be directly applied. It is seen that the distribution of the maximum magnitude in a given space-time volume is determined in the longterm by the background seismicity rate and the magnitude distribution of the largest events in each earthquake cluster. The techniques introduced were applied to the seismicity in the Japan region in the period from 1926 to 2009. It was found that the regions most likely to have big earthquakes are along the Tohoku (northeastern Japan Arc and the Kuril Arc, both with much higher probabilities than the offshore Nankai and Tokai regions.

  18. Public Attitudes Toward Sexual Expression in Long-Term Care: Does Context Matter?

    Science.gov (United States)

    Yelland, Erin; Hosier, Amy

    2017-08-01

    The purpose of this study was to (a) examine how age and sex of long-term care (LTC) residents influence public attitudes toward sexuality in LTC and (b) understand how, in the absence of cognitive decline, residing in LTC influences the perception of sexuality as a basic human right. Attitudes were examined using a factorial vignette with a probability sample of 325 respondents from a southern state. Results indicate that attitudes were not statistically affected by a vignette character's age or sex; but respondent education level, parenthood status, and religious affiliation did have direct bearing on attitudes. The notion of sexuality as a basic human right for residents of LTC was ultimately challenged as 19% of respondents said that LTC residents should not be permitted to have sexual relations with their spouse in the facility.

  19. A systematic review of long-term outcomes in ADHD: global publication trends

    Directory of Open Access Journals (Sweden)

    Paul eHodgkins

    2012-01-01

    Full Text Available There is increased global recognition of attention deficit hyperactivity disorder (ADHD as a serious medical condition with long-term consequences. Although originally conceived of as a childhood disorder, ADHD is being increasingly recognized in adults. Individual geographic regions may have specific interests and objectives for the study of ADHD. A systematic review of long-term outcomes (LTOs in ADHD was conducted to evaluate research on ADHD LTOs on a global scale. Studies that were at least two years in duration were examined. We identified nine outcomes of interest and classified studies by specific geographical regions, age groups studied and study design by region and over time. Published studies of LTOs in ADHD have increased in all geographical regions over the past three decades, with a peak number of publications in 2008. Although many world regions have published on ADHD LTOs, the majority of studies have emerged from the US and Canada, followed by Europe. While investigators in the US and Canada were predominantly interested in drug addiction as a LTO, European researchers were more interested in antisocial behavior, and Eastern Asian investigators focused on both of these LTOs as well as self-esteem. Proportionally fewer prospective longitudinal studies and proportionally more retrospective and cross-sectional studies have been published in more recent decades. Finally, more studies focusing on ADHD in adolescents and adults have been conducted in recent years, and particularly adolescents in Eastern Asia. This systematic review analysis of publication trends in ADHD LTOs reflects geographically-based interests that change over time.

  20. Long-term Safety of a Geologic Repository: What does the public want to know?

    International Nuclear Information System (INIS)

    Kotra, Janet

    2008-01-01

    Janet Kotra of the U.S. NRC recounted the questions most frequently asked of the Commission's staff, concerning the long-term safety of the planned Yucca Mountain repository. The first question was related to who would decide whether the facility is safe enough. The next question linked to it is if regulatory staff is sufficiently qualified, and if they have access to independent sources of information or depend merely on the information provided by the implementer. The subsequent questions were about what criteria the regulator used and whether they were comprehensive enough. A separate group of questions addressed the safety of the technology, including the geologic features of the site, the engineered structures and the packaging of waste. Issues of documentation, operational control, long-term monitoring, oversight, and enforcement were also raised, along with the transparency of such processes and the accessibility of documents to the public. In addition, several questions were related to the fairness of decision making, public involvement, and the flexibility of the implementation process with regard to future knowledge and RD and D. Ms Kotra propounded that a single question was behind those cited above, namely whether one could rely on the regulator or not. Since it is not realistic to expect an overall consensus on the decision of the regulator agency, the goal should rather be to build confidence in the decision-making process. Key factors of confidence include openness on the part of the regulator and other decision-making institutions, and access to trustworthy representatives of these organisations

  1. Long-Term Prediction of Severe Hypoglycemia in Type 1 Diabetes

    DEFF Research Database (Denmark)

    Henriksen, Marie Moth; Færch, Louise; Thorsteinsson, Birger

    2016-01-01

    BACKGROUND: Prediction of risk of severe hypoglycemia (SH) in patients with type 1 diabetes is important to prevent future episodes, but it is unknown if it is possible to predict the long-term risk of SH. The aim of the study is to assess if long-term prediction of SH is possible in type 1...... diabetes. METHODS: A follow-up study was performed with 98 patients with type 1 diabetes. At baseline and at follow-up, the patients filled in a questionnaire about diabetes history and complications, number of SH in the preceding year and state of awareness, and HbA1c and C-peptide levels were measured......-up. CONCLUSIONS: Long-term prediction of severe hypoglycemia in type 1 diabetes was not possible, although baseline hypoglycemia unawareness tended to remain a predictor for risk of SH at follow-up. Therefore, it is important repeatedly to assess the different risk factors of SH to determine the actual risk....

  2. Regional aspects of long-term public sector psychiatric care in the Eastern Cape

    Directory of Open Access Journals (Sweden)

    Kiran Sukeri

    2017-05-01

    Full Text Available Objectives: The objective of this research was to determine regional aspects (such as clinical, geographic and socio-demographic influencing the use of public sector long-term psychiatric services in the Eastern Cape. This is important in improving service delivery, to assist policy developers with evidence-based research and in providing equitable and efficient resource utilisation. Methodology: A situational analysis of Tower Psychiatric Hospital and Psychosocial Rehabilitation Centre (TPHPRC in the Eastern Cape was conducted. Patient administrative data were utilised to determine geographic origin, date and age at admission, gender and diagnosis as of December 2015. The number of admissions from each region for the years 2010–2015 was also extracted from these data. Results: As of December 2015, there were a total of 390 patients at TPHPRC. Of these, 87% were male patients. The average age at admission for male and female patients was 36 years and 44 years, respectively. Of the patients, 53% originated from the western regions and 57% of female patients presented with a dual diagnosis. The highest number of admissions was in 2015, with the majority originating from Port Elizabeth. Conclusion: Despite higher access to public psychiatric care in the western region, the majority of patients originated from there. Contributing factors to this include diagnoses, insufficient bed numbers and the absence of admission criteria and referral pathways. It is recommended that the provincial Department of Health set up a task team to determine a standardised working framework for all public sector psychiatric institutions. This should be informed by national policies, legislation and provincial norms and indicators.

  3. Does osteoprotegerin relate to micro- and macrovascular complications in long-term type 1 diabetes?

    DEFF Research Database (Denmark)

    Grauslund, Jakob; Rasmussen, Lars M; Green, Anders

    2010-01-01

    was 1257 pg/ml (range 379-5706 pg/ml). In univariate analyses, OPG was related to age, duration of diabetes, female gender, nephropathy and inversely to diastolic blood pressure. In an age- and sex-adjusted model, higher levels of OPG were associated with a higher risk of nephropathy (OR 2.54, 95......Abstract Purpose. Markers of micro- and macrovascular disease are needed in type 1 diabetes in order to identify patients at risk of severe complications. Osteoprotegerin (OPG) is expressed in vascular myocytes, and increasing levels have been reported in type 1 diabetes. Consequently, we...... investigated OPG as a non-invasive marker of micro- and macrovascular complications in long-term type 1 diabetic patients. Methods. This was a cross-sectional study of 200 type 1 diabetic patients with long diabetes duration from a population-based cohort from Fyn County, Denmark. Patients were examined...

  4. How professionals perceive types of risk in public service innovation: Reports from Copenhagen municipality

    DEFF Research Database (Denmark)

    Timeus, Krista; Ricard, Lykke Margot

    The paper addresses two questions; what do professionals working in the public administration understand by ‘risk’ in relation to their work on innovation?; and how do these professionals understand their own role in managing risks of innovation? The paper takes an inductive approach and focuses....... In the last five years, Copenhagen municipality has implemented programmes and partnerships for innovation, especially in social services, such as a new ‘innovation house’ to coordinate the municipality’s innovation strategy across all administrative departments. This context makes it a suitable case to study...... on individuals, namely, professionals in Copenhagen municipality working on public services innovation. Such innovation includes new services or new methods of service delivery. Although all types of innovation include some risk, in public services, risks are exacerbated by the vulnerability of many users...

  5. Look-ahead procedures for Lanczos-type product methods based on three-term recurrences

    Energy Technology Data Exchange (ETDEWEB)

    Gutknecht, M.H.; Ressel, K.J. [Swiss Center for Scientific Computing, Zuerich (Switzerland)

    1996-12-31

    Lanczos-type product methods for the solution of large sparse non-Hermitian linear systems either square the Lanczos process or combine it with a local minimization of the residual. They inherit from the underlying Lanczos process the danger of breakdown. For various Lanczos-type product methods that are based on the Lanczos three-term recurrence, look-ahead versions are presented, which avoid such breakdowns or near breakdowns with a small computational overhead. Different look-ahead strategies are discussed and their efficiency is demonstrated in several numerical examples.

  6. A novel TRNSYS type for short-term borehole heat exchanger simulation: B2G model

    International Nuclear Information System (INIS)

    De Rosa, Mattia; Ruiz-Calvo, Félix; Corberán, José M.; Montagud, Carla; Tagliafico, Luca A.

    2015-01-01

    Highlights: • A novel dynamic borehole heat exchanger model is presented. • Theoretical approach for model parameters calculation is described. • The short-term model is validated against experimental data of a real GSHP. • Strong dynamic conditions due to the ON–OFF regulation are investigated. - Abstract: Models of ground source heat pump (GSHP) systems are used as an aid for the correct design and optimization of the system. For this purpose, it is necessary to develop models which correctly reproduce the dynamic thermal behavior of each component in a short-term basis. Since the borehole heat exchanger (BHE) is one of the main components, special attention should be paid to ensuring a good accuracy on the prediction of the short-term response of the boreholes. The BHE models found in literature which are suitable for short-term simulations usually present high computational costs. In this work, a novel TRNSYS type implementing a borehole-to-ground (B2G) model, developed for modeling the short-term dynamic performance of a BHE with low computational cost, is presented. The model has been validated against experimental data from a GSHP system located at Universitat Politècnica de València, Spain. Validation results show the ability of the model to reproduce the short-term behavior of the borehole, both for a step-test and under normal operating conditions

  7. Evaluation of long term creep-fatigue life for type 304 stainless steel

    International Nuclear Information System (INIS)

    Kawasaki, Hirotsugu; Ueno, Fumiyoshi; Aoto, Kazumi; Ichimiya, Masakazu; Wada, Yusaku

    1992-01-01

    The long term creep-fatigue life of type 304 stainless steel was evaluated by the creep-fatigue life prediction method based on a linear damage fraction rule. The displacement controlled creep-fatigue tests were carried out, and the time to failure of longer than 10000 hours was obtained. The creep damage of long term creep-fatigue was evaluated by taking into account the stress relaxation behavior with elastic follow-up during the hold period. The relationship between life reduction of creep-fatigue and fracture mode was provided by the creep cavity growth. The results of this study are summarized as follows; (1) The long term creep-fatigue data can be reasonably evaluated by the present method. The predicted lives were within a factor of 3 of the observed ones. (2) The present method provides the capability to predict the long term creep-fatigue life at lower temperatures as well as that at the creep dominant temperature. (3) The value of creep damage for the long term creep-fatigue data increased by elastic follow-up. The creep-fatigue damage diagram intercepted between 0.3 and 1 can represent the observed creep-fatigue damages. (4) The cavity growth depends on the hold time. The fracture of long term creep-fatigue is caused by the intergranular cavity growth. The intergranular fracture of creep-fatigue is initiated by the cavity growth and followed by the microcrack propagation along grain boundaries starting from creep cavities. (author)

  8. Long term treatment with metformin in patients with type 2 diabetes and vitamin B 12

    Directory of Open Access Journals (Sweden)

    Yu V Pankratova

    2012-12-01

    Full Text Available Реферат по статье: De Jager J, Kooy A, Lehert P, Wulffelé MG, van der Kolk J, Bets D, Verburg J, Donker AJ, Stehouwer CD. Long term treatment with metformin in patients with type 2 diabetes and risk of vitamin B-12 deficiency: randomised placebo controlled trial. BMJ. 2010 May 20;340:c2181.

  9. LABORATORY FREQUENCY REDISTRIBUTION FUNCTION FOR THE POLARIZED Λ-TYPE THREE-TERM ATOM

    Energy Technology Data Exchange (ETDEWEB)

    Casini, R. [High Altitude Observatory, National Center for Atmospheric Research, P.O. Box 3000, Boulder, CO 80307-3000 (United States); Manso Sainz, R. [Max Planck Institute for Solar System Research, Justus-von-Liebig-Weg 3, D-37077 Göttingen (Germany)

    2016-12-20

    We present the frequency redistribution function for a polarized three-term atom of the Λ-type in the collisionless regime, and we specialize it to the case where both the initial and final terms of the three-state transition are metastable (i.e., with infinitely sharp levels). This redistribution function represents a generalization of the well-known R {sub II} function to the case where the lower terms of the transition can be polarized and carry atomic coherence, and it can be applied to the investigation of polarized line formation in tenuous plasmas, where collisional rates may be low enough that anisotropy-induced atomic polarization survives even in the case of metastable levels.

  10. N=2 type II - heterotic duality and higher derivative F-terms

    International Nuclear Information System (INIS)

    Antoniadis, I.; Narain, K.S.; Taylor, T.R.

    1995-07-01

    We test the recently conjectured duality between N-2 supersymmetric type II and heterotic string models by analyzing a class of higher dimensional interactions in the respective low-energy Lagrangians. These are F-terms of the form F g W 2g where W is the gravitational superfield. On the type II side these terms are generated at the g-loop level and in fact are given by topological partition functions of the twisted Calabi-Yan sigma model. We show that on the heterotic side these terms arise at the one-loop level. We study in detail a rank 3 example and show that the corresponding couplings, F g satisfy the same holomorphic anomaly equations as in the type II case. Moreover we study the leading singularities of F g 's on the heterotic side, near the enhanced symmetry point and show that they are universal poles of order 2g - 2 with coefficients that are given by the Euler number of the moduli space of genus-g Riemann surfaces. This confirms a recent conjecture that the physics near the conifold singularity is governed by c=1 string theory at the self-dual point. (author). 24 refs

  11. Long-term Evaluation of Type 2 Thyroplasty with Titanium Bridges for Adductor Spasmodic Dysphonia.

    Science.gov (United States)

    Sanuki, Tetsuji; Yumoto, Eiji

    2017-07-01

    Objectives Standard treatments of adductor spasmodic dysphonia (AdSD) provide temporary relief of symptoms. Type 2 thyroplasty offers a long-term solution; however, long-term voice outcome data are lacking. The objective of this study was to assess the long-term voice outcomes of type 2 thyroplasty with titanium bridges through use of a validated voice questionnaire. Study Design Case series with chart review. Setting University hospital. Subjects and Methods Forty-seven consecutively enrolled patients with AdSD underwent type 2 thyroplasty with titanium bridges between August 2006 and November 2014. Questionnaires were completed during regularly scheduled follow-ups and, in some cases, were sent to patients who missed follow-up appointments. In 2015, questionnaires were mailed to all 47 patients and included a Voice Handicap Index-10 evaluation, as well as questions on postoperative vocal symptoms, surgical site, and status of the implanted titanium bridges. Results Of 47 patients with AdSD, 31 (66%) completed the questionnaires. The average follow-up interval was 41.3 months. No patient reported experiencing an adverse event around the surgical site, and almost all were satisfied with their voices postoperatively. The mean postoperative (>3 years) Voice Handicap Index-10 score improved significantly, from 26.3 to 9.4 (n = 17, P = .0009). Conclusions Type 2 thyroplasty for AdSD significantly improved patient quality of life and voice symptoms and continued to do so long after the surgery. The results of this study suggest that type 2 thyroplasty provides relief from vocal symptoms in patients with AdSD for >3 years.

  12. Long-term Creep Life Prediction for Type 316LN Stainless Steel

    International Nuclear Information System (INIS)

    Kim, Woo Gon; Ryu, Woo Seog; Kim, Sung Ho; Lee, Chan Bok

    2007-01-01

    Since Sodium Fast Cooled Reactor (SFR) components are designed to be use for more than 30 years at a high temperature of 550 .deg. C, one of the most important properties of these components is the long term creep behavior. To accurately predict the long-term creep life of the components, it is essential to achieve reliable long-term test data beyond their design life. But, it is difficult to actually obtain long duration data because it is time-consuming work. So far, a variety of time-temperature parameters (TTPs) have been developed to predict a long-term creep life from shorter-time tests at higher temperatures. Among them, the Larson-Miller, the Orr-Sherby-Dorn, the Manson-Harferd and the Manson-Succop parameters have been typically used. None of these parameters has an overwhelming preference, and they have certain inherent restrictions imposed on their data in the application of the TTPs parameters. Meanwhile, it has been reported that the Minimum Commitment Method (MCM) proposed by Manson and Ensign has a greater flexibility for a creep rupture analysis. Thus, the MCM will be useful as another approach. Until now, the applicability of the MCM has not been investigated for type 316LN SS because of insufficient creep data. In this paper, the MCM was applied to predict a long-term creep life of type 316LN stainless steel (SS). Lots of creep rupture data was collected through literature surveys and the experimental data of KAERI. Using the short-term experimental data for under 2,000 hours, a longer-time rupture above 105 hours was predicted by the MCM at temperatures from 550 .deg. C to 800 .deg. C

  13. Effect of mass housing settlement type on the comfortable open areas in terms of noise.

    Science.gov (United States)

    Akdağ, Neşe Yüğrük; Gedik, Gülay Zorer; Kiraz, Fatih; Şener, Bekir

    2017-09-12

    The layout of the structures according to the noise source is an important parameter in terms of the level of noise reaching to both open usage areas and the structure surfaces. In this paper, it is aimed to reveal the effect of mass housing settlement type on the size of suitable open usage areas in terms of noise. Comfortable open usage areas in 25 mass housing alternatives are determined for the case of being affected by three different road noises. The reliability of the simulation results is validated by on-site noise level measurements. As a result, it is seen that better results are obtained in linear, L, C, and U type alternatives than point-type blocks. Especially in alternatives consisting of point-and linear-type blocks, if the noise level is above 75 Leq (dBA), the percentage of comfortable open usage areas is very low. It is determined that the percentage of comfortable open areas increases between 50 and 100% by means of appropriately designed noise barriers.

  14. The long-term functional outcome of type II odontoid fractures managed non-operatively.

    LENUS (Irish Health Repository)

    Butler, J S

    2010-10-01

    Odontoid fractures currently account for 9-15% of all adult cervical spine fractures, with type II fractures accounting for the majority of these injuries. Despite recent advances in internal fixation techniques, the management of type II fractures still remains controversial with advocates still supporting non-rigid immobilization as the definitive treatment of these injuries. At the NSIU, over an 11-year period between 1 July 1996 and 30 June 2006, 66 patients (n = 66) were treated by external immobilization for type II odontoid fractures. The medical records, radiographs and CT scans of all patients identified were reviewed. Clinical follow-up evaluation was performed using the Cervical Spine Outcomes Questionnaire (CSOQ). The objectives of this study were to evaluate the long-term functional outcome of patients suffering isolated type II odontoid fractures managed non-operatively and to correlate patient age and device type with clinical and functional outcome. Of the 66 patients, there were 42 males and 24 females (M:F = 1.75:1) managed non-operatively for type II odontoid fractures. The mean follow-up time was 66 months. Advancing age was highly correlated with poorer long-term functional outcomes when assessing neck pain (r = 0.19, P = 0.1219), shoulder and arm pain (r = 0.41, P = 0.0007), physical symptoms (r = 0.25, P = 0.472), functional disability (r = 0.24, P = 0.0476) and psychological distress (r = 0.41, P = 0.0007). Patients >65 years displayed a higher rate of pseudoarthrosis (21.43 vs. 1.92%) and established non-union (7.14 vs. 0%) than patients <65 years. The non-operative management of type II odontoid fractures is an effective and satisfactory method of treating type II odontoid fractures, particularly those of a stable nature. However, patients of advancing age have been demonstrated to have significantly poorer functional outcomes in the long term. This may be linked to higher rates of non-union.

  15. Impact of type 1 diabetes on maternal long-term risk of hospitalisation and mortality

    DEFF Research Database (Denmark)

    Knorr, Sine; Juul, Svend; Bytoft, Birgitte

    2018-01-01

    AIMS/HYPOTHESIS: The aims of this study were to examine long-term mortality and morbidity rates in mothers with type 1 diabetes, both overall and according to the level of albuminuria prior to pregnancy, the presence of hypertension, pre-eclampsia and periconceptional HbA1c. METHODS: This study...... was a part of the EPICOM (Environmental Versus Genetic and Epigenetic Influences on Growth, Metabolism and Cognitive Function in Offspring of Mothers with Type 1 Diabetes) study, which is a prospective follow-up study focusing on pregnancies complicated by maternal type 1 diabetes. We carried out...... a nationwide combined clinical and register-based cohort study of mortality rates and hospital admissions in mothers with diabetes (n = 986) who gave birth between 1992 and 2000. Control mothers (n = 91,441) were women from the background population, matched according to age and year of childbirth. Age...

  16. Radiation therapy for wet type age-related macular degeneration. Long term follow-up results

    Energy Technology Data Exchange (ETDEWEB)

    Sasai, Keisuke; Hiraoka, Masahiro; Mandai, Michiyo; Takahashi, Masayo; Honda, Yoshihito [Kyoto Univ. (Japan). Faculty of Medicine

    1998-12-01

    Between April, 1994 and July, 1995, 33 patients with occult type choroidal neovascularization (CNV) with or without the classical type CNV of the wet type age-related macular degeneration ARMD were treated with radiation therapy (10 Gy/5 fx/1 week or 20 Gy/10 fx/2 weeks). This phase I/II study showed that radiation therapy seems to be useful for CNV during the first 12 months. Some eyes which initially showed good response to irradiation began to lose their visual acuity. However, the dose of 20 Gy in 10 fractions seemed useful to maintain the visual acuity better than 0.1 in this long term follow-up study (24 months). (author)

  17. [Extreme types - a comparison of public health systems in Thuringia and the Warthegau].

    Science.gov (United States)

    Vossen, J

    2013-11-01

    Special policing measures in Nazi Germany required centralisation in the public health service which was mainly achieved through the Law for the Unification of Municipal and State Health Administration in 1934. The long-term aim for public health officers was now hereditary and racial welfare. Several following legal regulations contributed to the implementation of a specific national-socialist health and social policy on the basis of racial hygiene and gave immense power to the health officers. Especially with the Law for the Prevention of Hereditarily Sick Offspring, compulsory sterilisation was legalised and resulted in about 400,000 victims up to 1945. The central force in this new system was the public health office. The most extreme variation of public health administration was launched in Thuringia, where professional powers and state authority implemented an extensive institutional machinery which managed to reinforce Nazi population policy almost to perfection. After the invasion of western Poland the Germans built up an inhumane regime in the annexed and occupied regions, persecuted and murdered the Polish population and tried to exterminate the Jewish people. Here the health officers of the Warthegau could promote a rigorously racial dominated population policy of segregation. © Georg Thieme Verlag KG Stuttgart · New York.

  18. DESCRIPTION OF THE BUDGET CONTROL TYPES IN MODERN CONDITIONS OF PUBLIC FINANCE MANAGEMENT

    Directory of Open Access Journals (Sweden)

    Nataliya Melnichuk

    2016-11-01

    Full Text Available The article highlights the essence of budgetary control. The features of control in the public sector performance are grounded as well as the relationship between verifiability and the controllability. It is proved that the achievement of public finance management needs its controllability. There is no alternative verifiability by ensuring controllability of budget resources. The classification criteria of budgetary control types according to the different classification criteria are developed. It has allowed to distinguish its following types: scheduled, unscheduled, previous, current, next, state, municipal, specialized, departmental, public, external, internal, solid, selective, comprehensive, effective, ineffective, centralized, decentralized, legislative, realizable, further, active, passive, available, projected, intermediate, final, mixed. The purpose of the article is to provide a classification criteria of budgetary control development, taking into account the role and functions of control in public finance management. The subject of the study is a set of financial relationships arising during the budgetary control due to appropriation of financial resources. Methodology. The following methods have been used in the process of writing: cognition, induction, deduction, analysis and synthesis. Results of the survey. Thus, the main directions of budgetary control implementation we can consider the following ones: monitoring compliance with procedures for preparation, review and approval of state and local budgets; the implementation of revenue and expenditure of the budget at the national and local levels control; detection of theft of public funds, as well as their misuse; accuracy of accounting control; increasing the revenue base of the state budget detection; preventive measures to combat corruption and bribery in the public sector. The author’s approach to classification criteria of budgetary control types, unlike existing ones

  19. Trends in Type of Original Psoriasis Publications by Decade, 1960 to 2010.

    Science.gov (United States)

    Sako, Eric; Famenini, Shannon; Wu, Jashin J

    2016-01-01

    Research investigating psoriasis has spanned decades, and as our understanding of the disease has evolved, the focus of publications has changed. We sought to characterize the trends in original psoriasis-related research from 1960 to 2010 chronologically by decade. A literature review was performed using the keyword psoriasis in the MEDLINE database. All original psoriasis-related articles published at the beginning of each decade were searched and categorized by study type and topic. Number of articles per topic. A total of 869 original psoriasis-related articles were found. The number of publications increased 18 fold over 5 decades. The immunology and pathogenesis of psoriasis was the most frequently researched topic (36%), and retrospective studies were the most common study type (37%). Recent highly published topics included biologic therapy, genetics, and psoriasis-associated cardiovascular disease. Original psoriasis-related publications have grown substantially since 1960. Basic science research into the immunology and pathogenesis has been and continues to be the mainstay of psoriasis research. Recent research trends suggest the focus has expanded to topics such as psoriasis-associated cardiovascular disease, genetics, and biologic therapy.

  20. Long-term monitoring studies of pollutants on public lands: Bald Eagles in the Midwest

    Energy Technology Data Exchange (ETDEWEB)

    Bowerman, W.W. [Eagle Environmental Inc., Haslett, MI (United States)

    1995-12-31

    The role of public agencies to monitor the populations of wildlife species with protected status is paramount to the recovery of these species. Since the early 1960s, the bald eagle (Haliaeetus leucocephalus) populations within the Midwest have been monitored to determine number of breeding pairs, nest occupancy, and success rates. In addition to the reproductive outcome studies, abandoned eggs, blood samples, and feather samples have been collected to determine concentrations of organochlorine pesticides, PCBs, and heavy metals. These surveys give an actual measure of population dynamics of a top-predator species in aquatic systems that integrates the effects of many different environmental pollutants. As concentrations of the organochlorine compounds have declined, bald eagle populations have increased in numbers and their reproductive success has improved. The recovery of this species has not been uniform however. In regions where DDT and PCB concentrations are still above thresholds associated with reproductive impairment, eagles still have impaired reproduction. These areas include the shorelines of the Great Lakes and Voyageurs National Park. Some areas such as the Chippewa National Forest have begun to show declines in reproduction due to density dependent factors. Recent proposals for ecosystem management and reclassification of the bald eagle have led to reduced emphasis for maintaining these long-term data sets. The utility and importance of maintaining surveys of top-predators that can give a measure of population-level effects of pollutants rather than an index will be discussed using examples from the Midwest.

  1. Long-term follow-up of patients with Bartter syndrome type I and II.

    Science.gov (United States)

    Puricelli, Elena; Bettinelli, Alberto; Borsa, Nicolò; Sironi, Francesca; Mattiello, Camilla; Tammaro, Fabiana; Tedeschi, Silvana; Bianchetti, Mario G

    2010-09-01

    Little information is available on a long-term follow-up in Bartter syndrome type I and II. Clinical presentation, treatment and long-term follow-up (5.0-21, median 11 years) were evaluated in 15 Italian patients with homozygous (n = 7) or compound heterozygous (n = 8) mutations in the SLC12A1 (n = 10) or KCNJ1 (n = 5) genes. Thirteen new mutations were identified. The 15 children were born pre-term with a normal for gestational age body weight. Medical treatment at the last follow-up control included supplementation with potassium in 13, non-steroidal anti-inflammatory agents in 12 and gastroprotective drugs in five patients. At last follow-up, body weight and height were within normal ranges in the patients. Glomerular filtration rate was Bartter syndrome had a lower renin ratio (P Bartter syndrome. Patients with Bartter syndrome type I and II tend to present a satisfactory prognosis after a median follow-up of more than 10 years. Gallstones might represent a new complication of antenatal Bartter syndrome.

  2. [Neurologic vigor of term newborns according to the type of delivery and obstetric maneuvers].

    Science.gov (United States)

    Riesgo, Rudimar dos Santos; Ohlweiler, Lygia; Winckler, Maria Isabel Bragatti; Ranzan, Josiane; Riesgo, Itamar Dos Santos; Rotta, Newra Tellechea

    2009-06-01

    to evaluate the effect of delivery type and usual obstetric procedures on the neurologic condition of a sample of consecutive term and healthy neonates, in the first 48 hours of life, using the Neurologic Adaptative Capacity Score (NACS) system. cohort prospective study with 313 neonates, from a neonatology unit: Unidade de Neonatologia e Alojamento Conjunto. The variables analyzed were obstetric variables; clinical outcome: low neurologic vigor phase, evaluated by NACS, at 4, 24 and 48 hours of life. The data have been assessed twice: once with the whole sample and the other comparing the Vigorous Group, whose neonates kept a score of 35 or more during the three evaluations, and the Low Vigor Group, with less than 35 scores during the three consecutive evaluations. Bivariate and multivariate analyses have been done. Possible associations between low neurologic vigor phase and the type of delivery, as well between the low neurologic vigor phase and obstetric variables have been searched. in the bivariate analysis, the delivery type and the obstetric variables were not associated with the low neurologic vigor phase. Nevertheless, the association between the amniotic fluid and the low neurologic vigor phase reached values very close to significance and, then, it was included in the multivariate analysis. In the multivariate analysis, the only variable associated with low neurologic vigor was the presence of meconium stained amniotic fluid, which has shown to be 8.1 times more risky for the neurologic scoring, when Vigorous Group and Low Vigor Group were compared. In the analysis of the whole sample, the same risk was 1.7. neither the delivery type, nor the usual obstetric procedures were associated with low neurologic vigor phase. This is useful information, clinically or legally speaking, mainly for obstetricians. According to this sample data, when the term neonate is healthy, the delivery type and the usual obstetric procedures have no impact in the neurologic

  3. Shor-Preskill-type security proof for quantum key distribution without public announcement of bases

    International Nuclear Information System (INIS)

    Hwang, Won-Young; Wang Xiangbin; Matsumoto, Keiji; Kim, Jaewan; Lee, Hai-Woong

    2003-01-01

    We give a Shor-Preskill-type security proof to quantum key distribution without public announcement of bases [W.Y. Hwang et al., Phys. Lett. A 244, 489 (1998)]. First, we modify the Lo-Chau protocol once more so that it finally reduces to the quantum key distribution without public announcement of bases. Then we show how we can estimate the error rate in the code bits based on that in the checked bits in the proposed protocol, which is the central point of the proof. We discuss the problem of imperfect sources and that of large deviation in the error rate distributions. We discuss when the bases sequence must be discarded

  4. private placements as sources of long term funds for publicly quoted

    African Journals Online (AJOL)

    USER

    Nigerian capital market by publicly quoted companies. ... their activities in the market. The market provides a ... hybrid securities typically, are marketed to the public by investment bankers on behalf of the ... as a bank or an insurance company.

  5. Effects of Long-Term Exercise Interventions on Glycaemic Control in Type 1 and Type 2 Diabetes: a Systematic Review.

    Science.gov (United States)

    Röhling, M; Herder, C; Roden, M; Stemper, T; Müssig, K

    2016-09-01

    Aim: Physical activity is one of the cornerstones in the prevention and management of diabetes mellitus, but the effects of different training forms on metabolic control still remain unclear. The aims of this review are to summarize the recommendations of 5 selected diabetes associations and to systematically review the effects of long-term supervised exercise interventions without calorie-restriction on glycemic control in people with type 1 and 2 diabetes focusing on resistance, endurance and combined training consisting of both endurance and resistance training. Methods: Literature searches were performed using MEDLINE for articles published between January 1, 2000 and March 17, 2015. Of 76 articles retrieved, 15 randomized and controlled studies met the inclusion criteria and allowed for examining the effect of exercise training in type 1 and 2 diabetes. Results: Diabetes associations recommend volume-focused exercise in their guidelines. In our analysis, all 3 training forms have the potential to improve the glycemic control, as assessed by HbA 1c (absolute changes in HbA 1c ranging from -0.1% to -1.1% (-1.1 to -12 mmol/mol) in resistance training, from -0.2% to -1.6% (-2.2 to -17.5 mmol/mol) in endurance training and from +0.1% to -1.5% (+1.1 to -16.4 mmol/mol) in combined training, respectively). Conclusions: There is evidence that combined exercise training may improve glycemic control to a greater extent than single forms of exercise, especially under moderate-intensive training conditions with equal training durations. In addition, intensity of training appears to be an important determinant of the degree of metabolic improvement. Nonetheless, it is still unknown to what extent exercise effects glycemic homeostasis. © Georg Thieme Verlag KG Stuttgart · New York.

  6. Trust in the public sector: Is there any evidence for a long-term decline?

    NARCIS (Netherlands)

    S.G.J. Van de Walle (Steven); S. van Roosbroek (Steven); G. Bouckaert (Geert)

    2008-01-01

    textabstractConcerns with declining public trust in government have become a permanent element of the contemporary political discourse. This concern also extends to levels of citizens’ trust in the public administration and public services. Trust is said to be declining, and this decline is

  7. Long-term Prognosis in COPD Exacerbation: Role of Biomarkers, Clinical Variables and Exacerbation Type.

    Science.gov (United States)

    Grolimund, Eva; Kutz, Alexander; Marlowe, Robert J; Vögeli, Alaadin; Alan, Murat; Christ-Crain, Mirjam; Thomann, Robert; Falconnier, Claudine; Hoess, Claus; Henzen, Christoph; Zimmerli, Werner; Mueller, Beat; Schuetz, Philipp

    2015-06-01

    Long-term outcome prediction in COPD is challenging. We conducted a prospective 5-7-year follow-up study in patients with COPD to determine the association of exacerbation type, discharge levels of inflammatory biomarkers including procalctionin (PCT), C-reactive protein (CRP), white blood cell count (WBC) and plasma proadrenomedullin (ProADM), alone or combined with demographic/clinical characteristics, with long-term all-cause mortality in the COPD setting. The analyzed cohort comprised 469 patients with index hospitalization for pneumonic (n = 252) or non-pneumonic (n = 217) COPD exacerbation. Five-to-seven-year vital status was ascertained via structured phone interviews with patients or their household members/primary care physicians. We investigated predictive accuracy using univariate and multivariate Cox regression models and area under the receiver operating characteristic curve (AUC). After a median [25th-75th percentile] 6.1 [5.6-6.5] years, mortality was 55% (95%CI 50%-59%). Discharge ProADM concentration was strongly associated with 5-7-year non-survival: adjusted hazard ratio (HR)/10-fold increase (95%CI) 10.4 (6.2-17.7). Weaker associations were found for PCT and no significant associations were found for CRP or WBC. Combining ProADM with demographic/clinical variables including age, smoking status, BMI, New York Heart Association dyspnea class, exacerbation type, and comorbidities significantly improved long-term predictive accuracy over that of the demographic/clinical model alone: AUC (95%CI) 0.745 (0.701-0.789) versus 0.727 (0.681-0.772), (p) = .043. In patients hospitalized for COPD exacerbation, discharge ProADM levels appeared to accurately predict 5-7-year all-cause mortality and to improve long-term prognostic accuracy of multidimensional demographic/clinical mortality risk assessment.

  8. FREQUENCY REDISTRIBUTION OF POLARIZED LIGHT IN THE Λ-TYPE MULTI-TERM POLARIZED ATOM

    Energy Technology Data Exchange (ETDEWEB)

    Casini, R. [High Altitude Observatory, National Center for Atmospheric Research, P.O. Box 3000, Boulder, CO 80307-3000 (United States); Sainz, R. Manso [Max-Planck-Institut für Sonnensystemforschung, Justus-von-Liebig-Weg 3, D-37077 Göttingen (Germany)

    2016-06-20

    We study the effects of Rayleigh and Raman scattering on the formation of polarized spectral lines in a Λ-type multi-term atom. We fully take into account the partial redistribution of frequency and the presence of atomic polarization in the lower states of the atomic model. Problems that can be modeled with this formalism include, for example, the formation of the Ca ii H–K and IR triplet, the analogous system of Ba ii, and the Ly β –H α system of hydrogenic ions.

  9. Taking a vector supermultiplet apart: Alternative Fayet-Iliopoulos-type terms

    Science.gov (United States)

    Kuzenko, Sergei M.

    2018-06-01

    Starting from an Abelian N = 1 vector supermultiplet V coupled to conformal supergravity, we construct from it a nilpotent real scalar Goldstino superfield V of the type proposed in arxiv:arXiv:1702.02423. It contains only two independent component fields, the Goldstino and the auxiliary D-field. The important properties of this Goldstino superfield are: (i) it is gauge invariant; and (ii) it is super-Weyl invariant. As a result, the gauge prepotential can be represented as V = V + V, where V contains only one independent component field, modulo gauge degrees of freedom, which is the gauge one-form. Making use of V allows us to introduce new Fayet-Iliopoulos-type terms, which differ from the one proposed in arxiv:arXiv:1712.08601 and share with the latter the property that gauged R-symmetry is not required.

  10. Long-term changes in retinal vascular diameter and cognitive impairment in type 1 diabetes.

    Science.gov (United States)

    Nunley, Karen A; Metti, Andrea L; Klein, Ronald; Klein, Barbara E; Saxton, Judith A; Orchard, Trevor J; Costacou, Tina; Aizenstein, Howard J; Rosano, Caterina

    2018-05-01

    To assess associations between cognitive impairment and longitudinal changes in retinal microvasculature, over 18 years, in adults with type 1 diabetes. Participants of the Pittsburgh Epidemiology of Diabetes Complications Study received ≥3 fundus photographs between baseline (1986-1988) and time of cognitive assessment (2010-2015: N = 119; 52% male; mean age and type 1 diabetes duration 43 and 34 years, respectively). Central retinal arteriolar equivalent and central retinal venular equivalent were estimated via computer-based methods; overall magnitude and speed of narrowing were quantified as cumulative average and slope, respectively. Median regression models estimated associations of central retinal arteriolar equivalent and central retinal venular equivalent measures with cognitive impairment status, adjusted for type 1 diabetes duration. Interactions with HbA1c, proliferative retinopathy and white matter hyperintensities were assessed. Compared with participants without cognitive impairment, those with clinically relevant cognitive impairment experienced 1.8% greater and 31.1% faster central retinal arteriolar equivalent narrowing during prior years (t = -2.93, p = 0.004 and t = -3.97, p impairment. Long-term arterial retinal changes could indicate type 1 diabetes-related cognitive impairment. Studies examining longitudinal central retinal arteriolar equivalent changes as early biomarkers of cognitive impairment risk are warranted.

  11. Public Preferences Across Europe for Different Forest Stand Types as Sites for Recreation

    Directory of Open Access Journals (Sweden)

    David M. Edwards

    2012-03-01

    Full Text Available A Delphi survey involving experts in forest preference research was carried out to derive scores for the recreational value of 240 forest stand types across Europe. The survey was organized around four regional panels: Great Britain, Nordic Region, Central Europe, and Iberia. In each region, 60 forest stand types were defined according to five forest management alternatives (FMAs on a continuum of management intensity, four phases of development (establishment, young, medium, and adult, and three tree species types (conifer, broadleaved, and mixed stands of conifer and broadleaved. The resulting scores were examined using conjoint analysis to determine the relative importance of the three structural attributes (FMA, phase of development, and tree species type, and each level or component of the attributes. The findings quantify the extent to which forest visitors prefer a degree of management to unmanaged forest nature reserves across the four regions. Phase of development was shown to make the highest contribution to the recreational value of forests while the contribution of tree species type was shown to be relatively unimportant. While the results are indicative, they provide evidence to support long-term retention and low-impact silviculture in forests where recreation is a primary objective of management.

  12. Effect of organisational change type and frequency on long-term sickness absence in hospitals.

    Science.gov (United States)

    Bernstrøm, Vilde H; Kjekshus, Lars Erik

    2015-09-01

    The present study was conducted to investigate how the frequency of structural change and patient care-related change is related to employees' long-term sickness absence. Although a growing body of research is investigating the potentially harmful effects of organisational change on employee health, most studies have focused on single episodes of organisational change and do not differentiate among the types and frequencies of change. National registry data were collected from 2005 and 2007. A total of 34 712 health professionals from 56 hospitals were included (76% nurses, 18% physicians and 6% other health professionals) and the data were analysed using multilevel logistic regression. The research findings reveal a significantly higher probability of long-term sickness absence among employees who experienced more frequent structural changes (OR = 1.03; CI: 1.00-1.06; P changes. A higher frequency of organisational change may lead to more sickness-related absence among employees, with the effect depending on the type of change. These findings highlight the need for managers who are contemplating or are in the process of implementing organisational change to become more aware of the potentially harmful effects of frequent organisational change on employee health. © 2014 John Wiley & Sons Ltd.

  13. Public strategies for improving eHealth integration and long‐term sustainability in public health care systems: Findings from an Italian case study

    Science.gov (United States)

    Nuti, Sabina

    2017-01-01

    Summary eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long‐term sustainability. In a public health care system, the public actor is among the main “buyers” eHealth. However, public interventions have been increasingly focused on cost containment. How to match these 2 aspects? This article explores some central issues, mainly related to financial aspects, in the development of effective and valuable eHealth strategies in a public health care system: How can the public health care system (as a “buyer”) improve long‐term success and sustainability of eHealth solutions? What levers are available to match in the long period different interests of different stakeholders in the eHealth field? A case study was performed in the Region of Tuscany, Italy. According to our results, win‐win strategies should be followed. Investments should take into account the need to long‐term finance solutions, for sustaining changes in health care organizations for obtaining benefits. To solve the interoperability issues, the concept of the “platform approach” emerged, based on collaboration within and between organizations. Private sector as well as beneficiaries and final users of the eHealth solutions should participate in their design, provision, and monitoring. For creating value for all, the evidence gap and the financial needs could be addressed with a pull mechanism of funding, aimed at paying according to the outcomes produced by the eHealth solution, on the base of an ongoing monitoring, measurement, and evaluation of the outcomes. PMID:28791771

  14. The Role of the Government and the Public in the Planning of Long Term Management for Nuclear Fuel Wastes in Canada

    International Nuclear Information System (INIS)

    Diah Hidayanti; Yudi Pramono

    2007-01-01

    The generation of electricity from nuclear power has the consequence of producing some wastes that are radioactive, especially in the form of spent fuels which are classified as high level nuclear wastes. Nuclear fuel wastes must be managed properly in order to protect public and environment from its big potential hazard. One type of long term management for nuclear fuel wastes is the final disposal in a permanent storage. Because of the importance of safety aspects for final disposal, it needs the involvement of government and the public to determine the reliability and the acceptance of final disposal concept. Those involvements can be implemented in some aspects such as regulation aspect, review and assessment process, and the public feedback. The evaluation on the plan of long term management for nuclear fuel wastes in Canada provides Indonesia an overview of its long term management plans for all radioactive materials, including nuclear fuel wastes generated from the nuclear power plant which is planned to be in service by 2016. (author)

  15. Publicity.

    Science.gov (United States)

    Chisholm, Joan

    Publicity for preschool cooperatives is described. Publicity helps produce financial support for preschool cooperatives. It may take the form of posters, brochures, newsletters, open house, newspaper coverage, and radio and television. Word of mouth and general good will in the community are the best avenues of publicity that a cooperative nursery…

  16. Long-term use of metformin and colorectal cancer risk in type II diabetics

    DEFF Research Database (Denmark)

    Cardel, Majken; Jensen, S. M.; Pottegård, Anton

    2014-01-01

    of prescriptions for a cumulative dose of 2000 g within 5 years prior to the index date. To control for potential confounders, we used unconditional logistic regression. We generated adjusted odds ratios (OR) for the association between metformin and CRC and performed subanalyses for selected subgroups...... and for the dose-response relation. We identified 2088 cases and 9060 controls during the study period. The association between long-term metformin use and CRC gave an adjusted OR at 0.83 (95% CI 0.68-1.00). A protective effect on CRC with long-term use of metformin was only evident for women (OR 0.66 vs. 0.......99 for men). There was a significant dose-response association of metformin use > 250 defined daily dose (DDD) and for the duration of metformin use > 1 year. We found an indication of a protective effect of long-term metformin use against CRC in type II diabetics, although this effect was only seen in women....

  17. Short-term acclimation to warmer temperatures accelerates leaf carbon exchange processes across plant types.

    Science.gov (United States)

    Smith, Nicholas G; Dukes, Jeffrey S

    2017-11-01

    While temperature responses of photosynthesis and plant respiration are known to acclimate over time in many species, few studies have been designed to directly compare process-level differences in acclimation capacity among plant types. We assessed short-term (7 day) temperature acclimation of the maximum rate of Rubisco carboxylation (V cmax ), the maximum rate of electron transport (J max ), the maximum rate of phosphoenolpyruvate carboxylase carboxylation (V pmax ), and foliar dark respiration (R d ) in 22 plant species that varied in lifespan (annual and perennial), photosynthetic pathway (C 3 and C 4 ), and climate of origin (tropical and nontropical) grown under fertilized, well-watered conditions. In general, acclimation to warmer temperatures increased the rate of each process. The relative increase in different photosynthetic processes varied by plant type, with C 3 species tending to preferentially accelerate CO 2 -limited photosynthetic processes and respiration and C 4 species tending to preferentially accelerate light-limited photosynthetic processes under warmer conditions. R d acclimation to warmer temperatures caused a reduction in temperature sensitivity that resulted in slower rates at high leaf temperatures. R d acclimation was similar across plant types. These results suggest that temperature acclimation of the biochemical processes that underlie plant carbon exchange is common across different plant types, but that acclimation to warmer temperatures tends to have a relatively greater positive effect on the processes most limiting to carbon assimilation, which differ by plant type. The acclimation responses observed here suggest that warmer conditions should lead to increased rates of carbon assimilation when water and nutrients are not limiting. © 2017 John Wiley & Sons Ltd.

  18. Collagen Type III and VI Turnover in Response to Long-Term Immobilization.

    Directory of Open Access Journals (Sweden)

    Shu Sun

    Full Text Available Muscle mass and function are perturbed by immobilization and remobilization. When muscle mass changes, the quality and quantity of the extracellular matrix protein, particularly the collagens, change with it. In this study, we investigated the temporal profile of three peptide biomarkers derived from turnover of collagen type III and type VI in a long-term immobilization and remobilization study. We also compared individual biomarker levels with Lean body Mass (LBM and changes therein, hypothesizing that these biomarkers would be biomarkers of the remodeling processes associated with immobilization and/or remobilization.In the Berlin bed rest study, 20 young men were recruited and randomly assigned to 8-week's strict bed rest with or without resistive vibration exercise countermeasure. We measured three neo-epitope ELISA kits in the serum samples of this study: Pro-C3, measured the synthesis of collagen type III; Pro-C6, measured the synthesis of collagen type VI; and C6M measured the degradation of collagen type VI induced by MMP-2 and MMP-9 cleavage.Pro-C3 and Pro-C6 biomarkers are up-regulated with both immobilization and remobilization, whereas C6M is hardly affected at all. We found that Pro-C3 and C6M levels are related to LBM at baseline and that high levels of Pro-C6 are associated with smaller changes in muscle mass during both immobilization and remobilization.The Pro-C3 and-C6 biomarkers change likely reflect remodeling changes in response to unloading or reloading, whereas C6M does not appear to respond to unloading. Pro-C3 and C6M levels correlate with LBM at baseline, while Pro-C6 is related to the anabolic and catabolic responses to unloading and reloading.

  19. 78 FR 32001 - Public Notice for a Change in Use of Aeronautical Property and Long-Term Lease Approval at...

    Science.gov (United States)

    2013-05-28

    ... International Airport approved Airport Layout Plan (ALP). There is to be no sale or transfer of property rights... DEPARTMENT OF TRANSPORTATION Federal Aviation Administration Public Notice for a Change in Use of Aeronautical Property and Long-Term Lease Approval at Harrisburg International Airport (MDT), Middletown, PA...

  20. Can long-term thiamine treatment improve the clinical outcomes of myotonic dystrophy type 1?

    Directory of Open Access Journals (Sweden)

    Antonio Costantini

    2016-01-01

    Full Text Available Myotonic dystrophy type 1, also known as Steinert′s disease, is an autosomal dominant disorder with multisystemic clinical features affecting the skeletal and cardiac muscles, the eyes, and the endocrine system. Thiamine (vitamin B1 is a cofactor of fundamental enzymes involved in the energetic cell metabolism; recent studies described its role in oxidative stress, protein processing, peroxisomal function, and gene expression. Thiamine deficiency is critical mainly in the central and peripheral nervous system, as well as in the muscular cells. Our aim was to investigate the potential therapeutical effects of long-term treatment with thiamine in myotonic dystrophy type 1 in an observational open-label pilot study. We described two patients with myotonic dystrophy type 1 treated with intramuscular thiamine 100 mg twice a week for 12 or 11 months. We evaluated the patients using the grading of muscle strength according to Medical Research Council (MRC, the Muscular Impairment Rating Scale (MIRS, and the Modified Barthel index. High-dose thiamine treatment was well tolerated and effective in improving the motor symptomatology, particularly the muscle strength evaluated with the MRC scale, and the patients′ activities of daily living using the Modified Barthel Index. At the end of treatment, the MRC score was 5 in the proximal muscles and 2-4 in the distal muscles (the MRC score before the treatment was 3-4 and 1-3, respectively. The MIRS grade improved by 25% compared to baseline for both patients. In patient #1, the Modified Barthel Index improved by 44%, and in patient #2 by 29%. These findings suggest that clinical outcomes are improved by long-term thiamine treatment.

  1. Can long-term thiamine treatment improve the clinical outcomes of myotonic dystrophy type 1?

    Science.gov (United States)

    Costantini, Antonio; Trevi, Erika; Pala, Maria Immacolata; Fancellu, Roberto

    2016-09-01

    Myotonic dystrophy type 1, also known as Steinert's disease, is an autosomal dominant disorder with multisystemic clinical features affecting the skeletal and cardiac muscles, the eyes, and the endocrine system. Thiamine (vitamin B1) is a cofactor of fundamental enzymes involved in the energetic cell metabolism; recent studies described its role in oxidative stress, protein processing, peroxisomal function, and gene expression. Thiamine deficiency is critical mainly in the central and peripheral nervous system, as well as in the muscular cells. Our aim was to investigate the potential therapeutical effects of long-term treatment with thiamine in myotonic dystrophy type 1 in an observational open-label pilot study. We described two patients with myotonic dystrophy type 1 treated with intramuscular thiamine 100 mg twice a week for 12 or 11 months. We evaluated the patients using the grading of muscle strength according to Medical Research Council (MRC), the Muscular Impairment Rating Scale (MIRS), and the Modified Barthel index. High-dose thiamine treatment was well tolerated and effective in improving the motor symptomatology, particularly the muscle strength evaluated with the MRC scale, and the patients' activities of daily living using the Modified Barthel Index. At the end of treatment, the MRC score was 5 in the proximal muscles and 2-4 in the distal muscles (the MRC score before the treatment was 3-4 and 1-3, respectively). The MIRS grade improved by 25% compared to baseline for both patients. In patient #1, the Modified Barthel Index improved by 44%, and in patient #2 by 29%. These findings suggest that clinical outcomes are improved by long-term thiamine treatment.

  2. 12-lipoxygenase regulates hippocampal long-term potentiation by modulating L-type Ca2+ channels

    Science.gov (United States)

    DeCostanzo, Anthony J.; Voloshyna, Iryna; Rosen, Zev B.; Feinmark, Steven J.; Siegelbaum, Steven A.

    2010-01-01

    Although long-term potentiation (LTP) has been intensely studied, there is disagreement as to which molecules mediate and modulate LTP. This is partly due to the presence of mechanistically distinct forms of LTP that are induced by different patterns of stimulation and that depend on distinct Ca2+ sources. Here we report a novel role for the arachidonic acid-metabolizing enzyme 12-lipoxygenase (12-LO) in LTP at CA3-CA1 hippocampal synapses that is dependent on the pattern of tetanic stimulation. We find that 12-LO activity is required for the induction of LTP in response to a theta-burst stimulation (TBS) protocol, which depends on Ca2+ influx through both NMDA receptors and L-type voltage-gated Ca2+ channels. In contrast, LTP induced by 100 Hz tetanic stimulation, which requires Ca2+ influx through NMDA receptors but not L-type channels, does not require 12-LO. We find that 12-LO regulates LTP by enhancing postsynaptic somatodendritic Ca2+ influx through L-type channels during theta burst stimulation, an action exerted via 12(S)-HPETE, a downstream metabolite of 12-LO. These results help define the role of a long-disputed signaling enzyme in LTP. PMID:20130191

  3. Reporting on Long-Term Value Creation—The Example of Public Canadian Energy and Mining Companies

    Directory of Open Access Journals (Sweden)

    Petra F. A. Dilling

    2016-09-01

    Full Text Available This study empirically analyzes reporting on long-term value creation for Canadian public mining and energy companies. It represents an important first step in determining the quality of reporting and its determinants for large public companies. In this exploratory empirical study, a reporting quality scoring index was developed to measure disclosure quality of long-term value creation reporting. Content analysis was used to examine financial and sustainability reports for a sample of twenty Canadian public mining and energy companies. Corporate disclosure quality scores were then calculated by assessing the quality of reporting in four main categories. The findings suggest that overall disclosure quality on long-term value creation is still low. Companies disclosing higher quality information on long-term value creation are of bigger size, operate in the basic materials sector, have an independent board, are listed in the Dow Jones Sustainability Index, experience higher stock volatility and use more words related to long-term value creation in their annual financial and non-financial reports. In order to increase and restore stakeholder trust and credibility as well as a tool to maintain stability, it is strongly recommended to introduce adequate mandatory standardization resulting in a set of internationally recognized reporting standards as well as a requirement for external assurance of reports.

  4. Public aquaria as long-term enrichments for investigating planktonic Archaea

    Science.gov (United States)

    Goldenstein, Nadine I.; Warren, Courtney E.; Lipp, Julius S.; Pagani, Mark; Hinrichs, Kai-Uwe

    2016-04-01

    The most abundant group of planktonic Archaea , the so-called Thaumarchaeota, represents 20% of all marine planktonic microorganisms (Karner et al., 2001) and their energy efficient performance of nitrification makes them key players in the global nitrogen- and carbon-cycle (Könneke et al., 2014). Furthermore, planktonic Archaea are considered to be the major producers of specific microbial membrane lipids that are extensively used as paleoproxies in marine climate research (Schouten et al., 2002). Therefore, assessing the parameters controlling the distribution of Archaea in the marine water column is crucial for studies of modern and past marine environments. Although diverse studies utilizing DNA- and biomarker-based approaches have constrained the turnover and distribution of marine Archaea, the environmental factors affecting their abundance and activity (e.g., Wuchter et al., 2006; Bale et al., 2013) are still poorly understood. Further, previous surveys, using enrichment cultivation and pure culture experiments, provided valuable information on adaptation of planktonic Archaea to changes of parameters affecting growth conditions, such as temperature, salinity and growth stage (Elling et al., 2014, 2015). Hence, we know that planktonic Archaea directly adapt their membranes to changing growth conditions, but also that environmental selection for individual phylogenetic groups of these organisms is also reflected in the membrane lipid pool. Extending these studies, this project further aims at constraining the environmental parameters controlling archaeal abundance in the marine environment. Public aquaria, which are comparable to perfectly monitored long-term enrichment cultures, are optimal sampling sites for this task. A comprehensive set of 120 water and substrate samples from fresh, marine and brackish systems exhibiting diverse conditions was selected from 15 public aquaria at the east and west coast of the USA. These samples were examined for their

  5. Public health program planning logic model for community engaged type 2 diabetes management and prevention.

    Science.gov (United States)

    West, Joseph F

    2014-02-01

    Diabetes remains a growing epidemic with widening health inequity gaps in disease management, self-management knowledge, access to care and outcomes. Yet there is a paucity of evaluation tools for community engaged interventions aimed at closing the gaps and improving health. The Guide to Community Preventive Services (the Community Guide) developed by the Task Force on Community Preventive Services (the Task Force) at the Centers for Disease Control and Prevention (CDC) recommends two healthcare system level interventions, case management interventions and disease management programs, to improve glycemic control. However, as a public health resource guide for diabetes interventions a model for community engagement is a glaringly absent component of the Community Guide recommendations. In large part there are few evidence-based interventions featuring community engagement as a practice and system-level focus of chronic disease and Type 2 diabetes management. The central argument presented in this paper is that the absence of these types of interventions is due to the lack of tools for modeling and evaluating such interventions, especially among disparate and poor populations. A conceptual model emphasizing action-oriented micro-level community engagement is needed to complement the Community Guide and serve as the basis for testing and evaluation of these kinds of interventions. A unique logic model advancing the Community Guide diabetes recommendations toward measureable and sustainable community engagement for improved Type 2 diabetes outcomes is presented. Copyright © 2013 Elsevier Ltd. All rights reserved.

  6. Individual differences construed in terms of Jungian psychological types and Adlerian lifestyles

    Directory of Open Access Journals (Sweden)

    Zenon Uchnast

    2017-01-01

    Full Text Available Stern has drawn attention to the possibility of conducting research into the psychology of individual differences in a manner that treats nomothetic and idiographic approaches as being equal and complementary. Nevertheless, many psychologists, such as Strelau, strongly deny the scientific value of the idiographic approach. Jung's conception of psychological types, as presented here, has been created using the nomothetic approach, and its basic assumptions can be verified using the Myers-Briggs Type Indicator (MBTI. Bearing in mind the fact that Adler's conception of lifestyles was formulated and verified using only the idiographic method of psychography, carried out in the context of individual courses of psychotherapy, I draw attention to the possibility of using, for this purpose, my own Action Styles Questionnaire (ASQ, which offers some elements essential to the idiographic approach: e.g. a bipolar structural scale of individual preferences articulated in terms of cooperation with others on the one hand, and security and self-protection on the other (CO-SP - one which may be considered convergent with Adler's description of creative and uncreative lifestyles. Psychometric data obtained from the students (N=388 in respect of MBTI and ASQ were subjected to statistical covariation analysis (textit{r}-Pearson. Additionally, four homogeneous types were demarcated, using statistical cluster analysis. The final results obtained indicate that MBTI attitude scales (extroversion and introversion are significantly covariant with the results for persons belonging to different types along the bipolar CO-SP scale. However, there were almost no differences between the results obtained when using ASQ scales and when using the scales for the three pairs of psychological functions measured by MBTI.

  7. The Comparison of Typed and Handwritten Essays of Iranian EFL Students in terms of Length, Spelling, and Grammar

    Directory of Open Access Journals (Sweden)

    Behrouz Sarbakhshian

    2016-11-01

    Full Text Available This study attempted to compare typed and handwritten essays of Iranian EFL students in terms of length, spelling, and grammar. To administer the study, the researchers utilized Alice Touch Typing Tutor software to select 15 upper intermediate students with higher ability to write two essays: one typed and the other handwritten. The students were both males and females between the ages of 22 to 35. The analyses of the students’ scores in the three mentioned criteria through three paired samples t-tests indicate that typed essays are significantly better than handwritten ones in terms of length of texts and grammatical mistakes, but not significantly different in spelling mistakes. Positive effects of typing can provide a logical reason for students, especially TOEFL applicants, to spend more time on acquiring typing skill and also for teachers to encourage their students with higher typing ability to choose typed format in their essays.

  8. A comparison of two types of running wheel in terms of mouse preference, health, and welfare.

    Science.gov (United States)

    Walker, Michael; Mason, Georgia

    2018-07-01

    Voluntary wheel running occurs in mice of all strains, sexes, and ages. Mice find voluntary wheel running rewarding, and it leads to numerous health benefits. For this reason wheels are used both to enhance welfare and to create models of exercise. However, many designs of running wheel are used. This makes between-study comparisons difficult, as this variability could potentially affect the amount, pattern, and/or intensity of running behaviour, and thence the wheels' effects on welfare and exercise-related changes in anatomy and physiology. This study therefore evaluated two commercially available models, chosen because safe for group-housed mice: Bio Serv®'s "fast-trac" wheel combo and Ware Manufacturing Inc.'s stainless steel mesh 5″ upright wheel. Working with a total of three hundred and fifty one female C57BL/6, DBA/2 and BALB/c mice, we assessed these wheels' relative utilization by mice when access was free; the strength of motivation for each wheel-type when access required crossing an electrified grid; and the impact each wheel had on mouse well-being (inferred from acoustic startle responses and neophobia) and exercise-related anatomical changes (BMI; heart and hind limb masses). Mice ran more on the "fast-trac" wheel regardless of whether both wheel-types were available at once, or only if one was present. In terms of motivation, subjects required to work to access a single wheel worked equally hard for both wheel-types (even if locked and thus not useable for running), but if provided with one working wheel for free and the other type of wheel (again unlocked) accessible via crossing the electrified grid, the "fast-trac" wheel emerged as more motivating, as the Maximum Price Paid for the Ware metal wheel was lower than that paid for the "fast-trac" plastic wheel, at least for C57BL/6s and DBA/2s. No deleterious consequences were noted with either wheel in terms of health and welfare, but only mice with plastic wheels developed significantly larger

  9. On mixed derivatives type high dimensional multi-term fractional partial differential equations approximate solutions

    Science.gov (United States)

    Talib, Imran; Belgacem, Fethi Bin Muhammad; Asif, Naseer Ahmad; Khalil, Hammad

    2017-01-01

    In this research article, we derive and analyze an efficient spectral method based on the operational matrices of three dimensional orthogonal Jacobi polynomials to solve numerically the mixed partial derivatives type multi-terms high dimensions generalized class of fractional order partial differential equations. We transform the considered fractional order problem to an easily solvable algebraic equations with the aid of the operational matrices. Being easily solvable, the associated algebraic system leads to finding the solution of the problem. Some test problems are considered to confirm the accuracy and validity of the proposed numerical method. The convergence of the method is ensured by comparing our Matlab software simulations based obtained results with the exact solutions in the literature, yielding negligible errors. Moreover, comparative results discussed in the literature are extended and improved in this study.

  10. Mechanical properties of types 304 and 316 stainless steel after long-term aging and exposure

    International Nuclear Information System (INIS)

    Horak, J.A.; Sikka, V.K.; Raske, D.T.

    1983-01-01

    Because designs for Liquid Metal Fast Breeder Reactor (LMFBR) power plants include plant lifetimes to 40 years, an understanding of the mechanical behavior of the structural alloys used is required for times of approx. 2 to 2.5 x 10 5 h. Most of the alloys used for LMFBR out-of-core structures and components are in a metastable state at the beginning of plant lifetime and evolve to a more stable state and, therefore, microstructure during plant operation. We reviewed mechanical properties and microstructures after prolonged elevated-temperature exposure of types 304 and 316 stainless steel, two alloys used extensively in fast breeder systems. Aging alters properties; in particular, it decreases toughness and tensile ductility, but the properties are still adequate for service. Because stable microstructures have been reached in long-term exposures achieved so far, properties can be expected to remain adequate for service life exposures

  11. Modified Emden-type equation with dissipative term quadratic in velocity

    International Nuclear Information System (INIS)

    Ghosh, Subrata; Talukdar, B; Das, Umapada; Saha, Aparna

    2012-01-01

    Based on some physical observation we introduce a generalized modified Emden-type equation (MEE) with a position-dependent dissipative term which is quadratic in velocity. Unlike the usual MEE, the first integral of the proposed generalized MEE is such that one can express the velocity of the system as a function of coordinate for all values of the parameters of the system. This permits us to study the dynamical properties of the system using straightforward analytical methods. The results presented in the phase diagram and plots of vector fields clearly delineate how does the presence of quadratic damping affect the motion of our nonlinear oscillator. From the differential equation provided by the first integral of the generalized MEE, we have found an approximate analytical solution of the equation which reproduces the time variation of the corresponding numerical solution to a fair degree of accuracy. (paper)

  12. Sildenafil ameliorates long term peripheral neuropathy in type II diabetic mice.

    Directory of Open Access Journals (Sweden)

    Lei Wang

    Full Text Available Diabetic peripheral neuropathy is a common complication of long-standing diabetes mellitus. To mimic clinical trials in which patients with diabetes enrolled have advanced peripheral neuropathy, we investigated the effect of sildenafil, a specific inhibitor of phosphodiesterase type 5 enzyme, on long term peripheral neuropathy in middle aged male mice with type II diabetes. Treatment of diabetic mice (BKS.Cg-m+/+Leprdb/J, db/db at age 36 weeks with sildenafil significantly increased functional blood vessels and regional blood flow in the sciatic nerve, concurrently with augmentation of intra-epidermal nerve fiber density in the skin and myelinated axons in the sciatic nerve. Functional analysis showed that the sildenafil treatment considerably improved motor and sensory conduction velocities in the sciatic nerve and peripheral thermal stimulus sensitivity compared with the saline treatment. In vitro studies showed that mouse dermal endothelial cells (MDE cultured under high glucose levels exhibited significant down regulation of angiopoietin 1 (Ang1 expression and reduction of capillary-like tube formation, which were completely reversed by sildenafil. In addition, incubation of dorsal root ganglia (DRG neurons with conditioned medium harvested from MDE under high glucose levels suppressed neurite outgrowth, where as conditional medium harvested from MDE treated with sildenafil under high glucose levels did not inhibit neurite outgrowth of DRG neurons. Moreover, blockage of the Ang1 receptor, Tie2, with a neutralized antibody against Tie2 abolished the beneficial effect of sildenafil on tube formation and neurite outgrowth. Collectively, our data indicate that sildenafil has a therapeutic effect on long term peripheral neuropathy of middle aged diabetic mice and that improvement of neurovascular dysfunction by sildenafil likely contributes to the amelioration of nerve function. The Ang1/Tie2 signaling pathway may play an important role in these

  13. Teachers' attitudes and perceptions about preparation of public schools to assist students with type 1 diabetes.

    Science.gov (United States)

    Carral San Laureano, Florentino; Gutiérrez Manzanedo, José Vicente; Moreno Vides, Pablo; de Castro Maqueda, Guillermo; Fernández Santos, Jorge R; Ponce González, Jesús Gustavo; Ayala Ortega, María Del Carmen

    2018-04-01

    To assess teachers' attitudes and perceptions about preparation of public primary and secondary education schools in the Puerto Real University Hospital (Cádiz, Spain) area to care for students with type 1 diabetes mellitus (T1DM) METHODS: A descriptive observational study where answers to an attitude and perception questionnaire on the preparation of schools to care for pupils with T1DM were analyzed. A total of 765 teachers (mean age, 44.3±8.8 years; 61.7% women) from 44 public schools in the area of the Puerto Real University Hospital were selected by random sampling. Overall, 43.2% of teachers surveyed had or had previously had students with T1DM, but only 0.8% had received specific training on diabetes. 18.9% of teachers reported that one of their students with T1DM had experienced at least one episode of hypoglycemia at school, and half of them felt that their school was not prepared to deal with diabetic emergencies. 6.4% stated that their school had glucagon in its first aid kit, and 46.9% would be willing to administer it personally. Women, physical education teachers, and headmasters had a more positive perception of the school than their colleagues. Teachers with a positive perception of school preparation and with a positive attitude to administer glucagon were significantly younger than those with no positive perception and attitude. The study results suggest that teachers of public schools in our health area have not been specifically trained in the care of patients with T1DM and perceive that their educational centers are not qualified to address diabetic emergencies. Copyright © 2017 SEEN y SED. Publicado por Elsevier España, S.L.U. All rights reserved.

  14. Comparing WTP values of different types of QALY gain elicited from the general public.

    Science.gov (United States)

    Pennington, Mark; Baker, Rachel; Brouwer, Werner; Mason, Helen; Hansen, Dorte Gyrd; Robinson, Angela; Donaldson, Cam

    2015-03-01

    The appropriate thresholds for decisions on the cost-effectiveness of medical interventions remain controversial, especially in 'end-of-life' situations. Evidence of the values placed on different types of health gain by the general public is limited. Across nine European countries, 17,657 people were presented with different hypothetical health scenarios each involving a gain of one quality adjusted life year (QALY) and asked about their willingness to pay (WTP) for that gain. The questions included quality of life (QoL) enhancing and life extending health gains, and a scenario where respondents faced imminent, premature death. The mean WTP values for a one-QALY gain composed of QoL improvements were modest (PPP$11,000). When comparing QALY gains obtained in the near future, the valuation of life extension exceeded the valuation of QoL enhancing gains (mean WTP PPP$19,000 for a scenario in which a coma is avoided). The mean WTP values were higher still when respondents faced imminent, premature death (PPP$29,000). Evidence from the largest survey on the value of health gains by the general public indicated a higher value for life extending gains compared with QoL enhancing gains. A further modest premium may be indicated for life extension when facing imminent, premature death. Copyright © 2013 John Wiley & Sons, Ltd.

  15. Satisfactory short-term outcomes of the STABILISE technique for type B aortic dissection.

    Science.gov (United States)

    Melissano, Germano; Bertoglio, Luca; Rinaldi, Enrico; Mascia, Daniele; Kahlberg, Andrea; Loschi, Diletta; De Luca, Monica; Monaco, Fabrizio; Chiesa, Roberto

    2018-03-29

    The aim of this study was to evaluate the perioperative and short-term results in a cohort of patients treated during the last year at our institution with the stent-assisted balloon-induced intimal disruption and relamination in aortic dissection repair (STABILISE) technique for acute complicated aortic dissection. Between June 2016 and June 2017, 10 patients (all male; mean age, 62.6 ± 7.4 years) received treatment for acute complicated aortic dissection with the STABILISE technique. After a standard provisional extension to induce complete attachment procedure using the commercially available endovascular dissection system (Cook Medical, Bloomington, Ind), the distal stent graft area and the bare stent area were ballooned to completely exclude the thoracic false lumen (FL) and to obtain a single-channeled abdominal aorta. Computed tomography was routinely performed within the first postoperative week before discharge and then at 3 months, at 6 months, and yearly thereafter. The technical and clinical success rates were analyzed. The 30-day technical and clinical success rates were 100%, with complete thrombosis of the thoracic FL and no type I endoleak. Malperfusion was resolved in all cases. No aortic ruptures were recorded, and no open conversion was required. One case of delayed spinal cord ischemia fully resolved within the discharge period. Predischarge computed tomography showed complete thrombosis of the thoracic FL in all cases. In two cases, some degree of patency of the abdominal FL was observed. At short-term follow-up, the overall aortic diameters remained stable with no further dilation. The STABILISE technique was safe and feasible in this cohort of patients, with complete thrombosis of the thoracic FL and creation of a single-channeled aorta in most cases. Further studies are needed to ascertain the long-term behavior of the treated aorta. Copyright © 2018 Society for Vascular Surgery. Published by Elsevier Inc. All rights reserved.

  16. Type A aortic dissection in Marfan syndrome: extent of initial surgery determines long-term outcome.

    Science.gov (United States)

    Rylski, Bartosz; Bavaria, Joseph E; Beyersdorf, Friedhelm; Branchetti, Emanuela; Desai, Nimesh D; Milewski, Rita K; Szeto, Wilson Y; Vallabhajosyula, Prashanth; Siepe, Matthias; Kari, Fabian A

    2014-04-01

    Data on outcomes after Stanford type A aortic dissection in patients with Marfan syndrome are limited. We investigated the primary surgery and long-term results in patients with Marfan syndrome who suffered aortic dissection. Among 1324 consecutive patients with aortic dissection type A, 74 with Marfan syndrome (58% men; median age, 37 years [first and third quartiles, 29 and 48 years]) underwent surgical repair (85% acute dissections; 68% DeBakey I; 55% composite valved graft, 30% supracoronary ascending replacement, 15% valve-sparing aortic root replacement; 12% total arch replacement; 3% in-hospital mortality) at 2 tertiary centers in the United States and Europe over the past 25 years. The rate of aortic reintervention with resternotomy was 24% (18 of 74) and of descending aorta (thoracic+abdominal) intervention was 30% (22 of 74) at a median follow-up of 8.4 years (first and third quartiles, 2.2 and 12.7 years). Freedom from need for aortic root reoperation in patients who underwent primarily a composite valved graft or valve-sparing aortic root replacement procedure was 95±3%, 88±5%, and 79±5% and in patients who underwent supracoronary ascending replacement was 83±9%, 60±13%, 20±16% at 5, 10, and 20 years. Secondary aortic arch surgery was necessary only in patients with initial hemi-arch replacement. Emergency surgery for type A dissection in patients with Marfan syndrome is associated with low in-hospital mortality. Failure to extend the primary surgery to aortic root or arch repair leads to a highly complex clinical course. Aortic root replacement or repair is highly recommended because supracoronary ascending replacement is associated with a high need (>40%) for root reintervention.

  17. Long-term in vitro, cell-type-specific genome-wide reprogramming of gene expression

    International Nuclear Information System (INIS)

    Hakelien, Anne-Mari; Gaustad, Kristine G.; Taranger, Christel K.; Skalhegg, Bjorn S.; Kuentziger, Thomas; Collas, Philippe

    2005-01-01

    We demonstrate a cell extract-based, genome-wide and heritable reprogramming of gene expression in vitro. Kidney epithelial 293T cells have previously been shown to take on T cell properties following a brief treatment with an extract of Jurkat T cells. We show here that 293T cells exposed for 1 h to a Jurkat cell extract undergo genome-wide, target cell-type-specific and long-lasting transcriptional changes. Microarray analyses indicate that on any given week after extract treatment, ∼2500 genes are upregulated >3-fold, of which ∼900 are also expressed in Jurkat cells. Concomitantly, ∼1500 genes are downregulated or repressed, of which ∼500 are also downregulated in Jurkat cells. Gene expression changes persist for over 30 passages (∼80 population doublings) in culture. Target cell-type specificity of these changes is shown by the lack of activation or repression of Jurkat-specific genes by extracts of 293T cells or carcinoma cells. Quantitative RT-PCR analysis confirms the long-term transcriptional activation of genes involved in key T cell functions. Additionally, growth of cells in suspended aggregates, expression of CD3 and CD28 T cell surface markers, and interleukin-2 secretion by 293T cells treated with extract of adult peripheral blood T cells illustrate a functional nuclear reprogramming. Therefore, target cell-type-specific and heritable changes in gene expression, and alterations in cell function, can be promoted by extracts derived from transformed cells as well as from adult primary cells

  18. An Early Detection Method of Type-2 Diabetes Mellitus in Public Hospital

    Directory of Open Access Journals (Sweden)

    Hermansyah Hermansyah

    2011-08-01

    Full Text Available Diabetes is a chronic disease and major problem of morbidity and mortality in developing countries. The International Diabetes Federation estimates that 285 million people around the world have diabetes. This total is expected to rise to 438 million within 20 years. Type-2 diabetes mellitus (T2DM is the most common type of diabetes and accounts for 90-95% of all diabetes. Detection of T2DM from various factors or symptoms became an issue which was not free from false presumptions accompanied by unpredictable effects. According to this context, data mining and machine learning could be used as an alternative way help us in knowledge discovery from data. We applied several learning methods, such as instance based learners, naive bayes, decision tree, support vector machines, and boosted algorithm acquire information from historical data of patients medical records of Mohammad Hoesin public hospital in Southern Sumatera. Rules are extracted from Decision tree to offer decision-making support through early detection of T2DM for clinicians.

  19. Comparison effectiveness of cooperative learning type STAD with cooperative learning type TPS in terms of mathematical method of Junior High School students

    Science.gov (United States)

    Wahyuni, A.

    2018-05-01

    This research is aimed to find out whether the model of cooperative learning type Student Team Achievement Division (STAD) is more effective than cooperative learning type Think-Pair-Share in SMP Negeri 7 Yogyakarta. This research was a quasi-experimental research, using two experimental groups. The population of research was all students of 7thclass in SMP Negeri 7 Yogyakarta that consists of 5 Classes. From the population were taken 2 classes randomly which used as sample. The instrument to collect data was a description test. Measurement of instrument validity use content validity and construct validity, while measuring instrument reliability use Cronbach Alpha formula. To investigate the effectiveness of cooperative learning type STAD and cooperative learning type TPS on the aspect of student’s mathematical method, the datas were analyzed by one sample test. Comparing the effectiveness of cooperative learning type STAD and TPS in terms of mathematical communication skills by using t-test. Normality test was not conducted because the sample of research more than 30 students, while homogeneity tested by using Kolmogorov Smirnov test. The analysis was performed at 5% confidence level.The results show as follows : 1) The model of cooperative learning type STAD and TPS are effective in terms of mathematical method of junior high school students. 2). STAD type cooperative learning model is more effective than TPS type cooperative learning model in terms of mathematical methods of junior high school students.

  20. 75 FR 67666 - Use of Various Winemaking Terms on Wine Labels and in Advertisements; Request for Public Comment

    Science.gov (United States)

    2010-11-03

    ...The Alcohol and Tobacco Tax and Trade Bureau is considering amending the regulations concerning various winemaking terms commonly used on labels and in advertisements to provide consumers with information about the growing or bottling conditions of wine. We invite comments from industry members, consumers, and other interested parties as to whether and to what extent we should propose specific regulatory amendments for further public comment.

  1. Short-term mortality in patients with myocardial injury and myocardial infarction type 1 and type 2

    DEFF Research Database (Denmark)

    Sarkisian, Laura; Saaby, L.; Poulsen, T. S.

    2015-01-01

    -year period we prospectively studied hospitalized patients having cardiac troponin I (cTnI) measured on clinical indication. The diagnosis of type 1 and type 2 MI was according to the universal definition involving a rising and/or falling pattern of cTnI values above the decision limit of 30 ng/L. c....... The results are depicted in the figure (Kaplan-Meier curves, log-rank-test; p-value...

  2. Islet Transplantation in Type 1 Diabetes: Ongoing Challenges, Refined Procedures, and Long-Term Outcome

    Science.gov (United States)

    Shapiro, A.M. James

    2012-01-01

    Remarkable progress has been made in islet transplantation over a span of 40 years. Once just an experimental curiosity in mice, this therapy has moved forward, and can now provide robust therapy for highly selected patients with type 1 diabetes (T1D), refractory to stabilization by other means. This progress could not have occurred without extensive dynamic international collaboration. Currently, 1,085 patients have undergone islet transplantation at 40 international sites since the Edmonton Protocol was reported in 2000 (752 allografts, 333 autografts), according to the Collaborative Islet Transplant Registry. The long-term results of islet transplantation in selected centers now match registry data of pancreas-alone transplantation, with 6 sites reporting five-year insulin independence rates ≥50%. Islet transplantation has been criticized for the use of multiple donor pancreas organs, but progress has also occurred in single-donor success, with 10 sites reporting increased single-donor engraftment. The next wave of innovative clinical trial interventions will address instant blood-mediated inflammatory reaction (IBMIR), apoptosis, and inflammation, and will translate into further marked improvements in single-donor success. Effective control of auto- and alloimmunity is the key to long-term islet function, and high-resolution cellular and antibody-based assays will add considerable precision to this process. Advances in immunosuppression, with new antibody-based targeting of costimulatory blockade and other T-B cellular signaling, will have further profound impact on the safety record of immunotherapy. Clinical trials will move forward shortly to test out new human stem cell derived islets, and in parallel trials will move forward, testing pig islets for compatibility in patients. Induction of immunological tolerance to self-islet antigens and to allografts is a difficult challenge, but potentially within our grasp. PMID:23804275

  3. Determinants of Long-Term Durable Glycemic Control in New-Onset Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Kyoung Jin Kim

    2017-08-01

    Full Text Available BackgroundLong-term durable glycemic control is a difficult goal in the management of type 2 diabetes mellitus (T2DM. We evaluated the factors associated with durable glycemic control in a real clinical setting.MethodsWe retrospectively reviewed the medical records of 194 new-onset, drug-naïve patients with T2DM who were diagnosed between January 2011 and March 2013, and were followed up for >2 years. Glycemic durability was defined as the maintenance of optimal glycemic control (glycosylated hemoglobin [HbA1c] <7.0% for 2 years without substitution or adding other glucose-lowering agents. Clinical factors and glycemic markers associated with glycemic durability were compared between two groups: a durability group and a non-durability group.ResultsPatients in the durability group had a higher baseline body mass index (26.1 kg/m2 vs. 24.9 kg/m2 and lower HbA1c (8.6% vs. 9.7% than the non-durability group. The initial choice of glucose-lowering agents was similar in both groups, except for insulin and sulfonylureas, which were more frequently prescribed in the non-durability group. In multiple logistic regression analyses, higher levels of education, physical activity, and homeostasis model assessment of β-cell function (HOMA-β were associated with glycemic durability. Notably, lower HbA1c (<7.0% at baseline and first follow-up were significantly associated with glycemic durability (adjusted odds ratio [OR], 7.48; 95% confidence interval [CI], 2.51 to 22.3 (adjusted OR, 9.27; 95% CI, 1.62 to 53.1, respectively, after adjusting for confounding variables including the types of glucose-lowering agents.ConclusionEarly achievement of HbA1c level within the glycemic target was a determinant of long-term glycemic durability in new-onset T2DM, as were higher levels of education, physical activity, and HOMA-β.

  4. Short-Term Prediction of Ridership on Public Transport with Smart Card Data

    NARCIS (Netherlands)

    van Oort, N.; Brands, Ties; de Romph, E.

    2015-01-01

    Public transport operators are collecting massive amounts of data from smart card systems. In the Netherlands, every passenger checks in and checks out; this system creates detailed records of demand patterns. In buses and trams, users check in and check out in the vehicle; this factor provides good

  5. The long-term fiscal impact of funding cuts to Danish public fertility clinics

    NARCIS (Netherlands)

    Connolly, Mark P.; Postma, Maarten J.; Crespi, Simone; Andersen, Anders Nyboe; Ziebe, Soren

    2011-01-01

    This study evaluated the fiscal impact attributed to recent policy changes that limited funding to public fertility clinics in Denmark. Taking into consideration that introducing patient co-payments will influence the numbers of couples treated, the number of children born every year from assisted

  6. Improving health services in developing countries with new types of public and allied health personnel.

    Science.gov (United States)

    Blayney, K D; Trulove, J W

    1982-10-01

    Allied health manpower in developing countries should be able to serve the specific needs of these countries in solving malnutrition, diarrheal disease, and other health problems. Disease patterns tend to evolve in stages with each stage requiring a special type of health manpower: 1) the 1st stage where infectious diseases are linked to poverty, malnutrition, and poor personal hygiene for which personnel trained to improve health through providing safe water supplies, improving sanitation, and immunizing the population are needed; 2) in the 2nd stages, diseases such as cancer, arthritis, and cardiac diseases exist, requiring extensive technology such as is available in the US; and 3) the 3rd stage relates to an awareness of health hazards (caused by the environment, by the lifestyle dysfunctions of the society, and an emphasis on health promotion) and implies a responsibility for one's own health by the individual; this is a difficult stage to apply to developing countries since the ability to bring about change assumes literacy on the part of the population which is not always the case. Since most developing countries need to cause change in the 1st stage, more public health personnel such as sanitarians and generalist workers are needed. Training of these personnel should include on-the-job education; traditionally trained US allied health professionals are not always equipped to deal with health problems in developing countries. Health educators should look to the lessons learned by the US in the allied health movement: 1) the system of control that national membership organizations have over schooling and the job environment has contributed to an increased cost of health care delivery, unnecessary prolonged curricula, overspecialization, extreme protectionism for membership, and inappropriate fractionalization of health care delivery; 2) the emphasis on prolonged curricula sometimes causes the student to lose sight of the supposed direct relationship between

  7. MORTALITY TRENDS FOR MOST COMMON TYPES OF CANCER IN SILESIA VOIVODESHIP IN SHORT TERM PROJECTION

    Directory of Open Access Journals (Sweden)

    Brunon Zemła

    2011-06-01

    Full Text Available Background: The incidence of morbidity and mortality of cancers rapidly increase in the world and so it is in case of Poland and Silesia Voivodeship. Therefore an attempt is made to assess this phenomenon in projection scale within Silesia Voivodeship. Materials and methods: The time-trends analysis of the six most common types of cancer have been selected: stomach, colorectal, pancreas and lung (among both genders, prostate (among males and breast (among females. For the period 1990–2008 age standardized mortality rates have been determined. Time-trends in mortality with employment of joinpoint regression have been estimated and depending on trends linear or log-linear regression models were used which set up the base for short-term projection. Results: For the year 2018 projection values of mortality rates among males will drop (with the exception of lung and colorectal cancers. For prostate cancer – the values will be increasing. Among females stomach mortality rates will drop, but again lung cancer mortality rate will double in comparison to data for 1990. Conclusions: 1. The prognostic number of death to 2018 year concern all studied cancer increasing, for exept stomach cancer. 2. Especially will be increasing cancer mortality standardized rates for lung cancer among females and prostate and colorectal cancers among males.

  8. Analysis of Long-Term Performance of Initial Public Offerings in the brazilian stock market

    Directory of Open Access Journals (Sweden)

    Elisa Elaine Moreira Teixeira

    2012-07-01

    Full Text Available DOI: http://dx.doi.org/10.5007/2175-8077.2012v14n33p79 This paper describes the results of a twofold study that compared the performance of Initial Public Offering (IPOs in the Brazilian stock market with that of incorporated company in 2004 and 2005 and also checked if these IPOs were included in the Bovespa Index (IBOV in this period. We first collected data on stock price variations every year subsequent to the public offering. Thereafter, we compared the IPOs’ rates with those of the public corporations. The results show that 81.25% of the IPOs had positive returns in the first and the second years of anniversary, and only 50% of them had positive return in the third year. The youngest companies had the highest returns, and 45% of them were included in the IBOV in the period under scrutiny. The comparison of the ratios showed that IPOs of any age are more valued than the comparison companies. As a conclusion, we can say that the IPOs’ performance was significantly better than that of the comparison companies in the period studied.

  9. Upregulation of T-type Ca2+ channels in long-term diabetes determines increased excitability of a specific type of capsaicin-insensitive DRG neurons.

    Science.gov (United States)

    Duzhyy, Dmytro E; Viatchenko-Karpinski, Viacheslav Y; Khomula, Eugen V; Voitenko, Nana V; Belan, Pavel V

    2015-05-20

    Previous studies have shown that increased excitability of capsaicin-sensitive DRG neurons and thermal hyperalgesia in rats with short-term (2-4 weeks) streptozotocin-induced diabetes is mediated by upregulation of T-type Ca(2+) current. In longer-term diabetes (after the 8th week) thermal hyperalgesia is changed to hypoalgesia that is accompanied by downregulation of T-type current in capsaicin-sensitive small-sized nociceptors. At the same time pain symptoms of diabetic neuropathy other than thermal persist in STZ-diabetic animals and patients during progression of diabetes into later stages suggesting that other types of DRG neurons may be sensitized and contribute to pain. In this study, we examined functional expression of T-type Ca(2+) channels in capsaicin-insensitive DRG neurons and excitability of these neurons in longer-term diabetic rats and in thermally hypoalgesic diabetic rats. Here we have demonstrated that in STZ-diabetes T-type current was upregulated in capsaicin-insensitive low-pH-sensitive small-sized nociceptive DRG neurons of longer-term diabetic rats and thermally hypoalgesic diabetic rats. This upregulation was not accompanied by significant changes in biophysical properties of T-type channels suggesting that a density of functionally active channels was increased. Sensitivity of T-type current to amiloride (1 mM) and low concentration of Ni(2+) (50 μM) implicates prevalence of Cav3.2 subtype of T-type channels in the capsaicin-insensitive low-pH-sensitive neurons of both naïve and diabetic rats. The upregulation of T-type channels resulted in the increased neuronal excitability of these nociceptive neurons revealed by a lower threshold for action potential initiation, prominent afterdepolarizing potentials and burst firing. Sodium current was not significantly changed in these neurons during long-term diabetes and could not contribute to the diabetes-induced increase of neuronal excitability. Capsaicin-insensitive low-pH-sensitive type

  10. Using typing techniques in a specific outbreak: the ethical reflection of public health professionals.

    Science.gov (United States)

    Rump, B; Cornelis, C; Woonink, F; VAN Steenbergen, J; Verweij, M; Hulscher, M

    2017-05-01

    Typing techniques are laboratory methods used in outbreak management to investigate the degree to which microbes found within an outbreak are related. Knowledge about relational patterns between microbes benefits outbreak management, but inevitably also tells us something about the relational patterns of the people hosting them. Since the technique is often used without explicit consent of all individuals involved, this may raise ethical questions. The aim of this study was to unravel the complex ethical deliberation of professionals over the use of such techniques. We organised group discussions (n = 3) with Dutch outbreak managers (n = 23). The topic list was based on previously identified ethical issues and discussions were analysed for recurrent themes. We found that outbreak managers first and foremost reflect on the balance of individual harm with public health benefit. This key question was approached by way of discussing four more specific ethical themes: (1) justification of governmental intervention, (2) responsibility to prevent infections, (3) scientific uncertainty and (4) legal consequences. The themes found in this study, rephrased into accessible questions, represent the shared ethical understanding of professionals and can help to articulate the ethical dimensions of using molecular science in response to infectious disease outbreaks.

  11. PMK-2 the Hungarian integral type test facility. Documentations, publications and archivations of experiments

    International Nuclear Information System (INIS)

    Perneczky, L.; Guba, A.; Ezsoel, G.; Toth, I.; Szabados, L.

    2002-01-01

    The PMK-2 experimental facility at the KFKI-AEKI, Budapest, is a full pressure, scaled down model of the primary and partly the secondary circuit of the Paks NPP, which is equipped with four VVER-440/213-type reactors. Since the start-up of the facility altogether 48 experiments have been performed for groups of transients as follows: one- and two-phase natural circulation, loss of coolant accidents, special plant transients and experiments in support of accident management procedures. The results have been used for the validation of thermal-hydraulic system codes for VVER applications. Following the experiments a detailed documentation and archiving activity - using an optimised data storage - was required to preserve the essential information and to assure these for a widely utilisation for the international nuclear community. In the publication list related to the facility and the experiments for the moment altogether 280 items - documents, articles in periodicals, papers in proceedings and research reports - in six languages were collected. The paper gives an overview on this activity including the participation in the EU CERTA-TN programme, where AEKI introduced representative databases of two PMK-2 tests in the STRESA Network.(author)

  12. Missing Citations, Bulking Biographies, and Unethical Collaboration: Types of Cheating among Public Relations Majors

    Science.gov (United States)

    Auger, Giselle A.

    2013-01-01

    Students cheat. For the field of public relations, which continually struggles for credibility, the issue of student cheating should be paramount, as the unethical students of today become tomorrow's practitioners. Through a survey of 170 public relations majors, this study examined the importance students place on the Public Relations Society of…

  13. Long-Term Consequences for Teens with Older Sexual Partners. Fact Sheet. Publication #2008-16

    Science.gov (United States)

    Schelar, Erin; Ryan, Suzanne; Manlove, Jennifer

    2008-01-01

    Existing research on the risks of having sex at a young age with an older partner has focused on poorer reproductive health outcomes in the adolescent years, but scant attention has been paid to the longer-term implications of these relationships. Using survey data from high school students, this "Fact Sheet" presents findings from recent Child…

  14. The long-term fiscal impact of funding cuts to Danish public fertility clinics

    DEFF Research Database (Denmark)

    Connolly, Mark P; Postma, Maarten J; Crespi, Simone

    2011-01-01

    This study evaluated the fiscal impact attributed to recent policy changes that limited funding to public fertility clinics in Denmark. Taking into consideration that introducing patient co-payments will influence the numbers of couples treated, the number of children born every year from assisted...... reproductive technology will be affected. To reflect the government perspective, the model assessed the average life course of a cohort of assisted-conception singletons taking into consideration age-specific, per-capita government transfers (e.g. education, health care, family allowances, education, pensions...

  15. The long-term fiscal impact of funding cuts to Danish public fertility clinics

    DEFF Research Database (Denmark)

    Connolly, Mark P; Postma, Maarten J; Crespi, Simone

    2011-01-01

    reproductive technology will be affected. To reflect the government perspective, the model assessed the average life course of a cohort of assisted-conception singletons taking into consideration age-specific, per-capita government transfers (e.g. education, health care, family allowances, education, pensions......This study evaluated the fiscal impact attributed to recent policy changes that limited funding to public fertility clinics in Denmark. Taking into consideration that introducing patient co-payments will influence the numbers of couples treated, the number of children born every year from assisted...

  16. Re-analysis of public genetic data reveals a rare X-chromosomal variant associated with type 2 diabetes

    DEFF Research Database (Denmark)

    Bonàs-Guarch, Sílvia; Guindo-Martínez, Marta; Miguel-Escalada, Irene

    2018-01-01

    The reanalysis of existing GWAS data represents a powerful and cost-effective opportunity to gain insights into the genetics of complex diseases. By reanalyzing publicly available type 2 diabetes (T2D) genome-wide association studies (GWAS) data for 70,127 subjects, we identify seven novel...... available data using novel genetic resources and analytical approaches....... associated with the expression of Angiotensin II Receptor type 2 gene (AGTR2), a modulator of insulin sensitivity, and exhibits allelic specific activity in muscle cells. Beyond providing insights into the genetics and pathophysiology of T2D, these results also underscore the value of reanalyzing publicly...

  17. Long-term exercise adherence after public health training in at-risk adults

    DEFF Research Database (Denmark)

    Riktrup Hansen Saida, Trine Gro; Juul Sørensen, Tina; Langberg, Henning

    2017-01-01

    and self-rated health. Predictors of long-term exercise adherence were assessed by logistic regression, estimating crude odds-ratios (OR) and 95% confidence intervals (95% CIs) and adjusting for age, gender, education, smoking, moderate and vigorous exercise. Results: In total, 214 adults (mean age 58......Objectives: Sustainment of healthy exercise behavior is essential in preventing cardiovascular disease and diabetes. Few studies have explored long-term exercise adherence after an exercise referral scheme. The objective of this study was to examine 12-month exercise adherence after an exercise...... intervention program. Methods: This was a pragmatic follow-up study in at-risk people performed between June 2012 and January 2014. The main outcome measure was self-reported single-item exercise adherence. Secondary outcomes were change in exercise level, quality of life rated on a visual analog scale...

  18. Long-term clinical outcomes in type 1 Gaucher disease following 10 years of imiglucerase treatment.

    Science.gov (United States)

    Weinreb, Neal J; Goldblatt, Jack; Villalobos, Jacobo; Charrow, Joel; Cole, J Alexander; Kerstenetzky, Marcelo; vom Dahl, Stephan; Hollak, Carla

    2013-05-01

    We studied the effect of long-term alglucerase/imiglucerase (Ceredase®/Cerezyme®, Genzyme, a Sanofi company, Cambridge, MA, USA) treatment on hematological, visceral, and bone manifestations of Gaucher disease type 1 (GD1). The International Collaborative Gaucher Group (ICGG) Gaucher Registry identified GD1 patients treated with alglucerase/imiglucerase who had dose and clinical data at first infusion and after 10 years of follow-up. Data for hemoglobin, platelet count, organ volumes, bone pain, and bone crisis were analyzed. Tests of the null hypothesis (no change from first infusion to 10 years) were performed using t tests for within-patient absolute change in continuous measurements and McNemar/chi-square tests for change in distributions using categorical values. An alpha level of 0.05 designated statistical significance. As of October 2011, 557 nonsplenectomized and 200 splenectomized patients met the inclusion criteria. The majority of GD1 patients had at least one N370S allele. Compared with nonsplenectomized patients at first infusion, splenectomized patients had lower percentages of anemia (26.0 % vs. 42.8 %) and thrombocytopenia (14.2 % vs. 76.3 %), similar percentages of moderate or severe hepatomegaly (81.2 % vs. 80.0 %), and higher percentages of bone pain (88.9 % vs. 52.4 %) and bone crises (38.3 % vs. 16.0 %). After 10 years, both groups showed significant (p < 0.05) improvements in mean hemoglobin levels, platelet count, liver, and spleen (nonsplenectomized) volumes, and bone crises. Initial dosing in both groups ranged from <15 U/kg to ≤90 U/kg every 2 weeks. After 10 years, the majority was receiving 15 to ≤45 U/kg every 2 weeks. Ten years of imiglucerase treatment results in sustainable improvements in all GD1 parameters.

  19. Mid-term evaluation of the Climate Change Action Fund : Public education and outreach (PEO) Block

    International Nuclear Information System (INIS)

    2001-11-01

    In February 1998, the Government of Canada established the Climate Change Action Fund (CCAF) to assist Canada in meeting its commitments under the Kyoto Protocol for the reduction of greenhouse gas emissions. The CCAF managed a budget of 150 million dollars over three years, and the Public Education and Outreach (PEO) Block was allocated 30 million dollars of that total for its operations. Its mandate was to increase public awareness and understanding on the topic of climate change, as well as providing the required information to effect reductions in the emissions of greenhouse gases and adapt to climate change. An evaluation into this program was conducted, and it covered the period September 2000 to January 20, 2001. To date, 152 projects have been approved, which represents an investment of approximately 17.5 million dollars. Approximately 6 million dollars have been spent on the awareness component, while government communication activities used approximately 3.1 million dollars. Staff and project management fees in support of the program account for the remaining funds. This report addressed the performance to date in meeting the objectives, and also included recommendations for improved effectiveness. PEO files and records, a report entitled Interim review of the Climate Change Action Fund PEO Program, interviews with Departmental representatives, and interviews with external stakeholder groups formed the basis for the findings and recommendations. It was determined that future direction represents the most critical issue facing the PEO block. 1 tab

  20. Protected area types, strategies and impacts in Brazil's Amazon: public protected area strategies do not yield a consistent ranking of protected area types by impact.

    Science.gov (United States)

    Pfaff, Alexander; Robalino, Juan; Sandoval, Catalina; Herrera, Diego

    2015-11-05

    The leading policy to conserve forest is protected areas (PAs). Yet, PAs are not a single tool: land users and uses vary by PA type; and public PA strategies vary in the extent of each type and in the determinants of impact for each type, i.e. siting and internal deforestation. Further, across regions and time, strategies respond to pressures (deforestation and political). We estimate deforestation impacts of PA types for a critical frontier, the Brazilian Amazon. We separate regions and time periods that differ in their deforestation and political pressures and document considerable variation in PA strategies across regions, time periods and types. The siting of PAs varies across regions. For example, all else being equal, PAs in the arc of deforestation are relatively far from non-forest, while in other states they are relatively near. Internal deforestation varies across time periods, e.g. it is more similar across the PA types for PAs after 2000. By contrast, after 2000, PA extent is less similar across PA types with little non-indigenous area created inside the arc. PA strategies generate a range of impacts for PA types--always far higher within the arc--but not a consistent ranking of PA types by impact. © 2015 The Author(s).

  1. Mechanisms underlying major investment projects in the Romanian public administration: strong and long term collaboration among stakeholders

    Directory of Open Access Journals (Sweden)

    Tănăsescu Laurian Gabriel

    2017-07-01

    Full Text Available Starting from the existing situation, in order to understand the mechanisms underlying investment projects financed from public funds in Romania, we analysed the following public sources of information: For projects implemented before 2007, we analysed data available on the Internet, including databases of international donors such as www.dgmarket.com, http://www.ted.europa.eu/, etc. We analysed data made available by the Public Procurement Electronic System through the portal http://data.gov.ro. The data set analysed includes over 8 million awarding contract notices. For the EU funded projects, we requested the Ministry of European Funds to offer us access to the relevant database (SMIS, which includes all the projects financed under the European funding programme 2007 – 2013 (projects implemented before 31.12.2015. Comparing data from all these sources leads to the conclusion that the information is coherent and represents a credible basis for our analysis. We found that 48% of all investment projects implemented in Romania in 2007 – 2016 and co-funded under European funds (in terms of the share of eligible expenses requested outsourcing services for the preparation of the project documentation needed to apply for funds; such expenses represent almost 3 % of the total eligible project expenses approved. Almost 36% (in terms of the share of eligible expenses of all investment projects implemented in Romania in 2007 – 2016 and co-funded under European funds, revealed a strong and long term relationship between the company that participates in the elaboration of the grant application and the beneficiary of funds. This collaboration continued throughout the implementation of the project. These companies delivered services / supplied goods / carried out construction works whose value exceeds 15 billion lei, which represents over 54% of the total eligible costs of the respective projects.

  2. Public Awareness of Uterine Power Morcellation Through US Food and Drug Administration Communications: Analysis of Google Trends Search Term Patterns.

    Science.gov (United States)

    Wood, Lauren N; Jamnagerwalla, Juzar; Markowitz, Melissa A; Thum, D Joseph; McCarty, Philip; Medendorp, Andrew R; Raz, Shlomo; Kim, Ja-Hong

    2018-04-26

    Uterine power morcellation, where the uterus is shred into smaller pieces, is a widely used technique for removal of uterine specimens in patients undergoing minimally invasive abdominal hysterectomy or myomectomy. Complications related to power morcellation of uterine specimens led to US Food and Drug Administration (FDA) communications in 2014 ultimately recommending against the use of power morcellation for women undergoing minimally invasive hysterectomy. Subsequently, practitioners drastically decreased the use of morcellation. We aimed to determine the effect of increased patient awareness on the decrease in use of the morcellator. Google Trends is a public tool that provides data on temporal patterns of search terms, and we correlated this data with the timing of the FDA communication. Weekly relative search volume (RSV) was obtained from Google Trends using the term “morcellation.” Higher RSV corresponds to increases in weekly search volume. Search volumes were divided into 3 groups: the 2 years prior to the FDA communication, a 1-year period following, and thereafter, with the distribution of the weekly RSV over the 3 periods tested using 1-way analysis of variance. Additionally, we analyzed the total number of websites containing the term “morcellation” over this time. The mean RSV prior to the FDA communication was 12.0 (SD 15.8), with the RSV being 60.3 (SD 24.7) in the 1-year after and 19.3 (SD 5.2) thereafter (PGoogle search activity about morcellation of uterine specimens increased significantly after the FDA communications. This trend indicates an increased public awareness regarding morcellation and its complications. More extensive preoperative counseling and alteration of surgical technique and clinician practice may be necessary. ©Lauren N Wood, Juzar Jamnagerwalla, Melissa A Markowitz, D Joseph Thum, Philip McCarty, Andrew R Medendorp, Shlomo Raz, Ja-Hong Kim. Originally published in JMIR Public Health and Surveillance (http

  3. An assessment method of long-term radiation impacts to environment and public individual from tritium discharged by inland NPP

    International Nuclear Information System (INIS)

    Shangguan Zhihong; Huang Yanjun; Tao Yunliang

    2012-01-01

    In this paper, an assessment method of environmental impacts from long-term releases of tritium of inland nuclear power plant is proposed; the tritium concentrations in different environmental materials, including the two main chemical form HTO and OBT. and the radiation dose to public individuals including drinking water, food, inhalation. skin adsorption, are estimated based on the method and environmental parameters from typical inland NPP. The two discharge pathways, gaseous and liquid, are considered with particular concerns to drinking and irrigation ascribed to liquid discharge. This study would contribute to the assessment techniques of environmental impacts and safety of inland NPP. (authors)

  4. Protected area types, strategies and impacts in Brazil's Amazon: public protected area strategies do not yield a consistent ranking of protected area types by impact

    Science.gov (United States)

    Pfaff, Alexander; Robalino, Juan; Sandoval, Catalina; Herrera, Diego

    2015-01-01

    The leading policy to conserve forest is protected areas (PAs). Yet, PAs are not a single tool: land users and uses vary by PA type; and public PA strategies vary in the extent of each type and in the determinants of impact for each type, i.e. siting and internal deforestation. Further, across regions and time, strategies respond to pressures (deforestation and political). We estimate deforestation impacts of PA types for a critical frontier, the Brazilian Amazon. We separate regions and time periods that differ in their deforestation and political pressures and document considerable variation in PA strategies across regions, time periods and types. The siting of PAs varies across regions. For example, all else being equal, PAs in the arc of deforestation are relatively far from non-forest, while in other states they are relatively near. Internal deforestation varies across time periods, e.g. it is more similar across the PA types for PAs after 2000. By contrast, after 2000, PA extent is less similar across PA types with little non-indigenous area created inside the arc. PA strategies generate a range of impacts for PA types—always far higher within the arc—but not a consistent ranking of PA types by impact. PMID:26460126

  5. A New type of conserved quantity deduced from Mei symmetry of nonholonomic systems in terms of quasi-coordinates

    International Nuclear Information System (INIS)

    Ting, Pang; Jian-Hui, Fang; Ming-Jiang, Zhang; Peng, Lin; Kai, Lu

    2009-01-01

    This paper studies the new type of conserved quantity which is directly induced by Mei symmetry of nonholonomic systems in terms of quasi-coordinates. A coordination function is introduced, and the conditions for the existence of the new conserved quantities as well as their forms are proposed. Some special cases are given to illustrate the generalized significance of the new type conserved quantity. Finally, an illustrated example is given to show the application of the nonholonomic system's results. (general)

  6. Do NPM-type reforms lead to a cultural revolution within public sector organizations?

    OpenAIRE

    Wynen, Jan; Verhoest, Koen

    2015-01-01

    Agencification and granting public sector organizations managerial autonomy in particular, is believed to change organizational cultures, away from traditional compliance- oriented, detail- oriented, bureaucratic cultures, and towards organizational cultures which are more oriented towards external customers. There is however very little empirical information on the relationship between managerial autonomy and organizational culture. Using a unique dataset on public agencies in Flanders we no...

  7. Does public awareness increase support for invasive species management? Promising evidence across taxa and landscape types

    Czech Academy of Sciences Publication Activity Database

    Novoa, Ana; Dehnen-Schmutz, K.; Fried, J.; Vimercati, G.

    2017-01-01

    Roč. 19, č. 12 (2017), s. 3691-3705 ISSN 1387-3547 R&D Projects: GA ČR GB14-36079G Institutional support: RVO:67985939 Keywords : alien species * attitudes * non-native species * pPublic opposition * public perception Subject RIV: EH - Ecology, Behaviour OBOR OECD: Ecology Impact factor: 2.473, year: 2016

  8. Protection of people living in long-term contaminated areas after a nuclear accident: the guidance of ICRP Publication 111

    International Nuclear Information System (INIS)

    Lochard, Jacques

    2012-01-01

    The International Commission on Radiological Protection provides guidance for the protection of people living in long-term contaminated areas after nuclear accidents or radiological emergencies in ICRP Publication 111 (Ann. ICRP 2009, 39(3)). The prolonged exposures resulting from such events are defined as existing exposure situations and the driving principle for managing exposure situations is the optimization of protection. In conjunction with optimization, the Commission recommends the use of reference levels to restrict individual doses. To be effective, protection strategies to maintain and reduce exposure as low as reasonably achievable should include actions implemented by public authorities and private businesses, but also by the affected population itself. The process through which inhabitants living in a contaminated environment identify problems and apply their own protective actions has been named 'self-help protection' by the Commission. Such a process supposes that affected individuals are fully aware of the situation and are well informed. It is the responsibility of the authorities to establish programmes for continuous radiation monitoring, information and education of the population. The involvement of local professionals and inhabitants in the definition and implementation of protection strategies is a key factor for the sustainability of long-term rehabilitation programmes. (note)

  9. On $R^4$ terms and MHV amplitudes in N = 5,6 supergravity vacua of Type II superstrings

    CERN Document Server

    Bianchi, Massimo

    2011-01-01

    We compute one-loop threshold corrections to $R^4$ terms in N= 5,6 supergravity vacua of Type II superstrings. We then discuss non-perturbative corrections generated by asymmetric D-brane instantons. Finally we derive generating functions for MHV amplitudes at tree level in N = 5, 6 supergravities.

  10. Long-term effectiveness of a quality improvement program for patients with type 2 diabetes in general practice.

    NARCIS (Netherlands)

    Renders, C.M.; Valk, G.D.; Franse, L.V.; Schellevis, F.; Eijk, J.T.M. van; Wal, G. van der

    2001-01-01

    OBJECTIVE— To assess the long-term effectiveness of a quality improvement program on care provided and patient outcomes in patients with diabetes. RESEARCH DESIGN AND METHODS— A nonrandomized trial was performed with 312 patients with type 2 diabetes in the intervention group and 77 patients with

  11. Energy Consumption in Terms of Shear Stress for Two Types of Membrane Bioreactors Used for Municipal Wastewater Treatment Processes

    DEFF Research Database (Denmark)

    Ratkovich, Nicolas Rios; Bentzen, Thomas Ruby; Bérube, P.R.

    2011-01-01

    Two types of submerged membrane bioreactors (MBR): Hollow Fiber (HF) and Hollow Sheet (HS), have been studied and compared in terms of energy consumption and average shear stress over the membrane wall. The analysis of energy consumption was made using the correlation to determine the blower power...

  12. Long-term functional outcome after type A3 spinal fractures : operative versus non-operative treatment

    NARCIS (Netherlands)

    Post, Richard B.; van der Sluis, Corry K.; Leferink, Vincent J. M.; ten Duis, Henk-Jan

    The authors retrospectively studied, by questionnaires, the long-term (5 years) functional outcome after operative (posterior instrumentation : 38 cases) and non-operative treatment (25 cases) for type A3 spinal fractures (Comprehensive Classification) without neurological deficit. A possible bias

  13. Determination of a source term for a time fractional diffusion equation with an integral type over-determining condition

    Directory of Open Access Journals (Sweden)

    Timurkhan S. Aleroev

    2013-12-01

    Full Text Available We consider a linear heat equation involving a fractional derivative in time, with a nonlocal boundary condition. We determine a source term independent of the space variable, and the temperature distribution for a problem with an over-determining condition of integral type. We prove the existence and uniqueness of the solution, and its continuous dependence on the data.

  14. Long-Term Type 1 Diabetes Enhances In-Stent Restenosis after Aortic Stenting in Diabetes-Prone BB Rats

    NARCIS (Netherlands)

    Onuta, Geanina; Groenewegen, Hendrik C.; Klatter, Flip A.; Boer, Mark Walther; Goris, Maaike; van Goor, Harry; Roks, Anton J. M.; Rozing, Jan; de Smet, Bart J. G. L.; Hillebrands, Jan-Luuk

    2011-01-01

    Type 1 diabetic patients have increased risk of developing in-stent restenosis following endovascular stenting. Underlying pathogenetic mechanisms are not fully understood partly due to the lack of a relevant animal model to study the effect(s) of long-term autoimmune diabetes on development of

  15. Long-term type 1 diabetes enhances in-stent restenosis after aortic stenting in diabetes-prone BB rats

    NARCIS (Netherlands)

    J.-L. Hillebrands (Jan-Luuk); G. Onuta (Geanina); H.C. Groenewegen (Hendrik); F.A. Klatter (Flip); M. Walther Boer (Mark); M. Goris (Maaike); H. van Goor (Harry); A.J.M. Roks (Anton); J. Rozing (Jan); B.J.G.L. de Smet (Bart)

    2011-01-01

    textabstractType 1 diabetic patients have increased risk of developing in-stent restenosis following endovascular stenting. Underlying pathogenetic mechanisms are not fully understood partly due to the lack of a relevant animal model to study the effect(s) of long-term autoimmune diabetes on

  16. Short-term effects of liraglutide on kidney function and vasoactive hormones in type 2 diabetes

    DEFF Research Database (Denmark)

    Skov, J.; Pedersen, M.; Holst, Jens Juul

    2016-01-01

    AIMS: To investigate the effects of a single dose of 1.2 mg liraglutide, a once-daily glucagon-like peptide-1 (GLP-1) receptor agonist, on key renal parameters in patients with type 2 diabetes. METHODS: The study was a placebo-controlled, double-blind, cross-over in 11 male patients with type 2 d...

  17. Major Long-Term Benefits of Intensive Therapy for Type 1 Diabetes

    Science.gov (United States)

    ... Vehicle Donation Planned Giving Options Memorial Giving Brochures & Envelopes Do-it-Yourself Fundraising & Local Events Matching Gift ... longer-term consequences of these complications, including kidney failure, loss of vision, amputations and heart disease, were ...

  18. Long-term breast-feeding in women with type 1 diabetes

    DEFF Research Database (Denmark)

    Stage, E; Nørgård, Hanne; Damm, Peter

    2006-01-01

    Breast-feeding may be more difficult in women with diabetes because of neonatal morbidity and fluctuating maternal blood glucose values. The frequency of long-term breast-feeding and the possible predictors for successful breast-feeding were investigated.......Breast-feeding may be more difficult in women with diabetes because of neonatal morbidity and fluctuating maternal blood glucose values. The frequency of long-term breast-feeding and the possible predictors for successful breast-feeding were investigated....

  19. Employer, insurance, and health system response to long-term sick leave in the public sector: policy implications.

    Science.gov (United States)

    Heijbel, Bodil; Josephson, Malin; Jensen, Irene; Vingård, Eva

    2005-06-01

    This study has been conducted to describe the situation of long-term sick-listed persons employed in the public sector regarding the medical reasons of their sick leave, the duration of their problems, the duration of the actual sick leave, rehabilitation support, rehabilitation measures, and the persons expectations of the future. Response rate of a postal questionnaire, where 484 women and 51 men on long-term sick leave answered, was 69%. The study-group consisted of 90% women with a median age of 50 years. The most common reasons for sick listing were long-lasting musculoskeletal problems, especially neck/shoulder pain, low back pain and osteoarthritis or other joint problems and mental problems, especially depression and burn-out syndromes. Forty-seven procent of the men and 57% of the women had been on the sick list for more than a year. Only half of them had been subjected to the legally required rehabilitation investigation of the employer This half got access to rehabilitation programs and/or vocational rehabilitation to a greater extent than those who not had been subjected to rehabilitation investigation. Less than half had been in contact with the workplace-connected rehabilitation actors, the Occupational Health Service or the Trade Union. In spite of this the sick-listed persons had a positive view of their future return to work. For long-term sick-listed persons in the public sector, there is a great potential for improvements of the rehabilitation at the workplace arena, in the involvement and cooperation between the already existing rehabilitation actors, in order to promote return to work.

  20. Long-term renoprotective effect of nisoldipine and lisinopril in type 1 diabetic patients with diabetic nephropathy

    DEFF Research Database (Denmark)

    Tarnow, L; Rossing, P; Jensen, C

    2000-01-01

    ). Two patients in the lisinopril group and three patients in the nisoldipine group entered therapy for end-stage renal failure. CONCLUSIONS: Long-term treatment with lisinopril or nisoldipine has similar beneficial effects on progression of diabetic nephropathy in hypertensive type 1 diabetic patients.......OBJECTIVE: To compare the long-term effect on kidney function of a long-acting calcium antagonist (nisoldipine) versus a long-acting ACE inhibitor (lisinopril) in hypertensive type 1 diabetic patients with diabetic nephropathy. RESEARCH DESIGN AND METHODS: We performed a 4-year prospective......, randomized, double-dummy controlled study comparing nisoldipine (20-40 mg once a day) with lisinopril (10-20 mg once a day). The study was double-blinded for the first year and single-blinded thereafter. The study included 51 hypertensive type 1 diabetic patients with diabetic nephropathy. Three patients...

  1. ICRP Recommendations to the Protection of People Living in Long-Term Contaminated Areas ICRP publication 111 in brief

    International Nuclear Information System (INIS)

    Salama, S.; Gomaa, M. A.; Rashad, S.

    2013-01-01

    The main aim of the present study is to through some lights on ICRP free release publication at 4 April 2011-Internationally Known as ICRP publication 111. The title of the publication is (application of the commission's recommendations to the protection of people living in long-term contaminated areas after a nuclear accident or a radiation emergency). Nuclear accidents or a radiation emergency may cause contamination. The contamination may be spread on a large area. There are people living in these areas. For many factors the people refuse to leave their homes. They want to stay along their life as in the case of the normal conditions. So, it is important to facilitate their stay and make it safe. This is not easy. But it is possible without neglect the radiation hazard. The radiation hazard is effective on the life fields. It is harmful in plants, animals, foods, water, milk and the buildings it self. With considering the radiological protection principles the living of the people for a long time could be a fact of the life and will be more easy and safe. Optimization principle has priority to apply. This publication achieves these purposes.The ICRP-111 is translated into Arabic at August 2012. This work is a continuation of the efforts series to translate some of the most important of the ICRP radiological protection references into the Arabic; aiming to maximize the benefit. The previous translations include, ICRP-105 (radiation protection in medicine) and ICRP -113 (education and training in radiological protection for diagnostic and interventional procedures).

  2. Psychological Well Being In Type 2 Diabetes Mellitus Patients In Mulyorejo Public Health Center Surabaya

    Directory of Open Access Journals (Sweden)

    Rr Dian Tristiana

    2016-11-01

    Full Text Available Introduction: Living with chronic diseases such as Diabetes mellitus type 2 will make patients experience change or imbalance include biological, psychological, social and spiritual. One of psychology aspects in patients with Diabetes mellitus type 2 is psychological well being (PWB. Emotional response of type 2 DM patients since the early diagnosis to begin undergoing the treatment will be different for each person. Type 2 DM patients need a good transition process to achieve well being state. The transition from a healthy to a diseased condition is needed for the successful self care management of type 2 DM patients. The purpose of this research was to explore the description of PWB in patients of type 2 Diabetes mellitus in six aspects of PWB and PWB facilitate and inhibitor factors in type 2 DM patients. Methods: This research used qualitative design research with case studies approach. The subject of research was seven participants who met the inclusion criteria. Data collection was done by structured interview and observation. Data analysis was done by thematic analysis. Result and Analysis: This study generated 14 themes. The result showed that the process of type 2 DM patients subjected to the process of transition from a healthy condition into ill condition. The transition process started with cyclic lose response which influence type 2 DM patient to self control and make a right decision-making to self care. Self-control would make type 2 DM patients able to adapt and engage with new experiences that become a new habit for type 2 DM patients and will facilitate type 2 DM patients in adapting to the internal and external environment and make type 2 DM patients have a positive hope in their life. Discuss and conclusion: finding in this study would hopefully be beneficial for professional health staff to make assessment about PWB in type 2 DM patients, nurse hopefully can assist patients in transition with the condition of type 2 DM. Need

  3. Insulin requirement profiles of short-term intensive insulin therapy in patients with newly diagnosed type 2 diabetes and its association with long-term glycemic remission.

    Science.gov (United States)

    Liu, Liehua; Ke, Weijian; Wan, Xuesi; Zhang, Pengyuan; Cao, Xiaopei; Deng, Wanping; Li, Yanbing

    2015-05-01

    To investigate the insulin requirement profiles during short-term intensive continuous subcutaneous insulin infusion (CSII) in patients with newly diagnosed type 2 diabetes and its relationship with long-term glycemic remission. CSII was applied in 104 patients with newly diagnosed type 2 diabetes. Daily insulin doses were titrated and recorded to achieve and maintain euglycemia for 2 weeks. Measurements of blood glucose, lipid profiles as well as intravenous glucose tolerance tests were performed before and after the therapy. Afterwards, patients were followed up for 1 year. Total daily insulin dose (TDD) was 56.6±16.1IU at the first day when euglycemia was achieved (TDD-1). Thereafter, TDD progressively decreased at a rate of 1.4±1.0IU/day to 36.2±16.5IU at the end of the therapy. TDD-1 could be estimated with body weight, FPG, triglyceride and waist circumference in a multiple linear regression model. Decrement of TDD after euglycemia was achieved (ΔTDD) was associated with reduction of HOMA-IR (r=0.27, P=0.008) but not with improvement in β cell function. Patients in the lower tertile of ΔTDD had a significantly higher risk of hyperglycemia relapse than those in the upper tertile within 1 year (HR 3.4, 95%CI [1.4, 8.4], P=0.008). There is a steady decline of TDD after euglycemia is achieved in patients with newly diagnosed type 2 diabetes treated with CSII, and ΔTDD is associated with a better long-term glycemic outcome. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  4. A Logistic Regression Model with a Hierarchical Random Error Term for Analyzing the Utilization of Public Transport

    Directory of Open Access Journals (Sweden)

    Chong Wei

    2015-01-01

    Full Text Available Logistic regression models have been widely used in previous studies to analyze public transport utilization. These studies have shown travel time to be an indispensable variable for such analysis and usually consider it to be a deterministic variable. This formulation does not allow us to capture travelers’ perception error regarding travel time, and recent studies have indicated that this error can have a significant effect on modal choice behavior. In this study, we propose a logistic regression model with a hierarchical random error term. The proposed model adds a new random error term for the travel time variable. This term structure enables us to investigate travelers’ perception error regarding travel time from a given choice behavior dataset. We also propose an extended model that allows constraining the sign of this error in the model. We develop two Gibbs samplers to estimate the basic hierarchical model and the extended model. The performance of the proposed models is examined using a well-known dataset.

  5. Selection of appropriate Chinese terms to represent intensity and types of physical activity terms for use in the Taiwan version of IPAQ.

    Science.gov (United States)

    Liou, Yiing Mei; Jwo, Clark J C; Yao, Kaiping Grace; Chiang, Li-Chi; Huang, Lian-Hua

    2008-12-01

    In order to analyze the health risks of insufficient activity by international comparisons, the first author obtained the permission to translate and develop a Taiwan version of the International Physical Activity Questionnaire (IPAQ). The objective was to determine culturally sensitive Chinese translations for the terms "moderate", "vigorous" and "physical activity" as well as to identify representative types of physical activity for Taiwanese. This study used discussions by 12 expert focus groups, 6 expert audits, a scale survey, field study, Cognitive Aspect Survey Methodology (CASM), dual independent translation and back-translation to establish a consensus on physical activity-related concepts, terminologies and types that define the intensity of common activities of Taiwanese by integrating both local and foreign studies. The Chinese terms "fei li", "zhong deng fei li" and "shen ti huo dong", respectively, were identified as suitable and adequate translations for the English terms "vigorous", "moderate" and "physical activity". The common Taiwanese activities were accurately categorized and listed in questionnaires, forming culturally sensitive scales. Taiwan versions of IPAQ's self-administered long version (SL), self-administered short version (SS), and telephone interview short version (TS) were developed. Their content validity indices were .992, .994, and .980, as well as .994, .992, and .994 for language equivalence and meaning similarity between the English and Chinese versions of the IPAQ-LS, IPAQ-SS, and IPAQ-TS, respectively. Consistency values for the English and Chinese versions in terms of intraclass correlation coefficients were .945, .704, and .894, respectively. The IPAQ-Taiwan is not only a sensitive and precise tool, but also shows the effectiveness of the methodology (CASM) used in tool development. Subjects who did not regularly exercise and had an education less than a junior high school level underestimated the moderate

  6. Long-term tolerability of inhaled human insulin (Exubera) in patients with poorly controlled type 2 diabetes

    DEFF Research Database (Denmark)

    Barnett, A H; Lange, P; Dreyer, M

    2007-01-01

    OBJECTIVE: Inhaled human insulin (Exubera; EXU) has shown encouraging tolerability in short-term trials. We evaluated the safety profile of EXU after long-term exposure. DESIGN: In two, open-label, 2-year studies patients poorly controlled on a sulphonylurea were randomised to adjunctive EXU...... or metformin (study 1) and patients poorly controlled on metformin were randomised to adjunctive EXU or the sulphonylurea, glibenclamide (study 2). PATIENTS: The studies included 446 (study 1) and 476 (study 2) patients with type 2 diabetes, no clinically significant respiratory disease and glycosylated....... There was no discernable effect of long-term EXU therapy on pulmonary gas exchange. Insulin antibody binding reached a plateau at 6 months and did not correlate with HbA(1c) or lung function changes. Glycaemic control was maintained over 2 years. CONCLUSIONS: Exubera was well tolerated during long-term use. Pulmonary...

  7. Short-Term Criminal Pathways: Type and Seriousness of Offense and Recidivism

    Science.gov (United States)

    Nijhof, Karin S.; de Kemp, Raymond A. T.; Engels, Rutger C. M. E.; Wientjes, Jacqueline A. M.

    2008-01-01

    In this longitudinal study, the authors investigated short-term criminal pathways of children and early adolescents starting under the age of 14 years and the extent to which characteristics of the 1st crime influenced criminal pathways. Participants were 387 juvenile offenders with a mean age of 12.1 years (SD = 2.05 years). The authors followed…

  8. Publication trends of Allergy, Pediatric Allergy and Immunology, and Clinical and Translational Allergy journals: a MeSH term-based bibliometric analysis.

    Science.gov (United States)

    Martinho-Dias, Daniel; Sousa-Pinto, Bernardo; Botelho-Souza, Júlio; Soares, António; Delgado, Luís; Fonseca, João Almeida

    2018-01-01

    We performed a MeSH term-based bibliometric analysis aiming to assess the publication trends of EAACI journals, namely Allergy, Pediatric Allergy and Immunology (PAI) (from 1990 to 2015) and Clinical and Translational Allergy (CTA) (from its inception in 2011 to 2015). We also aimed to discuss the impact of the creation of CTA in the publication topics of Allergy and PAI. We analysed a total of 1973 articles and 23,660 MeSH terms. Most MeSH terms in the three journals fell in the category of "basic immunology and molecular biology" (BIMB). During the studied period, we observed an increase in the proportion of MeSH terms on BIMB, and a decreasing proportion of terms on allergic rhinitis and aeroallergens. The observed changes in Allergy and PAI publication topics hint at a possible impact from CTA creation.

  9. Report on research outline in 1999 fiscal year on public collection type research of nuclear fuel cycle.

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2000-07-01

    The Japan Nuclear Cycle Development Institute (JNC) initiated a system to promote the public collection type researches of nuclear fuel cycle since 1999, in order to intend to promote collaboration with universities and research institutes. The system aims to intend to activate researching environment in JNC by intercourse, information exchange, publication of results and so on between researchers in and out of JNC, effectively to proceed basic and fundamental R and D. Here were outlined on eleven researching theme, such as upgrading of velocity and temperature measurement of non-contact type fluid by using electromagnetic ultrasonic wave, development of temperature history memory elements for radiation environment test of a fast breeder reactor, direct glassification of salt wastes by using oxygen plasma, a method on dissolving extraction of metal oxides by using a super-critical fluid, creation of highly separable materials by assistance of computational chemistry (aiming at high order processing of high level radioactive wastes), and so on. (G.K.)

  10. Report on research outline in 1999 fiscal year on public collection type research of nuclear fuel cycle

    International Nuclear Information System (INIS)

    2000-07-01

    The Japan Nuclear Cycle Development Institute (JNC) initiated a system to promote the public collection type researches of nuclear fuel cycle since 1999, in order to intend to promote collaboration with universities and research institutes. The system aims to intend to activate researching environment in JNC by intercourse, information exchange, publication of results and so on between researchers in and out of JNC, effectively to proceed basic and fundamental R and D. Here were outlined on eleven researching theme, such as upgrading of velocity and temperature measurement of non-contact type fluid by using electromagnetic ultrasonic wave, development of temperature history memory elements for radiation environment test of a fast breeder reactor, direct glassification of salt wastes by using oxygen plasma, a method on dissolving extraction of metal oxides by using a super-critical fluid, creation of highly separable materials by assistance of computational chemistry (aiming at high order processing of high level radioactive wastes), and so on. (G.K.)

  11. Calculation of the source term for a S1B-sequence at a VVER-1000 type reactor. Part 1

    International Nuclear Information System (INIS)

    Sdouz, G.

    1990-10-01

    The behaviour of the source term in a VVER-1000 type reactor is calculated using the 'Source Term Code Package' (STCP). The input data are based on the russian plant Zaporozhye-5. The selected accident sequence is a small break LOCA in the hot leg followed by loss offsite and onsite electric power (S 1 B-sequence). According to the course of the calculation the results are presented and analyzed for each program. Except for the noble gases all release fractions are lower than 10 -4 . 18 refs., 10 tabs. (Author)

  12. Public Perspectives Toward the Sexual Behavior of an Individual With Dementia Residing in Long-Term Care.

    Science.gov (United States)

    Yelland, Erin L; Cless, Adam W; Mallory, Allen B; Cless, Jessica D

    2018-06-01

    This study examines public perspectives toward sexual behavior within a heterosexually married couple in which one individual has dementia and resides in a long-term care facility. Respondents included 318 adults in the Southern United States. Paired sample t tests were used to understand how the diagnosis of dementia statistically influenced participants' responses, and a logistic regression model was used to understand how a vignette character's sex and respondent characteristics influenced attitudes. Fifty-eight percent of respondents believed that a sexual relationship should be permitted for an adult with dementia, and t tests revealed that dementia had a statistical effect on participants' responses. Sex of the vignette character was not a predictor of attitudes. Participant's qualitative rationales are offered for additional insight. Respondents who felt that a couple should not engage in a sexual relationship commonly cited consent-related issues as their primary concern. Implications for policy development are discussed.

  13. Allocation of Public Resources for Psychological Therapy between Types of Mental Health Condition: Towards Structural Balance

    Science.gov (United States)

    Tustin, Don

    2009-01-01

    This paper addresses issues of allocating public resources efficiently between mental health conditions that are associated with different levels of disability, and presents an adaptation of an established framework to help decision-making in this area. The adapted framework refers to psychological interventions that are universal, indicated,…

  14. Development of public health program for type 1 diabetes in a university community: preliminary evaluation of behavioural change wheel.

    Science.gov (United States)

    Nwose, Ezekiel Uba; Digban, K A; Anyasodor, A E; Bwititi, P T; Richards, R S; Igumbor, E O

    2017-10-23

    Diabetes mellitus, including type 1 is a global public health problem among the young persons. While public health campaign and screening program is a potential strategy, but communication skills, knowledge and opinion of the healthcare personnel are indicated as variables that can impact patient's education, which will lead to better outcome of care. Thus, in designing or planning a program for public health, workforce development considers opinion and behavioural change wheel of prospective personnel. The purpose of this preliminary study was to evaluate if a university academic department has the behavioural change wheel to function as workforce infrastructure for an envisioned program. Survey of knowledge, attitude and practice (KAP) of a university community regarding diabetes type 1 was performed. The KAP were translated into behavioural change wheel comprising capacity, motivation and opportunity (CMO). There are baseline indications of the behavioural change wheel potential of the public health department to run a T1D screening program. The number of participants who knew someone with T1D was significantly higher than the subgroup with no such knowledge (pwheel or CMO to develop a workforce infrastructure for T1D screening program, the experience that comes with age of lecturers will be an important factor to enable such program to succeed.

  15. Meaningful public participation in scientific research: How to build an effective site-based long-term education program

    Science.gov (United States)

    Barnett, L.

    2013-12-01

    Many site-based educators (Wildlife Refuges, nature centers, Cooperative Extension Programs, schools, arboretums) struggle with developing and implementing cohesive long-term scientific monitoring projects into their existing outreach programming. Moreover, projects that are not meaningful to participants often have little or no sustainable long-term impact. Programs proven most effective are those which 1.) engage the participants in the study design and implementation process, 2.) answer a scientific question posed by site leaders; the data collected supports USA-NPN efforts as well as related site management and monitoring questions, 3.) are built into existing outreach and education programs, using phenology as a lens for understanding both natural and cultural history, and 4.) consistently share outcomes and results with the participants. The USA National Phenology Network's (USA-NPN) Education Program provides phenology curriculum and outreach to educators in formal, non-formal, and informal settings. Materials are designed to serve participants in grades 5-12, higher education, and adult learners. Phenology, used as a lens for place-based education, can inform science, environmental, and climate literacy, as well as other subject areas including cultural studies, art, and language arts. The USA-NPN offers consultation with site leaders on how to successfully engage site-based volunteers and students in long-term phenological studies using Nature's Notebook (NN), the professional and citizen science phenology monitoring program. USA-NPN education and educator instruction materials are designed and field-tested to demonstrate how to implement a long-term NN phenology-monitoring program at such sites. These curricula incorporate monitoring for public visitors, long-term volunteers, and school groups, while meeting the goals of USA-NPN and the site, and can be used as a model for other public participation in science programs interested in achieving similar

  16. Bianchi Type-V universe with a viscous fluid and Λ-term

    Indian Academy of Sciences (India)

    conclusion that the Big Bang singularity occurs in the infinite past. The solutions for open, closed and flat universes have been found by Santos et al [10] under the assumption that the bulk viscosity (ξ) is a power function of energy density (ρ). The nature of cosmological solutions for homogeneous Bianchi Type-I model was.

  17. Dowel-type fastener connections in timber structures subjected to short-term loading

    DEFF Research Database (Denmark)

    Lauritzen Jensen, J.

    Design of dowel-type fastener connections in framed timber structures usually involves a two-step analysis: determination of the distribution of the sectional forces, and design of the eccentrically loaded connections. This report presents an integrated model for design of framed timber structures...

  18. Long-term follow-up of patients with Herlitz-type junctional epidermolysis bullosa

    NARCIS (Netherlands)

    Yuen, W. Y.; Duipmans, J. C.; Molenbuur, B.; Herpertz, I.; Mandema, J. M.; Jonkman, M. F.

    Background Junctional epidermolysis bullosa, type Herlitz (JEB-H) is a rare, autosomal recessive disease caused by absence of the epidermal basement membrane adhesion protein laminin-332. It is characterized by extensive and devastating blistering of the skin and mucous membranes, leading to death

  19. Bianchi type I expanding universe in Weyl-invariant gravity with a quartic interaction term

    Energy Technology Data Exchange (ETDEWEB)

    Kao, W.F.; Lin, Ing-Chen [National Chiao Tung University, Institute of Physics, Hsinchu (China)

    2017-11-15

    We will focus on the effect of a Weyl-invariant model with a quadratic interaction term and a free scalar field ψ. A set of analytic solutions will be obtained for this model. This model provides a dynamical alternative to the standard ΛCDM model. In particular, we will show that the quartic Weyl-invariant model prediction is consistent with the Hubble diagram observations. (orig.)

  20. Modelling and simulation the radioactive source-term of fission products in PWR type reactors

    International Nuclear Information System (INIS)

    Porfirio, Rogilson Nazare da Silva

    1996-01-01

    The source-term was defined with the purpose the quantify all radioactive nuclides released the nuclear reactor in the case of accidents. Nowadays the source-term is limited to the coolant of the primary circuit of reactors and may be measured or modelled with computer coders such as the TFP developed in this work. The calculational process is based on the linear chain techniques used in the CINDER-2 code. The TFP code considers forms of fission products release from the fuel pellet: Recoil, Knockout and Migration. The release from the gap to the coolant fluid is determined from the ratio between activity measured in the coolant and calculated activity in the gap. Considered the operational data of SURRY-1 reactor, the TFP code was run to obtain the source=term of this reactor. From the measured activities it was verified the reliability level of the model and the employed computational logic. The accuracy of the calculated quantities were compared to the measured data was considered satisfactory. (author)

  1. Proof-Term Synthesis on Dependent-Type Systems via Explicit Substitutions

    Science.gov (United States)

    1999-11-01

    oriented functional language OCaml , in about 50 lines. We have also implemented a higher-order unification algorithm for ground expressions. The soundness... OCaml , and it is electronically available by contacting the author. The underlying theory of the method proposed here is the An^-calculus. We believe...CORNES, Conception d’un langage de haut niveau de representation de preuves: recurrence par filtrage de motifs, unification en presence de types

  2. Can long-term thiamine treatment improve the clinical outcomes of myotonic dystrophy type 1?

    OpenAIRE

    Costantini, Antonio; Trevi, Erika; Pala, Maria Immacolata; Fancellu, Roberto

    2016-01-01

    Myotonic dystrophy type 1, also known as Steinert′s disease, is an autosomal dominant disorder with multisystemic clinical features affecting the skeletal and cardiac muscles, the eyes, and the endocrine system. Thiamine (vitamin B1) is a cofactor of fundamental enzymes involved in the energetic cell metabolism; recent studies described its role in oxidative stress, protein processing, peroxisomal function, and gene expression. Thiamine deficiency is critical mainly in the central and periphe...

  3. Impact of Type 2 Myocardial Infarction (MI) on Hospital-Level MI Outcomes: Implications for Quality and Public Reporting.

    Science.gov (United States)

    Arora, Sameer; Strassle, Paula D; Qamar, Arman; Wheeler, Evan N; Levine, Alexandra L; Misenheimer, Jacob A; Cavender, Matthew A; Stouffer, George A; Kaul, Prashant

    2018-03-26

    The International Classification of Diseases (ICD) coding system does not recognize type 2 myocardial infarction (MI) as a separate entity; therefore, patients with type 2 MI continue to be categorized under the general umbrella of non-ST-segment-elevation myocardial infarction (NSTEMI). We aim to evaluate the impact of type 2 MI on hospital-level NSTEMI metrics and discuss the implications for quality and public reporting. We conducted a single-center retrospective analysis of 1318 patients discharged with a diagnosis of NSTEMI between July 2013 and October 2014. The Third Universal Definition was used to define type 1 and type 2 MI. Weighted Kaplan-Meier curves were used to analyze risk of mortality and readmission. Overall, 1039 patients met NSTEMI criteria per the Third Universal Definition; of those, 264 (25.4%) had type 2 MI. Patients with type 2 MI were older, were more likely to have chronic kidney disease, and had lower peak troponin levels. Compared with type 1 MI patients, those with type 2 MI had higher inpatient mortality (17.4% versus 4.7%, P <0.0001) and were more likely to die from noncardiovascular causes (71.7% versus 25.0%, P <0.0001). Despite weighting for patient characteristics and discharge medications, patients with type 2 MI had higher mortality at both 30 days (risk ratio: 3.63; 95% confidence interval, 1.67-7.88) and 1 year (risk ratio: 1.98; 95% confidence interval, 1.44-2.73) after discharge. Type 2 MI was also associated with a lower 30-day cardiovascular-related readmission (risk ratio: 0.49; 95% confidence interval, 0.12-2.06). NSTEMI metrics are significantly affected by type 2 MI patients. Type 2 MI patients have distinct etiologies, are managed differently, and have higher mortality compared with patients with type 1 MI. Moving forward, it may be appropriate to exclude type 2 MI data from NSTEMI quality metrics. © 2018 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.

  4. Long-Term Prognostic Value of Coronary CT Angiography in Asymptomatic Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Kang, Se Hun; Park, Gyung-Min; Lee, Seung-Whan; Yun, Sung-Cheol; Kim, Young-Hak; Cho, Young-Rak; Park, Hyun Woo; Suh, Jon; Yang, Dong Hyun; Kang, Joon-Won; Lim, Tae-Hwan; Jung, Chang Hee; Koh, Eun Hee; Lee, Woo Je; Kim, Min-Seon; Lee, Ki-Up; Park, Joong-Yeol

    2016-11-01

    This study sought to evaluate the long-term prognostic value of coronary computed tomography angiography (CTA) in asymptomatic patients with type 2 diabetes mellitus. There are limited data on the long-term prognostic impact of coronary CTA in asymptomatic patients with type 2 diabetes mellitus. This study analyzed clinical outcomes of 591 consecutive asymptomatic patients with type 2 diabetes mellitus who underwent coronary CTA (mean age 62.2 ± 8.3 years and 352 men [59.6%]). A cardiac event was defined as a composite of cardiac death, nonfatal myocardial infarction, unstable angina requiring hospitalization, or late coronary revascularization. Patients were categorized into 3 groups according to severity of coronary artery disease (CAD) on coronary CTA: normal coronary arteries, nonobstructive CAD (28.4%) had normal coronary arteries, whereas 236 (39.9%) patients had nonobstructive CAD and 187 (31.6%) had obstructive CAD. During the follow-up period (median 5.3 years [interquartile range: 4.7 to 5.8 years]), 37 cardiac events occurred in 29 patents: 10 cardiac deaths, 2 nonfatal myocardial infarctions, 8 cases of unstable angina, and 17 late coronary revascularizations. The 6-year event-free survival rates were 99.3 ± 0.7% in patients with normal coronary arteries, 96.7 ± 1.2% in patients with nonobstructive CAD, and 86.2 ± 3.0% in patients with obstructive CAD (log-rank p type 2 diabetes mellitus with normal coronary arteries or nonobstructive CAD on coronary CTA show excellent clinical outcomes over a follow-up period of more than 5 years, whereas prognosis is worse in patients with obstructive CAD. These findings suggest long-term prognostic value of coronary CTA for asymptomatic type 2 diabetes mellitus. Copyright © 2016 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  5. Influence of Term of Exposure to High-Fat Diet-Induced Obesity on Myocardial Collagen Type I and III

    International Nuclear Information System (INIS)

    Silva, Danielle Cristina Tomaz da; Lima-Leopoldo, Ana Paula; Leopoldo, André Soares; Campos, Dijon Henrique Salomé de; Nascimento, André Ferreira do; Oliveira, Sílvio Assis Junior de; Padovani, Carlos Roberto; Cicogna, Antonio Carlos

    2014-01-01

    Obesity is a risk factor for many medical complications; medical research has shown that hemodynamic, morphological and functional abnormalities are correlated with the duration and severity of obesity. Present study determined the influence of term of exposure to high-fat diet-induced obesity on myocardial collagen type I and III. Thirty-day-old male Wistar rats were randomly distributed into two groups: a control (C) group fed a standard rat chow and an obese (Ob) group alternately fed one of four palatable high-fat diets. Each diet was changed daily, and the rats were maintained on their respective diets for 15 (C 15 and Ob 15 ) and 30 (C 30 and Ob 30 ) consecutive weeks. Obesity was determined by adiposity index. The Ob 15 group was similar to the C 15 group regarding the expression of myocardial collagen type I; however, expression in the Ob 30 group was less than C 30 group. The time of exposure to obesity was associated with a reduction in collagen type I in Ob 30 when compared with Ob 15 . Obesity did not affect collagen type III expression. This study showed that the time of exposure to obesity for 30 weeks induced by unsaturated high-fat diet caused a reduction in myocardial collagen type I expression in the obese rats. However, no effect was seen on myocardial collagen type III expression

  6. Influence of Term of Exposure to High-Fat Diet-Induced Obesity on Myocardial Collagen Type I and III

    Energy Technology Data Exchange (ETDEWEB)

    Silva, Danielle Cristina Tomaz da [Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, SP (Brazil); Lima-Leopoldo, Ana Paula; Leopoldo, André Soares [Departamento de Esportes, Centro de Educação Física e Desportos da Universidade Federal do Espírito Santo (UFES), Vitória, ES (Brazil); Campos, Dijon Henrique Salomé de; Nascimento, André Ferreira do [Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, SP (Brazil); Oliveira, Sílvio Assis Junior de [Escola de Fisioterapia da Universidade Federal de Mato Grosso do Sul (UFMS), Campo Grande, MS (Brazil); Padovani, Carlos Roberto [Departamento de Bioestatística do Instituto de Ciências Biológicas da Universidade Estadual Paulista (UNESP), Botucatu, SP (Brazil); Cicogna, Antonio Carlos, E-mail: dany.tomaz@gmail.com [Departamento de Clínica Médica, Faculdade de Medicina de Botucatu, Universidade Estadual Paulista (UNESP), Botucatu, SP (Brazil)

    2014-02-15

    Obesity is a risk factor for many medical complications; medical research has shown that hemodynamic, morphological and functional abnormalities are correlated with the duration and severity of obesity. Present study determined the influence of term of exposure to high-fat diet-induced obesity on myocardial collagen type I and III. Thirty-day-old male Wistar rats were randomly distributed into two groups: a control (C) group fed a standard rat chow and an obese (Ob) group alternately fed one of four palatable high-fat diets. Each diet was changed daily, and the rats were maintained on their respective diets for 15 (C{sub 15} and Ob{sub 15}) and 30 (C{sub 30} and Ob{sub 30}) consecutive weeks. Obesity was determined by adiposity index. The Ob{sub 15} group was similar to the C{sub 15} group regarding the expression of myocardial collagen type I; however, expression in the Ob{sub 30} group was less than C{sub 30} group. The time of exposure to obesity was associated with a reduction in collagen type I in Ob{sub 30} when compared with Ob{sub 15}. Obesity did not affect collagen type III expression. This study showed that the time of exposure to obesity for 30 weeks induced by unsaturated high-fat diet caused a reduction in myocardial collagen type I expression in the obese rats. However, no effect was seen on myocardial collagen type III expression.

  7. Retinal Vessel Calibers Predict Long-term Microvascular Complications in Type 1 Diabetes

    DEFF Research Database (Denmark)

    Broe, Rebecca; Rasmussen, Malin L; Frydkjaer-Olsen, Ulrik

    2014-01-01

    Diabetic neuropathy, nephropathy, and retinopathy cause significant morbidity in patients with type 1 diabetes, even though improvements in treatment modalities delay the appearance and reduce the severity of these complications. To prevent or further delay the onset, it is necessary to better.......5-1 disc diameter from the disc margin were measured and summarized as the central artery and vein equivalents. In multiple regression analyses, we found wider venular diameters and smaller arteriolar diameters were both predictive of the 16-year development of nephropathy, neuropathy, and proliferative...

  8. Remission of type 2 diabetes in a hypogonadal man under long-term testosterone therapy

    Directory of Open Access Journals (Sweden)

    Ahmad Haider

    2017-09-01

    Full Text Available In daily practice, clinicians are often confronted with obese type 2 diabetes mellitus (T2DM patients for whom the treatment plan fails and who show an inadequate glycemic control and/or no sustainable weight loss. Untreated hypogonadism can be the reason for such treatment failure. This case describes the profound impact testosterone therapy can have on a male hypogonadal patient with metabolic syndrome, resulting in a substantial and sustained loss of body weight, pronounced improvement of all critical laboratory values and finally complete remission of diabetes.

  9. [Long term follow up of a patient with type I vitamin D-dependent rickets].

    Science.gov (United States)

    Velásquez-Jones, Luis; Medeiros, Mara; Valverde-Rosas, Saúl; Jiménez-Triana, Clímaco; Del Moral-Espinosa, Irma; Romo-Vázquez, José Carlos; Franco-Alvarez, Isidro

    Vitamin D dependent rickets type I is a rare hereditary disease due to a mutation in CYP27B1 encoding the 1α-hydroxylase gene. Clinically, the condition is characterized by hypocalcemic rickets in early infancy due to a deficit in the production of the vitamin D active metabolite 1,25-dihydroxy-vitamin D 3 . We report the case of a patient diagnosed at 11 months with follow-up until 9 years of age. The pathophysiology of the disease and the relevance of early diagnosis and management are discussed. Copyright © 2015. Publicado por Masson Doyma México S.A.

  10. Menstrual and reproductive factors and type 2 diabetes risk: the Japan Public Health Center-based Prospective Study.

    Science.gov (United States)

    Nanri, Akiko; Mizoue, Tetsuya; Noda, Mitsuhiko; Goto, Atsushi; Sawada, Norie; Tsugane, Shoichiro

    2018-04-18

    Menstrual and reproductive factors, including age at menarche, parity, and breastfeeding, have been linked to type 2 diabetes risk. We prospectively investigated the association between these factors and type 2 diabetes risk in a large Japanese cohort. Participants were 37,511 women aged 45-75 years who participated in the baseline (1990-1993), second (1995-1998), and third surveys (2000-2003) of the Japan Public Health Center-based Prospective Study and who had no history of diabetes at the second survey. Menstrual and reproductive history was ascertained using questionnaires at the baseline and second surveys. Odds ratios of self-reported, physician-diagnosed type 2 diabetes over the 5-year period from the second survey were estimated using logistic regression. At the third survey, 513 new cases of type 2 diabetes were self-reported. The odds ratios of type 2 diabetes tended to increase with the number of parity, after adjustment for covariates other than body mass index (P for trend = 0.029). The multivariable-adjusted odds ratios (95% confidence interval) of type 2 diabetes for women with ≥3 births was 1.56 (0.96-2.53) compared to those who were nulliparous. The association between parity and type 2 diabetes risk was attenuated after additional adjustment for body mass index (P for trend = 0.12). No factors other than parity were significantly associated with type 2 diabetes risk. Higher parity may be associated with increased risk of type 2 diabetes among Japanese women, partly through increasing body weight. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  11. Is Long Term Duration of Diabetes is a Factor to Cause Endothelial Dysfunction in Patients with Type 2 Diabetes Mellitus?

    Directory of Open Access Journals (Sweden)

    Siva Prasad Palem

    2017-12-01

    Full Text Available Introduction: Endothelial Dysfunction (ED is an earliest pathological process of atherosclerosis. Endothelium regulates vascular tone, platelet activity, leukocyte adhesion and thrombosis. Impaired function of endothelium initiates the development of atherosclerosis. Nitric oxide is one of the most effective endogenous vasodilator and also a marker for ED. Aim: To assess whether long term duration of diabetes is a factor to cause ED and its complications in patients with Type 2 diabetes mellitus. Hence, the study has been designed to assess the ED in patients with long term duration of Type 2 diabetes for early prediction of vascular complications. Materials and Methods: The study was conducted on 47 Type 2 diabetic subjects. Among these 27 subjects with 5 years duration of diabetes (Group-II. Glucose, HbA1c, BMI and lipid profile were estimated by well established methods in auto-analyzer, MDA by Thiobarbituric Acid Reactive Substances (TBARS, total antioxidant capacity as Ferric Reducing Ability of Plasma (FRAP and NO was estimated by kinetic cadmium reduction method using spectrophotometer. Statistical analysis was performed by “Kruskal-Wallis” test. Result: Significantly low level of NO was identified in Type 2 diabetic patients with >5 years duration of disease compared to 5 years duration of diabetes and no significant difference in the level of FRAP among the study groups. It has also shown significantly high level of age in >5 years duration of Type 2 diabetes than <5 years. But, no significant differences in the levels of HbA1c, lipid profile were identified between two study groups. Conclusion: Age and oxidative stress (lipid peroxidation has been recognized as risk factors for ED and future complications in patients with more than 5 years duration of Type 2 diabetes.

  12. Long-term colloidal stability of 10 carbon nanotube types in the absence/presence of humic acid and calcium

    International Nuclear Information System (INIS)

    Schwyzer, Irène; Kaegi, Ralf; Sigg, Laura; Smajda, Rita; Magrez, Arnaud; Nowack, Bernd

    2012-01-01

    The colloidal stabilities of ten carbon nanotubes (CNTs) having varying physico-chemical properties were compared in long-term experiments. The presence of Suwannee River Humic Acid (SRHA) increased the fraction of CNTs in the supernatants (4–88% for the various CNT types) after addition in pre-dispersed form and 20 days of shaking and 5 days of settling. These suspensions were monomodal, containing individually suspended CNTs with highly negative surface charges. Calcium (2 mM) removed most of the CNT types from the supernatant, due to CNT-agglomerate formation initiated by reduction in surface charge. The amount of SRHA adsorbed to the different CNT types did not correlate (r 2 < 0.1) with the percentage of CNTs remaining in suspension. Multiple linear regression analysis revealed that the oxygen content and the diameter of the CNTs significantly influenced the percentage of stabilized CNTs, resulting in an increased fraction of functionalized and large-diameter CNTs that remained in suspension. Highlights: ► Ten different CNT types with varying physico-chemical properties were used. ► The presence of SRHA increased the fraction of CNTs in the supernatants for all CNT-types. ► The O-content and diameter of the CNTs influenced the percentage of CNTs stabilized. ► Functionalization and large diameter made CNTs resistant against Ca flocculation. - The long-term colloidal stability of 10 different CNT types in the presence of humic acid was dependent on oxygen content and diameter of the CNTs.

  13. CO2 Emissions and Cost by Floor Types of Public Apartment Houses in South Korea

    Directory of Open Access Journals (Sweden)

    Hyoung Jae Jang

    2016-05-01

    Full Text Available In each country in the world, there is a strong need for all industries to reduce CO2 emissions for sustainable development as a preparation for climatic change. The biggest issue in many developed countries, including the United States, is to reduce CO2 emissions for the upcoming implementation of Carbon Emissions Trading. The construction industry, in particular, which accounts for up about 30% of CO2 emissions, will need studies on the amount of CO2 emissions. The purpose of this study is to present the most environmentally friendly and economical apartment house plan types according to the increasing number of layers by evaluating the amount of CO2 emissions and economic efficiency. The results indicated that flat and Y-shaped types are more eco-friendly and economical in lower levels of less than 20 stories. However, the L-shaped type is more highly eco-friendly and economically efficient in higher levels of more than 20 stories. The results of this paper would help to make a decision on the building types and the number of stories in the early stages of construction.

  14. Source term and radiological consequence evaluation for nuclear accidents using a 'hand type' methodology

    International Nuclear Information System (INIS)

    Margeanu, Sorin; Tatiana, Angelescu

    2005-01-01

    In the last decades, hand type calculations have been replaced by computerized solutions, which are much more accurate, but the preparation of an input to run the code can be a time consuming process and can require a laborious work. This is why, a place for hand calculation based on nomograms still exist in some areas. An example is emergency response to an accidental release of radioactive contaminants when the health of persons close to the accident site might be at risk. In this case, results from computerized accident consequences assessment models may be delayed due to the equipment malfunction or the time required developing minimal input files and performing the calculations (typically more than five minutes). A simple nomogram (developed using computerized dispersion model calculations) can provide dispersion and dose estimates within a minute. The paper presents the methodology used for these 'hand type' calculation and the nomograms, figures and tables used to evaluate the dose to an individual close to the release point. In order to illustrate the use of methodology, a hypothetical severe accident scenario involving 14-MW INR-TRIGA research reactor was considered. (authors)

  15. Antiobesity Pharmacotherapy for Patients with Type 2 Diabetes: Focus on Long-Term Management

    Directory of Open Access Journals (Sweden)

    Won Seon Jeon

    2014-12-01

    Full Text Available Type 2 diabetes and obesity have a complex relationship; obesity is linked to insulin resistance, the precursor to type 2 diabetes. The management of obesity is an important method to delay onset of diabetes and improve the glycemic durability of antidiabetic agents. However, insulin and some of the oral hypoglycemic agents used to treat diabetes cause significant weight gain, and it is difficult for patients with diabetes to reduce and maintain their weight by life-style changes alone. Thus, antiobesity medications or bariatric surgery may be a necessary adjunct for certain obese patients with diabetes. In 2012, the U.S. Food and Drug Administration (FDA approved lorcaserin and phentermine/topiramate extended-release for the management of chronic weight, and approval for naltrexone/bupropion sustained-release as an adjunct to exercise and reduced caloric intake followed in 2014. Liraglutide is pending FDA approval for antiobesity drug. Here we review the efficacy of approved and new promising drugs for the management of obesity.

  16. Clinical evaluation of Dyslipidemia among type II diabetic patients at Public hospital Penang, Malaysia

    Directory of Open Access Journals (Sweden)

    Zaki Nada F

    2010-11-01

    Full Text Available Abstract Background Global views emphasize the need for early; effective intervention against the atherogenic dyslipidemia associated with type 2 diabetes and metabolic syndrome to reduce the risk of premature cardiovascular diseases. Our aim was to determine the clinical practices and compliance among dyslipidemia with type II diabetes and hypertension in multiracial society. Method(s Study was carried out in out-patient department of General hospital Penang over a period of ten months (Jan - Oct 2008. Study reflects the retrospective data collection covering a period of three years from Jan 2005 - Dec 2007. Universal sampling technique was used to select all the patients' undergone treatment for diabetes type II and dyslipidemia. All the concerned approvals were obtained from Clinical research Committee (CRC. Data was analyzed by using SPSS 15®. Result(s A total of 501 diabetes type 2 patients with dyslipidemia were identified in this study. The demographic data showed that 55.9% (n = 280 were female patients and 44.1% (n = 221 were males. Patients on combination therapy of metformin with other antidiabetic agent were 79%, while 21% were on monotherapy. Lovastatin was received as monotherapy in 83% of study population, while only 17% were on combination with gemfibrozil. Means of FPG and lipid profile were reduced from the initial (2005 to the latest level (2007 significantly (p Conclusion Metformin and lovastatin use among patients of type 2 diabetes and dyslipidemia is significantly improved the clinical outcomes. No significant association of metformin or lovastatin is found against the hypertension. Metformin and calcium channel blocker combination therapy was found to be the best choice in the co-treatment of diabetes and hypertension.

  17. Public Opinions and Use of Various Types of Recreational Infrastructure in Boreal Forest Settings

    Directory of Open Access Journals (Sweden)

    Vegard Gundersen

    2016-05-01

    Full Text Available We have investigated public preferences for use intensity and visual quality of forest recreational infrastructure. Forest infrastructure covers five classes, along a continuum from unmarked paths to paved walkways. Altogether, 39 sites were categorized into the five classes and measured with automatic counters. A sample of 545 respondents living in southeastern and middle Norway were asked to rate 15 forest scenes and 35 preconceptions of recreational settings. The path scenarios were depicted as digitally calibrated photos that systematically displayed physical path feature in boreal, semi-natural settings. Survey participants showed a clearly greater preference for photos and preconceptions of forests settings containing minor elements of forest infrastructure; unmarked paths received the highest score and forest roads/walkways/bikeways the lowest. We identified a clear mismatch between public preferences for forest infrastructure and the intensity of use; the less appreciated infrastructure was the most used. Planning and management has to consider these different needs for recreational infrastructure, and we propose an area zoning system that meets the different segments of forest visitors.

  18. Complete loss of insulin secretion capacity in type 1A diabetes patients during long-term follow up.

    Science.gov (United States)

    Uno, Sae; Imagawa, Akihisa; Kozawa, Junji; Fukui, Kenji; Iwahashi, Hiromi; Shimomura, Iichiro

    2017-10-16

    Patients with type 1 diabetes are classified into three subtypes in Japan: acute onset, fulminant and slowly progressive. Acute-onset type 1 diabetes would be equivalent to type 1A diabetes, the typical type 1 diabetes in Western countries. The insulin secretion capacity in Japanese patients with long-standing type 1A diabetes is unclear. The aim of the present study was to clarify the course of endogenous insulin secretion during long-term follow up and the factors associated with residual insulin secretion in patients with acute-onset type 1 diabetes (autoimmune). We retrospectively investigated endogenous insulin secretion capacity in 71 patients who fulfilled the diagnostic criteria for acute-onset type 1 diabetes (autoimmune) in Japan. To assess the residual insulin secretion capacity, we evaluated randomly measured C-peptide levels and the results of glucagon stimulation test in 71 patients. In the first year of disease, the child- and adolescent-onset patients had significantly more in residual insulin secretion than the adult-onset patients (34 patients in total). C-peptide levels declined more rapidly in patients whose age of onset was ≤18 years than in patients whose age of onset was ≥19 years. Endogenous insulin secretion capacity stimulated by glucagon was completely lost in almost all patients at >15 years after onset (61 patients in total). Most patients with acute-onset type 1 diabetes (autoimmune) completely lose their endogenous insulin secretion capacity during the disease duration in Japan. Age of onset might affect the course of insulin secretion. © 2017 The Authors. Journal of Diabetes Investigation published by Asian Association for the Study of Diabetes (AASD) and John Wiley & Sons Australia, Ltd.

  19. Endovascular treatment of type B dissection in patients with Marfan syndrome: mid-term outcomes and aortic remodeling.

    Science.gov (United States)

    Eid-Lidt, Guering; Gaspar, Jorge; Meléndez-Ramírez, Gabriela; Cervantes S, Jorge; González-Pacheco, Hector; Dámas de Los Santos, Félix; Meave-González, Aloha; Ramírez Marroquín, Samuel

    2013-12-01

    To evaluate the mid-term outcomes, and the aortic remodeling in Marfan syndrome (MFS) patients with type B dissection that were treated with endovascular repair. MFS is a relative contraindication to thoracic endovascular aortic repair (TEVAR). Mid-term aortic outcomes data in MFS after TEVAR are limited, and the occurrence of late events remains unclear. Of 89 patients that underwent TEVAR between September 2002 and February 2011, 10 patients with mid-term follow-up fulfilled the Ghent criteria for MFS and complicated type B dissection. High risk for open surgery was documented in 90%. The mean age was 35.1 ± 9.4 years and all patients presented with acute aortic syndrome complicating a chronic type B dissection (DeBakey type IIIb). Five patients underwent a Bentall surgical procedure previous to endovascular repair, and in four patients initial TEVAR was followed by surgery of the ascending aorta. Treatment was limited to endovascular repair in only one patient. In-hospital mortality was 10%. At a mean follow-up of 59.6 ± 38.9 months, the cumulated mortality was of 20% and late mortality 11.1%. The rate of secondary endoleak was 44.4%, and late reintervention of 33.3%. Survival freedom from cardiovascular death at 8 years was 80.0%, and positive remodeling was documented in 37.5% of patients. Our results suggest that TEVAR is feasible, safe, and associated with a high reintervention rate and reduced rate of positive aortic remodeling in patients with Marfan syndrome. Survival at 8 years was comparable to contemporary series of open repair. Copyright © 2013 Wiley Periodicals, Inc.

  20. Long term energy and emission implications of a global shift to electricity-based public rail transportation system

    International Nuclear Information System (INIS)

    Chaturvedi, Vaibhav; Kim, Son H.

    2015-01-01

    With high reliance on light-duty vehicles in the present, the future of global transportation system is also geared towards private modes, which has significant energy and emission implications. Public transportation has been argued as an alternative strategy for meeting the rising transportation demands of the growing world, especially the poor, in a sustainable and energy efficient way. The present study analyzes an important yet under-researched question – what are the long-term energy and emission implications of an electric rail based passenger transportation system for meeting both long and short distance passenter transportation needs? We analyze a suite of electric rail share scenarios with and without climate policy. In the reference scenario, the transportation system will evolve towards dominance of fossil based light-duty vehicles. We find that an electric rail policy is more successful than an economy wide climate policy in reducing transport sector energy demand and emissions. Economy wide emissions however can only be reduced through a broader climate policy, the cost of which can be reduced by hundreds of billions of dollars across the century when implemented in combination with the transport sector focused electric rail policy. Moreover, higher share of electric rail enhances energy security for oil importing nations and reduces vehicular congestion and road infrastructure requirement as well. -- Highlights: •Economy wide carbon price policy will have little impact on transportation emissions. •Focused energy and emission mitigation policies required for transportation sector. •Large global shift towards electric rail based public transport is one possible option. •Transport sector focused policy will have marginal impact on total global emissions. •A combined transport sector and economy wide policy can reduce costs significantly

  1. Long-term aging of type 308 stainless steel welds: Effects on properties and microstructure

    International Nuclear Information System (INIS)

    Alexander, D.J.; Vitek, J.M.; David, S.A.

    1994-01-01

    Multipass gas tungsten arc welds with type 308 stainless steel filler metal in type 304L base plate have been aged at 400, 475, or 550 degrees C for times up to 5,000 h. The changes in mechanical properties as a result of these agings have been followed with tensile, impact, and fracture toughness testing, using subsize tensile, half-size Charpy, and 0.45T compact specimens, respectively. The changes in the microstructure were evaluated with optical and transmission electron microscopy. Relatively little change was observed in the tensile properties for any of the aging treatments, but significant embrittlement was observed in the impact and fracture toughness testing. The transition temperatures increased rapidly for aging at 475 or 550 degrees C, and more slowly for aging at 400 degrees C. The upper-shelf energies and the fracture toughness showed similar responses, with only a small decrease for 400 degrees C aging, but much greater and rapid decreases with aging at 475 or 550 degrees C. Aging at 400 or 475 degrees C resulted in the spinodal decomposition of the ferrite phase in the weld metal into iron-rich alpha and chromium-enriched alpha prime. In addition, at 475 degrees C G-phase precipitates formed homogeneously in the ferrite and also at dislocations. At 550 degrees C carbides formed and grew at the ferrite-austenite interfaces, and some ferrite transformed to sigma phase. These changes must all be considered in determining the effect of aging on the fracture properties

  2. Modeling the Movement of Homicide by Type to Inform Public Health Prevention Efforts.

    Science.gov (United States)

    Zeoli, April M; Grady, Sue; Pizarro, Jesenia M; Melde, Chris

    2015-10-01

    We modeled the spatiotemporal movement of hotspot clusters of homicide by motive in Newark, New Jersey, to investigate whether different homicide types have different patterns of clustering and movement. We obtained homicide data from the Newark Police Department Homicide Unit's investigative files from 1997 through 2007 (n = 560). We geocoded the address at which each homicide victim was found and recorded the date of and the motive for the homicide. We used cluster detection software to model the spatiotemporal movement of statistically significant homicide clusters by motive, using census tract and month of occurrence as the spatial and temporal units of analysis. Gang-motivated homicides showed evidence of clustering and diffusion through Newark. Additionally, gang-motivated homicide clusters overlapped to a degree with revenge and drug-motivated homicide clusters. Escalating dispute and nonintimate familial homicides clustered; however, there was no evidence of diffusion. Intimate partner and robbery homicides did not cluster. By tracking how homicide types diffuse through communities and determining which places have ongoing or emerging homicide problems by type, we can better inform the deployment of prevention and intervention efforts.

  3. Estimating the returns to United Kingdom publicly funded musculoskeletal disease research in terms of net value of improved health outcomes.

    Science.gov (United States)

    Glover, Matthew; Montague, Erin; Pollitt, Alexandra; Guthrie, Susan; Hanney, Stephen; Buxton, Martin; Grant, Jonathan

    2018-01-10

    Building on an approach applied to cardiovascular and cancer research, we estimated the economic returns from United Kingdom public- and charitable-funded musculoskeletal disease (MSD) research that arise from the net value of the improved health outcomes in the United Kingdom. To calculate the economic returns from MSD-related research in the United Kingdom, we estimated (1) the public and charitable expenditure on MSD-related research in the United Kingdom between 1970 and 2013; (2) the net monetary benefit (NMB), derived from the health benefit in quality adjusted life years (QALYs) valued in monetary terms (using a base-case value of a QALY of £25,000) minus the cost of delivering that benefit, for a prioritised list of interventions from 1994 to 2013; (3) the proportion of NMB attributable to United Kingdom research; and (4) the elapsed time between research funding and health gain. The data collected from these four key elements were used to estimate the internal rate of return (IRR) from MSD-related research investments on health benefits. We analysed the uncertainties in the IRR estimate using a one-way sensitivity analysis. Expressed in 2013 prices, total expenditure on MSD-related research from 1970 to 2013 was £3.5 billion, and for the period used to estimate the rate of return, 1978-1997, was £1.4 billion. Over the period 1994-2013 the key interventions analysed produced 871,000 QALYs with a NMB of £16 billion, allowing for the net NHS costs resulting from them and valuing a QALY at £25,000. The proportion of benefit attributable to United Kingdom research was 30% and the elapsed time between funding and impact of MSD treatments was 16 years. Our best estimate of the IRR from MSD-related research was 7%, which is similar to the 9% for CVD and 10% for cancer research. Our estimate of the IRR from the net health gain to public and charitable funding of MSD-related research in the United Kingdom is substantial, and justifies the research investments

  4. Communication: Cosolvency and cononsolvency explained in terms of a Flory-Huggins type theory

    Energy Technology Data Exchange (ETDEWEB)

    Dudowicz, Jacek, E-mail: dudowicz@jfi.uchicago.edu; Freed, Karl F. [The James Franck Institute and the Department of Chemistry, The University of Chicago, Chicago, Illinois 60637 (United States); Douglas, Jack F. [Materials Science and Engineering Division, National Institute of Standards and Technology, Gaithersburg, Maryland 20899 (United States)

    2015-10-07

    Standard Flory-Huggins (FH) theory is utilized to describe the enigmatic cosolvency and cononsolvency phenomena for systems of polymers dissolved in mixed solvents. In particular, phase boundaries (specifically upper critical solution temperature spinodals) are calculated for solutions of homopolymers B in pure solvents and in binary mixtures of small molecule liquids A and C. The miscibility (or immiscibility) patterns for the ternary systems are classified in terms of the FH binary interaction parameters (χ{sub αβ}) and the ratio r = ϕ{sub A}/ϕ{sub C} of the concentrations ϕ{sub A} and ϕ{sub C} of the two solvents. The trends in miscibility are compared to those observed for blends of random copolymers (A{sub x}C{sub 1−x}) with homopolymers (B) and to those deduced for A/B/C solutions of polymers B in liquid mixtures of small molecules A and C that associate into polymeric clusters (A{sub p}C{sub q}){sub i}, (i = 1, 2, …, ∞). Although the classic FH theory is able to explain cosolvency and cononsolvency phenomena, the theory does not include a consideration of the mutual association of the solvent molecules and the competitive association between the solvent molecules and the polymer. These interactions can be incorporated in refinements of the FH theory, and the present paper provides a foundation for such extensions for modeling the rich thermodynamics of polymers in mixed solvents.

  5. Delay-dependent stability of neural networks of neutral type with time delay in the leakage term

    International Nuclear Information System (INIS)

    Li, Xiaodi; Cao, Jinde

    2010-01-01

    This paper studies the global asymptotic stability of neural networks of neutral type with mixed delays. The mixed delays include constant delay in the leakage term (i.e. 'leakage delay'), time-varying delays and continuously distributed delays. Based on the topological degree theory, Lyapunov method and linear matrix inequality (LMI) approach, some sufficient conditions are derived ensuring the existence, uniqueness and global asymptotic stability of the equilibrium point, which are dependent on both the discrete and distributed time delays. These conditions are expressed in terms of LMI and can be easily checked by the MATLAB LMI toolbox. Even if there is no leakage delay, the obtained results are less restrictive than some recent works. It can be applied to neural networks of neutral type with activation functions without assuming their boundedness, monotonicity or differentiability. Moreover, the differentiability of the time-varying delay in the non-neutral term is removed. Finally, two numerical examples are given to show the effectiveness of the proposed method

  6. Spatial and temporal distribution of long term public policy costs under uncertainty, the case of climate change

    International Nuclear Information System (INIS)

    Lecocq, F.

    2000-07-01

    Because of the inertia of the climate system, policy makers cannot avoid making early decisions regarding climate change in a sea of uncertainties. In this context, the very legitimacy of economic analysis to tackle such questions, and in particular the underlying equity issues (who pays for climate mitigation? when?) faces widespread skepticism. This thesis aims at demonstrating how public economy still remains a powerful tool to try and put some rationale into the debate, by checking the internal consistency of the different discourses, and by providing robust insights, if not definitive answers, into climate decisions. We use a set of compact integrated climate policy optimization models to progressively introduce, articulate, and assess numerically the prominent issues at stake. We obtain three main results. We first demonstrate that the so-called timing debate between short term and long term action cannot be reduced to a mere dispute over discount rate. Given the high uncertainties surrounding climate change indeed, the margins of freedom we pass on to future generations, and in particular the technical and institutional systems we transmit, become more important than the discount rate value. Secondly, we apply the various emission quota allocation rules proposed in the literature for the enlargement of annex B to developing economies. We show that the distributive outcome of these rules depends critically on ex ante assumptions about future economic and emission growth. Therefrom, we conclude that a careful design of the institutions surrounding the tradable permits market is a necessary condition to enhance the systems robustness. Last, on a broader perspective, this thesis illustrates the complementarity between ethics and economics: though the economist does not have per se a superior word about what is fair, his toolbox is powerful enough to show how some intuitively appealing ideas, such as a zero discount rate to take care of both present and future

  7. Long-term visual acuity, retention and complications observed with the type-I and type-II Boston keratoprostheses in an Irish population.

    Science.gov (United States)

    Duignan, E S; Ní Dhubhghaill, S; Malone, C; Power, W

    2016-08-01

    To evaluate the outcomes of the type-I and type-II Boston keratoprostheses in a single Irish centre. A retrospective chart review of keratoprosthesis implantations carried out in our institution from November 2002 to March 2014 was performed. All procedures were performed by a single surgeon (WP). Thirty-four keratoprosthesis implantations were carried out in 31 patients with a mean follow-up of 42±31 months (range 2-110 months). Seventeen patients were female (54.8%) and 14 were male (45.2%). The majority of keratoprostheses implanted were type-I (31/34, 91.2%), and three were type-II (3/34, 8.8%). Twenty-nine patients (85.3%) had an improvement in distance best-corrected visual acuity (BCVA) from baseline. Fifty per cent (17/34) of patients had a best-ever BCVA of at least 6/12. Eighteen patients (64.3%) retained a BCVA of at least 6/60 at 1 year. Over the course of follow-up, six keratoprostheses were explanted from six eyes of five patients, one of which was a type-II keratoprosthesis. Twenty-six patients (76.5%) developed postoperative complications. Complications included retroprosthetic membrane (18 patients, 52.9%), an exacerbation or new diagnosis of glaucoma (6 patients, 17.6%), endophthalmitis (5 patients, 14.7%) and retinal detachment (2 patients, 5.9%). These data demonstrate excellent visual acuity and retention outcomes in a cohort with a long follow-up period in a single centre. Complications remain a considerable source of morbidity. These outcomes provide further evidence for the long-term stability of type-I and type-II Boston keratoprostheses in the management of patients in whom a traditional graft is likely to fail. 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/

  8. Long-term Cognitive Implications of Intrauterine Hyperglycemia in Adolescent Offspring of Women With Type 1 Diabetes (the EPICOM Study)

    DEFF Research Database (Denmark)

    Bytoft, Birgitte; Knorr, Sine; Vlachova, Zuzana

    2016-01-01

    OBJECTIVE: Exposure to maternal diabetes in utero may have a negative impact on the developing brain. The objective was to examine long-term cognitive consequences of intrauterine hyperglycemia in adolescent offspring of women with type 1 diabetes and to ascertain a possible association with mate......OBJECTIVE: Exposure to maternal diabetes in utero may have a negative impact on the developing brain. The objective was to examine long-term cognitive consequences of intrauterine hyperglycemia in adolescent offspring of women with type 1 diabetes and to ascertain a possible association...... using Reynolds Intellectual Assessment Scales and classified into indices of composite intelligence, verbal and nonverbal intelligence, and composite memory. Frequencies of reading and writing problems and attendance to classes for children with learning difficulties were assessed. RESULTS: Offspring...... of women with type 1 diabetes scored lower in all normalized and standardized intelligence indices compared with controls: composite intelligence (95.7 vs. 100, P = 0.001), verbal intelligence (96.2 vs. 100, P = 0.004), nonverbal intelligence (96.4 vs. 100, P = 0.008), and composite memory (95.7 vs. 100, P...

  9. Factors Associated with Long-Term Control of Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Mohammed Badedi

    2016-01-01

    Full Text Available Aims. This study assessed factors associated with glycemic control among Saudi patients with Type 2 diabetes mellitus (T2DM. Methods. We conducted an analytical cross-sectional study, which included a random sample of 288 patients with T2DM proportional to the diabetes population of each primary health care center in Jazan city, Kingdom of Saudi Arabia. Results. More than two-thirds (74% of patients had poor glycemic control. Lack of education, polypharmacy, and duration of diabetes ≥ 7 years were significantly associated with higher glycated hemoglobin (HbA1c. Moreover, patients who were smoker or divorced were significantly more likely to have higher HbA1c. The patients who did not comply with diet or take their medications as prescribed had poor glycemic control. The study found lower HbA1c levels among patients who received family support or had close relationship with their physicians. Similarly, knowledgeable patients towards diabetes or those with greater confidence in ability to manage self-care behaviors had a lower HbA1c. In contrast, risk factors such as depression or stress were significantly correlated with poorer glycemic control. Conclusion. The majority of T2DM patients had poor glycemic control. The study identified several factors associated with glycemic control. Effective and tailored interventions are needed to mitigate exposure to these risk factors. This would improve glycemic control and reduce the risks inherent to diabetes complications.

  10. Factors Associated with Long-Term Control of Type 2 Diabetes Mellitus.

    Science.gov (United States)

    Badedi, Mohammed; Solan, Yahiya; Darraj, Hussain; Sabai, Abdullah; Mahfouz, Mohamed; Alamodi, Saleh; Alsabaani, Abdullah

    2016-01-01

    Aims. This study assessed factors associated with glycemic control among Saudi patients with Type 2 diabetes mellitus (T2DM). Methods. We conducted an analytical cross-sectional study, which included a random sample of 288 patients with T2DM proportional to the diabetes population of each primary health care center in Jazan city, Kingdom of Saudi Arabia. Results. More than two-thirds (74%) of patients had poor glycemic control. Lack of education, polypharmacy, and duration of diabetes ≥ 7 years were significantly associated with higher glycated hemoglobin (HbA1c). Moreover, patients who were smoker or divorced were significantly more likely to have higher HbA1c. The patients who did not comply with diet or take their medications as prescribed had poor glycemic control. The study found lower HbA1c levels among patients who received family support or had close relationship with their physicians. Similarly, knowledgeable patients towards diabetes or those with greater confidence in ability to manage self-care behaviors had a lower HbA1c. In contrast, risk factors such as depression or stress were significantly correlated with poorer glycemic control. Conclusion. The majority of T2DM patients had poor glycemic control. The study identified several factors associated with glycemic control. Effective and tailored interventions are needed to mitigate exposure to these risk factors. This would improve glycemic control and reduce the risks inherent to diabetes complications.

  11. Cerebrotendinous xanthomatosis in a Saudi Arabian family geno typing and long-term follow-up

    International Nuclear Information System (INIS)

    Price Evans, David A.; Mobrad, M.A.; Salah, Kawther A.; Olin, M.; Eggertsen, G.; Mitchell, William D.

    2007-01-01

    A Saudi Arabian family is described in which there 2siblings with typical features of cerebral xanthomatosis (CTX) including premature cataracts, xanthomata of the Achilles tendons, neuro-psychiatric disturbances and atherosclerosis. The two patients were homozygous for a point mutation in the mitochondrial 27-hydroxylase gene (CYP27A1, OMIM 606530) located in the splice site of intron 6, where G exchanged for A (IVS6+1G>A). There parents were cousins, 5 siblings were healthy, 2 were heterozyguous for the mutation and one showed the wild-type genotype. The father was heterozyguous for the mutation, while the other family members were not tested. The progress of 2 CTX patients over 14 years is described; firstly when they were receiving treatment with chenodeoxycholic acid; when this medication was not available and then later when it was restored. A hereditary hyperlipidemia was also present in this family. It is suggested that when this occurs with CTX, a more seriuos illness results that merits more aggressive dual therapy. (author)

  12. Long-term ophthalmic health care in Usher syndrome type I from an ICF perspective.

    Science.gov (United States)

    Möller, Kerstin; Eriksson, Kristina; Sadeghi, André M; Möller, Claes; Danermark, Berth

    2009-01-01

    The aim was to explore ophthalmic health care in female patients with Usher Syndrome type I (USH I) over 20 years and to evaluate the relationship between the ophthalmic health care and the health state of the patients from a health perspective. A retrospective study of records from ophthalmology departments (OD) and low vision clinics (LVC) from 1985 to 2004. Assessment of the reports was performed based on the International Classification of Functioning, Disability and Health (ICF). Findings were analysed by manifest content analysis with ICF as a framework and using four themes: health care system, procedure examinations, patient's functioning and disability and procedure actions. The records of nine female patients (aged 25-39 years, 1985) with USH I were selected from the national database of USH. A great number of notes were collected (OD 344 and LVC 566). Procedure examinations were exclusively oriented towards body structure and function. All patients showed aggravated visual impairment over and above the hearing and vestibular impairment. Procedure actions were oriented towards environmental factors. No correlation was found between procedures performed and patient's experience of disability. The high degree of resource allocation was not correlated to the patients' impairment. The study indicates that the ophthalmic health care was characterised by inefficiency. This conclusion is very serious because patients very likely face severe disability and emotional difficulties. ICF is ought to be incorporated in ophthalmic health care strategy to improve the health care.

  13. Short-term thermal response of rapidly solidified Type 304 stainless steel containing helium

    International Nuclear Information System (INIS)

    Clark, D.E.

    1988-06-01

    Type 304 stainless steel was heat treated for short times near its melting point in order to determine its microstructural response to thermal cycles typical of the near heat-affected zones of welding processes. The material was rapidly solidified as a powder by centrifugal atomization in a helium environment and consolidated by hot extrusion. Along with the ingot metallurgy material used for canning the powder prior to hot extrusion, it was heat treated using a Gleeble at temperatures of 1200 and 1300 degree C for times ranging from <1 to 1000 s, and the samples were examined for microstructure and the existence of porosity due to entrapped helium. At higher test temperatures and longer treatment times, the material developed extensive porosity, which was stabilized by the presence of helium and which may also have a role in anchoring grain boundaries and inhibiting grain growth. The powder material. At lower test temperatures and shorter treatment times, grain growth in the γ phase appeared to be restricted in the powder material, possible by the presence of helium. An intermediate temperatures and times, a γ-δ duplex microstructure also restricted grain growth again occurred in the δ microstructure. 9 refs., 14 figs., 3 tabs

  14. Communication training improves sense of performance expectancy of public health nurses engaged in long-term elderly prevention care program.

    Science.gov (United States)

    Tanabe, Motoko; Suzukamo, Yoshimi; Tsuji, Ichiro; Izumi, Sin-Ichi

    2012-01-01

    This study examines the effectiveness of a communication skill training based on a coaching theory for public health nurses (PHNs) who are engaged in Japan's long-term care prevention program. The participants in this study included 112 PHNs and 266 service users who met with these PHNs in order to create a customized care plan within one month after the PHNs' training. The participants were divided into three groups: a supervised group in which the PHNs attended the 1-day training seminar and the follow-up supervision; a seminar group attended only the 1-day training seminar; a control group. The PHNs' sense of performance expectancy, and user's satisfaction, user's spontaneous behavior were evaluated at the baseline (T1), at one month (T2), and at three months (T3) after the PHNs' training. At T3, the PHNs performed a recalled evaluation (RE) of their communication skills before the training. The PHNs' sense of performance expectancy increased significantly over time in the supervised group and the control group (F = 11.28, P < 0.001; F = 4.03, P < 0.05, resp.). The difference score between T3-RE was significantly higher in the supervised group than the control group (P < 0.01). No significant differences in the users' outcomes were found.

  15. Long-Term Type 1 Diabetes Enhances In-Stent Restenosis after Aortic Stenting in Diabetes-Prone BB Rats

    Directory of Open Access Journals (Sweden)

    Geanina Onuta

    2011-01-01

    Full Text Available Type 1 diabetic patients have increased risk of developing in-stent restenosis following endovascular stenting. Underlying pathogenetic mechanisms are not fully understood partly due to the lack of a relevant animal model to study the effect(s of long-term autoimmune diabetes on development of in-stent restenosis. We here describe the development of in-stent restenosis in long-term (~7 months spontaneously diabetic and age-matched, thymectomized, nondiabetic Diabetes Prone BioBreeding (BBDP rats (n=6-7 in each group. Diabetes was suboptimally treated with insulin and was characterized by significant hyperglycaemia, polyuria, proteinuria, and increased HbA1c levels. Stented abdominal aortas were harvested 28 days after stenting. Computerized morphometric analysis revealed significantly increased neointima formation in long-term diabetic rats compared with nondiabetic controls. In conclusion, long-term autoimmune diabetes in BBDP rats enhances in-stent restenosis. This model can be used to study the underlying pathogenetic mechanisms of diabetes-enhanced in-stent restenosis as well as to test new therapeutic modalities.

  16. The effects of long term fasting in Ramadan on glucose regulation in type 2 diabetes mellitus.

    Science.gov (United States)

    Karatoprak, C; Yolbas, S; Cakirca, M; Cinar, A; Zorlu, M; Kiskac, M; Cikrikcioglu, M A; Erkoc, R; Tasan, E

    2013-09-01

    For Ramadan fasting, observing Muslims do not eat or drink between sunrise and sunset during Ramadan, Islam's holy month of the year according to the lunar calendar. In 2011, fasting patients with diabetes fasted for an average of 16.5 hours per day, having 2 meals between sunset and sunrise for a month. We aimed to evaluate the impact of extended fasting on glucose regulation and observe possible complications of extended fasting in type 2 diabetes mellitus patients. We conducted a randomized, retrospective, observational study. Patients who presented at the Diabetes Clinic during the 15 days before and after Ramadan in August 2011 Istanbul, whose hemoglobin A1c, fasting plasma glucose, postprandial plasma glucose, weight and height value examinations and follow-up were completed were included in the study. Seventy-six diabetes patients who fasted during Ramadan (fasting group) and 71 patients with diabetes who did not fast (non-fasting group) were included in the study. These two groups with similar demographic characteristics were compared before and after Ramadan. HbA1c, fasting and postprandial plasma glucose, body mass index, weight and adverse events were evaluated. No statistically significant difference was observed among the fasting and the non-fasting groups. There was no difference between the pre and post-Ramadan values of the fasting group. We could not find any negative effects of extended fasting on glucose regulation of patients with diabetes who are using certain medications. No serious adverse event was observed. We failed to demonstrate benefits of increasing the number of meals in patients with diabetes.

  17. Long-term tolerability of inhaled human insulin (Exubera) in patients with poorly controlled type 2 diabetes

    DEFF Research Database (Denmark)

    Barnett, A H; Lange, P; Dreyer, M

    2007-01-01

    or metformin (study 1) and patients poorly controlled on metformin were randomised to adjunctive EXU or the sulphonylurea, glibenclamide (study 2). PATIENTS: The studies included 446 (study 1) and 476 (study 2) patients with type 2 diabetes, no clinically significant respiratory disease and glycosylated....... There was no discernable effect of long-term EXU therapy on pulmonary gas exchange. Insulin antibody binding reached a plateau at 6 months and did not correlate with HbA(1c) or lung function changes. Glycaemic control was maintained over 2 years. CONCLUSIONS: Exubera was well tolerated during long-term use. Pulmonary...... function changes compared with comparator groups were small, non-progressive and reversed upon treatment discontinuation. Importantly, rates of lung function change were indistinguishable between EXU and comparator after 6 months of therapy. Udgivelsesdato: 2007-Oct...

  18. [Total gastrectomy for gastric cancer: can the type of lymphadenectomy condition the long-term results?].

    Science.gov (United States)

    Di Martino, N; Izzo, G; Cosenza, A; Vicenzo, L; Monaco, L; Torelli, F; Basciotti, A; Brillantino, A; Marra, A

    2005-01-01

    Gastric cancer is the second tumor for frequency in the world. Surgery is still the only curative treatment. Good results in terms of long distance survival, postoperative morbidity and mortality have been achieved in the last years. The extension of lymphadenectomy is an important and discussed matter and it is not clear if lymphadenectomy may contribute to improve the surgical results. The Japanese surgeons were the first ones, in the 60's, to introduce a D2-D3 extended lymphadenectomy, but the real benefits of this technique are still being discussed. Indeed lymphonodal metastasis seem to be one of the most important prognostic factors in the gastric cancer and the level and the number of metastatic nodes are useful to predict the patients' survival. The aim of this study is to value the D2 lymphadenectomy in the patients who were treated with total gastrectomy for gastric adenocarcinoma, comparing the results both with the D1 lymphadenectomy and the D3-D4, paying attention to the survival rates related with the lymphonodal dissection. From 1998 to 2004, we studied 87 patients with gastric cancer. Out of 78 patients treated surgically, 9 were judged unresectable. Out of 69 patients treated surgically, one died before surgery and so he was put away by this study. All the patients were treated with total gastrectomy and a GI tract reconstruction by Roux's Y termino-lateral esophageal-jejunal anastomosis. In 20 patients we also made a splenectomy. We followed the Japanese Research Society for Gastric Cancer guidelines, according to which nodes are gathered into 16 levels and divided in 4 groups (N1-N4) depending on the cancer localization. The extension of the lymphadenectomy has been classified according to the level of the removed nods. The patients were divided into 3 groups. First group: patients undergone a total gastrectomy with D1 lymphadenectomy. Second group: patients undergone D2 lymphadenectomy. Third group: patients undergone D3 and D4 lymphadenectomy

  19. Safety aspects of long-term dry interim storage of Type B spent fuel and high-level transport casks

    International Nuclear Information System (INIS)

    Wolff, D.; Probst, U.; Voelzke, H.; Droste, B.; Roedel, R.

    2004-01-01

    Based on the German decision to minimise transport of spent fuel casks between nuclear power plants, reprocessing plants and central storage facilities several on-site storage facilities were licensed until the end of 2003. Because of the large amount of Type B(U) transport casks which are going to be used for long-term interim storage the question of time-limited Type B(U) licence maintenance during the storage period of up to 40 years has been discussed under different aspects. This paper describes present technical aspects of the discussion. A main aspect of qualification of transport casks for interim storage is the long-term behaviour of the metallic seal-lid system. Here we present results from current long-term experimental tests with metallic 'Helicoflex' seals in which pool water is enclosed. This series of tests has been performed by the Federal Institute for Materials Research and Testing (BAM) on behalf of the Federal Office for Radiation Protection (BfS) since 2001. Finally, the paper presents a German concept for an exchange of experience, know-how and state-of-the-art between authorities and technical experts with regard to cask dispatch in nuclear facilities. BAM has taken over a central role in this so-called 'coordinating institution for cask dispatching information' ('KOBAF') which entails management of an online database of cask-specific documents and a technical working group meeting twice a year. The goal is to keep comparable technical standards for all nuclear sites and storage facilities which are going to load and dispatch casks of the same or similar types under the responsibility of different German state governments for the coming decades. (author)

  20. Safety aspects of long-term dry interim storage of type-B spent fuel and HLW transport casks

    International Nuclear Information System (INIS)

    Wolff, D.; Probst, U.; Voelzke, H.; Droste, B.; Roedel, R.

    2004-01-01

    Based on the German decision to minimise transports of spent fuel casks between nuclear power plants, reprocessing plants and central storage facilities several on-site storage facilities have been licensed till the end of 2003. Because of the large amount of type-B transport casks which are going to be used for long-term interim storage the question of time limited type-B license maintenance during the storage period of up to 40 years has been discussed under different aspects. This paper describes present technical aspects of the discussion. A main aspect of transport cask qualification for interim storage is the long-term behaviour of the metallic seal lid system. Concerning this results from current experimental long-term tests with metallic ''Helicoflex''-seals in which pool water is enclosed are presented. The test series has been performed by the Federal Institute for Materials Research and Testing (BAM) on behalf of the Federal Office for Radiation Protection (BfS) since 2001. Finally, the paper presents a German concept for an authorities' and technical experts' exchange of experience, know-how and state of the art referring to cask dispatch in nuclear facilities. BAM has taken over a central role in this so-called ''co-ordinating institution for cask dispatching information'' (''KOBAF'') which contains an online data base and a technical working group meeting twice a year. The goal is to keep comparable technical standards for all nuclear sites and storage facilities which are going to load and dispatch casks of the same or similar types under the responsibility of different German state governments for the next decades

  1. Quantifying the effects of oil shocks on long-term public debt: A review of empirical data and a scenario analysis of future projections

    Science.gov (United States)

    McMichael, Jillian Taylor

    Various authors have shown that each oil shock in the past 40 years has had statistically significant impacts on subsequent macroeconomic activity in the United States. Through these economic effects, oil shocks affect Federal revenues and expenditures and hence public debt. Published Federal budget scenarios do not currently reflect these impacts of oil shocks. I synthesize, in this paper, literature quantifying the impact of oil price increases on GDP growth and use that information to modify current long-term Federal budget models to present scenarios of how oil shocks are likely to affect long-term Federal debt. I argue that modeling the impact of oil price increases on long-term public debt could inform public policies, particularly those relating to Federal investments in energy conservation. Key Words: crude oil, oil shock, oil price spike, oil shock, Federal debt, debt projections, Congressional Budget Office

  2. Baseline red blood cell distribution width predicts long-term glycemic remission in patients with type 2 diabetes.

    Science.gov (United States)

    Xu, Lijuan; Wang, Liangjiao; Huang, Xinwei; Liu, Liehua; Ke, Weijian; He, Xiaoying; Huang, Zhimin; Liu, Juan; Wan, Xuesi; Cao, Xiaopei; Li, Yanbing

    2017-09-01

    We explored whether red blood cell distribution width (RDW), a routinely checked item of complete blood cell counts, was an indicator of long-term euglycemia remission in patients with type 2 diabetes after short-term continuous subcutaneous insulin infusion (CSII). We analyzed the original data of patients enrolled in three randomized control trials from 2002 to 2014. CSII was administered to drug-naїve patients with newly diagnosed type 2 diabetes to achieve and maintain euglycemia for 2weeks. A total of 185 patients were involved and 98 patients (52.97%) who achieved and maintained euglycemia for at least 12months were classified as the remission group, and the others as the non-remission group. Patients in remission group had a relatively lower value for baseline RDW (38.82±2.76vs 39.89±2.78fL, p=0.017) compared with those in non-remission group. A graded decrease of remission rate (67.50%, 55.00%, 53.66% and 30.77% for Quartile 1 to Quartile 4 respectively, P<0.05) was observed with the increasing of RDWs. The risk of hyperglycemic relapse was significantly increased for those in the highest quartile compared with the lowest (hazard ratio=2.68; 95% CI, 1.38-5.22). Those who achieved euglycemia within 7days or obtained a better fasting glucose after therapy had preferable remission rates. Patients with lower baseline RDWs are more likely to maintain a one-year euglycemia remission after short-term CSII. A faster normalization of glucose during treatment and a lower fasting glucose after therapy are correlated with a long-term glucose control. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. The long-term treatment of a patient with type 1 diabetes mellitus and glutaric aciduria type 1: the effect of insulin.

    Science.gov (United States)

    Del Rizzo, Monica; Galderisi, Alfonso; Celato, Andrea; Furlan, Francesca; Giordano, Laura; Cazzorla, Chiara; Fasan, Ilaria; Moretti, Carlo; Zschocke, Johannes; Burlina, Alberto B

    2016-08-01

    The coexistence of two diseases associated with different metabolic disorders is a very rare event. Some associations, although sporadic, can be particularly challenging both in terms of diagnostic and therapeutic management and in terms of theoretical perspective. Here, we report a child affected by type 1 diabetes mellitus (T1DM) and glutaric aciduria type 1 (GA1). The child was diagnosed with classical T1DM at 15 months of age, with a tendency toward hypoglycemia. A few months later, during an acute intercurrent infective episode, the child displayed acute hypotonia of the lower limbs and limbs dystonia. A brain MRI showed bilateral striatal necrosis, suggesting GA1 diagnosis. Treatment with a low-lysine dietary regimen and carnitine supplementation was started and resulted in an improvement in metabolic control and a reduction of hypoglycemic episodes along with an increasing in insulin daily dose. After 2 years, the neurological outcome consisted of a reduction in dystonic movements and a metabolic stability of both diseases. This case provides some insight into the reciprocal interconnections between the two metabolic disorders. Similar pathogenic mechanisms responsible for the neuronal injury might have impacted each other, and a strict relationship between a specific aspect of GA1-impaired metabolism and glucose homeostasis might explain how the tailored management of GA1 was not only effective in controlling the disease, but it also resulted in an improvement in the control of the glycemic profile. What in known: • Glutaric aciduria type 1 (GA1) usually presents in childhood with severe and possibly irreversible neuronal damage, triggered by a catabolic stress • The association of GA1 with other diseases, including type 1 diabetes mellitus (T1DM), is a rare event, complicating the treatment management What is new: • Insulin treatment has a role in preventing GA1 metabolic decompensation, even in the catabolic condition of hypoglycemia • Promoting

  4. On exponential cosmological type solutions in the model with Gauss-Bonnet term and variation of gravitational constant

    International Nuclear Information System (INIS)

    Ivashchuk, V.D.; Kobtsev, A.A.

    2015-01-01

    A D-dimensional gravitational model with Gauss.Bonnet term is considered. When an ansatz with diagonal cosmological type metrics is adopted, we find solutions with an exponential dependence of the scale factors (with respect to a @gsynchronous-like@h variable) which describe an exponential expansion of @gour@h 3-dimensional factor space and obey the observational constraints on the temporal variation of effective gravitational constant G. Among them there are two exact solutions in dimensions D = 22, 28 with constant G and also an infinite series of solutions in dimensions D ≥ 2690 with the variation of G obeying the observational data. (orig.)

  5. On exponential cosmological type solutions in the model with Gauss-Bonnet term and variation of gravitational constant

    Energy Technology Data Exchange (ETDEWEB)

    Ivashchuk, V.D. [VNIIMS, Center for Gravitation and Fundamental Metrology, Moscow (Russian Federation); Peoples' Friendship University of Russia, Institute of Gravitation and Cosmology, Moscow (Russian Federation); Kobtsev, A.A. [Peoples' Friendship University of Russia, Institute of Gravitation and Cosmology, Moscow (Russian Federation)

    2015-05-15

    A D-dimensional gravitational model with Gauss.Bonnet term is considered. When an ansatz with diagonal cosmological type metrics is adopted, we find solutions with an exponential dependence of the scale factors (with respect to a @gsynchronous-like@h variable) which describe an exponential expansion of @gour@h 3-dimensional factor space and obey the observational constraints on the temporal variation of effective gravitational constant G. Among them there are two exact solutions in dimensions D = 22, 28 with constant G and also an infinite series of solutions in dimensions D ≥ 2690 with the variation of G obeying the observational data. (orig.)

  6. Long-term administration of theophylline and glucose recovery after hypoglycaemia in patients with type 1 diabetes mellitus

    DEFF Research Database (Denmark)

    Hvidberg, A; Rosenfalck, A; Christensen, N J

    1998-01-01

    .0241) but there were no concomitant significant increases in plasma c-AMP or in endogenous glucose production rate. Whether the increase in glucose recovery is large enough to suggest that chronic theophylline administration will protect against insulin-induced hypoglycaemia remains unsettled....... hormone secretion. In this study we tested the hypothesis that long-term administration of theophylline might augment glucose recovery after insulin-induced hypoglycaemia. Eleven healthy subjects and 8 patients with Type 1 diabetes mellitus were made hypoglycaemic by 60 min insulin infusion (40 mU m(-2...

  7. Risk factors for mortality and ischemic heart disease in patients with long-term type 1 diabetes

    DEFF Research Database (Denmark)

    Grauslund, Jakob; Mejnert Jørgensen, Trine; Nybo, Mads

    2010-01-01

    AIMS: The purpose of this study is to evaluate the effect of glycemic regulation, dyslipidemia, and renal dysfunction on mortality (all-cause and cardiovascular) and ischemic heart disease (IHD) in a long-term follow-up of a population-based cohort of Danish type 1 diabetic patients with at least......-density lipoprotein cholesterol (inversely), total cholesterol, creatinine, and macroalbuminuria. Furthermore, all markers except macroalbuminuria were associated with IHD. Microalbuminuria at baseline was not related to any of the endpoints. CONCLUSIONS: Glycemic regulation, dyslipidemia, and renal dysfunction were...

  8. Long-term mortality in patients with diabetes mellitus type 2 after acute myocardial infarction

    Directory of Open Access Journals (Sweden)

    Miljković Dušan

    2014-01-01

    Full Text Available Introduction. Myocardial infarction is the most common cause of death in patients with diabetes, and several studies have shown that people with diabetes have twice the risk of dying from a heart attack compared to non diabetics. Objective. The aim of this study was to determine the mortality of patients that have survived acute myocardial infarction, in population of patients with diabetes mellitus and without diabetes. Method. The study included 135 patients recovered from myocardial infarction, of whom 51 (37.8% had type 2 diabetes mellitus, and 84 (62.2% were without diabetes, mean age 55,4±9,6 years. All patients underwent a complete cardiac and hemodynamic testing, cardiac catheterization with selective coronary angiography, and in most patients the aortocoronary bypass revascularization or percutaneous coronary intervention. Start of follow-up was the date of acute myocardial infarction. The study included only patients who survived at least one month after acute myocardial infarction. All patients with diabetes and without diabetes were monitored for an average of 84 months, i.e. 7 years. Results. The average age of patients with diabetes and myocardial infarction was 57.1±8.7 years, and of patients with myocardial infarction without diabetes 54.5 ± 9.6 years (t=1.62; p>0.05. Among patients with diabetes 14 (27.5% were women and 37 (72.5% were men, and in non-diabetics 15 (17.9% were women and 69 (82.1% were men (χ2=1.66; p>0.05. In the follow-up period died 15 (29.4% patients with diabetes, and 7 (8.3% patients without diabetes. Mortality in patients with diabetes and myocardial infarction was significantly higher than the mortality of patients with myocardial infarction without diabetes (χ2=11.2; p0.05. In the group of 27 patients who were treated with insulin, died five (18.5% and in the group of 24 patients on oral therapy died 10 (41.7%. There was no significant difference in mortality in patients with diabetes treated with

  9. Long-term patterns of adherence to medication therapy among patients with type 2 diabetes mellitus in Denmark

    DEFF Research Database (Denmark)

    Jensen, Majken Linnemann; Jørgensen, Marit Eika; Hansen, Ebba Holme

    2017-01-01

    : Adherence to six medicine groups (metformin, sulfonylureas, acetylsalicylic acid, thiazide diuretics, renin angiotensin system inhibitors, and statins) were analysed among 5,232 patients with type 2 diabetes at a tertiary referral hospital during 1998-2009. Rate-ratios of initiation of treatment, recurrent......AIMS: Poor adherence to medication therapy among type 2 diabetes patients is a clinical challenge. We aimed to determine which factors are associated with the three phases of long-term adherence to medication: initiation, implementation and discontinuation in a register-based study. METHODS...... gaps in supply of medication, and discontinuation of treatment were analysed using Poisson regression. RESULTS: Poor initiation rather than poor implementation or discontinuation was the main contributor to medication nonadherence. Polypharmacy was a risk factor for slower initiation of treatment...

  10. Long-term performance of the CANDU-type of vanadium self-powered neutron detectors in NRU

    Energy Technology Data Exchange (ETDEWEB)

    Leung, T.C. [Atomic Energy of Canada Limited, Chalk River, Ontario (Canada)]. E-mail: leungt@aecl.ca

    2007-07-01

    The CANDU-type of in-core vanadium self-powered neutron flux detectors have been installed in NRU to monitor the axial neutron flux distributions adjacent to the loop fuel test sites since 1996. This paper describes how the thermal neutron fluxes were measured at two monitoring sites, and presents a method of correcting the vanadium burn-up effect, which can be up to 2 to 3% per year, depending on the detector locations in the reactor. It also presents the results of measurements from neutron flux detectors that have operated for over eight-years in NRU. There is good agreement between the measured and simulated neutron fluxes, to within {+-} 6.5%, and the long-term performance of the CANDU-type of vanadium neutron flux detectors in NRU is satisfactory. (author)

  11. Long-term voice handicap index after type II thyroplasty using titanium bridges for adductor spasmodic dysphonia.

    Science.gov (United States)

    Sanuki, Tetsuji; Yumoto, Eiji; Kodama, Narihiro; Minoda, Ryosei; Kumai, Yoshihiko

    2014-06-01

    To determine the long-term functional outcomes of type II thyroplasty using titanium bridges for adductor spasmodic dysphonia (AdSD) by perceptual analysis using the Voice Handicap Index-10 (VHI-10) and by acoustic analysis. Fifteen patients with AdSD underwent type II thyroplasty using titanium brides between August 2006 and February 2011. VHI-10 scores, a patient-based survey that quantifies a patient's perception of his or her vocal handicap, were determined before and at least 2 years after surgery. Concurrent with the VHI-10 evaluation, acoustic parameters were assessed, including jitter, shimmer, harmonic-to-noise ratio (HNR), standard deviation of F0 (SDF0), and degree of voice breaks (DVB). The average follow-up interval was 30.1 months. No patient had strangulation of the voice, and all were satisfied with the voice postoperatively. In the perceptual analysis, the mean VHI-10 score improved significantly, from 26.7 to 4.1 two years after surgery. All patients had significantly improved each score of three different aspects of VHI-10, representing improved functional, physical, and emotional well-being. All acoustic parameters improved significantly 2 years after surgery. The treatment of AdSD with type II thyroplasty significantly improved the voice-related quality of life and acoustic parameters 2 years after surgery. The results of the study suggest that type II thyroplasty using titanium bridges provides long-term relief of vocal symptoms in patients with AdSD. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  12. Public Values

    DEFF Research Database (Denmark)

    Beck Jørgensen, Torben; Rutgers, Mark R.

    2015-01-01

    administration is approached in terms of processes guided or restricted by public values and as public value creating: public management and public policy-making are both concerned with establishing, following and realizing public values. To study public values a broad perspective is needed. The article suggest......This article provides the introduction to a symposium on contemporary public values research. It is argued that the contribution to this symposium represent a Public Values Perspective, distinct from other specific lines of research that also use public value as a core concept. Public...... a research agenda for this encompasing kind of public values research. Finally the contributions to the symposium are introduced....

  13. Long Term Stability Of Farmer Type Ionization Chamber Calibration Coefficient belonging To Local Radiotherapy Centres In Malaysia

    International Nuclear Information System (INIS)

    Mukhtar, A.M.; Samat, S.B.; Mohd Taufik Dolah

    2014-01-01

    The accuracy of the ionization chambers calibration coefficient is one of the factors that would contribute to efficient radiotherapy treatment. The IAEA therefore has recommended that an ionization chamber be calibrated every year, with a condition that the deviations between the previous and new calibration coefficients N D,w should not differ by ±1.5 %. It has been identified that Farmer type ionization chambers is the most popular ionization chamber among the radiotherapy centres in Malaysia. For this reason, the purpose of this work is to evaluate the calibration coefficients long term stability of the Farmer type ionization chambers. A total of 33 Farmer type ionization chambers were studied and the mean μ of the N D,w deviation together with its standard error SE were calculated. This μ ±SE will be used to measure stability of N D,w . Our results showed that most chambers have μ ±SE lies within the ±1.5 %. It is thus concluded that most of the Farmer type ionization chamber were stable in their N D,w and safe to be used for radiotherapy treatment. (author)

  14. Re-analysis of public genetic data reveals a rare X-chromosomal variant associated with type 2 diabetes.

    Science.gov (United States)

    Bonàs-Guarch, Sílvia; Guindo-Martínez, Marta; Miguel-Escalada, Irene; Grarup, Niels; Sebastian, David; Rodriguez-Fos, Elias; Sánchez, Friman; Planas-Fèlix, Mercè; Cortes-Sánchez, Paula; González, Santi; Timshel, Pascal; Pers, Tune H; Morgan, Claire C; Moran, Ignasi; Atla, Goutham; González, Juan R; Puiggros, Montserrat; Martí, Jonathan; Andersson, Ehm A; Díaz, Carlos; Badia, Rosa M; Udler, Miriam; Leong, Aaron; Kaur, Varindepal; Flannick, Jason; Jørgensen, Torben; Linneberg, Allan; Jørgensen, Marit E; Witte, Daniel R; Christensen, Cramer; Brandslund, Ivan; Appel, Emil V; Scott, Robert A; Luan, Jian'an; Langenberg, Claudia; Wareham, Nicholas J; Pedersen, Oluf; Zorzano, Antonio; Florez, Jose C; Hansen, Torben; Ferrer, Jorge; Mercader, Josep Maria; Torrents, David

    2018-01-22

    The reanalysis of existing GWAS data represents a powerful and cost-effective opportunity to gain insights into the genetics of complex diseases. By reanalyzing publicly available type 2 diabetes (T2D) genome-wide association studies (GWAS) data for 70,127 subjects, we identify seven novel associated regions, five driven by common variants (LYPLAL1, NEUROG3, CAMKK2, ABO, and GIP genes), one by a low-frequency (EHMT2), and one driven by a rare variant in chromosome Xq23, rs146662057, associated with a twofold increased risk for T2D in males. rs146662057 is located within an active enhancer associated with the expression of Angiotensin II Receptor type 2 gene (AGTR2), a modulator of insulin sensitivity, and exhibits allelic specific activity in muscle cells. Beyond providing insights into the genetics and pathophysiology of T2D, these results also underscore the value of reanalyzing publicly available data using novel genetic resources and analytical approaches.

  15. Garcinia kola aqueous suspension prevents cerebellar neurodegeneration in long-term diabetic rat - a type 1 diabetes mellitus model.

    Science.gov (United States)

    Farahna, Mohammed; Seke Etet, Paul F; Osman, Sayed Y; Yurt, Kıymet K; Amir, Naheed; Vecchio, Lorella; Aydin, Isınsu; Aldebasi, Yousef H; Sheikh, Azimullah; Chijuka, John C; Kaplan, Süleyman; Adem, Abdu

    2017-01-04

    The development of compounds able to improve metabolic syndrome and mitigate complications caused by inappropriate glycemic control in type 1 diabetes mellitus is challenging. The medicinal plant with established hypoglycemic properties Garcinia kola Heckel might have the potential to mitigate diabetes mellitus metabolic syndrome and complications. We have investigated the neuroprotective properties of a suspension of G. kola seeds in long-term type 1 diabetes mellitus rat model. Wistar rats, made diabetic by single injection of streptozotocin were monitored for 8 months. Then, they were administered with distilled water or G. kola oral aqueous suspension daily for 30 days. Body weight and glycemia were determined before and after treatment. After sacrifice, cerebella were dissected out and processed for stereological quantification of Purkinje cells. Histopathological and immunohistochemical analyses of markers of neuroinflammation and neurodegeneration were performed. Purkinje cell counts were significantly increased, and histopathological signs of apoptosis and neuroinflammation decreased, in diabetic animals treated with G. kola compared to diabetic rats given distilled water. Glycemia was also markedly improved and body weight restored to non-diabetic control values, following G. kola treatment. These results suggest that G. kola treatment improved the general condition of long-term diabetic rats and protected Purkinje cells partly by improving the systemic glycemia and mitigating neuroinflammation. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  16. Identification and understanding the factors affecting the public and political acceptance of long term storage of spent fuel and high-level radioactive wastes

    International Nuclear Information System (INIS)

    Gorea, Valica

    2006-01-01

    , during the storage. There is a powerful scientific and technical consensus according to which a well placed final repository must be provided with some barriers, including the geological and engineered ones. The wide-spread and accepted concept of final repository for spent fuel and high level waste is the so-called geological disposal which means the solid radioactive waste storage in underground repositories in a stable geological structure (ordinary at some hundreds of meters deep) so ensuring the isolation of radionuclides from biosphere on long term. The types of radioactive waste (high level and long life waste) which will be placed in geological repository are established by the national strategy and politics for the safe management of the radioactive waste. The development and implementation process of a repository can be achieved in the next non compulsory steps: - Developing the national politics in the field of safe management of the radioactive waste - Developing the legislative and institutional framework - Developing the technical concept of geological repository - Initiation of underground and surface investigations for the characterization of the host rock - Selecting the suitable site for an underground repository - Design, licensing for construction (which takes into account the environmental impact, nuclear safety and so on), operation and shut down. The decision to construct a geological repository must be taken by the Government or by the producers of waste. The steps for the establishing the legal framework, regulation and licensing are prerogatives of the Government, all the others steps could be achieved by non governmental organizations. The achievement of a geological repository, from the technical concept to the operation may last even more than 50 years and its operation some hundreds years. The paper contains the following sections: 1. Introduction; 2. Public and political acceptance; 3. Factors which affect the public and political

  17. High Rates of Herpes Simplex Virus Type 2 Infection in Homeless Women: Informing Public Health Strategies.

    Science.gov (United States)

    Kelly, J Daniel; Cohen, Jennifer; Grimes, Barbara; Philip, Susan S; Weiser, Sheri D; Riley, Elise D

    2016-08-01

    Homeless and unstably housed women living in an urban setting are at risk for sexually transmitted diseases, yet the seroprevalence and correlates of herpes simplex virus type 2 (HSV-2) specific to impoverished women are poorly understood. Between April and October 2010, we conducted a cross-sectional analysis of sociodemographic, structural, and behavioral factors associated with prevalent HSV-2 infection (recent and historical infections) within a community-recruited cohort of homeless and unstably housed women. Logistic regression modeling was used to identify independent sociobehavioral correlates of HSV-2 infection. Among 213 women (114 HIV positive and 99 HIV negative), the median age was 49, 48% were African American, and 63% had completed high school. HSV-2 seroprevalence was 88%, and only 17% of infected women were aware of their infection. In adjusted analysis, odds of HSV-2 infection were significantly higher for those reporting at-risk drinking (adjusted odds ratio [AOR] = 7.04; 95% confidence interval [CI] = 1.59, 67.91), heterosexual orientation (AOR = 4.56; 95% CI = 1.81, 11.69), and for those who were HIV positive (AOR = 3.64; 95% CI = 1.43, 10.30). Odds of HSV-2 infection decreased as current income increased (AOR for each $500 monthly increase = 0.90; 95% CI = 0.78, 0.997). There is an extremely high seroprevalence of HSV-2 infection among homeless and unstably housed women, and most are unaware of their HSV-2 status. Screening all unstably housed women for HSV-2 infection, with additional counseling for sexual risk and alcohol use, may lead to the identification of more infections and be a first step in reducing additional disease transmission.

  18. Short-term intensive insulin therapy in type 2 diabetes mellitus: a systematic review and meta-analysis.

    Science.gov (United States)

    Kramer, Caroline Kaercher; Zinman, Bernard; Retnakaran, Ravi

    2013-09-01

    Studies have shown that, when implemented early in the course of type 2 diabetes mellitus, treatment with intensive insulin therapy for 2-3 weeks can induce a glycaemic remission, wherein patients are able to maintain normoglycaemia without any anti-diabetic medication. We thus did a systematic review and meta-analysis of interventional studies to assess the effect of short-term intensive insulin therapy on the pathophysiological defects underlying type 2 diabetes mellitus (pancreatic β-cell dysfunction and insulin resistance) and identify clinical predictors of remission. We identified studies published between 1950 and Nov 19, 2012, which assessed the effect of intensive insulin therapy on β-cell function or insulin resistance, or both, or assessed long-term drug-free glycaemic remission in adults aged 18 years or older with newly diagnosed type 2 diabetes mellitus. We calculated pooled estimates by random-effects model. This study is registered with International Prospective Register of Systematic Reviews, number CRD42012002829. We identified 1645 studies of which seven fulfilled inclusion criteria (n=839 participants). Five studies were non-randomised. A pooled analysis of the seven studies showed a post-intensive insulin therapy increase in Homeostasis Model Assessment of β-cell function as compared with baseline (1·13, 95% CI 1·02 to 1·25) and a decrease in Homeostasis Model Assessment of Insulin Resistance (-0·57, -0·84 to -0·29). In the four studies that assessed glycaemic remission (n=559 participants), the proportion of participants in drug-free remission was about 66·2% (292 of 441 patients) after 3 months of follow-up, about 58·9% (222 of 377 patients) after 6 months, about 46·3% (229 of 495 patients) after 12 months, and about 42·1% (53 of 126 patients) after 24 months. Patients who achieved remission had higher body-mass index than those who did not achieve remission (1·06 kg/m(2), 95% CI 0·55 to 1·58) and lower fasting plasma glucose

  19. Short-term association between sulfur dioxide and daily mortality: the Public Health and Air Pollution in Asia (PAPA) study.

    Science.gov (United States)

    Kan, Haidong; Wong, Chit-Ming; Vichit-Vadakan, Nuntavarn; Qian, Zhengmin

    2010-04-01

    Sulfur dioxide (SO(2)) has been associated with increased mortality and morbidity, but only few studies were conducted in Asian countries. Previous studies suggest that SO(2) may have adverse health effects independent of other pollutants. In the Public Health and Air Pollution in Asia (PAPA) project, the short-term associations between ambient sulfur dioxide (SO(2)) and daily mortality were examined in Bangkok, Thailand, and three Chinese cities: Hong Kong, Shanghai, and Wuhan. Poisson regression models incorporating natural spline smoothing functions were used to adjust for seasonality and other time-varying covariates. Effect estimates were obtained for each city and then for the cities combined. The impact of alternative model specifications, such as lag structure of pollutants and degree of freedom (df) for time trend, on the estimated effects of SO(2) were also examined. In both individual-city and combined analysis, significant effects of SO(2) on total non-accidental and cardiopulmonary mortality were observed. An increase of 10 microg/m(3) of 2-day moving average concentrations of SO(2) corresponded to 1.00% [95% confidence interval (CI), 0.75-1.24], 1.09% (95% CI, 0.71-1.47), and 1.47% (95% CI, 0.85-2.08) increase of total, cardiovascular and respiratory mortality, respectively, in the combined analysis. Sensitivity analyzes suggested that these findings were generally insensitive to alternative model specifications. After adjustment for PM(10) or O(3), the effect of SO(2) remained significant in three Chinese cities. However, adjustment for NO(2) diminished the associations and rendered them statistically insignificant in all four cities. In conclusion, ambient SO(2) concentration was associated with daily mortality in these four Asian cities. These associations may be attributable to SO(2) serving as a surrogate of other substances. Our findings suggest that the role of outdoor exposure to SO(2) should be investigated further in this region. (c) 2010

  20. The roles of the cyclo-oxygenases types one and two in prostaglandin synthesis in human fetal membranes at term.

    Science.gov (United States)

    Sawdy, R J; Slater, D M; Dennes, W J; Sullivan, M H; Bennett, P R

    2000-01-01

    The aim of this study was to determine the relative contributions of cyclo-oxygenase (COX) types 1 and 2 to prostaglandin synthesis at term. Fetal membranes were collected from 6 pregnancies after elective caesarean section at term, prior to labour. The presence of COX-1 and COX-2 protein was determined using Western analysis. The relative contributions of the two isoforms of COX to prostaglandin synthesis were determined by incubation of fetal membrane discs with either a COX-2 selective inhibitor, SC236, or a COX-1 selective inhibitor, SC560, and measurement of prostaglandin release during 24 h using enzyme-linked immuno-sorbent assay (ELISA). Both COX-1 and COX-2 protein were demonstrated in amnion and chorion-decidua. The COX-2 selective inhibitor, SC-236, significantly reduced prostaglandin synthesis, both in its COX-2 specific and higher, non-specific concentration ranges. The COX-1 selective inhibitor, SC-560, had no effect upon prostaglandin synthesis in its COX-1 specific concentration range, but did significantly reduce prostaglandin synthesis at higher, non-selective concentrations. Fetal membranes contain both COX-1 and COX-2 at term, but only COX-2 contributes towards prostaglandin synthesis. COX-2 selective NSAI drugs will be as effective as non-selective agents in inhibition of fetal membrane prostaglandin synthesis and may represent a new strategy for tocolysis. Copyright 2000 Harcourt Publishers Ltd.

  1. Short-term stability in refractive status despite large fluctuations in glucose levels in diabetes mellitus type 1 and 2.

    Directory of Open Access Journals (Sweden)

    Byki Huntjens

    Full Text Available PURPOSE: This work investigates how short-term changes in blood glucose concentration affect the refractive components of the diabetic eye in patients with long-term Type 1 and Type 2 diabetes. METHODS: Blood glucose concentration, refractive error components (mean spherical equivalent MSE, J0, J45, central corneal thickness (CCT, anterior chamber depth (ACD, crystalline lens thickness (LT, axial length (AL and ocular aberrations were monitored at two-hourly intervals over a 12-hour period in: 20 T1DM patients (mean age ± SD 38±14 years, baseline HbA1c 8.6±1.9%; 21 T2DM patients (mean age ± SD 56±11 years, HbA1c 7.5±1.8%; and in 20 control subjects (mean age ± SD 49±23 years, HbA1c 5.5±0.5%. The refractive and biometric results were compared with the corresponding changes in blood glucose concentration. RESULTS: Blood glucose concentration at different times was found to vary significantly within (p0.05. Minor changes of marginal statistical or optical significance were observed in some biometric parameters. Similarly there were some marginally significant differences between the baseline biometric parameters of well-controlled and poorly-controlled diabetic subjects. CONCLUSION: This work suggests that normal, short-term fluctuations (of up to about 6 mM/l on a timescale of a few hours in the blood glucose levels of diabetics are not usually associated with acute changes in refractive error or ocular wavefront aberrations. It is therefore possible that factors other than refractive error fluctuations are sometimes responsible for the transient visual problems often reported by diabetic patients.

  2. Predictors of Long-Term Remission and Relapse of Type 2 Diabetes Mellitus Following Gastric Bypass in Severely Obese Patients.

    Science.gov (United States)

    de Oliveira, Vanessa Lopes Preto; Martins, Gianluca P; Mottin, Cláudio C; Rizzolli, Jacqueline; Friedman, Rogério

    2018-01-01

    Diabetes remission is not observed in all obese patients with type 2 diabetes submitted to bariatric surgery. Relapses occur in patients in whom remission is achieved. We investigated the factors associated with long-term (≥3 years) remission and relapse of type 2 diabetes after Roux-en-Y gastric bypass (RYGB) in these patients. By a retrospective review, we analyzed data from 254 patients with type 2 diabetes who had undergone RYGB from May 2000 to November 2011 and had at least 3 years of follow-up. The criteria for remission and relapse of type 2 diabetes followed the current American Diabetes Association recommendations. Remission was achieved in almost 82% of participants (69.7% complete, and 12.2% partial remission). Of these, 12% relapsed within a mean follow-up of 5.1 ± 2.0 years after surgery. Predictors of complete remission were younger age, better preoperative glycemic control, and shorter diabetes duration. Preoperative insulin use was associated with a ninefold increase in the relapse hazard (HR = 9.1 (95% CI: 3.3-25.4)). Use of two or more oral anti-diabetic agents increased the relapse hazard sixfold (HR = 6.1 (95% CI: 1.8-20.6)). Eighteen point one percent of patients did not achieve any remission during follow-up. However, they exhibited significant improvements in glycemic control. These data indicate that RYGB should not be delayed when remission of type 2 diabetes is a therapeutic goal, and also suggest that the best possible metabolic control should be sought in obese patients who may eventually be candidates for RYGB.

  3. Metabolic control in patients with type 2 diabetes mellitus in a public hospital in Peru: a cross-sectional study in a low-middle income country.

    Science.gov (United States)

    Huayanay-Espinoza, Irma Elizabeth; Guerra-Castañon, Felix; Lazo-Porras, María; Castaneda-Guarderas, Ana; Thomas, Nimmy Josephine; Garcia-Guarniz, Ana-Lucia; Valdivia-Bustamante, Augusto A; Málaga, Germán

    2016-01-01

    The objective of this study was to assess patients' achievement of ADA (American Diabetes Association) guideline recommendations for glycosylated hemoglobin, lipid profile, and blood pressure in a type 2 diabetes mellitus (T2DM) outpatient clinic in a low-middle income country (LMIC) setting. This is a descriptive cross-sectional study with 123 ambulatory T2DM patients who are being treated at a public hospital in Lima, Peru. Data was gathered via standardized interviews, clinical surveys, and anthropomorphic measurements for each patient. Blood samples were drawn in fasting state for measures of glucose, glycosylated hemoglobin (HbA1c), and lipid profile. Laboratory parameters and blood pressure were evaluated according to ADA recommendations. Of the 123 patients, 81 were women and the mean age was 61.8 years. Glycemic control was abnormal in 82 (68.33%) participants, and 45 (37.50%) were unable to control their blood pressure. Lipid profile was abnormal in 73 (60.83%) participants. Only nine (7.50%) participants fulfilled ADA recommendations for glycemic, blood pressure, and lipid control. Amongst individuals with type 2 diabetes, there was poor attainment of the ADA recommendations (HbA1c, blood pressure and LDL-cholesterol) for ambulatory T2DM patients. Interventions are urgently needed in order to prevent long-term diabetic complications.

  4. Metabolic control in patients with type 2 diabetes mellitus in a public hospital in Peru: a cross-sectional study in a low-middle income country

    Directory of Open Access Journals (Sweden)

    Irma Elizabeth Huayanay-Espinoza

    2016-10-01

    Full Text Available Objective The objective of this study was to assess patients’ achievement of ADA (American Diabetes Association guideline recommendations for glycosylated hemoglobin, lipid profile, and blood pressure in a type 2 diabetes mellitus (T2DM outpatient clinic in a low-middle income country (LMIC setting. Methods This is a descriptive cross-sectional study with 123 ambulatory T2DM patients who are being treated at a public hospital in Lima, Peru. Data was gathered via standardized interviews, clinical surveys, and anthropomorphic measurements for each patient. Blood samples were drawn in fasting state for measures of glucose, glycosylated hemoglobin (HbA1c, and lipid profile. Laboratory parameters and blood pressure were evaluated according to ADA recommendations. Results Of the 123 patients, 81 were women and the mean age was 61.8 years. Glycemic control was abnormal in 82 (68.33% participants, and 45 (37.50% were unable to control their blood pressure. Lipid profile was abnormal in 73 (60.83% participants. Only nine (7.50% participants fulfilled ADA recommendations for glycemic, blood pressure, and lipid control. Conclusions Amongst individuals with type 2 diabetes, there was poor attainment of the ADA recommendations (HbA1c, blood pressure and LDL-cholesterol for ambulatory T2DM patients. Interventions are urgently needed in order to prevent long-term diabetic complications.

  5. Long-Term Cost-Effectiveness of Insulin Glargine Versus Neutral Protamine Hagedorn Insulin for Type 2 Diabetes in Thailand.

    Science.gov (United States)

    Permsuwan, Unchalee; Chaiyakunapruk, Nathorn; Dilokthornsakul, Piyameth; Thavorn, Kednapa; Saokaew, Surasak

    2016-06-01

    Even though Insulin glargine (IGlar) has been available and used in other countries for more than a decade, it has not been adopted into Thai national formulary. This study aimed to evaluate the long-term cost effectiveness of IGlar versus neutral protamine Hagedorn (NPH) insulin in type 2 diabetes from the perspective of Thai Health Care System. A validated computer simulation model (the IMS CORE Diabetes Model) was used to estimate the long-term projection of costs and clinical outcomes. The model was populated with published characteristics of Thai patients with type 2 diabetes. Baseline risk factors were obtained from Thai cohort studies, while relative risk reduction was derived from a meta-analysis study conducted by the Canadian Agency for Drugs and Technology in Health. Only direct costs were taken into account. Costs of diabetes management and complications were obtained from hospital databases in Thailand. Both costs and outcomes were discounted at 3 % per annum and presented in US dollars in terms of 2014 dollar value. Incremental cost-effectiveness ratio (ICER) was calculated. One-way and probabilistic sensitivity analyses were also performed. IGlar is associated with a slight gain in quality-adjusted life years (0.488 QALYs), an additional life expectancy (0.677 life years), and an incremental cost of THB119,543 (US$3522.19) compared with NPH insulin. The ICERs were THB244,915/QALY (US$7216.12/QALY) and THB176,525/life-year gained (LYG) (US$5201.09/LYG). The ICER was sensitive to discount rates and IGlar cost. At the acceptable willingness to pay of THB160,000/QALY (US$4714.20/QALY), the probability that IGlar was cost effective was less than 20 %. Compared to treatment with NPH insulin, treatment with IGlar in type 2 diabetes patients who had uncontrolled blood glucose with oral anti-diabetic drugs did not represent good value for money at the acceptable threshold in Thailand.

  6. Arthroscopic Partial Capitate Resection for Type Ia Avascular Necrosis: A Short-Term Outcome Analysis.

    Science.gov (United States)

    Shimizu, Takamasa; Omokawa, Shohei; del Piñal, Francisco; Shigematsu, Koji; Moritomo, Hisao; Tanaka, Yasuhito

    2015-12-01

    To examine short-term clinical results of arthroscopic partial resection for type Ia avascular necrosis of the capitate. Patients who underwent arthroscopic treatment for type 1a avascular necrosis of the capitate with at least 1-year follow-up were identified through a retrospective chart review. The necrotic capitate head was arthroscopically resected with removal of the lunate facet and preservation of the scaphoid and hamate facets. Wrist range of motion, grip strength, and radiographic parameters--carpal height ratio, radioscaphoid angle, and radiolunate angle-were determined before surgery and at the latest follow-up. Patients completed a visual analog scale for pain; Disabilities of the Arm, Shoulder, and Hand measure; and the Patient-Rated Wrist Evaluation score before surgery and at the latest follow-up. Five patients (1 male, 4 females) with a mean age of 34 years (range, 16-49 years) and a mean follow-up duration of 20 months (range, 12-36 months) were identified during the chart review. All were type Ia (Milliez classification). Arthroscopy revealed fibrillation or softening with cartilage detachment at the lunate facet of the capitate head and an intact articular surface at the scaphoid and hamate facet. At the latest follow-up, the mean wrist flexion-extension was 123° (vs 81° before surgery) and grip strength was 74% (vs 37% before surgery). The visual analog scale score for pain; the Disabilities of the Arm, Shoulder, and Hand score; and the Patient-Rated Wrist Evaluation score before surgery showed a significant improvement following treatment. Radiographic parameters did not significantly change at the final follow-up, although the proximal carpal row trended toward flexion. Arthroscopic partial resection of the capitate head was an acceptable treatment for type Ia avascular necrosis of the capitate. It provided adequate pain relief and improved the range of wrist motion and grip strength during short-term follow-up. Therapeutic IV. Copyright

  7. 77 FR 57545 - Long Term 2 Enhanced Surface Water Treatment Rule: Public Meeting on Monitoring Data Analysis...

    Science.gov (United States)

    2012-09-18

    ... Water Treatment Rule: Public Meeting on Monitoring Data Analysis, Occurrence Forecasts, Binning, and the... solicit public input on data and information related to several topics. The first topic is the results of... Review process. EPA will consider the data and/or information discussed at this meeting during the agency...

  8. Multicultural, Intercultural Diversity--What Do We Call "It" and How Do These Terms Show Up in Public Relations Efforts?

    Science.gov (United States)

    Neff, Bonita Dostal

    Diversity should be first understood from an individual's own culture. Yet few public relations professionals have had a course in interpersonal communication. If public relations is viewed as a profession where the management of people is important, then knowledge of diversity in the workplace seems imperative. The multicultural, intercultural,…

  9. 41 CFR Appendix C to Part 102 - 37-Glossary of Terms for Determining Eligibility of Public Agencies and Nonprofit Organizations

    Science.gov (United States)

    2010-07-01

    ... available on a regular visiting basis, qualified professionals in the fields of medicine, psychology... in a community or given political area. Public educational programs may include public school systems... library services free to all residents of a community, district, State, or region. Licensed means...

  10. The decision-making process in public healthcare entities – identification of the decision-making process type

    Directory of Open Access Journals (Sweden)

    Szymaniec-Mlicka Karolina

    2017-05-01

    Full Text Available The decisions made in the organization determine its success, therefore, conducting studies in the scope of decision-making seems important both for theory and practice. The aim of the studies was to identify the type of decision-making process in public medical entities with the use of typology developed by P. Nutt. For this purpose we used qualitative methods. Interviews with 8 directors of hospitals were conducted and the reconstruction was made on the basis of the decision-making process, which enabled the assignment of the model of decision-making process to the organization. The research indicated that four organizations use the historical decision-making model, three organizations represent the model of generating solutions, and one organization uses the model of available solutions.

  11. Sensory and short-term memory formations observed in a Ag2S gap-type atomic switch

    Science.gov (United States)

    Ohno, Takeo; Hasegawa, Tsuyoshi; Nayak, Alpana; Tsuruoka, Tohru; Gimzewski, James K.; Aono, Masakazu

    2011-11-01

    Memorization caused by the change in conductance in a Ag2S gap-type atomic switch was investigated as a function of the amplitude and width of input voltage pulses (Vin). The conductance changed little for the first few Vin, but the information of the input was stored as a redistribution of Ag-ions in the Ag2S, indicating the formation of sensory memory. After a certain number of Vin, the conductance increased abruptly followed by a gradual decrease, indicating the formation of short-term memory (STM). We found that the probability of STM formation depends strongly on the amplitude and width of Vin, which resembles the learning behavior of the human brain.

  12. Long-term effect of smartphone-delivered Interval Walking Training on physical activity in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Valentiner, Laura Staun; Ried-Larsen, Mathias; Karstoft, Kristian

    2017-01-01

    INTRODUCTION: Physical activity is a cornerstone in type 2 diabetes (T2D) rehabilitation. Effective long-term and low-cost strategies to keep these patients' physically active are needed. However, maintaining physical activity behaviour is difficult once formalised interventions end. Structured...... exercise training supported by mobile technology and remote feedback is potentially an effective strategy. The objective of the trial is to investigate whether mobile health support using the InterWalk application for smartphones is effective in increasing physical activity levels in persons with T2D over...... time compared with standard care. We investigate whether Interval Walking Training using the InterWalk application is superior to Danish municipality-based rehabilitation in increasing moderate-and-vigorous physical activity levels in patients with T2D across 52 weeks. Secondary, we hypothesise...

  13. Long-Term effect of smartphone-delivered Interval Walking Training on physical activity in patients with type 2 diabetes

    DEFF Research Database (Denmark)

    Valentiner, Laura Staun; Ried-Larsen, Mathias; Karstoft, Kristian

    2017-01-01

    exercise training supported by mobile technology and remote feedback is potentially an effective strategy. The objective of the trial is to investigate whether mobile health support using the InterWalk application for smartphones is effective in increasing physical activity levels in persons with T2D over......Introduction Physical activity is a cornerstone in type 2 diabetes (T2D) rehabilitation. Effective long-Term and low-cost strategies to keep these patients' physically active are needed. However, maintaining physical activity behaviour is difficult once formalised interventions end. Structured...... time compared with standard care. We investigate whether Interval Walking Training using the InterWalk application is superior to Danish municipality-based rehabilitation in increasing moderate-And-vigorous physical activity levels in patients with T2D across 52â €..weeks. Secondary, we hypothesise...

  14. Long term immersion test of aluminum alloy AA 6061 used for fuel cladding in MTR type reactors

    International Nuclear Information System (INIS)

    Linardi, Evelina M.; Rodriguez, Sebastian; Haddad, Roberto; Lanzani, Liliana

    2009-01-01

    In this work we present the results of long term immersion tests performed in the aluminum alloy AA 6061, used for fuel cladding in MTR type reactors. The tests were performed at open circuit potential in high purity water (ρ = 18.2 MΩ.cm) and in 10 -3 M NaCl solution. Two kinds of assemblies were studied: simple sheets and artificial crevices, immersed during 6, 12 and 18 months at room temperature. In both media and both assemblies, the aluminum hydroxide phases crystalline bayerite and bohemite were identified. It was found that a kind of localized attack named alkaline attack occurs around the iron-rich intermetallics. These particles were confirmed to control the corrosion of the AA 6061 alloy in an aerated medium. Immersion times for up to 18 months did not increase the oxide growth or the alkaline attack on the AA 6061 alloy. (author)

  15. Post-stroke angiotensin II type 2 receptor activation provides long-term neuroprotection in aged rats

    DEFF Research Database (Denmark)

    Bennion, Douglas M; Isenberg, Jacob D; Harmel, Allison T

    2017-01-01

    Activation of the angiotensin II type 2 receptor (AT2R) by administration of Compound 21 (C21), a selective AT2R agonist, induces neuroprotection in models of ischemic stroke in young adult animals. The mechanisms of this neuroprotective action are varied, and may include direct and indirect....... These findings demonstrate that the neuroprotection previously characterized only during earlier time points using stroke models in young animals is sustained long-term in aged rats, implying even greater clinical relevance for the study of AT2R agonists for the acute treatment of ischemic stroke in human....... Intraperitoneal injections of C21 (0.03mg/kg) after ischemic stroke induced by transient monofilament middle cerebral artery occlusion resulted in protective effects that were sustained for up to at least 3-weeks post-stroke. These included improved neurological function across multiple assessments...

  16. Energy Consumption in Terms of Shear Stress for Two Types of Membrane Bioreactors used for Municipal Wastewater Treatment Processes

    DEFF Research Database (Denmark)

    Ratkovich, Nicolas Rios; Bentzen, Thomas Ruby; Rasmussen, Michael R.

    2012-01-01

    Two types of submerged membrane bioreactors (MBR): hollow fiber (HF) and hollow sheet (HS), have been studied and compared in terms of energy consumption and average shear stress over the membrane wall. The analysis of energy consumption was made using the correlation to determine the blower power...... of shear stress over the membrane surface was made using computational fluid dynamics (CFD) modelling. Experimental measurements for the HF MBR were compared with the CFD model and an error less that 8% was obtained. For the HS MBR, experimental measurements of velocity profiles were made and an error...... of 11% was found. This work uses an empirical relationship to determine the shear stress based on the ratio of aeration blower power to tank volume. This relationship is used in bubble column reactors and it is extrapolate to determine shear stress on MBR systems. This relationship proved...

  17. The Employee’s Perception of Leadership Style in the Independent Public Institution as National Bank of Romania (NBR Type

    Directory of Open Access Journals (Sweden)

    Sergiu GEANTĂ

    2015-12-01

    Full Text Available Leadership style literature in the independent public institution, such as national bank type, is a subject with a high potential for research studies, especially in Romania. As organizational culture, leadership style is considered to be an important element for the public institution performance and work satisfaction of the employees. The aim of this research paper is to identify which leadership style is more common in the employee’s perception of National Bank of Romania (NBR. According to this, as a scientific research method it was used a quantitative method based on a questionnaire. In the period of March-June 2015 it was applied a questionnaire with 23 items on a Likert Scale (20 regarding leadership style and 3 regarding respondent profile on a total population of 1860 employees. Items measured were used from Leader Behavior Description Questionnaire Version 12 LBDQ XII and Multifactor Leadership Questionnaire (5X. After analyzing and interpreting the results related to the perception of employees on leadership style to hierarchic direct superior, it can be concluded that leadership styles often identified by employees are authoritarian leadership style and participative leadership style, both with a 82% percentage of totally agree responses.

  18. Behavioral and biological correlates of medicine use in type 2 diabetic patients attended by Brazilian public healthcare system

    Directory of Open Access Journals (Sweden)

    Jamile Sanches Codogno

    2013-01-01

    Full Text Available DOI: http://dx.doi.org/10.5007/1980-0037.2013v15n1p82 The relationship between physical activity and the use of medicines is not clear. The purpose of this study was to investigate this relationship between the level of physical activity and the use of medications by type 2 diabetic patients who were attended in the Brazilian public healthcare system. The sample was composed of 121 Brazilian diabetic patients, of both genders, attended by the public healthcare system. Body fat (estimated by anthropometry and bioelectrical impedance, physical activity (measured by Baecke’s questionnaire, and the participant’s use of medicines (during the 15 days before evaluation were assessed. There was a relationship between the use of medicines and: gender (r = 0.18; p = 0.045, body mass index (BMI (r = 0.22; p = 0.012, waist circumference (r = 0.19; p = 0.029, body fat percentage (r = 0.21; p = 0.016, age (r = 0.23; p = 0.009, and level of physical activity (r = -0.22; p = 0.012. Linear regression included in the multivariate model only age (β = 0.718; p = 0.057, BMI (β= 0.057; p = 0.022, and level of physical activity (β = -0.176; p = 0.044. In conclusion, physical activity decreases medicinal use independent of age or obesity.

  19. Prognosis of type 1 autoimmune pancreatitis after corticosteroid therapy-induced remission in terms of relapse and diabetes mellitus.

    Directory of Open Access Journals (Sweden)

    Masaki Miyazawa

    Full Text Available Relapse and diabetes mellitus (DM are major problems for the prognosis of autoimmune pancreatitis (AIP. We examined the prognosis of type 1 AIP after corticosteroid therapy (CST-induced remission in terms of relapse and DM.The study enrolled 82 patients diagnosed with type 1 AIP who achieved remission with CST. We retrospectively evaluated the relapse rate in terms of the administration period of CST, clinical factors associated with relapse, and the temporal change in glucose tolerance.During follow-up, 32 patients (39.0% experienced relapse. There was no significant clinical factor that could predict relapse before beginning CST. AIP patients who ceased CST within 2 or 3 years experienced significantly earlier relapse than those who had the continuance of CST (p = 0.050 or p = 0.020. Of the 37 DM patients, 15 patients (40.5% had pre-existing DM, 17 (45.9% showed new-onset DM, and 5 (13.5% developed CST-induced DM. Patients with new-onset DM were significantly more likely to show improvement (p = 0.008 than those with pre-existing DM.It was difficult to predict relapse of AIP based on clinical parameters before beginning CST. Relapse was likely to occur within 3 years after the beginning of CST and maintenance of CST for at least 3 years reduced the risk of relapse. The early initiation of CST for AIP with impaired glucose tolerance is desirable because pre-existing DM is refractory to CST.

  20. Impact of maternal diabetes type 1 on proliferative potential, differentiation and apoptotic activity in villous capillaries of term placenta.

    Science.gov (United States)

    Jirkovská, Marie; Kučera, Tomáš; Dvořáková, Veronika; Jadrníček, Martin; Moravcová, Milena; Žižka, Zdeněk; Krejčí, Vratislav

    2016-04-01

    Maternal diabetes mellitus changes morphology and impairs function of placental capillaries. Here, quantitative parameters characterizing cell proliferation using detection of Ki67, differentiation reflected by nestin expression and apoptosis in placental capillary bed with active caspase 3 as a marker were compared in normal term placentas and placentas from pregnancies complicated by Type 1 maternal diabetes mellitus. Specimens of sixteen diabetic placentas and eight control placentas were collected by systematic uniform random sampling. Immunohistochemical detections of Ki67, nestin, and active caspase 3 were performed in histological sections of five haphazardly chosen blocks per placenta. Twenty fields of view per section, i.e. one hundred fields of view per placenta, were used for analysis of proliferation as well as of apoptosis, and in approximately 70 capillary cross-sections per placenta the nestin-positive segments of their circumference were measured. The percentage of Ki67-positive cells counted in the capillary wall was significantly lower in diabetic group. The counts of Ki67-labelled nuclei per villous area unit were significantly lower in cytotrophoblast and capillary wall of terminal villi in diabetic placenta. The proportion of nestin-labeled segments of capillary circumference was significantly higher in placentas of diabetic group. No differences in the numbers of apoptotic cells were found between studied groups. The results show that the term placenta in Type 1 diabetes has lower potential to enlarge the surface area of structures involved in maternofetal transport, and that the villous capillary bed displays delayed differentiation. Those factors may participate in decreased ability of diabetic placenta to comply with fetal requirements in the final stage of pregnancy. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. How does aging affect the types of error made in a visual short-term memory 'object-recall' task?

    Science.gov (United States)

    Sapkota, Raju P; van der Linde, Ian; Pardhan, Shahina

    2014-01-01

    This study examines how normal aging affects the occurrence of different types of incorrect responses in a visual short-term memory (VSTM) object-recall task. Seventeen young (Mean = 23.3 years, SD = 3.76), and 17 normally aging older (Mean = 66.5 years, SD = 6.30) adults participated. Memory stimuli comprised two or four real world objects (the memory load) presented sequentially, each for 650 ms, at random locations on a computer screen. After a 1000 ms retention interval, a test display was presented, comprising an empty box at one of the previously presented two or four memory stimulus locations. Participants were asked to report the name of the object presented at the cued location. Errors rates wherein participants reported the names of objects that had been presented in the memory display but not at the cued location (non-target errors) vs. objects that had not been presented at all in the memory display (non-memory errors) were compared. Significant effects of aging, memory load and target recency on error type and absolute error rates were found. Non-target error rate was higher than non-memory error rate in both age groups, indicating that VSTM may have been more often than not populated with partial traces of previously presented items. At high memory load, non-memory error rate was higher in young participants (compared to older participants) when the memory target had been presented at the earliest temporal position. However, non-target error rates exhibited a reversed trend, i.e., greater error rates were found in older participants when the memory target had been presented at the two most recent temporal positions. Data are interpreted in terms of proactive interference (earlier examined non-target items interfering with more recent items), false memories (non-memory items which have a categorical relationship to presented items, interfering with memory targets), slot and flexible resource models, and spatial coding deficits.

  2. Free triiodothyronine levels and short-term prognosis in chronic heart failure patients with type 2 diabetes.

    Science.gov (United States)

    Chen, Pingan; Li, Shaonan; Lei, Xiaoming; Liu, Zhen; Wu, Daihong; Luo, Yi; Xu, Dingli

    2015-08-01

    In chronic heart failure (CHF) patients with type 2 diabetes mellitus (T2DM), the role of thyroid hormone (TH) in predicting CHF severity and prognosis is unclear. The authors therefore investigated the role of TH in predicting CHF severity and prognosis in these specific patients. A total of 224 CHF patients (114 with T2DM) over a mean follow-up time of 6.56 ± 0.18 months were studied. TH, N-terminal pro-B-type natriuretic peptide (NT-proBNP) and other parameters were measured. Free triiodothyronine (FT3) levels were lower in the T2DM group compared with the nondiabetes group (P = 0.026) and higher in the New York Heart Association (NYHA) I group than in the NYHA III and IV groups (both P < 0.05). Compared with the low NT-proBNP group, the high NT-proBNP group had lower FT3 levels (P < 0.01). NT-proBNP correlated with NYHA classes (r = 0.541, P < 0.001), and inversely correlated with left ventricular ejection fraction (r = -0.431, P < 0.001) and FT3 levels (r = -0.335, P < 0.001). In multiple linear regression analysis, NT-proBNP was significantly correlated with NYHA classes (P < 0.001), left ventricular ejection fraction (P < 0.001) and FT3 (P = 0.004). Kaplan-Meier curves showed that the low FT3 group had an increased rate of short-term adverse outcomes of CHF (log rank, χ = 9.794, P = 0.002). FT3 levels are associated with the severity of CHF and seem to reflect short-term outcomes in CHF patients with T2DM.

  3. Evaluation of the long-term cost-effectiveness of liraglutide therapy for patients with type 2 diabetes in France.

    Science.gov (United States)

    Roussel, Ronan; Martinez, Luc; Vandebrouck, Tom; Douik, Habiba; Emiel, Patrick; Guery, Matthieu; Hunt, Barnaby; Valentine, William J

    2016-01-01

    The present study aimed to compare the projected long-term clinical and cost implications associated with liraglutide, sitagliptin and glimepiride in patients with type 2 diabetes mellitus failing to achieve glycemic control on metformin monotherapy in France. Clinical input data for the modeling analysis were taken from two randomized, controlled trials (LIRA-DPP4 and LEAD-2). Long-term (patient lifetime) projections of clinical outcomes and direct costs (2013 Euros; €) were made using a validated computer simulation model of type 2 diabetes. Costs were taken from published France-specific sources. Future costs and clinical benefits were discounted at 3% annually. Sensitivity analyses were performed. Liraglutide was associated with an increase in quality-adjusted life expectancy of 0.25 quality-adjusted life years (QALYs) and an increase in mean direct healthcare costs of €2558 per patient compared with sitagliptin. In the comparison with glimepiride, liraglutide was associated with an increase in quality-adjusted life expectancy of 0.23 QALYs and an increase in direct costs of €4695. Based on these estimates, liraglutide was associated with an incremental cost-effectiveness ratio (ICER) of €10,275 per QALY gained vs sitagliptin and €20,709 per QALY gained vs glimepiride in France. Calculated ICERs for both comparisons fell below the commonly quoted willingness-to-pay threshold of €30,000 per QALY gained. Therefore, liraglutide is likely to be cost-effective vs sitagliptin and glimepiride from a healthcare payer perspective in France.

  4. A prospective study of severe hypoglycemia and long-term spatial memory in children with type 1 diabetes.

    Science.gov (United States)

    Hershey, Tamara; Lillie, Rema; Sadler, Michelle; White, Neil H

    2004-06-01

    In a previous retrospective study, severe hypoglycemia (SH) was associated with decreased long-term spatial memory in children with type 1 diabetes mellitus (T1DM). In this study, we tested the hypothesis that prospectively ascertained SH would also be associated with decreased spatial long-term memory over time. Children with T1DM (n = 42) and sibling controls (n = 25) performed a spatial delayed response (SDR) task with short and long delays and other neuropsychological tests at baseline and after 15 months of monitoring. Extreme glycemic events and other medical complications were recorded prospectively during follow-up. Fourteen T1DM children experienced at least one episode of SH during the follow-up period (range = 1-5). After controlling for long-delay SDR performance at baseline, age, gender, and age of onset, the presence of SH during the prospective period was statistically associated with decreased long-delay SDR performance at follow-up (semipartial r = -0.38, p = 0.017). This relationship was not seen with short-delay SDR or with verbal or object memory, attention, or motor speed. These results, together with previously reported data, support the hypothesis that SH has specific, negative effects on spatial memory skills in T1DM children.

  5. Long-Term Spectroscopic Monitoring and Surveys of Early-Type Stars with and without Circumstellar Envelopes

    Directory of Open Access Journals (Sweden)

    Miroshnichenko Anatoly S.

    2017-11-01

    Full Text Available Ongoing studies of different groups of stars result in improving our knowledge of their fundamental parameters and evolutionary status. Also, they result in finding new phases of stellar evolution, which require theoretical explanation. At the same time, availability of large telescopes and sensitivity improvement of detectors shift the focus of many observational programs toward fainter and more distant objects. However, there are still many problems in our understanding of details of stellar evolution which can now be solved with small telescopes and observations of bright stars. Approaching these problems implies conducting surveys of large groups of stars and long-term monitoring of individual objects. In this talk, we present the results of recent international programs of photometric and spectral monitoring of several groups of early-type stars. In particular, we discuss the role of binarity in creation of the Be phenomenon and show examples of recently discovered binary systems as well as the problem of refining fundamental parameters of B and A type supergiants. Special attention will be paid to collaboration with the amateur community and use of échelle spectrographs mounted on small telescopes.

  6. Oscillatory patterns in the light curves of five long-term monitored type 1 active galactic nuclei

    Science.gov (United States)

    Kovačević, Andjelka B.; Pérez-Hernández, Ernesto; Popović, Luka Č.; Shapovalova, Alla I.; Kollatschny, Wolfram; Ilić, Dragana

    2018-04-01

    New combined data of five well-known type 1 active galactic nuclei (AGNs) are probed with a novel hybrid method in a search for oscillatory behaviour. Additional analysis of artificial light curves obtained from the coupled oscillatory models gives confirmation for detected periods that could have a physical background. We find periodic variations in the long-term light curves of 3C 390.3, NGC 4151 and NGC 5548, and E1821 + 643, with correlation coefficients larger than 0.6. We show that the oscillatory patterns of two binary black hole candidates, NGC 5548 and E1821 + 643, correspond to qualitatively different dynamical regimes of chaos and stability, respectively. We demonstrate that the absence of oscillatory patterns in Arp 102B could be the result of a weak coupling between oscillatory mechanisms. This is the first good evidence that 3C 390.3 and Arp 102B, categorized as double-peaked Balmer line objects, have qualitative different dynamics. Our analysis shows a novelty in the oscillatory dynamical patterns of the light curves of these type 1 AGNs.

  7. Review of mechanical properties and microstructures of types 304 and 316 stainless steel after long-term aging

    International Nuclear Information System (INIS)

    Horak, J.A.; Sikka, V.K.; Raske, D.T.

    Because commercial liquid metal fast breeder reactors (LMFBRs) will be designed to last for 35 to 40 years, an understanding of the mechanical behavior of the structural alloys used is required for times of 2.2 to 2.5x10 5 h (assuming a 70% availability factor). Types 304 and 316 stainless steel are used extensively in LMFBR systems. These alloys are in a metastable state when installed and evolve to a more stable state and, therefore, microstructure during plant operation. Correlations of microstructures and mechanical properties during aging under representative LMFBR temperature and loading conditions is desirable from the standpoint of assuring safe, reliable, and economic plant operation. We reviewed the mechanical properties and microstructures of types 304 and 316 stainless steel wrought alloys, welds, and castings after long-term aging in air to 9x10 4 h (about 10-1/2 years). The principal effect of such aging is to reduce fracture toughness (as measured in Charpy impact tests) and tensile ductility. Examples are cited, however, where, because stable microstructures are achieved, these as well as strength-related properties can be expected to remain adequate for service life exposures. (author)

  8. Underground pedestrian routes as an option for arranging the transfer from one type of public transport to another

    Science.gov (United States)

    Glozman, O.

    2017-10-01

    The article highlights the issues of pedestrian movements within cities and focuses on the architectural and planning organization of transfer between two types of public transport. The amount of time citizens lose on the pedestrian sections of their way from home to work were analyzed. The article describes factors that influence the speed and the comfort of pedestrian movements as well as provides rationalization for connecting two types of transport in the underground space. The article also touches upon the issue of the negative cost impact caused by excessive time losses, including the ones that appear on the pedestrian sections of the route. Architectural methods that may ease a pedestrian’s psychological adaptation to the underground space are listed in the article. The results of experimental designing that prove the reduction of the travel time by forming underground pedestrian ways in cities were described. The article features the model of a multi-functional underground space under Serpukhovskaya Zastava square in Moscow. It is noted that pedestrian routes in the cities which do not allow easy movement on the above-the-surface space provide comfortable movement for the citizens.

  9. [Medium-term outcome, follow-up, and quality of life in children treated for type III esophageal atresia].

    Science.gov (United States)

    Lepeytre, C; De Lagausie, P; Merrot, T; Baumstarck, K; Oudyi, M; Dubus, J-C

    2013-10-01

    The aim of this study was to evaluate the medium-term outcome (health status, medical and surgical French National Health Authority-recommended follow-up, and quality of life) of children born with type III esophageal atresia (EA). Previous events (during the perinatal period, associated abnormalities, respiratory and digestive complications) of children treated for type III EA at the Marseille university hospitals between 1999 and 2009 were noted. Parents completed a standardized questionnaire concerning the health of their children during the previous year, and a quality-of-life questionnaire (PedsQL 4.0) was also completed by children aged more than 8 years. Among the 68 children treated, 44 responded to our solicitation (mean age, 7.6 years; range, 3-12.8 years). Previous important events were : pneumonia(s) (65%), asthma before the age of 3 years (66%), hospitalization for a respiratory event (45%), fundoplication (20%), and esophageal dilatation (45%). We noted current chronic cough (16%), asthma (30%), dysphagia (39%), and symptomatic gastroesophageal reflux (9%). National guidelines were not respected, except for the surgical indications in children aged less than 6 years. The quality-of-life scores (n=43 children) were similar to healthy controls but were negatively influenced by a gastrostomy procedure (P=0.020), pneumonia (P=0.013), and hospitalization due to a respiratory event (P=0.006) or a digestive event (P=0.010), and also by current asthma (P=0.004). In conclusion, despite recurrent respiratory or digestive symptoms and inadequate recommended follow-up, the quality of life of children treated for type III of EA is good. Copyright © 2013. Published by Elsevier SAS.

  10. Persistence of type-specific human papillomavirus infection and increased long-term risk of cervical cancer.

    Science.gov (United States)

    Chen, Hui-Chi; Schiffman, Mark; Lin, Ching-Yu; Pan, Mei-Hung; You, San-Lin; Chuang, Li-Chung; Hsieh, Chang-Yao; Liaw, Kai-Li; Hsing, Ann W; Chen, Chien-Jen

    2011-09-21

    Human papillomavirus (HPV) persistence is the pivotal event in cervical carcinogenesis. We followed a large-scale community-based cohort for 16 years to investigate the role of genotype-specific HPV persistence in predicting cervical cancer including invasive and in situ carcinoma. At the baseline examination in 1991-1992, 11,923 participants (aged 30-65 years) consented to HPV testing and cytology; 6923 participants were reexamined in 1993-1995. For HPV testing, we used a polymerase chain reaction-based assay that detected 39 HPV types. Women who developed cervical cancer were identified from cancer and death registries. Cumulative risks for developing cervical cancer among infected and persistently infected women were calculated by the Kaplan-Meier method. Of 10,123 women who were initially cytologically normal, 68 developed cervical cancer. The 16-year cumulative risks of subsequent cervical cancer for women with HPV16, HPV58 (without HPV16), or other carcinogenic HPV types (without HPV16 or HPV58) were 13.5%, 10.3%, and 4.0%, respectively, compared with 0.26% for HPV-negative women. Women with type-specific persistence of any carcinogenic HPV had greatly increased risk compared with women who were HPV-negative at both visits (hazard ratio = 75.4, 95% confidence interval = 31.8 to 178.9). The cumulative cervical cancer risks following persistent carcinogenic HPV infections increased with age: The risks were 5.5%, 14.4%, and 18.1% for women aged 30-44 years, 45-54 years, and 55 years and older, respectively. However, newly acquired infections were associated with a low risk of cervical cancer regardless of age. HPV negativity was associated with a very low long-term risk of cervical cancer. Persistent detection of HPV among cytologically normal women greatly increased risk. Thus, it is useful to perform repeated HPV testing following an initial positive test.

  11. The influence of biochar type on long-term stabilization for Cd and Cu in contaminated paddy soils.

    Science.gov (United States)

    Li, Hongying; Ye, Xinxin; Geng, Zhigang; Zhou, Hongjian; Guo, Xisheng; Zhang, Yunxia; Zhao, Huijun; Wang, Guozhong

    2016-03-05

    Long-term effect of biochar on PTEs (potential toxic elements) immobilization depends upon biochar own property and its aging process in soil. To understand the role of biachar type on PTEs stabilization, two types of biochar, corn-straw-derived biochar (CB) and hardwood-derived biochar (HB), were compared for their efficacy in achieving a stable decrease in the bio-availability of Cd and Cu in soils. The 3-year pot-culture experiment showed that HB reduced the concentration of CaCl2-extractable Cd and Cu by 57.9 and 63.8% in soil, and Cd and Cu uptake by 63.6 and 56.3% in rice tissue respectively, in the first year, whereas these values increased in the next two years. On the other hand, CB decreased these values steadily year by year. At the end of the 3 years, CB at 5% level had lowered the levels of CaCl2-extractable Cd and Cu by 53.6 and 66.8%, respectively. These variations between CB and HB were due to the differences in the way the two types of biochar age in the soil. The aging process was simulated in the laboratory, and the XPS results showed that the oxidization of the biochars introduced more oxygen-containing groups (especially carboxyl) on the surface of CB than HB, leading to a correspondingly greater number of oxygenated binding sites for Cd and Cu in the case of CB. The content of lignin was the major factor resulting in the variation of oxidation degree in two biochars. These results suggest that it is important to select the right kind of biochar to stably decrease the bio-availability of potential toxic elements (Cd and Cu) in contaminated soils. Copyright © 2015 Elsevier B.V. All rights reserved.

  12. Long-term engagement with a mobile self-management system for people with type 2 diabetes.

    Science.gov (United States)

    Tatara, Naoe; Arsand, Eirik; Skrøvseth, Stein Olav; Hartvigsen, Gunnar

    2013-03-27

    In a growing number of intervention studies, mobile phones are used to support self-management of people with Type 2 diabetes mellitus (T2DM). However, it is difficult to establish knowledge about factors associated with intervention effects, due to considerable differences in research designs and outcome measures as well as a lack of detailed information about participants' engagement with the intervention tool. To contribute toward accumulating knowledge about factors associated with usage and usability of a mobile self-management application over time through a thorough analysis of multiple types of investigation on each participant's engagement. The Few Touch application is a mobile-phone-based self-management tool for patients with T2DM. Twelve patients with T2DM who have been actively involved in the system design used the Few Touch application in a real-life setting from September 2008 until October 2009. During this period, questionnaires and semistructured interviews were conducted. Recorded data were analyzed to investigate usage trends and patterns. Transcripts from interviews were thematically analyzed, and the results were further analyzed in relation to the questionnaire answers and the usage trends and patterns. The Few Touch application served as a flexible learning tool for the participants, responsive to their spontaneous needs, as well as supporting regular self-monitoring. A significantly decreasing (Pmanual entry; intuitive and informative feedback; and rich learning materials, especially about foods. Many grounded design implications were identified through a thorough analysis of results from multiple types of investigations obtained through a year-long field trial of the Few Touch application. The study showed the importance and value of involving patient-users in a long-term trial of a tool to identify factors influencing usage and usability over time. In addition, the study confirmed the importance of detailed analyses of each participant

  13. Citation success of different publication types: a case study on all references in psychology publications from the German-speaking countries (D-A-CH-L-L) in 2009, 2010, and 2011.

    Science.gov (United States)

    Krampen, Günter; Weiland, Peter; Wiesenhütter, Jürgen

    Scientometric data on the citation success of different publication types and publication genres in psychology publications are presented. Data refer to references that are cited in these scientific publications and that are documented in PSYNDEX, the exhaustive database of psychology publications from the German-speaking countries either published in German or in English language. Firstly, data analyses refer to the references that are cited in publications of 2009 versus 2010 versus 2011. With reference to all cited references, the portion of journal articles ranges from 57 to 61 %, of books from 22 to 24 %, and of book chapters from 14 to 15 %, with a rather high stability across the three publication years analysed. Secondly, data analyses refer to the numbers of cited references from the German-speaking countries, which are also documented in PSYNDEX. These compose about 11 % of all cited references indicating that nearly 90 % of the references cited are of international and/or interdisciplinary publications not stemming from the German-speaking countries. The subsample shows the proportion of journal articles, books, and chapters, and these are very similar to the percentages identified for all references that are cited. Thirdly, analyses refer to document type, scientific genre, and psychological sub-discipline of the most frequently cited references in the psychology publications. The frequency of top-cited references of books and book chapters is almost equal to that of journal articles; two-thirds of the top-cited references are non-empirical publications, only one-third are empirical publications. Top-cited references stem particularly from clinical psychology, experimental psychology, as well as tests, testing and psychometrics. In summary, the results point to the fact that citation analyses, which are limited to journal papers, tend to neglect very high portions of references that are cited in scientific publications.

  14. Resumption of transport of KUR spent fuel from Japan to USA - Very long-term storage and public acceptance for transport

    International Nuclear Information System (INIS)

    Nakagome, Yoshihiro; Nishimaki, Kenzo; Kanda, Keiji

    1999-01-01

    The Research Reactor Institute, Kyoto University (KURRI) has more than 250 MTR-type HEU spent fuel elements. They have been stored in water pools after irradiation in the Kyoto University Research Reactor (KUR) core. The longest pool residence time is 25 years. In accordance with the Foreign Research Reactor Spent Nuclear Fuel Receipt Program of the United States, sixty KUR spent fuel elements were shipped from KURRI to the Savannah River Site of the USDOE in August, 1999. This shipment was done successfully through a public port in Osaka Prefecture, Japan. This is the first shipment in the past twenty-six years after the last shipment through the Yokohama Port. Concerning the use of a public port, we had to solve many issues for public acceptance. In this paper, we describe how we have stored the spent fuels for a long time with high integrity and how we have obtained public acceptance for the transport. (author)

  15. Building long-term constituencies for space exploration: The challenge of raising public awareness and engagement in the United States and in Europe

    Science.gov (United States)

    Ehrenfreund, P.; Peter, N.; Billings, L.

    2010-08-01

    Space exploration is a multifaceted endeavor and will be a "grand challenge" of the 21st century. It has already become an element of the political agenda of a growing number of countries worldwide. However, the public is largely unaware of space exploration activities and in particular does not perceive any personal benefit. In order to achieve highly ambitious space exploration goals to explore robotically and with humans the inner solar system, space agencies must improve and expand their efforts to inform and raise the awareness of the public about what they are doing, and why. Therefore adopting new techniques aiming at informing and engaging the public using participatory ways, new communication techniques to reach, in particular, the younger generation will be a prerequisite for a sustainable long-term exploration program: as they will enable it and carry most of the associated financial burden. This paper presents an environmental analysis of space exploration in the United States and Europe and investigates the current branding stature of the National Aeronautics and Space Administration (NASA) and the European Space Agency (ESA). We discuss how improved market research and new branding methods can increase public space awareness and improve the image of NASA and ESA. We propose a new participatory approach to engage the public as major stakeholder (along governments, the industrial space sector and the science community) that may provide sufficient resources for and sustainability of a long-term space exploration program.

  16. On the long-term trends of public debt. Implications of the government’s Ponzi game and ageing

    OpenAIRE

    Zsuzsa Mosolygó

    2011-01-01

    This paper sets out to analyse the impact of global ageing on the financeability of states. It covers issues regarding the sustainability of public debt and theories addressing the repayability of debt. It presents the possibilities of a fiscal Ponzi game, which would allow the financing of the debt burden from borrowings and enable succeeding generations to roll over public debt. Sustainability depends greatly on the relationship between interest rates and economic growth, and if the growth ...

  17. Honeymoon, medical treatment or big business? An analysis of the meanings of the term "reproductive tourism" in German and Israeli public media discourses.

    Science.gov (United States)

    Bassan, Sharon; Michaelsen, Merle A

    2013-08-20

    Infertile couples that travel to another country for reproductive treatment do not refer to themselves as "reproductive tourists". They might even be offended by this term. "Tourism" is a metaphor with hidden connotations. We will analyze these connotations in public media discourses on "reproductive tourism" in Israel and Germany. We chose to focus on these two countries since legal, ethical and religious restrictions give couples a similar motivation to travel for reproductive care, while the cultural backgrounds and conceptions of reproduction are different. Our research shows that the use of the metaphor "reproductive treatment" and its hidden messages depends on the writers' intention and the target population. Although the phenomenon of patients travelling for reproductive treatment can fit into the definitions of tourism, the term emphasizes aspects that do not reflect patients' reality. In both the German and the Israeli public media debate the term "reproductive tourism" is either used to criticize the economic aspects of the phenomenon or to attract patients as potential clients. Ethicists should be cautious when borrowing metaphors like "reproductive tourism" from the public debate. Our findings support Penning's suggestion to use instead an unloaded term like cross-border reproductive care to describe the phenomenon in a more neutral way and to make it explicit whenever criticism is necessary.

  18. Honeymoon, medical treatment or big business? An analysis of the meanings of the term “reproductive tourism” in German and Israeli public media discourses

    Science.gov (United States)

    2013-01-01

    Background/Introduction Infertile couples that travel to another country for reproductive treatment do not refer to themselves as “reproductive tourists”. They might even be offended by this term. “Tourism” is a metaphor with hidden connotations. We will analyze these connotations in public media discourses on “reproductive tourism” in Israel and Germany. We chose to focus on these two countries since legal, ethical and religious restrictions give couples a similar motivation to travel for reproductive care, while the cultural backgrounds and conceptions of reproduction are different. Results Our research shows that the use of the metaphor “reproductive treatment” and its hidden messages depends on the writers’ intention and the target population. Although the phenomenon of patients travelling for reproductive treatment can fit into the definitions of tourism, the term emphasizes aspects that do not reflect patients’ reality. In both the German and the Israeli public media debate the term “reproductive tourism” is either used to criticize the economic aspects of the phenomenon or to attract patients as potential clients. Conclusions Ethicists should be cautious when borrowing metaphors like “reproductive tourism” from the public debate. Our findings support Penning’s suggestion to use instead an unloaded term like cross-border reproductive care to describe the phenomenon in a more neutral way and to make it explicit whenever criticism is necessary. PMID:23962355

  19. Short-term trajectories of use of a caloric-monitoring mobile phone app among patients with type 2 diabetes mellitus in a primary care setting.

    Science.gov (United States)

    Goh, Glenn; Tan, Ngiap Chuan; Malhotra, Rahul; Padmanabhan, Uma; Barbier, Sylvaine; Allen, John Carson; Østbye, Truls

    2015-02-03

    Self-management plays an important role in maintaining good control of diabetes mellitus, and mobile phone interventions have been shown to improve such self-management. The Health Promotion Board of Singapore has created a caloric-monitoring mobile health app, the "interactive Diet and Activity Tracker" (iDAT). The objective was to identify and describe short-term (8-week) trajectories of use of the iDAT app among patients with type 2 diabetes mellitus in a primary care setting in Singapore, and identify patient characteristics associated with each trajectory. A total of 84 patients with type 2 diabetes mellitus from a public primary care clinic in Singapore who had not previously used the iDAT app were enrolled. The app was demonstrated and patients' weekly use of the app was monitored over 8 weeks. Weekly use was defined as any record in terms of food entry or exercise workout entry in that week. Information on demographics, diet and exercise motivation, diabetes self-efficacy (Diabetes Empowerment Scale-Short Form), and clinical variables (body mass index, blood pressure, and glycosylated hemoglobin/HbA1c) were collected at baseline. iDAT app use trajectories were delineated using latent-class growth modeling (LCGM). Association of patient characteristics with the trajectories was ascertained using logistic regression analysis. Three iDAT app use trajectories were observed: Minimal Users (66 out of 84 patients, 78.6%, with either no iDAT use at all or use only in the first 2 weeks), Intermittent-Waning Users (10 out of 84 patients, 11.9%, with occasional weekly use mainly in the first 4 weeks), and Consistent Users (8 out of 84 patients, 9.5%, with weekly use throughout all or most of the 8 weeks). The adjusted odds ratio of being a Consistent User, relative to a Minimal User, was significantly higher for females (OR 19.55, 95% CI 1.78-215.42) and for those with higher exercise motivation scores at baseline (OR 4.89, 95% CI 1.80-13.28). The adjusted odds ratio

  20. Senile dementia of Lewy body type and Alzheimer type are biochemically distinct in terms of paired helical filaments and hyperphosphorylated tau protein.

    Science.gov (United States)

    Harrington, C R; Perry, R H; Perry, E K; Hurt, J; McKeith, I G; Roth, M; Wischik, C M

    1994-01-01

    We have used biochemical assays to examine cingulate and occipital cortices from age-matched cases of Alzheimer's disease (AD; n = 12), senile dementia of the Lewy body type (SDLT; n = 13), Parkinson's disease (PD; 5 non-demented cases and 7 cognitively impaired cases) and controls (n = 11) for paired helical filaments (PHFs), phosphorylated and normal tau protein and beta/A4-protein. Whereas cingulate cortex is characterised by relatively high densities of cortical Lewy bodies in the SDLT cases and lower numbers in PD, these inclusion bodies were absent in the cingulate cortex from AD and control cases. Protease-resistant PHFs and hyperphosphorylated tau protein were found in AD and, at low levels, in a minority of SDLT cases. Qualitatively, both of these preparations were indistinguishable in SDLT from those found in AD but levels of both parameters in SDLT were less than 5% of those in AD. SDLT, PD and control groups did not differ from each other in terms of the quantity of protease-resistant PHFs or the level of hyperphosphorylated tau. Furthermore, PHF accumulation did not distinguish between PD cases with or without dementia. The levels of normal tau protein did not differ between the four groups. beta/A4 protein levels did not distinguish between PD and control groups, between AD and SDLT groups, or between SDLT and control groups for either cingulate or occipital cortices. Thus extensive accumulation of PHFs in either neurofibrillary tangles or dystrophic neurites is not a feature of either SDLT or PD. Our findings provide molecular support for the neuropathological and clinical separation of SDLT as a form of dementia that is distinct from AD.

  1. LONG-TERM FOLLOW-UP OF PATIENTS WITH RETINITIS PIGMENTOSA TYPE 12 CAUSED BY CRB1 MUTATIONS : A Severe Phenotype With Considerable Interindividual Variability

    NARCIS (Netherlands)

    Mathijssen, Inge B; Florijn, Ralph J; van den Born, L Ingeborgh; Zekveld-Vroon, Renate C; Ten Brink, Jacoline B; Plomp, Astrid S; Baas, Frank; Meijers-Heijboer, Hanne; Bergen, Arthur A B; van Schooneveld, Mary J

    2017-01-01

    PURPOSE: To examine the long-term clinical course and variability in a large pedigree segregating CRB1 type autosomal recessive retinitis pigmentosa. METHODS: An observational case study of 30 patients with CRB1 type autosomal recessive retinitis pigmentosa, homozygous for the CRB1 c.3122T > C;

  2. Post-stroke angiotensin II type 2 receptor activation provides long-term neuroprotection in aged rats.

    Directory of Open Access Journals (Sweden)

    Douglas M Bennion

    Full Text Available Activation of the angiotensin II type 2 receptor (AT2R by administration of Compound 21 (C21, a selective AT2R agonist, induces neuroprotection in models of ischemic stroke in young adult animals. The mechanisms of this neuroprotective action are varied, and may include direct and indirect effects of AT2R activation. Our objectives were to assess the long-term protective effects of post-stroke C21 treatments in a clinically-relevant model of stroke in aged rats and to characterize the cellular localization of AT2Rs in the mouse brain of transgenic reporter mice following stroke. Intraperitoneal injections of C21 (0.03mg/kg after ischemic stroke induced by transient monofilament middle cerebral artery occlusion resulted in protective effects that were sustained for up to at least 3-weeks post-stroke. These included improved neurological function across multiple assessments and a significant reduction in infarct volume as assessed by magnetic resonance imaging. We also found AT2R expression to be on neurons, not astrocytes or microglia, in normal female and male mouse brains. Stroke did not induce altered cellular localization of AT2R when assessed at 7 and 14 days post-stroke. These findings demonstrate that the neuroprotection previously characterized only during earlier time points using stroke models in young animals is sustained long-term in aged rats, implying even greater clinical relevance for the study of AT2R agonists for the acute treatment of ischemic stroke in human disease. Further, it appears that this sustained neuroprotection is likely due to a mix of both direct and indirect effects stemming from selective activation of AT2Rs on neurons or other cells besides astrocytes and microglia.

  3. Enucleation and limited pancreatic resection provide long-term cure for insulinoma in multiple endocrine neoplasia type 1.

    Science.gov (United States)

    Bartsch, Detlef K; Albers, Max; Knoop, Richard; Kann, Peter H; Fendrich, Volker; Waldmann, Jens

    2013-01-01

    To assess the characteristics and long-term outcome after surgery in patients with multiple endocrine neoplasia type 1 (MEN1)-associated insulinoma. Retrospective analysis of prospectively collected data of MEN1 patients with organic hyperinsulinism at a tertiary referral center. Thirteen (17%) of 74 patients with MEN1 had organic hyperinsulinism. The median age at diagnosis was 27 (range 9-48) years. In 7 patients insulinoma was the first manifestation of the syndrome. All patients had at least one pancreatic neuroendocrine neoplasm (pNEN) upon imaging, including CT, MRI or endoscopic ultrasonography. Seven patients had solitary lesions upon imaging, 4 patients had one dominant tumor with coexisting multiple small pNENs, and 2 patients had multiple lesions without dominance. Eight patients had limited resections (1 segmental resection, 7 enucleations), 4 subtotal distal pancreatectomies, and 1 patient a partial duodenopancreatectomy. There was no postoperative mortality. Six patients experienced complications, including pancreatic fistula in 5 patients. Pathological examination revealed median three (range 1-14) macro-pNENs sized between 6 and 40 mm, and a total of 14 potentially benign insulinomas were detected in the 13 patients. After median follow-up of 156 months, only 1 patient developed recurrent hyperinsulinism after initial enucleation. Twelve patients developed new pNENs in the pancreatic remnant and 4 patients underwent reoperations (3 for metastatic ZES, 1 for recurrent hyperinsulinism). One of 5 patients with an initial extended pancreatic resection developed insulin-dependent diabetes mellitus. Enucleation and limited resection provide long-term cure for MEN1 insulinoma in patients with solitary or dominant tumors. Subtotal distal pancreatectomy should thus be preserved for patients with multiple pNENs without dominance given the risk of exocrine and endocrine pancreas insufficiency in the mostly young patients. © 2013 S. Karger AG, Basel.

  4. Post-stroke angiotensin II type 2 receptor activation provides long-term neuroprotection in aged rats.

    Science.gov (United States)

    Bennion, Douglas M; Isenberg, Jacob D; Harmel, Allison T; DeMars, Kelly; Dang, Alex N; Jones, Chad H; Pignataro, Megan E; Graham, Justin T; Steckelings, U Muscha; Alexander, Jon C; Febo, Marcelo; Krause, Eric G; de Kloet, Annette D; Candelario-Jalil, Eduardo; Sumners, Colin

    2017-01-01

    Activation of the angiotensin II type 2 receptor (AT2R) by administration of Compound 21 (C21), a selective AT2R agonist, induces neuroprotection in models of ischemic stroke in young adult animals. The mechanisms of this neuroprotective action are varied, and may include direct and indirect effects of AT2R activation. Our objectives were to assess the long-term protective effects of post-stroke C21 treatments in a clinically-relevant model of stroke in aged rats and to characterize the cellular localization of AT2Rs in the mouse brain of transgenic reporter mice following stroke. Intraperitoneal injections of C21 (0.03mg/kg) after ischemic stroke induced by transient monofilament middle cerebral artery occlusion resulted in protective effects that were sustained for up to at least 3-weeks post-stroke. These included improved neurological function across multiple assessments and a significant reduction in infarct volume as assessed by magnetic resonance imaging. We also found AT2R expression to be on neurons, not astrocytes or microglia, in normal female and male mouse brains. Stroke did not induce altered cellular localization of AT2R when assessed at 7 and 14 days post-stroke. These findings demonstrate that the neuroprotection previously characterized only during earlier time points using stroke models in young animals is sustained long-term in aged rats, implying even greater clinical relevance for the study of AT2R agonists for the acute treatment of ischemic stroke in human disease. Further, it appears that this sustained neuroprotection is likely due to a mix of both direct and indirect effects stemming from selective activation of AT2Rs on neurons or other cells besides astrocytes and microglia.

  5. Coccidian oöcysts as type-specimens: long-term storage in aqueous potassium dichromate solution preserves DNA.

    Science.gov (United States)

    Williams, R B; Thebo, P; Marshall, R N; Marshall, J A

    2010-05-01

    Preservation of the exogenous oöcyst stage of coccidian parasites (phylum Apicomplexa N.D. Levine, 1970) as type-specimens of newly described species has long been problematical. Conventional fixatives have proved unsatisfactory, and compromises such as embedding oöcysts in resin or photographing them are not entirely appropriate for various reasons. As an alternative, chilled potassium dichromate solution (normally used in the laboratory to prevent putrefaction of temporary preparations of live oöcysts) has been tested as a long-term preservative of sporulated oöcysts of Eimeria brunetti P.P. Levine, 1942, E. maxima Tyzzer, 1929, E. mitis Tyzzer, 1929, E. necatrix Johnson, 1930, E. praecox Johnson, 1930 and E. tenella (Railliet & Lucet, 1891) (suborder Eimeriorina Léger, 1911; family Eimeriidae Minchin, 1903). Oöcysts from faeces of chickens Gallus gallus (Linnaeus) were placed in 2.5% w/v aqueous potassium dichromate solution (PDS) and stored in the dark at 4 +/- 2 degrees C. After 23 years in storage, oöcysts of each species were administered orally to chickens and failed to initiate infections, indicating that the oöcysts were dead. Nevertheless, after about 24 years, DNA was still recoverable from the oöcysts, and the original species identifications made by classic parasitological methods were confirmed by polymerase chain reaction assays. Furthermore, after almost 25 years, microscopical examination revealed that the walls and internal structures remained well preserved in 83-98% of the oöcysts of the six species investigated. Hence, PDS is potentially suitable for the long-term preservation of sporulated coccidian oöcysts as type-specimens for taxonomic purposes. The samples used in this study are now in the care of the Natural History Museum, London, UK. It is recommended that they be monitored in like manner, by suitably qualified scientists, at intervals of about 5 years to assess their state of preservation and the recoverability of DNA

  6. Intrauterine growth-restricted sheep fetuses exhibit smaller hindlimb muscle fibers and lower proportions of insulin-sensitive Type I fibers near term.

    Science.gov (United States)

    Yates, Dustin T; Cadaret, Caitlin N; Beede, Kristin A; Riley, Hannah E; Macko, Antoni R; Anderson, Miranda J; Camacho, Leticia E; Limesand, Sean W

    2016-06-01

    Intrauterine growth restriction (IUGR) reduces muscle mass and insulin sensitivity in offspring. Insulin sensitivity varies among muscle fiber types, with Type I fibers being most sensitive. Differences in fiber-type ratios are associated with insulin resistance in adults, and thus we hypothesized that near-term IUGR sheep fetuses exhibit reduced size and proportions of Type I fibers. Placental insufficiency-induced IUGR fetuses were ∼54% smaller (P fetal muscles develop smaller fibers and have proportionally fewer Type I fibers, which is indicative of developmental adaptations that may help explain the link between IUGR and adulthood insulin resistance. Copyright © 2016 the American Physiological Society.

  7. Long-term efficacy and safety of vildagliptin add-on therapy in type 2 diabetes mellitus with insulin treatment.

    Science.gov (United States)

    Kanazawa, Ippei; Tanaka, Ken-Ichiro; Notsu, Masakazu; Tanaka, Sayuri; Kiyohara, Nobuaki; Koike, Sayo; Yamane, Yuko; Tada, Yuko; Sasaki, Motofumi; Yamauchi, Mika; Sugimoto, Toshitsugu

    2017-01-01

    The use of dipeptidyl peptidase (DPP)-4 inhibitors in patients with type 2 diabetes treated with insulin may be beneficial. However, the long-term efficacy and safety of vildagliptin add-on therapy in these patients remains unclear. A total of 73 patients with type 2 diabetes treated with insulin were randomly assigned to receive either add-on therapy of vildagliptin (n=37) or conventional therapy without DPP-4 inhibitors (n=36) for glucose control. Hemoglobin A1c (HbA1c) levels, dose and number of insulin injections, number of hypoglycemia episodes, and liver and renal function were monitored for 2years. The baseline characteristics of subjects, including age, dose of insulin injections, or HbA1c levels, did not differ between the two groups. In the vildagliptin group, HbA1c levels significantly decreased and the significance of HbA1c reduction was maintained for 24months (from 8.0±1.2% to 7.4±1.0%, pinsulin injections significantly reduced (-5.6units, p1, and -0.9 times, p1). However, these parameters were unchanged in the control group. The number of patients who experienced three or more episodes of hypoglycemia per year was significantly lower in the vildagliptin group (n=4) than in the control group (n=11) (odds ratio, 0.28; 95% confidence interval, 0.08-0.97; pinsulin treatment for 24months was well tolerated and led to sustained reductions in HbA1c, the dose and number of insulin injections, and the risk of hypoglycemia. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  8. KIC 6048106: an Algol-type eclipsing system with long-term magnetic activity and hybrid pulsations - I. Binary modelling

    Science.gov (United States)

    Samadi Ghadim, A.; Lampens, P.; Jassur, M.

    2018-03-01

    The A-F-type stars and pulsators (δ Scuti-γ Dor) are in a critical regime where they experience a transition from radiative to convective transport of energy in their envelopes. Such stars can pulsate in both gravity and acoustic modes. Hence, the knowledge of their fundamental parameters along with their observed pulsation characteristics can help in improving the stellar models. When residing in a binary system, these pulsators provide more accurate and less model-dependent stellar parameters than in the case of their single counterparts. We present a light-curve model for the eclipsing system KIC 6048106 based on the Kepler photometry and the code PHOEBE. We aim to obtain accurate physical parameters and tough constraints for the stellar modelling of this intermediate-mass hybrid pulsator. We performed a separate modelling of three light-curve segments which show a distinct behaviour due to a difference in activity. We also analysed the Kepler Eclipse Time Variations (ETVs). KIC 6048106 is an Algol-type binary with F5-K5 components, a near-circular orbit and a 1.56-d period undergoing variations of the order of Δ P/P˜eq 3.60× 10^{-7} in 287 ± 7 d. The primary component is a main-sequence star with M1 = 1.55 ± 0.11 M⊙, R1 = 1.57 ± 0.12 R⊙. The secondary is a much cooler subgiant with M2 = 0.33 ± 0.07 M⊙, R2 = 1.77 ± 0.16 R⊙. Many small near-polar spots are active on its surface. The second quadrature phase shows a brightness modulation on a time-scale 290 ± 7 d, in good agreement with the ETV modulation. This study reveals a stable binary configuration along with clear evidence of a long-term activity of the secondary star.

  9. Long-term outcomes after immediate aortic repair for acute type A aortic dissection complicated by coma.

    Science.gov (United States)

    Tsukube, Takuro; Haraguchi, Tomonori; Okada, Yasushi; Matsukawa, Ritsu; Kozawa, Shuichi; Ogawa, Kyoichi; Okita, Yutaka

    2014-09-01

    The management of acute type A aortic dissection complicated by coma remains controversial. We previously reported an excellent rate of recovery of consciousness provided aortic repair was performed within 5 hours of the onset of symptoms. This study evaluates the early and long-term outcomes using this approach. Between August 2003 and July 2013, of the 241 patients with acute type A aortic dissection brought to the Japanese Red Cross Kobe Hospital and Hyogo Emergency Medical Center, 30 (12.4%) presented with coma; Glasgow Coma Scale was less than 11 on arrival. Surgery was performed in 186 patients, including 27 (14.5%) who were comatose. Twenty-four comatose patients underwent successful aortic repair immediately (immediate group). Their mean age was 71.0 ± 11.1 years, Glasgow Coma Scale was 6.5 ± 2.4, and prevalence of carotid dissection was 79%. For brain protection, deep hypothermia with antegrade cerebral perfusion was used, and postoperative induced hypothermia was performed. Neurologic evaluations were performed using the Glasgow Coma Scale, National Institutes of Health Stroke Scale, and modified Rankin Scale. In the immediate group, the time from the onset of symptoms to arrival in the operating theater was 222 ± 86 minutes. Hospital mortality was 12.5%. Full recovery of consciousness was achieved in 79% of patients in up to 30 days. Postoperative Glasgow Coma Scale and National Institutes of Health Stroke Scale improved significantly when compared with the preoperative score (P coma were satisfactory. Copyright © 2014 The American Association for Thoracic Surgery. Published by Mosby, Inc. All rights reserved.

  10. The prevalence of radiological glenohumeral osteoarthritis in long-term type 1 diabetes: the Dialong shoulder study.

    Science.gov (United States)

    Juel, N G; Brox, J I; Hellund, J C; Holte, K B; Berg, T J

    2017-12-14

    This study compares the prevalence of radiological osteoarthritis (OA) in patients with type 1 diabetes mellitus (DM1) for > 45 years and controls, and explores the association with shoulder pain and glycaemic burden in patients with DM1. The Dialong study is a cross-sectional, observational study with 30 years of historical data on long-term glycaemic control. We included 102 patients with DM1 and 73 diabetes-free controls. Demographic data, worst shoulder pain last week [numeric rating scale (NRS) 0-10], pain on abduction at examination (NRS 0-10), and current and historical glycosylated haemoglobin (HbA 1c ) levels were collected. Standardized shoulder X-rays were taken and interpreted for OA applying the Kellgren-Lawrence classification. In the diabetes group (49% women), the mean ± sd duration of DM1 was 50.6 ± 4.8 years, mean 30 year HbA 1c 7.4%, and age 61.9 ± 7.1 years. The mean age of controls (57% women) was 62.6 ± 7.0 years. Radiological glenohumeral OA was found in 36 diabetes patients (35%) and 10 controls (14%) [odds ratio (OR) 3.4, 95% confidence interval (CI) 1.6 to 7.5; p = 0.002]. Few persons had moderate and severe OA [6.9% vs 1.3%, OR 5.3 (95% Cl 0.6 to 44.1); p = 0.1]. Fifteen diabetes patients had painful OA versus two controls (adjusted OR 5.4, 95% CI 0.6 to 47.9; p = 0.13). There was no association between OA and long-term glycaemic burden (mean 30 year HbA 1c ) in the diabetes group (p > 0.2). Radiological glenohumeral OA was more common in patients with DM1 than in controls for mild, but not moderate and severe OA. The radiological findings were not associated with shoulder pain or long-term glycaemic burden.

  11. Long-Term Pioglitazone Treatment for Patients With Nonalcoholic Steatohepatitis and Prediabetes or Type 2 Diabetes Mellitus: A Randomized Trial.

    Science.gov (United States)

    Cusi, Kenneth; Orsak, Beverly; Bril, Fernando; Lomonaco, Romina; Hecht, Joan; Ortiz-Lopez, Carolina; Tio, Fermin; Hardies, Jean; Darland, Celia; Musi, Nicolas; Webb, Amy; Portillo-Sanchez, Paola

    2016-09-06

    The metabolic defects of nonalcoholic steatohepatitis (NASH) and prediabetes or type 2 diabetes mellitus (T2DM) seem to be specifically targeted by pioglitazone. However, information about its long-term use in this population is limited. To determine the efficacy and safety of long-term pioglitazone treatment in patients with NASH and prediabetes or T2DM. Randomized, double-blind, placebo-controlled trial. (ClinicalTrials.gov: NCT00994682). University hospital. Patients (n = 101) with prediabetes or T2DM and biopsy-proven NASH were recruited from the general population and outpatient clinics. All patients were prescribed a hypocaloric diet (500-kcal/d deficit from weight-maintaining caloric intake) and then randomly assigned to pioglitazone, 45 mg/d, or placebo for 18 months, followed by an 18-month open-label phase with pioglitazone treatment. The primary outcome was a reduction of at least 2 points in the nonalcoholic fatty liver disease activity score in 2 histologic categories without worsening of fibrosis. Secondary outcomes included other histologic outcomes, hepatic triglyceride content measured by magnetic resonance and proton spectroscopy, and metabolic parameters. Among patients randomly assigned to pioglitazone, 58% achieved the primary outcome (treatment difference, 41 percentage points [95% CI, 23 to 59 percentage points]) and 51% had resolution of NASH (treatment difference, 32 percentage points [CI, 13 to 51 percentage points]) (P < 0.001 for each). Pioglitazone treatment also was associated with improvement in individual histologic scores, including the fibrosis score (treatment difference, -0.5 [CI, -0.9 to 0.0]; P = 0.039); reduced hepatic triglyceride content from 19% to 7% (treatment difference, -7 percentage points [CI, -10 to -4 percentage points]; P < 0.001); and improved adipose tissue, hepatic, and muscle insulin sensitivity (P < 0.001 vs. placebo for all). All 18-month metabolic and histologic improvements persisted over 36 months of

  12. Long term unemployment, income, poverty, and social public expenditure, and their relationship with self-perceived health in Spain (2007-2011).

    Science.gov (United States)

    López Del Amo González, M Puerto; Benítez, Vivian; Martín-Martín, José J

    2018-01-15

    There is scant research that simultaneously analyzes the joint effects of long-term unemployment, poverty and public expenditure policies on poorer self-perceived health during the financial crisis. The aim of the study is to analyze the joint relationship between long-term unemployment, social deprivation, and regional social public expenditure on one side, and self-perceived health in Spain (2007-2011) on the other. Longitudinal data were extracted from the Survey on Living Conditions, 2007-2010 and 2008-2011 (9105 individuals and 36,420 observations), which were then used to estimate several random group effects in the constant multilevel logistic longitudinal models (level 1: year; level 2: individual; level 3: region). The dependent variable was self-perceived health. Individual independent interest variables were long and very long term unemployment, available income, severe material deprivation and regional variables were per capita expenditure on essential public services and per capita health care expenditure. All of the estimated models show a robust association between bad perceived health and the variables of interest. When compared to employed individuals, long term unemployment increases the odds of reporting bad health by 22% to 67%; very long-term unemployment (24 to 48 months) increases the odds by 54% to 132%. Family income reduces the odds of reporting bad health by 16% to 28% for each additional percentage point in income. Being a member of a household with severe material deprivation increases the odds of perceiving one's health as bad by between 70% and 140%. Regionally, per capita expenditure on essential public services increases the odds of reporting good health, although the effect of this association was limited. Long and very long term unemployment, available income and poverty were associated to self-perceived bad health in Spain during the financial crisis. Regional expenditure on fundamental public services is also associated to poor

  13. Public Health and Air Pollution in Asia (PAPA): A Multicity Study of Short-Term Effects of Air Pollution on Mortality

    OpenAIRE

    Wong, Chit-Ming; Vichit-Vadakan, Nuntavarn; Kan, Haidong; Qian, Zhengmin

    2008-01-01

    Background and Objectives: Although the deleterious effects of air pollution from fossil fuel combustion have been demonstrated in many Western nations, fewer studies have been conducted in Asia. The Public Health and Air Pollution in Asia (PAPA) project assessed the effects of short-term exposure to air pollution on daily mortality in Bangkok, Thailand, and in three cities in China: Hong Kong, Shanghai, and Wuhan. Methods: Poisson regression models incorporating natural spline smoothing func...

  14. Redefining Influencers : Scrutinizing the Term Social Media Influencer from a Public Perspective and Examining its Role in the Modern Media Landscape

    OpenAIRE

    Petersen, Gustaf

    2018-01-01

    This paper explores how influencers can be categorised using a self-administered questionnaire. In doing so, the study can contribute to an understanding of the phenomenon that is more extensive than what previous research has attributed. The focus of this paper is on how influencers can be better understood for the benefit of public relations (PR), marketing, and communication. The purpose of this project is to investigate whether the term influencers (short for social media influencers) are...

  15. Investigation of whether various types of radioactive waste are equivalent in terms of the radiological impact associated with their disposal

    International Nuclear Information System (INIS)

    Fearn, H.S.; Smith, G.M.; Davis, J.P.; Hill, M.D.

    1989-01-01

    The aim of this study is to investigate the possibility that various types of waste are equivalent in terms of the risks associated with their disposal in so far as they are viewed by different sections of society. If such a framework can be established it could be used as an aid to decisions as to whether central disposal facilities, to accept waste from several countries, should be constructed. Details are presented of assumed radionuclide inventories for a representative range of radioactive wastes, calculations and results of the radiological impacts of their disposal, and illustrative methods for weighting the various components of impact which when summed provide an overall measure of impact. Five sets of weighting factors have been devised which are intended to represent the views of a) the radiological protection community, b) those with a pro-nuclear industry view, c) those who oppose nuclear power on safety grounds, d) the inhabitants of the country receiving wastes for disposal, and e) the inhabitants of the country dispatching wastes. On the basis of the calculated weighted radiological impacts it is demonstrated how conclusions can be drawn about general views on the disposal of each waste, about likely attitudes to the export of wastes from one country for disposal in another, and attitudes to exchanging wastes between countries. The study is preliminary and of limited scope. However, the results show that the general methodology is practicable and could be applied in a wider ranging investigation

  16. Microaneurysm count as a predictor of long-term progression in diabetic retinopathy in young patients with type 1 diabetes

    DEFF Research Database (Denmark)

    Rasmussen, M L; Broe, R; Frydkjaer-Olsen, U

    2015-01-01

    PURPOSE: To investigate microaneurysm (MA) count as a predictor of long-term progression of diabetic retinopathy (DR) in young patients with type 1 diabetes mellitus (T1DM). METHODS: We examined 185 patients with T1DM at baseline (1995) and at follow-up (2011). At baseline, mean age and duration...... of diabetes were 20.6 and 12.9 years, respectively. Two-field (1995) and seven-field (2011) fundus photographs were taken in accordance with the European Diabetes Study Group (EURODIAB) and the Early Treatment Diabetic Retinopathy Study (ETDRS) protocol, respectively. DR was graded in accordance to the ETDRS......), and incident diabetic macula edema (DME). RESULTS: We included 138 patients (138 eyes). Of these, 58 had no retinopathy and 80 had MAs only. At follow-up, rates of two-step progression of DR, progression to PDR and incident DME were 52.9, 21.7, and 10.1 %, respectively. In logistic regression models, MA count...

  17. Long-term results after cardiac surgery in patients infected with the human immunodeficiency virus type-1 (HIV-1).

    Science.gov (United States)

    Mestres, Carlos A; Chuquiure, Javier E; Claramonte, Xavier; Muñoz, Josefa; Benito, Natividad; Castro, Miguel A; Pomar, José L; Miró, José M

    2003-06-01

    Assessment of long-term results of immunodeficiency virus type-1 (HIV-1)-infected patients undergoing cardiac surgery. Retrospective analysis of profile and outcomes of 31 HIV-1-infected patients (35 operations, 1985-2002). Twenty-seven males and four females (mean age 34.67) in three groups: acute infective endocarditis (AIE) 21 (67.74%), coronary (CAD) 5 (16.13%) and non-infective valvular disease (NIVD) 5 (16.13%). HIV factors: drug addiction (23-74.19%), homosexuality (5-16.12%), heterosexuality (3-9.67%), hemodialysis (1-3.22%). HIV stage: A (17), B (2), C (2) in AIE; A (2), B (3) in CAD and A (3), C (2) in NIVD. Mean preoperative CD4 count was 278 cells/microL (12infected patients requiring cardiac surgery, a decrease in AIE, however NIVD and CAD increasingly seen. Cardiac surgery did not blunt CD4 response induced by antiretrovirals. The late cause of death were not AIDS-related events.

  18. Long-term effects of the Mediterranean lifestyle program: a randomized clinical trial for postmenopausal women with type 2 diabetes

    Directory of Open Access Journals (Sweden)

    Ritzwoller Debra P

    2007-01-01

    Full Text Available Abstract Background Multiple-risk-factor interventions offer a promising means for addressing the complex interactions between lifestyle behaviors, psychosocial factors, and the social environment. This report examines the long-term effects of a multiple-risk-factor intervention. Methods Postmenopausal women (N = 279 with type 2 diabetes participated in the Mediterranean Lifestyle Program (MLP, a randomized, comprehensive lifestyle intervention study. The intervention targeted healthful eating, physical activity, stress management, smoking cessation, and social support. Outcomes included lifestyle behaviors (i.e., dietary intake, physical activity, stress management, smoking cessation, psychosocial variables (e.g., social support, problem solving, self-efficacy, depression, quality of life, and cost analyses at baseline, and 6, 12, and 24 months. Results MLP participants showed significant 12- and 24-month improvements in all targeted lifestyle behaviors with one exception (there were too few smokers to analyze tobacco use effects, and in psychosocial measures of use of supportive resources, problem solving, self-efficacy, and quality of life. Conclusion The MLP was more effective than usual care over 24 months in producing improvements on behavioral and psychosocial outcomes. Directions for future research include replication with other populations.

  19. Cryogenic distillation: a fuel enrichment system for near-term tokamak-type D-T fusion reactors

    International Nuclear Information System (INIS)

    Misra, B.; Davis, J.F.

    1980-02-01

    The successful operation and economic viability of deuterium-tritium- (D-T-) fueled tokamak-type commercial power fusion reactors will depend to a large extent on the development of reliable tritium-containment and fuel-recycle systems. Of the many operating steps in the fuel recycle scheme, separation or enrichment of the isotropic species of hydrogen by cryogenic distillation is one of the most important. A parametric investigation was carried out to study the effects of the various operating conditions and the composition of the spent fuel on the degree of separation. A computer program was developed for the design and analysis of a system of interconnected distillation columns for isotopic separation such that the requirements of near-term D-T-fueled reactors are met. The analytical results show that a distillation cascade consisting of four columns is capable of reprocessing spent fuel varying over a wide range of compositions to yield reinjection-grade fuel with essentially unlimited D/T ratio

  20. Flirting with disaster: short-term mating orientation and hostile sexism predict different types of sexual harassment.

    Science.gov (United States)

    Diehl, Charlotte; Rees, Jonas; Bohner, Gerd

    2012-01-01

    We combine evolutionary and sociocultural accounts of sexual harassment, proposing that sexuality-related and hostility-related motives lead to different types of harassment. Specifically, men's short-term mating orientation (STMO) was hypothesized to predict only unwanted sexual attention but not gender harassment, whereas men's hostile sexism (HS) was hypothesized to predict both unwanted sexual attention and gender harassment. As part of an alleged computer-chat task, 100 male students could send sexualized personal remarks (representing unwanted sexual attention), sexist jokes (representing gender harassment), or nonharassing material to an attractive female target. Independently, participants' STMO, HS, and sexual harassment myth acceptance (SHMA) were assessed. Correlational and path analyses revealed that STMO specifically predicted unwanted sexual attention, whereas HS predicted both unwanted sexual attention and gender harassment. Furthermore, SHMA fully mediated the effect of HS on gender harassment, but did not mediate effects of STMO or HS on unwanted sexual attention. Results are discussed in relation to motivational explanations for sexual harassment and antiharassment interventions. © 2012 Wiley Periodicals, Inc.

  1. A Glossary of Research Terms for Out-of-School Time Program Practitioners. Research-to-Results Fact Sheet. Publication #2007-02

    Science.gov (United States)

    Bronte-Tinkew, Jacinta; Horowitz, Allison; Redd, Zakia; Moore, Kristin A.; Valladares, Sherylls

    2007-01-01

    This glossary of common research and evaluation terms can serve as a quick reference guide for out-of school time practitioners as they face the challenges posed in this new era of program accountability. Subsequent briefs will provide more detailed information on particular types of research and evaluation designs. A list of additional resources…

  2. A 4-year prospective study on long-term complications of type 2 diabetic patients: the Thai DMS diabetes complications (DD.Comp.) project.

    Science.gov (United States)

    Potisat, Somkiat; Krairittichai, Udom; Jongsareejit, Amporn; Sattaputh, Charnvate; Arunratanachote, Woranut

    2013-06-01

    To assess the clinical course of long-term diabetic complications; diabetic retinopathy, nephropathy, and foot problems in Thai patients with type 2 diabetes. Patients with type 2 diabetes were followed for four years between March 2006 and September 2010. Seven hospitals in all levels of care under the Ministry of Public Health Thailand were included in the present study. A physical examination and a diabetic complications assessment were performed each year during the study period, by physician specialists in the related areas. Among 1,120 patients who participated in the present study, 705 (62.95%) patients completed the 4-year follow-up time. There were 88 (7.86%) patients reported deaths during the present study period. The mean age was 59.14 +/- 10.12 years. The average duration of diabetes was 7.30 +/- 6.14 years. Approximately 57.32% of patients had a family history of diabetes. The average plasma glucose level and HbA1C were 153 to 160 mg/dl and 8.25 to 8.75%. Moreover less than one-fourth of patients had HbA1C below 7%. The prevalence for diabetic retinopathy and nephropathy were approximately 23.7% and 38.3%. In addition, more than 15% of patients had diabetic foot problems, loss of protective sensation and pedal pulse deficit. Finally, the incidence rates were 80.1 per 1,000 person-years (95% CI 69.7, 91.8) for diabetic retinopathy, and 91.1 per 1,000 person-years (95% CI 78.8, 105.1) for diabetic nephropathy Problems regarding poor diabetes control exist in Thai diabetes patients. It results in high prevalence and incidence of diabetic complications. As such, it is crucial to establish the country's diabetes management plan as well as evaluate the long-term complications in diabetic patients annually, in order for patients to receive the benefits of early treatment and prevent further complications.

  3. Long-term follow-up studies of Gamma Knife surgery for patients with neurofibromatosis Type 2.

    Science.gov (United States)

    Sun, Shibin; Liu, Ali

    2014-12-01

    The aim of this study was to evaluate long-term clinical outcomes after Gamma Knife surgery (GKS) for patients with neurofibromatosis Type 2 (NF2) and the role of GKS in the management of NF2. From December 1994 through December 2008, a total of 46 patients (21 male, 25 female) with NF2 underwent GKS and follow-up evaluation for at least 5 years at the Gamma Knife Center of the Beijing Neurosurgical Institute. GKS was performed using the Leksell Gamma Knife Models B and C. The mean age of the patients was 30 years (range 13-59 years). A family history of NF2 was found for 9 (20%) patients. The NF2 phenotype was thought to be Wishart for 20 (44%) and Feiling-Gardner for 26 (56%) patients. Among these 46 patients, GKS was performed to treat 195 tumors (73 vestibular schwannomas and 122 other tumors including other schwannomas and meningiomas). For vestibular schwannomas, the mean volume was 5.1 cm(3) (median 3.6 cm(3), range 0.3-27.3 cm(3)), the mean margin dose was 12.9 Gy (range 10-14 Gy), and the mean maximum dose was 27.3 Gy (range 16.2-40 Gy). For other tumors, the mean volume was 1.7 cm(3) (range 0.3-5.5 cm(3)), the mean margin dose was 13.3 Gy (range 11-14 Gy), and the mean maximum dose was 26.0 Gy (range 18.0-30.4 Gy). The median duration of follow-up was 109 months (range 8-195 months). For the 73 vestibular schwannomas that underwent GKS, the latest follow-up MR images demonstrated regression of 30 (41%) tumors, stable size for 31 (43%) tumors, and enlargement of 12 (16%) tumors. The total rate of tumor control for bilateral vestibular schwannomas in patients with NF2 was 84%. Of the 122 other types of tumors that underwent GKS, 103 (85%) showed no tumor enlargement. The rate of serviceable hearing preservation after GKS was 31.9% (15/47). The actuarial rates for hearing preservation at 3 years, 5 years, 10 years, and 15 years were 98%, 93%, 44%, and 17%, respectively. Of the 46 patients, 22 (48%) became completely bilaterally deaf, 17 (37%) retained

  4. A Taxonomy of Injuries for Public Health Monitoring and Reporting. Addendum 1, Body Regions and Injury Types. Addendum 2, Fiscal Year 2018 Update

    Science.gov (United States)

    2017-12-01

    This document establishes a taxonomy for categorizing and consistently defining physical injuries that are included in public health surveillance...public health epidemiologic efforts. As its focus is on physical injuries, behavioral and mental conditions are excluded. 3 INTRODUCTION...military health care, as well as the physical readiness of individual Soldiers and units. In 2006, the most common type of non-fatal military injury

  5. When the private sphere goes public: exploring the issues facing family caregiver organizations in the development of long-term care policies.

    Science.gov (United States)

    Rozario, Philip A; Palley, Elizabeth

    2008-01-01

    Though family caregiving forms the backbone of the long-term care system in the United States, long-term care policies have traditionally focused on paid services that frail older people and people with disabilities utilize for their day-to-day functioning. Part of the exclusion of family caregiving from the long-term care discourse stems from the traditional separation of the private sphere, where family caregiving occurs, from the public sphere of policy making. However, the passage of the Family and Medical Leave Act (FMLA), the National Family Caregiver Support Program (NFCSP) and Medicaid waiver legislation may reflect recent changes in the government's position on their role in addressing issues related to the "private spheres." In this article, we explore the nature of family caregiving in the United States, the divide between the public and private spheres and provide an overview of family caregiving-related policies and programs in the U.S. In our review, we examine the provisions in the FMLA, NFCSP, and Medicaid waiver legislation that support family caregiving efforts. We also examine the roles of family caregiver organizations in making family caregiving an important element of long-term care policy and influencing policy-making.

  6. Long-term leach testing of solidified radioactive waste forms (International Standard Publication ISO 6961:1982)

    International Nuclear Information System (INIS)

    Stefanik, J.

    2001-01-01

    Processes are developed for the immobilization of radionuclides by solidification of radioactive wastes. The resulting solidification products are characterized by strong resistance to leaching aimed at low release rates of the radionuclides to the environment. To measure this resistance to leaching of the solidified materials: glass, glass-ceramics, bitumen, cement, concrete, plastics, a long-term leach test is presented. The long-term leach test is aimed at: a) the comparison of different kinds or compositions of solidified waste forms; b) the intercomparison between leach test results from different laboratories on one product; c) the intercomparison between leach test results on products from different processes

  7. Determining a functional responsibility allocation between public and private parties in a long-term maintenance contract for waterworks

    NARCIS (Netherlands)

    Brommet, O.D.; Schoenmaker, R.; Hertogh, M.J.C.M.; Kleijn van Willigen, G.R.; Chen, Y.; Bakker, Jaap; Frangopol, Dan M.; van Breugel, Klaas

    2017-01-01

    A proper allocation of risks and responsibilities is vital for the success of long-term maintenance contracts. This paper focuses on a method to identify an adequate allocation of responsibilities for the maintenance of waterworks. The Dutch agency recently started outsourcing the maintenance of

  8. Layer- and cell-type-specific subthreshold and suprathreshold effects of long-term monocular deprivation in rat visual cortex.

    Science.gov (United States)

    Medini, Paolo

    2011-11-23

    Connectivity and dendritic properties are determinants of plasticity that are layer and cell-type specific in the neocortex. However, the impact of experience-dependent plasticity at the level of synaptic inputs and spike outputs remains unclear along vertical cortical microcircuits. Here I compared subthreshold and suprathreshold sensitivity to prolonged monocular deprivation (MD) in rat binocular visual cortex in layer 4 and layer 2/3 pyramids (4Ps and 2/3Ps) and in thick-tufted and nontufted layer 5 pyramids (5TPs and 5NPs), which innervate different extracortical targets. In normal rats, 5TPs and 2/3Ps are the most binocular in terms of synaptic inputs, and 5NPs are the least. Spike responses of all 5TPs were highly binocular, whereas those of 2/3Ps were dominated by either the contralateral or ipsilateral eye. MD dramatically shifted the ocular preference of 2/3Ps and 4Ps, mostly by depressing deprived-eye inputs. Plasticity was profoundly different in layer 5. The subthreshold ocular preference shift was sevenfold smaller in 5TPs because of smaller depression of deprived inputs combined with a generalized loss of responsiveness, and was undetectable in 5NPs. Despite their modest ocular dominance change, spike responses of 5TPs consistently lost their typically high binocularity during MD. The comparison of MD effects on 2/3Ps and 5TPs, the main affected output cells of vertical microcircuits, indicated that subthreshold plasticity is not uniquely determined by the initial degree of input binocularity. The data raise the question of whether 5TPs are driven solely by 2/3Ps during MD. The different suprathreshold plasticity of the two cell populations could underlie distinct functional deficits in amblyopia.

  9. Enhancement of electron emission and long-term stability of tip-type carbon nanotube field emitters via lithium coating

    International Nuclear Information System (INIS)

    Kim, Jong-Pil; Chang, Han-Beet; Kim, Bu-Jong; Park, Jin-Seok

    2013-01-01

    Carbon nanotubes (CNTs) were deposited on conical tip-type substrates via electrophoresis and coated with lithium (Li) thin films with diverse thicknesses via electroplating. For the as-deposited (i.e., without Li coating) CNT, the turn-on (or triggering) electric field was 0.92 V/μm, and the emission current, which was generated at an applied field of 1.2 V/μm was 56 μA. In the case of the 4.7 nm-thick Li-coated CNT, the turn-on field decreased to 0.65 V/μm and the emission current at the same applied field increased more than ten times to 618 μA. The analysis based on the Kelvin probe measurement and Fowler–Nordheim theory indicated that the coating of Li caused a loss in the structural-aspect-ratio of the CNTs and it reduced their effective work functions from 5.36 eV to 4.90 eV, which led to a great improvement of their electron emission characteristics. The results obtained in this study also showed that the long-term emission stability could be enhanced by the coating of thin Li films on CNTs. - Highlights: ► CNTs are deposited via electrophoretic deposition (EPD). ► Thin films of Li are coated on CNTs via electroplating, without plasma damage. ► Li coating enhanced field emission properties and emission stability of CNTs. ► The effective work functions and field enhancement factors of CNTs are evaluated

  10. Long-term safety and efficacy of AAV gene therapy in the canine model of glycogen storage disease type Ia.

    Science.gov (United States)

    Lee, Young Mok; Conlon, Thomas J; Specht, Andrew; Coleman, Kirsten E; Brown, Laurie M; Estrella, Ana M; Dambska, Monika; Dahlberg, Kathryn R; Weinstein, David A

    2018-05-25

    Viral mediated gene therapy has progressed after overcoming early failures, and gene therapy has now been approved for several conditions in Europe and the USA. Glycogen storage disease (GSD) type Ia, caused by a deficiency of glucose-6-phosphatase-α, has been viewed as an outstanding candidate for gene therapy. This follow-up report describes the long-term outcome for the naturally occurring GSD-Ia dogs treated with rAAV-GPE-hG6PC-mediated gene therapy. A total of seven dogs were treated with rAAV-GPE-hG6PC-mediated gene therapy. The first four dogs were treated at birth, and three dogs were treated between 2 and 6 months of age to assess the efficacy and safety in animals with mature livers. Blood and urine samples, radiographic studies, histological evaluation, and biodistribution were assessed. Gene therapy improved survival in the GSD-Ia dogs. With treatment, the biochemical studies normalized for the duration of the study (up to 7 years). None of the rAAV-GPE-hG6PC-treated dogs had focal hepatic lesions or renal abnormalities. Dogs treated at birth required a second dose of rAAV after 2-4 months; gene therapy after hepatic maturation resulted in improved efficacy after a single dose. rAAV-GPE-hG6PC treatment in GSD-Ia dogs was found to be safe and efficacious. GSD-Ia is an attractive target for human gene therapy since it is a monogenic disorder with limited tissue involvement. Blood glucose and lactate monitoring can be used to assess effectiveness and as a biomarker of success. GSD-Ia can also serve as a model for other hepatic monogenic disorders.

  11. Single-donor islet transplantation and long-term insulin independence in select patients with type 1 diabetes mellitus.

    Science.gov (United States)

    Al-Adra, David P; Gill, Richdeep S; Imes, Sharleen; O'Gorman, Doug; Kin, Tatsuya; Axford, Sara J; Shi, Xinzhe; Senior, Peter A; Shapiro, A M James

    2014-11-15

    Islet transplantation is a recognized treatment option for select patients with type I diabetes mellitus. However, islet infusions from multiple donors are often required to achieve insulin independence. Ideally, insulin independence would be achieved routinely with only a single donor. Identification of factors associated with insulin independence after single-donor islet transplantation may help to select recipient-donor combinations with the highest probability of success. Subjects undergoing islet transplantation at a single center (Edmonton, Canada) between March 1999 and August 2013 were included. Recipient, donor, and transplant characteristics were collected and compared between recipients who became insulin independent after one islet transplantation and those who did not. Thirty-one patients achieved insulin independence after a single-donor islet transplantation, and 149 did not. Long-term insulin-free survival was not different between the groups. Factors significantly associated with single-donor success included recipient age, insulin requirement at baseline, donor weight, donor body mass index, islet transplant mass, and peritransplant heparin and insulin administration. On multivariate analysis, pretransplantation daily insulin requirements, the use of peritransplantation heparin and insulin infusions, and islet transplant mass remained significant. We have identified clinically relevant differences defining the achievement of insulin independence after single-donor transplantation. Based on these differences, a preoperative insulin requirement of less than 0.6 U/kg per day and receiving more than 5,646 islet equivalents (IEQ)/kg have a sensitivity of 84% and 71% and specificity of 50% and 50%, respectively, for insulin independence after single-donor islet transplantation. With ideal patient selection, this finding could potentially increase single-donor transplantation success and may be especially relevant for presensitized subjects or those who

  12. Long-term efficacy of liraglutide in Indian patients with Type 2 diabetes in a real-world setting

    Directory of Open Access Journals (Sweden)

    Parjeet Kaur

    2016-01-01

    Full Text Available Background: Long-term efficacy of liraglutide, a glucagon-like peptide-1 analog, on body weight and glycemic control has not been studied in Indian Type 2 diabetes mellitus (T2DM subjects. Aim: To evaluate the effect of liraglutide on glycemic control and body weight for 1 year in Indian T2DM patients. Methods: Liraglutide was prescribed to 96 obese patients with T2DM and followed up for 1 year. Clinical parameters were measured at baseline and 3, 6, 9, and 12 months. Dosage of liraglutide and other medications was adjusted according to clinical judgment. Results: 1 year data were available for 74 patients. Mean age was 50.9 ± 9.6 years. Mean duration of diabetes was 11.6 ± 6.3 years. Glycosylated hemoglobin (HbA1c significantly decreased from 8.9 ± 1.3% at baseline to 7.4 ± 1.2% at 1 year. Body weight significantly declined from 98.9 ± 16.0 kg at baseline to 93.8 ± 15.0 kg at 1 year. After an initial decline, subset of patients had an increase in mean HbA1c (n = 30/74 and mean body weight (n = 33/74 after 6 months of liraglutide initiation. Baseline HbA1c and baseline body weight were positively associated with a reduction of HbA1c and body weight at 1 year, respectively. No major side effects occurred. Conclusion: Liraglutide treatment resulted in a significant and sustained reduction in HbA1c and body weight over 1 year in Indian T2DM patients. Magnitude of reduction of HbA1c and body weight at 1 year was positively associated with baseline HbA1c and baseline weight, respectively.

  13. Long-term outcomes of frozen elephant trunk for type A aortic dissection in patients with Marfan syndrome.

    Science.gov (United States)

    Ma, Wei-Guo; Zhang, Wei; Zhu, Jun-Ming; Ziganshin, Bulat A; Zhi, Ai-Hua; Zheng, Jun; Liu, Yong-Min; Elefteriades, John A; Sun, Li-Zhong

    2017-10-01

    The use of the frozen elephant trunk (FET) technique for repair of type A aortic dissection (TAAD) in Marfan syndrome (MFS) is controversial. We seek to evaluate the efficacy of FET and total arch replacement (TAR) for TAAD in patients with MFS. The early and long-term outcomes were analyzed for 106 patients with MFS (mean age, 34.5 ± 9.7 years) undergoing FET + TAR for TAAD. Operative mortality was 6.6% (7 of 106). Spinal cord injury and stroke occurred in 1 patient each (0.9%), and reexploration for bleeding occurred in 6 patients (5.7%). Extra-anatomic bypass was the sole risk factor for operative mortality and morbidity (odds ratio [OR], 7.120; 95% confidence interval [CI], 1.018-49.790; P = .048). Follow-up was complete in 97.0% (96 of 99), averaging 6.3 ± 2.8 years. Late death occurred in 17 patients. Patients with acute TAAD were less prone to late death than those with chronic TAAD (OR, 0.112; 95% CI, 0.021-0.587; P = .048). Twelve patients required late reoperation, including thoracoabdominal aortic repair in 8, thoracic endovascular aortic repair for distal new entry in 3, and coronary anastomotic repair in 1. At 5 years, survival was 86.6% (95% CI, 77.9%-92.0%) and freedom from reoperation was 88.8% (95% CI, 80.1%-93.4%), and at 8 years, survival was 74.1% (95% CI, 61.9%-83.0%) and freedom from reoperation was 84.2% (95% CI, 72.4%-91.2%). In competing risks analysis, mortality was 4% at 5 years, 18% at 8 years, and 25% at 10 years; the respective rates of reoperation were 10%, 15%, and 15%; and the respective rates of survival without reoperation were 86%, 67%, and 60%. Survival was significantly higher in patients who underwent root procedures during FET + TAR (P = .047). Risk factors for reoperation were days from diagnosis to surgery (OR, 1.160; 95% CI, 1.043-1.289; P = .006) and Bentall procedure (OR, 12.012; 95% CI, 1.041-138.606; P = .046). The frozen elephant trunk and total arch replacement procedure can be safely performed

  14. Changes of β-cell function after short-term transient intensive insulin treatment in newly diagnosed type 2 diabetes patients

    International Nuclear Information System (INIS)

    Tian Xiaoping; Zhuang Huiqin; Su Cainu; Xu Ning; Yin Dong; Hui Yuan; Wu Yan

    2007-01-01

    To evaluate the effect of short-term intensive insulin treatment on β-cell function in newly diagnosed type 2 diabetes patients with apparently hyperglycemia, twenty-four newly diagnosed type 2 diabetes patients with FPG more than 12.0 mmol/L were treated by short-term transient intensive insulin in average 9.04-4.8 days. Their β-cell function was assessed by oral glucose tolerance test. The FPG, HbAlc and HOMA IR of patients were significantly decreased (P<0.01), while the insulin, the Area Under Curve (AUC) of insulin and HOMA β were significantly increased (P<0.01) after the treatment with insulin. Improvement of β-cell function can be induced by short-term intensive insulin treatment for newly diagnosed type 2 diabetes patients with apparently hyperglycemia. (authors)

  15. Economic rationality, the affordability of private long-term care insurance, and the role for public policy.

    Science.gov (United States)

    Crown, W H; Capitman, J; Leutz, W N

    1992-08-01

    This study uses data from the 1984 panel of the Survey of Income and Program Participation (SIPP) of the U.S. Bureau of the Census to develop new estimates of the potential market for private long-term care insurance. It found that this market is potentially significant--especially among individuals in the 65-69 age group who are willing to spend up to 50% of their discretionary income on such insurance--but considerably lower than previous estimates, such as those of Cohen and colleagues (1987).

  16. Species and tissue type regulate long-term decomposition of brackish marsh plants grown under elevated CO2 conditions

    Science.gov (United States)

    Jones, Joshua A; Cherry, Julia A; Mckee, Karen L.

    2016-01-01

    Organic matter accumulation, the net effect of plant production and decomposition, contributes to vertical soil accretion in coastal wetlands, thereby playing a key role in whether they keep pace with sea-level rise. Any factor that affects decomposition may affect wetland accretion, including atmospheric CO2 concentrations. Higher CO2 can influence decomposition rates by altering plant tissue chemistry or by causing shifts in plant species composition or biomass partitioning. A combined greenhouse-field experiment examined how elevated CO2 affected plant tissue chemistry and subsequent decomposition of above- and belowground tissues of two common brackish marsh species, Schoenoplectus americanus (C3) and Spartina patens (C4). Both species were grown in monoculture and in mixture under ambient (350-385 μL L-1) or elevated (ambient + 300 μL L-1) atmospheric CO2 conditions, with all other growth conditions held constant, for one growing season. Above- and belowground tissues produced under these treatments were decomposed under ambient field conditions in a brackish marsh in the Mississippi River Delta, USA. Elevated CO2 significantly reduced nitrogen content of S. americanus, but not sufficiently to affect subsequent decomposition. Instead, long-term decomposition (percent mass remaining after 280 d) was controlled by species composition and tissue type. Shoots of S. patens had more mass remaining (41 ± 2%) than those of S. americanus (12 ± 2 %). Belowground material decomposed more slowly than that placed aboveground (62 ± 1% vs. 23 ± 3% mass remaining), but rates belowground did not differ between species. Increases in atmospheric CO2concentration will likely have a greater effect on overall decomposition in this brackish marsh community through shifts in species dominance or biomass allocation than through effects on tissue chemistry. Consequent changes in organic matter accumulation may alter marsh capacity to accommodate sea-level rise

  17. Intended Use of a Building in Terms of Updating the Cadastral Database and Harmonizing the Data with other Public Records

    Directory of Open Access Journals (Sweden)

    Buśko Małgorzata

    2017-06-01

    Full Text Available According to the original wording of the Regulation on the register of land and buildings of 2001, in the real estate cadastre there was one attribute associated with the use of a building structure - its intended use, which was applicable until the amendment to the Regulation was introduced in 2013. Then, additional attributes were added, i.e. the type of the building according to the Classification of Fixed Assets (KST, the class of the building according to the Polish Classification of Types of Constructions (PKOB and, at the same time, the main functional use and other functions of the building remained in the Regulation as well. The record data on buildings are captured for the real estate cadastre from other data sets, for example those maintained by architectural and construction authorities. At the same time, the data contained in the cadastre, after they have been entered or changed in the database, are transferred to other registers, such as tax records, or land and mortgage court registers. This study is the result of the analysis of the laws applicable to the specific units and registers. A list of discrepancies in the attributes occurring in the different registers was prepared. The practical part of the study paid particular attention to the legal bases and procedures for entering the function of a building in the real estate cadastre, which is extremely significant, as it is the attribute determining the property tax basis.

  18. Intended Use of a Building in Terms of Updating the Cadastral Database and Harmonizing the Data with other Public Records

    Science.gov (United States)

    Buśko, Małgorzata

    2017-06-01

    According to the original wording of the Regulation on the register of land and buildings of 2001, in the real estate cadastre there was one attribute associated with the use of a building structure - its intended use, which was applicable until the amendment to the Regulation was introduced in 2013. Then, additional attributes were added, i.e. the type of the building according to the Classification of Fixed Assets (KST), the class of the building according to the Polish Classification of Types of Constructions (PKOB) and, at the same time, the main functional use and other functions of the building remained in the Regulation as well. The record data on buildings are captured for the real estate cadastre from other data sets, for example those maintained by architectural and construction authorities. At the same time, the data contained in the cadastre, after they have been entered or changed in the database, are transferred to other registers, such as tax records, or land and mortgage court registers. This study is the result of the analysis of the laws applicable to the specific units and registers. A list of discrepancies in the attributes occurring in the different registers was prepared. The practical part of the study paid particular attention to the legal bases and procedures for entering the function of a building in the real estate cadastre, which is extremely significant, as it is the attribute determining the property tax basis.

  19. The reasons for withdrawal and term use of new types of cows of brown Schwyz and Sychevskaya breeds

    OpenAIRE

    Seltsov, V.; Filipchenko, A.

    2014-01-01

    The performance of dairy cows productivity of the type "Vazuzsky" in the Sychevskaya breed and the type "Smolensky" in the Brown Schwyz breed depending on the cause and age of retirement for a number of years were studied. 203 cows of the type "Vazuzsky" with a total of 898 lactations and lifetime milk yield of 22507 kg per cow, with an average age of productive use of 4,9 lactations were examined. At 423 cows of the type "Smolensky" these figures were: 2196 lactations, 26818 kg and 5,4 lacta...

  20. Terms of transactions monitoring on the French wholesale electricity and gas markets. Public consultation. Synthesis of contributions

    International Nuclear Information System (INIS)

    2008-01-01

    In its communication dated 16 April 2008, CRE published its practical methods used to monitor transactions concluded on the French electricity and gas markets. CRE invited any companies to comment on the practical arrangements of such monitoring activities. The monitoring system described by CRE is divided into two steps. In the first step, CRE wants to be able to request any information concerning transactions for physical delivery concluded after 1 January 2007. CRE will make an initial request that will focus on: - for electricity: transactions concluded in 2007 on yearly products for delivery in 2008 and 2009, base-load and peak-load; - for gas: transactions concluded in 2007 on seasonal and yearly products for delivery in 2008 and 2009, base-load and peak-load. The second step, based on feedback received, will see CRE liaise with market players and consider the possibility of setting up systematic procedures to gather transactions data. A final decision will be made by the end of 2008. 17 contributors responded to the public consultation. The remarks made on the practical methods used to gather data can be summarized along the following themes: Preamble: the monitoring principle; Theme 1: scope of transactions monitoring; Theme 2: content and format of requested data; Theme 3: procedures, transmission deadlines and confidentiality issues; Theme 4: stage II of systematic data gathering

  1. Ordering the mob: Insights into replicon and MOB typing schemes from analysis of a curated dataset of publicly available plasmids.

    Science.gov (United States)

    Orlek, Alex; Phan, Hang; Sheppard, Anna E; Doumith, Michel; Ellington, Matthew; Peto, Tim; Crook, Derrick; Walker, A Sarah; Woodford, Neil; Anjum, Muna F; Stoesser, Nicole

    2017-05-01

    Plasmid typing can provide insights into the epidemiology and transmission of plasmid-mediated antibiotic resistance. The principal plasmid typing schemes are replicon typing and MOB typing, which utilize variation in replication loci and relaxase proteins respectively. Previous studies investigating the proportion of plasmids assigned a type by these schemes ('typeability') have yielded conflicting results; moreover, thousands of plasmid sequences have been added to NCBI in recent years, without consistent annotation to indicate which sequences represent complete plasmids. Here, a curated dataset of complete Enterobacteriaceae plasmids from NCBI was compiled, and used to assess the typeability and concordance of in silico replicon and MOB typing schemes. Concordance was assessed at hierarchical replicon type resolutions, from replicon family-level to plasmid multilocus sequence type (pMLST)-level, where available. We found that 85% and 65% of the curated plasmids could be replicon and MOB typed, respectively. Overall, plasmid size and the number of resistance genes were significant independent predictors of replicon and MOB typing success. We found some degree of non-concordance between replicon families and MOB types, which was only partly resolved when partitioning plasmids into finer-resolution groups (replicon and pMLST types). In some cases, non-concordance was attributed to ambiguous boundaries between MOBP and MOBQ types; in other cases, backbone mosaicism was considered a more plausible explanation. β-lactamase resistance genes tended not to show fidelity to a particular plasmid type, though some previously reported associations were supported. Overall, replicon and MOB typing schemes are likely to continue playing an important role in plasmid analysis, but their performance is constrained by the diverse and dynamic nature of plasmid genomes. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  2. Insulin resistance in multiple tissues in patients with type 1 diabetes mellitus on long-term continuous subcutaneous insulin infusion therapy

    NARCIS (Netherlands)

    Donga, Esther; van Dijk, Marieke [Leiden Univ., LUMC; Hoogma, Roel P. L. M.; Corssmit, Eleonora P. M.; Romijn, Johannes A.

    2013-01-01

    The aim of this study was to determine whether insulin resistance is present in lean patients with uncomplicated type 1 diabetes mellitus on long-term continuous subcutaneous insulin infusion (CSII), compared with matched healthy controls. We studied eight patients (four men and four women) with

  3. Verification of alternative dew point hygrometer for CV-LRT in MONJU. Short- and long-term verification of capacitance-type dew point hygrometer (Translated document)

    International Nuclear Information System (INIS)

    Ichikawa, Shoichi; Chiba, Yusuke; Ono, Fumiyasu; Hatori, Masakazu; Kobayashi, Takanori; Uekura, Ryoichi; Hashiri, Nobuo; Inuzuka, Taisuke; Kitano, Hiroshi; Abe, Hisashi

    2017-03-01

    To reduce the influence of maintenance of dew point hygrometers on the plant schedule at the prototype fast-breeder reactor MONJU, Japan Atomic Energy Agency examined a capacitance-type dew point hygrometer as an alternative to the lithium-chloride dew point hygrometer being used in the containment vessel leak rate test. As verifications, a capacitance-type dew point hygrometer was compared with a lithium-chloride dew point hygrometer under a containment vessel leak rate test condition. And the capacitance-type dew point hygrometer was compared with a high-precision-mirror-surface dew point hygrometer for long-term (2 years) in the containment vessel as an unprecedented try. A comparison of a capacitance-type dew point hygrometer with a lithium-chloride dew point hygrometer in a containment vessel leak rate test (Atmosphere: nitrogen, Testing time: 24 h) revealed no significant difference between the capacitance-type dew point hygrometer and the lithium-chloride dew point hygrometer. A comparison of the capacitance-type dew point hygrometer with the high-precision-mirror-surface dew point hygrometer for long-term verification (Atmosphere: air, Testing time: 24 months) revealed that the capacitance-type dew point hygrometer satisfied the instrumental specification (synthesized precision of detector and converter: ±2.04°C) specified in the Leak Rate Test Regulations for Nuclear Reactor Containment Vessel. It was confirmed that the capacitance-type dew point hygrometer can be used as a long-term alternative to the lithium-chloride dew point hygrometer without affecting the dew point hygrometer maintenance schedule of the MONJU plant. (author)

  4. [Nonuniform distribution and contribution of the P- and P/Q-type calcium channels to short-term inhibitory synaptic transmission in cultured hippocampal neurons].

    Science.gov (United States)

    Mizerna, O P; Fedulova, S A; Veselovs'kyĭ, M S

    2010-01-01

    In the present study, we investigated the sensitivity of GABAergic short-term plasticity to the selective P- and P/Q-type calcium channels blocker omega-agatoxin-IVA. To block the P-type channels we used 30 nM of this toxin and 200 nM of the toxin was used to block the P/Q channel types. The evoked inhibitory postsynaptic currents (eIPSC) were studied using patch-clamp technique in whole-cell configuration in postsynaptic neuron and local extracellular stimulation of single presynaptic axon by rectangular pulse. The present data show that the contribution of P- and P/Q-types channels to GABAergic synaptic transmission in cultured hippocampal neurons are 30% and 45%, respectively. It was shown that the mediate contribution of the P- and P/Q-types channels to the amplitudes of eIPSC is different to every discovered neuron. It means that distribution of these channels is non-uniform. To study the short-term plasticity of inhibitory synaptic transmission, axons of presynaptic neurons were paired-pulse stimulated with the interpulse interval of 150 ms. Neurons demonstrated both the depression and facilitation. The application of 30 nM and 200 nM of the blocker decreased the depression and increased facilitation to 8% and 11%, respectively. In addition, we found that the mediate contribution of the P- and P/Q-types channels to realization of synaptic transmission after the second stimuli is 4% less compared to that after the first one. Therefore, blocking of both P- and P/Q-types calcium channels can change the efficiency of synaptic transmission. In this instance it facilitates realization of the transmission via decreased depression or increased facilitation. These results confirm that the P- and P/Q-types calcium channels are involved in regulation of the short-term inhibitory synaptic plasticity in cultured hippocampal neurons.

  5. Semantic relatedness and similarity of biomedical terms: examining the effects of recency, size, and section of biomedical publications on the performance of word2vec.

    Science.gov (United States)

    Zhu, Yongjun; Yan, Erjia; Wang, Fei

    2017-07-03

    Understanding semantic relatedness and similarity between biomedical terms has a great impact on a variety of applications such as biomedical information retrieval, information extraction, and recommender systems. The objective of this study is to examine word2vec's ability in deriving semantic relatedness and similarity between biomedical terms from large publication data. Specifically, we focus on the effects of recency, size, and section of biomedical publication data on the performance of word2vec. We download abstracts of 18,777,129 articles from PubMed and 766,326 full-text articles from PubMed Central (PMC). The datasets are preprocessed and grouped into subsets by recency, size, and section. Word2vec models are trained on these subtests. Cosine similarities between biomedical terms obtained from the word2vec models are compared against reference standards. Performance of models trained on different subsets are compared to examine recency, size, and section effects. Models trained on recent datasets did not boost the performance. Models trained on larger datasets identified more pairs of biomedical terms than models trained on smaller datasets in relatedness task (from 368 at the 10% level to 494 at the 100% level) and similarity task (from 374 at the 10% level to 491 at the 100% level). The model trained on abstracts produced results that have higher correlations with the reference standards than the one trained on article bodies (i.e., 0.65 vs. 0.62 in the similarity task and 0.66 vs. 0.59 in the relatedness task). However, the latter identified more pairs of biomedical terms than the former (i.e., 344 vs. 498 in the similarity task and 339 vs. 503 in the relatedness task). Increasing the size of dataset does not always enhance the performance. Increasing the size of datasets can result in the identification of more relations of biomedical terms even though it does not guarantee better precision. As summaries of research articles, compared with article

  6. Long-Term Effects of the Family Check-Up in Public Secondary School on Diagnosed Major Depressive Disorder in Adulthood.

    Science.gov (United States)

    Connell, Arin M; Dishion, Thomas J

    2017-03-01

    Given the public health importance of depression, the identification of prevention programs with long-term effects on reducing the rate of depression is of critical importance, as is the examination of factors that may moderate the magnitude of such prevention effects. This study examines the impact of the Family Check-Up, delivered in public secondary schools beginning in sixth grade, on the development of major depression in adulthood (aged 28-30). The multilevel intervention program included (a) a universal classroom-based intervention focused on problem solving and peer relationship skills, (b) the Family Check-Up (selected), a brief assessment-based intervention designed to motivate parents to improve aspects of family functioning when warranted, and (c) family management treatment (indicated), focused on improving parenting skills. Demographic (gender and ethnicity) and baseline risk factors (family conflict, academic problems, antisocial behavior, and peer deviance) were examined as possible moderators in logistic regression analyses. Intervention effects on depression were moderated by baseline family conflict and academic performance, with stronger intervention effects for youth with low grade point averages and from low-conflict families at baseline. Such findings extend the emerging literature on prevention programs with long-term effects on depression, and highlight directions for future research to enhance such effects.

  7. Perceptions of safety and exposure to violence in public places among working age adults with disabilities or long-term health conditions in the UK: cross sectional study.

    Science.gov (United States)

    Emerson, E; Krnjacki, L; Llewellyn, G; Vaughan, C; Kavanagh, A

    2016-06-01

    To examine perceptions of safety and exposure to violence in public places among working age adults with and without disabilities in the UK and to assess the extent to which any between-group differences may be moderated by gender and socio-economic situation. Cross-sectional study. Secondary analysis of data collected in Wave 3 (2011-13) of Understanding Society. Data were extracted on a subsample of 5069 respondents aged 16 to 64 years (28% of whom had a disability/long-term health condition) who were administered a questionnaire module addressing experiences of harassment. Between-group comparisons were made on four self-reported indicators of safety. Respondents with disabilities/long-term health conditions were significantly more likely to have been attacked (adjusted OR 2.30, 95%CI 1.17-4.50, P condition are at significantly increased risk of exposure to interpersonal violence, particularly if they are living in poverty or are women. As such, there is a clear need to develop interventions that are targeted to the particular circumstances and needs of these high risk groups. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  8. Study on long term creep of two different types of compressed wood sheets used in library shelves

    Directory of Open Access Journals (Sweden)

    Saeid Azimi

    2016-12-01

    Full Text Available In this study, the creep behaviors of composite panels used in library shelves were investigated. For this purpose, two types of wood-composite panels (medium density fiberboard and particleboard, and three types of covering including synthetic laminates, natural veneer, and without cove, and two types of wood joints (fixed and detachable were used. Dimensions of the book-shelves were in actual shelf size, that is, 1,000 × 300 mm. Totally, 48 shelf specimens were prepared. For the creep test, a 23.5 kg loading level was applied in the center part of the shelves. Measurements on the creep behavior were carried out over 155 days at different intervals. Results indicated that the type of wood-composite as well as the type of veneer had statistically significant effect on the creep behaviors of panels. The lowest creep was observed in MDF panels. Moreover, those panels covered with natural veneer demonstrated significantly lower creep values. The type of joint also had a significant effect on the creeping behavior of the shelves, though not as conspicuous as the type of panels and veneers. Based on the results of the present research project, it is suggested that in order to increase the service life of library shelves it would be better to produce the shelves from MDF panels covered with natural veneers; these shelves should be fixed on supports.

  9. Possible source term of high concentrations of mecoprop-p in leachate and water quality: impact of climate change, public use and disposal.

    Science.gov (United States)

    Idowu, I A; Alkhaddar, R M; Atherton, W

    2014-08-01

    Mecoprop-p herbicide is often found in wells and water abstractions in many areas around Europe, the UK inclusive. There is a growing environmental and public health concern about mecoprop-p herbicide pollution in ground and surface water in England. Reviews suggest that extensive work has been carried out on the contribution of mecoprop-p herbicides from agricultural use whilst more work needs to be carried out on the contribution of mecoprop-p herbicide from non-agricultural use. The study covers two landfill sites in Weaver/Gowy Catchment. Mecoprop-p herbicide concentrations in the leachate quality range between 0.06 and 290 microg l1 in cells. High concentration ofmecoprop-p herbicide in the leachate quality suggests that there is a possible source term in the waste stream. This paper addresses the gap by exploring possible source terms of mecoprop-p herbicide contamination on landfill sites and evaluates the impact of public purchase, use and disposal alongside climate change on seasonal variations in mecoprop-p concentrations. Mecoprop-p herbicide was found to exceed the EU drinking water quality standards at the unsaturated zone/aquifer with observed average concentrations ranging between 0.005 and 7.96 microg l1. A route map for mecoprop-p herbicide source term contamination is essential for mitigation and pollution management with emphasis on both consumer and producer responsibility towards use of mecoprop-p product. In addition, improvement in data collection on mecoprop-p concentrations and detailed seasonal herbicide sales for non-agricultural purposes are needed to inform the analysis and decision process.

  10. Long-term obestatin treatment of mice type 2 diabetes increases insulin sensitivity and improves liver function.

    Science.gov (United States)

    Kołodziejski, Paweł A; Pruszyńska-Oszmałek, Ewa; Strowski, Mathias Z; Nowak, Krzysztof W

    2017-06-01

    Obestatin and ghrelin are peptides encoded by the preproghrelin gene. Obestatin inhibits food intake, in addition to regulation of glucose and lipid metabolism. Here, we test the ability of obestatin at improving metabolic control and liver function in type 2 diabetic animals (type 2 diabetes mellitus). The effects of chronic obestatin treatment of mice with experimentally induced type 2 diabetes mellitus on serum levels of glucose and lipids, and insulin sensitivity are characterized. In addition, alterations of hepatic lipid and glycogen contents are evaluated. Obestatin reduced body weight and decreased serum glucose, fructosamine, and β-hydroxybutyrate levels, as well as total and low-density lipoprotein fractions of cholesterol. In addition, obestatin increased high-density lipoproteins cholesterol levels and enhanced insulin sensitivity in mice with type 2 diabetes mellitus. Moreover, obestatin diminished liver mass, hepatic triglycerides and cholesterol contents, while glycogen content was higher in livers of healthy and mice with type 2 diabetes mellitus treated with obestatin. These changes were accompanied by reduction of increased alanine aminotransferase, aspartate aminotransferase, and gamma glutamyl transpeptidase in T2DM mice with type 2 diabetes mellitus. Obestatin increased adiponectin levels and reduced leptin concentration. Obestatin influenced the expression of genes involved in lipid and carbohydrate metabolism by increasing Fabp5 and decreasing G6pc, Pepck, Fgf21 mRNA in the liver. Obestatin increased both, AKT and AMPK phosphorylation, and sirtuin 1 (SIRT1) protein levels as well as mRNA expression in the liver. Obestatin improves metabolic abnormalities in type 2 diabetes mellitus, restores hepatic lipid contents and decreases hepatic enzymes. Therefore, obestatin could potentially have a therapeutic relevance in treating of insulin resistance and metabolic dysfunctions in type 2 diabetes mellitus.

  11. Polymorphonuclear leucocyte dysfunction during short term metabolic changes from normo- to hyperglycemia in type 1 (insulin dependent) diabetic patients

    DEFF Research Database (Denmark)

    Kjersem, H; Hilsted, J; Madsbad, S

    1988-01-01

    Polymorphonuclear leucocyte (PMN) ingestion of particles coated with lipopolysaccharide (LPS) from Escherichia coli was compared to other PMN functions in seven patients with insulin dependent diabetes mellitus (IDDM) during short-term controlled metabolic changes from normo- to hyperglycemia...... without ketoacidosis. Factors known to interfere with PMN functions were excluded. PMN ingestion of particles coated with both LPS and bovine serum albumin became reduced from normo- to hyperglycemia. PMN motility was impaired in IDDM, but did not seem to be affected by short-term changes in metabolic...... control. PMN metabolism did not change from normo-to hyperglycemia. Particle-uptake by diabetic PMN is impaired after short term hyperglycemia in the range normally occurring in diabetics in every-day life....

  12. Public green spaces and positive mental health - investigating the relationship between access, quantity and types of parks and mental wellbeing.

    Science.gov (United States)

    Wood, Lisa; Hooper, Paula; Foster, Sarah; Bull, Fiona

    2017-11-01

    Associations between parks and mental health have typically been investigated in relation to the presence or absence of mental illness. This study uses a validated measure of positive mental health and data from RESIDential Environments (RESIDE) Project to investigate the association between the presence, amount and attributes of public green space in new greenfield neighbourhood developments and the mental health of local residents (n = 492). Both the overall number and total area of public green spaces were significantly associated with greater mental wellbeing, and findings support a dose-response relationship. Positive mental health was not only associated with parks with a nature focus, but also with green spaces characterised by recreational and sporting activity. The study demonstrates that adequate provision of public green space in local neighbourhoods and within walking distance is important for positive mental health. Copyright © 2017. Published by Elsevier Ltd.

  13. The effects of fabric type, fabric width and model type on the cost of unit raw material in terms of apparel

    Science.gov (United States)

    Bilgiç, H.; Duru Baykal, P.

    2017-10-01

    The cost of the fabric which is the raw material of apparel constitutes approximately the half of the total product cost. So, it is highly important that the fabric should be used with the greatest productivity. Cost analysis are of great importance in terms of competitiveness of readymade clothing and apparel sector both in national and international markets. The proximity of costs to international average and the average cost of the countries that are competitors of Turkey in clothing market is essential for Turkey to sustain its effect in textile sector. In the contrary case, the sector won’t be able to maintain its competitive capacity sustainably [1].The main cost elements of textile and apparel sector consist of raw material, labor, energy and financing [2].

  14. Short-term plasticity in turtle dorsal horn neurons mediated by L-type Ca2+ channels

    DEFF Research Database (Denmark)

    Russo, R E; Hounsgaard, J

    1994-01-01

    Windup--the gradual increase of the response--of dorsal horn neurons to repeated activation of primary afferents is an elementary form of short-term plasticity that may mediate central sensitization to pain. In deep dorsal horn neurons of the turtle spinal cord in vitro we report windup of the re......Windup--the gradual increase of the response--of dorsal horn neurons to repeated activation of primary afferents is an elementary form of short-term plasticity that may mediate central sensitization to pain. In deep dorsal horn neurons of the turtle spinal cord in vitro we report windup...

  15. Collaborative Chat Reference Service Effectiveness Varies by Question Type for Public Library Patrons. A review of: Kwon, Nahyun. ʺPublic Library Patronsʹ Use of Collaborative Chat Reference Service: The Effectiveness of Question Answering by Question Type.ʺ Library & Information Science Research 29.1 (Mar. 2007: 70‐91.

    Directory of Open Access Journals (Sweden)

    Stephanie Hall

    2008-03-01

    Full Text Available Objective – To assess the effectiveness of a collaborative chat reference service in answering different types of question. Specifically, the study compares the degree of answer completion and the level of user satisfaction for simple factual questions vs. more in‐depth subject‐based reference questions, and for ‘local’ (pertaining to a particular library and non‐local questions.Design – Content analysis of 415 transcripts of reference transactions, which were also compared to corresponding user satisfaction survey results.Setting – An online collaborative reference service offered by a large public library system (33 branch and regional locations. This service is part of the Metropolitan Cooperative Library System: a virtual reference consortium of U.S. libraries (public, academic, special, and corporate that provides 24/7 service.Subjects – Reference librarians from around the U.S. (49 different libraries, and users logging into the service via the public library system’s portal (primarily patrons of the 49 libraries. Method – Content analysis was used to evaluate virtual reference transcripts recorded between January and June, 2004. Reliability was enhanced through triangulation, with researchers comparing the content analysis of each transcript against the results of a voluntary exit survey. Of 1,387 transactions that occurred during the period of study, 420 users completed the survey and these formed the basis of the study, apart from 5 transactions that were omitted because the questions were incomprehensible. Questions were examined and assigned to five categories: “simple, factual questions; subject‐based research questions; resource access questions; circulation‐related questions; and local library information inquiries” (80‐81. Answers were classed as either “completely answered, partially answered or unanswered, referred, and problematic endings” (82. Lastly, user satisfaction was surveyed on three

  16. Short-term and long-term effects of dipeptidyl peptidase-4 inhibitors in type 2 diabetes mellitus patients with renal impairment: a meta-analysis of randomized controlled trials.

    Science.gov (United States)

    Li, Ruifei; Wang, Rui; Li, Haixia; Sun, Sihao; Zou, Meijuan; Cheng, Gang

    2016-09-01

    To assess the short-term and long-term effects of dipeptidyl peptidase-4 (DPP-4) inhibitors in type 2 diabetes mellitus patients with renal impairment, a meta-analysis of randomized clinical trials of DPP-4 inhibitor interventions in type 2 diabetes mellitus patients with renal impairment was performed. PubMed, Embase, Cochrane Library and ClinicalTrials.gov were searched through the end of March 2015. Randomized clinical trials were selected if (1) DPP-4 inhibitors were compared with a placebo or other active-comparators, (2) the treatment duration was ≥12 weeks and (3) data regarding changes in haemoglobin A1c (HbA1c ), changes in fasting plasma glucose or hypoglycaemia and other adverse events were reported. Of 790 studies, ten studies on eight randomized clinical trials were included. Compared with the control group, DPP-4 inhibitors were associated with a greater HbA1c reduction in both the short-term [mean differences (MD) = -0.45, 95% confidence intervals (-0.57, -0.33), p 1] and long-term [MD = -0.33, 95% confidence intervals (-0.63, -0.03), p = 0.03] treatments. However, the long-term greater reduction in HbA1c with DPP-4 inhibitor treatment was only significant when the control treatment comprised placebo plus stable background treatment, but not glipizide plus stable background treatment. DPP-4 inhibitors were associated with a greater fasting plasma glucose reduction [MD = -12.59, 95% confidence intervals (-22.01, -3.17), p = 0.009] over the short-term; however, this effect was not present over the long-term. Regarding the hypoglycaemia adverse events assessment, the long-term treatment data indicated there was no increased risk of hypoglycaemia compared with placebo or active-controlled anti-diabetic drugs. The present meta-analysis confirms that DPP-4 inhibitors are effective and equivalent to other agents in type 2 diabetes mellitus patients with renal impairment. Copyright © 2015 John Wiley & Sons, Ltd. Copyright © 2015

  17. Endoscopic submucosal dissection of early colorectal neoplasms with a monopolar scissor-type knife: short- to long-term outcomes.

    Science.gov (United States)

    Kuwai, Toshio; Yamaguchi, Toshiki; Imagawa, Hiroki; Sumida, Yuki; Takasago, Takeshi; Miyasako, Yuki; Nishimura, Tomoyuki; Iio, Sumio; Yamaguchi, Atsushi; Kouno, Hirotaka; Kohno, Hiroshi; Ishaq, Sauid

    2017-09-01

    Background and study aims  Endoscopic submucosal dissection (ESD) for colorectal neoplasms remains challenging because of technical issues imposed by the complex anatomical features of the large intestine. We evaluated the feasibility, and the short- and long-term clinical outcomes of ESD for early colorectal neoplasms performed using the Stag-beetle Knife Jr. (SB Knife Jr.) Patients and methods  We retrospectively assessed 228 patients who underwent ESD for 247 colorectal lesions with the SB Knife Jr. Clinicopathological characteristics of the neoplasms, complications, and various short- and long-term outcomes were evaluated. Results  Mean tumor size was 34.3 mm and median procedure time was 76 minutes. The SB Knife Jr. achieved 98.4 % en bloc resection, 93.9 % complete resection, and 85.4 % curative resection. No perforations occurred during the procedure, and a delayed bleeding rate of 2.4 % was observed. Long-term outcomes were favorable with no distant recurrence, 1.1 % local recurrence, a 5-year overall survival rate of 94.1 % and 5-year tumor-specific survival rate of 98.6 % in patients with cancer. Conclusions  ESD using the SB Knife Jr. is technically efficient and safe in treating early colorectal neoplasms and is associated with favorable short- and long-term outcomes. © Georg Thieme Verlag KG Stuttgart · New York.

  18. Effects of Different Types of True-False Questions on Memory Awareness and Long-Term Retention

    Science.gov (United States)

    Schaap, Lydia; Verkoeijen, Peter; Schmidt, Henk

    2014-01-01

    This study investigated the effects of two different true-false questions on memory awareness and long-term retention of knowledge. Participants took four subsequent knowledge tests on curriculum learning material that they studied at different retention intervals prior to the start of this study (i.e. prior to the first test). At the first and…

  19. N-terminal pro-B-type natriuretic peptide and long-term mortality in stable coronary heart disease

    DEFF Research Database (Denmark)

    Kragelund, Charlotte; Grønning, Bjørn; Køber, Lars

    2005-01-01

    quartile was 2.4 (95 percent confidence interval, 1.5 to 4.0; Pfamily history with respect to ischemic heart disease; the presence or absence of a history......-term mortality in patients with stable coronary disease and provides prognostic information above and beyond that provided by conventional cardiovascular risk factors and the degree of left ventricular systolic dysfunction....

  20. METHODOLOGICAL FEATURES OF HISTORICAL TYPES OF ECONOMIC THEORY'S SCIENTIFIC RATIONALITY IN TERMS OF MODERN PHILOSOPHY OF SCIENCE

    Directory of Open Access Journals (Sweden)

    T. Gaidai

    2015-10-01

    Full Text Available The article studies the evolution of basic methodological features of economic theory on its different historical stages.The research highlights the fruitful usage of a new analytical approach on the basis of the achievements of modern philosophy of science. Its presents the research of main types of scientific rationality dominating at certain historical stages of science maturity. Such as historical, classical, nonclassical and postnonclassical types of scientific rationality. Structuring and research of basic methodological features of such historical types of economic theory’s scientific rationality as classical economics (end of ХVII century – 70-th of XIX century, nonclassical economics (70-th of ХІХ century – 70-th of ХХ century, postnonclassical economics (70-th of ХХст. – the beginning of ХХI century are undertaken. Methodological analysis accentuated ideological, ontological, epistemological dominants and main differences in basic techniques of the main types of economic theory’s scientific rationality. The research argues the illegality of existing in the economics literature attempts to identification or simplified reduction of more mature types of scientific rationality to the less mature. The article shows the contribution made by the leaders of classical, nonclassical and postnonclassical economics in the development of normative and positive economic methodology. It is emphasized a general tendency to methodological pluralism, pluralism of paradigmal structureand interdisciplinary of scientific economic knowledge throughout its historical development.

  1. Long-term sorption of metals is similar among plastic types: implications for plastic debris in aquatic environments.

    Directory of Open Access Journals (Sweden)

    Chelsea M Rochman

    Full Text Available Concerns regarding plastic debris and its ability to accumulate large concentrations of priority pollutants in the aquatic environment led us to quantify relationships between different types of mass-produced plastic and metals in seawater. At three locations in San Diego Bay, we measured the accumulation of nine targeted metals (aluminum, chromium, manganese, iron, cobalt, nickel, zinc, cadmium and lead sampling at 1, 3, 6, 9 and 12 months, to five plastic types: polyethylene terephthalate (PET, high-density polyethylene (HDPE, polyvinyl chloride (PVC, low-density polyethylene (LDPE, and polypropylene (PP. Accumulation patterns were not consistent over space and time, and in general all types of plastic tended to accumulate similar concentrations of metals. When we did observe significant differences among concentrations of metals at a single sampling period or location in San Diego Bay, we found that HDPE typically accumulated lesser concentrations of metals than the other four polymers. Furthermore, over the 12-month study period, concentrations of all metals increased over time, and chromium, manganese, cobalt, nickel, zinc and lead did not reach saturation on at least one plastic type during the entire 12-month exposure. This suggests that plastic debris may accumulate greater concentrations of metals the longer it remains at sea. Overall, our work shows that a complex mixture of metals, including those listed as priority pollutants by the US EPA (Cd, Ni, Zn and Pb, can be found on plastic debris composed of various plastic types.

  2. Long-term sorption of metals is similar among plastic types: implications for plastic debris in aquatic environments.

    Science.gov (United States)

    Rochman, Chelsea M; Hentschel, Brian T; Teh, Swee J

    2014-01-01

    Concerns regarding plastic debris and its ability to accumulate large concentrations of priority pollutants in the aquatic environment led us to quantify relationships between different types of mass-produced plastic and metals in seawater. At three locations in San Diego Bay, we measured the accumulation of nine targeted metals (aluminum, chromium, manganese, iron, cobalt, nickel, zinc, cadmium and lead) sampling at 1, 3, 6, 9 and 12 months, to five plastic types: polyethylene terephthalate (PET), high-density polyethylene (HDPE), polyvinyl chloride (PVC), low-density polyethylene (LDPE), and polypropylene (PP). Accumulation patterns were not consistent over space and time, and in general all types of plastic tended to accumulate similar concentrations of metals. When we did observe significant differences among concentrations of metals at a single sampling period or location in San Diego Bay, we found that HDPE typically accumulated lesser concentrations of metals than the other four polymers. Furthermore, over the 12-month study period, concentrations of all metals increased over time, and chromium, manganese, cobalt, nickel, zinc and lead did not reach saturation on at least one plastic type during the entire 12-month exposure. This suggests that plastic debris may accumulate greater concentrations of metals the longer it remains at sea. Overall, our work shows that a complex mixture of metals, including those listed as priority pollutants by the US EPA (Cd, Ni, Zn and Pb), can be found on plastic debris composed of various plastic types.

  3. Long term low dose rate irradiation causes recovery from type II diabetes and suppression of aging in type II diabetes-prone mice

    International Nuclear Information System (INIS)

    Namura, T.; Oda, T.

    2003-01-01

    The effects of low dose rate gamma irradiation on model C57BL/KsJ-db/db mice with Type II diabetes mellitus was investigated. These mice develop Type II diabetes by 10 weeks of age, due to obesity, and are characterized by hyperinsulinemia. A group of 12 female 10-week old mice were irradiated at 0.65 mGy/hr in the low dose rate irradiation facility in the Low Dose Radiation Research Center. The urine glucose levels of all of the mice were strongly positive at the beginning of the irradiation. In the irradiated group, a decrease in the glucose level was observed in three mice, one in the 35th week, another in the 52nd week and the third in the 80th week. No recovery from the diabetes was observed in the 12 mice of non-irradiated control group. There was no systematic change of body weight or consumption of food and drinking water between the irradiated group and the non-irradiated group or between the recovered mice and the non-recovered mice. Survival was better in the irradiated group. The surviving fraction at the age of 90 weeks was 75 % in the irradiated group but only 40 % in the non-irradiated. A marked difference was also observed in the appearance of the coat hair, skin and tail. The irradiated group was in much better condition. Mortality was delayed and the healthy appearance was prolonged in the irradiated mice by about 20-30 weeks compared with the control mice. These results suggest that the low dose irradiation modified the condition of the diabetic mice, leading not only to recovery from diabetes, but also to suppression of the aging process

  4. Learning from and for rare floods in Dresden – how public officials interpret damage simulation results at the building type level

    Directory of Open Access Journals (Sweden)

    Hutter Gerard

    2016-01-01

    Full Text Available Public officials in Dresden are concerned about learning from and for rare flood events like the Elbe river flood in August 2002. This is interesting because research on individual as well as organizational learning from rare events indicates that this kind of learning faces significant difficulties (e.g., overestimation of rare events for decision-making based on “emotionalized event experience”. Up to now, only little is known what and how public officials in Dresden specifically learn from and for rare floods. Therefore, the paper follows an exploratory purpose in line with principles of qualitative social research. Firstly, the paper explores dealing with rare floods with reference to a conceptual framework that highlights relations between regulative, normative, and cognitive institutions on the one hand and learning of public officials on the other. Secondly, it adopts a single case study design in Dresden with embedded sub-cases that are defined with reference to organizations of FRM. The case study shows, among others, that regulations like the Floods Directive are important for justifying FRM with regard to rare flood events which is less obvious than it sounds. However, public officials display different interpretations of the term “rare flood event”, for instance, in the context of analysing the consequences of floods on the building stock. Furthermore, the case study findings indicate that public officials may follow alternative approaches to sustain commitment in the context of rare flood events (systematic versus pragmatic approach.

  5. Long-term risk of type 2 diabetes mellitus in relation to BMI and weight change among women with a history of gestational diabetes mellitus

    DEFF Research Database (Denmark)

    Bao, Wei; Yeung, Edwina; Tobias, Deirdre K

    2015-01-01

    AIMS/HYPOTHESIS: Women with a history of gestational diabetes mellitus (GDM) are advised to control their weight after pregnancy. We aimed to examine how adiposity and weight change influence the long-term risk of developing type 2 diabetes after GDM. METHODS: We included 1,695 women who had...... incident GDM between 1991 and 2001, as part of the Diabetes & Women's Health study, and followed them until the return of the 2009 questionnaire. Body weight and incident type 2 diabetic cases were reported biennially. We defined baseline as the questionnaire period when women reported an incident GDM...... pregnancy. We estimated HRs and 95% CIs using Cox proportional hazards models. RESULTS: We documented 259 incident cases of type 2 diabetes during up to 18 years of follow-up. The adjusted HRs of type 2 diabetes associated with each 1 kg/m(2) increase in BMI were 1.16 (95% CI 1.12, 1.19) for baseline BMI...

  6. Creep and long-term strength of heat-resistant steels with different structures with the account taken of the type of stress deviator

    International Nuclear Information System (INIS)

    Giginyak, F.F.; Dragunov, Yu.G.; Mozharovskaya, T.N.; Titov, V.F.

    1993-01-01

    The results of the experimental investigations into creep and long-term strength of heat-resistant steels 15Kh2MFA and 15Kh2NMFA in the initial state and after heat-treatment simulating the metal irradiation embrittlement at the end of the product service date under static loading at the complex stress state and at high temperatures are presented. The experimentally substantiated equations of state describing creep and long-term stability of materials taking into account the type of the stress state are derived. (author)

  7. Pseudospin symmetry in the relativistic Manning-Rosen potential including a Pekeris-type approximation to the pseudo-centrifugal term

    International Nuclear Information System (INIS)

    Wei Gaofeng; Dong Shihai

    2010-01-01

    Based on the Sturm-Liouville theorem and shape invariance formalism, we study by applying a Pekeris-type approximation to the pseudo-centrifugal term the pseudospin symmetry of a Dirac nucleon subjected to scalar and vector Manning-Rosen potentials including the spin-orbit coupling term. A quartic energy equation and spinor wave functions with arbitrary spin-orbit coupling quantum number k are presented. The bound states are calculated numerically. The relativistic Manning-Rosen potential could not trap a Dirac nucleon in the limit case β→∞.

  8. Promoting long-term survival of insulin-producing cell grafts that differentiate from adipose tissue-derived stem cells to cure type 1 diabetes.

    Directory of Open Access Journals (Sweden)

    Shuzi Zhang

    Full Text Available BACKGROUND: Insulin-producing cell clusters (IPCCs have recently been generated in vitro from adipose tissue-derived stem cells (ASCs to circumvent islet shortage. However, it is unknown how long they can survive upon transplantation, whether they are eventually rejected by recipients, and how their long-term survival can be induced to permanently cure type 1 diabetes. IPCC graft survival is critical for their clinical application and this issue must be systematically addressed prior to their in-depth clinical trials. METHODOLOGY/PRINCIPAL FINDINGS: Here we found that IPCC grafts that differentiated from murine ASCs in vitro, unlike their freshly isolated islet counterparts, did not survive long-term in syngeneic mice, suggesting that ASC-derived IPCCs have intrinsic survival disadvantage over freshly isolated islets. Indeed, β cells retrieved from IPCC syngrafts underwent faster apoptosis than their islet counterparts. However, blocking both Fas and TNF receptor death pathways inhibited their apoptosis and restored their long-term survival in syngeneic recipients. Furthermore, blocking CD40-CD154 costimulation and Fas/TNF signaling induced long-term IPCC allograft survival in overwhelming majority of recipients. Importantly, Fas-deficient IPCC allografts exhibited certain immune privilege and enjoyed long-term survival in diabetic NOD mice in the presence of CD28/CD40 joint blockade while their islet counterparts failed to do so. CONCLUSIONS/SIGNIFICANCE: Long-term survival of ASC-derived IPCC syngeneic grafts requires blocking Fas and TNF death pathways, whereas blocking both death pathways and CD28/CD40 costimulation is needed for long-term IPCC allograft survival in diabetic NOD mice. Our studies have important clinical implications for treating type 1 diabetes via ASC-derived IPCC transplantation.

  9. Smoking and long-term risk of type 2 Diabetes: The EPIC-InterAct Study in European populations

    NARCIS (Netherlands)

    The InterAct Consortium, A.; Spijkerman, A.M.W.; A, van der D.L.; Nilsson, P.; Balkau, B.; Beulens, J.W.J.; Boeing, H.; Feskens, E.J.M.; Kaaks, R.

    2014-01-01

    OBJECTIVE The aims of this study were to investigate the association between smoking and incident type 2 diabetes, accounting for a large number of potential confounding factors, and to explore potential effect modifiers and intermediate factors. RESEARCH DESIGN AND METHODS The European Prospective

  10. Long-term patterns of adherence to medication therapy among patients with type 2 diabetes mellitus in Denmark

    DEFF Research Database (Denmark)

    Jensen, Majken Linnemann; Jørgensen, Marit Eika; Hansen, Ebba Holme

    2017-01-01

    : Adherence to six medicine groups (metformin, sulfonylureas, acetylsalicylic acid, thiazide diuretics, renin angiotensin system inhibitors, and statins) were analysed among 5,232 patients with type 2 diabetes at a tertiary referral hospital during 1998-2009. Rate-ratios of initiation of treatment, recurrent...

  11. Characterization of low-level waste from the industrial sector, and near-term projection of waste volumes and types

    International Nuclear Information System (INIS)

    MacKenzie, D.R.

    1988-01-01

    A telephone survey of low-level waste generators has been carried out in order to make useful estimates of the volume and nature of the waste which the generators will be shipping for disposal when the compacts and states begin operating new disposal facilities. Emphasis of the survey was on the industrial sector, since there has been little information available on characteristics of industrial LLW. Ten large industrial generators shipping to Richland, ten shipping to Barnwell, and two whose wastes had previously been characterized by BNL were contacted. The waste volume shipped by these generators accounted for about two-thirds to three-quarters of the total industrial volume. Results are given in terms of the categories of LLW represented and of the chemical characteristics of the different wastes. Estimates by the respondents of their near-term waste volume projections are presented

  12. Short-term retention of pictures and words as a function of type of distraction and length of delay interval.

    Science.gov (United States)

    Pellegrino, J W; Siegel, A W; Dhawan, M

    1976-01-01

    Picture and word triads were tested in a Brown-Peterson short-term retention task at varying delay intervals (3, 10, or 30 sec) and under acoustic and simultaneous acoustic and visual distraction. Pictures were superior to words at all delay intervals under single acoustic distraction. Dual distraction consistently reduced picture retention while simultaneously facilitating word retention. The results were interpreted in terms of the dual coding hypothesis with modality-specific interference effects in the visual and acoustic processing systems. The differential effects of dual distraction were related to the introduction of visual interference and differential levels of functional acoustic interference across dual and single distraction tasks. The latter was supported by a constant 2/1 ratio in the backward counting rates of the acoustic vs. dual distraction tasks. The results further suggest that retention may not depend on total processing load of the distraction task, per se, but rather that processing load operates within modalities.

  13. Characterization of low-level waste from the industrial sector, and near-term projection of waste volumes and types

    International Nuclear Information System (INIS)

    MacKenzie, D.R.

    1988-01-01

    A telephone survey of low-level waste generators has been carried out in order to make useful estimates of the volume and nature of the waste which the generators are shipping for disposal when the compacts and states begin operating new disposal facilities. Emphasis of the survey was on the industrial sector, since there has been little information available on characteristics of industrial LLW. Ten large industrial generators shipping to Richland, ten shipping to Barnwell, and two whose wastes had previously been characterized by BNL were contacted. The waste volume shipped by these generators accounted for about two-thirds to three-quarters of the total industrial volume. Results are given in terms of the categories of LLW represented and of the chemical characteristics of the different wastes. Estimates by the respondents of their near-term waste volume projections are presented

  14. Long-term patterns of fruit production in five forest types of the South Carolina upper coastal plain

    International Nuclear Information System (INIS)

    Greenberg, Cathryn H.; Levey, Douglas J.; Kwit, Charles; Mccarty, John P.; Pearson, Scott F.

    2012-01-01

    Fleshy fruit is a key food resource for many vertebrates and may be particularly important energy source to birds during fall migration and winter. Hence, land managers should know how fruit availability varies among forest types, seasons, and years. We quantified fleshy fruit abundance monthly for 9 years (1995–2003) in 56 0.1-ha plots in 5 forest types of South Carolina's upper Coastal Plain, USA. Forest types were mature upland hardwood and bottomland hardwood forest, mature closed-canopy loblolly (Pinus taeda) and longleaf pine (P. palustris) plantation, and recent clearcut regeneration harvests planted with longleaf pine seedlings. Mean annual number of fruits and dry fruit pulp mass were highest in regeneration harvests (264,592 ± 37,444 fruits; 12,009 ± 2,392 g/ha), upland hardwoods (60,769 ± 7,667 fruits; 5,079 ± 529 g/ha), and bottomland hardwoods (65,614 ± 8,351 fruits; 4,621 ± 677 g/ha), and lowest in longleaf pine (44,104 ± 8,301 fruits; 4,102 ± 877 g/ha) and loblolly (39,532 ± 5,034 fruits; 3,261 ± 492 g/ha) plantations. Fruit production was initially high in regeneration harvests and declined with stand development and canopy closure (1995–2003). Fruit availability was highest June–September and lowest in April. More species of fruit-producing plants occurred in upland hardwoods, bottomland hardwoods, and regeneration harvests than in loblolly and longleaf pine plantations. Several species produced fruit only in 1 or 2 forest types. In sum, fruit availability varied temporally and spatially because of differences in species composition among forest types and age classes, patchy distributions of fruiting plants both within and among forest types, fruiting phenology, high inter-annual variation in fruit crop size by some dominant fruit-producing species, and the dynamic process of disturbance-adapted species colonization and decline, or recovery in recently harvested stands. As a result, land managers could enhance fruit

  15. Which type of leader do I support in step-level public good dilemmas? The roles of level of threshold and trust.

    Science.gov (United States)

    De Cremer, David

    2007-02-01

    The present research examined the moderating effect of the level of threshold on people's preferences for different leader types in step-level public good dilemmas. It was assumed that the primary focus of people in step-level public good dilemmas is to make sure that the group surpasses the threshold. Consequently, when the level of threshold is difficult to reach people are expected to provide more support for and cooperate with a leader that monitors and controls the contributions made toward the public good. However, if the threshold is easy to surpass people will focus more on whether the obtained public good or bonus will be distributed according to agreements, suggesting that people will provide more support to and cooperate with a leader that monitors and controls the distribution of the bonus. These predictions were confirmed across two experiments using a step-level public good paradigm with a dichotomous (Study 1) and a continuous (Study 2) contribution choice. Moreover, the results also revealed that perceptions of trust accounted, in part, for the effect of level of threshold on people's leadership preferences.

  16. Short- and long-term memory in Drosophila require cAMP signaling in distinct neuron types.

    Science.gov (United States)

    Blum, Allison L; Li, Wanhe; Cressy, Mike; Dubnau, Josh

    2009-08-25

    A common feature of memory and its underlying synaptic plasticity is that each can be dissected into short-lived forms involving modification or trafficking of existing proteins and long-term forms that require new gene expression. An underlying assumption of this cellular view of memory consolidation is that these different mechanisms occur within a single neuron. At the neuroanatomical level, however, different temporal stages of memory can engage distinct neural circuits, a notion that has not been conceptually integrated with the cellular view. Here, we investigated this issue in the context of aversive Pavlovian olfactory memory in Drosophila. Previous studies have demonstrated a central role for cAMP signaling in the mushroom body (MB). The Ca(2+)-responsive adenylyl cyclase RUTABAGA is believed to be a coincidence detector in gamma neurons, one of the three principle classes of MB Kenyon cells. We were able to separately restore short-term or long-term memory to a rutabaga mutant with expression of rutabaga in different subsets of MB neurons. Our findings suggest a model in which the learning experience initiates two parallel associations: a short-lived trace in MB gamma neurons, and a long-lived trace in alpha/beta neurons.

  17. Long-Term Behaviors of the OPC Concrete with Fly-ash and Type V Concrete Applied on Reactor Containment Building

    International Nuclear Information System (INIS)

    Yoon, Eui Sik; Lee, Hee Taik; Paek, Yong Lak; Park, Young Soo

    2010-01-01

    The prestressed concrete has been used extensively in the construction of Reactor Containment Buildings (RCBs) in Korea in order to strengthen the RCBs and at the same time, prevent the release of radiation due to the Design Basis Accident and Design Basis Earthquake. It is well known that the prestressed concrete loses its prestressing force over the age, and the shrinkage and creep of the concrete significantly contributes to these long term prestressing losses. In this study, an evaluations of long term behaviors of the concrete such as creep and shrinkage have been performed for two types of concretes : Ordinary Portland Cement containing fly-ash used for the Shin- Kori 1 and 2 NPP and Type V cement used for the Ul- Chin 5 and 6 NPP

  18. Long-Term Behaviors of the OPC Concrete with Fly-ash and Type V Concrete Applied on Reactor Containment Building

    Energy Technology Data Exchange (ETDEWEB)

    Yoon, Eui Sik; Lee, Hee Taik; Paek, Yong Lak [Korea Institute of Nuclear Safety, Daejeon (Korea, Republic of); Park, Young Soo [Korea Hydro and Nuclear Power Co., Busan (Korea, Republic of)

    2010-10-15

    The prestressed concrete has been used extensively in the construction of Reactor Containment Buildings (RCBs) in Korea in order to strengthen the RCBs and at the same time, prevent the release of radiation due to the Design Basis Accident and Design Basis Earthquake. It is well known that the prestressed concrete loses its prestressing force over the age, and the shrinkage and creep of the concrete significantly contributes to these long term prestressing losses. In this study, an evaluations of long term behaviors of the concrete such as creep and shrinkage have been performed for two types of concretes : Ordinary Portland Cement containing fly-ash used for the Shin- Kori 1 and 2 NPP and Type V cement used for the Ul- Chin 5 and 6 NPP

  19. Impaired autoregulation of cerebral blood flow in long-term type I (insulin-dependent) diabetic patients with nephropathy and retinopathy

    DEFF Research Database (Denmark)

    Kastrup, J; Rørsgaard, S; Parving, H H

    1986-01-01

    Autoregulation of cerebral blood flow, i.e., the maintenance of cerebral blood flow within narrow limits during changes in arterial perfusion pressure, was studied in nine healthy control subjects and in 12 long-term Type I (insulin-dependent) diabetic patients with clinical microangiopathy...... the previous findings suggesting that autoregulation of cerebral blood flow is impaired in some long-term Type I diabetic patients with clinical microangiopathy (arteriolar hyalinosis)........ Cerebral blood flow was measured by the intravenous 133Xenon method. Mean arterial blood pressure was elevated approximately 30 mmHg by intravenous infusion of angiotensin amide II and lowered about 10 mmHg by intravenous infusion of trimethaphan camsylate. In the control subjects the flow/pressure curve...

  20. Still-Born Autonomy Insurance Plan in Quebec: An Example of a Public Long-Term Care Insurance System in Canada.

    Science.gov (United States)

    Hébert, Réjean

    2016-01-01

    Funding long-term care (LTC) is a challenge under the existing Beveridgean universal healthcare system. The Autonomy Insurance (AI) plan developed in Quebec was an attempt to introduce public LTC insurance into our healthcare system. The AI benefit was based on an assessment of the needs of older people and those with disabilities using a disability scale (SMAF) and case-mix classification system (Iso-SMAF Profiles). Under the plan, the benefit would be used to fund public institutions or purchase services from private organizations. Case managers were responsible for assessments and helping users and their families plan services and decide how to use the AI benefit. Funding AI was based on general tax revenues without capitalized funding, under a separate protected budget program. Projections were made for the additional budget needed to support AI, which would have mitigated the forecast increase in LTC spending due to population aging. All the legal, administrative, funding, training and contractual issues were dealt with, for implementation of the plan in April 2015. Unfortunately, the project was still-born for political reasons, but it demonstrates the feasibility of this essential innovation for Canada.

  1. [Analysis of public quality reports for home care and long-term care with respect to their usefulness for the customer].

    Science.gov (United States)

    Sünderkamp, Susanne; Weiß, Christian; Rothgang, Heinz

    2014-10-01

    Public quality reports, based on new legislative regulations of 2008, were supposed to offer potential customers the possibility to make a well-informed choice of a care provider. This empirical study on marks for long-term care is based on the public quality reports of the Medical Service of the Health Insurance Companies (MDK), of 11 884 home care services and 10 310 nursing homes, which corresponds to a comprehensive survey of almost all care providers in Germany. Descriptive statistical methods and discussion of the results concerning the customer benefit. The analysis of transparency reports reveals a limited value for customers, which is particularly caused by very good quality results with low scattering. In addition, a high amount of missing data - especially in the area of home care providers - leads to a growing influence of service criteria on the final grade. Though deficits in nursing might be compensated by good marks in service criteria, it rarely occurs. At present, a more detailed look at risk criteria hardly improves the customer benefit. The marks for nursing need to be improved to increase their informative value for the customer.

  2. Norwegian long-term care: Legacies, trends, and controversies - See more at: http://www.gigapp.org/index.php/component/jresearch/?view=publication&task=show&id=1807#sthash.eCzEqbqK.dpuf

    Directory of Open Access Journals (Sweden)

    Daatland, SveinOlav

    2015-02-01

    Full Text Available The NorSpaR project aims to analyse the main public policy initiatives by which Norway and Spain cope with the new social and economic challenges derived from the so-called New Social Risks (NSR. Although both countries present significant differences in their institutional settings (such as Spanish EU membership, or its belonging to diverse welfare regimes types (Norway is generally included in the Nordic regime, while Spain is part of the Mediterranean one, both countries share a common interest in addressing the aforementioned challenges while maintaining social cohesion. In the last decade, governments in both countries have tried to respond to those challenges by reforming their labour markets, adapting their unemployment schemes, as well as their gender, family and long-term care policies. The analysis covered in this project includes three areas of public policy addressing NSR. First, dependency is one of the most daunting challenges for post-industrial societies experiencing population ageing and with an increasing number of frail people in need of care. This situation is forcing governments to rethink their long-term care policies. Second, family and gender public programs need to respond to the growing difficulties of families in reconciling professional and family life. Third, in the transition to a post-industrial order, and in a context of mass unemployment, social protection systems have a renewed prominence. Along with the so-called passive policies offering financial support to the unemployed, active labour market policies are geared to put people back into work. In our analysis we try to find answers to the following questions: What are the challenges that each of these policies have been trying to address in recent years? How have these policies evolved? What kinds of reforms have been implemented, and which ones have been neglected? Have the policy goals and targets of welfare programs been modified in any significant way

  3. American Ginseng Extract (Panax quinquefolius L. Is Safe in Long-Term Use in Type 2 Diabetic Patients

    Directory of Open Access Journals (Sweden)

    Iva Mucalo

    2014-01-01

    Full Text Available Aim. The objective of the present study was to test the safety of supplementation with the American ginseng (AG interventional material as an adjunct to conventional therapy (diet and/or medications in type 2 diabetes, using a double-blind, randomized, placebo-controlled, parallel design. Methods. Each participant received either AG (10% ginsenosides or placebo capsules (500 mg/meal = 3 g/day for a period of 12 weeks. Outcomes included measures of safety including kidney function (urates and creatinine, liver function (AST and ALT, and haemostatic function (PV and INR. Results. Seventy-four participants with well-controlled type 2 diabetes (sex: 28 M and 46 F, age: 63 ± 9.5, BMI: 32 ± 5, and HbA1c: 7 ± 1.3, randomized to either intervention (n=35 or control (n=39 group, completed the study. There was no change in any of the measures of safety between treatments from baseline. The number or severity of adverse events did not differ between the AG intervention and placebo. Conclusion. Following 12 weeks of supplementation with AG, safety was not compromised in a high cardiovascular disease (CVD risk population of patients with type 2 diabetes. This demonstrated that safety is noteworthy, as reviews have continuously warned of possible adverse effects of ginseng consumption.

  4. Long-term effects of an educational intervention on self-medication and appropriate drug use in single-sex secondary public schools, Quito, Ecuador.

    Science.gov (United States)

    Maldonado, Juan-Carlos; Meléndez, Sergio D; Figueras, Albert

    2007-01-01

    *Self-medication is extensively practised in both developed and less-developed countries, sometimes inappropriately. *Educational intervention in secondary schools has been proven to be useful. *Most educational interventions in adolescent populations have focused on the reduction of addictive substance abuse. *Educational intervention can improve knowledge about self-medication and reduce misconceptions about diarrhoea, common cold and vitamins in an adolescent population. *A specific lecture followed by small working-group seminars produces better results than a general lecture alone in terms of 'knowledge' and 'attitude'. *The positive effects of the intervention are detectable even 1 year later. Yearly reinforcing interventions while in secondary school would allow long-lasting effects. Improving knowledge about rational drug use at an early age may be a good way to increase the population's awareness of health, medicines and self-medication. We set out to evaluate the short- and long-term effects of an educational intervention to promote rational drug use and self-medication in secondary school students. A non-randomized, controlled clinical trial. The participants were 367 female students (10-13 years old) from two secondary public schools of the metropolitan district of Quito (Ecuador). The educational campaign had two components [a specific lecture (intervention and control schools) and subsequent small working group seminars (intervention school)] providing short and clear messages of five topics related to rational drug use. The main outcome measures were an increase in 'knowledge' short term (1 month) and long term (up to 1 year) after intervention and the relative risk (RR) reduction in misconceptions or wrong ideas about medicine use. The intervention group showed a significant increase in knowledge both short and long term and in comparison with the control group, mainly regarding oral rehydration salts preparation (+59.4%; P < 0.001), lack of

  5. Authenticity in Obesity Public Service Announcements: Influence of Spokesperson Type, Viewer Weight, and Source Credibility on Diet, Exercise, Information Seeking, and Electronic Word-of-Mouth Intentions.

    Science.gov (United States)

    Phua, Joe; Tinkham, Spencer

    2016-01-01

    This study examined the joint influence of spokesperson type in obesity public service announcements (PSAs) and viewer weight on diet intention, exercise intention, information seeking, and electronic word-of-mouth (eWoM) intention. Results of a 2 (spokesperson type: real person vs. actor) × 2 (viewer weight: overweight vs. non-overweight) between-subjects experiment indicated that overweight viewers who saw the PSA featuring the real person had the highest diet intention, exercise intention, information seeking, and eWoM intention. Parasocial interaction was also found to mediate the relationships between spokesperson type/viewer weight and two of the dependent variables: diet intention and exercise intention. In addition, viewers who saw the PSA featuring the real person rated the spokesperson as significantly higher on source credibility (trustworthiness, competence, and goodwill) than those who saw the PSA featuring the actor.

  6. The long-term development of public attitudes towards people with epilepsy in the Czech Republic: 1981, 1984, 1998 and 2009 studies.

    Science.gov (United States)

    Novotná, I; Rektor, I

    2017-04-01

    The long-term development of public attitudes towards people with epilepsy (PWE) was studied. Four questions (Q) used in Czech questionnaires for studies in 1981, 1984, 1998 and 2009 concerned: Q1, familiarity with the concept of epilepsy; Q2, tolerance towards children with epilepsy; Q3, whether epilepsy is considered to be a mental disease; and Q4, attitudes towards employment of PWE. The quality of information about epilepsy increased significantly between 1981 and 1998, 1981 and 2009, and 1998 and 2009. The 1981 and 1984 studies reflected a level of information inferior to the levels seen in Germany and the USA, and the difference had almost disappeared in 1998 and 2009. The long-term follow-up studies in Czech Republic displayed a permanent increase in knowledge about epilepsy. This may reflect the progress in the spread of information, the efforts of patient associations and specialists and perhaps also a change in general attitudes towards people with disabilities. The dramatic change of information levels in Czech surveys could also reflect the change of the political system in 1989. A question that remains to be answered is the extent to which the positive trend reflects positive attitudes in real life. The answers to questions concerning whether people would be willing to help a person having a seizure remain unsatisfactory. Greater efforts should be made to improve the situation of PWE and to minimize their stigmatization. © 2016 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  7. Final programmatic environmental impact statement for alternative strategies for the long-term management and use of depleted uranium hexafluoride. Volume 3: Responses to public comments

    International Nuclear Information System (INIS)

    1999-04-01

    This PEIS assesses the potential impacts of alternative management strategies for depleted uranium hexafluoride (UF 6 ) currently stored at three DOE sites: Paducah site near Paducah, Kentucky, Portsmouth site near Portsmouth, Ohio; and K-25 site on the Oak Ridge Reservation, Oak Ridge, Tennessee. The alternatives analyzed in the PEIS include no action, long-term storage as UF 6 , long-term storage as uranium oxide, use as uranium oxide, use as uranium metal, and disposal. DOE's preferred alternative is to begin conversion of the depleted UF 6 inventory as soon as possible, either to uranium oxide, uranium metal, or a combination of both, while allowing for use of as much of this inventory as possible. This volume of the Final PEIS contains the comments and DOE's responses to comments received during the comment period. Chapter 2 contains photocopies of written submissions received by DOE on the Draft PEIS; DOE's responses to those comments are listed in Chapter 3. Chapter 4 provides the oral comments received at the public hearings and DOE's responses. Chapter 5 provides indices to comments and responses arranged by commentor name and by comment number

  8. Stability issues of high-energy resolution diode type CdTe nuclear radiation detectors in a long-term operation

    CERN Document Server

    Niraula, M; Aoki, T; Tomita, Y; Hatanaka, Y

    2002-01-01

    High-energy resolution diode type CdTe detectors were fabricated by growing an n-type epitaxial layer on high resistivity p-like crystal wafers, and their stability issues during a long-term operation were studied. Room temperature stability of the detectors was not good at low operating biases of around 200 V. However, it could be improved significantly by operating them at higher biases under full depletion conditions. On the other hand, detectors exhibited excellent stability by cooling them slightly below room temperature down to 0 deg. C. The effect of this low level of cooling on detector stability was found to be more significant than that of applying high biases at room temperature. By using the detector type presented here, stable operation could be obtained at moderate operating voltages of around 400 V and with a modest degree of cooling.

  9. The Effects of Long-Term Oral Benfotiamine Supplementation on Peripheral Nerve Function and Inflammatory Markers in Patients With Type 1 Diabetes

    Science.gov (United States)

    Fraser, David A.; Diep, Lien M.; Hovden, Inger Anette; Nilsen, Kristian B.; Sveen, Kari Anne; Seljeflot, Ingebjørg; Hanssen, Kristian F.

    2012-01-01

    OBJECTIVE To study the effects of long-term oral benfotiamine supplementation on peripheral nerve function and soluble inflammatory markers in patients with type 1 diabetes. RESEARCH DESIGN AND METHODS The study randomly assigned 67 patients with type 1 diabetes to receive 24-month benfotiamine (300 mg/day) or placebo supplementation. Peripheral nerve function and levels of soluble inflammatory variables were assessed at baseline and at 24 months. RESULTS Fifty-nine patients completed the study. Marked increases in whole-blood concentrations of thiamine and thiamine diphosphate were found in the benfotiamine group (both P benfotiamine (300 mg/day) supplementation over 24 months has no significant effects upon peripheral nerve function or soluble markers of inflammation in patients with type 1 diabetes. PMID:22446172

  10. Conventional and advanced implant treatment in the type II diabetic patient: surgical protocol and long-term clinical results.

    Science.gov (United States)

    Tawil, Georges; Younan, Roland; Azar, Pierre; Sleilati, Ghassan

    2008-01-01

    To investigate the effect of type-2 diabetes on implant survival and complication rate. Prospective study enrolling type-2 diabetic patients suffering from edentulism, having a mean perioperative HbA1c level of 7.2%, and compliant with a maintenance program. All the patients underwent dental and periodontal examinations and had laboratory testing for HbA1c, fasting plasma glucose, blood lipids, and microalbuminuria. Nondiabetic patients matched for implant treatment indication served as controls. The influence of clinical diabetes-related factors and periodontal parameters (Plaque Index, bleeding on probing, probing depth) on implant survival were assessed via univariate then multivariate methods. Forty-five diabetic patients, followed for 1 to 12 years, mean age 64.7 years, received 255 implants: 143 following a classical protocol and 112 in cases of sinus floor elevation, immediate loading, and guided bone regeneration. Forty-five nondiabetic control patients received 244 implants: 142 following a classical protocol and 102 in cases of advanced surgery. Implant survival following conventional or advanced implant therapy was not statistically different between the well-controlled (HbA1c diabetic group was 97.2% (control 98.8%) and was not significantly different for age, gender, diabetes duration, smoking, or type of hypoglycemic therapy. The mean peri-implant bone loss was 0.41 +/- 0.58 mm (control, 0.49 +/- 0.64 mm). PI and BOP fairly correlated with postoperative complications. HbA1c was the only multivariate independent factor affecting the complication rate (P = .04). No statistically significant difference was found for patients (P = .81) or for implants (P = .66) for the advanced surgery cases or the conventional approach in diabetic patients compared to nondiabetic patients.

  11. Crisis communication online: How medium, crisis type and emotions affected public reactions in the Fukushima Daiichi nuclear disaster

    NARCIS (Netherlands)

    Utz, S.; Schultz, F.

    2013-01-01

    Social media play in today's societies a fundamental role for the negotiation and dynamics of crises. However, classical crisis communication theories neglect the role of the medium and focus mainly on the interplay between crisis type and crisis communication strategy. Building on the recently

  12. Invading Public Spaces: Exploring the Effects of Media Type and Social Prompts on Learning Outcomes in an Interactive Environment

    Science.gov (United States)

    Downs, Edward; Erickson, Sarah; Borrett, Jacqueline

    2017-01-01

    A 2 × 2, fully-crossed, quasi-experimental design was employed to determine if type of media (rich media vs. lean media) and social prompting (presence of prompts vs. absence of prompts) would differentially impact learning outcomes for patrons interacting with an aquatic invasive species exhibit. Results indicated that the lean-media condition…

  13. Cerebral hemodynamics and systemic endothelial function are already impaired in well-controlled type 2 diabetic patients, with short-term disease.

    Directory of Open Access Journals (Sweden)

    Paola Palazzo

    Full Text Available Impaired cerebral vasomotor reactivity (VMR and flow-mediated dilation (FMD were found in selected subgroups of type 2 diabetes mellitus (T2DM patients with long-term disease. Our study aimed to evaluate cerebral hemodynamics, systemic endothelial function and sympatho-vagal balance in a selected population of well-controlled T2DM patients with short-term disease and without cardiac autonomic neuropathy (CAN.Twenty-six T2DM patients with short-term (4.40±4.80 years and well-controlled (HbA1C = 6.71±1.29% disease, without any complications, treated with diet and/or metformin, were consecutively recruited. Eighteen controls, comparable by sex and age, were enrolled also.FMD and shear rate FMD were found to be reduced in T2DM subjects with short-term disease (8.5% SD 3.5 and 2.5 SD 1.3, respectively compared to controls (15.4% SD 4.1 and 3.5 SD 1.4; p.05.In well-controlled T2DM patients with short-term disease cerebral hemodynamics and systemic endothelial function are altered while autonomic balance appeared to be preserved.

  14. Photo-induced electrochemical anodization of p-type silicon: achievement and demonstration of long term surface stability

    International Nuclear Information System (INIS)

    Dhanekar, Saakshi; Islam, S S; Harsh

    2012-01-01

    Surface stability is achieved and demonstrated by porous silicon (PS) fabricated using a wavelength-dependent photo-electrochemical (PEC) anodization technique. During anodization, the photon flux for all wavelengths was kept constant while only the effect of light wavelength on the surface morphology of PS was investigated. PS optical sensors were realized, characterized and tested using a photoluminescence (PL) quenching technique. An aliphatic chain of alcohols (methanol to n-octanol) was detected in the range of 10–200 ppm. Long term surface stability was observed from samples prepared under red (750–620 nm) and green illumination (570–495 nm), where the PL quenching cycles evoke the possibility of using PS for stable sensor device applications. This study provides a route for preparing highly sensitive organic vapour sensors with a precise selection of the fabrication parameters and demonstrating their prolonged performance. (paper)

  15. Fasting and meal-stimulated residual beta cell function is positively associated with serum concentrations of proinflammatory cytokines and negatively associated with anti-inflammatory and regulatory cytokines in patients with longer term type 1 diabetes

    DEFF Research Database (Denmark)

    Pham, Minh-Long; Kolb, H; Battelino, T

    2013-01-01

    Cytokines may promote or inhibit disease progression in type 1 diabetes. We investigated whether systemic proinflammatory, anti-inflammatory and regulatory cytokines associated differently with fasting and meal-stimulated beta cell function in patients with longer term type 1 diabetes.......Cytokines may promote or inhibit disease progression in type 1 diabetes. We investigated whether systemic proinflammatory, anti-inflammatory and regulatory cytokines associated differently with fasting and meal-stimulated beta cell function in patients with longer term type 1 diabetes....

  16. Short-term intensive insulin therapy could be the preferred option for new onset Type 2 diabetes mellitus patients with HbA1c > 9.

    Science.gov (United States)

    Weng, Jianping

    2017-10-01

    Type 2 diabetes mellitus (T2DM) is a heterogeneous disease. Currently, the typical clinical therapeutic pathway for the disease consists of the stepwise addition of antihyperglycemic preparations over time, followed lastly by insulin therapy when functional β-cell capacity is severely deteriorated. Recognizing the complexity of disease management, personalized (precision) medicine approaches may enable the physician to tailor diabetes treatment based on HbA1c levels, body mass index (BMI), efficacy, risk of hypoglycemia, risk of weight gain, age, safety, cost, and even genetic characteristics. Although insulin therapy has traditionally been recommended as the last option in the sequential treatment algorithm of T2DM, it is notable that several guidelines and consensus statements suggest consideration of insulin as part of a first-line regimen. In the American Association of Clinical Endocrinologists (AACE)/American College of Endocrinology (ACE) comprehensive T2DM 2017 management algorithm, insulin is recommended for T2DM patients presenting with symptoms and an HbA1c >9.0%. In addition, the American Diabetes Association (ADA)/European Association for the Study of Diabetes (EASD) consensus statement recommends initial insulin therapy as an option when HbA1c ≥9%, and definite consideration with HbA1c ≥10-12%, and mentions that it may be possible to taper off insulin once initial glucotoxicity is reversed and to consider transfer to other types of non-insulin therapies. Based on accumulating evidence, an expert group has endorsed the concept of short-term intensive insulin (STII) therapy as an option for some patients with T2DM at the time of diagnosis. Notably, the latest Israeli guidelines suggest considering immediate, sometimes short-term, insulin treatment for patients with HbA1c >9% or with symptoms. It has been reported that nearly one-quarter (23%) of newly diagnosed T2DM patients in the US had an HbA1c ≥9.0% prior to initiation of treatment. For such

  17. [Influences of long-term application of organic and inorganic fertilizers on the composition and abundance of nirS-type denitrifiers in black soil].

    Science.gov (United States)

    Yin, Chang; Fan, Fen-Liang; Li, Zhao-Jun; Song, A-Lin; Zhu, Ping; Peng, Chang; Liang, Yong-Chao

    2012-11-01

    The objectives of this study were to explore the effects of long-term organic and inorganic fertilizations on the composition and abundance of nirS-type denitrifiers in black soil. Soil samples were collected from 4 treatments (i. e. no fertilizer treatment, CK; organic manure treatment, OM; chemical fertilizer treatment (NPK) and combination of organic and chemical fertilizers treatment (MNPK)) in Gongzhuling Long-term Fertilization Experiment Station. Composition and abundance of nirS-type denitrifiers were analyzed with terminal restriction fragment length polymorphism (T-RFLP) and real-time quantitative PCR (Q-PCR), respectively. Denitrification enzyme activity (DEA) and soil properties were also measured. Application of organic fertilizers (OM and MNPK) significantly increased the DEAs of black soil, with the DEAs in OM and MNPK being 5.92 and 6.03 times higher than that in CK treatment, respectively, whereas there was no significant difference between NPK and CK. OM and MNPK treatments increased the abundances of nirS-type denitrifiers by 2.73 and 3.83 times relative to that of CK treatment, respectively. The abundance of nirS-type denitrifiers in NPK treatment was not significantly different from that of CK. The T-RFLP analysis of nirS genes showed significant differences in community composition between organic and inorganic treatments, with the emergence of a 79 bp T-RF, a significant decrease in relative abundance of the 84 bp T-RF and a loss of the 99 bp T-RF in all organic treatments. Phylogenetic analysis indicated that the airS-type denitrifiers in the black soil were mainly composed of alpha, beta and gamma-Proteobacteria. The 79 bp-type denitrifiers inhabiting exclusively in organic treatments (OM and MNPK) were affiliated to Pseudomonadaceae in gamma-Proteobacteria and Burkholderiales in beta-Proteobacteria. The 84 bp-types were related to Burkholderiales and Rhodocyclales. Correlation analysis indicated that pH, concentrations of total nitrogen

  18. [The profile of plasma non-esterified fatty acids in children with different terms of type 1 diabetes mellitus].

    Science.gov (United States)

    Akmurzina, V A; Petryairina, E E; Saveliev, S V; Selishcheva, A A

    2016-01-01

    Composition and quantitative content of non-esterified fatty acids (NEFA) were investigated in plasma samples of healthy children (12) and children with type 1 diabetes mellitus (DM1) (31) by gas chromatography (GC) after preliminary NEFA solid-phase extraction from plasma lipids. There was a significant (p<0.001) 1.6-fold increase in the total level of NEFA regardless of the disease duration. In the group of DM1 children with the disease period less than 1 year there was an increase in the arachidonic acid (20:4) content (30%) and the oleic acid trans-isomer (18:1) content (82%), and also a decrease in the docosahexaenoic acid (22:6 n3) content (26% ) and the docosapentaenoic acids (22:5 n-6) content (60%). In the group of DM1 children with prolonged course of this disease the altered NEFA levels returned to the normal level.

  19. Recovery Effect and Life Prolong Effect of Long Term Low-Dose Rate Irradiation on Type II Diabetes Model Mice

    International Nuclear Information System (INIS)

    Nomura, T.; Makino, N.; Oda, T.; Suzuki, I.; Sakai, K

    2004-01-01

    The effects of low-dose rate gamma-irradiation were investigated on model mice for type II diabetes mellitus, C57BL/KsJ-db/db. The mice develop the type II diabetes by 10 weeks of age due to obesity and are characterized by hyperinsulinemia. Female 10-week old mice, a group of 12 mice, were irradiated at 0.65 mGy/hr from 137-Cs (370 GBq). The urine glucose levels of all of the mice were strongly positive at the beginning of the irradiation. In the irradiated group, the decrease in the glucose level was observed in 3 mice. Such recovery from the diabetes was never observed in 12 mice of non-irradiated control group. There is no systematic difference in the change of body weight, food assumption, and amount of drinking water, between the irradiated group and the non-irradiated group or between the recovered mice and the non-recovered mice. The survival was better in the irradiated group: the surviving fraction at the age of 90 weeks was 75% in the irradiated group, while 40% in the non-irradiated. Marked difference was also observed in the appearance of the coat hair, skin, and tail; better condition was kept in the irradiated group. In the irradiated mice mortality was delayed and the healthy appearance was prolonged in the irradiated mice by about 20 ? 30 weeks compared with the non-irradiated mice. These results suggest that the low-dose irradiation modified the condition of the diabetic mice, which lead not only to the recovery of the diabetes, but also to the suppression of the aging process. (Author)

  20. Public Transparency

    OpenAIRE

    UNCTAD; World Bank

    2018-01-01

    This note provides guidance on the type of information about agricultural investments that investors and governments can make publicly available. Transparency about certain aspects of investments can improve relations between investors and communities, enable external stakeholders to hold investors to commitments, and improve investors’ public image. Although some information should be kep...

  1. Long term effect of alkali types on waste activated sludge hydrolytic acidification and microbial community at low temperature.

    Science.gov (United States)

    Jin, Baodan; Wang, Shuying; Xing, Liqun; Li, Baikun; Peng, Yongzhen

    2016-01-01

    The effect of four alkali reagents (NaOH, KOH, Ca(OH)2, mixed alkali) on waste activated sludge (WAS) hydrolytic acidification and microbial community was studied in semi-continuous fermentation systems at low temperature (15°C) over long term operational time (65day). The results showed that protein and polysaccharide of NaOH (124.26, 11.92) was similar to that of KOH (109.53, 11.30), both were higher than Ca(OH)2 (70.66, 3.74) and mixed alkali (90.66, 8.71). The short chain fatty acids (SCFAs) of NaOH (231.62) was higher than KOH (220.62mg chemical oxygen demand (COD)/g VSS). Although Ca(OH)2 system had strong acidification capacity, the shortage of SCFAs occurred due to the low activity of hydrolase. Illumina MiSeq sequencing revealed that Tissierella and Erysipelothrix were enriched in the NaOH and Ca(OH)2 systems, where Peptostreptococcaceae incertae_sedis was enriched in the NaOH and KOH systems, less Anaerolinea was involved in Ca(OH)2 condition. Copyright © 2015. Published by Elsevier Ltd.

  2. DNA typing for personal identification of urine after long-term preservation for testing in doping control.

    Science.gov (United States)

    Aoki, Kimiko; Tanaka, Hiroyuki; Ueki, Makoto

    2017-08-01

    When the tampering of a urine sample is suspected in doping control, personal identification of the sample needs to be determined by short tandem repeat (STR) analysis using DNA. We established a method for extracting DNA from urine samples stored at -20 °C without using any additives or procedures, which is consistent with how samples are required to be managed for doping control. The method, using the Puregene® Blood Core kit followed by NucleoSpin® gDNA Clean-up or NucleoSpin® gDNA Clean-up XS kit, does not need any special instrument and can provide a purified extract with high-quality DNA from up to 40 mL of urine suitable for STR analysis using an AmpFlSTR® Identifiler® PCR amplification kit. Storing urine at -20 °C is detrimental to the stability of DNA. The DNA concentration of preserved urine could not be predicted by specific gravity or creatinine level at the time of urine collection. The DNA concentration of a purified extract (10 μL) was required to be >0.06 ng/μL to ensure a successful STR analysis. Thus, the required extraction volumes of urine preserved for 3-7 years at -20 °C were estimated to be 30 mL and 20 mL to succeed in at least 86% of men and 91% of women, respectively. Considering the long half-life of DNA during long-term preservation, our extraction method is applicable to urine samples stored even for 10 years, which is currently the storage duration allowed (increased from 8 years) before re-examination in doping control. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  3. Challenges and reforms in Long-Term Care policy in Spain - See more at: http://www.gigapp.org/index.php/component/jresearch/?view=publication&task=show&id=1808#sthash.QjsbaT7Q.dpuf

    Directory of Open Access Journals (Sweden)

    Moreno-Fuentes, Francisco Javier

    2015-02-01

    Full Text Available The NorSpaR project aims to analyse the main public policy initiatives by which Norway and Spain cope with the new social and economic challenges derived from the so-called New Social Risks (NSR. Although both countries present significant differences in their institutional settings (such as Spanish EU membership, or its belonging to diverse welfare regimes types (Norway is generally included in the Nordic regime, while Spain is part of the Mediterranean one, both countries share a common interest in addressing the aforementioned challenges while maintaining social cohesion. In the last decade, governments in both countries have tried to respond to those challenges by reforming their labour markets, adapting their unemployment schemes, as well as their gender, family and long-term care policies. The analysis covered in this project includes three areas of public policy addressing NSR. First, dependency is one of the most daunting challenges for post-industrial societies experiencing population ageing and with an increasing number of frail people in need of care. This situation is forcing governments to rethink their long-term care policies. Second, family and gender public programs need to respond to the growing difficulties of families in reconciling professional and family life. Third, in the transition to a post-industrial order, and in a context of mass unemployment, social protection systems have a renewed prominence. Along with the so-called passive policies offering financial support to the unemployed, active labour market policies are geared to put people back into work. In our analysis we try to find answers to the following questions: What are the challenges that each of these policies have been trying to address in recent years? How have these policies evolved? What kinds of reforms have been implemented, and which ones have been neglected? Have the policy goals and targets of welfare programs been modified in any significant way

  4. A workplace physical activity program at a public university in Mexico can reduce medical costs associated with type 2 diabetes and hypertension.

    Science.gov (United States)

    Méndez-Hernández, Pablo; Dosamantes-Carrasco, Darina; Siani, Carole; Flores, Yvonne N; Arredondo, Armando; Lumbreras-Delgado, Irma; Granados-García, Víctor M; Denova-Gutiérrez, Edgar; Gallegos-Carrillo, Katia; Salmerón, Jorge

    2012-01-01

    To assess the impact of a workplace leisure physical activity program on healthcare expenditures for type 2 diabetes and hypertension treatment. We assessed a workplace program's potential to reduce costs by multiplying the annual healthcare costs of patients with type 2 diabetes and hypertension by the population attributable risk fraction of non-recommended physical activity levels. Feasibility of a physical activity program was assessed among 425 employees of a public university in Mexico. If 400 sedentary employees engaged in a physical activity program to decrease their risk of diabetes and hypertension, the potential annual healthcare cost reduction would be 138 880 US dollars. Each dollar invested in physical activity could reduce treatment costs of both diseases by 5.3 dollars. This research meets the call to use health economics methods to re-appraise health priorities, and devise strategies for optimal allocation of financial resources in the health sector.

  5. ICRP Publication 111 - Application of the Commission's recommendations to the protection of people living in long-term contaminated areas after a nuclear accident or a radiation emergency.

    Science.gov (United States)

    Lochard, J; Bogdevitch, I; Gallego, E; Hedemann-Jensen, P; McEwan, A; Nisbet, A; Oudiz, A; Oudiz, T; Strand, P; Janssens, A; Lazo, T; Carr, Z; Sugier, A; Burns, P; Carboneras, P; Cool, D; Cooper, J; Kai, M; Lecomte, J-F; Liu, H; Massera, G; McGarry, A; Mrabit, K; Mrabit, M; Sjöblom, K-L; Tsela, A; Weiss, W

    2009-06-01

    In this report, the Commission provides guidance for the protection of people living in long-term contaminated areas resulting from either a nuclear accident or a radiation emergency. The report considers the effects of such events on the affected population. This includes the pathways of human exposure, the types of exposed populations, and the characteristics of exposures. Although the focus is on radiation protection considerations, the report also recognises the complexity of post-accident situations, which cannot be managed without addressing all the affected domains of daily life, i.e. environmental, health, economic, social, psychological, cultural, ethical, political, etc. The report explains how the 2007 Recommendations apply to this type of existing exposure situation, including consideration of the justification and optimisation of protection strategies, and the introduction and application of a reference level to drive the optimisation process. The report also considers practical aspects of the implementation of protection strategies, both by authorities and the affected population. It emphasises the effectiveness of directly involving the affected population and local professionals in the management of the situation, and the responsibility of authorities at both national and local levels to create the conditions and provide the means favouring the involvement and empowerment of the population. The role of radiation monitoring, health surveillance, and the management of contaminated foodstuffs and other commodities is described in this perspective. The Annex summarises past experience of longterm contaminated areas resulting from radiation emergencies and nuclear accidents, including radiological criteria followed in carrying out remediation measures.

  6. Changes in chemical quality indices during long-term storage of palm-olein oil under heated storage and transport-type conditions

    CSIR Research Space (South Africa)

    Van der Merwe, GH

    2004-01-15

    Full Text Available of Food and Agriculture J Sci Food Agric 84:52?58 (online: 2003) DOI: 10.1002/jsfa.1609 Changes in chemical quality indices during long-term storage of palm-olein oil under heated storage and transport-type conditions Gretel H van der Merwe,1asteriskmath... Lourens M du Plessis1 and John RN Taylor2 1CSIR Bio/Chemtek, PO Box 395, Pretoria 0001, South Africa 2Department of Food Science, University of Pretoria, Pretoria 0002, South Africa Abstract: Six quality indices, namely free fatty acids (FFA), peroxide...

  7. Application feasibility study of evaluation technology for long-term rock behavior. 2. Parameter setting of variable compliance type model and application feasibility study for rock behavior evaluation

    International Nuclear Information System (INIS)

    Sato, Shin; Noda, Masaru; Niunoya, Sumio; Hata, Koji; Matsui, Hiroya; Mikake, Shinichiro

    2012-01-01

    Creep phenomenon is one of the long-term rock behaviors. In many of rock-creep studies, model and parameter have been verified in 2D analysis using model parameter acquired by uniaxial compression test etc considering rock types. Therefore, in this study model parameter was set by uniaxial compression test with classified rock samples which were taken from pilot boring when the main shaft was constructed. Then, comparison between measured value and 3D excavation analysis with identified parameter was made. By and large, the study showed that validity of identification methodology of parameter to identify reproduction of measured value and analysis method. (author)

  8. Long-term impact of childhood-onset type 1 diabetes on social life, quality of life and sexuality.

    Science.gov (United States)

    Mellerio, H; Guilmin-Crépon, S; Jacquin, P; Labéguerie, M; Lévy-Marchal, C; Alberti, C

    2015-12-01

    This study describes the socio-professional outcomes, health-related quality of life (HRQOL) and sexuality of adults with childhood-onset type 1 diabetes (T1D). The study participants (n=388), recruited from a nationwide registry (age: 28.5 ± 3.1 years; T1D duration: 17.0 ± 2.7 years), completed a questionnaire (198 items); the results were compared with the French general population using standardized incidence ratios (SIRs) and Z scores matched for age, gender and period with/without education levels and patterns of family life. Linear regression models also investigated correlates of SF-36 Physical (PCS) and Mental Composite Scores (MCS). Compared with the French general population, education levels of people with T1D were similar, with 68.6% having at least a high-school diploma or higher (SIR: 1.06, 95% CI: 0.93; 1.20), as were also their patterns of family life. Unemployment was higher in T1D women (15.3%, SIR: 1.50, 1.00; 2.05), but not in T1D men (8.6%, SIR: 0.96, 0.51; 1.57). Social discrimination was more common (SIR: 5.64, 4.64; 6.62), and frequency of daily alcohol consumption was higher (SIR: men, 3.34, 2.38; 4.54; women, 6.53, 4.57; 12.99). PCS and MCS were decreased moderately (mean ± SD: 52.0 ± 7.5; mean Z score: -0.2, 95% CI: -0.3; -0.1) and substantially (mean ± SD: 42.1 ± 12.4; mean Z score: -0.7, -0.8; -0.6), respectively. Fatigue and abandoning sports were predictive of a lower HRQOL. Both men and women were more frequently dissatisfied with their sex life. Prevalence of sexual problems was higher in women (SIR for: dysorgasmia, 1.91, 1.21-2.88; decreased/loss of desire: 2.11, 1.35-3.08), but similar in men. Participants with T1D-related complications had preserved social outcomes, but altered HRQOL. Young adults with T1D have satisfactory social participation. However, their higher alcohol consumption, lower MCS and frequent dissatisfaction with sexuality suggest a heavy impact of the disease on morale, especially in women. Improving the

  9. Long-term changes in collagen formation expressed by serum carboxyterminal propeptide of type-I procollagen and relation to left ventricular function after acute myocardial infarction

    DEFF Research Database (Denmark)

    Poulsen, S H; Høst, N B; Egstrup, K

    2001-01-01

    and prognosis following acute myocardial infarction (AMI). Forty-eight consecutive patients with their first AMI and 15 control subjects were studied. Patients with AMI were stratified according to the changes in s-PICP levels between days 1 and 90 (DeltaPICP) and divided into group I with ...The purpose of this study was to investigate the long-term sequential changes in serum levels of the carboxyterminal propeptide of type-I procollagen (s-PICP), which is a marker of type-I collagen synthesis, and to assess its clinical value in relation to left ventricular (LV) function....../l or group II with >16.0 microg/l. Patients in group II were characterized by LV dilatation, no improvement in ejection fraction and development of impaired diastolic filling from day 1 to 360, findings which were in contrast to group I. Cox regression analysis identified changes in s-PICP of >16.0 microg...

  10. Short-term cost-effectiveness of insulin detemir and insulin aspart in people with type 1 diabetes who are prone to recurrent severe hypoglycemia

    DEFF Research Database (Denmark)

    Pedersen-Bjergaard, Ulrik; Kristensen, Peter Lommer; Nørgaard, Kirsten

    2016-01-01

    to a lower event rate. QALYs were higher with insulin analogues vs. human insulin (difference 0.0672). The resulting ICER was 27,685 DKK (2674 GBP) per QALY gained, which is well below the generally accepted cost–effectiveness threshold. Conclusions: The analysis shows that treating people with type 1......Objective: Based on the data of the HypoAna trial (ClinicalTrials.gov NCT00346996), a short-term cost–effectiveness analysis was conducted comparing an all insulin analogue regimen with an all human insulin regimen in people with type 1 diabetes who are prone to recurrent severe hypoglycemia....... Methods: Clinical data from the HypoAna trial and Danish cost data related to the treatment of severe hypoglycemia were used to populate a 1-year cost–effectiveness analysis. Hypoglycemia quality-of-life data were based on previously published utility values, used to calculate the quality-adjusted life...

  11. Meaning Of The Term "Corruption Offense" As A Feature Of The Public Prosecutor's Supervision Over The Legislation On The Corruption Counteraction In The Municipal Governments Execution

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    Kseniya D. Okuneva

    2014-12-01

    Full Text Available In the present article theoretical and practical aspects of the corruption offense definition, which are being characteristic features of the methodology of prosecutorial supervision over the legislation on counteraction to corruption in local government are analyzed. Federal Law of Jan. 17, 1992 No. 2202-1 "On the Procuracy of the Russian Federation" (Article 21 establishes the public prosecutor's supervision over the legislation on combating corruption in local government execution, which is a special sub-cluster. On general terms of theoretical techniques of the prosecutor's supervision, taking into account its specific and complex nature of corruption prosecutors based activities in this area. Author emphasizes attention on characteristics of the corruption offense, as well as aspects of legal responsibility, which lie in the fact that it is applied in accordance with law to offender as measures of state coercion of personal, financial or organizational nature for the offense committed; responsibilities of the person, who committed the offense, to be subject to measures of state coercion. In the conclusion author notes that specifics of corruption offenses that are subject of prosecutorial supervision over the execution of legislation on combating corruption in local government is determined by the special status of the offense subjects, as well as the content of legal prohibitions and legal responsibilities in the field of ​​anti-corruption at the municipal level.

  12. Public Health and Air Pollution in Asia (PAPA): a multicity study of short-term effects of air pollution on mortality.

    Science.gov (United States)

    Wong, Chit-Ming; Vichit-Vadakan, Nuntavarn; Kan, Haidong; Qian, Zhengmin

    2008-09-01

    Although the deleterious effects of air pollution from fossil fuel combustion have been demonstrated in many Western nations, fewer studies have been conducted in Asia. The Public Health and Air Pollution in Asia (PAPA) project assessed the effects of short-term exposure to air pollution on daily mortality in Bangkok, Thailand, and in three cities in China: Hong Kong, Shanghai, and Wuhan. Poisson regression models incorporating natural spline smoothing functions were used to adjust for seasonality and other time-varying covariates that might confound the association between air pollution and mortality. Effect estimates were determined for each city and then for the cities combined using a random effects method. In individual cities, associations were detected between most of the pollutants [nitrogen dioxide, sulfur dioxide, particulate matter air pollution than those in Western industrial nations because they spend more time outdoors and less time in air conditioning. Although the social and environmental conditions may be quite different, it is reasonable to apply estimates derived from previous health effect of air pollution studies in the West to Asia.

  13. Perceived organizational justice as a predictor of long-term sickness absence due to diagnosed mental disorders: results from the prospective longitudinal Finnish Public Sector Study.

    Science.gov (United States)

    Elovainio, Marko; Linna, Anne; Virtanen, Marianna; Oksanen, Tuula; Kivimäki, Mika; Pentti, Jaana; Vahtera, Jussi

    2013-08-01

    Organizational justice perceptions have been suggested to be associated with symptoms of mental health but the nature of the association is unknown due to reporting bias (measurement error related to response style and reversed causality). In this study, we used prospective design and long-term (>9 days) sickness absence with psychiatric diagnosis as the outcome measure. Participants were 21,221 Finnish public sector employees (the participation rate at baseline in 2000-2002 68%), who responded to repeated surveys of procedural and interactional justice in 2000-2004 along with register data on sickness absence with a diagnosis of depression or anxiety disorders (822 cases). Results from logistic regression analyses showed that a one-unit increase in self-reported and work-unit level co-worker assessed interactional justice was associated with a 25-32% lower odds of sickness absence due to anxiety disorders. These associations were robust to adjustments for a variety of potential individual-level confounders including chronic disease (adjusted OR for self-reported interactional justice 0.77, 95% CI 0.65-0.91) and were replicated using co-worker assessed justice. Only weak evidence of reversed causality was found. The results suggest that low organizational justice is a risk factor for sickness absence due to anxiety disorders. Copyright © 2013 Elsevier Ltd. All rights reserved.

  14. Brokering: a process for establishing long-term and stable links with gay male communities for research and public health education.

    Science.gov (United States)

    Silvestre, A J

    1994-02-01

    The success of efforts to prevent continued transmission of the human immunodeficiency virus (HIV) and to increase compliance with HIV prophylactic interventions among homosexual and bisexual men will depend in part on health care professionals' understanding of and ability to establish linkages with these men. In order to recruit men into a research project and an educational program, staff at the Pitt Men's Study, an epidemiological investigation of HIV infection, developed a process described here as "brokering," which was based on community organizing and marketing principles. Brokering is a dynamic process by which researchers and public health professionals exchange goods and services with formal and informal leaders of the gay community in order to establish strong, long-term linkages. To date, this process yielded 2,989 homosexual and bisexual recruits into the study, which began in 1983. After 8 years, 79% of those still alive continue to return for follow-up. While recruitment techniques will need to vary from city to city, the importance of establishing linkages with the local indigenous leadership remains of major importance.

  15. Effects of Short-Term Exenatide Treatment on Regional Fat Distribution, Glycated Hemoglobin Levels, and Aortic Pulse Wave Velocity of Obese Type 2 Diabetes Mellitus Patients

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    Ju-Young Hong

    2016-03-01

    Full Text Available BackgroundMost type 2 diabetes mellitus patients are obese and have obesity related vascular complications. Exenatide treatment is well known for both decreasing glycated hemoglobin levels and reduction in body weight. So, this study aimed to determine the effects of exenatide on body composition, glycated hemoglobin levels, and vascular stiffness in obese type 2 diabetes mellitus patients.MethodsFor 1 month, 32 obese type 2 diabetes mellitus patients were administered 5 µg of exenatide twice daily. The dosage was then increased to 10 µg. Patients' height, body weight, glycated hemoglobin levels, lipid profile, pulse wave velocity (PWV, body mass index, fat mass, and muscle mass were measured by using Inbody at baseline and after 3 months of treatment.ResultsAfter 3 months of treatment, glycated hemoglobin levels decreased significantly (P=0.007. Triglyceride, total cholesterol, and low density lipoprotein levels decreased, while aspartate aminotransferase and alanine aminotransferase levels were no change. Body weight, and fat mass decreased significantly (P=0.002 and P=0.001, respectively, while interestingly, muscle mass did not decrease (P=0.289. In addition to, Waist-to-hip ratio and aortic PWV decreased significantly (P=0.006 and P=0.001, respectively.ConclusionEffects of short term exenatide use in obese type 2 diabetes mellitus with cardiometabolic high risk patients not only reduced body weight without muscle mass loss, body fat mass, and glycated hemoglobin levels but also improved aortic PWV in accordance with waist to hip ratio.

  16. Implications of publicly available genomic data resources in searching for therapeutic targets of obesity and type 2 diabetes.

    Science.gov (United States)

    Jung, Sungwon

    2018-04-20

    Obesity and type 2 diabetes (T2D) are two major conditions that are related to metabolic disorders and affect a large population. Although there have been significant efforts to identify their therapeutic targets, few benefits have come from comprehensive molecular profiling. This limited availability of comprehensive molecular profiling of obesity and T2D may be due to multiple challenges, as these conditions involve multiple organs and collecting tissue samples from subjects is more difficult in obesity and T2D than in other diseases, where surgical treatments are popular choices. While there is no repository of comprehensive molecular profiling data for obesity and T2D, multiple existing data resources can be utilized to cover various aspects of these conditions. This review presents studies with available genomic data resources for obesity and T2D and discusses genome-wide association studies (GWAS), a knockout (KO)-based phenotyping study, and gene expression profiles. These studies, based on their assessed coverage and characteristics, can provide insights into how such data can be utilized to identify therapeutic targets for obesity and T2D.

  17. Public values in public-private partnerships

    NARCIS (Netherlands)

    Reynaers, A.; de Graaf, G.

    2014-01-01

    Although public-private partnerships (PPPs) are often evaluated in terms of efficiency, their impact on public values is often neglected. In order to find out what we know about the public values-PPPs relation, this article reviews public administration literature and describes two opposite

  18. Applying a private sector capitation model to the management of type 2 diabetes in the South African public sector: a cost-effectiveness analysis.

    Science.gov (United States)

    Volmink, Heinrich C; Bertram, Melanie Y; Jina, Ruxana; Wade, Alisha N; Hofman, Karen J

    2014-09-30

    Diabetes mellitus contributes substantially to the non-communicable disease burden in South Africa. The proposed National Health Insurance system provides an opportunity to consider the development of a cost-effective capitation model of care for patients with type 2 diabetes. The objective of the study was to determine the potential cost-effectiveness of adapting a private sector diabetes management programme (DMP) to the South African public sector. Cost-effectiveness analysis was undertaken with a public sector model of the DMP as the intervention and a usual practice model as the comparator. Probabilistic modelling was utilized for incremental cost-effectiveness ratio analysis with life years gained selected as the outcome. Secondary data were used to design the model while cost information was obtained from various sources, taking into account public sector billing. Modelling found an incremental cost-effectiveness ratio (ICER) of ZAR 8 356 (USD 1018) per life year gained (LYG) for the DMP against the usual practice model. This fell substantially below the Willingness-to-Pay threshold with bootstrapping analysis. Furthermore, a national implementation of the intervention could potentially result in an estimated cumulative gain of 96 997 years of life (95% CI 71 073 years - 113 994 years). Probabilistic modelling found the capitation intervention to be cost-effective, with an ICER of ZAR 8 356 (USD 1018) per LYG. Piloting the service within the public sector is recommended as an initial step, as this would provide data for more accurate economic evaluation, and would also allow for qualitative analysis of the programme.

  19. Short-term high-intensity interval and moderate-intensity continuous training reduce leukocyte TLR4 in inactive adults at elevated risk of type 2 diabetes.

    Science.gov (United States)

    Robinson, Emily; Durrer, Cody; Simtchouk, Svetlana; Jung, Mary E; Bourne, Jessica E; Voth, Elizabeth; Little, Jonathan P

    2015-09-01

    Exercise can have anti-inflammatory effects in obesity, but the optimal type and intensity of exercise are not clear. This study compared short-term high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) in terms of improvement in cardiorespiratory fitness, markers of inflammation, and glucose control in previously inactive adults at elevated risk of developing type 2 diabetes. Thirty-nine inactive, overweight/obese adults (32 women) were randomly assigned to 10 sessions over 2 wk of progressive HIIT (n = 20, four to ten 1-min sessions at ∼90% peak heart rate, 1-min rest periods) or MICT (n = 19, 20-50 min at ∼65% peak heart rate). Before and 3 days after training, participants performed a peak O2 uptake test, and fasting blood samples were obtained. Both HIIT (1.8 ± 0.4 vs. 1.9 ± 0.4 l/min, pre vs. post) and MICT (1.8 ± 0.5 vs. 1.9 ± 0.5 l/min, pre vs. post) improved peak O2 uptake (P fasting plasma glucose (P fasting glucose. Copyright © 2015 the American Physiological Society.

  20. Short-term high-intensity interval and moderate-intensity continuous training reduce leukocyte TLR4 in inactive adults at elevated risk of type 2 diabetes

    Science.gov (United States)

    Robinson, Emily; Durrer, Cody; Simtchouk, Svetlana; Jung, Mary E.; Bourne, Jessica E.; Voth, Elizabeth

    2015-01-01

    Exercise can have anti-inflammatory effects in obesity, but the optimal type and intensity of exercise are not clear. This study compared short-term high-intensity interval training (HIIT) with moderate-intensity continuous training (MICT) in terms of improvement in cardiorespiratory fitness, markers of inflammation, and glucose control in previously inactive adults at elevated risk of developing type 2 diabetes. Thirty-nine inactive, overweight/obese adults (32 women) were randomly assigned to 10 sessions over 2 wk of progressive HIIT (n = 20, four to ten 1-min sessions at ∼90% peak heart rate, 1-min rest periods) or MICT (n = 19, 20-50 min at ∼65% peak heart rate). Before and 3 days after training, participants performed a peak O2 uptake test, and fasting blood samples were obtained. Both HIIT (1.8 ± 0.4 vs. 1.9 ± 0.4 l/min, pre vs. post) and MICT (1.8 ± 0.5 vs. 1.9 ± 0.5 l/min, pre vs. post) improved peak O2 uptake (P HIIT and MICT (P HIIT and MICT (P HIIT or MICT can improve cardiorespiratory fitness and glucose control and lead to reductions in TLR2 and TLR4 expression. MICT, which involved a longer duration of exercise, may be superior for reducing fasting glucose. PMID:26139217

  1. NMDA receptors in mouse anterior piriform cortex initialize early odor preference learning and L-type calcium channels engage for long-term memory.

    Science.gov (United States)

    Mukherjee, Bandhan; Yuan, Qi

    2016-10-14

    The interactions of L-type calcium channels (LTCCs) and NMDA receptors (NMDARs) in memories are poorly understood. Here we investigated the specific roles of anterior piriform cortex (aPC) LTCCs and NMDARs in early odor preference memory in mice. Using calcium imaging in aPC slices, LTCC activation was shown to be dependent on NMDAR activation. Either D-APV (NMDAR antagonist) or nifedipine (LTCC antagonist) reduced somatic calcium transients in pyramidal cells evoked by lateral olfactory tract stimulation. However, nifedipine did not further reduce calcium in the presence of D-APV. In mice that underwent early odor preference training, blocking NMDARs in the aPC prevented short-term (3 hr) and long-term (24 hr) odor preference memory, and both memories were rescued when BayK-8644 (LTCC agonist) was co-infused. However, activating LTCCs in the absence of NMDARs resulted in loss of discrimination between the conditioned odor and a similar odor mixture at 3 hr. Elevated synaptic AMPAR expression at 3 hr was prevented by D-APV infusion but restored when LTCCs were directly activated, mirroring the behavioral outcomes. Blocking LTCCs prevented 24 hr memory and spared 3 hr memory. These results suggest that NMDARs mediate stimulus-specific encoding of odor memory while LTCCs mediate intracellular signaling leading to long-term memory.

  2. Low-carbohydrate diet and type 2 diabetes risk in Japanese men and women: the Japan Public Health Center-Based Prospective Study.

    Directory of Open Access Journals (Sweden)

    Akiko Nanri

    Full Text Available Evidence is sparse and contradictory regarding the association between low-carbohydrate diet score and type 2 diabetes risk, and no prospective study examined the association among Asians, who consume greater amount of carbohydrate. We prospectively investigated the association of low-carbohydrate diet score with type 2 diabetes risk.Participants were 27,799 men and 36,875 women aged 45-75 years who participated in the second survey of the Japan Public Health Center-Based Prospective Study and who had no history of diabetes. Dietary intake was ascertained by using a validated food-frequency questionnaire, and low-carbohydrate diet score was calculated from total carbohydrate, fat, and protein intake. The scores for high animal protein and fat or for high plant protein and fat were also calculated. Odds ratios of self-reported, physician-diagnosed type 2 diabetes over 5-year were estimated by using logistic regression.During the 5-year period, 1191 new cases of type 2 diabetes were self-reported. Low-carbohydrate diet score for high total protein and fat was significantly associated with a decreased risk of type 2 diabetes in women (P for trend <0.001; the multivariable-adjusted odds ratio of type 2 diabetes for the highest quintile of the score were 0.63 (95% confidence interval 0.46-0.84, compared with those for the lowest quintile. Additional adjustment for dietary glycemic load attenuated the association (odds ratio 0.75, 95% confidence interval 0.45-1.25. When the score separated for animal and for plant protein and fat, the score for high animal protein and fat was inversely associated with type 2 diabetes in women, whereas the score for high plant protein and fat was not associated in both men and women.Low-carbohydrate diet was associated with decreased risk of type 2 diabetes in Japanese women and this association may be partly attributable to high intake of white rice. The association for animal-based and plant-based low

  3. Diabetes MILES--Australia (management and impact for long-term empowerment and success: methods and sample characteristics of a national survey of the psychological aspects of living with type 1 or type 2 diabetes in Australian adults

    Directory of Open Access Journals (Sweden)

    Speight Jane

    2012-02-01

    Full Text Available Abstract Background Successful management of diabetes requires attention to the behavioural, psychological and social aspects of this progressive condition. The Diabetes MILES (Management and Impact for Long-term Empowerment and Success Study is an international collaborative. Diabetes MILES--Australia, the first Diabetes MILES initiative to be undertaken, was a national survey of adults living with type 1 or type 2 diabetes in Australia. The aim of this study was to gather data that will provide insights into how Australians manage their diabetes, the support they receive and the impact of diabetes on their lives, as well as to use the data to validate new diabetes outcome measures. Methods/design The survey was designed to include a core set of self-report measures, as well as modules specific to diabetes type or management regimens. Other measures or items were included in only half of the surveys. Cognitive debriefing interviews with 20 participants ensured the survey content was relevant and easily understood. In July 2011, the survey was posted to 15,000 adults (aged 18-70 years with type 1 or type 2 diabetes selected randomly from the National Diabetes Services Scheme (NDSS database. An online version of the survey was advertised nationally. A total of 3,338 eligible Australians took part; most (70.4% completed the postal survey. Respondents of both diabetes types and genders, and of all ages, were adequately represented in both the postal and online survey sub-samples. More people with type 2 diabetes than type 1 diabetes took part in Diabetes MILES--Australia (58.8% versus 41.2%. Most respondents spoke English as their main language, were married/in a de facto relationship, had at least a high school education, were occupied in paid work, had an annual household income > $AUS40,000, and lived in metropolitan areas. Discussion A potential limitation of the study is the under-representation of respondents from culturally and

  4. Long pulsed Nd: YAG laser with inbuilt cool sapphire tip for long term hair reduction on type- IV and V skin: A prospective analysis of 200 patients

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    Nanda Soni

    2010-01-01

    Full Text Available Background: Laser hair reduction has become a very popular means to get rid of unwanted hair. Aims: We conducted the current study to evaluate the safety and efficacy of Nd: YAG laser on dark skin. We also evaluated the effect of increasing the gap between sessions on the long term efficacy of hair reduction achieved with long pulsed Nd: YAG laser. Methods: A prospective study was conducted on 200 consecutive female patients who underwent laser hair reduction for unwanted hair over the face, at Kaya skin clinic Delhi, with long pulsed Nd: YAG laser, from May 2006 to May 2009. The gap between sessions was increased from 2 nd session itself. Results were evaluated 6 months after 6 sessions. Also a note was made of worsening of hair growth or any side effects experienced the patient during any of the sessions. Results: A total of 200 female patients (160 skin type IV and 40 skin type V were followed up. Of these, 64 enrolled for lower face, 88 for chin or upper neck and 48 for upper lip. 6 months after 6 sessions, more than 50% improvement was seen in 68.7% of lower face, 89.69% cases of chin and 59% of upper lip cases. None of the patients had any worsening. Conclusions: The current study shows that long pulsed Nd: YAG is a very safe and effective means of hair reduction in skin types IV and V. Adequate fluences and increasing the gap between sessions from the 2 nd session could be the key to achieving long term hair reduction with Nd: YAG laser. Adequate cooling and proper shaving are the key factors determining the safety.

  5. [Analysis on the long-term effects of modified double endobutton technique in the treatment of Tossy type III acromioclavicular joint dislocations].

    Science.gov (United States)

    Yan, Rui-Jian; Lu, Jian-Wei; Zhang, Chun

    2014-01-01

    To investigate the long-term clinical effects of modified double Endobutton technique for the treatment of acromioclavicular joint dislocations of Tossy type III. A retrospective study was done in 42 patients with acromioclavicular joint dislocations of Tossy type III treated with modified double Endobutton technique from December 2008 to December 2010. There were 24 males and 18 females, ranging in age from 21 to 56 years old (averaged, 32.5 years old). All the patients were treated with open reduction, coracoclavicular ligament reconstruction using double Endobutton technique, and repair of acromioclavicular ligament. The Karlsson system was used to evaluate therapeutic effects. The distance from coracoid to clavicle was measured to evaluate reduction loss. All the patients were followed up, and the duration ranged from 2.0 to 3.2 years (averaged,2.4 years). According to Karlsson system, 32 patients got an A degree and 10 patients got a B degree at three months post-operatively; 26 patients got an A degree and 16 patients got a B degree at the latest follow-up; 6 patients got an A degree at 3 months after operation lowered to B degree at the latest follow-up. The coracoid-clavicle distance increased from (26.91 +/- 0.91) mm at 3 months after operation to (27.41 +/- 1.10) mm at the latest follow-up. Te patients treated with over-reduction during operation or with heavy physical labour work after operation had obvious widened coracoid-clavicle distance. Bone absorption was found around the plate in most cases, mainly in the clavicular side. Treatment for acromioclavicular joint dislocations of Tossy type III with modified double Endobutton technique has satisfactory early clinical results. But with time passing, loss of reduction and bone absorption around the plate could be observed, and clinical outcomes of some cases downgrade during the long-term follow-up.

  6. Proof-of-concept, randomized, controlled clinical trial of Bacillus-Calmette-Guerin for treatment of long-term type 1 diabetes.

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    Denise L Faustman

    Full Text Available No targeted immunotherapies reverse type 1 diabetes in humans. However, in a rodent model of type 1 diabetes, Bacillus Calmette-Guerin (BCG reverses disease by restoring insulin secretion. Specifically, it stimulates innate immunity by inducing the host to produce tumor necrosis factor (TNF, which, in turn, kills disease-causing autoimmune cells and restores pancreatic beta-cell function through regeneration.Translating these findings to humans, we administered BCG, a generic vaccine, in a proof-of-principle, double-blind, placebo-controlled trial of adults with long-term type 1 diabetes (mean: 15.3 years at one clinical center in North America. Six subjects were randomly assigned to BCG or placebo and compared to self, healthy paired controls (n = 6 or reference subjects with (n = 57 or without (n = 16 type 1 diabetes, depending upon the outcome measure. We monitored weekly blood samples for 20 weeks for insulin-autoreactive T cells, regulatory T cells (Tregs, glutamic acid decarboxylase (GAD and other autoantibodies, and C-peptide, a marker of insulin secretion. BCG-treated patients and one placebo-treated patient who, after enrollment, unexpectedly developed acute Epstein-Barr virus infection, a known TNF inducer, exclusively showed increases in dead insulin-autoreactive T cells and induction of Tregs. C-peptide levels (pmol/L significantly rose transiently in two BCG-treated subjects (means: 3.49 pmol/L [95% CI 2.95-3.8], 2.57 [95% CI 1.65-3.49] and the EBV-infected subject (3.16 [95% CI 2.54-3.69] vs.1.65 [95% CI 1.55-3.2] in reference diabetic subjects. BCG-treated subjects each had more than 50% of their C-peptide values above the 95(th percentile of the reference subjects. The EBV-infected subject had 18% of C-peptide values above this level.We conclude that BCG treatment or EBV infection transiently modified the autoimmunity that underlies type 1 diabetes by stimulating the host innate immune response. This suggests that BCG or other

  7. [Long-term destiny of adolescents and young adults with de novo acute lymphoblastic leukemia treated with a pediatric protocol type].

    Science.gov (United States)

    López-Hernández, Manuel Antonio; Alvarado-Ibarra, Martha; Álvarez-Veral, José Luis; Ortiz-Zepeda, Maricela; Guajardo-Leal, Martha Lilia; Cota-Range, Xochitl

    The prognosis, in the long term, of adolescents and young adults with acute de novo lymphoblastic leukemia, treated with a pediatric type protocol. To analyze the efficacy and tolerability of a chemotherapy regimen of pediatric type on patients 15-35 years old with de novo acute lymphoblastic leukemia, Ph(-). A retrospective study of patients received from 2001 to 2013, without initial infiltration of the central nervous system. They received the regimen called LALÍN. Terminal goals: frequency of initial remission, probability of survival free of leukemia and event-free survival for five years. We included 101 patients; there were 29 relapses and 19 deaths. There was initial remission in 97% of the cases; survival free of leukemia of 0.58 and event-free survival 0.44. No difference in patients aged 16-21 years vs. 22-35 (p > 0.55). Negative prognostic factors: abnormal karyotypes, except hyperdiploids (p = 0.001); > 5% of blasts, on 14 day induction (p = 0. 0001); delay in the punctuality of the courses of the chemotherapy regimen (p = 0.0001). A pediatric type regimen is applicable to patients aged from 16 to 35 years with acute lymphoblastic leukemia, without greater toxicity and a best survival free of leukemia. The count of > 5% of blasts and the delay in the execution of the stages of the chemotherapy regimen are the stronger negative prognostic factors.

  8. Long-Term Protective Effect of Lactation on the Development of Type 2 Diabetes in Women With Recent Gestational Diabetes Mellitus

    Science.gov (United States)

    Ziegler, Anette-G.; Wallner, Maike; Kaiser, Imme; Rossbauer, Michaela; Harsunen, Minna H.; Lachmann, Lorenz; Maier, Jörg; Winkler, Christiane; Hummel, Sandra

    2012-01-01

    Women with gestational diabetes mellitus (GDM) have a high risk of developing postpartum type 2 diabetes. Strategies to prevent postpartum type 2 diabetes are important to reduce the epidemic of diabetes and its societal impact. Breastfeeding was reported to improve early postpartum glucose tolerance and reduce the subsequent risk of type 2 diabetes. To investigate whether breastfeeding influences short- and long-term postpartum diabetes outcomes, women with GDM (n = 304) participating in the prospective German GDM study were followed from delivery for up to 19 years postpartum for diabetes development. All participants were recruited between 1989 and 1999. Postpartum diabetes developed in 147 women and was dependent on the treatment received during pregnancy (insulin vs. diet), BMI, and presence/absence of islet autoantibodies. Among islet autoantibody-negative women, breastfeeding was associated with median time to diabetes of 12.3 years compared with 2.3 years in women who did not breastfeed. The lowest postpartum diabetes risk was observed in women who breastfed for >3 months. On the basis of these results, we recommend that breastfeeding should be encouraged among these women because it offers a safe and feasible low-cost intervention to reduce the risk of subsequent diabetes in this high-risk population. PMID:23069624

  9. Long-term field measurement of sorption of organic contaminants to five types of plastic pellets: implications for plastic marine debris.

    Science.gov (United States)

    Rochman, Chelsea M; Hoh, Eunha; Hentschel, Brian T; Kaye, Shawn

    2013-02-05

    Concerns regarding marine plastic pollution and its affinity for chemical pollutants led us to quantify relationships between different types of mass-produced plastic and organic contaminants in an urban bay. At five locations in San Diego Bay, CA, we measured sorption of polychlorinated biphenyls (PCBs) and polycyclic aromatic hydrocarbons (PAHs) throughout a 12-month period to the five most common types of mass-produced plastic: polyethylene terephthalate (PET), high-density polyethylene (HDPE), polyvinyl chloride (PVC), low-density polyethylene (LDPE), and polypropylene (PP). During this long-term field experiment, sorption rates and concentrations of PCBs and PAHs varied significantly among plastic types and among locations. Our data suggest that for PAHs and PCBs, PET and PVC reach equilibrium in the marine environment much faster than HDPE, LDPE, and PP. Most importantly, concentrations of PAHs and PCBs sorbed to HDPE, LDPE, and PP were consistently much greater than concentrations sorbed to PET and PVC. These data imply that products made from HDPE, LDPE, and PP pose a greater risk than products made from PET and PVC of concentrating these hazardous chemicals onto fragmented plastic debris ingested by marine animals.

  10. Short-term glucagon stimulation test of C-peptide effect on glucose utilization in patients with type 1 diabetes mellitus.

    Science.gov (United States)

    Mojto, Viliam; Rausova, Zuzana; Chrenova, Jana; Dedik, Ladislav

    2015-12-01

    This work aimed to evaluate the use of a four-point glucagon stimulation test of C-peptide effect on glucose utilization in type 1 diabetic patients using a new mathematical model. A group of 32 type 1 diabetic patients and a group of 10 healthy control subjects underwent a four-point glucagon stimulation test with blood sampling at 0, 6, 15 and 30 min after 1 mg glucagon bolus intravenous administration. Pharmacokinetic and pharmacokinetic/pharmacodynamic models of C-peptide effect on glucose utilization versus area under curve (AUC) were used. A two-sample t test and ANOVA with Bonferroni correction were used to test the significance of differences between parameters. A significant difference between control and patient groups regarding the coefficient of whole-body glucose utilization and AUC C-peptide/AUC glucose ratio (p ≪ 0.001 and p = 0.002, respectively) was observed. The high correlation (r = 0.97) between modeled coefficient of whole-body glucose utilization and numerically calculated AUC C-peptide/AUC glucose ratio related to entire cohort indicated the stability of used method. The short-term four-point glucagon stimulation test allows the numerically calculated AUC C-peptide/AUC glucose ratio and/or the coefficient of whole-body glucose utilization calculated from model to be used to diagnostically identify type 1 diabetic patients.

  11. The effectiveness of regular leisure-time physical activities on long-term glycemic control in people with type 2 diabetes: A systematic review and meta-analysis.

    Science.gov (United States)

    Pai, Lee-Wen; Li, Tsai-Chung; Hwu, Yueh-Juen; Chang, Shu-Chuan; Chen, Li-Li; Chang, Pi-Ying

    2016-03-01

    The objective of this study was to systematically review the effectiveness of different types of regular leisure-time physical activities and pooled the effect sizes of those activities on long-term glycemic control in people with type 2 diabetes compared with routine care. This review included randomized controlled trials from 1960 to May 2014. A total of 10 Chinese and English databases were searched, following selection and critical appraisal, 18 randomized controlled trials with 915 participants were included. The standardized mean difference was reported as the summary statistic for the overall effect size in a random effects model. The results indicated yoga was the most effective in lowering glycated haemoglobin A1c (HbA1c) levels. Meta-analysis also revealed that the decrease in HbA1c levels of the subjects who took part in regular leisure-time physical activities was 0.60% more than that of control group participants. A higher frequency of regular leisure-time physical activities was found to be more effective in reducing HbA1c levels. The results of this review provide evidence of the benefits associated with regular leisure-time physical activities compared with routine care for lowering HbA1c levels in people with type 2 diabetes. Copyright © 2016 The Authors. Published by Elsevier Ireland Ltd.. All rights reserved.

  12. Spread of CTX-M-type ESßLs in isolates of E. coli from long-term care and rehabilitation facilities in Northern Italy

    Directory of Open Access Journals (Sweden)

    Elisabetta Nucleo

    2008-09-01

    Full Text Available During the period March 2003 – May 2004 at the Laboratory of Clinical Microbiology “Redaelli” LTCRF in Milan, Italy, a total of 529 E. coli, obtained from inpatients of 3 different Long Term Care Rehabilitation Facilities (LTCRFs in Northern Italy, were processed and 77 ESßLs producers (14.5% were identified by Vitek System. The results were confirmed by double-disk synergy test with tazobactam (TZP. 61/77 isolates were characterized by higher levels of resistance to cefotaxime (CTX than to ceftazidime (CAZ. (ß-lactamase production was investigated by analytical isoelectric focusing (IEF coupled with a bioassay and showed multiple (ß-lactamase bands including one enzyme with pI 8.4 that, in a bioassay, was more active on CTX,ATM than on CAZ. The presence of (ß-lactamase genes was investigated by colony blot hybridization and by PCR amplification of blaTEM, blaSHV and blaCTX-M alleles. 43/61 isolates produced both TEM-1 and CTX-M-type enzymes, 14/61 expressed only CTX-M-type while in 4 cases were found blaCTX-M, blaTEM and blaSHV genes.The remainders (16/77, characterized by high levels of resistance to both CTX and CAZ, produced TEM-1 and SHV-5 enzymes (1/16 and TEM type ESßLs (15/16. Conjugation experiments, performed in liquid medium, confermed that the ESßLs determinants were transferable. Pulsed-field gel electrophoresis profiles of genomic DNA, digested with NotI, were analysed and revealed clonal heterogeneity. Our work confirms the emergence of CTX-M-type enzymes and their spread in Northern Italy also in longterm care and rehabilitation facilities that may be an important reservoir of ES?L producing E. coli.

  13. Influence of long-term in vivo exposure, debris accumulation and archwire material on friction force among different types of brackets and archwires couples.

    Science.gov (United States)

    Mezeg, Uroš; Primožic, Jasmina

    2017-11-30

    The aim was to assess the influence of long-term in vivo exposure, debris accumulation and archwire material on static and kinetic friction force among different types of brackets and archwires couples. Friction testing was performed among four lower incisors' brackets, conventional and self-ligating (SL), coupled with either nickel-titanium or stainless steel archwires, as-received and in vivo exposed in 18 subjects. The friction testing was performed for a sliding distance of 14 mm at a speed of 10 mm/min, with a starting force of 0.2 N. Wear and quantitative assessment of debris accumulation was performed on pictures of brackets obtained using a scanning electron microscope. Non parametric tests were used for statistical analysis. Only bracket type, but not exposure duration, amount of debris accumulation, archwire material or their manufacturer, was significantly correlated with both static (rho = 0.602, P bracket type no significant difference was observed between as-received and in vivo exposed brackets for any friction parameter except for the SL brackets in which significantly higher static and kinetic (P = 0.001, at least) friction forces were seen in in vivo exposed SL brackets (164.9 cN and 217.63 cN, respectively) in comparison with as-received SL brackets (19.69 cN and 55.72 cN, respectively). The frictional testing was performed in the dry condition which might have influenced the results. A significant correlation was seen between friction force and bracket type, while treatment duration, amount of debris accumulation, archwire material or their manufacturer was not significantly correlated to it. Nevertheless, higher friction forces were measured among in vivo aged SL brackets in comparison with as-received ones. © The Author 2017. Published by Oxford University Press on behalf of the European Orthodontic Society. All rights reserved. For permissions, please email: journals.permissions@oup.com

  14. An Examination of Shareholders Wealth Effects of Mergers and Acquisitions in Short Term: The Evidences from U.S. Public Target Acquisitions

    OpenAIRE

    Han, Jin

    2011-01-01

    This paper examines the shareholders wealth effects in short run of U.S. domestic public target acquirers using alternative payment methods from 2001 to 2005, providing insights into what can learn from the stock abnormal returns to public target acquirers when they announcing an acquisition. At a first level the study documents that, in short run, public target acquirers significantly lose value. This result is robust after controlling for acquirer firm size (large/small) and bidder’s book-t...

  15. Title I Preschool Program in the Wake County Public School System (WCPSS): Short- and Long-Term Outcomes. Eye on Evaluation. E&R Report No.11.16

    Science.gov (United States)

    Baenen, Nancy

    2011-01-01

    The longitudinal study of the 2005-06 preschool in Wake County Public School System (WCPSS) found short-term gains during the preschool year, but limited impact by kindergarten and no average impact by the end of 3rd grade on achievement, retention rates, special education placements, or attendance. Small sample sizes limit conclusions that can be…

  16. Determinants of medication adherence among adults with type 2 diabetes mellitus in three Malaysian public health clinics: a cross-sectional study.

    Science.gov (United States)

    Chew, Boon-How; Hassan, Noor-Hasliza; Sherina, Mohd-Sidik

    2015-01-01

    Medication adherence (MA) in adults with type 2 diabetes mellitus (T2D) is associated with improved disease control (glycated hemoglobin, blood pressure, and lipid profile), lower rates of death and diabetes-related complications, increased quality of life, and decreased health care resource utilization. However, there is a paucity of data on the effect of diabetes-related distress, depression, and health-related quality of life on MA. This study examined factors associated with MA in adults with T2D at the primary care level. This was a cross-sectional study conducted in three Malaysian public health clinics, where adults with T2D were recruited consecutively in 2013. We used the 8-item Morisky Medication Adherence Scale (MMAS-8) to assess MA as the main dependent variable. In addition to sociodemographic data, we included diabetes-related distress, depressive symptoms, and health-related quality of life as independent variables. Independent association between the MMAS-8 score and its determinants was done using generalized linear models with a gamma distribution and log link function. The participant response rate was 93.1% (700/752). The majority were female (52.8%), Malay (52.9%), and married (79.1%). About 43% of patients were classified as showing low MA (MMAS-8 score health care providers in public health clinics should focus on MA counselling for adult T2D patients who are younger, have a higher income, and symptoms of depression.

  17. Self-esteem and illness self-concept in emerging adults with Type 1 diabetes: Long-term associations with problem areas in diabetes.

    Science.gov (United States)

    Luyckx, Koen; Rassart, Jessica; Aujoulat, Isabelle; Goubert, Liesbet; Weets, Ilse

    2016-04-01

    This long-term prospective study examined whether illness self-concept (or the degree to which chronic illness becomes integrated in the self) mediated the pathway from self-esteem to problem areas in diabetes in emerging adults with Type 1 diabetes. Having a central illness self-concept (i.e. feeling overwhelmed by diabetes) was found to relate to lower self-esteem, and more treatment, food, emotional, and social support problems. Furthermore, path analyses indicated that self-esteem was negatively related to both levels and relative changes in these problem areas in diabetes over a period of 5 years. Illness self-concept fully mediated these associations. © The Author(s) 2014.

  18. Insulin secretion after short- and long-term low-grade free fatty acid infusion in men with increased risk of developing type 2 diabetes

    DEFF Research Database (Denmark)

    Storgaard, Heidi; Jensen, Christine B; Vaag, Allan A

    2003-01-01

    We studied the effect of a low-grade short- and long-term 20% Intralipid infusion (0.4 mL(-1) x kg(-1) x h(-1)) on insulin secretion and insulin action in 15 elderly obese men; 7 glucose intolerant first-degree relatives of type 2 diabetic patients (impaired glucose tolerance [IGT] relatives) and 8...... healthy controls of similar age and body mass index (BMI). Intravenous glucose tolerance test (IVGTT) and a graded glucose infusion (dose-response test [DORE]) were performed to determine first phase insulin response and to explore the dose response relationship between glucose concentration and insulin...... secretion rates (ISR). ISR were calculated by deconvolution of plasma C-peptide concentrations. Insulin action was determined by performing a 120-minute hyperinsulinemic euglycemic clamp. All tests were performed 3 times, preceded by 0, 2, or 24 hours Intralipid infusion. Disposition indices (DI) were...

  19. Effects of long-term multicomponent exercise on health-related quality of life in older adults with type 2 diabetes: evidence from a cohort study.

    Science.gov (United States)

    Baptista, Liliana C; Dias, Gonçalo; Souza, Nelba R; Veríssimo, Manuel T; Martins, Raul A

    2017-08-01

    To establish the effect of a long-term multicomponent exercise (LTMEX) intervention (24 months) on health-related quality of life (HRQoL), in older adults with type 2 diabetes (T2D). This longitudinal retrospective cohort study analyzes the effects of a supervised LTMEX program on HRQoL in older adults with T2D (n = 279). Participants underwent one of two conditions: LTMEX (n = 241) trained three times per week; and unchanged lifestyle-the control group (CO; n = 38). Participants completed baseline, and 2-year follow-up evaluations including the Short Form Health Survey 36 (SF-36), anthropometric, hemodynamic components, and cardiorespiratory fitness (VO 2 peak). LTMEX improves HRQoL, specifically physical functioning (P health (P health (MH; P older adults with T2D, and also anthropometric, hemodynamic profile, and cardiorespiratory fitness.

  20. Long-Term Placement of Subcutaneous Ruesch-Type Stents for Double Biliary Stenosis in a Living-Donor Liver Transplant Recipient

    Energy Technology Data Exchange (ETDEWEB)

    Adani, Gian Luigi, E-mail: adanigl@hotmail.com; Baccarani, Umberto; Lorenzin, Dario; Risaliti, Andrea [Udine University School of Medicine, Department of Surgery and Transplantation (Italy); Como, Giuseppe [Udine University School of Medicine, Department of Radiology (Italy); Gasparini, Daniele; Sponza, Massimo [AOSMM-Hospital, Department of Interventional Radiology (Italy); Bresadola, Vittorio; Bresadola, Fabrizio [Udine University School of Medicine, Department of Surgery and Transplantation (Italy)

    2007-04-15

    Biliary reconstruction continues to be a major source of morbidity following liver transplantation. The spectrum of biliary complications is evolving due to the increasing number of split-liver and living-donor liver transplantation, which are even associated with a higher incidence of biliary complications. Bile duct strictures are the most common cause of late biliary complications and account for up to 40% of all biliary complications. Optimal therapy for posttransplantation anastomotic biliary strictures remains uncertain and requires a multidisciplinary approach. We report the case of a 54-year-old Caucasian male affected by hepatocarcinoma and hepatitis C-related cirrhosis who underwent right-lobe living-donor liver transplantation from his son complicated by double anastomotic stenosis of the main right hepatic duct and of an accessory biliary duct draining segments 6 and 7 of the graft that was successfully treated by percutaneous transhepatic cholangiography with long-term subcutaneous placement of two internal Ruesch-type biliary stents.

  1. Long-Term Placement of Subcutaneous Ruesch-Type Stents for Double Biliary Stenosis in a Living-Donor Liver Transplant Recipient

    International Nuclear Information System (INIS)

    Adani, Gian Luigi; Baccarani, Umberto; Lorenzin, Dario; Risaliti, Andrea; Como, Giuseppe; Gasparini, Daniele; Sponza, Massimo; Bresadola, Vittorio; Bresadola, Fabrizio

    2007-01-01

    Biliary reconstruction continues to be a major source of morbidity following liver transplantation. The spectrum of biliary complications is evolving due to the increasing number of split-liver and living-donor liver transplantation, which are even associated with a higher incidence of biliary complications. Bile duct strictures are the most common cause of late biliary complications and account for up to 40% of all biliary complications. Optimal therapy for posttransplantation anastomotic biliary strictures remains uncertain and requires a multidisciplinary approach. We report the case of a 54-year-old Caucasian male affected by hepatocarcinoma and hepatitis C-related cirrhosis who underwent right-lobe living-donor liver transplantation from his son complicated by double anastomotic stenosis of the main right hepatic duct and of an accessory biliary duct draining segments 6 and 7 of the graft that was successfully treated by percutaneous transhepatic cholangiography with long-term subcutaneous placement of two internal Ruesch-type biliary stents

  2. How does aging affect the types of error made in a visual short-term memory ‘object-recall’ task?

    Directory of Open Access Journals (Sweden)

    Raju P Sapkota

    2015-01-01

    Full Text Available This study examines how normal aging affects the occurrence of different types of incorrect responses in a visual short-term memory object-recall task. Seventeen young (Mean = 23.3 years, SD = 3.76, and 17 normally aging older (Mean = 66.5 years, SD = 6.30 adults participated. Memory stimuli comprised 2 or 4 real world objects (the memory load presented sequentially, each for 650ms, at random locations on a computer screen. After a 1000ms retention interval, a test display was presented, comprising an empty box at one of the previously presented 2 or 4 memory stimulus locations. Participants were asked to report the name of the object presented at the cued location. Errors rates wherein participants reported the names of objects that had been presented in the memory display but not at the cued location (non-target errors vs. objects that had not been presented at all in the memory display (non-memory errors were compared. Significant effects of aging, memory load and target recency on error type and absolute error rates were found. Non-target error rate was higher than non-memory error rate in both age groups, indicating that VSTM may have been more often than not populated with partial traces of previously presented items. At high memory load, non-memory error rate was higher in young participants (compared to older participants when the memory target had been presented at the earliest temporal position. However, non-target error rates exhibited a reversed trend, i.e., greater error rates were found in older participants when the memory target had been presented at the two most recent temporal positions. Data are interpreted in terms of proactive interference (earlier examined non-target items interfering with more recent items, false memories (non-memory items which have a categorical relationship to presented items, interfering with memory targets, slot and flexible resource models, and spatial coding deficits.

  3. Short-term use of continuous glucose monitoring system adds to glycemic control in young type 1 diabetes mellitus patients in the long run: A clinical trial

    Directory of Open Access Journals (Sweden)

    Bukara-Radujković Gordana

    2011-01-01

    Full Text Available Background/Aim. Balancing strict glycemic control with setting realistic goals for each individual child and family can optimize growth, ensure normal pubertal development and emotional maturation, and control long term complications in children with type 1 diabetes (T1DM. The aim of this study was to evaluate the efficacy of short-term continuous glucose monitoring system (CGMS application in improvement of glycemic control in pediatric type 1 diabetes mellitus (T1DM patients. Methods. A total of 80 pediatric T1DM patients were randomly assigned into the experimental and the control group. The experimental group wore CGMS sensor for 72 hours at the beginning of the study. Self-monitored blood glucose (SMBG levels and hemoglobin A1c (HbA1c levels were obtained for both groups at baseline, and at 3 and 6 months. Results. There was a significant improvement in HbA1c (p < 0.001, in both the experimental and the control group, without a significant difference between the groups. Nevertheless, after 6 months the improvement of mean glycemia was noticed only in the experimental group. This finding was accompanied with a decrease in the number of hyperglycemic events and no increase in the number of hypoglycemic events in the experimental group. Conclusions. The results suggest that the CGMS can be considered as a valuable tool in treating pediatric T1DM patients, however further research is needed to more accurately estimate to what extent, if any, it outperforms intensive self-monitoring of blood glucose.

  4. Short-term effect of G-400, polyherbal formulation in the management of hyperglycemia and hyperlipidemia conditions in patients with type 2 diabetes mellitus.

    Science.gov (United States)

    Kurian, Gino A; Manjusha, V; Nair, Sunitha S; Varghese, Thomas; Padikkala, Jose

    2014-10-01

    Salacia oblonga, Tinospora cordifolia, Emblica offinalis Gaertn, Curcuma longa and Gymnema sylvestre are Ayurvedic medicinal plants reported to lower plasma glucose levels in animal models. To our knowledge, however, no clinical validations of those extracts for efficacy have been. The aim of this study was to evaluate the effect of polyherbal combination in patients with type 2 diabetes mellitus. We screened 250 patients enrolled in a diabetes mellitus screening camp held at District Ayurvedic Hospital, Kottayam, Kerala, India. Of these, 89 patients diagnosed with type 2 diabetes mellitus and 50 healthy volunteers of similar age group were included in the study. Patients were treated with a polyherbal combination drug namely G-400 (1000 mg/d) for 8 wk with a follow-up of 2wk interval. Fasting and postprandial blood glucose levels measured after 8 wk of G-400 treatment in patients were significantly lower. Indeed diabetic rats showed similar protection with G-400 administration. Furthermore, glycosylated hemoglobin, serum total cholesterol, both high- and low-density lipoprotein cholesterol, and triglycerides showed a significant improvement in G-400-administered patients. Toxicologic profile of the drug was assessed by analyzing the enzyme activities of alkaline phosphatase and alanine aminotransferase along with the concentration of blood urea nitrogen and creatinine in blood and found insignificant change compared with control. Short-term supplementation of G-400 not only attenuates the hyperglycemia, but also acts as hypolipidemic agent in patients with diabetes. Further study should be done for the long-term effect of the drug in larger populations. Copyright © 2014 Elsevier Inc. All rights reserved.

  5. Long-term habituation of the gill-withdrawal reflex in Aplysia requires gene transcription, calcineurin and L-type voltage-gated calcium channels

    Directory of Open Access Journals (Sweden)

    Joseph eEsdin

    2010-11-01

    Full Text Available Although habituation is possibly the simplest form of learning, we still do not fully understand the neurobiological basis of habituation in any organism. To advance the goal of a comprehensive understanding of habituation, we have studied long-term habituation (LTH of the gill-withdrawal reflex (GWR in the marine snail Aplysia californica. Previously, we showed that habituation of the GWR in a reduced preparation lasts for up to 12 hr, and depends on protein synthesis, as well as activation of protein phosphatases 1 and 2A and postsynaptic glutamate receptors. Here, we have used the reduced preparation to further analyze the mechanisms of LTH in Aplysia. We found that LTH of the GWR depends on RNA synthesis because it was blocked by both the irreversible transcriptional inhibitor actinomycin-D and the reversible transcriptional inhibitor, 5,6-dichlorobenzimidazole riboside (DRB. In addition, LTH requires activation of protein phosphatase 2B (calcineurin, because it was disrupted by ascomycin. Finally, LTH was blocked by nitrendipine, which indicates that activation of L-type voltage-gated Ca2+ channels is required for this form of learning. Together with our previous results, the present results indicate that exclusively presynaptic mechanisms, although possibly sufficient for short-term habituation, are insufficient for LTH. Rather, LTH must involve postsynaptic, as well as presynaptic, mechanisms.

  6. Long-term ketogenic diet contributes to glycemic control but promotes lipid accumulation and hepatic steatosis in type 2 diabetic mice.

    Science.gov (United States)

    Zhang, Xiaoyu; Qin, Juliang; Zhao, Yihan; Shi, Jueping; Lan, Rong; Gan, Yunqiu; Ren, Hua; Zhu, Bing; Qian, Min; Du, Bing

    2016-04-01

    The ketogenic diet (KD) has been widely used in weight and glycemic control, although potential side effects of long-term KD treatment have caused persistent concern. In this study, we hypothesized that the KD would ameliorate the progression of diabetes but lead to disruptions in lipid metabolism and hepatic steatosis in a mouse model of diabetes. In type 2 diabetic mouse model, mice were fed a high-fat diet and administered streptozotocin treatment before given the test diets for 8 weeks. Subsequently, ameliorated glucose and insulin tolerance in KD-fed diabetic mice was found, although the body weight of high-fat diet- and KD-fed mice was similar. Interestingly, the weight of adipose tissue in KD mice was greater than in the other groups. The KD diet resulted in higher serum triacylglycerol and cholesterol levels in diabetic mice. Moreover, the KD-fed mice showed greater hepatic lipid accumulation. Mice fed the KD showed significant changes in several key genes such as sterol regulatory element-binding protein, fibroblast growth factor 21, and peroxisome proliferator-activated receptor α, which are all important in metabolism. In summary, KD ameliorates glucose and insulin tolerance in a mouse model of diabetes, but severe hepatic lipid accumulation and hepatic steatosis were observed, which should be considered carefully in the long-term application of KD. Copyright © 2016 Elsevier Inc. All rights reserved.

  7. Epidemiology and Characteristics of Escherichia coli Sequence Type 131 (ST131) from Long-Term Care Facility Residents Colonized Intestinally with Fluoroquinolone-Resistant Escherichia coli

    Science.gov (United States)

    Han, Jennifer H.; Garrigan, Charles; Johnston, Brian; Nachamkin, Irving; Clabots, Connie; Bilker, Warren B.; Santana, Evelyn; Tolomeo, Pam; Maslow, Joel; Myers, Janice; Carson, Lesley; Lautenbach, Ebbing; Johnson, James R.

    2016-01-01

    The objective of this study was to evaluate molecular and epidemiologic factors associated with Escherichia coli sequence type 131 (ST131) among long-term care facility (LTCF) residents who acquired gastrointestinal tract colonization with fluoroquinolone-resistant E. coli (FQREC). Colonizing isolates from 37 residents who newly developed FQREC colonization at three LTCFs from 2006–2008 were evaluated. Twenty-nine (78%) of 37 total FQREC colonizing isolates were ST131. Most ST131 isolates had a distinctive combination of gyrA and parC replacement mutations. The ST131 and non-ST131 isolates differed significantly for the prevalence of many individual virulence factors but not for the proportion that qualified molecularly as extraintestinal pathogenic E. coli (ExPEC) or aggregate virulence factor scores. E. coli ST131 was highly prevalent among LTCF residents with FQREC colonization. Future studies should determine the risk factors for infection among ST131-colonized residents, and assess the potential for increased transmissibility of ST131 in the long-term care setting. PMID:27939288

  8. Safety and efficacy of ipragliflozin in elderly versus non-elderly Japanese patients with type 2 diabetes mellitus: a subgroup analysis of the STELLA-LONG TERM study.

    Science.gov (United States)

    Maegawa, Hiroshi; Tobe, Kazuyuki; Tabuchi, Hiromi; Nakamura, Ichiro; Uno, Satoshi

    2018-03-01

    This subgroup analysis of STELLA-LONG TERM interim data explored the long-term safety and efficacy of ipragliflozin in non-elderly vs. elderly Japanese type 2 diabetes mellitus (T2DM) patients. STELLA-LONG TERM is an ongoing 3-year prospective surveillance study of Japanese T2DM patients receiving ipragliflozin 50 mg once daily. In this subgroup analysis, patient characteristics, laboratory variables, and adverse drug reactions (ADRs) were compared between non-elderly (<65 years) and elderly (≥65 years) patients. Non-elderly patients had significantly higher body mass index and low-density lipoprotein cholesterol than elderly patients (P < 0.001). The proportion of patients with hemoglobin A1c (HbA1c) <8.0% was significantly higher among elderly patients (P < 0.001). HbA1c, fasting plasma glucose, and body weight significantly decreased from baseline to 3 and 12 months in both groups (all P < 0.05 vs. baseline). The ADR incidence was 10.83% vs. 10.42% in non-elderly and elderly patients. The incidence of skin complications was 0.98% vs. 1.65% and that of renal disorder was 0.47% vs. 0.95% in non-elderly and elderly patients (both P = 0.003). Ipragliflozin was effective in non-elderly and elderly Japanese T2DM patients in a real-world clinical setting. The incidence of renal disorder and skin complications was significantly higher in elderly vs. non-elderly patients.

  9. Long-term Therapeutic Impact of the Timing of Antiretroviral Therapy in Patients Diagnosed With Primary Human Immunodeficiency Virus Type 1 Infection.

    Science.gov (United States)

    Novelli, Sophie; Lécuroux, Camille; Avettand-Fenoel, Véronique; Seng, Rémonie; Essat, Asma; Morlat, Philippe; Viard, Jean-Paul; Rouzioux, Christine; Meyer, Laurence; Goujard, Cécile

    2018-05-02

    We aimed to determine the consequences of delayed human immunodeficiency virus type 1 (HIV-1) infection diagnosis by comparing long-term outcomes depending on the time of combination antiretroviral therapy (cART) initiation in patients diagnosed during primary HIV infection (PHI). We selected patients from the French National Agency for Research on AIDS and Viral Hepatitis (ANRS) PRIMO cohort, treated for ≥36 months, with sustained HIV RNA 12 months after infection (deferred ART). We measured inflammatory biomarkers from PHI through the last visit on cART, and CD4+ and CD8+ T-cell activation and plasma ultrasensitive HIV RNA at the last visit. Inflammation/activation levels were compared with those of uninfected controls. We modeled CD4+ count, CD4:CD8 ratio, and HIV DNA dynamics on cART. The decrease of HIV DNA levels was more marked in the immediate than deferred ART group, leading to a sustained mean difference of -0.6 log10 copies/106 peripheral blood mononuclear cells. Immediate ART led to improved CD4+ T-cell counts and CD4:CD8 ratios over the first 4 years of cART. At the last visit (median, 82 months), there was no difference between groups in CD4+ counts, CD4:CD8 ratio, ultrasensitive HIV RNA, or inflammation/activation marker levels. Long-term suppressive cART failed to normalize inflammation levels, which were not associated with immunovirological markers. Antiretroviral therapy initiated during PHI promotes long-term reduction of HIV reservoir size. In patients with sustained virologic suppression, inflammation may be driven by non-HIV-related factors.

  10. Avocado oil induces long-term alleviation of oxidative damage in kidney mitochondria from type 2 diabetic rats by improving glutathione status.

    Science.gov (United States)

    Ortiz-Avila, Omar; Figueroa-García, María Del Consuelo; García-Berumen, Claudia Isabel; Calderón-Cortés, Elizabeth; Mejía-Barajas, Jorge A; Rodriguez-Orozco, Alain R; Mejía-Zepeda, Ricardo; Saavedra-Molina, Alfredo; Cortés-Rojo, Christian

    2017-04-01

    Hyperglycemia and mitochondrial ROS overproduction have been identified as key factors involved in the development of diabetic nephropathy. This has encouraged the search for strategies decreasing glucose levels and long-term improvement of redox status of glutathione, the main antioxidant counteracting mitochondrial damage. Previously, we have shown that avocado oil improves redox status of glutathione in liver and brain mitochondria from streptozotocin-induced diabetic rats; however, the long-term effects of avocado oil and its hypoglycemic effect cannot be evaluated because this model displays low survival and insulin depletion. Therefore, we tested during 1 year the effects of avocado oil on glycemia, ROS levels, lipid peroxidation and glutathione status in kidney mitochondria from type 2 diabetic Goto-Kakizaki rats. Diabetic rats exhibited glycemia of 120-186 mg/dL the first 9 months with a further increase to 250-300 mg/dL. Avocado oil decreased hyperglycemia at intermediate levels between diabetic and control rats. Diabetic rats displayed augmented lipid peroxidation and depletion of reduced glutathione throughout the study, while increased ROS generation was observed at the 3rd and 12th months along with diminished content of total glutathione at the 6th and 12th months. Avocado oil ameliorated all these defects and augmented the mitochondrial content of oleic acid. The beneficial effects of avocado oil are discussed in terms of the hypoglycemic effect of oleic acid and the probable dependence of glutathione transport on lipid peroxidation and thiol oxidation of mitochondrial carriers.

  11. Lack of regulation of 11β-hydroxysteroid dehydrogenase type 1 during short-term manipulation of GH in patients with hypopituitarism

    Science.gov (United States)

    Sigurjonsdottir, Helga A; Andrew, Ruth; Stimson, Roland H; Johannsson, Gudmundur; Walker, Brian R

    2009-01-01

    Objective Evidence from long-term clinical studies measuring urinary steroid ratios, and from in vitro studies, suggests that GH administered for longer than 2 months down-regulates 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1), thereby reducing cortisol regeneration in liver and adipose tissue. We aimed to measure acute effects of GH on 11β-HSD1 in liver and adipose tissue in vivo, including using a stable isotope tracer. Design Observational studies of GH withdrawal and reintroduction in patients with hypopituitarism. Methods Twelve men with benign pituitary disease causing GH and ACTH deficiency on stable replacement therapy for >6 months were studied after GH withdrawal for 3 weeks, and after either placebo or GH injections were reintroduced for another 3 weeks. We measured cortisol kinetics during 9,11,12,12-2H4-cortisol (d4-cortisol) infusion, urinary cortisol/cortisone metabolite ratios, liver 11β-HSD1 by appearance of plasma cortisol after oral cortisone, and 11β-HSD1 mRNA levels in subcutaneous adipose biopsies. Results GH withdrawal and reintroduction had no effect on 9,12,12-[2H]3-cortisol (d3-cortisol) appearance, urinary cortisol/cortisone metabolite ratios, initial appearance of cortisol after oral cortisone, or adipose 11β-HSD1 mRNA. GH withdrawal increased plasma cortisol 30–180 min after oral cortisone, increased d4-cortisol clearance, and decreased relative excretion of 5α-reduced cortisol metabolites. Conclusions In this setting, GH did not regulate 11β-HSD1 rapidly in vivo in humans. Altered cortisol metabolism with longer term changes in GH may reflect indirect effects on 11β-HSD1. These data do not suggest that glucocorticoid replacement doses need to be increased immediately after introducing GH therapy to compensate for reduced 11β-HSD1 activity, although dose adjustment may be required in the longer term. PMID:19549748

  12. Effects of testing on subsequent re-encoding and long-term forgetting of action-relevant materials: On the influence of recall type.

    Science.gov (United States)

    Kubik, Veit; Nilsson, Lars-Göran; Olofsson, Jonas K; Jönsson, Fredrik U

    2015-10-01

    Testing one's memory of previously studied information reduces the rate of forgetting, compared to restudy. However, little is known about how this direct testing effect applies to action phrases (e.g., "wash the car") - a learning material relevant to everyday memory. As action phrases consist of two different components, a verb (e.g., "wash") and a noun (e.g., "car"), testing can either be implemented as noun-cued recall of verbs or verb-cued recall of nouns, which may differently affect later memory performance. In the present study, we investigated the effect of testing for these two recall types, using verbally encoded action phrases as learning materials. Results showed that repeated study-test practice, compared to repeated study-restudy practice, decreased the forgetting rate across 1 week to a similar degree for both noun-cued and verb-cued recall types. However, noun-cued recall of verbs initiated more new subsequent learning during the first restudy, compared to verb-cued recall of nouns. The study provides evidence that testing has benefits on both subsequent restudy and long-term retention of action-relevant materials, but that these benefits are differently expressed with testing via noun-cued versus verb-cued recall. © 2015 Scandinavian Psychological Associations and John Wiley & Sons Ltd.

  13. Altered Polarization, Morphology, and Impaired Innate Immunity Germane to Resident Peritoneal Macrophages in Mice with Long-Term Type 2 Diabetes

    Directory of Open Access Journals (Sweden)

    Hui-Fang Liu

    2012-01-01

    Full Text Available Type 2 diabetes (T2D is associated with perturbed innate immunity. Macrophages, bridging innate immunity and metabolic disturbances, play important roles in controlling immune homeostasis. However, the effect of long-term diabetic milieu (DM on the functions and phenotypes of macrophages is still not clear. In this study, we used resident peritoneal macrophages (RPMs from 5-month-old db/db mice to investigate the changes of macrophages. It was found that RPMs in db/db mice significantly reduced phagocytosis and adhesion capacity. After standardization with body weight, the number of F4/80+ RPMs markedly reduced in db/db mice, and, furthermore, the macrophages skewed to M2-polarizated macrophages. The results of morphology found that the RPMs shape of db/db mice was nearly round, but the RPMs shape of control mice was spindle-shaped and irregular. In this study, we found the cell numbers, morphology, and innate immunity functions of RPMs in 5-month-old type 2 diabetic mice (db/db mice obtained by abdominal cavity lavage were significantly altered. Importantly, we also found the remarkably increased M2-RPMs in diabetic mice for the first time.

  14. Review of effects of long-term aging on the mechanical properties and microstructures of Types 304 and 316 stainless steel

    International Nuclear Information System (INIS)

    Horak, J.A.; Sikka, V.K.; Raske, D.T.

    1985-01-01

    Because commercial liquid metal fast breeder reactor (LMFBR) are designed to last for 40 years or more, an understanding of the mechanical behavior of the structural alloys used in them is required for times on the order of 2.5 x 10 5 h (assuming a 70% availability factor). Types 304 and 316 stainless steel are used extensively in LMFBR systems. At the beginning of life these alloys are in a metastable state and evolve to a more stable state and, therefore, more stable microstructure during plant operation. Correlations of microstructures and mechanical properties during aging under representative LMFBR temperature and loading conditions are desirable from the standpoint of assuring safe, reliable, and economic plant operation. We reviewed the mechanical properties and microstructures of types 304 and 316 stainless steel wrought alloys after long-term aging in air for times up to 9 x 10 4 h (about 10-1/2 years). The principal effect of such aging is to reduce low temperature fracture toughness (as measured by Charpy impact test) and tensile ductility. Examples are cited, however, where, because stable microstructures are achieved, these as well as strength-related properties can be expected to remain adequate for anticipated service life conditions. 16 refs., 19 figs

  15. Short-term course and outcome of acute and transient psychotic disorders: Differences from other types of psychosis with acute onset.

    Science.gov (United States)

    Castagnini, Augusto C; Munk-Jørgensen, Povl; Bertelsen, Aksel

    2016-02-01

    The category of 'acute and transient psychotic disorders' (ATPDs) appeared in the ICD-10 Classification of Mental and Behavioural Disorders (ICD-10), but its distinctive features remain uncertain. To examine the course and outcome of ATPDs, pointing out differences from other types of psychosis. A one-year follow-up investigation of patients enrolled at the former World Health Organization (WHO) Centre for Research and Training in Mental Health in Aarhus (Denmark) for the WHO collaborative study on acute psychoses. Of 91 patients aged 15-60 years presenting with acute psychosis, 47 (51.6%) were diagnosed with ATPD, and it occurred more commonly in females; yet, the other acute psychoses featured mainly mood disorders and affected equally both genders. After 1 year, the ATPD diagnosis did not change in 28 cases (59.6%); the remaining developed either affective psychoses (27.7%), or schizophrenia and schizoaffective disorder (12.8%). Nearly, all patients with unchanged diagnosis of ATPD enjoyed full recovery, while those with other types of acute psychosis had significantly higher rates of recurrence or incomplete remission. Duration of illness within 4 weeks and stressful events in the 3 months before symptom onset predicted 1-year favourable clinical outcome for acute psychoses. Although ATPDs fared better over the short-term than other acute psychoses, their diagnostic stability is relatively low. © The Author(s) 2015.

  16. Long-term HPV type-specific risks for ASCUS and LSIL: a 14-year follow-up of a randomized primary HPV screening trial.

    Science.gov (United States)

    Elfström, K Miriam; Smelov, Vitaly; Johansson, Anna L V; Eklund, Carina; Naucler, Pontus; Arnheim-Dahlström, Lisen; Dillner, Joakim

    2015-01-15

    Human papillomavirus (HPV) infections result in a significant burden of low-grade cervical lesions. Between 1997 and 2000, our randomized trial of primary HPV screening enrolled 12,527 women participating in population-based screening. Women between 32 and 38 years of age (median: 34, interquartile range: 33-37) were randomized to HPV and cytology double testing (intervention arm, n = 6,257 enrolled, n = 5,888 followed-up) or to cytology, with samples frozen for future HPV testing (control arm, n = 6,270 enrolled, n = 5,795 followed-up). We estimated the HPV type-specific, long-term absolute risks (AR), and population attributable proportions (PAR) for cytological diagnoses of atypical squamous cells of undetermined significance (ASCUS) or low-grade squamous intraepithelial lesion (LSIL) and for histopathologically diagnosed cervical intraepithelial neoplasia grade 1 (CIN1). The women were followed using comprehensive, nationwide register-based follow-up. During a mean follow-up time of 11.07 years, 886 ASCUS and LSIL lesions were detected, 448 in the intervention arm and 438 in the control arm. Poisson regression estimated the incidence rate ratios (IRRs) of low-grade lesions by HPV type. The IRRs were strongly dependent on follow-up time. The IRRs for ASCUS/LSIL associated with high-risk HPV positivity were 18.6 (95% CI: 14.9-23.4) during the first screening round, 4.1 (95% CI: 2.8-6.2) during the second, 2.6 (95% CI: 1.7-4.1) during the third, and 1.1 (95% CI: 0.7-1.8) for >9 years of follow-up, with similar declines seen for the individual types. Type 16 contributed consistently to the greatest proportion of ASCUS, LSIL, and CIN1 risk in the population (first screening round PAR: ASCUS: 15.5% (95% CI: 9.7-21.9), LSIL: 14.7% (95% CI: 8.0-20.9), and CIN1: 13.4% (95% CI: 3.2-22.5)), followed by type 31 [8.4% (95% CI: 4.2-12.5) for ASCUS to 17.3% (95% CI: 6.8-26.6) for CIN1]. In summary, most ASCUS/LSIL lesions associated with HPV infection are caused by new HPV

  17. The Long-Term Safety, Public Health Impact, and Cost-Effectiveness of Routine Vaccination with a Recombinant, Live-Attenuated Dengue Vaccine (Dengvaxia): A Model Comparison Study.

    Science.gov (United States)

    Flasche, Stefan; Jit, Mark; Rodríguez-Barraquer, Isabel; Coudeville, Laurent; Recker, Mario; Koelle, Katia; Milne, George; Hladish, Thomas J; Perkins, T Alex; Cummings, Derek A T; Dorigatti, Ilaria; Laydon, Daniel J; España, Guido; Kelso, Joel; Longini, Ira; Lourenco, Jose; Pearson, Carl A B; Reiner, Robert C; Mier-Y-Terán-Romero, Luis; Vannice, Kirsten; Ferguson, Neil

    2016-11-01

    Large Phase III trials across Asia and Latin America have recently demonstrated the efficacy of a recombinant, live-attenuated dengue vaccine (Dengvaxia) over the first 25 mo following vaccination. Subsequent data collected in the longer-term follow-up phase, however, have raised concerns about a potential increase in hospitalization risk of subsequent dengue infections, in particular among young, dengue-naïve vaccinees. We here report predictions from eight independent modelling groups on the long-term safety, public health impact, and cost-effectiveness of routine vaccination with Dengvaxia in a range of transmission settings, as characterised by seroprevalence levels among 9-y-olds (SP9). These predictions were conducted for the World Health Organization to inform their recommendations on optimal use of this vaccine. The models adopted, with small variations, a parsimonious vaccine mode of action that was able to reproduce quantitative features of the observed trial data. The adopted mode of action assumed that vaccination, similarly to natural infection, induces transient, heterologous protection and, further, establishes a long-lasting immunogenic memory, which determines disease severity of subsequent infections. The default vaccination policy considered was routine vaccination of 9-y-old children in a three-dose schedule at 80% coverage. The outcomes examined were the impact of vaccination on infections, symptomatic dengue, hospitalised dengue, deaths, and cost-effectiveness over a 30-y postvaccination period. Case definitions were chosen in accordance with the Phase III trials. All models predicted that in settings with moderate to high dengue endemicity (SP9 ≥ 50%), the default vaccination policy would reduce the burden of dengue disease for the population by 6%-25% (all simulations: -3%-34%) and in high-transmission settings (SP9 ≥ 70%) by 13%-25% (all simulations: 10%- 34%). These endemicity levels are representative of the participating sites in

  18. The Long-Term Safety, Public Health Impact, and Cost-Effectiveness of Routine Vaccination with a Recombinant, Live-Attenuated Dengue Vaccine (Dengvaxia: A Model Comparison Study.

    Directory of Open Access Journals (Sweden)

    Stefan Flasche

    2016-11-01

    Full Text Available Large Phase III trials across Asia and Latin America have recently demonstrated the efficacy of a recombinant, live-attenuated dengue vaccine (Dengvaxia over the first 25 mo following vaccination. Subsequent data collected in the longer-term follow-up phase, however, have raised concerns about a potential increase in hospitalization risk of subsequent dengue infections, in particular among young, dengue-naïve vaccinees. We here report predictions from eight independent modelling groups on the long-term safety, public health impact, and cost-effectiveness of routine vaccination with Dengvaxia in a range of transmission settings, as characterised by seroprevalence levels among 9-y-olds (SP9. These predictions were conducted for the World Health Organization to inform their recommendations on optimal use of this vaccine.The models adopted, with small variations, a parsimonious vaccine mode of action that was able to reproduce quantitative features of the observed trial data. The adopted mode of action assumed that vaccination, similarly to natural infection, induces transient, heterologous protection and, further, establishes a long-lasting immunogenic memory, which determines disease severity of subsequent infections. The default vaccination policy considered was routine vaccination of 9-y-old children in a three-dose schedule at 80% coverage. The outcomes examined were the impact of vaccination on infections, symptomatic dengue, hospitalised dengue, deaths, and cost-effectiveness over a 30-y postvaccination period. Case definitions were chosen in accordance with the Phase III trials. All models predicted that in settings with moderate to high dengue endemicity (SP9 ≥ 50%, the default vaccination policy would reduce the burden of dengue disease for the population by 6%-25% (all simulations: -3%-34% and in high-transmission settings (SP9 ≥ 70% by 13%-25% (all simulations: 10%- 34%. These endemicity levels are representative of the

  19. Stressors in Teens with Type 1 Diabetes and Their Parents: Immediate and Long-Term Implications for Transition to Self-Management.

    Science.gov (United States)

    Ersig, Anne L; Tsalikian, Eva; Coffey, Julie; Williams, Janet K

    2016-01-01

    Teens with Type 1 diabetes and their parents experience every day and illness-related stress; however, understanding of how these stressors relate to the transition to adulthood is limited. The purpose of this study was to identify stressors of teens with Type 1 diabetes (T1DM) and their parents related to the impending transition to adulthood. This study used open-ended questions to identify every day and illness-related stressors among 15 teens with T1DM and 25 parents seen in one pediatric diabetes clinic. Qualitative descriptive analysis identified themes in interview transcripts. The primary teen stressor related to impending transition centered on ineffective self-management, often when they were taking over responsibility for T1DM management. Parents' concerns included immediate and long-term negative outcomes of teen self-management as well as financial resources and health insurance for the teen. Teens and parents both expressed specific concerns about outcomes and prevention of nocturnal hypoglycemia, and identified uncertainties related to teen health and diabetes-focused health care when no longer living in the parent's home. Teens with Type 1 diabetes and their parents understand that independent teen self-management is a component of transition to adulthood, but worry about teen self-management outcomes. Concerns specific to health care transition included health insurance, T1DM resources, and teens' abilities to handle new situations. Identifying current and future self-management concerns of individuals and families can facilitate targeted education and interventions to support successful transition to adulthood. Copyright © 2016 Elsevier Inc. All rights reserved.

  20. Middle-term follow-up results of Pipkin type IV femoral head fracture patients treated by reconstruction plate and bioabsorbable screws

    Directory of Open Access Journals (Sweden)

    Shan-Xi Wang

    2018-06-01

    Full Text Available Purpose: To investigate the mid-term curative effects of the treatment of Pipkin type IV femoral head fractures using a reconstruction plate and bioabsorbable screws and provide the evidence for clinical practice. Methods: From February 2010 to September 2014, 21 patients with Pipkin type IV femoral head fractures were treated surgically. There were 13 males and 8 females with an average age of 41.1 years (range, 20–65 years. The causes of the fractures included traffic accidents (13 cases, falls from a height (four cases, heavy lifting injuries (three cases, and sport injury (one case. All patients were followed up with radiography and three-dimensional reconstruction computed tomography and other checks and any complications were actively managed. Closed reduction of fracture-dislocation of the hip was attempted under general anesthesia using the Kocher-Langenbeck approach. Femoral head fractures were treated with internal fixation or excision based on the size of the fracture fragments, whereas acetabular fractures were fixed with a reconstruction plate and screws following anatomic reduction. Results: The incisions healed by primary intention in all patients after surgery, without any infection, deep venous thrombosis, or other complications. All 21 patients were followed up for 36–76 months, with an average follow-up duration of 49 months. Postoperative imaging data showed that all dislocations and fractures were anatomically reduced, and bony union of the fractures was achieved. Heterotopic ossification was found in four patients, post-traumatic osteoarthritis in three, and avascular necrosis of the femoral head in two. At the final follow-up, the assessment of hip joint function according to the Thompson-Epstein scoring scale was excellent in 10 cases, good in six cases, fair in three cases, and poor in two cases. The rate of excellent and good functional outcomes was 76.1%. Conclusion: The mid-term curative effects of a

  1. Long-term Cost-effectiveness of Two GLP-1 Receptor Agonists for the Treatment of Type 2 Diabetes Mellitus in the Italian Setting: Liraglutide Versus Lixisenatide.

    Science.gov (United States)

    Hunt, Barnaby; Kragh, Nana; McConnachie, Ceilidh C; Valentine, William J; Rossi, Maria C; Montagnoli, Roberta

    2017-07-01

    Maintaining glycemic control is the key treatment target for patients with type 2 diabetes mellitus. In addition, the glucagon-like peptide-1 (GLP-1) receptor agonists may be associated with other favorable treatment characteristics, such as reduction in body weight and reduced risk of hypoglycemia compared with traditional diabetes interventions. The aim of the present analysis was to compare the long-term cost-effectiveness of 2 GLP-1 receptor agonists, liraglutide 1.8 mg and lixisenatide 20 μg (both administered once daily), in the treatment of patients with type 2 diabetes failing to achieve glycemic control with metformin monotherapy in the Italian setting. The IMS CORE Diabetes Model was used to project long-term clinical outcomes and subsequent costs (in 2015 Euros [€]) associated with liraglutide 1.8 mg versus lixisenatide 20 μg treatment in a cohort with baseline characteristics derived from the open-label LIRA-LIXI trial (Efficacy and Safety of Liraglutide Versus Lixisenatide as Add-on to Metformin in Subjects With Type 2 Diabetes; NCT01973231) over patient lifetimes from the perspective of a health care payer. Efficacy data were taken from the 26-week end points of the same trial, including changes in glycated hemoglobin, body mass index, serum lipid levels, and hypoglycemic event rates. Outcomes projected included life expectancy, quality-adjusted life expectancy, cumulative incidence and time to onset of diabetes-related complications, and direct medical costs. Outcomes were discounted at 3% annually, and sensitivity analyses were performed. Liraglutide 1.8 mg was associated with improved discounted life expectancy (14.07 vs 13.96 years) and quality-adjusted life expectancy (9.18 vs 9.06 quality-adjusted life years [QALYs]) compared with lixisenatide 20 μg. These improvements were mostly attributable to a greater reduction in glycated hemoglobin level with liraglutide 1.8 mg versus lixisenatide 20 μg, leading to reduced incidence and

  2. Publicity and public relations

    Science.gov (United States)

    Fosha, Charles E.

    1990-01-01

    This paper addresses approaches to using publicity and public relations to meet the goals of the NASA Space Grant College. Methods universities and colleges can use to publicize space activities are presented.

  3. A Promising Tool to Assess Long Term Public Health Effects of Natural Disasters: Combining Routine Health Survey Data and Geographic Information Systems to Assess Stunting after the 2001 Earthquake in Peru.

    Science.gov (United States)

    Rydberg, Henny; Marrone, Gaetano; Strömdahl, Susanne; von Schreeb, Johan

    2015-01-01

    Research on long-term health effects of earthquakes is scarce, especially in low- and middle-income countries, which are disproportionately affected by disasters. To date, progress in this area has been hampered by the lack of tools to accurately measure these effects. Here, we explored whether long-term public health effects of earthquakes can be assessed using a combination of readily available data sources on public health and geographic distribution of seismic activity. We used childhood stunting as a proxy for public health effects. Data on stunting were attained from Demographic and Health Surveys. Earthquake data were obtained from U.S. Geological Survey's ShakeMaps, geographic information system-based maps that divide earthquake affected areas into different shaking intensity zones. We combined these two data sources to categorize the surveyed children into different earthquake exposure groups, based on how much their area of residence was affected by the earthquake. We assessed the feasibility of the approach using a real earthquake case--an 8.4 magnitude earthquake that hit southern Peru in 2001. Our results indicate that the combination of health survey data and disaster data may offer a readily accessible and accurate method for determining the long-term public health consequences of a natural disaster. Our work allowed us to make pre- and post-earthquake comparisons of stunting, an important indicator of the well-being of a society, as well as comparisons between populations with different levels of exposure to the earthquake. Furthermore, the detailed GIS based data provided a precise and objective definition of earthquake exposure. Our approach should be considered in future public health and disaster research exploring the long-term effects of earthquakes and potentially other natural disasters.

  4. A Promising Tool to Assess Long Term Public Health Effects of Natural Disasters: Combining Routine Health Survey Data and Geographic Information Systems to Assess Stunting after the 2001 Earthquake in Peru.

    Directory of Open Access Journals (Sweden)

    Henny Rydberg

    Full Text Available Research on long-term health effects of earthquakes is scarce, especially in low- and middle-income countries, which are disproportionately affected by disasters. To date, progress in this area has been hampered by the lack of tools to accurately measure these effects. Here, we explored whether long-term public health effects of earthquakes can be assessed using a combination of readily available data sources on public health and geographic distribution of seismic activity.We used childhood stunting as a proxy for public health effects. Data on stunting were attained from Demographic and Health Surveys. Earthquake data were obtained from U.S. Geological Survey's ShakeMaps, geographic information system-based maps that divide earthquake affected areas into different shaking intensity zones. We combined these two data sources to categorize the surveyed children into different earthquake exposure groups, based on how much their area of residence was affected by the earthquake. We assessed the feasibility of the approach using a real earthquake case--an 8.4 magnitude earthquake that hit southern Peru in 2001.Our results indicate that the combination of health survey data and disaster data may offer a readily accessible and accurate method for determining the long-term public health consequences of a natural disaster. Our work allowed us to make pre- and post-earthquake comparisons of stunting, an important indicator of the well-being of a society, as well as comparisons between populations with different levels of exposure to the earthquake. Furthermore, the detailed GIS based data provided a precise and objective definition of earthquake exposure. Our approach should be considered in future public health and disaster research exploring the long-term effects of earthquakes and potentially other natural disasters.

  5. List of U.S. Army Research Institute Research and Technical Publications for Public Release/Unlimited Distribution. Fiscal Year 2007 (October 1, 2006 to September 30, 2007) With Author Index and Report Titles and Subject Terms Index

    Science.gov (United States)

    2008-04-01

    Year 2007 October 1, 2006 to September 30, 2007 With Author Index and Report Titles and Subject Terms Index United States Army Research Institute for...Fiscal Year 2007 October 1, 2006 to September 30, 2007 With Author Index and Report Titles and Subject Terms Index CONTENTS Page Introduction...39 Author Index .................................................................................................................. 39

  6. The Impact of the Choice of Evaluation Criteria and the Type of Tender on the Awarding Public Contracts (in the Case of Construction Contracts at the Local Level in the Czech Republic

    Directory of Open Access Journals (Sweden)

    František Ochrana

    2015-01-01

    Full Text Available Public procurement may be examined from different perspectives. Using the Czech Republic as an example, this study is devoted to examining the impact of decisions made by the contracting authority regarding a public tender on the tender process itself and on the outcomes of the tender. The contracting authority addresses a number of decision-making issues regarding public procurements. For example, it needs to decide between two types of criteria (choosing between a single-criterion evaluation or rather opting for several evaluation criteria. At the same time, the authority is free to choose among different types of award procedures while adhering to certain restrictions imposed by the Act on Public Contracts. Using a sample of 1,027 construction work contracts awarded in the Czech Republic, the study examines, in more detail, the impacts of individual choices made by the contracting authority (namely the type of evaluation criteria chosen and the type of procedure for awarding contracts on the estimated and final price of public contracts. Recommendations on how to streamline the process of public procurement can be drawn from conclusions from the empirical analysis.

  7. Public values in public-private partnerships

    NARCIS (Netherlands)

    Reynaers, A.

    2014-01-01

    Although public-private partnerships (PPPs) are frequently analyzed and lauded in terms of efficiency, their impact on public values is often neglected. As a result, there is little empirical evidence supporting or rejecting the claim that PPPs have a negative effect on public values. This case

  8. Determinants of medication adherence among adults with type 2 diabetes mellitus in three Malaysian public health clinics: a cross-sectional study

    Directory of Open Access Journals (Sweden)

    Chew BH

    2015-05-01

    Full Text Available Boon-How Chew,1 Noor-Hasliza Hassan,2 Mohd-Sidik Sherina3 1Department of Family Medicine, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, 2Klinik Kesihatan Dengkil, Ministry of Health, 3Department of Psychiatry, Faculty of Medicine and Health Sciences, Universiti Putra Malaysia, Serdang, Malaysia Abstract: Medication adherence (MA in adults with type 2 diabetes mellitus (T2D is associated with improved disease control (glycated hemoglobin, blood pressure, and lipid profile, lower rates of death and diabetes-related complications, increased quality of life, and decreased health care resource utilization. However, there is a paucity of data on the effect of diabetes-related distress, depression, and health-related quality of life on MA. This study examined factors associated with MA in adults with T2D at the primary care level. This was a cross-sectional study conducted in three Malaysian public health clinics, where adults with T2D were recruited consecutively in 2013. We used the 8-item Morisky Medication Adherence Scale (MMAS-8 to assess MA as the main dependent variable. In addition to sociodemographic data, we included diabetes-related distress, depressive symptoms, and health-related quality of life as independent variables. Independent association between the MMAS-8 score and its determinants was done using generalized linear models with a gamma distribution and log link function. The participant response rate was 93.1% (700/752. The majority were female (52.8%, Malay (52.9%, and married (79.1%. About 43% of patients were classified as showing low MA (MMAS-8 score <6. Higher income (adjusted odds ratio 0.90 and depressive symptoms (adjusted odds ratio 0.99 were significant independent determinants of medication non-adherence in young adults with T2D. Low MA in adults with T2D is a prevalent problem. Thus, primary health care providers in public health clinics should focus on MA counselling for adult T2D patients who are

  9. Effects of curcumin on short-term spatial and recognition memory, adult neurogenesis and neuroinflammation in a streptozotocin-induced rat model of dementia of Alzheimer's type.

    Science.gov (United States)

    Bassani, Taysa B; Turnes, Joelle M; Moura, Eric L R; Bonato, Jéssica M; Cóppola-Segovia, Valentín; Zanata, Silvio M; Oliveira, Rúbia M M W; Vital, Maria A B F

    2017-09-29

    Curcumin is a natural polyphenol with evidence of antioxidant, anti-inflammatory and neuroprotective properties. Recent evidence also suggests that curcumin increases cognitive performance in animal models of dementia, and this effect would be related to its capacity to enhance adult neurogenesis. The aim of this study was to test the hypothesis that curcumin treatment would be able to preserve cognition by increasing neurogenesis and decreasing neuroinflammation in the model of dementia of Alzheimer's type induced by an intracerebroventricular injection of streptozotocin (ICV-STZ) in Wistar rats. The animals were injected with ICV-STZ or vehicle and curcumin treatments (25, 50 and 100mg/kg, gavage) were performed for 30days. Four weeks after surgery, STZ-lesioned animals exhibited impairments in short-term spatial memory (Object Location Test (OLT) and Y maze) and short-term recognition memory (Object Recognition Test - ORT), decreased cell proliferation and immature neurons (Ki-67- and doublecortin-positive cells, respectively) in the subventricular zone (SVZ) and dentate gyrus (DG) of hippocampus, and increased immunoreactivity for the glial markers GFAP and Iba-1 (neuroinflammation). Curcumin treatment in the doses of 50 and 100mg/kg prevented the deficits in recognition memory in the ORT, but not in spatial memory in the OLT and Y maze. Curcumin treatment exerted only slight improvements in neuroinflammation, resulting in no improvements in hippocampal and subventricular neurogenesis. These results suggest a positive effect of curcumin in object recognition memory which was not related to hippocampal neurogenesis. Copyright © 2017 Elsevier B.V. All rights reserved.

  10. Liraglutide Reduces CNS Activation in Response to Visual Food Cues Only After Short-term Treatment in Patients With Type 2 Diabetes.

    Science.gov (United States)

    Ten Kulve, Jennifer S; Veltman, Dick J; van Bloemendaal, Liselotte; Barkhof, Frederik; Drent, Madeleine L; Diamant, Michaela; IJzerman, Richard G

    2016-02-01

    Glucagon-like peptide-1 receptor agonists (GLP-1RAs) are associated with reduced appetite and body weight. We investigated whether these effects could be mediated by the central nervous system (CNS). We performed a randomized crossover study in obese patients with type 2 diabetes (n = 20, mean age 59.3 ± 4.1 years, mean BMI 32 ± 4.7 kg/m(2)), consisting of two periods of 12-week treatment with either liraglutide 1.8 mg or insulin glargine. Using functional MRI, we determined the effects of treatment on CNS responses to viewing food pictures in the fasted condition and 30 min after meal intake. After 12 weeks, the decrease in HbA1c was larger with liraglutide versus insulin glargine (Δ-0.7% vs. -0.2%, P food pictures in insula and putamen (P ≤ 0.02). In addition, liraglutide enhanced the satiating effect of meal intake on responses in putamen and amygdala (P ≤ 0.05). Differences between liraglutide and insulin glargine were not observed after 12 weeks. Compared with insulin, liraglutide decreased CNS activation significantly only after short-term treatment, suggesting that these effects of GLP-1RA on the CNS may contribute to the induction of weight loss, but not necessarily to its maintenance, in view of the absence of an effect of liraglutide on CNS activation in response to food pictures after longer-term treatment. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  11. [Long-term effect of a cognitive intervention on learning and participation in a significant leisure activity in early dementia of Alzheimer type: a case study].

    Science.gov (United States)

    Provencher, Véronique; Bier, Nathalie; Audet, Thérèse; Gagnon, Lise

    2009-06-01

    Decreased ability to accomplish significant leisure activities often occurs in early stages of dementia of Alzheimer type (DAT). As a long term effect, it may eventually affect the quality of life of the patient as well as that of the caregiver's. In a previous study, a woman with early DAT (77 years old, MMSE: 24/30) improved her participation in 2 leisure activities (listening to music and praying in a group) following the learning of a few tasks (e.g. using a radio cassette, remembering the significance of an pre-programmed ring) as a result of a cognitive intervention. The present study presents the long term effect of this intervention on the retention of the learned tasks and on spontaneous participation in both leisure activities of her daily living. Measures of tasks' learning and spontaneous participation in activities have been obtained through direct observation (ex: ability to use the tasks learned without assistance) and telephone conversations with the caregiver. The measures were taken 9 to 15 months post-intervention. Nine months after the end of the intervention, the participant could no longer use the radio cassette, but was able to remember the significance of the pre-programmed ring. Similarly, she stopped listening to music, but still attended her prayer group. The intervention appears to maintain participation in a leisure activity for several months in a patient with early DAT, in spite of expected functional decline. This functional impact can be achieved through retention of specific learned tasks as well as by strong external cues (daily pre-programmed ring), and can increase the quality of life for patients with DAT.

  12. Associations between long-term exposure to ambient particulate air pollution and type 2 diabetes prevalence, blood glucose and glycosylated hemoglobin levels in China

    Science.gov (United States)

    Zhao, Yaohui; Ma, Zongwei; Bi, Jun; Liu, Yang; Meng, Xia; Wang, Yafeng; Cai, Jing; Chen, Renjie; Kan, Haidong

    2016-01-01

    Background The evidence for an association between particulate air pollution and type 2 diabetes mellitus (T2DM) in developing countries was very scarce. Objective To investigate the associations of long-term exposure to fine particulate matter (PM2.5) with T2DM prevalence and with fasting glucose and glycosylated hemoglobin (HbA1c) levels in China. Methods This is a cross-sectional study based on a nation-wide baseline survey of 11,847 adults who participated in the China Health and Retirement Longitudinal Study from June 2011 to March 2012. The average residential exposure to PM2.5 for each participant in the same period was estimated using a satellite-based spatial statistical model. We determined the association between PM2.5 and T2DM prevalence by multivariable logistic regression models. We also evaluated the association between PM2.5 and fasting glucose and HbA1c levels using multivariable linear regression models. Stratification analyses were conducted to explore potential effect modification. Results We identified 1,760 cases of T2DM, corresponding to 14.9% of the study population. The average PM2.5 exposure for all participants was 72.6 μg/m3 during the study period. An interquartile range increase in PM2.5 (41.1μg/m3) was significantly associated with increased T2DM prevalence (prevalence ratio, PR=1.14), and elevated levels of fasting glucose (0.26 mmol/L) and HbA1c (0.08%). The associations of PM2.5 with T2DM prevalence and with fasting glucose and HbA1c were stronger in several subgroups. Conclusions This nationwide cross-sectional study suggested that long-term exposure to PM2.5 might increase the risk of T2DM in China. PMID:27148900

  13. Impact of self-monitoring of blood glucose log reliability on long-term glycemic outcomes in children with type 1 diabetes

    Directory of Open Access Journals (Sweden)

    Chitra Selvan

    2017-01-01

    Full Text Available Introduction: Logbooks of self-monitoring of blood glucose (SMBG are useful in the modulation of insulin regimens, which aid in achieving glycemic control in type 1 diabetes mellitus (T1DM. However, discrepancies in SMBG charting may impede its utility. This study aimed to assess the accuracy of log entries and its impact on long-term glycemic control. Methods: SMBG in logbooks was compared with readings in glucometer memory and discrepancies between the two were evaluated in 101 children with T1DM. The relationship between these discrepancies and glycated hemoglobin (HbA1c over 44 months was assessed. Results: Errors in glucose charting were observed in 32.67% children. The most common observed error was omission (42.42%, followed by fabrication (27.27%, erroneous (18.18%, and others (12.12%. Age was not significantly different among children having accurate versus inaccurate SMBG logs. During follow-up of 44 months, children with accurate SMBG logs consistently had lower HbA1c as compared to children having inaccurate logs, which was statistically significant at 4, 16, 20, and 28 months' follow-up. The same was reflected in the proportion of children achieving HbA1c <7% and 7%–9%. Of the 14 children who had omissions, 9 had omission of high values only, 3 patients had omission of low values only, 1 had omission of both high and low values, and 1 had omission of normal values. Among logs with fabrication, parents were responsible in 2 of 9 incidents. In the remaining 7, it was the child himself/herself. Children with fabrication consistently had the highest HbA1c values among the different types of inaccurate blood glucose chartings, which was statistically significant at 32 and 36 months of follow-up. Conclusions: Reliability of SMBG logs is a significant problem among children with T1DM at our center. Children with accurate logs of SMBG readings were more likely to have better glycemic control on long-term follow-up.

  14. Immunization of mice with the nef gene from Human Immunodeficiency Virus type 1: Study of immunological memory and long-term toxicology

    Directory of Open Access Journals (Sweden)

    Engström Gunnel

    2007-07-01

    Full Text Available Abstract Background The human immunodeficiency virus type 1 (HIV-1 regulatory protein, Nef, is an attractive vaccine target because it is involved in viral pathogenesis, is expressed early in the viral life cycle and harbors many T and B cell epitopes. Several clinical trials include gene-based vaccines encoding this protein. However, Nef has been shown to transform certain cell types in vitro. Based on these findings we performed a long-term toxicity and immunogenicity study of Nef, encoded either by Modified Vaccinia virus Ankara or by plasmid DNA. BALB/c mice were primed twice with either DNA or MVA encoding Nef and received a homologous or heterologous boost ten months later. In the meantime, the Nef-specific immune responses were monitored and at the time of sacrifice an extensive toxicological evaluation was performed, where presence of tumors and other pathological changes were assessed. Results The toxicological evaluation showed that immunization with MVAnef is safe and does not cause cellular transformation or other toxicity in somatic organs. Both DNAnef and MVAnef immunized animals developed potent Nef-specific cellular responses that declined to undetectable levels over time, and could readily be boosted after almost one year. This is of particular interest since it shows that plasmid DNA vaccine can also be used as a potent late booster of primed immune responses. We observed qualitative differences between the T cell responses induced by the two different vectors: DNA-encoded nef induced long-lasting CD8+ T cell memory responses, whereas MVA-encoded nef induced CD4+ T cell memory responses. In terms of the humoral immune responses, we show that two injections of MVAnef induce significant anti-Nef titers, while repeated injections of DNAnef do not. A single boost with MVAnef could enhance the antibody response following DNAnef prime to the same level as that observed in animals immunized repeatedly with MVAnef. We also demonstrate

  15. The Financial-Organizational Foundations of Assessment and Comparison of Scientific-Publication Activity of the Employees of Scientific Sphere in Terms of the Paradigm of the Public-Creative Patriotism of Nation

    Directory of Open Access Journals (Sweden)

    Karpinsky Borys A.

    2017-12-01

    Full Text Available The article is aimed at allocating both the specific features of financing the scientific sphere of Ukraine in the current period of transformation and the reform of sectors of the national economy, as well as the development of financial-organizational foundations of assessment and comparison of scientific-publication activity of the employees through conformity of the occupied position, proceeding from the paradigm of public-creative patriotism of nation. It has been proved that, in its fundamental essence, the paradigm of public-creative patriotism of nation is manifested and materialized through the physical participation of every citizen in formation of the own state, and is most fully implemented in the simultaneous interaction of individual dominants of such a patriotism: qualitative and quantitative (tax. A characteristic manifestation of such a patriotism in the scientific sphere is the increase of productivity of scholars on the basis of scientific-publication activity, which was for the first time suggested to be assessed on the basis of the Hirsch index for employees in view of the hold position with the relevant rating. The financial-organizational foundations of assessment and comparison of the public-creative patriotism of both the scientific and the teaching staff, allowing to increase potential of scientific sphere of the State in the context of basics of behavioral economics, have been substantiated.

  16. An Analysis of Business Models in Public Service Platforms

    DEFF Research Database (Denmark)

    Ranerup, Agneta; Zinner Henriksen, Helle; Hedman, Jonas

    2016-01-01

    Public Service Platforms (PSPs) are a new type of technology platform. They are based in the philosophy of New Public Management (NPM) and support public services for citizens in quasi-markets. This article increases our understanding of the business models behind these PSPs in terms of their Value......” that includes dialogues, user evaluations, long-term perspectives on choice, promotion of the ideal of choice, and self-promotion by public agencies. The article contributes to research with its empirical example of the digitalization of NPM and the underlying business logic of PSPs....

  17. [Application of the concetrations ratio of soluble receptor tyrosine kinase type 1, and placental growth factor for short-term prediction and diagnosis of preeclampsia].

    Science.gov (United States)

    Bubeníková, Š; Cíchová, A; Roubalová, L; Durdová, V; Vlk, R

    Bring a comprehensive overview of the available information about applications of the concetration ratio of soluble receptor tyrosine kinase type 1 (sFlt-1), and placental growth factor for short-term prediction and diagnosis of preeclampsia. Overview study. Department of Midwifery, Faculty of Health Sciences, Olomouc; Department of Clinical Biochemistry, University Hospital Olomouc; Department of Obstetrics and Gynecology, University Hospital Olomouc; Department of Obstetrics and Gynecology, 2nd Faculty of Medicine, Charles University in Prague and Motol University Hospital. Analysis of literary sources and databases Ovid, Medline (2001-2016). Preeclampsia is a multisystem disease with not fully understood etiology. This disease occurs in 2-5% of pregnant women. Preeclampsia is one of the main causes of global maternal and perinatal morbidity and mortality. It manifests itself as a newborn hypertension and proteinuria after 20 weeks of pregnancy in previously normotensive women. The only effective treatment is the delivery of the child. Diagnosis of preeclampsia comprises measuring blood pressure and proteinuria. These indicators have low diagnostic sensitivity and specificity. In preeclampsia, there is a decrease of serum levels of placental growth factor (PlGF). Soluble receptor tyrosine kinase type 1 (sFlt-1) is an antagonist of PlGF. Increased levels of sFlt-1 in proportion to the reduced level of PlGF are associated with an increased risk of preeclampsia. The sFlt-1/PlGF ratio can be a better predictive marker in the diagnosis of pre-eclampsia after 20 weeks of gestation.

  18. Usefulness of repeated N-terminal pro-B-type natriuretic peptide measurements as incremental predictor for long-term cardiovascular outcome after vascular surgery.

    Science.gov (United States)

    Goei, Dustin; van Kuijk, Jan-Peter; Flu, Willem-Jan; Hoeks, Sanne E; Chonchol, Michel; Verhagen, Hence J M; Bax, Jeroen J; Poldermans, Don

    2011-02-15

    Plasma N-terminal pro-B-type natriuretic peptide (NT-pro-BNP) levels improve preoperative cardiac risk stratification in vascular surgery patients. However, single preoperative measurements of NT-pro-BNP cannot take into account the hemodynamic stress caused by anesthesia and surgery. Therefore, the aim of the present study was to assess the incremental predictive value of changes in NT-pro-BNP during the perioperative period for long-term cardiac mortality. Detailed cardiac histories, rest left ventricular echocardiography, and NT-pro-BNP levels were obtained in 144 patients before vascular surgery and before discharge. The study end point was the occurrence of cardiovascular death during a median follow-up period of 13 months (interquartile range 5 to 20). Preoperatively, the median NT-pro-BNP level in the study population was 314 pg/ml (interquartile range 136 to 1,351), which increased to a median level of 1,505 pg/ml (interquartile range 404 to 6,453) before discharge. During the follow-up period, 29 patients (20%) died, 27 (93%) from cardiovascular causes. The median difference in NT-pro-BNP in the survivors was 665 pg/ml, compared to 5,336 pg/ml in the patients who died (p = 0.01). Multivariate Cox regression analyses, adjusted for cardiac history and cardiovascular risk factors (age, angina pectoris, myocardial infarction, stroke, diabetes mellitus, renal dysfunction, body mass index, type of surgery and the left ventricular ejection fraction), demonstrated that the difference in NT-pro-BNP level between pre- and postoperative measurement was the strongest independent predictor of cardiac outcome (hazard ratio 3.06, 95% confidence interval 1.36 to 6.91). In conclusion, the change in NT-pro-BNP, indicated by repeated measurements before surgery and before discharge is the strongest predictor of cardiac outcomes in patients who undergo vascular surgery. Copyright © 2011 Elsevier Inc. All rights reserved.

  19. 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

  20. In-hospital and long-term outcomes of congestive heart failure: Predictive value of B-type and amino-terminal pro-B-type natriuretic peptides and their ratio.

    Science.gov (United States)

    Dai, Yuxiang; Yang, Jun; Takagi, Atsutoshi; Konishi, Hakuoh; Miyazaki, Tetsuro; Masuda, Hiroshi; Shimada, Kazunori; Miyauchi, Katsumi; Daida, Hiroyuki

    2017-08-01

    Relative changes in B-type natriuretic peptide (BNP) and amino terminal pro-BNP (NT-proBNP) levels may help to assess the risk of congestive heart failure (CHF). However, whether these levels at the time of admission enable the prediction of outcomes with acute exacerbation remains unknown. The current study determined the abilities of BNP, NT-proBNP and their ratio to predict in-hospital and long-term outcomes of patients with CHF. Patients who were admitted to the cardiac care unit of Juntendo University Hospital (Tokyo, Japan) with acute CHF onset were consecutively enrolled into the present observational study. Serum levels of BNP and NT-proBNP were immediately measured on admission, and other biomarkers and clinical data were also investigated. Of 195 enrolled patients, 16 (8.2%) succumbed to CHF in hospital and 124 (69.3%) reached the endpoint of mortality or readmission following a median follow-up of 14 months. Multiple linear regression analysis revealed body mass index, low density lipoprotein cholesterol, hemoglobin, estimated glomerular filtration rate and C-reactive protein as independent predictors of the NT-proBNP/BNP ratio. BNP, NT-proBNP and their ratio were significantly higher among those who succumbed to CHF than in those who remained alive in hospital (P<0.05). Logistic regression analysis indicated that the ratio was an independent predictor for in-hospital mortality and long-term outcomes. In conclusion, the ratio of NT-proBNP to BNP more effectively predicts in-hospital outcomes than either factor alone and it may also help to predict outcomes among patients with acute exacerbation of HF.

  1. The Glycated Albumin (GA) to HbA1c Ratio Reflects Shorter-Term Glycemic Control than GA: Analysis of Patients with Fulminant Type 1 Diabetes.

    Science.gov (United States)

    Koga, Masafumi; Inada, Shinya; Nakao, Taisei; Kawamori, Ryuzo; Kasayama, Soji

    2017-01-01

    Glycated albumin (GA) reflects shorter-term glycemic control than HbA1c. We have reported that HbA1c is paradoxically increased in diabetic patients whose glycemic control deteriorated before ameliorating. In this study, we analyzed paradoxical increases of glycemic control indicators after treatment in patients with fulminant type 1 diabetes (FT1D). We also investigated whether the GA/HbA1c ratio may reflect shorter-term glycemic control than GA. Five FT1D patients whose post-treatment HbA1c and GA levels were measured were enrolled. We also used a formula to estimate HbA1c and GA from the fictitious models of changes in plasma glucose in FT1D patients. In this model, the periods during which HbA1c, GA, and the GA/HbA1c ratio were higher than at the first visit were compared. In addition, the half-life for the GA/HbA1c ratio was calculated in accordance with the half-lives for HbA1c and GA (36 and 14 days, respectively). In all FT1D patients, HbA1c levels 2-4 weeks after treatment were increased, with three patients (60%) experiencing an increase of GA levels. In contrast, an increase of the GA/HbA1c ratio was observed in only one patient. In all of the different models of changes in plasma glucose in FT1D patients, the length of time during which the values were higher than at the first visit was in the order of HbA1c > GA > GA/HbA1c ratio. The half-life for the GA/HbA1c ratio was 9 days, shorter than GA. These findings suggest that the GA/HbA1c ratio reflects shorter-term glycemic control than GA. © 2016 Wiley Periodicals, Inc.

  2. Low Carbohydrate-Diet Scores and Long-term Risk of Type 2 Diabetes Among Women With a History of Gestational Diabetes Mellitus: A Prospective Cohort Study.

    Science.gov (United States)

    Bao, Wei; Li, Shanshan; Chavarro, Jorge E; Tobias, Deirdre K; Zhu, Yeyi; Hu, Frank B; Zhang, Cuilin

    2016-01-01

    Low-carbohydrate diets (LCDs) may improve short-term glycemic control in patients with gestational diabetes mellitus (GDM), but the long-term effect on progression from GDM to type 2 diabetes mellitus (T2DM) is unknown. We aimed to examine the long-term risk of T2DM in association with a low-carbohydrate dietary pattern among women with a history of GDM. Overall, 4,502 women with a history of GDM from the Nurses' Health Study II (NHSII) cohort, as part of the Diabetes & Women's Health (DWH) study, were followed up from 1991 to 2011. Overall, animal, or vegetable LCD scores, which represent adherence to different low-carbohydrate dietary patterns, were calculated using diet intake information assessed every 4 years since 1991 by validated food-frequency questionnaires. We used Cox proportional hazards models to estimate hazard ratios (HRs) and 95% CIs. We documented 722 incident cases of T2DM during 68,897 person-years of observation. The multivariable-adjusted HRs (95% CIs) of T2DM, comparing the highest with lowest quintiles, were 1.36 (1.04-1.78) for overall LCD score (P = 0.003 for trend), 1.40 (1.06-1.84) for animal LCD score (P = 0.004 for trend), and 1.19 (0.91-1.55) for vegetable LCD score (P = 0.50 for trend). Among women with a history of GDM, a low-carbohydrate dietary pattern, particularly with high protein and fat intake mainly from animal-source foods, is associated with higher T2DM risk, whereas a low-carbohydrate dietary pattern with high protein and fat intake from plant-source foods is not significantly associated with risk of T2DM. © 2016 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.

  3. On the electrical contact and long-term behavior of compression-type connections with conventional and high-temperature conductor ropes with low sag

    International Nuclear Information System (INIS)

    Hildmann, Christian

    2016-01-01

    In Germany and in Europe it is due to the ''Energiewende'' necessary to transmit more electrical energy with existing overhead transmission lines. One possible technical solution to reach this aim is the use of high temperature low sag conductors (HTLS-conductors). Compared to the common Aluminium Conductor Steel Reinforced (ACSR), HTLS-conductors have higher rated currents and rated temperatures. Thus the electrical connections for HTLS-conductors are stressed to higher temperatures too. These components are most important for the safe and reliable operation of an overhead transmission line. Besides other connection technologies, hexagonal compression connections with ordinary transmission line conductors have proven themselves since decades. From the literature, mostly empirical studies with electrical tests for compression connections are known. The electrical contact behaviour, i.e. the quality of the electrical contact after assembly, of these connections has been investigated insufficiently. This work presents and enhances an electrical model of compression connections, so that the electrical contact behaviour can be determined more accurate. Based on this, principal considerations on the current distribution in the compression connection and its influence on the connection resistance are presented. As a result from the theoretical and the experimental work, recommendations for the design of hexagonal compression connections for transmission line conductors were developed. Furthermore it is known from the functional principle of compression type connections, that the electrical contact behaviour can be influenced from their form fit, force fit and cold welding. In particular the forces in compression connections have been calculated up to now by approximation. The known analytical calculations simplify the geometry and material behaviour and do not consider the correct mechanical load during assembly. For these reasons the joining process

  4. Long-term stability of Sm2Co17-type magnets for control rod drive mechanism (CRDM) in a nuclear reactor

    International Nuclear Information System (INIS)

    Iida, H.; Imayoshi, S.; Morimoto, K.; Watanabe, M.; Komada, N.; Takeshita, T.

    1995-01-01

    Control rod drive mechanism (CRDM) is an apparatus that regulates vertical position of control rods in a nuclear reactor by using a driving motor of synchronous type. While CRDM is usually placed outside the reactor vessel to escape from the severe environment inside the vessel, built-in type CRDM, which is now being developed for advanced marine reactors, is placed inside the vessel for making the reactor compact. The driving motor must stand in high-temperature (573--603 K) and high-pressure (approximately 120 atm) water which contains a trace amount of hydrogen. Although the magnet rotor is sealed by corrosion-resistant alloy, the magnets still need to have excellent thermal and chemical stabilities in order to ensure the reliability of the system. For an application of Sm 2 Co 17 -type magnets for a driving motor of control rod drive mechanism (CRDM) placed inside a nuclear reactor vessel, long-term stabilities of Sm(Co 0.61 Fe 0.28 Cu 0.08 Ni 0.01 Zr 0.02 ) 7.3 magnets were evaluated under the severe conditions. Initial magnetic properties of the specimens at room temperature were: B r = 1.03 T, H cJ = 1,400 kA/m and (BH) max = 207 kJ/m 3 . Irreversible losses of open-circuit remanent flux of the specimens exposed for 19,000 hours in 1 atm Ar atmosphere were 5--10% at the temperature (573--603 K) and the operating point (permeance coefficient of 1.7--2.4) of the actual driving motor application. Large fraction of the irreversible loss is attributed to permanent flux loss due to oxidation of the specimen. Losses due to thermal fluctuation aftereffect of these specimens are estimated to be less than 5%. Multilayer coating of Ni, Cu, Ni and Au was found to be effective to protect the magnets from the oxidation. The coated specimens exhibited a small permanent loss value of 0.5% after the exposure to 120 atm water for 2,000 hours at 613 K

  5. Association between Short-Term Exposure to Air Pollution and Dyslipidemias among Type 2 Diabetic Patients in Northwest China: A Population-Based Study.

    Science.gov (United States)

    Wang, Minzhen; Zheng, Shan; Nie, Yonghong; Weng, Jun; Cheng, Ning; Hu, Xiaobin; Ren, Xiaowei; Pei, Hongbo; Bai, Yana

    2018-03-30

    Air pollution exposure may play an adverse role in diabetes. However, little data are available directly evaluating the effects of air pollution exposure in blood lipids of which dysfunction has been linked to diabetes or its complications. We aimed to evaluate the association between air pollution and lipids level among type 2 diabetic patients in Northwest China. We performed a population-based study of 3912 type 2 diabetes patients in an ongoing cohort study in China. Both spline and multiple linear regressions analysis were used to examine the association between short-term exposure to PM 10 , SO₂, NO₂ and total cholesterol (TC), triglycerides (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C). By spline analyses, we observed that the relationship between SO₂ and HDL-C and LDL-C was shown to be non-linear ( p _non-lin-association = 0.0162 and 0.000). An inverted U-shaped non-linear relationship between NO₂ and LDL-C was found ( p _non-lin-association < 0.0001). A J-shaped non-linear relationship between PM 10 and TC, HDL-C ( p _non-lin-association = 0.0173, 0.0367) was also revealed. In linear regression analyses, a 10 μg/m³ increment in SO₂ was associated with 1.31% (95% CI: 0.40-2.12%), 3.52% (95% CI: 1.07-6.03%) and 7.53% (95% CI: 5.98-9.09%) increase in TC, TG and LDL-C, respectively. A 10 μg/m³ increment in PM 10 was associated with 0.45% (95% CI: 0.08-0.82%), 0.29% (95% CI: 0.10-0.49%) and 0.83% (95% CI: 0.21-1.45%) increase in TC, HDL-C and LDL-C, respectively. For NO₂, an increment of 10 μg/m³ was statistically associated with -3.55% (95% CI: -6.40-0.61%) and 39.01% (95% CI: 31.43-47.03%) increase in HDL-C and LDL-C. The adverse effects of air pollutants on lipid levels were greater in female and elder people. Further, we found SO₂ and NO₂ played a more evident role in lipid levels in warm season, while PM 10 appeared stronger in cold season. The findings suggest that exposure to air

  6. Meal replacement reduces insulin requirement, HbA1c and weight long-term in type 2 diabetes patients with >100 U insulin per day.

    Science.gov (United States)

    Kempf, K; Schloot, N C; Gärtner, B; Keil, R; Schadewaldt, P; Martin, S

    2014-04-01

    Despite high insulin doses, good glycaemic control is often lacking in type 2 diabetes patients and new therapeutic options are needed. In a proof of principle study, an energy-restricted, protein-rich meal replacement (PRMR) was examined as a means of reducing insulin requirement, HbA1C and body weight. Obese type 2 diabetes patients (n = 22) with >100 U insulin per day replaced, in week 1, the three main meals with 50 g of PRMR (Almased-Vitalkost) each (= 4903 kJ day(-1) ). In weeks 2-4, breakfast and dinner were replaced, and, in weeks 5-12, only dinner was replaced. Clinical parameters were determined at baseline, and after 4, 8 and 12 weeks, as well as after 1.5 years of follow-up. The Wilcoxon signed-rank test was used for the intention-to-treat analysis and the Mann-Whitney U-test for subgroup analyses. The 12-week-programme was completed by 15 participants (68%). After 1 week, the mean insulin dose was reduced from 147 (75) U to 91 (55) U day(-1) (P = 0.0001), and to 65 (32) U (P fasting blood glucose, triglycerides and high-density lipoprotein cholesterol improved significantly. After 1.5 years, insulin requirement and weight remained significantly lower than baseline. Participants who continued PRMR further reduced their HbA1c, weight and insulin dose. Two patients were able to stop insulin therapy altogether. Energy-restricted PRMR was effective in reducing insulin requirement of type 2 diabetes patients with intensified insulin therapy accompanied by a reduction of HbA1c, weight and other cardiometabolic risk factors. With the continuous use of PRMR, glycaemic control might be improved in the long term. © 2013 The British Dietetic Association Ltd.

  7. Treating Type 1 Diabetes Mellitus with a Rapid-Acting Analog Insulin Regimen vs. Regular Human Insulin in Germany: A Long-Term Cost-Effectiveness Evaluation.

    Science.gov (United States)

    Valentine, William J; Van Brunt, Kate; Boye, Kristina S; Pollock, Richard F

    2018-06-01

    The aim of the present study was to evaluate the cost effectiveness of rapid-acting analog insulin relative to regular human insulin in adults with type 1 diabetes mellitus in Germany. The PRIME Diabetes Model, a patient-level, discrete event simulation model, was used to project long-term clinical and cost outcomes for patients with type 1 diabetes from the perspective of a German healthcare payer. Simulated patients had a mean age of 21.5 years, duration of diabetes of 8.6 years, and baseline glycosylated hemoglobin of 7.39%. Regular human insulin and rapid-acting analog insulin regimens reduced glycosylated hemoglobin by 0.312 and 0.402%, respectively. Compared with human insulin, hypoglycemia rate ratios with rapid-acting analog insulin were 0.51 (non-severe nocturnal) and 0.80 (severe). No differences in non-severe diurnal hypoglycemia were modeled. Discount rates of 3% were applied to future costs and clinical benefits accrued over the 50-year time horizon. In the base-case analysis, rapid-acting analog insulin was associated with an improvement in quality-adjusted life expectancy of 1.01 quality-adjusted life-years per patient (12.54 vs. 11.53 quality-adjusted life-years). Rapid-acting analog insulin was also associated with an increase in direct costs of €4490, resulting in an incremental cost-effectiveness ratio of €4427 per quality-adjusted life-year gained vs. human insulin. Sensitivity analyses showed that the base case was driven predominantly by differences in hypoglycemia; abolishing these differences reduced incremental quality-adjusted life expectancy to 0.07 quality-adjusted life-years, yielding an incremental cost-effectiveness ratio of €74,622 per quality-adjusted life-year gained. Rapid-acting analog insulin is associated with beneficial outcomes in patients with type 1 diabetes and is likely to be considered cost effective in the German setting vs. regular human insulin.

  8. Comparison of long-term clinical outcome between patients with chronic versus acute type B aortic dissection treated by implantation of a stent graft: a single-center report

    Directory of Open Access Journals (Sweden)

    Chen SL

    2013-04-01

    Full Text Available Shao-Liang Chen, Jian-Cheng Zhu, Xiao-Bo Li, Fei Ye, Jun-Jie Zhang, Zhi-Zhong Liu, Nai-Liang Tian, Song Lin, Cheng-Yu Lv Nanjing First Hospital, Nanjing Medical University, Nanjing, People's Republic of China Background: Stent grafting for treatment of type B aortic dissection has been extensively used. However, the difference in the long-term clinical outcome between patients with chronic versus acute type B aortic dissection remains unknown. This study aimed to analyze the difference in long-term clinical outcome after endovascular repair for patients with chronic (93% complete false-lumen thrombosis. Untreated tear and type I endoleak were predictors of clinical events during follow-up. Conclusion: Comparable long-term clinical results were achieved in patients with chronic or acute type B aortic dissection after implantation of a stent graft. Keywords: aortic dissection, endovascular repair, procedure-related events, propensity score matching

  9. Bidirectional enhancing activities between human T cell leukemia-lymphoma virus type I and human cytomegalovirus in human term syncytiotrophoblast cells cultured in vitro.

    Science.gov (United States)

    Tóth, F D; Aboagye-Mathiesen, G; Szabó, J; Liu, X; Mosborg-Petersen, P; Kiss, J; Hager, H; Zdravkovic, M; Andirkó, I; Aranyosi, J

    1995-12-01

    The syncytiotrophoblast layer of the human placenta has an important role in limiting transplacental viral spread from mother to fetus. Human cytomegalovirus (HCMV) is capable of establishing a latent infection in syncytiotrophoblast cells, with restriction of gene expression to immediate-early and early proteins. We analyzed the extent of replication of human T cell leukemia-lymphoma virus type I (HTLV-I) in human term syncytiotrophoblasts infected with HTLV-I alone or coinfected with HTLV-I and HCMV. Although syncytiotrophoblasts could be infected with cell-free HTLV-I, no viral protein expression was found in the singly infected cells. On the contrary, coinfection of the cells with HTLV-I and HCMV resulted in simultaneous replication of both viruses. Bidirectional enhancing activities between HTLV-I and HCMV were mediated primarily by the Tax and immediate-early proteins, respectively. The stimulatory effect of HTLV-I Tax on HCMV replication appeared to be mediated partly by tumor necrosis factor beta and transforming growth factor beta-1. We observed formation of pseudotypes with HTLV-I nucleocapsids within HCMV envelopes, whereas HCMV was not pseudotyped by HTLV-I envelopes in dually infected syncytiotrophoblast cells. Our data suggest that in vivo dual infection of syncytiotrophoblast cells with HTLV-I and HCMV may facilitate the transplacental transmission of both viruses.

  10. Air pollution and blood lipid markers levels: Estimating short and long-term effects on elderly hypertension inpatients complicated with or without type 2 diabetes.

    Science.gov (United States)

    Xiao, Sanhua; Liu, Ranran; Wei, Youxiu; Feng, Lin; Lv, Xuemin; Tang, Fei

    2016-08-01

    With the development of society and the economy, many Chinese cities are shrouded in pollution haze for much of the year. Scientific studies have identified various adverse effects of air pollutants on human beings. However, the relationships between air pollution and blood lipid levels are still unclear. The objective of this study is to explore the short and long-term effects of air pollution on eight blood lipid markers among elderly hypertension inpatients complicated with or without type 2 diabetes (T2D). Blood lipid markers which met the pre-established inclusion criteria were exported from the medical record system. Air pollution data were acquired from the official environmental protection website. Associations between the air quality index and the blood lipid indexes were analyzed by one-way ANOVA and further Bonferroni correction. In an exposure time of 7 days or longer, blood lipid markers were somewhat affected by poor air quality. However, the results could not predict whether atherosclerosis would be promoted or inhibited by poorer air condition. Changes of blood lipid markers of hypertension inpatients with or without T2D were not completely the same, but no blood lipid markers had an opposite trend between the two populations. The air quality index was associated with changes to blood lipid markers to some extent in a population of hypertension inpatients with or without T2D. Further studies are needed to investigate the potential mechanism by which air pollutants induce blood lipids changes. Copyright © 2016 Elsevier Ltd. All rights reserved.

  11. KTA collection of terms and definitions. As of June 30, 1991. (To replace publication KTA-GS--12 of June 30, 1989)

    International Nuclear Information System (INIS)

    Skerhut, G.

    1991-01-01

    The collection of definitions mainly comprises terms which are laid down in the recommendations of the Nuclear Engineering Committee (KTA) or in overriding regulations and specifications. The collection aims at a KTA-standardized use of terms and at the avoidance of groundless divergences. The compiled definitions are followed by a list of the sources considered, namely laws, ordinances, administrative recommendations, KTA regulations as well as other recommendations and standards. (orig.) [de

  12. Are intragastric N-nitroso compounds elevated after short-term acid suppression?

    NARCIS (Netherlands)

    Houben, G.M.P.; Hooi, J.D.; Brummer, R.J.M.; Stobberingh, E.E.; Stockbrügger, R.W.

    1996-01-01

    Are intragastric N-nitroso compounds elevated after short-term acid suppression? Houben GM, Hooi J, Brummer RJ, Stobberingh EE, Stockbrugger RW. Department of Gastroenterolgy, Academic Hospital Maastricht, The Netherlands. Publication Types: Clinical Trial Randomized Controlled Trial

  13. Pro B-type natriuretic peptide plasma value: a new criterion for the prediction of short- and long-term outcomes after transcatheter aortic valve implantation.

    Science.gov (United States)

    López-Otero, Diego; Trillo-Nouche, Ramiro; Gude, Francisco; Cid-Álvarez, Belen; Ocaranza-Sanchez, Raimundo; Alvarez, Melisa Santas; Lear, Pamela V; Gonzalez-Juanatey, José R

    2013-09-30

    To determine the prognostic value of pro B-type natriuretic peptide (pro-BNP) to predict mortality after transcatheter aortic valve implantation (TAVI). Logistic EuroSCORE (LES) overestimates observed mortality after TAVI. A new risk score specific to TAVI is needed to accurately assess mortality and outcome. Eighty-five patients were included. Indications for TAVI were nonoperable or surgically high-risk patients (LES>20%). Pro-BNP was measured 24h before the procedure. Cox proportional hazards model was used to evaluate clinical factors. The predictive accuracy of these Cox models was determined by using time-dependent receiver operating characteristic (ROC) curves. Pro-BNP levels (log-transformed) were significantly higher in non-survivors than in survivors at 30 days (3.36 ± 0.43 vs. 3.81 ± 0.43, p<0.004) and at the end of follow-up (3.34 ± 0.42 vs. 3.63 ± 0.48, p<0.011). Multivariate analysis revealed that only increased log pro-BNP levels were associated with higher mortality rate at short [hazard ratio (HR) (95% confidence intervals (CI)]=5.35 (1.74-16.5), p=0.003] and long-term follow-ups [HR=11 (CI: 1.51-81.3), p=0.018]. LES was not associated with increased mortality at either time point [HR=1.03 (CI: 0.95-1.10), p=0.483 and HR=1.03 (CI: 0.98-1.07), p=0.230, respectively]. At 30, 90, 180, and 365 days, the c-index was 0.72 for log pro-BNP and 0.63 for LES (p=0.044). Pre-procedure log transform of plasma pro-BNP levels are an independent and strong predictor of short- and long-term outcomes after TAVI and are more discriminatory than LES. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  14. Vacinação contra Haemophilus influenzae tipo b: proteção a longo prazo Haemophilus influenzae type b vaccination: long term protection

    Directory of Open Access Journals (Sweden)

    Cristiana M. Nascimento-Carvalho

    2006-07-01

    Full Text Available OBJETIVO: Identificar as evidências sobre o impacto da vacina conjugada para Haemophilus influenzae tipo b (Hib na epidemiologia da doença invasiva por Hib. FONTE DOS DADOS: Pesquisa nas bases de dados do MEDLINE, LILACS, publicações técnicas de organizações internacionais, diretrizes nacionais e internacionais, nos últimos 15 anos (1991-2005, utilizando os seguintes unitermos: Haemophilus influenzae type b, immunization, impact, effectiveness. Foram incluídas as publicações que apresentaram informação para atender o objetivo deste artigo. Artigos publicados em período anterior ao da pesquisa e citados em referências dos artigos incluídos foram analisados quanto à apresentação de informação de interesse. SÍNTESE DOS DADOS: A introdução da vacina conjugada para Hib produziu grande declínio na incidência de casos de doença invasiva por Hib nos diversos países em que seu uso foi incorporado à rotina de vacinação das crianças. No entanto, o ressurgimento de casos com doença invasiva por Hib tem mobilizado vários investigadores na busca das possíveis explicações para esses eventos, bem como a identificação das medidas a serem implementadas para evitar o reaparecimento da doença. CONCLUSÕES: O uso da vacina conjugada para Hib em escala populacional tem sido extremamente efetivo. No entanto, mudanças no esquema vacinal poderão ser necessárias para a manutenção do controle da doença invasiva por Hib, frente ao atual cenário epidemiológico das infecções pelo Hib.OBJECTIVE: To identify evidence of the impact of Haemophilus influenzae type b (Hib conjugate vaccine on the epidemiology of invasive Hib disease. SOURCES OF DATA: This review was based on a search of MEDLINE, LILACS, technical reports, national and international guidelines (publications from 1991 to 2005. The keywords Haemophilus influenzae type b, immunization, impact and effectiveness, alone or in combination, were used to retrieve the

  15. Intrathecal long-term gene expression by self-complementary adeno-associated virus type 1 suitable for chronic pain studies in rats

    Directory of Open Access Journals (Sweden)

    Janssen William GM

    2006-01-01

    Full Text Available Abstract Background Intrathecal (IT gene transfer is an attractive approach for targeting spinal mechanisms of nociception but the duration of gene expression achieved by reported methods is short (up to two weeks impairing their utility in the chronic pain setting. The overall goal of this study was to develop IT gene transfer yielding true long-term transgene expression defined as ≥ 3 mo following a single vector administration. We defined "IT" administration as atraumatic injection into the lumbar cerebrospinal fluid (CSF modeling a lumbar puncture. Our studies focused on recombinant adeno-associated virus (rAAV, one of the most promising vector types for clinical use. Results Conventional single stranded rAAV2 vectors performed poorly after IT delivery in rats. Pseudotyping of rAAV with capsids of serotypes 1, 3, and 5 was tested alone or in combination with a modification of the inverted terminal repeat. The former alters vector tropism and the latter allows packaging of self-complementary rAAV (sc-rAAV vectors. Combining both types of modification led to the identification of sc-rAAV2/l as a vector that performed superiorly in the IT space. IT delivery of 3 × 10e9 sc-rAAV2/l particles per animal led to stable expression of enhanced green fluorescent protein (EGFP for ≥ 3 mo detectable by Western blotting, quantitative PCR, and in a blinded study by confocal microscopy. Expression was strongest in the cauda equina and the lower sections of the spinal cord and only minimal in the forebrain. Microscopic examination of the SC fixed in situ with intact nerve roots and meninges revealed strong EGFP fluorescence in the nerve roots. Conclusion sc-rAAVl mediates stable IT transgene expression for ≥ 3 mo. Our findings support the underlying hypothesis that IT target cells for gene transfer lack the machinery for efficient conversion of the single-stranded rAAV genome into double-stranded DNA and favor uptake of serotype 1 vectors over 2

  16. [Blood Levels of Proprotein Convertase Subtilisin/Kexin Type 9 (PCSK9) in Men from Different Population Groups and Its Relation to Unfavorable Long-Term Prognosis].

    Science.gov (United States)

    Ragino, Yu I; Astrakova, K S; Shakhtshneider, E V; Stakhneva, E M; Gafarov, V V; Bogatyrev, S N; Voevoda, M I

    2017-04-01

    of the study was to investigate blood levels of proprotein convertase subtilisin/kexin type 9 (PCSK9) in men from different population subgroups, their associations with cardiovascular risk factors and with unfavorable 7-years long-term prognosis. The study included three subgroups of men from a population sample of residents of Novosibirsk, 44-73 years old, not receiving lipid-lowering drugs: subgroup of population proper (183 men), subgroup with hypercholesterolemia (46 men), and subgroup with hypocholesterolemia (18 men). Blood level of PCSK9 was determined by ELISA using the test-systems "Human Proprotein Convertase 9/PCSK9 Immunoassay". Study endpoints (myocardial infarction, cardiovascular death) were registered during 7 years after baseline examination of subgroups using the data of the Registers of myocardial infarction and cardiovascular mortality. Distribution of PCSK9 protein in subgroups with hyper- and hypocholesterolemia was normal. In the subgroup of population proper it was abnormal with leftward shift. PCSK9 protein concentration in the subgroup with hypercholesterolemia was 1.2 times higher than in the population subgroup. PCSK9 protein level correlated significantly with blood levels of total cholesterol (CH), low density lipoprotein (LDL) CH, and glucose. Only 15% of PCSK9 variability was due to the influence of other factors (R Square=0.155, pblood level of PCSK9 protein were levels of high density lipoprotein CH (=0.238, p=0.023), triglycerides (=0.253, p=0.049) and LDL CH (=0.751, p=0.009). Multivariate regression analysis revealed significant independent association of PCSK9 protein levels with cardiovascular death during period of registration (7-years) (p=0.048, OR=1.01). This result indicates that in men increase of blood level of PCSK9 protein by 1ng/ml independently of other parameters increases relative risk of cardiovascular death during following 7 years by 1%.

  17. Effects of vildagliptin as add-on treatment in patients with type 2 diabetes mellitus: insights from long-term clinical studies in Japan.

    Science.gov (United States)

    Odawara, Masato; Sagara, Rieko

    2015-01-01

    Vildagliptin, a dipeptidyl peptidase-4 (DPP-4) inhibitor, is wildly used to treat type 2 diabetes mellitus (T2DM) with mono- or combination-therapy. We review two previously published open-label studies to extract insights on the long-term efficacy and safety of vildagliptin. Two studies were conducted in Japan to assess the efficacy and safety of vildagliptin as an add-on to other oral antidiabetes drugs (OADs) for 52 weeks. These studies were performed under the similar protocol in Japanese patients with T2DM who were inadequately controlled with OAD monotherapy [excluding other dipeptidyl peptidase-4 (DPP-4) inhibitors]. Addition of vildagliptin (50 mg twice daily) to other OAD monotherapy [sulfonylurea (SU), metformin, thiazolidinedione, alpha-glucosidase inhibitor and glinide] reduced glycated hemoglobin (HbA1c) levels by -0.64 %,-0.75 %,-0.92 %,-0.94 % and - 0.64 %, respectively, over 52 weeks of treatment. Overall, the incidence of hypoglycemia was low and was slightly higher in the add-on to SU treatment group compared with the other groups. The incidences of adverse events were comparable among the treatment groups, and vildagliptin was well-tolerated as add-on therapy to other OADs. The evidence from the two studies indicates that vildagliptin as an add-on therapy to other OADs is a clinically reasonable option for Japanese patients with T2DM who respond inadequately to other OAD monotherapy.

  18. Short-term inhibition of 11β-hydroxysteroid dehydrogenase type 1 reversibly improves spatial memory but persistently impairs contextual fear memory in aged mice

    Science.gov (United States)

    Wheelan, Nicola; Webster, Scott P.; Kenyon, Christopher J.; Caughey, Sarah; Walker, Brian R.; Holmes, Megan C.; Seckl, Jonathan R.; Yau, Joyce L.W.

    2015-01-01

    High glucocorticoid levels induced by stress enhance the memory of fearful events and may contribute to the development of anxiety and posttraumatic stress disorder. In contrast, elevated glucocorticoids associated with ageing impair spatial memory. We have previously shown that pharmacological inhibition of the intracellular glucocorticoid-amplifying enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) improves spatial memory in aged mice. However, it is not known whether inhibition of 11β-HSD1 will have any beneficial effects on contextual fear memories in aged mice. Here, we examined the effects of UE2316, a selective 11β-HSD1 inhibitor which accesses the brain, on both spatial and contextual fear memories in aged mice using a vehicle-controlled crossover study design. Short-term UE2316 treatment improved spatial memory in aged mice, an effect which was reversed when UE2316 was substituted with vehicle. In contrast, contextual fear memory induced by foot-shock conditioning was significantly reduced by UE2316 in a non-reversible manner. When the order of treatment was reversed following extinction of the original fear memory, and a second foot-shock conditioning was given in a novel context, UE2316 treated aged mice (previously on vehicle) now showed increased fear memory compared to vehicle-treated aged mice (previously on UE2316). Renewal of the original extinguished fear memory triggered by exposure to a new environmental context may explain these effects. Thus 11β-HSD1 inhibition reverses spatial memory impairments with ageing while reducing the strength and persistence of new contextual fear memories. Potentially this could help prevent anxiety-related disorders in vulnerable elderly individuals. PMID:25497454

  19. Short-term inhibition of 11β-hydroxysteroid dehydrogenase type 1 reversibly improves spatial memory but persistently impairs contextual fear memory in aged mice.

    Science.gov (United States)

    Wheelan, Nicola; Webster, Scott P; Kenyon, Christopher J; Caughey, Sarah; Walker, Brian R; Holmes, Megan C; Seckl, Jonathan R; Yau, Joyce L W

    2015-04-01

    High glucocorticoid levels induced by stress enhance the memory of fearful events and may contribute to the development of anxiety and posttraumatic stress disorder. In contrast, elevated glucocorticoids associated with ageing impair spatial memory. We have previously shown that pharmacological inhibition of the intracellular glucocorticoid-amplifying enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) improves spatial memory in aged mice. However, it is not known whether inhibition of 11β-HSD1 will have any beneficial effects on contextual fear memories in aged mice. Here, we examined the effects of UE2316, a selective 11β-HSD1 inhibitor which accesses the brain, on both spatial and contextual fear memories in aged mice using a vehicle-controlled crossover study design. Short-term UE2316 treatment improved spatial memory in aged mice, an effect which was reversed when UE2316 was substituted with vehicle. In contrast, contextual fear memory induced by foot-shock conditioning was significantly reduced by UE2316 in a non-reversible manner. When the order of treatment was reversed following extinction of the original fear memory, and a second foot-shock conditioning was given in a novel context, UE2316 treated aged mice (previously on vehicle) now showed increased fear memory compared to vehicle-treated aged mice (previously on UE2316). Renewal of the original extinguished fear memory triggered by exposure to a new environmental context may explain these effects. Thus 11β-HSD1 inhibition reverses spatial memory impairments with ageing while reducing the strength and persistence of new contextual fear memories. Potentially this could help prevent anxiety-related disorders in vulnerable elderly individuals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Long-term persistence of immunity and B-cell memory following Haemophilus influenzae type B conjugate vaccination in early childhood and response to booster.

    Science.gov (United States)

    Perrett, K P; John, T M; Jin, C; Kibwana, E; Yu, L-M; Curtis, N; Pollard, A J

    2014-04-01

    Protection against Haemophilus influenzae type b (Hib), a rapidly invading encapsulated bacteria, is dependent on maintenance of an adequate level of serum antibody through early childhood. In many countries, Hib vaccine booster doses have been implemented after infant immunization to sustain immunity. We investigated the long-term persistence of antibody and immunological memory in primary-school children following infant (with or without booster) Hib vaccination. Anti-polyribosylribitol phosphate (PRP) immunoglobulin G (IgG) concentration and the frequency of circulating Hib-specific memory B cells were measured before a booster of a Hib-serogroup C meningococcal (MenC) conjugate vaccine and again 1 week, 1 month, and 1 year after the booster in 250 healthy children aged 6-12 years in an open-label phase 4 clinical study. Six to 12 years following infant priming with 3 doses of Hib conjugate vaccine, anti-PRP IgG geometric mean concentrations were 3.11 µg/mL and 0.71 µg/mL and proportions with anti-PRP IgG ≥1.0 µg/mL were 79% and 43% in children who had or had not, respectively, received a fourth Hib conjugate vaccine dose (mean age, 3.9 years). Higher baseline and post-Hib-MenC booster responses (anti-PRP IgG and memory B cells) were found in younger children and in those who had received a fourth Hib dose. Sustained Hib conjugate vaccine-induced immunity in children is dependent on time since infant priming and receipt of a booster. Understanding the relationship between humoral and cellular immunity following immunization with conjugate vaccines may direct vaccine design and boosting strategies to sustain individual and population immunity against encapsulated bacteria in early childhood. Clinical Trials Registration ISRCTN728588998.

  1. Long-Term Effects of Botulinum Toxin Complex Type A Injection on Mechano- and Metabo-Sensitive Afferent Fibers Originating from Gastrocnemius Muscle.

    Directory of Open Access Journals (Sweden)

    Guillaume Caron

    Full Text Available The aim of the present study was to investigate long term effects of motor denervation by botulinum toxin complex type A (BoNT/A from Clostridium Botulinum, on the afferent fibers originating from the gastrocnemius muscle of rats. Animals were divided in 2 experimental groups: 1 untreated animals acting as control and 2 treated animals in which the toxin was injected in the left muscle, the latter being itself divided into 3 subgroups according to their locomotor recovery with the help of a test based on footprint measurements of walking rats: i no recovery (B0, ii 50% recovery (B50 and iii full recovery (B100. Then, muscle properties, metabosensitive afferent fiber responses to potassium chloride (KCl and lactic acid injections and Electrically-Induced Fatigue (EIF, and mechanosensitive responses to tendon vibrations were measured. At the end of the experiment, rats were killed and the toxin injected muscles were weighted. After toxin injection, we observed a complete paralysis associated to a loss of force to muscle stimulation and a significant muscle atrophy, and a return to baseline when the animals recover. The response to fatigue was only decreased in the B0 group. The responses to KCl injections were only altered in the B100 groups while responses to lactic acid were altered in the 3 injected groups. Finally, our results indicated that neurotoxin altered the biphasic pattern of response of the mechanosensitive fiber to tendon vibrations in the B0 and B50 groups. These results indicated that neurotoxin injection induces muscle afferent activity alterations that persist and even worsen when the muscle has recovered his motor activity.

  2. Long-Term Effects of Botulinum Toxin Complex Type A Injection on Mechano- and Metabo-Sensitive Afferent Fibers Originating from Gastrocnemius Muscle.

    Science.gov (United States)

    Caron, Guillaume; Marqueste, Tanguy; Decherchi, Patrick

    2015-01-01

    The aim of the present study was to investigate long term effects of motor denervation by botulinum toxin complex type A (BoNT/A) from Clostridium Botulinum, on the afferent fibers originating from the gastrocnemius muscle of rats. Animals were divided in 2 experimental groups: 1) untreated animals acting as control and 2) treated animals in which the toxin was injected in the left muscle, the latter being itself divided into 3 subgroups according to their locomotor recovery with the help of a test based on footprint measurements of walking rats: i) no recovery (B0), ii) 50% recovery (B50) and iii) full recovery (B100). Then, muscle properties, metabosensitive afferent fiber responses to potassium chloride (KCl) and lactic acid injections and Electrically-Induced Fatigue (EIF), and mechanosensitive responses to tendon vibrations were measured. At the end of the experiment, rats were killed and the toxin injected muscles were weighted. After toxin injection, we observed a complete paralysis associated to a loss of force to muscle stimulation and a significant muscle atrophy, and a return to baseline when the animals recover. The response to fatigue was only decreased in the B0 group. The responses to KCl injections were only altered in the B100 groups while responses to lactic acid were altered in the 3 injected groups. Finally, our results indicated that neurotoxin altered the biphasic pattern of response of the mechanosensitive fiber to tendon vibrations in the B0 and B50 groups. These results indicated that neurotoxin injection induces muscle afferent activity alterations that persist and even worsen when the muscle has r