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Sample records for therapy dependency assessment

  1. Assessment of cognitive impairment in long-term oxygen therapy-dependent COPD patients.

    Science.gov (United States)

    Karamanli, Harun; Ilik, Faik; Kayhan, Fatih; Pazarli, Ahmet Cemal

    2015-01-01

    A number of studies have shown that COPD, particularly in its later and more severe stages, is associated with various cognitive deficits. Thus, the primary goal of the present study was to elucidate the extent of cognitive impairment in patients with long-term oxygen therapy-dependent (LTOTD) COPD. In addition, this study aimed to determine the effectiveness of two cognitive screening tests, the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA), for COPD patients and the ability of oxygen therapy to mitigate COPD-related deficits in cognitive function. The present study enrolled 45 subjects: 24 nonuser and 21 regular-user LTOTD-COPD patients. All subjects had a similar grade of education, and there were no significant differences regarding age or sex. The MoCA (cutoff: therapy increased the risk of cognitive impairment (MoCA, P=0.007 and MMSE, P=0.014), and the MoCA and MMSE scores significantly correlated with the number of emergency admissions and the number of hospitalizations in the last year. In the present study, the nonuser LTOTD-COPD group exhibited a significant decrease in cognitive status compared with the regular-user LTOTD-COPD group. This suggests that the assessment of cognitive function in nonuser LTOTD-COPD patients and the use of protective strategies, such as continuous supplemental oxygen treatment, should be considered during the management of COPD in this population. In addition, the MoCA score was superior to the MMSE score for the determination of cognitive impairment in the nonuser LTOTD-COPD patients.

  2. Assessment of the effectiveness of yoga therapy as an adjunct in patients with alcohol dependence syndrome

    Directory of Open Access Journals (Sweden)

    Dipesh Bhagabati

    2017-01-01

    Full Text Available Introduction: Substance use disorders, alcohol use in particular, are among the leading disorders in psychiatry in terms of prevalence. They put a lot of burden on health as well as family, society, and economic status of the patient. What more challenging is that such patients often suffer from comorbid anxiety and depression, which has the potential to perpetuate the alcohol use. Yoga is an alternative and complementary therapy which is widely practiced by people in India. However, its effectiveness in alcohol use disorders is not tested systematically. Aims and objectives: To study the effectiveness of yoga as an adjunctive therapy in patients of alcohol use disorders and to evaluate its ability to reduce comorbid depression, anxiety, and craving. Materials and methods: Hundred patients of alcohol use disorders as per the tenth revision of the International Classification of Diseases and Related Health Problems (ICD-10 were selected and were divided into two groups each containing 50 patients. The case group received structured yoga session in addition to standard pharmacotherapy while the control group received only pharmacotherapy. Assessment of depression (Hamilton depression rating scale [HAM-D], anxiety (Hamilton anxiety rating scale [HAM-A], and craving (Obsessive-compulsive drinking scale [OCDS] was done at baseline, two weeks, and at one month. Results were compared between the two groups and statistical analysis was done. Results: Both the case and control groups were similar in HAM-D (p=0.9634, HAM-A (p=0.7744, and OCDS (p= 0.8626 scores at baseline. There was significant reduction in HAM-A score at one month (p=0.0091, and OCDS score at two weeks (p=0.0428 and one month (p<0.0001 respectively in yoga group as compared to control group. Within case group, only reduction in HAM-A (p<0.001 and p<0.01 and OCDS (p<0.0001 and p<0.0001 scores were progressively better statistically at two weeks and one month while reduction in HAM-D score

  3. Systems dependability assessment

    CERN Document Server

    Aubry, Jean-François

    2015-01-01

    Presents recent developments of probabilistic assessment of systems dependability based on stochastic models, including graph theory, finite state automaton and language theory, for both dynamic and hybrid contexts.

  4. Assessment in Cognitive Therapy

    OpenAIRE

    Brown, Gary P.; Clark, David A.

    2015-01-01

    This volume brings together leading experts to explore the state of the art of cognitive clinical assessment and identify cutting-edge approaches of interest to clinicians and researchers. The book highlights fundamental problems concerning the validity of assessments that are widely used in cognitive-behavioral therapy (CBT). Key directions for further research and development are identified. Updated cognitive assessment methods are described in detail, with particular attention to transdiag...

  5. Assessing Imaging Response to Therapy.

    Science.gov (United States)

    Minocha, Jeet; Lewandowski, Robert J

    2015-09-01

    Locoregional therapies (LRTs) have proved valuable in the treatment of patients with cancer, most commonly in the liver. Accurate assessment of response to these therapies is crucial because objective response can be a surrogate of improved survival. Imaging plays an essential role in the objective evaluation of tumor response to most cancer therapies, including LRTs. Assessing imaging response to LRTs, however, can be challenging and is evolving. This article reviews the different criteria used to assess radiologic response to LRTs, with special attention to imaging assessment following treatment of hepatocellular carcinoma. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. Dependence and addiction during chronic opioid therapy.

    Science.gov (United States)

    Juurlink, David N; Dhalla, Irfan A

    2012-12-01

    The use of opioids for chronic noncancer pain has increased dramatically over the past 25 years in North America and has been accompanied by a major increase in opioid addiction and overdose deaths. The increase in opioid prescribing is multifactorial and partly reflects concerns about the effectiveness and safety of alternative medications, particularly the nonsteroidal anti-inflammatory drugs. However, much of the rise in opioid prescribing reflects the assertion, widely communicated to physicians in the 1990s, that the risks of dependence and addiction during chronic opioid therapy were low, predictable, and could be minimized by the use of controlled-release opioid formulations. In this narrative review, we offer a critical appraisal of the publications most frequently cited as evidence that the risk of addiction during chronic opioid therapy is low. We conclude that very few well-designed studies support the notion that opioid addiction is rare during chronic opioid therapy and that none can be readily generalized to present-day practice. Despite serious methodological limitations, these studies have been repeatedly mischaracterized as showing that the risk of addiction during chronic opioid therapy is rare. These studies are countered by a larger, more rigorous and contemporary body of evidence demonstrating that dependence and addiction are relatively common consequences of chronic opioid therapy, occurring in up to one-third of patients in some series.

  7. Music therapy assessment

    DEFF Research Database (Denmark)

    Wigram, Tony

    2007-01-01

    Når klienter henvises til musikterapi, gennemgår de en assessment-procedure (en klinisk vurdering), som kræver terapeutens ekspertise inden for forskellige områder - med henblik på at stille en en diagnose og identificere klientens behov og potentialer, samt at opstille realistiske forventninger ...

  8. Spiritual Assessments in Occupational Therapy

    Directory of Open Access Journals (Sweden)

    Barbara Hemphill

    2015-07-01

    Full Text Available Spirituality is recognized as an important concept in the study and practice of medicine, including occupational therapy. This aligns with occupational therapy’s core value of treating people holistically—mind, body, and spirit. Currently, the Joint Commission for the Accreditation of Hospital Organizations ( JCAHO requires that a spiritual assessment be given to patients on admission. To conduct effective spiritual assessments, occupational therapists must distinguish between religion and spirituality. They also must be aware of their own spiritual beliefs and practices and how those might influence their clinical interactions. This article presents spiritual assessment tools that occupational therapists can use in clinical practice; they range from history taking, to questionnaires, to observation scales. Guidelines are presented for selecting among several spiritual assessments. A case study is presented in which a patient’s faith tradition is being challenged, which could affect the outcome of therapy. Finally, treatment and intervention planning and ethical considerations are discussed.

  9. Electroconvulsive Therapy: A Comprehensive Assessment

    Directory of Open Access Journals (Sweden)

    Tayfun Zeren

    2003-08-01

    Full Text Available Electroconvulsive therapy (ECT is one of the most important discoveries of psychiatric treatments. This article comprehensively assesses historical progress, mechanism of actions, practical methods, indications, side effects, complications, drug interactions of ECT and attitudes towards ECT. [Archives Medical Review Journal 2003; 12(4.000: 340-377

  10. Accelerated neuroregulation for therapy of opiate dependency

    Directory of Open Access Journals (Sweden)

    S. Sunatrio

    2004-03-01

    Full Text Available Acute weaning from chronic opioid abuse during general anesthesia is usually followed by adrenergic outflow effects. This article is to report our experience with accelerated neuroregulation that reverses the physical and psychological dependency. After a comprehensive psychological and medical examination, 361 heroin dependent patients were admitted to ICU to be hospitalized for a full 24 or 36 hours, including a 6 hour pre-procedure medication process (solbutamol, clonidine, diazepam, ranitidine, omeprazole, vitamin C, octreotide, and ondansetron. Anesthesia was induced with midazolam and propofol iv and maintained with propofol infusion. Naltrexon, clonidine, octreotide, and diazepam were then administered. Anesthesia was maintained for 3 ½ - 5 hours depending on severity of withdrawal symptoms precipitated by naltrexone. Analgetics and sedatives were given as needed afterwards. Upon discharge on the following day, patient was prescribed a regimen of oral naltrexone for 10-12 months. All 361 patients were successfully detoxified without any adverse anesthetic events. The side effects encountered were fatigue, insomnia, drowsy, shivering, abdominal pain, nausea, diarrhoea, myalgia, goose bumps and uncomfortable feeling. In most of the patients these symptoms disappeared without any treatment. Symptomatic treatments were needed in 32.7% of patients. In all 166 patients who completed their naltrexone maintenance treatment, craving disappeared in the 10th month. The main problem was the low patient compliance to oral naltrexone, so that only 45.9% of the patients completed their therapy. Conclusion: Accelerated neuroregulation which includes naltrexone maintenance treatment (10-12 months was highly effective to detoxify and to abolish craving in the heroin dependent patients. (Med J Indones 2004; 13: 53-8Keywords: detoxification, craving management

  11. Can psychedelic compounds play a part in drug dependence therapy?

    Science.gov (United States)

    Sessa, Ben; Johnson, Matthew W

    2015-01-01

    After a 40-year hiatus there is now a revisiting of psychedelic drug therapy throughout psychiatry, with studies examining the drugs psilocybin, ketamine, ibogaine and ayahuasca in the treatment of drug dependence. Limitations to these therapies are both clinical and legal, but the possibility of improving outcomes for patients with substance dependency imposes an obligation to research this area. Royal College of Psychiatrists.

  12. Cognitive remediation therapy during treatment for alcohol dependence.

    Science.gov (United States)

    Rupp, Claudia I; Kemmler, Georg; Kurz, Martin; Hinterhuber, Hartmann; Fleischhacker, W Wolfgang

    2012-07-01

    Cognitive impairments in individuals with alcohol dependence may interfere with the progress of treatment and contribute to the progression of the disease. This study aimed to determine whether cognitive remediation (CR) therapy applied during treatment for alcohol dependence improves cognitive functioning in alcohol-dependent inpatients. A secondary aim was to evaluate whether the benefits of CR generalize to noncognitive clinically meaningful outcomes at the end of inpatient treatment. Forty-one alcohol-dependent patients entering inpatient treatment for alcohol dependence were randomly assigned to receive conventional treatment (n = 21) or an additional 12 sessions of computer-assisted CR focusing on cognitive enhancement in attention/executive function and memory domains (n = 20). Assessments of cognitive abilities in these domains as well as of psychological well-being and alcohol craving were conducted at baseline (at the beginning of inpatient treatment) and after CR (at the end of treatment). Results indicated that, relative to patients completing conventional treatment, those who received supplemental CR showed significant improvement in attention/executive function and memory domains, particularly in attention (alertness, divided attention), working memory, and delayed memory (recall). In addition, patients receiving CR during alcohol-dependence treatment showed significantly greater improvements in psychological well-being (Symptom Checklist-90-Revised) and in the compulsion aspect of craving (Obsessive Compulsive Drinking Scale-German version). CR during inpatient treatment for alcohol dependence is effective in improving cognitive impairments in alcohol-dependent patients. The benefits generalize to noncognitive outcomes, demonstrating that CR may be an efficacious adjunctive intervention for the treatment of alcohol dependence.

  13. Assessment of Dependency, Agreeableness, and Their Relationship

    Science.gov (United States)

    Lowe, Jennifer Ruth; Edmundson, Maryanne; Widiger, Thomas A.

    2009-01-01

    Agreeableness is central to the 5-factor model conceptualization of dependency. However, 4 meta-analyses of the relationship of agreeableness with dependency have failed to identify a consistent relationship. It was the hypothesis of the current study that these findings might be due in part to an emphasis on the assessment of adaptive, rather…

  14. Material interaction in art therapy assessment

    NARCIS (Netherlands)

    Pénzes, I.J.N.J.; Hooren, S. van; Dokter, D.; Smeijsters, H.; Hutschemaekers, G.J.M.

    2014-01-01

    Diverse approaches to art therapy assessment agree that art materials should play a central role. However, relatively little research is done on the role of different art materials. This article describes the results of a qualitative study on the use of art materials by art therapists in art therapy

  15. Assessment and therapy of vitiligo

    NARCIS (Netherlands)

    Komen, L.

    2016-01-01

    Vitiligo is a common skin disorder causing depigmented macules that can alter a patient's appearance and impair a patient's quality of life. This thesis contains studies on different methods of assessment of vitiligo and their quality as well as studies assessing repigmentation and depigmentation

  16. Therapy assessment in multiple myeloma with PET.

    Science.gov (United States)

    Nanni, Cristina; Zamagni, Elena

    2017-08-01

    Multiple myeloma is a plasma cell dyscrasia producing bone lytic lesions. In recent years, a wide spectrum of therapeutic approaches are available to treat the disease: an accurate therapy assessment has, therefore, become of utmost importance. In this field, imaging is becoming a cornerstone, especially in association with clinical parameters. Among imaging procedures, FDG PET/CT is recognized to provide reliable information, achieved in a very safe and fast procedure.  The literature has produced very concordant results from different groups assessing the value of FDG PET/CT as a prognostic factor in general and in therapy assessment, but some issues remain regarding a standardization of image interpretation especially in borderline cases. So far, no data regarding nor other imaging compounds and the use of hybrid tomographs PET/MR are available to define therapy assessment in PET.

  17. Therapy assessment in multiple myeloma with PET

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    Nanni, Cristina [Medicina Nucleare Metropolitana di Bologna, Bologna (Italy); Zamagni, Elena [Bologna University School of Medicine, Seragnoli Institute of Hematology, Bologna (Italy)

    2017-08-15

    Multiple myeloma is a plasma cell dyscrasia producing bone lytic lesions. In recent years, a wide spectrum of therapeutic approaches are available to treat the disease: an accurate therapy assessment has, therefore, become of utmost importance. In this field, imaging is becoming a cornerstone, especially in association with clinical parameters. Among imaging procedures, FDG PET/CT is recognized to provide reliable information, achieved in a very safe and fast procedure. The literature has produced very concordant results from different groups assessing the value of FDG PET/CT as a prognostic factor in general and in therapy assessment, but some issues remain regarding a standardization of image interpretation especially in borderline cases. So far, no data regarding nor other imaging compounds and the use of hybrid tomographs PET/MR are available to define therapy assessment in PET. (orig.)

  18. Assessments in outcome evaluation in aphasia therapy

    DEFF Research Database (Denmark)

    Isaksen, Jytte; Brouwer, Catherine E.

    2015-01-01

    Abstract Outcomes of aphasia therapy in Denmark are documented in evaluation sessions in which both the person with aphasia and the speech-language therapist take part. The participants negotiate agreements on the results of therapy. By means of conversation analysis, we study how such agreements...... on therapy outcome are reached interactionally. The sequential analysis of 34 video recordings focuses on a recurrent method for reaching agreements in these outcome evaluation sessions. In and through a special sequence of conversational assessment it is claimed that the person with aphasia has certain...

  19. Multidimensional assessment of nicotine dependence in adolescents.

    Science.gov (United States)

    Clark, Duncan B; Wood, D Scott; Martin, Christopher S; Cornelius, Jack R; Lynch, Kevin G; Shiffman, Saul

    2005-03-07

    Despite the critical importance of adolescent smoking, the assessment of nicotine dependence during this developmental period has been the subject of relatively little research. In this study, 301 adolescents (ages 12 through 18 years) reporting daily smoking were recruited for a project on alcohol use disorders (AUDs). The sample included 140 females and 161 males, 251 subjects from clinical and 50 from community sources, and 176 subjects with AUDs at the baseline assessment. Subjects were evaluated with the Nicotine Dependence Syndrome Scale (NDSS), the Fagerstrom Test for Nicotine Dependence (FTND) and a determination of average number of cigarettes per day (cigarettes/day). A varimax factor analysis of 27 NDSS items revealed four factors: (1) Drive/Tolerance (13 items; Cronbach alpha = 0.91); (2) Continuity (five items; Cronbach alpha = 0.67); (3) Priority (three items; Cronbach alpha = 0.64); (4) Stereotypy (five items; Cronbach alpha = 0.66). The NDSS total score, refined by the removal of four items, was also examined (23 items; Cronbach alpha = 0.90). Predicting cigarettes/day at follow-up, initial smoking rate was the best predictor, with the FTND and NDSS Total score showing significant and similar predictive validity. The NDSS Total showed incremental validity in the prediction of smoking progression in a model including demographic characteristics, initial smoking rate and FTND. The findings suggest that the NDSS has acceptable psychometric properties when applied to adolescents, complementing smoking rate and FTND in a multidimensional smoking assessment.

  20. [Early language assessment and therapy].

    Science.gov (United States)

    Van der Horst, L

    2010-03-01

    A child's functional language develops during his first three years as a part of its general development (motor, senses, affection and cognition) based upon components of non-verbal communication and progressive learning of phonological, lexical and syntactic capabilities, first from a receptive then from an expressive side. When difficulties in the development of a child are observed, the assessment of its capacity of non-verbal communication and understanding allows defining the necessary conditions to install an oral language. Secondly, the speech therapist evaluates the level of the language of the child compared to other parts of its development (are the deviations compared to standards, observed using development scales, homogeneous between applications?). The interdisciplinary assessment is necessary. The installation of communication, being the exchange with a person using an object, a situation or a need and the development of the verbal understanding, related to the experience of the child, are precursory to oral productions. Precocious requests of language functions (using questions, comments, stories, dialogue...), using plays adapted for every individual child, giving support to parents, allows to prevent difficult behavior caused by the frustration due to the impossibility to express himself. Waiting for a child with difficulties to talk before a speech therapist's intervention means taking the risk to react too late to correct verbal communication troubles, with possible repercussions on the person's autonomy. Copyright 2009. Published by Elsevier SAS.

  1. Targeting phosphatase-dependent proteoglycan switch for rheumatoid arthritis therapy.

    Science.gov (United States)

    Doody, Karen M; Stanford, Stephanie M; Sacchetti, Cristiano; Svensson, Mattias N D; Coles, Charlotte H; Mitakidis, Nikolaos; Kiosses, William B; Bartok, Beatrix; Fos, Camille; Cory, Esther; Sah, Robert L; Liu-Bryan, Ru; Boyle, David L; Arnett, Heather A; Mustelin, Tomas; Corr, Maripat; Esko, Jeffrey D; Tremblay, Michel L; Firestein, Gary S; Aricescu, A Radu; Bottini, Nunzio

    2015-05-20

    Despite the availability of several therapies for rheumatoid arthritis (RA) that target the immune system, a large number of RA patients fail to achieve remission. Joint-lining cells, called fibroblast-like synoviocytes (FLS), become activated during RA and mediate joint inflammation and destruction of cartilage and bone. We identify RPTPσ, a transmembrane tyrosine phosphatase, as a therapeutic target for FLS-directed therapy. RPTPσ is reciprocally regulated by interactions with chondroitin sulfate or heparan sulfate containing extracellular proteoglycans in a mechanism called the proteoglycan switch. We show that the proteoglycan switch regulates FLS function. Incubation of FLS with a proteoglycan-binding RPTPσ decoy protein inhibited cell invasiveness and attachment to cartilage by disrupting a constitutive interaction between RPTPσ and the heparan sulfate proteoglycan syndecan-4. RPTPσ mediated the effect of proteoglycans on FLS signaling by regulating the phosphorylation and cytoskeletal localization of ezrin. Furthermore, administration of the RPTPσ decoy protein ameliorated in vivo human FLS invasiveness and arthritis severity in the K/BxN serum transfer model of RA. Our data demonstrate that FLS are regulated by an RPTPσ-dependent proteoglycan switch in vivo, which can be targeted for RA therapy. We envision that therapies targeting the proteoglycan switch or its intracellular pathway in FLS could be effective as a monotherapy or in combination with currently available immune-targeted agents to improve control of disease activity in RA patients. Copyright © 2015, American Association for the Advancement of Science.

  2. Approaches to chemical dependency: chemical dependency and interactive group therapy--a synthesis.

    Science.gov (United States)

    Matano, R A; Yalom, I D

    1991-07-01

    Though the focus on interpersonal interaction is a powerful therapeutic factor in group therapy, traditional chemical dependency therapy groups generally fail to employ the interactional group orientation. An interactional approach can be effectively applied to alcoholics if the following guidelines are observed: (1) recovery is always accorded priority, (2) the patient accepts identification as an alcoholic, (3) anxiety is carefully modulated, (4) the proper distinction is made between what the alcoholic is and is not responsible for, (5) the therapist is thoroughly familiar with Alcoholics Anonymous language, steps, and traditions. It is important that therapists not permit misperceptions of A.A. to be used as therapy resistance and that they be able to harness the wisdom of A.A. for psychotherapeutic ends. Group therapists must also be prepared to deal with common themes arising in the treatment of the alcoholic patient: idealization, devaluation, externalization, defiance, grandiosity, conning, and avoidance.

  3. [Geriatric assessment prior to oncological therapy].

    Science.gov (United States)

    Wedding, U

    2013-06-01

    Ageing is the single most important risk factor for cancer. This is also true for most cancer diseases of the genitourinary tract. In combination with the demographic changes in Germany and most other countries, the consequence is a substantial increase in the number of elderly patients with cancer. Most therapies in oncology have a high risk for toxic side effects. Ageing is a very heterogeneous process. The chronological age of a patient insufficiently reflects the individual resources, deficits and risk factors but this can be assessed by a structured geriatric assessment. Integration of geriatric assessment into oncological treatment decisions is still low and is one of the major tasks in cancer care in the future.

  4. Randomized Trial of Dual-Focused versus Single-Focused Individual Therapy for Personality Disorders and Substance Dependence

    Science.gov (United States)

    Ball, Samuel A.; Maccarelli, Lisa M.; LaPaglia, Donna M.; Ostrowski, Mark J.

    2011-01-01

    We conducted a randomized comparison of Dual Focus Schema Therapy with Individual Drug Counseling as enhancements to residential treatment for 105 substance dependent patients with versus without specific personality disorders. Both therapies were manual-guided and delivered for 6 months by experienced psychotherapists intensively trained and supervised with independent fidelity assessment. Using Cox Proportional Hazards, we found no psychotherapy differences in retention (days in treatment). Hierarchical Linear Modeling indicated that personality disordered participants started with higher psychiatric, interpersonal, and dysphoria symptoms, and both therapies reduced symptoms over 6 months. Contrary to predictions, Individual Drug Counseling resulted in more sustained reductions than Dual Focus Schema Therapy in several symptoms for several personality disorders. Our findings raised important questions about the added value of integrative or dual-focus therapies for co-occurring personality disorders and substance dependence relative to empirically supported therapies focused more specifically on addiction symptoms. PMID:21543951

  5. Mindfulness Therapy for Maladaptive Interpersonal Dependency: A Preliminary Randomized Controlled Trial.

    Science.gov (United States)

    McClintock, Andrew S; Anderson, Timothy; Cranston, Saryn

    2015-11-01

    Existing treatments for maladaptive interpersonal dependency and dependent personality disorder do not meet basic scientific standards for effectiveness. The present investigation tested the efficacy of a mindfulness-based approach: mindfulness therapy for maladaptive interpersonal dependency (MT-MID). Forty-eight participants who reported consistently high levels of maladaptive dependency (i.e., scored higher than 1 standard deviation above the mean on the Interpersonal Dependency Inventory at two separate assessments) were randomized to either 5 sessions of MT-MID or a minimal contact control. Five self-reported outcomes (mindfulness, maladaptive interpersonal dependency, helplessness, fears of negative evaluation, and excessive reassurance seeking) were assessed at pretreatment, posttreatment, and a 4-week follow-up. Intent-to-treat analyses indicated that MT-MID yielded greater improvements than the control on all 5 outcomes at posttreatment (median d=1.61) and follow-up (median d=1.51). Participants assigned to MT-MID were more likely than control participants to meet criteria for clinically significant change at posttreatment (56.5% vs. 0%) and follow-up (42.9% vs. 0%). There was also evidence that increases in mindfulness mediated the dependency-related improvements. These results provide preliminary support for the efficacy of a mindfulness-based approach for treating the symptoms of maladaptive dependency. Copyright © 2015. Published by Elsevier Ltd.

  6. Adherence to raloxifene therapy: assessment methods and relationship with efficacy.

    Science.gov (United States)

    Finigan, J; Naylor, K; Paggiosi, M A; Peel, N F; Eastell, R

    2013-11-01

    Response to therapy depends on patient compliance but accurate assessment is difficult and adequate levels of adherence are uncertain. Adherence to raloxifene treatment may be assessed more accurately by electronic monitoring than by counting returned tablets. The level of adherence is positively associated with the degree of bone response. Adherence to study medication is usually estimated by counting returned tablets. This method relies on subjects' honesty and may be inaccurate. We aimed to assess adherence more accurately, and examine its effect on measures of bone response, by using electronic monitoring. Osteopenic women, ages 50 to 80, were prescribed daily raloxifene for 2 years. Electronic bottle caps (Medication Event Monitoring System (MEMS), Aardex) recorded the date and time on opening. Returned tablets were also counted. We measured bone mineral density (BMD) in duplicate at the spine and hip at baseline and 2 years. We also measured urinary N-terminal cross-linked telopeptide of type I collagen (NTX) at baseline, 1 and 2 years. We calculated the percentage changes in BMD and NTX from mean baseline to mean follow up measurements. Percentage adherence was assessed by both methods for 71 subjects that completed the study. The two methods correlated significantly (p caps (95.7 vs. 85.0%, p caps may assess adherence more accurately than tablet counts and would be the preferred method in clinical trials. The degree of adherence is associated with both bone turnover and BMD responses to anti-resorptive therapy.

  7. Assessment of the chestnut production weather dependence

    Science.gov (United States)

    Pereira, Mário; Caramelo, Liliana; Gouveia, Célia; Gomes-Laranjo, José

    2010-05-01

    The vegetative cycle of chestnut trees is highly dependent on weather. Photosynthesis and pollen germination are mainly conditioned by the air temperature while heavy precipitation and strong wind have significant impacts during the flushing phase period (Gomes-Laranjo et al., 2005, 2006). In Portugal, chestnut tree orchads are located in mountainous areas of the Northeast region of Trás-os-Montes, between 600 and 1000 m of altitude. Topography controls the atmospheric environment and assures adequate conditions for the chestnut production. In the above mentioned context, remote sensing plays an important role because of its ability to monitor and characterise vegetation dynamics. A number of studies, based on remote sensing, have been conducted in Europe to analyse the year-to-year variations in European vegetation greenness as a function of precipitation and temperature (Gouveia et al., 2008). A previous study focusing on the relationship between meteorological variables and chestnut productivity provides indication that simulation models may benefit from the incorporation of such kind of relationships. The aim of the present work is to provide a detailed description of recent developments, in particular of the added value that may be brought by using satellite data. We have relied on regional fields of the Normalized Difference Vegetation Index (NDVI) dataset, at 8-km resolution, provided by the Global Inventory Monitoring and Modelling System (GIMMS) group. The data are derived from the Advanced Very High Resolution Radiometers (AVHRR), and cover the period from 1982 to 2006. Additionally we have used the chestnut productivity dataset, which includes the annual values of chestnut production and area of production provided by INE, the National Institute of Statistics of Portugal and the meteorological dataset which includes values of several variables from different providers (Meteorod, NCEP/NCAR, ECA&D and national Meteorological Institute). Results show that

  8. Assessment of seismic loss dependence using copula.

    Science.gov (United States)

    Goda, Katsuichiro; Ren, Jiandong

    2010-07-01

    The catastrophic nature of seismic risk is attributed to spatiotemporal correlation of seismic losses of buildings and infrastructure. For seismic risk management, such correlated seismic effects must be adequately taken into account, since they affect the probability distribution of aggregate seismic losses of spatially distributed structures significantly, and its upper tail behavior can be of particular importance. To investigate seismic loss dependence for two closely located portfolios of buildings, simulated seismic loss samples, which are obtained from a seismic risk model of spatially distributed buildings by taking spatiotemporally correlated ground motions into account, are employed. The characterization considers a loss frequency model that incorporates one dependent random component acting as a common shock to all buildings, and a copula-based loss severity model, which facilitates the separate construction of marginal loss distribution functions and nonlinear copula function with upper tail dependence. The proposed method is applied to groups of wood-frame buildings located in southwestern British Columbia. Analysis results indicate that the dependence structure of aggregate seismic losses can be adequately modeled by the right heavy tail copula or Gumbel copula, and that for the considered example, overall accuracy of the proposed method is satisfactory at probability levels of practical interest (at most 10% estimation error of fractiles of aggregate seismic loss). The developed statistical seismic loss model may be adopted in dynamic financial analysis for achieving faster evaluation with reasonable accuracy.

  9. Methadone Replacement Therapy and Sexual Disorders among Opium Dependent Iranian Men: A Meta-Analysis Study.

    Science.gov (United States)

    Babakhanian, Masoudeh; Haghdoost, Ali Akbar; Afshari, Mahdi; Taghizadeh, Fatemeh; Moosazadeh, Mahmood

    2017-01-01

    Evaluation of sexual disorders among persons receiving methadone replacement therapy is of great importance, because these problems may lead to non-compliance and relapse. This study aimed to estimate the effect of methadone maintenance therapy (MMT) on sexual function among addicted Iranian men using met-analysis. Investigating the available data banks, relevant studies were identified. After exclusion of duplicates, irrelevant papers and low quality articles, eligible papers were entered into the meta-analysis. Prevalence and standardized mean difference of sexual function scores were illustrated by forest plots based on sexual desire, orgasm and erectile function. During the primary search, 5341 evidences were identified. After application of the inclusion/exclusion criteria and quality assessment, nine papers were detected eligible for final meta-analysis. Total prevalence [95% confidence intervals (CI)] of sexual disorders and erectile dysfunction among Iranian men under methadone therapy were estimated as 66.3% (27.1-105.5) and 77.5% (61.9-93.1), respectively. The standardized mean differences (95% CI) of Sexual desire, orgasm and erection before and after methadone therapy were estimated as 0.16 (-0.68, 0.99), -0.01 (-0.75, 0.74) and 0.11 (-0.41, 0.64), respectively. This meta-analysis showed that methadone therapy did not significantly influence the sexual desire, erectile function and orgasm among opium dependent men.

  10. Healthy and maladaptive dependency and its relationship to pain management and perceptions in physical therapy patients.

    Science.gov (United States)

    Huprich, Steven K; Hoban, Patrick; Boys, Ashley; Rosen, Alexandra

    2013-12-01

    This study examined the association among healthy and maladaptive aspects of interpersonal dependency and the management of pain in physical therapy outpatients. Ninety-eight patients were administered the Relationship Profile Test, West Haven-Yale Multidimensional Pain Inventory, and Pain Catastrophizing Scale. Results indicated that Destructive Overdependence was positively associated with an increased number of office visits, pain interference in one's daily life, pain severity, affective distress, and receiving positive partner responses. Dysfunctional Detachment was associated with affective distress, pain interference in one's daily life, and rumination about pain. Healthy Dependency was only associated with receiving distracting responses from others. Believing that a spouse/partner is supportive and caring about one's pain partially mediated the relationship between overdependency and pain interfering in one's life. These results support the clinical utility of assessing interpersonal dependency for its relationship to managing one's pain and health care utilization.

  11. Guidance on Dependence Assessment in SPAR-H

    Energy Technology Data Exchange (ETDEWEB)

    April M. Whaley

    2012-06-01

    As part of the effort to develop the SPAR-H user guidance, particular attention was paid to the assessment of dependence in order to address user questions about proper application of dependence. This paper presents a discussion of dependence from a psychological perspective and provides guidance on applying this information during the qualitative analysis of dependence to ensure more realistic and appropriate dependence assessments with the SPAR-H method. While this guidance was developed with SPAR-H in mind, it may be informative to other human reliability analysis methods that also use a THERP-based dependence approach, particularly if applied at the human failure event level.

  12. Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment.

    Science.gov (United States)

    Imani, Saeed; Atef Vahid, Mohammad Kazem; Gharraee, Banafsheh; Noroozi, Alireza; Habibi, Mojtaba; Bowen, Sarah

    2015-06-01

    This study investigated the effectiveness of mindfulness-based group therapy (MBGT) compared to the usual opioid dependence treatment (TAU).Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS) were randomly assigned into experimental (Mindfulness-Based Group Therapy) and control groups (the Usual Treatment).The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program. The Five Factor Mindfulness Questionnaire (FFMQ) and the Addiction Sevier Index (ASI) were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments. The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group. The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders.

  13. Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment

    Science.gov (United States)

    Imani, Saeed; Atef Vahid, Mohammad Kazem; Gharraee, Banafsheh; Noroozi, Alireza; Habibi, Mojtaba; Bowen, Sarah

    2015-01-01

    Objective: This study investigated the effectiveness of mindfulness-based group therapy (MBGT) compared to the usual opioid dependence treatment (TAU).Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS) were randomly assigned into experimental (Mindfulness-Based Group Therapy) and control groups (the Usual Treatment).The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program. Methods: The Five Factor Mindfulness Questionnaire (FFMQ) and the Addiction Sevier Index (ASI) were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments. Results: The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group. Conclusion: The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders. PMID:26877751

  14. Effectiveness of Mindfulness-Based Group Therapy Compared to the Usual Opioid Dependence Treatment

    Directory of Open Access Journals (Sweden)

    Saeed Imani

    2015-11-01

    Full Text Available  Objective: This study investigated the effectiveness of mindfulness-based group therapy (MBGT compared to the usual opioid dependence treatment (TAU.Thirty outpatients meeting the DSM-IV-TR criteria for opioid dependence from Iranian National Center for Addiction Studies (INCAS were randomly assigned into experimental (Mindfulness-Based Group Therapy and control groups (the Usual Treatment.The experimental group undertook eight weeks of intervention, but the control group received the usual treatment according to the INCAS program.  Methods:The Five Factor Mindfulness Questionnaire (FFMQ and the Addiction Sevier Index (ASI were administered at pre-treatment and post-treatment assessment periods. Thirteen patients from the experimental group and 15 from the control group completed post-test assessments. Results:The results of MANCOVA revealed an increase in mean scores in observing, describing, acting with awareness, non-judging, non-reacting, and decrease in mean scores of alcohol and opium in MBGT patient group. Conclusion:The effectiveness of MBGT, compared to the usual treatment, was discussed in this paper as a selective protocol in the health care setting for substance use disorders.

  15. Isotretinoin therapy: Any need for laboratory assessment? | Tallab ...

    African Journals Online (AJOL)

    Background: Recently studies showed the no need for laboratory follow up of patients on isotretinoin therapy. The aim of this study is to assess this issue. Patients and methods: A retrospective study on 400 patients was performed to analyze the laboratory data before and after isotretinoin therapy of acne vulgaris patients.

  16. ICU Patients Requiring Renal Replacement Therapy Initiation: Fewer Survivors and More Dialysis Dependents From 80 Years Old.

    Science.gov (United States)

    Commereuc, Morgane; Guérot, Emmanuel; Charles-Nelson, Anais; Constan, Adrien; Katsahian, Sandrine; Schortgen, Frédérique

    2017-08-01

    To assess the role of advanced age on survival and dialysis dependency after initiation of renal replacement therapy for acute kidney injury. Retrospective pooled analysis of prospectively collected data. ICUs of two teaching hospitals in Paris area, France. One thousand five hundred thirty adult patients who required renal replacement therapy initiation in the ICU. None. Survival and post acute kidney injury chronic dialysis dependency were assessed at hospital discharge according to the quintile (Q) of age. The oldest quintile included 289 patients 80 years old and over. Seventy-three percent of included patients had respiratory and hemodynamic supports at renal replacement therapy initiation, similarly distributed across quintiles. Mortality increased with age strata from 63% in Q1 (≤ 52 yr) to 76% in Q5 (≥ 80 yr) (p Dialysis dependency was more frequent among survivors 80 years old or older (30% vs 14%; p = 0.001). Age 80 years old or older was an independent risk for dialysis dependency only for patients with prior advanced chronic kidney disease (p = 0.04). Baseline estimated glomerular filtration rate was the only one predictor of dialysis dependency identified. Patients with advanced age represent a substantial subgroup of patients requiring renal replacement therapy in the ICU. From 80 years, age should be considered as an additional risk of dying over the severity of organ failures. Patients 80 years old or older are likely to recover sufficient renal function allowing renal replacement therapy discontinuation when baseline estimated glomerular filtration rate is above 44 mL/min/1.73 m. At 3 months, only 6% were living at home, dialysis independent.

  17. [Diet therapy in non-insulin dependent diabetes mellitus (NIDDM)].

    Science.gov (United States)

    Cavallo-Perin, P; Bodoni, P; Marena, S

    1997-12-01

    The main approach in NIDDM therapy is diet. Most patients present insulin resistance characterized by overweight, VLDL increase, minimal increase of LDL, decrease of HDL cholesterol, and hypertension. The overall goals of nutrition therapy are the maintenance of near normal glucose levels, and the achievement of optimal serum lipid levels with adequate calories for maintaining or attaining a reasonable body weight. In presence of obesity and hypertension even a slightly weight loss could achieve an improvement in metabolic control and in hypertension with a better life expectance. General-ly carbohydrate intake would represent the 50-60% of total caloric amount (with preference to those with low glycemic index), and lipids no more than 35% (less than 10% of these 10-15% from monounsaturated fats with less than 300 mg/day of cholesterol). If elevated very low density lipoproteins level is the primary problem, a beneficial approach is 10% of total caloric intake from saturated fats, 10% from polyunsaturated, and 15-20% from monounsaturated fats with less than 200 mg/day of cholesterol and 40% of carbohydrates. A large amount of fructose (20% of calories) may increase LDL levels but sweeteners as saccarine or aspartame are approved and determine a better diet compliance. Daily consumpion of 20-35 g of dietary fibres from food sources is recommended for metabolic control. Protein intake would be of about 10% of total caloric amount especially in presence of diabetic nepropathy. Alcohol would not exceed 30 g/day for men and 20 g/day for women keeping in mild that alcohol may worsen metabolic control, diet compliance, and may be dangerous itself. For people with hypertension a decrease of dietary sodium intake is recommended. Nutritional recommendations are developed to meet treatment goals and desired outcomes. Monitoring metabolic parameters, blood pressure, and body weight is very important to ensure successful outcomes.

  18. Urine protein electrophoresis study in dogs with pituitary dependent hyperadrenocorticism during therapy with trilostane

    Directory of Open Access Journals (Sweden)

    Douglas S. Caragelasco

    Full Text Available ABSTRACT: Hyperadrenocorticism is one of the most common endocrine disorders in dogs. Regarding to the kidneys, chronic hypercortisolemia can cause damage to the glomerulus, and evolve into chronic kidney disease. This study evaluated nine normotensive dogs with pituitary dependent hyperadrenocorticism, before and after therapy with trilostane, during the follow-up period of six months, in order to investigate the development of pathological proteinuria by quantitative (urinary protein-to-creatinine ratio and qualitative (urinary protein electrophoresis methods, and also to monitor its intensity over the course of the disease and therapy. The main renal lesion detected in dogs with hyperadrenocorticism was in the tubular segment, evidenced by the prevalence of urinary protein bands of lower molecular weight, indicating the lack absorption of these proteins in the proximal segment of the nephron. Low molecular weight proteins persisted throughout the follow-up. Regarding the future of routine veterinary medical clinic in the care of patients with hyperadrenocorticism, the assessments of proteinuria determinations by the urinary protein-to-creatinin ratio and urinary protein electrophoresis, according to the results obtained in this study, can add more information about the renal damage in these animals, and contribute to the prognosis.

  19. Quantitative assessment of target dependence of pion fluctuation in ...

    Indian Academy of Sciences (India)

    Quantitative assessment of target dependence of pion fluctuation in hadronic interactions – estimation through erraticity. DIPAK GHOSH1, ARGHA DEB1, MITALI MONDAL2,∗,. ARINDAM MONDAL3 and SITARAM PAL4. 1Nuclear and Particle Physics Research Centre, Department of Physics,. Jadavpur University, Kolkata ...

  20. Assessment of the Tobacco Dependence Screener Among Smokeless Tobacco Users.

    Science.gov (United States)

    Mushtaq, Nasir; Beebe, Laura A

    2016-05-01

    Variants of the Fagerström Tolerance Questionnaire and Fagerström Test for Nicotine Dependence (FTND) are widely used to study dependence among smokeless tobacco (ST) users. However, there is a need for a dependence measure which is based on the clinical definition of dependence and is easy to administer. The Tobacco Dependence Screener (TDS), a self-administered 10-item scale, is based on the Diagnostic and Statistical Manual, fourth edition (DSM-IV) and ICD-10 definitions of dependence. It is commonly used as a tobacco dependence screening tool in cigarette smoking studies but it has not been evaluated for dependence in ST users. The purpose of this study is to evaluate the TDS as a measure of tobacco dependence among ST users. Data collected from a community-based sample of exclusive ST users living in Oklahoma (n = 95) was used for this study. TDS was adapted to be used for ST dependence as the references for smoking were changed to ST use. Concurrent validity and reliability of TDS were evaluated. Salivary cotinine concentration was used as a criterion variable. Overall accuracy of the TDS was assessed by receiver's operating characteristic (ROC) curve and optimal cutoff scores for dependence diagnosis were evaluated. There was no floor or ceiling effect in TDS score (mean = 5.42, SD = 2.61). Concurrent validity of TDS as evaluated by comparing it with FTND-ST was affirmative. Study findings showed significant association between TDS and salivary cotinine concentration. The internal consistency assessed by Cronbach's alpha indicated that TDS had acceptable reliability (α = 0.765). TDS was negatively correlated with time to first chew/dip and positively correlated with frequency (number of chews per day) and years of ST use. Results of logistic regression analysis showed that at an optimal cutoff score of TDS 5+, ST users classified as dependent had significantly higher cotinine concentration and FTND-ST scores. TDS demonstrated acceptable reliability and

  1. Cognitive behaviour therapy and objective assessments in chronic fatigue syndrome.

    Science.gov (United States)

    McPhee, Graham

    2017-08-01

    Most evaluations of cognitive behavioural therapy to treat people with chronic fatigue syndrome/myalgic encephalomyelitis rely exclusively on subjective self-report outcomes to evaluate whether treatment is effective. Few studies have used measures appropriate to assessing whether cognitive behavioural therapy changes in more objective measures. A review of studies incorporating objective measures suggests that there is a lack of evidence that cognitive behavioural therapy produces any improvement in a patient's physical capabilities or other objective measures such as return to work. Future studies of chronic fatigue syndrome/myalgic encephalomyelitis should include some objective assessments as primary outcomes. If this is to include activity monitors, we first need a sound baseline dataset.

  2. Dependability modeling and assessment in UML-based software development.

    Science.gov (United States)

    Bernardi, Simona; Merseguer, José; Petriu, Dorina C

    2012-01-01

    Assessment of software nonfunctional properties (NFP) is an important problem in software development. In the context of model-driven development, an emerging approach for the analysis of different NFPs consists of the following steps: (a) to extend the software models with annotations describing the NFP of interest; (b) to transform automatically the annotated software model to the formalism chosen for NFP analysis; (c) to analyze the formal model using existing solvers; (d) to assess the software based on the results and give feedback to designers. Such a modeling→analysis→assessment approach can be applied to any software modeling language, be it general purpose or domain specific. In this paper, we focus on UML-based development and on the dependability NFP, which encompasses reliability, availability, safety, integrity, and maintainability. The paper presents the profile used to extend UML with dependability information, the model transformation to generate a DSPN formal model, and the assessment of the system properties based on the DSPN results.

  3. for assessing efficacy of artemisinin combination therapy against ...

    African Journals Online (AJOL)

    SD Bioline malaria antigen Pf (HRP-2/pLHD) for assessing efficacy of artemisinin combination therapy against Plasmodium falciparum in pediatric patients in the Democratic Republic of the Congo. ... Methods: Five hundred and one patients with malaria symptoms were screened for P. falciparum in Kinshasa, DRC.

  4. Assessment of patients' knowledge of their drug therapy in a ...

    African Journals Online (AJOL)

    Patients' knowledge of their medications is an important factor in ensuring adherence. Medication adherence is essential for rational drug use and derivation of optimal therapy. This study was conducted to assess knowledge of outpatients regarding their medications. A well structured questionnaire was administered to 200 ...

  5. Degree of Postictal Suppression Depends on Seizure Induction Time in Magnetic Seizure Therapy and Electroconvulsive Therapy.

    Science.gov (United States)

    Kayser, Sarah; Bewernick, Bettina H; Soehle, Martin; Switala, Christina; Gippert, Sabrina M; Dreimueller, Nadine; Schlaepfer, Thomas E

    2017-09-01

    Anesthesia is required for both magnetic seizure therapy (MST) and electroconvulsive therapy (ECT), although it has anticonvulsant properties. In this case, bispectral index (BIS) monitoring, a specific electroencephalogram-derived monitoring, can be used to find the optimal seizure induction time during anesthesia to elicit adequate seizures. A measurement of seizure adequacy in electroencephalogram is the postictal suppression. The purpose of this study was to investigate the influence of seizure induction time on the degree of postictal suppression by comparing BIS versus no-BIS monitoring in MST and ECT. Twenty patients with treatment-resistant depression were randomly assigned to either MST or ECT. Each patient underwent 3 treatments with the determination of seizure induction time by defined prestimulation BIS (BIS condition) and 3 treatments with determination of seizure induction time by controlled clinical trial protocol (no-BIS condition). Statistical analysis was calculated by repeated-measures analysis of variance. The degree of postictal suppression was more pronounced in both MST and ECT, with BIS monitoring. In this connection, no differences between MST and ECT were found. Seizure induction time was significantly later in the BIS condition (181.3 ± 6 seconds) compared with the no-BIS condition (114.3 ± 12 seconds) (P < 0.001). Adequacy of seizures, in the form of the degree of postictal suppression, was superior by determining the seizure induction time with BIS in both MST and ECT. Further research is needed to investigate the correlation between the degree of postictal suppression and treatment response.

  6. Patient Reported Outcome Assessment of Periodontal Therapy: A Systematic Review

    Science.gov (United States)

    Peter, Elbe; Varghese, N.O.; Anju, P

    2017-01-01

    Introduction Patient Reported Outcomes (PROs) are now regarded as a fundamental measure of therapeutic success. Patient’s opinion regarding the impact of disease and its treatment is assessed using scales such as Oral Health Related Quality Of Life (OHRQoL) tools. Patient centred outcome assessment is now being considered as a primary outcome measure in clinical trials. Aim To evaluate whether treatment of periodontal disease could influence OHRQoL based on available literature. Materials and Methods An electronic search was done in Google, Google Scholar and Pubmed for articles in English language using the terms Quality of Life or ORHQoL or PROs or patient centered outcome and periodontal therapy. The search commenced on 1st September 2016 and ended on 15th December 2016. Studies that employed one or more than one multi-item OHRQoL instrument to assess PROs related to either non-surgical or surgical periodontal therapy were reviewed. Results Initially 423 relevant articles were obtained, from which based on screening titles and abstracts 396 were excluded. Full text of remaining 27 articles were retrieved. Nineteen clinical studies with 1345 participants and 2 systematic reviews were included after the full text review. Conclusion Both surgical and Non-surgical Periodontal Therapy (NSPT) significantly influenced the OHRQoL scores. However the change in scores after surgical therapy when compared to nonsurgical therapy was not statistically significant. There is a need for a specific PROs scale that could potentially tap the entire dimension of the change in patients’ perception brought about by periodontal therapy. PMID:28969266

  7. USING COPULAS TO MODEL DEPENDENCE IN SIMULATION RISK ASSESSMENT

    Energy Technology Data Exchange (ETDEWEB)

    Dana L. Kelly

    2007-11-01

    Typical engineering systems in applications with high failure consequences such as nuclear reactor plants often employ redundancy and diversity of equipment in an effort to lower the probability of failure and therefore risk. However, it has long been recognized that dependencies exist in these redundant and diverse systems. Some dependencies, such as common sources of electrical power, are typically captured in the logic structure of the risk model. Others, usually referred to as intercomponent dependencies, are treated implicitly by introducing one or more statistical parameters into the model. Such common-cause failure models have limitations in a simulation environment. In addition, substantial subjectivity is associated with parameter estimation for these models. This paper describes an approach in which system performance is simulated by drawing samples from the joint distributions of dependent variables. The approach relies on the notion of a copula distribution, a notion which has been employed by the actuarial community for ten years or more, but which has seen only limited application in technological risk assessment. The paper also illustrates how equipment failure data can be used in a Bayesian framework to estimate the parameter values in the copula model. This approach avoids much of the subjectivity required to estimate parameters in traditional common-cause failure models. Simulation examples are presented for failures in time. The open-source software package R is used to perform the simulations. The open-source software package WinBUGS is used to perform the Bayesian inference via Markov chain Monte Carlo sampling.

  8. Dialectical behavior therapy for patients with borderline personality disorder and drug-dependence.

    Science.gov (United States)

    Linehan, M M; Schmidt, H; Dimeff, L A; Craft, J C; Kanter, J; Comtois, K A

    1999-01-01

    A randomized clinical trial was conducted to evaluate whether Dialectical Behavior Therapy (DBT), an effective cognitive-behavioral treatment for suicidal individuals with borderline personality disorder (BPD), would also be effective for drug-dependent women with BPD when compared with treatment-as-usual (TAU) in the community. Subjects were randomly assigned to either DBT or TAU for a year of treatment. Subjects were assessed at 4, 8, and 12 months, and at a 16-month follow-up. Subjects assigned to DBT had significantly greater reductions in drug abuse measured both by structured interviews and urinalyses throughout the treatment year and at follow-up than did subjects assigned to TAU. DBT also maintained subjects in treatment better than did TAU, and subjects assigned to DBT had significantly greater gains in global and social adjustment at follow-up than did those assigned to TAU. DBT has been shown to be more effective than treatment-as-usual in treating drug abuse in this study, providing more support for DBT as an effective treatment for severely dysfunctional BPD patients across a range of presenting problems.

  9. Research into the Development of Voice Assessment in Music Therapy

    DEFF Research Database (Denmark)

    Storm, Sanne

    This study was a research into the development of a voice assessment profile (VOIAS). Already a preliminary literature search showed that no such profile within music therapy existed, and only very sparse research within music therapy focusing on and involving the human voice. The development...... of VOIAS is based on vocal parameters extracted from the literature review and my clinical approach “Psychodynamic Voice Therapy”. The parameters’ relevance is based on clinical practice and the focus of population in this study, clients suffering from depression....

  10. Delivering occupational therapy hand assessment and treatment sessions via telehealth.

    Science.gov (United States)

    Worboys, Tess; Brassington, Melinda; Ward, Elizabeth C; Cornwell, Petrea L

    2017-01-01

    Introduction Telehealth offers a solution to assist delivery of occupational therapy (OT) services for hand therapy in rural and remote locations. However, there is currently no evidence to validate this service model. The aim of this study was to examine the validity of clinical decisions made during hand therapy sessions conducted via telehealth compared to a traditional clinical model (TCM) assessment, and explore patient and clinician satisfaction. Methods Eighteen patients referred for hand therapy to a rural/remote hospital-based outpatient service were assessed simultaneously via telehealth and a TCM assessment. An allied health assistant supported data collection at the patient end. Hand function was assessed using a range of objective measures, subjective scales and patient reported information. Minimal level of percent exact agreement (PEA) between the telehealth OT (T-OT) and the TCM-OT was set at ≥80%. Results Level of agreement for all objective measures (dynamometer and pinch gauge reading, goniometer flexion and extension, circumference in millimetres) ranged between 82% and 100% PEA. High agreement (>80% PEA) was also obtained for judgements of scar and general limb function, exercise compliance, pain severity and sensitivity location, activities of daily living and global ratings of change (GROC) scores. There was 100% PEA for overall recommendations. Minimal technical issues were experienced. Patient and clinician satisfaction was high. Discussion Clinical decisions made via telehealth were comparable to the TCM and consumers were satisfied with telehealth as a service option. Telehealth offers the potential to improve access to hand therapy services for rural and remote patients.

  11. Adaptive control with state-dependent modeling of patient impairment for robotic movement therapy.

    Science.gov (United States)

    Bower, C; Taheri, H; Wolbrecht, E

    2013-06-01

    This paper presents an adaptive control approach for robotic movement therapy that learns a state-dependent model of patient impairment. Unlike previous work, this approach uses an unstructured inertial model that depends on both the position and direction of the desired motion in the robot's workspace. This method learns a patient impairment model that accounts for movement specific disability in neuro-muscular output (such as flexion vs. extension and slow vs. dynamic tasks). Combined with assist-as-needed force decay, this approach may promote further patient engagement and participation. Using the robotic therapy device, FINGER (Finger Individuating Grasp Exercise Robot), several experiments are presented to demonstrate the ability of the adaptive control to learn state-dependent abilities.

  12. Diagnosis and treatment of nicotine dependence with emphasis on nicotine replacement therapy. A status report.

    Science.gov (United States)

    Balfour, D; Benowitz, N; Fagerström, K; Kunze, M; Keil, U

    2000-03-01

    Tobacco use is a global health care problem. Repetitive exposure to nicotine produces neuroadaptation resulting in nicotine dependence. Cigarette smoking is particularly addictive due to the repeated delivery of bolus doses of nicotine to the bloodstream. Although compulsive tobacco use is sustained by nicotine addiction, it is the toxic combustion products in tobacco smoke such as carbon monoxide and oxidant gases that adversely affect the cardiovascular system. Smoking cessation produces significant health benefits and is a very cost-effective intervention. Evidence that nicotine is the addictive component of tobacco provides the rationale for using nicotine replacement therapy to aid cessation. Nicotine replacement therapy doubles successful smoking cessation rates and evidence-based guidelines for the treatment of tobacco addiction recommend routine use of nicotine replacement therapy, particularly in heavily dependent smokers. Success rates of up to 40% can be achieved in specialist clinics. Despite early concerns regarding the safety of nicotine replacement therapy in smokers with heart disease, it is now clear that the health risks of using nicotine replacement therapy to assist such patients to stop, or significantly reduce, smoking far outweigh any treatment-related risks. Copyright 2000 The European Society of Cardiology.

  13. [Clinical assessment of physical dependence potential of dihydroetorphine hydrochloride (DHE)].

    Science.gov (United States)

    Ge, Y; Li, M; Sun, W L; Cai, Z J

    1994-01-01

    This paper reports the DHE substitution clinical trial in 38 heroin addicts. The CINA (Clinical Institute Narcotic Assessment) scale was used to assess physical dependence potential. The CINA scale contains 10 opioid withdrawal signs (nausea, vomiting, gooseflesh, sweating, restlessness, tremor, larcrimation, nasal congestion, yawning, changes in heart rate and systolic blood pressure) and 3 opiate withdrawal symptoms (abdominal pain, muscle pain and feeling hot or cold). For each subject admitted to the Drug Detoxification and Treatment Center his (her) status on each of the 13 items of CINA were immediately rated. Then, naloxone 0.4 mg was injected iv to precipitate withdrawal symptoms and at 5, 10, 15 min after the naloxone injection, the CINA score of each patient was rated again. The differences among the scores of pre- and post-naloxone injection is a measurement of the degree of withdrawal symptoms. Then, a single dose of DHE was administered sublingually to each patient, all withdrawal symptoms disappeared. These results show that DHE can compete with naloxone for opioid receptors. A good dose-response relationship was found between the 100% suppressive withdrawal sign doses of DHE and the degree of withdrawal sign in heroin addicts. The physical dependence potential of DHE given to heroin addicts sublingually was probably more than that of methadone given to heroin addicts orally by making reference to the report of Dr. Peachy.

  14. Time-dependent reliability analysis and condition assessment of structures

    Energy Technology Data Exchange (ETDEWEB)

    Ellingwood, B.R. [Johns Hopkins Univ., Baltimore, MD (United States)

    1997-01-01

    Structures generally play a passive role in assurance of safety in nuclear plant operation, but are important if the plant is to withstand the effect of extreme environmental or abnormal events. Relative to mechanical and electrical components, structural systems and components would be difficult and costly to replace. While the performance of steel or reinforced concrete structures in service generally has been very good, their strengths may deteriorate during an extended service life as a result of changes brought on by an aggressive environment, excessive loading, or accidental loading. Quantitative tools for condition assessment of aging structures can be developed using time-dependent structural reliability analysis methods. Such methods provide a framework for addressing the uncertainties attendant to aging in the decision process.

  15. Progress and prospects: gene therapy for genetic diseases with helper-dependent adenoviral vectors.

    Science.gov (United States)

    Brunetti-Pierri, N; Ng, P

    2008-04-01

    Preclinical studies in small and large animal models using helper-dependent adenoviral vectors (HDAds) have generated promising results for the treatment of genetic diseases. However, clinical translation is complicated by the dose-dependent, capsid-mediated acute toxic response following systemic vector injection. With the advancements in vectorology, a better understanding of vector-mediated toxicity, and improved delivery methods, HDAds may emerge as an important vector for gene therapy of genetic diseases and this report highlights recent progress and prospects in this field.

  16. Driving simulators for occupational therapy screening, assessment, and intervention.

    Science.gov (United States)

    Classen, Sherrilene; Brooks, Johnell

    2014-04-01

    Simulation technology provides safe, objective, and repeatable performance measures pertaining to operational (e.g., avoiding a collision) or tactical (e.g., lane maintenance) driver behaviors. Many occupational therapy researchers and others are using driving simulators to test a variety of applications across diverse populations. A growing body of literature provides support for associations between simulated driving and actual on-road driving. One limitation of simulator technology is the occurrence of simulator sickness, but management strategies exist to curtail or mitigate its onset. Based on the literature review and a consensus process, five consensus statements are presented to support the use of driving simulation technology among occupational therapy practitioners. The evidence suggests that by using driving simulators occupational therapy practitioners may detect underlying impairments in driving performance, identify driving errors in at-risk drivers; differentiate between driving performance of impaired and healthy controls groups; show driving errors with absolute and relative validity compared to on-road studies; and mitigate the onset of simulator sickness. Much progress has been made among occupational therapy researchers and practitioners in the use of driving simulation technology; however, empirical support is needed to further justify the use of driving simulators in clinical practice settings as a valid, reliable, clinical useful, and cost effective tool for driving assessment and intervention.

  17. Hormonal therapy with estradiol and drospirenone improves endothelium-dependent vasodilation in the coronary bed of ovariectomized spontaneously hypertensive rats

    Energy Technology Data Exchange (ETDEWEB)

    Borgo, M.V.; Claudio, E.R.G.; Silva, F.B.; Romero, W.G.; Gouvea, S.A.; Moysés, M.R.; Santos, R.L.; Almeida, S.A. [Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal de Espírito Santo, Vitória, ES (Brazil); Podratz, P.L.; Graceli, J.B. [Departamento de Morfologia, Centro de Ciências da Saúde, Universidade Federal do Espírito Santo, Vitória, ES (Brazil); Abreu, G.R. [Departamento de Ciências Fisiológicas, Centro de Ciências da Saúde, Universidade Federal de Espírito Santo, Vitória, ES (Brazil)

    2015-11-17

    Drospirenone (DRSP) is a progestin with anti-aldosterone properties and it reduces blood pressure in hypertensive women. However, the effects of DRSP on endothelium-dependent coronary vasodilation have not been evaluated. This study investigated the effects of combined therapy with estrogen (E2) and DRSP on endothelium-dependent vasodilation of the coronary bed of ovariectomized (OVX) spontaneously hypertensive rats. Female spontaneously hypertensive rats (n=87) at 12 weeks of age were randomly divided into sham operated (Sham), OVX, OVX treated with E2 (E2), and OVX treated with E2 and DRSP (E2+DRSP) groups. Hemodynamic parameters were directly evaluated by catheter insertion into the femoral artery. Endothelium-dependent vasodilation in response to bradykinin in the coronary arterial bed was assessed using isolated hearts according to a modified Langendorff method. Coronary protein expression of endothelial nitric oxide synthase and estrogen receptor alpha (ER-α) was assessed by Western blotting. Histological slices of coronary arteries were stained with hematoxylin and eosin, and morphometric parameters were analyzed. Oxidative stress was assessed in situ by dihydroethidium fluorescence. Ovariectomy increased systolic blood pressure, which was only prevented by E2+DRSP treatment. Estrogen deficiency caused endothelial dysfunction, which was prevented by both treatments. However, the vasodilator response in the E2+DRSP group was significantly higher at the three highest concentrations compared with the OVX group. Reduced ER-α expression in OVX rats was restored by both treatments. Morphometric parameters and oxidative stress were augmented by OVX and reduced by E2 and E2+DRSP treatments. Hormonal therapy with E2 and DRSP may be an important therapeutic option in the prevention of coronary heart disease in hypertensive post-menopausal women.

  18. Functional assessment of ubiquitin-depended processes under microgravity conditions

    Science.gov (United States)

    Zhabereva, Anastasia; Shenkman, Boris S.; Gainullin, Murat; Gurev, Eugeny; Kondratieva, Ekaterina; Kopylov, Arthur

    , were separated by SDS-PAGE and subjected for mass spectrometry-based analysis.With the described workflow, we identified more than 200 proteins including of 26S proteasome subunits, members of SUMO (Small Ubiquitin-like Modifier) family and ubiquitylated substrates. On the whole, our results provide an unbiased view of ubiquitylation state under microgravity conditions and thereby demonstrate the utility of proposed combination of analytical methods for functional assessment of ubiquitin-depended processes. Acknowledgment - We thank teams of Institute of Biomedical Problems of Russian Academy of Sciences and TsSKB “Progress” Samara for organization and preparation for spaceflight. This work is partially supported by the Russian Foundation for Basic Research (grant12-04-01836).

  19. Coping mediates the effects of cognitive-behavioral therapy for alcohol use disorder among out-patient clients in Project MATCH when dependence severity is high.

    Science.gov (United States)

    Roos, Corey R; Maisto, Stephen A; Witkiewitz, Katie

    2017-09-01

    There is inconsistent evidence that alcohol-specific coping is a mechanism of change in cognitive-behavioral therapy (CBT) for alcohol use disorder (AUD). Our primary aim was to test whether baseline dependence severity moderates the mediational effect of CBT on drinking outcomes via coping. Secondary data analysis of Project MATCH , a multi-site alcohol treatment trial in which participants, recruited in out-patient and aftercare arms, were randomized to three treatments: CBT, motivational enhancement therapy (MET) and Twelve-Step facilitation (TSF). Nine research sites in the United States. A total of 1063 adults with AUD. The primary outcomes were percentage days abstinent and percentage heavy drinking days at the 1-year follow-up. Coping was assessed with the Processes of Change Questionnaire . Dependence severity was measured with the Alcohol Dependence Scale . Among the full available sample (across treatment arms), there were no significant moderated mediation effects. Double moderated mediation analyses indicated that several moderated mediation effects were moderated by treatment arm (all P cognitive-behavioral therapy for alcohol use disorder was conditional on dependence severity. End-of-treatment coping mediated the positive treatment effects of cognitive-behavioral therapy on 1-year drinking outcomes among out-patient clients when dependence severity was high, but not when dependence severity was low or moderate. © 2017 Society for the Study of Addiction.

  20. Dosage dependent hormonal counter regulation to combination therapy in patients with left ventricular dysfunction

    DEFF Research Database (Denmark)

    Galløe, A.M.; Skagen, K.; Christensen, Niels Juel

    2006-01-01

    The present study attempts to assess the efficacy combination therapy for heart failure. Genuine dose-response studies on combination therapy are not available and published studies involved adding one drug on top of 'usual treatment'. Sixteen different dosage combinations of trandolapril...... with the maximal effect at 0.5 mg daily. Both drugs significantly increased renin concentration with a significant potentiating interaction. It was not possible to detect beneficial effects of combination therapies. The optimal dosage of Bumetanide appeared to be 0.5 mg twice daily based on its effect on quality...... of life and weight loss. Estimated by the reduction in systolic blood pressure the optimal dosage of Trandolapril appeared to be 0.5 mg once daily. CONCLUSIONS: It appears that patients should be given less than the usually recommended dosages. Patients may be treated with a low dose loop diuretic...

  1. Hierarchical Simulation to Assess Hardware and Software Dependability

    Science.gov (United States)

    Ries, Gregory Lawrence

    1997-01-01

    This thesis presents a method for conducting hierarchical simulations to assess system hardware and software dependability. The method is intended to model embedded microprocessor systems. A key contribution of the thesis is the idea of using fault dictionaries to propagate fault effects upward from the level of abstraction where a fault model is assumed to the system level where the ultimate impact of the fault is observed. A second important contribution is the analysis of the software behavior under faults as well as the hardware behavior. The simulation method is demonstrated and validated in four case studies analyzing Myrinet, a commercial, high-speed networking system. One key result from the case studies shows that the simulation method predicts the same fault impact 87.5% of the time as is obtained by similar fault injections into a real Myrinet system. Reasons for the remaining discrepancy are examined in the thesis. A second key result shows the reduction in the number of simulations needed due to the fault dictionary method. In one case study, 500 faults were injected at the chip level, but only 255 propagated to the system level. Of these 255 faults, 110 shared identical fault dictionary entries at the system level and so did not need to be resimulated. The necessary number of system-level simulations was therefore reduced from 500 to 145. Finally, the case studies show how the simulation method can be used to improve the dependability of the target system. The simulation analysis was used to add recovery to the target software for the most common fault propagation mechanisms that would cause the software to hang. After the modification, the number of hangs was reduced by 60% for fault injections into the real system.

  2. Can Nutritional Assessment Tools Predict Response to Nutritional Therapy?

    Science.gov (United States)

    Patel, Chirag; Omer, Endashaw; Diamond, Sarah J; McClave, Stephen A

    2016-04-01

    Traditional tools and scoring systems for nutritional assessment have focused solely on parameters of poor nutritional status in the past, in an effort to define the elusive concept of malnutrition. Such tools fail to account for the contribution of disease severity to overall nutritional risk. High nutritional risk, caused by either deterioration of nutritional status or greater disease severity (or a combination of both factors), puts the patient in a metabolic stress state characterized by adverse outcome and increased complications. Newer scoring systems for determining nutritional risk, such as the Nutric Score and the Nutritional Risk Score-2002 have created a paradigm shift connecting assessment and treatment with quality outcome measures of success. Clinicians now have the opportunity to identify high risk patients through their initial assessment, provide adequate or sufficient nutrition therapy, and expect improved patient outcomes as a result. These concepts are supported by observational and prospective interventional trials. Greater clinical experience and refinement in these scoring systems are needed in the future to optimize patient response to nutrition therapy.

  3. Sleep quality in opioid-naive and opioid-dependent patientson methadone maintenance therapy in Malaysia.

    Science.gov (United States)

    Zahari, Zalina; Inrahim, Muslih Abdulkarim; Tan, Soo Choon; Mohamad, Nasir; Ismail, Rusli

    2016-12-20

    Sleep disturbances may contribute to poor treatment outcomes in opioid-dependent patients. The extent to which the sleep profiles of opioid-dependent patients differ from those of the general Malaysian population is not documented. This study compared opioid-naive subjects and opioid-dependent patients on methadone maintenance therapy (MMT) in terms of their sleep quality. Participants comprised Malay male opioid-naive subjects (n = 159) and opioid-dependent patients (n = 160) from MMT clinics in Kelantan, Malaysia, between March and October 2013. Sleep quality was evaluated using the translated and validated Malay version of the Pittsburgh Sleep Quality Index (PSQI). The opioid-dependent patients exhibited higher global PSQI scores [adjusted mean (95% CI) = 5.46 (5.02, 5.90)] than the opioid-naive group [4.71 (4.26, 5.15)] [F (1, 313) = 4.77, P = 0.030]. This study confirmed the poorer sleep quality among opioid-dependent patients on MMT, as manifested by their higher global PSQI scores. The sleep complaints in this patient population are a factor to consider and, when necessary, sleep evaluation and treatment should be undertaken to improve MMT patients' quality of sleep and overall treatment outcome.

  4. Immune response to helper dependent adenoviral mediated liver gene therapy: challenges and prospects.

    Science.gov (United States)

    Seiler, Michael P; Cerullo, Vincenzo; Lee, Brendan

    2007-10-01

    Adenovirus-mediated gene therapy holds significant potential especially for applications requiring high levels of target tissue transduction. While significant advances in clinical adenoviral gene therapy applications have been made in cancer, the clinical translation of adenoviral gene replacement therapy for genetic disease has lagged. Encouragingly, advances in vector production have led to the development of Helper-Dependent ("gutted" or "high capacity") adenoviral vectors (HDV) deleted of all viral coding genes. HDV significantly reduces the chronic toxicity associated with early generation adenoviral vectors that has been most significant after systemic administration in both small and large animal models. However, the field remains confounded by innate immune responses inherent to adenovirus, and more generally, to the adaptive immune response to transgene. Together they decrease the effective therapeutic index for any particular treatment. This review summarizes the current advances toward understanding the decisive cell and molecular mechanisms underlying the acute toxicity to systemic HDV administration. We focus on the complex immune response and consequences of systemic vector delivery in the context of liver-directed monogenic disease therapy. Future development of interventions to avoid the innate immune response, including vector and pharmacologic manipulations, should further contribute to minimizing vector toxicity while maximizing the efficacy of systemic HDV gene transfer.

  5. Virtual Reality Therapy for the Treatment of Alcohol Dependence: A Preliminary Investigation With Positron Emission Tomography/Computerized Tomography.

    Science.gov (United States)

    Son, Ji Hyun; Lee, Sang Hoon; Seok, Ju Won; Kee, Baik Seok; Lee, Hyun Woong; Kim, Hyung Joon; Lee, Tae Kyung; Han, Doug Hyun

    2015-07-01

    Virtual reality therapy (VRT) uses multimodal stimulation that includes visual, auditory, olfactory, and gustatory stimuli. The aim of this study was to assess the effectiveness of VRT in treating subjects with alcohol dependence (AD) by evaluating changes in brain metabolism. The VRT protocol consisted of three steps: relaxation, presentation of a high-risk situation, and presentation of an aversive situation. Twelve alcohol-dependent subjects underwent 10 sessions of VRT. The alcohol-dependent subjects were assessed with 18F-fluorodeoxyglucose positron emission tomography images before and after VRT, whereas the control group underwent imaging according to the same protocol only at baseline. Compared with the healthy control group, AD subjects showed higher metabolism in the right lentiform nucleus and right temporal lobe (BA20) at baseline (P(FDR brain metabolism in the right lentiform nucleus (P(FDR < .05) = .026) and right temporal lobe (BA38, P(FDR < .05) = .032) relative to that at baseline. Our results suggest a neurobiological imbalance, notably, a high sensitivity to stimuli, in the limbic system in subjects with AD. Furthermore, we determined that metabolism decreased in the basal ganglia after VRT, which may explain the limbic-regulated responses of reward and regulation. Therefore, we tentatively recommend VRT to treat AD through its regulating effect on limbic circuits.

  6. The role of homework in cognitive-behavioral therapy for cocaine dependence.

    Science.gov (United States)

    Gonzalez, Vivian M; Schmitz, Joy M; DeLaune, Katherine A

    2006-06-01

    This study examines the effect of homework compliance on treatment outcome in 123 participants receiving cognitive-behavioral therapy (CBT) for cocaine dependence. Regression analyses revealed a significant relationship between homework compliance and cocaine use that was moderated by readiness to change. Homework compliance predicted less cocaine use during treatment but only for participants higher in readiness to change. For those lower in readiness to change, homework compliance was not associated with cocaine use during treatment. Homework compliance early in therapy was associated with better retention in treatment. Homework compliance was not predicted by participants' level of education or readiness to change. These findings support the use of homework during CBT for substance use disorders. Copyright 2006 APA, all rights reserved.

  7. Sulfonylurea therapy improves glucose disposal without changing skeletal muscle GLUT4 levels in noninsulin-dependent diabetes mellitus subjects

    DEFF Research Database (Denmark)

    Vestergaard, H; Weinreb, J E; Rosen, A S

    1995-01-01

    A major pathological feature of noninsulin-dependent diabetes (NIDDM) is defective insulin-stimulated glucose transport in skeletal muscle. When NIDDM subjects are assessed as a group, GLUT4 gene expression in skeletal muscle varies widely and is not different from that in controls. Thus, longitu......A major pathological feature of noninsulin-dependent diabetes (NIDDM) is defective insulin-stimulated glucose transport in skeletal muscle. When NIDDM subjects are assessed as a group, GLUT4 gene expression in skeletal muscle varies widely and is not different from that in controls. Thus......, longitudinal studies are needed to assess whether changes in GLUT4 expression in muscle of NIDDM subjects could be responsible for changes in glucose disposal. The question is timely because recent studies in transgenic mice show that increasing GLUT4 expression can increase insulin-stimulated glucose uptake...... in vivo and in vitro. Here we use a longitudinal design to investigate the effects of 8 weeks of therapy with the sulfonylurea gliclazide on glycemic control, glucose tolerance, insulin-stimulated glucose disposal, and GLUT4 expression in muscle of 10 obese NIDDM subjects. Subjects were on a weight...

  8. 78 FR 70307 - Guidance for Industry: Preclinical Assessment of Investigational Cellular and Gene Therapy...

    Science.gov (United States)

    2013-11-25

    ... Investigational Cellular and Gene Therapy Products; Availability AGENCY: Food and Drug Administration, HHS. ACTION... entitled ``Guidance for Industry: Preclinical Assessment of Investigational Cellular and Gene Therapy... and Gene Therapies (OCTGT). The product areas covered by this guidance are cellular therapy, gene...

  9. Economics of dialysis dependence following renal replacement therapy for critically ill acute kidney injury patients

    Science.gov (United States)

    Ethgen, Olivier; Schneider, Antoine G.; Bagshaw, Sean M.; Bellomo, Rinaldo; Kellum, John A.

    2015-01-01

    Background The obective of this study was to perform a cost-effectiveness analysis comparing intermittent with continuous renal replacement therapy (IRRT versus CRRT) as initial therapy for acute kidney injury (AKI) in the intensive care unit (ICU). Methods Assuming some patients would potentially be eligible for either modality, we modeled life year gained, the quality-adjusted life years (QALYs) and healthcare costs for a cohort of 1000 IRRT patients and a cohort of 1000 CRRT patients. We used a 1-year, 5-year and a lifetime horizon. A Markov model with two health states for AKI survivors was designed: dialysis dependence and dialysis independence. We applied Weibull regression from published estimates to fit survival curves for CRRT and IRRT patients and to fit the proportion of dialysis dependence among CRRT and IRRT survivors. We then applied a risk ratio reported in a large retrospective cohort study to the fitted CRRT estimates in order to determine the proportion of dialysis dependence for IRRT survivors. We conducted sensitivity analyses based on a range of differences for daily implementation cost between CRRT and IRRT (base case: CRRT day $632 more expensive than IRRT day; range from $200 to $1000) and a range of risk ratios for dialysis dependence for CRRT as compared with IRRT (from 0.65 to 0.95; base case: 0.80). Results Continuous renal replacement therapy was associated with a marginally greater gain in QALY as compared with IRRT (1.093 versus 1.078). Despite higher upfront costs for CRRT in the ICU ($4046 for CRRT versus $1423 for IRRT in average), the 5-year total cost including the cost of dialysis dependence was lower for CRRT ($37 780 for CRRT versus $39 448 for IRRT on average). The base case incremental cost-effectiveness analysis showed that CRRT dominated IRRT. This dominance was confirmed by extensive sensitivity analysis. Conclusions Initial CRRT is cost-effective compared with initial IRRT by reducing the rate of long-term dialysis

  10. Economics of dialysis dependence following renal replacement therapy for critically ill acute kidney injury patients.

    Science.gov (United States)

    Ethgen, Olivier; Schneider, Antoine G; Bagshaw, Sean M; Bellomo, Rinaldo; Kellum, John A

    2015-01-01

    The obective of this study was to perform a cost-effectiveness analysis comparing intermittent with continuous renal replacement therapy (IRRT versus CRRT) as initial therapy for acute kidney injury (AKI) in the intensive care unit (ICU). Assuming some patients would potentially be eligible for either modality, we modeled life year gained, the quality-adjusted life years (QALYs) and healthcare costs for a cohort of 1000 IRRT patients and a cohort of 1000 CRRT patients. We used a 1-year, 5-year and a lifetime horizon. A Markov model with two health states for AKI survivors was designed: dialysis dependence and dialysis independence. We applied Weibull regression from published estimates to fit survival curves for CRRT and IRRT patients and to fit the proportion of dialysis dependence among CRRT and IRRT survivors. We then applied a risk ratio reported in a large retrospective cohort study to the fitted CRRT estimates in order to determine the proportion of dialysis dependence for IRRT survivors. We conducted sensitivity analyses based on a range of differences for daily implementation cost between CRRT and IRRT (base case: CRRT day $632 more expensive than IRRT day; range from $200 to $1000) and a range of risk ratios for dialysis dependence for CRRT as compared with IRRT (from 0.65 to 0.95; base case: 0.80). Continuous renal replacement therapy was associated with a marginally greater gain in QALY as compared with IRRT (1.093 versus 1.078). Despite higher upfront costs for CRRT in the ICU ($4046 for CRRT versus $1423 for IRRT in average), the 5-year total cost including the cost of dialysis dependence was lower for CRRT ($37 780 for CRRT versus $39 448 for IRRT on average). The base case incremental cost-effectiveness analysis showed that CRRT dominated IRRT. This dominance was confirmed by extensive sensitivity analysis. Initial CRRT is cost-effective compared with initial IRRT by reducing the rate of long-term dialysis dependence among critically ill AKI

  11. Integrated exposure-based therapy for co-occurring posttraumatic stress disorder and substance dependence: a randomized controlled trial.

    Science.gov (United States)

    Mills, Katherine L; Teesson, Maree; Back, Sudie E; Brady, Kathleen T; Baker, Amanda L; Hopwood, Sally; Sannibale, Claudia; Barrett, Emma L; Merz, Sabine; Rosenfeld, Julia; Ewer, Philippa L

    2012-08-15

    There is concern that exposure therapy, an evidence-based cognitive-behavioral treatment for posttraumatic stress disorder (PTSD), may be inappropriate because of risk of relapse for patients with co-occurring substance dependence. To determine whether an integrated treatment for PTSD and substance dependence, Concurrent Treatment of PTSD and Substance Use Disorders Using Prolonged Exposure (COPE), can achieve greater reductions in PTSD and substance dependence symptom severity compared with usual treatment for substance dependence. Randomized controlled trial enrolling 103 participants who met DSM-IV-TR criteria for both PTSD and substance dependence. Participants were recruited from 2007-2009 in Sydney, Australia; outcomes were assessed at 9 months postbaseline, with interim measures collected at 6 weeks and 3 months postbaseline. Participants were randomized to receive COPE plus usual treatment (n = 55) or usual treatment alone (control) (n = 48). COPE consists of 13 individual 90-minute sessions (ie, 19.5 hours) with a clinical psychologist. Change in PTSD symptom severity as measured by the Clinician-Administered PTSD Scale (CAPS; scale range, 0-240) and change in severity of substance dependence as measured by the number of dependence criteria met according to the Composite International Diagnostic Interview version 3.0 (CIDI; range, 0-7), from baseline to 9-month follow-up. A change of 15 points on the CAPS scale and 1 dependence criterion on the CIDI were considered clinically significant. From baseline to 9-month follow-up, significant reductions in PTSD symptom severity were found for both the treatment group (mean difference, -38.24 [95% CI, -47.93 to -28.54]) and the control group (mean difference, -22.14 [95% CI, -30.33 to -13.95]); however, the treatment group demonstrated a significantly greater reduction in PTSD symptom severity (mean difference, -16.09 [95% CI, -29.00 to -3.19]). No significant between-group difference was found in relation to

  12. Cognitive and social learning models of drug dependence: implications for the assessment of tobacco dependence in adolescents.

    Science.gov (United States)

    Brandon, Thomas H; Herzog, Thaddeus A; Irvin, Jennifer E; Gwaltney, Chad J

    2004-06-01

    This paper is part of a series that has the goal of identifying potential approaches toward developing new instruments for assessing tobacco dependence among adolescents. The fundamental assumption underlying the series is that contemporary theories of drug dependence offer a rich source of opportunities for the development of theoretically based assessment tools. The present paper focuses on cognitive and social-learning models of drug dependence and the implications of these models for novel assessment instruments. In particular, the paper focuses on Mark Goldman's model of drug expectancies, Albert Bandura's model of self-efficacy, Thomas Wills's model of stress and coping and Stephen Tiffany's cognitive-processing model of drug urges and cravings. In addition to traditional self-report measures, naturalistic and laboratory-based assessments are identified that may yield information relevant to multi-dimensional measurement of tobacco dependence.

  13. Dependence of simulated positron emitter yields in ion beam cancer therapy on modeling nuclear fragmentation

    DEFF Research Database (Denmark)

    Lühr, Armin; Priegnitz, Marlen; Fiedler, Fine

    2014-01-01

    In ion beam cancer therapy, range verification in patients using positron emission tomography (PET) requires the comparison of measured with simulated positron emitter yields. We found that (1) changes in modeling nuclear interactions strongly affected the positron emitter yields and that (2) Monte...... Carlo simulations with SHIELD-HIT10A reasonably matched the most abundant PET isotopes 11C and 15O. We observed an ion-energy (i.e., depth) dependence of the agreement between SHIELD-HIT10A and measurement. Improved modeling requires more accurate measurements of cross-section values....

  14. Challenges and Prospects for Helper-Dependent Adenoviral Vector-Mediated Gene Therapy

    Directory of Open Access Journals (Sweden)

    Pasquale Piccolo

    2014-04-01

    Full Text Available Helper-dependent adenoviral (HDAd vectors that are devoid of all viral coding sequences are promising non-integrating vectors for gene therapy because they efficiently transduce a variety of cell types in vivo, have a large cloning capacity, and drive long-term transgene expression without chronic toxicity. The main obstacle preventing clinical applications of HDAd vectors is the host innate inflammatory response against the vector capsid proteins that occurs shortly after intravascular vector administration and result in acute toxicity, the severity of which is dose dependent. Intense efforts have been focused on elucidating adenoviral vector–host interactions and the factors involved in the acute toxicity. This review focuses on the recent acquisition of data on such interactions and on strategies investigated to improve the therapeutic index of HDAd vectors.

  15. Effectiveness of group cognitive therapy about opium addict complications on attitude of adolescents with drug dependent parents

    Directory of Open Access Journals (Sweden)

    Kaveh Hojjat

    2015-12-01

    Full Text Available Background and Aim: Statistics show that 30% to 40 % of  opium addicted fathers’ children are prone to substance abuse in the future. The present study aimed at assessing the effectiveness of cognitive therapy approach  to attitude changing of adolescents with substance dependent fathers. Materials and Methods:  In this controlled. field-trail randomized study. .data collection tool was “attitude to addiction questionnaire”. The study population was all male students in the first grade of high school in Maneh - Samalghan city. . Six sessions of group cognitive therapy based on the effectiveness of drug side-effects in drug-addicted fathers’ adolescent children’s attitude were held. The above-mentioned questionnaire was filled out before and after intervention. The obtained data  was fed into SPSS software (V: 16 using. Independent t-test .and paired t-test were used for analysis and P<0.05 was taken as the significant level. Results:  There were no significant differences between the two groups in pre-test regarding their attitude about drug abuse (P=.20%. Mean score variance from pre-test to post-test in the intervention group decreased, but in the control group, it showed a slight increase. This means that the intervention reduced the positive attitude towards drugs, but the changes were not statistically significant (p=0.57. Besides, among ten factors decisive in an individual’s attitude about addiction, only group cognitive therapy  was able  to decrease mean points of an individual’s attitude about drug abuse .. Significantly (P = 0.04. Conclusion: It was found that group cognitive therapy education about opium  addict complicationsdidn`t have a significant effect on the attitude of the students with addicted fathers. Thus, a change of adolescents’ attitude requires more research.

  16. The Use of Contingency Management and Motivational/Skills-Building Therapy to Treat Young Adults with Marijuana Dependence

    Science.gov (United States)

    Carroll, Kathleen M.; Easton, Caroline J.; Nich, Charla; Hunkele, Karen A.; Neavins, Tara M.; Sinha, Rajita; Ford, Haley L.; Vitolo, Sally A.; Doebrick, Cheryl A.; Rounsaville, Bruce J.

    2006-01-01

    Marijuana-dependent young adults (N = 136), all referred by the criminal justice system, were randomized to 1 of 4 treatment conditions: a motivational/skills-building intervention (motivational enhancement therapy/cognitive-behavioral therapy; MET/CBT) plus incentives contingent on session attendance or submission of marijuana-free urine…

  17. Medication Reconciliation and Therapy Management in Dialysis-Dependent Patients: Need for a Systematic Approach

    Science.gov (United States)

    Cardone, Katie E.; Manley, Harold J.; St. Peter, Wendy L.; Shaffer, Rachel; Somers, Michael; Mehrotra, Rajnish

    2013-01-01

    Summary Patients with ESRD undergoing dialysis have highly complex medication regimens and disproportionately higher total cost of care compared with the general Medicare population. As shown by several studies, dialysis-dependent patients are at especially high risk for medication-related problems. Providing medication reconciliation and therapy management services is critically important to avoid costs associated with medication-related problems, such as adverse drug events and hospitalizations in the ESRD population. The Medicare Modernization Act of 2003 included an unfunded mandate stipulating that medication therapy management be offered to high-risk patients enrolled in Medicare Part D. Medication management services are distinct from the dispensing of medications and involve a complete medication review for all disease states. The dialysis facility is a logical coordination center for medication management services, like medication therapy management, and it is likely the first health care facility that a patient will present to after a care transition. A dedicated and adequately trained clinician, such as a pharmacist, is needed to provide consistent, high-quality medication management services. Medication reconciliation and medication management services that could consistently and systematically identify and resolve medication-related problems would be likely to improve ESRD patient outcomes and reduce total cost of care. Herein, this work provides a review of available evidence and recommendations for optimal delivery of medication management services to ESRD patients in a dialysis facility-centered model. PMID:23990162

  18. Assessment of benzodiazepine dependence in alcohol and drug dependent outpatients: a research report.

    NARCIS (Netherlands)

    Kan, C.C.; Breteler, M.H.M.; Ven, A.H.G.S. van der; Timmermans, M.A.Y.; Zitman, F.G.

    2001-01-01

    In this study on 99 outpatients who were being treated for alcohol and/or drug dependence and also using benzodiazepines (BZDs), prevalence rates of DSM-III-R and ICD-10 substance dependence diagnoses were ascertained and scalability, reliability and validity of the scales of the Benzodiaepine

  19. Assessment of Benzodiazepine dependence in alcohol and drug dependent outpatients: A research report

    NARCIS (Netherlands)

    Kan, C.C.; Breteler, M.H.M.; Ven, A.H.G.S. van der; Timmermans, M.A.Y.; Zitman, F.G.

    2001-01-01

    In this study on 99 outpatients who were being treated for alcohol and/or drug dependence and also using benzodiazepines (BZDs), prevalence rates of DSM-III-R and ICD-10 substance dependence diagnoses were ascertained and scalability, reliability and validity of the scales of the Benzodiazepine

  20. Assessment of the effects of massage therapy on premenstrual syndrome

    Directory of Open Access Journals (Sweden)

    Leily Ghaedi

    2011-05-01

    Full Text Available Background: Premenstrual syndrome is characterized by the cyclic occurrence physical, psychological and behavioral symptoms during the luteal phase of the menstruation cycle and will be disappear within a few days of the onset of menstruation. The aim of this research was to assess the effect of massage therapy on premenstrual syndrome. Materials and Method: A randomized clinical trial was carried out on 30 volunteer students of Tehran University with PMS diagnosis. After surveying two menstruation cycles and confirming PMS existence, subjects were randomly assigned into massage and control group. Massage protocol was performed for eight weeks. Volunteers completed Daily Symptom Rating (DSR during 2 cycles before and 2 cycles after intervention. Data collected via data gathering form, criteria for PMS (DSM- IV, DSR and Beck test. Data were analyzed by descriptive and analytic statistics (χ2, Fischer's exact test, paired and independent t tests.Results: In comparison between before and after intervention, massage group showed significant decrease averagely in mean of somatic (56.7%, psychological (64.8% (p<0.001.This is while, in control group only mean of somatic symptoms (averagely 21.2% relieved obviously (p=0.02. comparing two groups often intervention, we did not found any significant difference in mean of somatic symptoms while psychological (p=0.01 and total symptoms (p=0.03 in massage group was significantly less than controls.Conclusion: The authors concluded that massage therapy is an effective method for relieving symptoms of premenstrual syndrome

  1. A systematic review of health economic models of opioid agonist therapies in maintenance treatment of non-prescription opioid dependence.

    Science.gov (United States)

    Chetty, Mersha; Kenworthy, James J; Langham, Sue; Walker, Andrew; Dunlop, William C N

    2017-02-24

    Opioid dependence is a chronic condition with substantial health, economic and social costs. The study objective was to conduct a systematic review of published health-economic models of opioid agonist therapy for non-prescription opioid dependence, to review the different modelling approaches identified, and to inform future modelling studies. Literature searches were conducted in March 2015 in eight electronic databases, supplemented by hand-searching reference lists and searches on six National Health Technology Assessment Agency websites. Studies were included if they: investigated populations that were dependent on non-prescription opioids and were receiving opioid agonist or maintenance therapy; compared any pharmacological maintenance intervention with any other maintenance regimen (including placebo or no treatment); and were health-economic models of any type. A total of 18 unique models were included. These used a range of modelling approaches, including Markov models (n = 4), decision tree with Monte Carlo simulations (n = 3), decision analysis (n = 3), dynamic transmission models (n = 3), decision tree (n = 1), cohort simulation (n = 1), Bayesian (n = 1), and Monte Carlo simulations (n = 2). Time horizons ranged from 6 months to lifetime. The most common evaluation was cost-utility analysis reporting cost per quality-adjusted life-year (n = 11), followed by cost-effectiveness analysis (n = 4), budget-impact analysis/cost comparison (n = 2) and cost-benefit analysis (n = 1). Most studies took the healthcare provider's perspective. Only a few models included some wider societal costs, such as productivity loss or costs of drug-related crime, disorder and antisocial behaviour. Costs to individuals and impacts on family and social networks were not included in any model. A relatively small number of studies of varying quality were found. Strengths and weaknesses relating to model structure, inputs and approach were identified across

  2. Arteriosclerosis and vascular calcification: causes, clinical assessment and therapy.

    Science.gov (United States)

    Tölle, Markus; Reshetnik, Alexander; Schuchardt, Mirjam; Höhne, Matthias; van der Giet, Markus

    2015-09-01

    Arteriosclerosis is a pathological, structural (media vascular calcification) and physiological (modified vascular smooth vessel cells; increased arterial stiffness) alteration of the vessel wall. Through improved assessment methods (functional and imaging), it has become a well-known phenomenon in recent decades. However, its clinical importance was underestimated until recently. Currently available English-speaking data about conditions/diseases associated with arteriosclerosis, its clinical sequels, available diagnostic procedures and therapeutic modalities were reviewed and summarized. In recent decades, emerging data have brought about a better understanding of causes and consequences of arteriosclerosis and highlight its growing clinical impact. Although arteriosclerosis showed an independent clinical impact on cardiovascular morbidity and mortality, especially in patients with chronic kidney disease/end-stage renal disease (CKD/ESRD) and diabetes mellitus, convincing clinical therapy concepts are not available until now. The establishment of novel therapeutic strategies derived from basic research is strongly needed. © 2015 Stichting European Society for Clinical Investigation Journal Foundation.

  3. Microneedling therapy in atrophic facial scars: An objective assessment

    Directory of Open Access Journals (Sweden)

    Majid Imran

    2009-01-01

    Full Text Available Background: Atrophic facial scars are always a challenge to treat, especially the ones that are deep-seated and/or involve much of the face. Microneedling or dermaroller therapy is a new addition to the treatment armamentarium for such scars that offers a simple and reportedly effective management of these scars. Aims: The aim of the present study was to perform an objective evaluation of the efficacy of dermaroller treatment in atrophic facial scars of varying etiology. Materials and Methods: Thirty-seven patients of atrophic facial scarring were offered multiple sittings of microneedling (dermaroller treatment and their scars were evaluated and graded clinically and by serial photography at the start as well as at two months after the conclusion of the treatment protocol. Any change in the grading of scars after the end of treatment and follow-up period was noted down. The patients were also asked to evaluate the effectiveness of the treatment received on a 1-10 point scale. The efficacy of dermaroller treatment was thus assessed both subjectively by the patients as well as objectively by a single observer. Results: Overall 36 out of the total of 37 patients completed the treatment schedule and were evaluated for its efficacy. Out of these 36 patients, 34 achieved a reduction in the severity of their scarring by one or two grades. More than 80% of patients assessed their treatment as ′excellent′ on a 10-point scale. No significant adverse effects were noted in any patient. Conclusions: Microneedling therapy seems to be a simple and effective treatment option for the management of atrophic facial scars.

  4. Craving sensation in the assessment of alcohol-dependent persons

    Directory of Open Access Journals (Sweden)

    Artur Juczyński

    2016-09-01

    Conclusions: The approach to the problems of the occurrence of and coping with alcohol craving in the course of the therapy should be similar in men and women. However, there should be more focus on the working out of coping strategies, especially in the younger patients, because of the more frequent and intensive craving they experience, which poses a greater risk of relapse and recurrence of the problem.

  5. An end-to-end assessment of range uncertainty in proton therapy using animal tissues

    Science.gov (United States)

    Zheng, Yuanshui; Kang, Yixiu; Zeidan, Omar; Schreuder, Niek

    2016-11-01

    Accurate assessment of range uncertainty is critical in proton therapy. However, there is a lack of data and consensus on how to evaluate the appropriate amount of uncertainty. The purpose of this study is to quantify the range uncertainty in various treatment conditions in proton therapy, using transmission measurements through various animal tissues. Animal tissues, including a pig head, beef steak, and lamb leg, were used in this study. For each tissue, an end-to-end test closely imitating patient treatments was performed. This included CT scan simulation, treatment planning, image-guided alignment, and beam delivery. Radio-chromic films were placed at various depths in the distal dose falloff region to measure depth dose. Comparisons between measured and calculated doses were used to evaluate range differences. The dose difference at the distal falloff between measurement and calculation depends on tissue type and treatment conditions. The estimated range difference was up to 5, 6 and 4 mm for the pig head, beef steak, and lamb leg irradiation, respectively. Our study shows that the TPS was able to calculate proton range within about 1.5% plus 1.5 mm. Accurate assessment of range uncertainty in treatment planning would allow better optimization of proton beam treatment, thus fully achieving proton beams’ superior dose advantage over conventional photon-based radiation therapy.

  6. The Lebanese Cigarette Dependence (LCD) Score: a comprehensive tool for cigarette dependence assessment.

    Science.gov (United States)

    Salameh, P; Khayat, G; Waked, M

    2014-04-01

    Cigarette smoking induces dependence. The primary objective of this work was to validate the use of the Fagerström test for nicotine dependence (FTND) in the Lebanese population, and to broaden it eventually by adding new items covering DSM-IV and ICD-10 dependence components. We used data from two samples: a cross-sectional national study and a case-control study. A standardized questionnaire was administered, with items related to cigarette dependence: the FTND and the new Lebanon Cigarette Dependence (LCD) scale. For both tools, an exploratory factor analysis was performed on sample 1, while confirmatory factor analysis was performed on sample 2. Although the FTND test showed satisfactory psychometric properties, the LCD showed better validity and reliability, covered dependence concept better, and showed a higher correlation with the number of times the participant tried to stop smoking (r = -0.087; p = 0.029 versus r = -0.215; p LCD scale may be more useful.

  7. Developmental trajectories of amphibian microbiota: response to bacterial therapy depends on initial community structure.

    Science.gov (United States)

    Davis, Leyla R; Bigler, Laurent; Woodhams, Douglas C

    2017-04-01

    Improving host health through microbial manipulation requires untangling factors that shape the microbiome. There is currently little understanding of how initial community structure may drive the microbiota trajectory across host development or influence bacterial therapy outcomes. Probiotic baths of surface symbionts, Pseudomonas fluorescens and Flavobacterium johnsoniae were administered to 240 tadpoles of the midwife toad, Alytes obstetricans in semi-natural outdoor mesocosms originating from geographically and genetically distinct populations in Switzerland. Host bacterial and fungal assemblages were compared in tadpoles from the pond of origin, across metamorphosis, and in toadlets via microbial fingerprinting. Bacterial and fungal community structures differed significantly among populations and a microbial population signature persisted from the tadpole stage, through metamorphosis, and following probiotic treatment. A minimal core surface microbiota is described by persistence through development and by shared membership across populations. The impact of F. johnsoniae on the tadpole surface microbiome was assessed with shotgun metagenomics. Bacterial therapy reduced abundance, diversity, and functional repertoire compared to untreated controls. A correlation between host skin peptides and microbiota suggests a mechanism of host-directed symbiosis throughout development. Early developmental stages are ideal targets for amphibian bacterial therapy that can govern a microbiome trajectory at critical timepoints and may impact susceptibility to disease. © 2017 Society for Applied Microbiology and John Wiley & Sons Ltd.

  8. Physical Therapy Observation and Assessment in the Neonatal Intensive Care Unit

    Science.gov (United States)

    Byrne, Eilish; Campbell, Suzann K.

    2013-01-01

    This article presents the elements of the Observation and Assessment section of the Infant Care Path for Physical Therapy in the Neonatal Intensive Care Unit (NICU). The types of physical therapy assessments presented in this path are evidence-based and the suggested timing of these assessments is primarily based on practice knowledge from expert…

  9. Assessing environmental dependence using asset and income measures

    DEFF Research Database (Denmark)

    Charlery, Lindy Callen; Walelign, Solomon Zena

    2015-01-01

    on income and asset measures. Using a composite asset index, we were able to distinguish the asset poor from the asset non-poor. We then combined income data with the asset index, enabling us to disentangle the stochastic and structural nature of poverty. The distribution of poor and non-poor households...... based on income measures was significantly different from that based on asset measures. The income poor are substantially more dependent on environmental resources than the income non-poor (about 15% difference) while strikingly minimal difference was observed in environmental dependence between...

  10. Model-driven dependability assessment of software systems

    CERN Document Server

    Bernardi, Simona; Petriu, Dorina C

    2013-01-01

    In this book, the authors present cutting-edge model-driven techniques for modeling and analysis of software dependability. Most of them are based on the use of UML as software specification language. From the software system specification point of view, such techniques exploit the standard extension mechanisms of UML (i.e., UML profiling). UML profiles enable software engineers to add non-functional properties to the software model, in addition to the functional ones. The authors detail the state of the art on UML profile proposals for dependability specification and rigorously describe the t

  11. Prescription Opioid Abuse and Dependence: Assessment Strategies for Counselors

    Science.gov (United States)

    Weigel, Daniel J.; Donovan, Kimberly A.; Krug, Kevin S.; Dixon, Wayne A.

    2007-01-01

    The authors review the article "Prescription Drug Use and Abuse: Risk Factors, Red Flags, and Prevention Strategies" (J. H. Isaacson, J. A. Hopper, D. P. Alford, & T. Parran, 2005), which provides an overview of the recent increase in prescription opioid abuse and dependence from the physician's perspective. In the present article, the authors…

  12. Major Depression in Long-Term Oxygen Therapy Dependent Chronic Obstructive Pulmonary Disease.

    Science.gov (United States)

    Kayhan, Fatih; Ilik, Faik; Karamanli, Harun; Pazarli, Ahmet Cemal; Kayhan, Ayşegül

    2016-05-25

    We aimed to investigate the frequency of major depression (MD) in long-term oxygen therapy (LTOT) dependent chronic obstructive pulmonary disease (COPD) patients and the effect of depression on patients' compliance with the treatment. Fifty-four consecutive patients were enrolled in the study and diagnosed as stage 4 COPD according to Global Initiative for Chronic Obstructive Lung Disease guideline. MD was diagnosed with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition/Clinical Version. Thirty-four (63.0%) patients had MD. MD frequency was significantly higher in patients who were noncompliant with LTOT compared with compliant patients. MD is a common psychiatric disorder in COPD patients receiving LTOT. © 2016 Wiley Periodicals, Inc.

  13. Gene Therapy with Helper-Dependent Adenoviral Vectors: Current Advances and Future Perspectives

    Directory of Open Access Journals (Sweden)

    Philip Ng

    2010-09-01

    Full Text Available Recombinant Adenoviral vectors represent one of the best gene transfer platforms due to their ability to efficiently transduce a wide range of quiescent and proliferating cell types from various tissues and species. The activation of an adaptive immune response against the transduced cells is one of the major drawbacks of first generation Adenovirus vectors and has been overcome by the latest generation of recombinant Adenovirus, the Helper-Dependent Adenoviral (HDAd vectors. HDAds have innovative features including the complete absence of viral coding sequences and the ability to mediate high level transgene expression with negligible chronic toxicity. This review summarizes the many aspects of HDAd biology and structure with a major focus on in vivo gene therapy application and with an emphasis on the unsolved issues that these vectors still presents toward clinical application.

  14. Nabiximols combined with motivational enhancement/cognitive behavioral therapy for the treatment of cannabis dependence: A pilot randomized clinical trial.

    Directory of Open Access Journals (Sweden)

    Jose M Trigo

    Full Text Available The current lack of pharmacological treatments for cannabis use disorder (CUD warrants novel approaches and further investigation of promising pharmacotherapy. We previously showed that nabiximols (27 mg/ml Δ9-tetrahydrocannabinol (THC/ 25 mg/ml cannabidiol (CBD, Sativex® can decrease cannabis withdrawal symptoms. Here, we assessed in a pilot study the tolerability and safety of self-titrated nabiximols vs. placebo among 40 treatment-seeking cannabis-dependent participants.Subjects participated in a double blind randomized clinical trial, with as-needed nabiximols up to 113.4 mg THC/105 mg CBD or placebo daily for 12 weeks, concurrently with Motivational Enhancement Therapy and Cognitive Behavioral Therapy (MET/CBT. Primary outcome measures were tolerability and abstinence, secondary outcome measures were days and amount of cannabis use, withdrawal, and craving scores. Participants received up to CDN$ 855 in compensation for their time.Medication was well tolerated and no serious adverse events (SAEs were observed. Rates of adverse events did not differ between treatment arms (F1,39 = 0.205, NS. There was no significant change in abstinence rates at trial end. Participants were not able to differentiate between subjective effects associated with nabiximols or placebo treatments (F1,40 = 0.585, NS. Cannabis use was reduced in the nabiximols (70.5% and placebo groups (42.6%. Nabiximols reduced cannabis craving but no significant differences between the nabiximols and placebo groups were observed on withdrawal scores.Nabiximols in combination with MET/CBT was well tolerated and allowed for reduction of cannabis use. Future clinical trials should explore the potential of high doses of nabiximols for cannabis dependence.

  15. Risks for Opioid Abuse and Dependence Among Recipients of Chronic Opioid Therapy: Results from the TROUP Study

    Science.gov (United States)

    Edlund, Mark J.; Martin, Bradley C.; Fan, Ming-Yu; Devries, Andrea; Braden, Jennifer B.; Sullivan, Mark D.

    2010-01-01

    Objective To estimate the prevalence of and risk factors for opioid abuse/dependence in long-term users of opioids for chronic pain, including risk factors for opioid abuse/dependence that can potentially be modified to decrease the likelihood of opioid abuse/dependence, and non-modifiable risk factors for opioid abuse/dependence that may be useful for risk stratification when considering prescribing opioids. Methods We used claims data from two disparate populations, one national, commercially insured population (HealthCore) and one state-based, publicly insured (Arkansas Medicaid). Among users of chronic opioid therapy, we regressed claims-based diagnoses of opioid abuse/dependence on patient characteristics, including physical health, mental health and substance abuse diagnoses, sociodemographic factors, and pharmacological risk factors. Results Among users of chronic opioid therapy, 3% of both the HealthCore and Arkansas Medicaid samples had a claims-based opioid abuse/dependence diagnosis. There was a strong inverse relationship between age and a diagnosis of opioid abuse/dependence. Mental health and substance use disorders were associated with an increased risk of opioid abuse/dependence. Effects of substance use disorders were especially strong, although mental health disorders were more common. Concerning opioid exposure; lower days supply, lower average doses, and use of Schedule III-IV opioids only, were all associated with lower likelihood of a diagnosis of opioid abuse/dependence. Conclusion Opioid abuse and dependence are diagnosed in a small minority of patients receiving chronic opioid therapy, but this may underestimate actual misuse. Characteristics of the patients and of the opioid therapy itself are associated with the risk of abuse and dependence. PMID:20634006

  16. Pharmacological treatment and BBB-targeted genetic therapy for MCT8-dependent hypomyelination in zebrafish

    Directory of Open Access Journals (Sweden)

    David Zada

    2016-11-01

    Full Text Available Hypomyelination is a key symptom of Allan-Herndon-Dudley syndrome (AHDS, a psychomotor retardation associated with mutations in the thyroid-hormone (TH transporter MCT8 (monocarboxylate transporter 8. AHDS is characterized by severe intellectual deficiency, neuromuscular impairment and brain hypothyroidism. In order to understand the mechanism for TH-dependent hypomyelination, we developed an mct8 mutant (mct8−/− zebrafish model. The quantification of genetic markers for oligodendrocyte progenitor cells (OPCs and mature oligodendrocytes revealed reduced differentiation of OPCs into oligodendrocytes in mct8−/− larvae and adults. Live imaging of single glial cells showed that the number of oligodendrocytes and the length of their extensions are reduced, and the number of peripheral Schwann cells is increased, in mct8−/− larvae compared with wild type. Pharmacological analysis showed that TH analogs and clemastine partially rescued the hypomyelination in the CNS of mct8−/− larvae. Intriguingly, triiodothyronine (T3 treatment rescued hypomyelination in mct8−/− embryos before the maturation of the blood–brain barrier (BBB, but did not affect hypomyelination in older larvae. Thus, we expressed Mct8-tagRFP in the endothelial cells of the vascular system and showed that even relatively weak mosaic expression completely rescued hypomyelination in mct8−/− larvae. These results suggest potential pharmacological treatments and BBB-targeted gene therapy that can enhance myelination in AHDS and possibly in other TH-dependent brain disorders.

  17. Marriage of scintillator and semiconductor for synchronous radiotherapy and deep photodynamic therapy with diminished oxygen dependence.

    Science.gov (United States)

    Zhang, Chen; Zhao, Kuaile; Bu, Wenbo; Ni, Dalong; Liu, Yanyan; Feng, Jingwei; Shi, Jianlin

    2015-02-02

    Strong oxygen dependence and limited penetration depth are the two major challenges facing the clinical application of photodynamic therapy (PDT). In contrast, ionizing radiation is too penetrative and often leads to inefficient radiotherapy (RT) in the clinic because of the lack of effective energy accumulation in the tumor region. Inspired by the complementary advantages of PDT and RT, we present herein the integration of a scintillator and a semiconductor as an ionizing-radiation-induced PDT agent, achieving synchronous radiotherapy and depth-insensitive PDT with diminished oxygen dependence. In the core-shell Ce(III)-doped LiYF4@SiO2@ZnO structure, the downconverted ultraviolet fluorescence from the Ce(III)-doped LiYF4 nanoscintillator under ionizing irradiation enables the generation of electron-hole (e(-)-h(+)) pairs in ZnO nanoparticles, giving rise to the formation of biotoxic hydroxyl radicals. This process is analogous to a type I PDT process for enhanced antitumor therapeutic efficacy. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  18. Symptom assessment in children receiving cancer therapy: the parents' perspective.

    Science.gov (United States)

    Dupuis, L Lee; Milne-Wren, Cindy; Cassidy, Marilyn; Barrera, Maru; Portwine, Carol; Johnston, Donna L; Silva, Mariana Pradier; Sibbald, Cathryn; Leaker, Michael; Routh, Stacey; Sung, Lillian

    2010-03-01

    We aimed to develop an instrument to assess cancer-treatment-related adverse effects that parents believe children find most bothersome and use it to solicit the opinions of parents regarding this issue. Parents of children 4 to 18 years of age who had received intravenous antineoplastic therapy in the last month were asked to rank prevalence, severity, and degree of bother of each symptom on behalf of their child using a questionnaire. One hundred fifty-eight of 200 (82%) questionnaires were evaluable. The most prevalent symptoms identified were mood swings (85%), fatigue (80%), and disappointment at missing activities with friends/peers (74%). These symptoms were also most commonly identified as being significantly severe. Symptoms most commonly identified as the most bothersome were disappointment at missing activities with friends/peers (50%) and feeling worried about receiving treatment, procedures, or side effects (43%). Symptoms most commonly identified as the most severe and bothersome were disappointment at missing activities with friend/peers (46%); feeling worried about receiving treatment, procedures, or side effects (40%); and painful, aching, or stiff bones, joints, or muscles (36%). This information can be used when explaining the effects of cancer treatment to patients/families, creating policies regarding pediatric cancer care and framing research hypotheses in pediatric supportive care.

  19. The Use of Contingency Management and Motivational/Skills-Building Therapy to Treat Young Adults With Marijuana Dependence

    OpenAIRE

    Carroll, Kathleen M.; Easton, Caroline J.; Nich, Charla; Hunkele, Karen A.; Neavins, Tara M.; Sinha, Rajita; Ford, Haley L.; Vitolo, Sally A.; Doebrick, Cheryl A.; Rounsaville, Bruce J.

    2006-01-01

    Marijuana-dependent young adults (N = 136), all referred by the criminal justice system, were randomized to 1 of 4 treatment conditions: a motivational/skills-building intervention (motivational enhancement therapy/cognitive–behavioral therapy; MET/CBT) plus incentives contingent on session attendance or submission of marijuana-free urine specimens (contingency management; CM), MET/CBT without CM, individual drug counseling (DC) plus CM, and DC without CM. There was a significant main effect ...

  20. Assessing Competencies in Couples and Family Therapy/Counseling: A Call to the Profession

    Science.gov (United States)

    Perosa, Linda M.; Perosa, Sandra L.

    2010-01-01

    Psychometrically sound measures of family therapy competencies are necessary to assess the effectiveness of training on student performance. This article critiques the self-report and observer rating measures developed to date to assess the clinical skills of trainees in the individual and in the family therapy fields. Suggestions are made to…

  1. Dependence assessment in human reliability analysis based on D numbers and AHP

    Energy Technology Data Exchange (ETDEWEB)

    Zhou, Xinyi; Deng, Xinyang [School of Computer and Information Science, Southwest University, Chongqing 400715 (China); Deng, Yong, E-mail: ydeng@swu.edu.cn [School of Computer and Information Science, Southwest University, Chongqing 400715 (China); Institute of Fundamental and Frontier Sciences, University of Electronic Science and Technology of China, Chengdu, Sichuan 610054 (China); Mahadevan, Sankaran [School of Engineering, Vanderbilt University, Nashville, TN 37235 (United States)

    2017-03-15

    Highlights: • D numbers and AHP are combined to implement dependence assessment in HRA. • A new tool, called D numbers, is used to deal with the uncertainty in HRA. • The proposed method can well address the fuzziness and subjectivity in linguistic assessment. • The proposed method is well applicable in dependence assessment which inherently has a linguistic assessment process. - Abstract: Since human errors always cause heavy loss especially in nuclear engineering, human reliability analysis (HRA) has attracted more and more attention. Dependence assessment plays a vital role in HRA, measuring the dependence degree of human errors. Many researches have been done while still have improvement space. In this paper, a dependence assessment model based on D numbers and analytic hierarchy process (AHP) is proposed. Firstly, identify the factors used to measure the dependence level of two human operations. Besides, in terms of the suggested dependence level, determine and quantify the anchor points for each factor. Secondly, D numbers and AHP are adopted in model. Experts evaluate the dependence level of human operations for each factor. Then, the evaluation results are presented as D numbers and fused by D number’s combination rule that can obtain the dependence probability of human operations for each factor. The weights of factors can be determined by AHP. Thirdly, based on the dependence probability for each factor and its corresponding weight, the dependence probability of two human operations and its confidence can be obtained. The proposed method can well address the fuzziness and subjectivity in linguistic assessment. The proposed method is well applicable to assess the dependence degree of human errors in HRA which inherently has a linguistic assessment process.

  2. Assessment of non-standard HIV antiretroviral therapy regimens at ...

    African Journals Online (AJOL)

    2016-03-06

    Mar 6, 2016 ... Lighthouse Trust in Lilongwe, Malawi serves approximately 25,000 patients with HIV antiretroviral therapy (ART) regimens standardized according to national treatment .... Table 2: Most common non-standard antiretroviral therapy regimens. The most .... patients, three-NRTI regimens can maintain HIV-RNA.

  3. Trauma-Focused Cognitive Behavioral Therapy: Assessing the Evidence

    Science.gov (United States)

    Ramirez de Arellano, Michael A.; Jobe-Shields, Lisa; George, Preethy; Dougherty, Richard H.; Daniels, Allen S.; Ghose, Sushmita Shoma; Huang, Larke; Delphin-Rittmon, Miriam E.

    2015-01-01

    Objective Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a conjoint parent-child treatment developed by Cohen, Mannarino, and Deblinger that uses cognitive-behavioral principles and exposure techniques to prevent and treat posttraumatic stress, depression, and behavioral problems. This review defined TF-CBT, differentiated it from other models, and assessed the evidence base. Methods Authors reviewed meta-analyses, reviews, and individual studies (1995 to 2013). Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, PILOTS, the ERIC, and the CINAHL. They chose from three levels of research evidence (high, moderate, and low) on the basis of benchmarks for number of studies and quality of their methodology. They also described the evidence of effectiveness. Results The level of evidence for TF-CBT was rated as high on the basis of ten RCTs, three of which were conducted independently (not by TF-CBT developers). TF-CBT has demonstrated positive outcomes in reducing symptoms of posttraumatic stress disorder, although it is less clear whether TF-CBT is effective in reducing behavior problems or symptoms of depression. Limitations of the studies include concerns about investigator bias and exclusion of vulnerable populations. Conclusions TF-CBT is a viable treatment for reducing trauma-related symptoms among some children who have experienced trauma and their nonoffending caregivers. Based on this evidence, TF-CBT should be available as a covered service in health plans. Ongoing research is needed to further identify best practices for TF-CBT in various settings and with individuals from various racial and ethnic backgrounds and with varied trauma histories, symptoms, and stages of intellectual, social, and emotional development. PMID:24638076

  4. Assessment of the Evolution of Cancer Treatment Therapies

    Directory of Open Access Journals (Sweden)

    Mónica Valladares

    2011-08-01

    Full Text Available Cancer therapy has been characterized throughout history by ups and downs, not only due to the ineffectiveness of treatments and side effects, but also by hope and the reality of complete remission and cure in many cases. Within the therapeutic arsenal, alongside surgery in the case of solid tumors, are the antitumor drugs and radiation that have been the treatment of choice in some instances. In recent years, immunotherapy has become an important therapeutic alternative, and is now the first choice in many cases. Nanotechnology has recently arrived on the scene, offering nanostructures as new therapeutic alternatives for controlled drug delivery, for combining imaging and treatment, applying hyperthermia, and providing directed target therapy, among others. These therapies can be applied either alone or in combination with other components (antibodies, peptides, folic acid, etc.. In addition, gene therapy is also offering promising new methods for treatment. Here, we present a review of the evolution of cancer treatments, starting with chemotherapy, surgery, radiation and immunotherapy, and moving on to the most promising cutting-edge therapies (gene therapy and nanomedicine. We offer an historical point of view that covers the arrival of these therapies to clinical practice and the market, and the promises and challenges they present.

  5. Assessment of the Evolution of Cancer Treatment Therapies

    Energy Technology Data Exchange (ETDEWEB)

    Arruebo, Manuel [Instituto de Nanociencia de Aragón (INA), Mariano Esquillor, Edif. I+D, University of Zaragoza, Zaragoza 50018 (Spain); CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza 50018 (Spain); Vilaboa, Nuria [CIBER de Bioingeniería, Biomateriales y Nanomedicina (CIBER-BBN), Zaragoza 50018 (Spain); Hospital Universitario La Paz-IdiPAZ, Paseo de la Castellana 261, Madrid 28046 (Spain); Sáez-Gutierrez, Berta; Lambea, Julio; Tres, Alejandro [Instituto de Nanociencia de Aragón (INA), Mariano Esquillor, Edif. I+D, University of Zaragoza, Zaragoza 50018 (Spain); Servicio de Oncología Médica, Hospital Clínico Universitario Lozano Blesa, Avda. San Juan Bosco 50009, Zaragoza (Spain); Instituto Aragonés de Ciencias de la Salud (I-CS), Avda. Gómez Laguna, 25, Zaragoza 50009 (Spain); Valladares, Mónica [Lonza Biologics Porriño, A relva s/n, Porriño (Pontevedra) 36410 (Spain); González-Fernández, África, E-mail: africa@uvigo.es [Immunology Department, Biomedical Research Center (CINBIO), University of Vigo, Campus Lagoas Marcosende, Vigo (Pontevedra) 36310 (Spain)

    2011-08-12

    Cancer therapy has been characterized throughout history by ups and downs, not only due to the ineffectiveness of treatments and side effects, but also by hope and the reality of complete remission and cure in many cases. Within the therapeutic arsenal, alongside surgery in the case of solid tumors, are the antitumor drugs and radiation that have been the treatment of choice in some instances. In recent years, immunotherapy has become an important therapeutic alternative, and is now the first choice in many cases. Nanotechnology has recently arrived on the scene, offering nanostructures as new therapeutic alternatives for controlled drug delivery, for combining imaging and treatment, applying hyperthermia, and providing directed target therapy, among others. These therapies can be applied either alone or in combination with other components (antibodies, peptides, folic acid, etc.). In addition, gene therapy is also offering promising new methods for treatment. Here, we present a review of the evolution of cancer treatments, starting with chemotherapy, surgery, radiation and immunotherapy, and moving on to the most promising cutting-edge therapies (gene therapy and nanomedicine). We offer an historical point of view that covers the arrival of these therapies to clinical practice and the market, and the promises and challenges they present.

  6. Neospora caninum calcium-dependent protein kinase 1 is an effective drug target for neosporosis therapy.

    Science.gov (United States)

    Ojo, Kayode K; Reid, Molly C; Kallur Siddaramaiah, Latha; Müller, Joachim; Winzer, Pablo; Zhang, Zhongsheng; Keyloun, Katelyn R; Vidadala, Rama Subba Rao; Merritt, Ethan A; Hol, Wim G J; Maly, Dustin J; Fan, Erkang; Van Voorhis, Wesley C; Hemphill, Andrew

    2014-01-01

    Despite the enormous economic importance of Neospora caninum related veterinary diseases, the number of effective therapeutic agents is relatively small. Development of new therapeutic strategies to combat the economic impact of neosporosis remains an important scientific endeavor. This study demonstrates molecular, structural and phenotypic evidence that N. caninum calcium-dependent protein kinase 1 (NcCDPK1) is a promising molecular target for neosporosis drug development. Recombinant NcCDPK1 was expressed, purified and screened against a select group of bumped kinase inhibitors (BKIs) previously shown to have low IC50s against Toxoplasma gondii CDPK1 and T. gondii tachyzoites. NcCDPK1 was inhibited by low concentrations of BKIs. The three-dimensional structure of NcCDPK1 in complex with BKIs was studied crystallographically. The BKI-NcCDPK1 structures demonstrated the structural basis for potency and selectivity. Calcium-dependent conformational changes in solution as characterized by small-angle X-ray scattering are consistent with previous structures in low Calcium-state but different in the Calcium-bound active state than predicted by X-ray crystallography. BKIs effectively inhibited N. caninum tachyzoite proliferation in vitro. Electron microscopic analysis of N. caninum cells revealed ultra-structural changes in the presence of BKI compound 1294. BKI compound 1294 interfered with an early step in Neospora tachyzoite host cell invasion and egress. Prolonged incubation in the presence of 1294 interfered produced observable interference with viability and replication. Oral dosing of BKI compound 1294 at 50 mg/kg for 5 days in established murine neosporosis resulted in a 10-fold reduced cerebral parasite burden compared to untreated control. Further experiments are needed to determine the PK, optimal dosage, and duration for effective treatment in cattle and dogs, but these data demonstrate proof-of-concept for BKIs, and 1294 specifically, for therapy of bovine

  7. Neospora caninum calcium-dependent protein kinase 1 is an effective drug target for neosporosis therapy.

    Directory of Open Access Journals (Sweden)

    Kayode K Ojo

    Full Text Available Despite the enormous economic importance of Neospora caninum related veterinary diseases, the number of effective therapeutic agents is relatively small. Development of new therapeutic strategies to combat the economic impact of neosporosis remains an important scientific endeavor. This study demonstrates molecular, structural and phenotypic evidence that N. caninum calcium-dependent protein kinase 1 (NcCDPK1 is a promising molecular target for neosporosis drug development. Recombinant NcCDPK1 was expressed, purified and screened against a select group of bumped kinase inhibitors (BKIs previously shown to have low IC50s against Toxoplasma gondii CDPK1 and T. gondii tachyzoites. NcCDPK1 was inhibited by low concentrations of BKIs. The three-dimensional structure of NcCDPK1 in complex with BKIs was studied crystallographically. The BKI-NcCDPK1 structures demonstrated the structural basis for potency and selectivity. Calcium-dependent conformational changes in solution as characterized by small-angle X-ray scattering are consistent with previous structures in low Calcium-state but different in the Calcium-bound active state than predicted by X-ray crystallography. BKIs effectively inhibited N. caninum tachyzoite proliferation in vitro. Electron microscopic analysis of N. caninum cells revealed ultra-structural changes in the presence of BKI compound 1294. BKI compound 1294 interfered with an early step in Neospora tachyzoite host cell invasion and egress. Prolonged incubation in the presence of 1294 interfered produced observable interference with viability and replication. Oral dosing of BKI compound 1294 at 50 mg/kg for 5 days in established murine neosporosis resulted in a 10-fold reduced cerebral parasite burden compared to untreated control. Further experiments are needed to determine the PK, optimal dosage, and duration for effective treatment in cattle and dogs, but these data demonstrate proof-of-concept for BKIs, and 1294 specifically, for

  8. Combinatorial treatment with oncolytic adenovirus and helper-dependent adenovirus augments adenoviral cancer gene therapy.

    Science.gov (United States)

    Farzad, Lisa; Cerullo, Vincenzo; Yagyu, Shigeki; Bertin, Terry; Hemminki, Akseli; Rooney, Cliona; Lee, Brendan; Suzuki, Masataka

    2014-01-01

    Oncolytic adenoviruses (Onc.Ads) produce significant antitumor effects but as single agents they rarely eliminate tumors. Investigators have therefore incorporated sequences into these vectors that encode immunomodulatory molecules to enhance antitumor immunity. Successful implementation of this strategy requires multiple tumor immune inhibitory mechanisms to be overcome, and insertion of the corresponding multiple functional genes reduces the titer and replication of Onc.Ads, compromising their direct ant-tumor effects. By contrast, helper-dependent (HD) Ads are devoid of viral coding sequences, allowing inclusion of multiple transgenes. HDAds, however, lack replicative capacity. Since HDAds encode the adenoviral packaging signal, we hypothesized that the coadministration of Onc.Ad with HDAd would allow to be amplified and packaged during replication of Onc.Ad in transduced cancer cells. This combination could provide immunostimulation without losing oncolytic activity. We now show that coinfection of Onc.Ad with HDAd subsequently replicates HDAd vector DNA in trans in human cancer cell lines in vitro and in vivo, amplifying the transgenes the HDAd encode. This combinatorial treatment significantly suppresses the tumor growth compared to treatment with a single agent in an immunocompetent mouse model. Hence, combinatorial treatment of Onc.Ad with HDAd should overcome the inherent limitations of each agent and provide a highly immunogenic oncolytic therapy.

  9. Cell-cycle-dependent efficacy of photodynamic therapy with ATX-S10(Na).

    Science.gov (United States)

    Sano, Munetaka; Furuta, Takahisa; Takahira, Kenichiro; Kajimura, Masayoshi; Hanai, Hiroyuki; Kohno, Eiji; Hirano, Toru; Hishida, Akira

    2005-01-01

    Photodynamic therapy (PDT) is a useful strategy for treating various cancers. Details of the mechanisms of PDT have not been made clear yet. We intended to study the efficacy of PDT in relation to the cell cycle. HeLa S3 cells were synchronized by the thymidine block method. Cells in different cell cycle phases after release were treated with the water-soluble photosensitizer, ATX-S10(Na). The cellular viability after PDT was determined by the MTT assay. Intracellular levels of ATX-S10(Na) in different cell cycle phases were also determined. We found that cells in the S and G(2)/M phases were hypersensitive to PDT with ATX-S10(Na) in comparison with those in the G(1) phase, and that cellular levels of ATX-S10(Na) were increased in cells in the S and G(2)/M phases compared to those in the G(1) phase. We conclude that cellular ATX-S10(Na) levels differ among the different cell cycle phases, which is associated with the cell-cycle-dependent efficacy of PDT with ATX-S10(Na).

  10. Pharmacological management of alcohol dependence: from mono-therapy to pharmacogenetics and beyond.

    Science.gov (United States)

    Caputo, Fabio; Vignoli, Teo; Grignaschi, Alice; Cibin, Mauro; Addolorato, Giovanni; Bernardi, Mauro

    2014-02-01

    Almost 10% of the world's population is affected by alcohol use disorders, and the treatment of alcohol dependence (AD) still remains a challenge. Patients with AD can differ in many traits. Three drugs (disulfiram, naltrexone, and acamprosate) have been approved by the FDA for the treatment of AD, and in some European countries sodium oxybate is also approved for this purpose. Combined pharmacological therapy has not provided such convincing results. Considering the fact that the "ideal" and effective drug for all types of alcoholic patients does not exists, the future challenge will be to identify a personalized approach. Recent data has shown that this objective can be achieved by investigating the genetic variability of the patient. Moreover, the use of replacement molecules can probably be considered an advantageous therapeutic opportunity (i.e. sodium oxybate). In addition, reduction of alcohol consumption is increasingly accepted as a viable treatment goal, and the use of nalmefene "as-needed" (a pharmacological approach similar to naltrexone, but, possibly, with lower hepatotoxicity) may help in the treatment of AD. Thus, it is important to stress that a pharmacological approach to treat AD should be preceded by the definition of patient characteristics; this may help in the choice of the most appropriate drug and it can be done more easily when more pharmacological options approved for the treatment of AD are also available. © 2013 Published by Elsevier B.V. and ECNP.

  11. Multimodal OCT for complex assessment of tumors response to therapy

    Science.gov (United States)

    Sirotkina, Marina A.; Kiseleva, Elena B.; Gubarkova, Ekaterina V.; Matveev, Lev A.; Zaitsev, Vladimir Yu.; Matveyev, Alexander L.; Shirmanova, Marina V.; Sovetsky, Alexander A.; Moiseev, Alexander A.; Zagaynova, Elena V.; Vitkin, Alex; Gladkova, Natalia D.

    2017-07-01

    Multimodal OCT is a promising tool for monitoring of individual tumor response to antitumor therapies. The changes of tumor cells, connective tissue, microcirculation and stiffness can be estimated simultaneously in real time with high resolution.

  12. A music therapy tool for assessing parent-child interaction in cases of emotional neglect

    DEFF Research Database (Denmark)

    Jacobsen, Stine Lindahl; H. McKinney, Cathy

    2015-01-01

    Using a music therapy approach to assess emotional communication and parent–child interaction is new to the field of child protection. However, musical improvisations in music therapy has long been known as an analogue to affect attunement and early non-verbal communication between parent...... dyads underwent two video recorded music therapy assessment sessions. Video analyses focused on autonomy relationship, turns, and parental response types producing scores on Mutual Attunement, Nonverbal Communication Skills and Emotional Parental Response. Psychometric analyses of the APC-R included...... and infant, which called for an investigation of the value of music therapy within the field of family assessment and family therapy. More specifically, we wanted to investigate and further strengthen assessment of parenting competencies (APC). We developed scores and examined the psychometric properties...

  13. Force dependent internalization of magnetic nanoparticles results in highly loaded endothelial cells for use as potential therapy delivery vectors.

    Science.gov (United States)

    MacDonald, Cristin; Barbee, Kenneth; Polyak, Boris

    2012-05-01

    To investigate the kinetics, mechanism and extent of MNP loading into endothelial cells and the effect of this loading on cell function. MNP uptake was examined under field on/off conditions, utilizing varying magnetite concentration MNPs. MNP-loaded cell viability and functional integrity was assessed using metabolic respiration, cell proliferation and migration assays. MNP uptake in endothelial cells significantly increased under the influence of a magnetic field versus non-magnetic conditions. Larger magnetite density of the MNPs led to a higher MNP internalization by cells under application of a magnetic field without compromising cellular respiration activity. Two-dimensional migration assays at no field showed that higher magnetite loading resulted in greater cell migration rates. In a three-dimensional migration assay under magnetic field, the migration rate of MNP-loaded cells was more than twice that of unloaded cells and was comparable to migration stimulated by a serum gradient. Our results suggest that endothelial cell uptake of MNPs is a force dependent process. The in vitro assays determined that cell health is not adversely affected by high MNP loadings, allowing these highly magnetically responsive cells to be potentially beneficial therapy (gene, drug or cell) delivery systems.

  14. Multidimensional family therapy lowers the rate of cannabis dependence in adolescents: a randomised controlled trial in Western European outpatient settings.

    Science.gov (United States)

    Rigter, Henk; Henderson, Craig E; Pelc, Isidore; Tossmann, Peter; Phan, Olivier; Hendriks, Vincent; Schaub, Michael; Rowe, Cindy L

    2013-06-01

    Noticing a lack of evidence-based programmes for treating adolescents heavily using cannabis in Europe, government representatives from Belgium, France, Germany, The Netherlands, and Switzerland decided to have U.S.-developed multidimensional family therapy (MDFT) tested in their countries in a trans-national trial, called the International Need for Cannabis Treatment (INCANT) study. INCANT was a 2 (treatment condition)×5 (time) repeated measures intent-to-treat randomised effectiveness trial comparing MDFT to Individual Psychotherapy (IP). Data were gathered at baseline and 3, 6, 9 and 12 months thereafter. Study participants were recruited at outpatient secondary level addiction, youth, and forensic care clinics in Brussels, Berlin, Paris, The Hague, and Geneva. Participants were adolescents from 13 through 18 years of age with a recent cannabis use disorder. 85% were boys; 40% were of foreign descent. One-third had been arrested for a criminal offence in the past 3 months. Three primary outcomes were assessed: (1) treatment retention, (2) prevalence of cannabis use disorder and (3) 90-day frequency of cannabis consumption. Positive outcomes were found in both the MDFT and IP conditions. MDFT outperformed IP on the measures of treatment retention (pcannabis dependence (p=0.015). MDFT reduced the number of cannabis consumption days more than IP in a subgroup of adolescents reporting more frequent cannabis use (p=0.002). Cannabis use disorder was responsive to treatment. MDFT exceeded IP in decreasing the prevalence of cannabis dependence. MDFT is applicable in Western European outpatient settings, and may show moderately greater benefits than IP in youth with more severe substance use. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  15. TOBACCO DEPENDENCE TREATMENT WITH NICOTINE REPLACEMENT THERAPY AS ONE OF THE METHODS FOR CARDIOVASCULAR DISEASE RISK REDUCTION

    Directory of Open Access Journals (Sweden)

    O. V. Vikhireva

    2005-01-01

    Full Text Available Aim. To investigate efficacy and safety of nicotine chewing gum and inhaler in individuals trying to quit smoking. To assess expected reduction of cardiovascular disease (CVD and total mortality relative risks (RR.Material and methods. In this open, parallel study, 169 relatively healthy male smokers aged 18-60 years were randomly assigned to free choice vs admission of Nicorette gum (2/4 mg or inhaler (10 mg. At baseline, all participants smoked ≥15 cig/d, for ≥3 years. The intervention phase lasted 3 months; follow-up evaluations were made at 3, 6 and 12 months after nicotine replacement therapy (NRT initiation.Results. Twelve-month results were obtained for 152 subjects (response rate 89.9%. Point prevalence abstinence and reduction (smoking ≤50% of basic daily cigarette amount rates were 19.7% and 35.5%, respectively. Neither abstinence, nor reduction rates depended on Nicorette form (gum vs inhaler, or on choice vs admission factor. The main predictors of long-term efficacy were nicotine dependence severity and contacts with other smokers.NRT was not associated with negative dynamics in objective health parameters (blood pressure, heart rate, ECG parameters, body weight, and body mass index or self-evaluation of health. Both Nicorette forms seemed to be safe and well-tolerated.At 12 months, the expected mean RR reduction for CVD mortality reached 19%, for total mortality – 21%.Conclusion. In Russian clinical settings, NRT efficacy and safety are similar to that demonstrated in numerous international trials. NRT can be recommended as one of the methods of assistance to quit smoking and, therefore, for CVD risk reduction.

  16. A computational hypothesis for allostasis: delineation of substance dependence, conventional therapies, and alternative treatments

    Directory of Open Access Journals (Sweden)

    Yariv Z. Levy

    2013-12-01

    Full Text Available The allostatic theory of drug abuse describes the brain's reward system alterations as substance misuse progresses. Neural adaptations arising from the reward system itself and from the antireward system provide the subject with functional stability, while affecting the person's mood. We propose a computational hypothesis describing how a virtual subject's drug consumption, cognitive substrate, and mood interface with reward and antireward systems. Reward system adaptations are assumed interrelated with the ongoing neural activity defining behavior towards drug intake, including activity in the nucleus accumbens, ventral tegmental area, and prefrontal cortex (PFC. Antireward system adaptations are assumed to mutually connect with higher-order cognitive processes occurring within PFC, orbitofrontal cortex, and anterior cingulate cortex. The subject's mood estimation is a provisional function of reward components.The presented knowledge repository model incorporates pharmacokinetic, pharmacodynamic, neuropsychological, cognitive, and behavioral components. Patterns of tobacco smoking exemplify the framework's predictive properties: escalation of cigarette consumption, conventional treatments similar to nicotine patches, and alternative medical practices comparable to meditation. The primary outcomes include an estimate of the virtual subject's mood and the daily account of drug intakes. The main limitation of this study resides in the 21 time-dependent processes which partially describe the complex phenomena of drug addiction and involve a large number of parameters which may underconstrain the framework.Our model predicts that reward system adaptations account for mood stabilization, whereas antireward system adaptations delineate mood improvement and reduction in drug consumption. This investigation provides formal arguments encouraging current rehabilitation therapies to include meditation-like practices along with pharmaceutical drugs and

  17. Yoga: As an adjunct therapy to trim down the Ayurvedic drug requirement in non insulin-dependent diabetes mellitus.

    Science.gov (United States)

    Sharma, Rohit; Amin, Hetal; Prajapati, P K

    2014-01-01

    In spite of a large number of drugs showing anti-hyperglycemic activities, none of them have been successful in complete management of diabetes mellitus (DM). Yoga and Ayurveda are the two schools of thought in India, which have a history of curing diseases since thousands of years. Yogic techniques and Ayurvedic herbs have proven their anti-diabetic potential without inducing untoward effects. The present study combines Ayurvedic medication with Yoga techniques as a new approach toward healing DM. To assess the effect of Yoga therapy in the management of non insulin-dependent DM (NIDDM) and to decrease the oral drug dose requirement of guḍūcī ghana Tablet. Thirty known NIDDM patients of both genders, who were on guḍūcī ghana (solidified aqueous extract of Tinospora cordifolia (Willd.) Miers.) tablets from past 2 months as Ayurvedic remedy for DM were selected. Along with guḍūcī ghana administration, the subjects were instructed to follow Yogic procedures including Āsanas, prāṇāyāma, and śuddhi kriyās. The study was conducted for 8 weeks, wherein fasting blood sugar (FBS) and postprandial blood sugar (PPBS) levels along with relief in sign and symptoms were assessed at every 2 weeks intervals, and according to relief in sign and symptoms, tapering of drug dosage was carried out. The obtained data were analyzed statistically by applying paired t-test. The results obtained were promising as the relief in diabetic symptomatology was highly significant in terms of P value. 80.83% reduction in dose of guḍūcī ghana tablets and 7.85% and 8.78% fall in FBS and PPBS levels, respectively, after the complete course of treatment. The obtained P value showed highly significant results.

  18. Heavy dependent nicotine smokers--Newfound lifestyle appreciation after quitting successfully. Experiences from inpatient smoking cessation therapy.

    Science.gov (United States)

    Schoberberger, R; Böhm, G; Schroeder, Y

    2015-05-01

    This is an evaluation of an ongoing inpatient smoking cessation program available in Austria and aims to show to what extent even heavy nicotine dependent smokers can benefit from a three-week inpatient therapy. A particular focus lies on analyzing the benefits and changes in lifestyle and sense of well-being. 270 initially heavy nicotine dependent smokers are observed for a one year period consisting of recruitment, therapy and two post-therapy follow-up visits; post program smokers are compared to post program ex-smokers. 12 month post-therapy, 42.6% of participants are identified by carbon monoxide-verifications as ex-smokers, 34% as smokers and the remaining did not attend follow-up visits. Significant changes in lifestyle satisfaction are reported by ex-smokers compared to still smokers. Convincing heavy dependent nicotine smokers that significant changes in lifestyle satisfaction can be expected as part of a successful cessation process should lead to enough motivation for these individuals to seek such inpatient smoking cessation program. Copyright © 2015 The Royal Society for Public Health. Published by Elsevier Ltd. All rights reserved.

  19. Dosage assessment for radioiodine therapy in benign thyroid disorders

    NARCIS (Netherlands)

    Isselt, J.W. van

    2001-01-01

    The general aim of this thesis was to investigate the value and the shortcomings of the becquerel-per-gram method for radioiodine therapy in various benign thyroid disorders. The history of this treatment form, which goes back to the late 1940s, is described in Chapter 1. Almost fifty years after

  20. Material interaction and art product in art therapy assessment in adult mental health

    NARCIS (Netherlands)

    Pénzes, I.J.N.J.; Hooren, S. van; Dokter, D.; Smeijsters, H.; Hutschemaekers, G.J.M.

    2016-01-01

    Background: Art materials have a central role in art therapy. The way a client interacts with art materials - material interaction - is an important source of information in art therapy assessment in adult mental health. The aim of this study was to develop the categories of material interaction and

  1. A checklist to assess patient education in physical therapy practice: development and reliability.

    NARCIS (Netherlands)

    Sluijs, E.M.

    1991-01-01

    Patient education in physical therapy is gaining attention because it can contribute to patient compliance and prevention. This article describes the development of an assessment tool for investigating patient education in physical therapy. A checklist of 65 educational activity items was

  2. Prospective Assessment of Cannabis Withdrawal in Adolescents with Cannabis Dependence: A Pilot Study

    Science.gov (United States)

    Milin, Robert; Manion, Ian; Dare, Glenda; Walker, Selena

    2008-01-01

    A study to identify and assess the withdrawal symptoms in adolescents afflicted with cannabis dependence is conducted. Results conclude that withdrawal symptoms of cannabis were present in adolescents seeking treatment for this substance abuse.

  3. A Rabbit Model for Testing Helper-Dependent Adenovirus-Mediated Gene Therapy for Vein Graft Atherosclerosis

    Directory of Open Access Journals (Sweden)

    Lianxiang Bi

    2017-12-01

    Full Text Available Coronary artery bypass vein grafts are a mainstay of therapy for human atherosclerosis. Unfortunately, the long-term patency of vein grafts is limited by accelerated atherosclerosis. Gene therapy, directed at the vein graft wall, is a promising approach for preventing vein graft atherosclerosis. Because helper-dependent adenovirus (HDAd efficiently transduces grafted veins and confers long-term transgene expression, HDAd is an excellent candidate for delivery of vein graft-targeted gene therapy. We developed a model of vein graft atherosclerosis in fat-fed rabbits and demonstrated long-term (≥20 weeks persistence of HDAd genomes after graft transduction. This model enables quantitation of vein graft hemodynamics, wall structure, lipid accumulation, cellularity, vector persistence, and inflammatory markers on a single graft. Time-course experiments identified 12 weeks after transduction as an optimal time to measure efficacy of gene therapy on the critical variables of lipid and macrophage accumulation. We also used chow-fed rabbits to test whether HDAd infusion in vein grafts promotes intimal growth and inflammation. HDAd did not increase intimal growth, but had moderate—yet significant—pro-inflammatory effects. The vein graft atherosclerosis model will be useful for testing HDAd-mediated gene therapy; however, pro-inflammatory effects of HdAd remain a concern in developing HDAd as a therapy for vein graft disease.

  4. Nursing-care dependency : Development of an assessment scale for demented and mentally handicapped patients

    NARCIS (Netherlands)

    Dijkstra, Ate; Buist, Girbe; Dassen, T

    1996-01-01

    This article describing the first phase in the development of an assessment scale of nursing-care dependency (NCD) for Dutch demented and mentally handicapped patients focuses on the background to the study and the content validation of the nursing-care dependency scale. The scale aims to

  5. Quantitative Assessment of Dance Therapy Infulence on the Parkinson’s Disease Patients’ Lower Limb Biomechanics

    Directory of Open Access Journals (Sweden)

    Donatas Lukšys

    2017-01-01

    Full Text Available Parkinson’s disease – progressive neurologic disorder that damages a variety of motor function and reduces the quality of life. Patients with PD are subject to various physical therapy exercises, but recently is applied more often the dance – music therapy. This study aims assessing the therapeutic effect of the modified Lindy Hop dance therapy on lower extremity biomechanics. The experimental study was performed using inertial sensors that registered lower extremity biomechanical parameters during gait. Several spatio-temporal parameters of lower limb were calculated and were found statistically significant between groups, which allows quantifying the influence of dance therapy.

  6. Assessing Treatment Integrity in Alcohol Behavioral Couple Therapy.

    Science.gov (United States)

    Hallgren, Kevin A; Crotwell, Shirley M; Muñoz, Rosa E; Gius, Becky K; McCrady, Barbara S; Ladd, Benjamin O; Epstein, Elizabeth E

    2016-06-01

    Alcohol Behavioral Couple Therapy (ABCT) is an efficacious treatment for alcohol use disorders. Coding treatment integrity can shed light on the active ingredients of ABCT, but there are no published studies of treatment integrity instruments for ABCT. The present study describes the development and initial reliability of the Treatment Integrity Rating System - Couples Version (C-TIRS) for ABCT. The C-TIRS was used to rate 284 first- and mid-treatment ABCT sessions of 188 couples in four randomized clinical trials. Average inter-rater reliability for distinguishing ratings between C-TIRS items was fair-to-good for quantity items (intraclass correlation [ICC] = 0.64) and poor-to-fair for quality items (ICC = 0.41). Five C-TIRS subscales were defined a priori to measure treatment components involving cognitive-behavioral therapy, spouse involvement, couple therapy, common therapeutic factors, and overall adherence to the treatment protocol and had adequate internal reliability (α = 0.74-0.89). Inter-rater reliability was fair to good on seven of ten scales but poor on three scales (ICC range = 0.17-0.72). The C-TIRS was designed to provide information about quantity and quality of the delivery of ABCT components; however, further refinement of the C-TIRS is warranted before it should be used in frontline practice. Clinical implications and recommendations for future research are discussed.

  7. [STRATEGY FOR THE ASSESSMENT OF COMPLIANCE WITH ANTIRETROVIRAL THERAPY IN PATIENTS WITH HIV INFECTION].

    Science.gov (United States)

    Yushchuk, N D; Fedyaeva, O N; Sirota, N A

    2016-01-01

    The study was aimed at identifying prognostic factors of antiretroviral therapy (ARVT) in patients with HIV infection at different stages of the disease and developing an algorithm for the three-component assessment of compliance with therapy. A total of 280 patients given ARVT for at least 6 months were available for comprehensive examination, questionnaire study for the detection of non-compliance risk factors, and psychological testing with the evaluation of non-compliance from the anxiety level (Sheehan scale) with the use of cluster analysis. The study revealed the most significant criteria for the assessment of compliance with therapy and non-compliance risk factors associated with ARVT conditions.

  8. In vivo assessment of antiretroviral therapy-associated side effects

    Directory of Open Access Journals (Sweden)

    Eduardo Milton Ramos-Sanchez

    2014-07-01

    Full Text Available Antiretroviral therapy has been associated with side effects, either from the drug itself or in conjunction with the effects of human immunodeficiency virus infection. Here, we evaluated the side effects of the protease inhibitor (PI indinavir in hamsters consuming a normal or high-fat diet. Indinavir treatment increased the hamster death rate and resulted in an increase in triglyceride, cholesterol and glucose serum levels and a reduction in anti-oxLDL auto-antibodies. The treatment led to histopathological alterations of the kidney and the heart. These results suggest that hamsters are an interesting model for the study of the side effects of antiretroviral drugs, such as PIs.

  9. PET/CT for therapy response assessment in lymphoma

    DEFF Research Database (Denmark)

    Hutchings, Martin; Barrington, Sally F

    2009-01-01

    PET with (18)F-FDG is a standard staging procedure for most lymphoma subtypes. Performed during and after therapy for Hodgkin lymphoma (HL) and aggressive non-Hodgkin lymphoma (NHL), (18)F-FDG PET results have a high prognostic value and correlate with survival. (18)F-FDG PET has been incorporated...... into revised response criteria for aggressive lymphomas, and several ongoing trials are under way to investigate the value of treatment adaptation based on early (18)F-FDG PET results for HL and aggressive NHL. There is little evidence to support the use of (18)F-FDG PET for monitoring of the treatment...... of indolent lymphomas and for routine use in the surveillance setting. So that trial results can be compared and translated easily into clinical practice, uniform and evidence-based guidelines for the interpretation and reporting of response monitoring scans are warranted. Because it is still not proven...

  10. A Review of the Principles for Culturally Appropriate Art Therapy Assessment Tools

    Science.gov (United States)

    Betts, Donna

    2013-01-01

    In an increasingly diverse society, and with the broadening scope of art therapy, the duty of art therapists to ensure responsible and appropriate assessment is ever more important. This article discusses considerations that are necessary for the successful adaptation and use of drawing-based assessments in cross-cultural and multicultural…

  11. Prediction of Drug Therapy for Chronic Hepatitis C Depending on the IL28B Gene Polymorphism

    Directory of Open Access Journals (Sweden)

    Moroz L.V. Moroz L.V.

    2014-09-01

    Molecular and genetic analysis of IL28V (rs12979860 gene polymorphism, located at a distance of 3 thousand nucleotide pairs from IL28V gene, using the polymerase chain reaction allows to predict the success of combination antiviral therapy, and the presence of C/C genotype can be a predictor of sustained virological response in patients chronic hepatitis C.

  12. [Substance dependence. Information, diagnosis and therapy--encouragement for pragmatic treatment].

    Science.gov (United States)

    Salloch-Vogel, R R; Frege, I

    1996-06-01

    According to the author's experience with addiction diseases, questions of etiology, diagnostics, and therapy are reviewed. Starting with basic terms: such as the addicted human and his background, the drugs and the disease, chosen facts are combined with the author's individual experiences and theories for pragmatic actions are derived.

  13. HLA dependent immune escape mechanisms in B-cell lymphomas : Implications for immune checkpoint inhibitor therapy?

    NARCIS (Netherlands)

    Nijland, Marcel; Veenstra, Rianne N.; Visser, Lydia; Xu, Chuanhui; Kushekhar, Kushi; van Imhoff, Gustaaf W.; Kluin, Philip M.; van den Berg, Anke; Diepstra, Arjan

    2017-01-01

    Antigen presentation by tumor cells in the context of Human Leukocyte Antigen (HLA) is generally considered to be a prerequisite for effective immune checkpoint inhibitor therapy. We evaluated cell surface HLA class I, HLA class II and cytoplasmic HLA-DM staining by immunohistochemistry (IHC) in 389

  14. Dyslipidemia therapy update: the importance of full lipid profile assessment.

    LENUS (Irish Health Repository)

    Menown, I B A

    2009-07-01

    Lipid guidelines typically focus on total cholesterol +\\/- low-density lipoprotein cholesterol levels with less emphasis on high-density lipoprotein cholesterol (HDL-C) or triglyceride assessment, thus potentially underestimating cardiovascular (CV) risk and the need for lifestyle or treatment optimization. In this article, we highlight how reliance on isolated total cholesterol assessment may miss prognostically relevant lipid abnormalities; we describe from the European Systematic COronary Risk Evaluation (SCORE) data set how incorporation of HDL-C may improve estimation of CV risk; and, finally, we critically evaluate the evidence base surrounding triglycerides and CV risk.

  15. Rapid iron loading in a pregnant woman with transfusion-dependent thalassemia after brief cessation of iron chelation therapy.

    Science.gov (United States)

    Farmaki, Kallistheni; Gotsis, Efstathios; Tzoumari, Ioanna; Berdoukas, Vasilios

    2008-08-01

    In general, in women with transfusion-dependent thalassemia, during pregnancy, iron chelation therapy is ceased. We report a splenectomized patient, who was an excellent complier with chelation therapy, who before embarking on a pregnancy showed no evidence of iron overload, with normal cardiac, thyroid function and glucose metabolism. Laboratory findings showed ferritin 67 microg/L, myocardial T(2)* of 34 ms and liver magnetic resonance imaging (MRI) liver iron concentration of 1 mg/g dry weight. She became pregnant by in vitro fertilization in October 2006, delivery occurred in June 2007. She breast fed for 2 months. After 12 months without iron chelation, ferritin was 1583 microg/L. Quantitative MRI showed myocardial T(2)* of 27 ms, that the liver iron concentration had increased to 11.3 mg/g dry weight, indicative of moderate to heavy iron load. This case demonstrates that iron overload can develop rapidly and that physicians caring for patients with transfusion-dependent thalassemia should be particularly alert to any discontinuation of chelation therapy over time.

  16. Assessing dependency using self-report and indirect measures: examining the significance of discrepancies.

    Science.gov (United States)

    Cogswell, Alex; Alloy, Lauren B; Karpinski, Andrew; Grant, David A

    2010-07-01

    The present study addressed convergence between self-report and indirect approaches to assessing dependency. We were moderately successful in validating an implicit measure, which was found to be reliable, orthogonal to 2 self-report instruments, and predictive of external criteria. This study also examined discrepancies between scores on self-report and implicit measures, and has implications for their significance. The possibility that discrepancies themselves are pathological was not supported, although discrepancies were associated with particular personality profiles. Finally, this study offered additional evidence for the relation between dependency and depressive symptomatology and identified implicit dependency as contributing unique variance in predicting past major depression.

  17. The Effectiveness of Cognitive Behavioral Therapy on Increasing of Self-Efficacy and Improving of Addiction Symptoms among Drug Dependency Patients

    Directory of Open Access Journals (Sweden)

    Hamid Kamarzarin

    2012-08-01

    Full Text Available Introduction: The aim of this study was to determine the effectiveness of cognitive behavior therapy on increasing of self efficacy and improving of addiction symptoms among drug dependency patients. Method: For this purpose, 90 substance abusers were selected of private addiction center, Central Prison and drop in center by using of random sampling, and they were divided into two experimental (45 subjects and witness groups (45 subjects randomly. The members of experimental group were under 12 sessions of cognitive behavioral therapy by Carol method, and control group only have taken Methadone and other physical drugs. All participants at the beginning of research, during the study (after three months and three months after treatment completed self-efficacy questionnaire and Maudsley addiction profile (Map by a psychologist were assessed. The symptoms of addiction recovery and addiction treatment process. Results: Analysis of covariance indicated the treatment effectiveness and its maintenance on increasing of efficacy and reducing of the symptoms of Maudsley addiction profile. Conclusion: Cognitive behavior therapy is effective to increase self-efficacy and improve symptoms in substance abusers.

  18. [Assessment of individual clinical outcomes: regarding an electroconvulsive therapy case].

    Science.gov (United States)

    Iraurgi, Ioseba; Gorbeña, Susana; Martínez-Cubillos, Miren-Itxaso; Escribano, Margarita; Gómez-de-Maintenant, Pablo

    2015-01-01

    Evaluation of therapeutic results and of the efficacy and effectiveness of treatments is an area of interest both for clinicians and researchers. In general, randomized controlled trial designs have been used as the methodology of choice in which intergroup comparisons are made having a minimum of participants in each arm of treatment. However, these procedures are seldom used in daily clinical practice. Despite this fact, the evaluation of treatment results for a specific patient is important for the clinician in order to address if therapeutic goals have been accomplished both in terms of statistical significance and clinical meaningfulness. The methodology based on the reliable change index (Jacobson y Truax)1 provides an estimate of these two criteria. The goal of this article is to propose a procedure to apply the methodology with a single case study of a woman diagnosed with major depression and treated with electroconvulsive therapy. Copyright © 2014 SEP y SEPB. Published by Elsevier España. All rights reserved.

  19. MDT-MB therapy in paucibacillary leprosy: A clinicopathological assessment

    Directory of Open Access Journals (Sweden)

    Prasad P

    2005-01-01

    Full Text Available BACKGROUND: The World Health Organization recommends treatment regimens for paucibacillary (PB and multibacillary (MB leprosy, which differ in their duration and components. Hence accurate classification of the disease is required. To overcome difficulties in classification Uniform Multi Drug Therapy (U-MDT has been recommended. AIM : To evaluate the benefit of adding clofazimine to paucibacillary regimens in leprosy patients by measuring clinical and histological resolution. METHODS: Forty-four paucibacillary patients were included in the study. Twenty-two patients were given MDT-PB regimen and the remaining MDT-MB regimen for six months . Skin biopsies were done before the commencement and at the end of treatment. Clinical and histological resolutions were measured according to the standard criteria a laid down. The results were analyzed using Fishers′ test and Crammers′ V test. RESULTS: Clinical improvement was observed in 90.9% in the MB group as compared to 27.3% in the PB group. Regression in the nerve swelling was observed in 70% in the MB group and in 37.5% in the PB group while histological resolution was observed in 72.8% and 54.5% respectively. CONCLUSIONS: Addition of clofazimine helps to resolve leprosy lesions both clinically and histologically, thus justifying the concept of Uniform MDT regimen for all patients.

  20. Cognitive assessment of pycnogenol therapy following traumatic brain injury.

    Science.gov (United States)

    Scheff, Stephen W; Roberts, Kelly N

    2016-11-10

    We have previously shown that pycnogenol (PYC) increases antioxidants, decreases oxidative stress, suppresses neuroinflammation and enhances synaptic plasticity following traumatic brain injury (TBI). Here, we investigate the effects of PYC on cognitive function following a controlled cortical impact (CCI). Adult Sprague-Dawley rats received a CCI injury followed by an intraperitoneal injection of PYC (50 or 100mg/kg). Seven days post trauma, subjects were evaluated in a Morris water maze (MWM) and evaluated for changes in lesion volume. Some animals were evaluated at 48h for hippocampal Fluoro-jade B (FJB) staining. The highest dose of PYC therapy significantly reduced lesion volume, with no improvement in MWM compared to vehicle controls. PYC failed to reduce the total number of FJB positive neurons in the hippocampus. These results suggest that the reduction of oxidative stress and neuroinflammation are not the key components of the secondary injury that contribute to cognitive deficits following TBI. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  1. Ultrasound assessment of carotid plaque echogenicity response to statin therapy: a systematic review and meta-analysis.

    Science.gov (United States)

    Ibrahimi, Pranvera; Jashari, Fisnik; Bajraktari, Gani; Wester, Per; Henein, Michael Y

    2015-05-12

    To evaluate in a systematic review and meta-analysis model the effect of statin therapy on carotid plaque echogenicity assessed by ultrasound. We have systematically searched electronic databases (PubMed, MEDLINE, EMBASE and Cochrane Center Register) up to April, 2015, for studies evaluating the effect of statins on plaque echogenicity. Two researchers independently determined the eligibility of studies evaluating the effect of statin therapy on carotid plaque echogenicity that used ultrasound and grey scale median (GSM) or integrated back scatter (IBS). Nine out of 580 identified studies including 566 patients' carotid artery data were meta-analyzed for a mean follow up of 7.2 months. A consistent increase in the echogenicity of carotid artery plaques, after statin therapy, was reported. Pooled weighted mean difference % (WMD) on plaque echogenicity after statin therapy was 29% (95% CI 22%-36%), ptherapy is associated with a favorable increase of carotid plaque echogenicity. This effect seems to be dependent on the period of treatment and hsCRP change from the baseline, independent of changes in LDL and HDL.

  2. Efficacy of melody-based aphasia therapy may strongly depend on rhythm and conversational speech formulas

    OpenAIRE

    Benjamin Stahl

    2014-01-01

    Left-hemisphere stroke patients suffering from language and speech disorders are often able to sing entire pieces of text fluently. This finding has inspired a number of melody-based rehabilitation programs – most notable among them a treatment known as Melodic Intonation Therapy – as well as two fundamental research questions. When the experimental design focuses on one point in time (cross section), one may determine whether or not singing has an immediate effect on syllable production in p...

  3. Dose- and time-dependence of the host-mediated response to paclitaxel therapy: a mathematical modeling approach.

    Science.gov (United States)

    Benguigui, Madeleine; Alishekevitz, Dror; Timaner, Michael; Shechter, Dvir; Raviv, Ziv; Benzekry, Sebastien; Shaked, Yuval

    2018-01-05

    It has recently been suggested that pro-tumorigenic host-mediated processes induced in response to chemotherapy counteract the anti-tumor activity of therapy, and thereby decrease net therapeutic outcome. Here we use experimental data to formulate a mathematical model describing the host response to different doses of paclitaxel (PTX) chemotherapy as well as the duration of the response. Three previously described host-mediated effects are used as readouts for the host response to therapy. These include the levels of circulating endothelial progenitor cells in peripheral blood and the effect of plasma derived from PTX-treated mice on migratory and invasive properties of tumor cells in vitro . A first set of mathematical models, based on basic principles of pharmacokinetics/pharmacodynamics, did not appropriately describe the dose-dependence and duration of the host response regarding the effects on invasion. We therefore provide an alternative mathematical model with a dose-dependent threshold, instead of a concentration-dependent one, that describes better the data. This model is integrated into a global model defining all three host-mediated effects. It not only precisely describes the data, but also correctly predicts host-mediated effects at different doses as well as the duration of the host response. This mathematical model may serve as a tool to predict the host response to chemotherapy in cancer patients, and therefore may be used to design chemotherapy regimens with improved therapeutic outcome by minimizing host mediated effects.

  4. [First experience with the personalised dependence degree assessment for the purposes of care allowance].

    Science.gov (United States)

    Celedová, Libuše; Cevela, Rostislav; Ornerová, Alena

    2013-01-01

    Personalised medicine in disability assessment was first implemented in 2010. It was not until two years later that the medical assessment paradigm used for dependence degree assessment for the purposes of care allowance was transformed. Since January 2012, there has been an aggregation of the 36 self-care and self-sufficiency tasks into ten basic living needs , i.e. mobility, orientation, communication, food intake, putting on clothes and shoes, body hygiene, using the toilet, health care, personal activities, and household cleaning. Until the present moment, more than 150 thousand assessment cases have confirmed that personalised assessment of functional disabilities represents a significant improvement in the individualised approach to all clients of the social security system. The increase in the number of patients with confirmed dependence degrees III and IV has demonstrated that modern functional assessment is beneficial especially for patients with the most severe health impairments. Personalised medical assessment service represents the pursuit of an improved medical assessment of clients functional disabilities.

  5. Assessment of adherence to visual correction and occlusion therapy in the Infant Aphakia Treatment Study

    Directory of Open Access Journals (Sweden)

    Carolyn Drews-Botsch

    2016-08-01

    Full Text Available Occlusion therapy throughout early childhood is believed to be efficacious in treating deprivation amblyopia but has not been rigorously assessed in clinical trials. Further, tools to assess adherence to such therapy over an extended period of time are lacking. Using data from the Infant Aphakia Treatment Study, a randomized clinical trial of treatment for unilateral congenital cataract, we examined the use of quarterly 48-h recall interviews and annual 7-day prospective diaries to assess reported hours of patching in 114 children throughout the first 5 years of life. Consistency of data reported was assessed using correlation coefficients and intraclass correlation coefficients. Both interview and diary data showed excellent consistency with Cronbach’s Alpha’s ranging from 0.69 to 0.88 for hours of patching and 0.60 to 0.73 for hours of sleep. However, caregivers reported somewhat more adherence in prospective diaries than retrospective interviews. Completion rates, on the other hand, were substantially higher for telephone interviews than prospective diaries. For example, four years after surgery response rates to telephone interviews exceeded 75% versus completion rates of only 54% for diaries. In situations where occlusion dose monitors cannot be used for assessing adherence to occlusion therapy, such as in infants or over an extended period of time, quantitative assessments of occlusion therapy can be obtained by parental report, either as a series of prospective diaries or a series of recall interviews.

  6. Development of the Music Therapy Assessment Tool for Advanced Huntington's Disease: A Pilot Validation Study.

    Science.gov (United States)

    O'Kelly, Julian; Bodak, Rebeka

    2016-01-01

    Case studies of people with Huntington's disease (HD) report that music therapy provides a range of benefits that may improve quality of life; however, no robust music therapy assessment tools exist for this population. Develop and conduct preliminary psychometric testing of a music therapy assessment tool for patients with advanced HD. First, we established content and face validity of the Music Therapy Assessment Tool for Advanced HD (MATA-HD) through focus groups and field testing. Second, we examined psychometric properties of the resulting MATA-HD in terms of its construct validity, internal consistency, and inter-rater and intra-rater reliability over 10 group music therapy sessions with 19 patients. The resulting MATA-HD included a total of 15 items across six subscales (Arousal/Attention, Physical Presentation, Communication, Musical, Cognition, and Psychological/Behavioral). We found good construct validity (r ≥ 0.7) for Mood, Communication Level, Communication Effectiveness, Choice, Social Behavior, Arousal, and Attention items. Cronbach's α of 0.825 indicated good internal consistency across 11 items with a common focus of engagement in therapy. The inter-rater reliability (IRR) Intra-Class Coefficient (ICC) scores averaged 0.65, and a mean intra-rater ICC reliability of 0.68 was obtained. Further training and retesting provided a mean of IRR ICC of 0.7. Preliminary data indicate that the MATA-HD is a promising tool for measuring patient responses to music therapy interventions across psychological, physical, social, and communication domains of functioning in patients with advanced HD. © the American Music Therapy Association 2016. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

  7. Assessment of Practical Skills. Part 2. Context Dependency and Construct Validity.

    Science.gov (United States)

    Lock, Roger

    1990-01-01

    Investigated are the context dependency and construct validity of practical skill assessment in science which may include the skills of observing, manipulating, planning, interpreting, reporting, and self-reliance. Pupil performance on a variety of practical tasks were compared with external examination grades in biology and chemistry. (CW)

  8. Traditional Chinese medicine combination therapy for patients with steroid-dependent ulcerative colitis: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Zheng, Kai; Shen, Hong; Jia, Jia; Lu, Yuelin; Zhu, Lei; Zhang, Lu; Shen, Zhaofeng

    2017-01-10

    Approximately 20% of patients with ulcerative colitis become steroid dependent. Azathioprine is recommended in steroid-dependent ulcerative colitis, but its side effects limit its use. Chinese herbal medicine has been widely used to treat ulcerative colitis in China. However, its effectiveness in steroid-dependent patients has not been evaluated. This study aims to investigate the efficacy of traditional Chinese medicine combination therapy with 5-aminosalicylic acid in patients with steroid-dependent ulcerative colitis. This is a parallel, multicenter, randomized controlled trial. One hundred and twenty eligible patients will be randomly assigned to a traditional Chinese medicine group or azathioprine group. All patients will be given basic treatment, which includes steroids and 5-aminosalicylic acid. Patients allocated to the traditional Chinese medicine group will receive basic treatment plus Chinese herbal medicine granules, while patients in the azathioprine group will receive basic treatment plus azathioprine. The whole study will last 24 weeks. The primary outcome measure is the steroid-free remission rate. Secondary outcome measures are health-related quality of life, efficacy of endoscopic response, degree of mucosal healing, and inflammation indicators. Results from this study may provide evidence for the effectiveness of traditional Chinese medicine combined with 5-aminosalicylic acid in patients with steroid-dependent ulcerative colitis. The findings will provide a basis for further confirmatory studies. Chinese Clinical Trial Register, ChiCTR-IPR-15005760 . Registered on 2 January 2015.

  9. Impaired decision-making in opiate-dependent subjects: effect of pharmacological therapies.

    Science.gov (United States)

    Pirastu, R; Fais, R; Messina, M; Bini, V; Spiga, S; Falconieri, D; Diana, M

    2006-06-28

    Cognitive dysfunction is a major feature of drug addiction. In the present paper, we compared the decision-making ability using the Iowa gambling task of methadone- and buprenorphine-maintained individuals to non opiate-dependent drug-free controls. Buprenorphine-maintained individuals performed better than methadone-maintained individuals, and not differently than non opiate-dependent controls. In addition, methadone-maintained individuals had more perseverative errors on the Wisconsin card sorting task (WCST) as compared with non opiate-dependent drug-free controls whereas buprenorphine-maintained individuals had intermediate scores. Scores on Weschler adult intelligence scale (WAIS-R) were similar for methadone- and buprenorphine-maintained individuals whereas drug-free controls had significantly higher scores. In addition, both opiate-dependent groups performed more poorly than drug-free controls on the Benton visual retention test (BVRT). The results suggest that buprenorphine in contrast to methadone improves decision-making, and thus may be more effective in rehabilitation programs of opiate-dependent subjects and this improvement may be related to its distinct pharmacological action as a k antagonist.

  10. Treatment of Methamphetamine Dependence with Electroconvulsive Therapy (ECT in Iran: A Critical Note.

    Directory of Open Access Journals (Sweden)

    Babak Roshanaei-Moghaddam

    2014-09-01

    Full Text Available This comment article reviews the literature to explore whether the use of ECT for the treatment of methamphetamine dependence can be justified by scientific rationale and/or evidence.This article reviews the literature on the use of ECT in addictive disorders. It describes a patient with methamphetamine dependence treated with ECT. It then offers a historical review of the moral and ethical difficulties encountered in the treatment of addictive disorders. It proposes a dynamic understanding as to why clinicians might deploy such brutal actions in the face of hopeless and emotionally intense encounters.We found no scientific evidence or justification for ECT as a treatment of methamphetamine dependence or as the first line treatment for methamphetamine-induced psychiatric comorbidities.the current available evidence does not support using ECT for the treatment of addictive disorders, and hence is unethical, unacceptable and inhumane and warrants immediate social and political attention.

  11. Effect of computerized cognitive behavioral therapy on acquisition of coping skills among cocaine-dependent individuals enrolled in methadone maintenance.

    Science.gov (United States)

    Kiluk, Brian D; DeVito, Elise E; Buck, Matthew B; Hunkele, Karen; Nich, Charla; Carroll, Kathleen M

    2017-11-01

    The acquisition of coping skills has long been considered one of the putative mechanisms of cognitive behavioral therapy (CBT) for substance use disorders, yet consistent statistical support is lacking. This study sought to replicate and extend prior findings regarding the quality of coping skills as a mediator of abstinence outcomes from a computerized CBT program for substance users. Participants were methadone-maintained, cocaine dependent individuals enrolled in a clinical trial evaluating the efficacy of computer-based training for CBT ('CBT4CBT') as an add-on to treatment as usual (TAU+CBT4CBT) compared to TAU only. A subsample (N=71) completed a role play assessment to measure coping skills, the Drug Risk Response Test (DRRT), which was administered before, during (week 4), and after the 8-week treatment period. Participants' verbal responses to various high-risk situations for cocaine use were recorded and independent evaluators rated the quality of the coping responses. Results of repeated measures analyses revealed a main effect of time for the quality of overall responses [F(1, 141.26)=4.29, pcoping skills across groups, yet no differential effect of treatment. Despite the significant association between coping responses and abstinence outcomes, analyses did not support the quality of coping skills as a mediator of treatment effects. However, among the high-risk situations wherein individuals provided lower quality responses at baseline, those assigned to TAU+CBT4CBT showed greater improvement compared to those assigned to TAU only [F(1, 697.65)=6.47, p=0.01]. This study failed to replicate the quality of coping skills as a mediator of CBT4CBT's effect on reducing drug use previously shown in a mixed outpatient substance use sample. However, in this methadone maintained sample, those with poorer quality skills in response to certain high-risk situations at baseline appeared to improve their coping strategies following CBT4CBT compared to standard

  12. Development of the music therapy assessment Tool for advanced Huntington’s disease: A pilot validation study

    DEFF Research Database (Denmark)

    O'Kelly, Julian; Bodak, Rebeka

    2016-01-01

    Background: Case studies of people with Huntington's disease (HD) report that music therapy provides a range of benefits that may improve quality of life; however, no robust music therapy assessment tools exist for this population. Objective: Develop and conduct preliminary psychometric testing o...... patient responses to music therapy interventions across psychological, physical, social, and communication domains of functioning in patients with advanced HD.......Background: Case studies of people with Huntington's disease (HD) report that music therapy provides a range of benefits that may improve quality of life; however, no robust music therapy assessment tools exist for this population. Objective: Develop and conduct preliminary psychometric testing...... of a music therapy assessment tool for patients with advanced HD. Methods: First, we established content and face validity of the Music Therapy Assessment Tool for Advanced HD (MATA-HD) through focus groups and field testing. Second, we examined psychometric properties of the resulting MATA-HD in terms...

  13. CT in the assessment of early response to neoadjuvant therapy of colon

    DEFF Research Database (Denmark)

    Rafaelsen, Søren Rafael; Dam, Claus; Lund-Rasmussen, Vera

    Purpose: Neoadjuvant drug therapy is presumed to improve outcome in colon cancer. Using multi-detector computed tomography (MDCT) we aimed to assess the early response of neoadjuvant drug therapy for locally advanced colon cancer. Material and Methods: MDCT with i.v. contrast were acquired from...... consecutive 67 patients before and after preoperative drug therapy. All patients had at baseline histologically confirmed colon cancer with ctT4 or ctT3 tumour with extramural invasion ≥5mm and without distant metastases or peritoneal nodules. The tumour diameter in 2 different planes, extension of extramural...... disease. Conclusion: Using MDCT we demonstrate a significant reduction in tumour size, extramural tumour invasion, number and size of enlarged lymph nodes following neoadjuvant therapy for colon cancer. Using the RESIST criteria 45% had a response....

  14. The use of occupation-based assessments and intervention in the hand therapy setting - A survey.

    Science.gov (United States)

    Grice, Kimatha Oxford

    2015-01-01

    Descriptive survey. This study specifically explored the use of occupation-based assessments and intervention in the hand therapy setting, but also more generally, current practice trends about all assessments being utilized in this setting, frequency of their use, and therapists' perceptions about them. An online survey was distributed via email to members of the American Society of Hand Therapists (ASHT). The survey consisted of ten questions and was administered via Survey Monkey. Responses were received from 22% of those surveyed. A descriptive analysis was completed of the results and indicated that over half use occupation-based assessments on a daily basis; most are related to ADL function and used for the development of goals. The primary reason for not utilizing occupation-based assessments is time limitation. Seventy-nine percent believe these measures are important for the services provided in the hand therapy setting. Occupation-based assessments and intervention are not utilized as much as therapists would like in the hand therapy setting, primarily due to time constraints. While not formally assessed, the majority of those who responded indicated that they do address occupation in their assessments and interventions. Not applicable. Copyright © 2015 Hanley & Belfus. Published by Elsevier Inc. All rights reserved.

  15. Assessing the quality of study reports on spa therapy based on randomized controlled trials by the spa therapy checklist (SPAC).

    Science.gov (United States)

    Kamioka, Hiroharu; Tsutani, Kiichiro; Maeda, Masaharu; Hayasaka, Shinya; Okuizum, Hiroyasu; Goto, Yasuaki; Okada, Shinpei; Kitayuguchi, Jun; Abe, Takafumi

    2014-11-01

    The purpose of this study was to assess the quality of study reports on spa therapy based on randomized controlled trials by the spa therapy and balneotherapy checklist (SPAC), and to show the relationship between SPAC score and the characteristics of publication. We searched the following databases from 1990 up to September 30, 2013: MEDLINE via PubMed, CINAHL, Web of Science, Ichushi Web, Global Health Library, the Western Pacific Region Index Medicus, PsycINFO, and the Cochrane Database of Systematic Reviews. We used the SPAC to assess the quality of reports on spa therapy and balneotherapy trials (SPAC) that was developed using the Delphi consensus method. Fifty-one studies met all inclusion criteria. Forty studies (78%) were about "Diseases of the musculoskeletal system and connective)". The total SPAC score (full-mark; 19 pts) was 10.8 ± 2.3 pts (mean ± SD). The items for which a description was lacking (very poor; spa facility where the data were collected"; "pH"; "scale of bathtub"; "presence of other facility and exposure than bathing (sauna, steam bath, etc.)"; "qualification and experience of care provider"; "Instructions about daily life" and "adherence". We clarified that there was no relationship between the publish period, languages, and the impact factor (IF) for the SPAC score. In order to prevent flawed description, SPAC could provide indispensable information for researchers who are going to design a research protocol according to each disease. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Optimal neurocognitive, personality and behavioral measures for assessing impulsivity in cocaine dependence.

    Science.gov (United States)

    LoBue, Christian; Cullum, C Munro; Braud, Jacqueline; Walker, Robrina; Winhusen, Theresa; Suderajan, Prabha; Adinoff, Bryon

    2014-11-01

    Impulsivity may underlie the poor treatment retention and high relapse rates observed in cocaine-dependent persons. However, observed differences in measures of impulsivity between cocaine-dependent and healthy control participants often do not reach clinical significance, suggesting that the clinical relevance of these differences may be limited. To examine which measures of impulsivity (i.e. self-report impulsivity, self-report personality, neurocognitive testing) best distinguish cocaine-dependent and healthy control participants (i.e. showing differences at least 1.5 standard deviations [SD] from controls). Optimal measures were considered to demonstrate sufficient classification accuracy. Sixty-five recently abstinent cocaine-dependent and 25 healthy control participants were assessed using select neurocognitive tests and self-report questionnaires including the NEO Personality Inventory-Revised (NEO-PI-R), Temperament and Character Inventory (TCI), Barratt Impulsiveness Scale (BIS-11a), and the Frontal Systems Behavior Scale (FrSBe). When corrected for years of education and gender, neurocognitive measures did not demonstrate clinically significant differences between cocaine-dependent and control participants. The personality measures TCI Purposefulness and Congruent Second Nature and NEO-PI-R Impulsiveness, and the self-rating measures FrSBe Disinhibition and BIS-11 Motor Impulsivity and Total successfully identified clinically meaningful elevations in impulsivity within cocaine-dependent participants (>1.5 SDs from controls). Furthermore, these measures achieved 84-93% accuracy in discriminating cocaine-dependent from control participants. Clinically significant neurocognitive impairment in cocaine-dependent participants was not observed in this sample. As the BIS-11 or FrSBe are brief to administer, accurate, and have been shown to predict treatment retention and relapse, these measures appear to be optimal, relative to the personality measures, for

  17. Optimal neurocognitive, personality and behavioral measures for assessing impulsivity in cocaine dependence

    Science.gov (United States)

    LoBue, Christian; Cullum, C. Munro; Braud, Jacqueline; Walker, Robrina; Winhusen, Theresa; Suderajan, Prabha; Adinoff, Bryon

    2015-01-01

    Background Impulsivity may underlie the poor treatment retention and high relapse rates observed in cocaine-dependent persons. However, observed differences in measures of impulsivity between cocaine-dependent and healthy control participants often do not reach clinical significance, suggesting that the clinical relevance of these differences may be limited. Objectives To examine which measures of impulsivity (i.e. self-report impulsivity, self-report personality, neurocognitive testing) best distinguish cocaine-dependent and healthy control participants (i.e. showing differences at least 1.5 standard deviations [SD] from controls). Optimal measures were considered to demonstrate sufficient classification accuracy. Methods Sixty-five recently abstinent cocaine-dependent and 25 healthy control participants were assessed using select neurocognitive tests and self-report questionnaires including the NEO Personality Inventory-Revised (NEO-PI-R), Temperament and Character Inventory (TCI), Barratt Impulsiveness Scale (BIS-11a), and the Frontal Systems Behavior Scale (FrSBe). Results When corrected for years of education and gender, neurocognitive measures did not demonstrate clinically significant differences between cocaine-dependent and control participants. The personality measures TCI Purposefulness and Congruent Second Nature and NEO-PI-R Impulsiveness, and the self-rating measures FrSBe Disinhibition and BIS-11 Motor Impulsivity and Total successfully identified clinically meaningful elevations in impulsivity within cocaine-dependent participants (>1.5 SDs from controls). Furthermore, these measures achieved 84–93% accuracy in discriminating cocaine-dependent from control participants. Conclusion Clinically significant neurocognitive impairment in cocaine-dependent participants was not observed in this sample. As the BIS-11 or FrSBe are brief to administer, accurate, and have been shown to predict treatment retention and relapse, these measures appear to be

  18. Communicative-Pragmatic Assessment Is Sensitive and Time-Effective in Measuring the Outcome of Aphasia Therapy

    Science.gov (United States)

    Stahl, Benjamin; Mohr, Bettina; Dreyer, Felix R.; Lucchese, Guglielmo; Pulvermüller, Friedemann

    2017-01-01

    A range of methods in clinical research aim to assess treatment-induced progress in aphasia therapy. Here, we used a crossover randomized controlled design to compare the suitability of utterance-centered and dialogue-sensitive outcome measures in speech-language testing. Fourteen individuals with post-stroke chronic non-fluent aphasia each received two types of intensive training in counterbalanced order: conventional confrontation naming, and communicative-pragmatic speech-language therapy (Intensive Language-Action Therapy, an expanded version of Constraint-Induced Aphasia Therapy). Motivated by linguistic-pragmatic theory and neuroscience data, our dependent variables included a newly created diagnostic instrument, the Action Communication Test (ACT). This diagnostic instrument requires patients to produce target words in two conditions: (i) utterance-centered object naming, and (ii) communicative-pragmatic social interaction based on verbal requests. In addition, we administered a standardized aphasia test battery, the Aachen Aphasia Test (AAT). Composite scores on the ACT and the AAT revealed similar patterns of changes in language performance over time, irrespective of the treatment applied. Changes in language performance were relatively consistent with the AAT results also when considering both ACT subscales separately from each other. However, only the ACT subscale evaluating verbal requests proved to be successful in distinguishing between different types of training in our patient sample. Critically, testing duration was substantially shorter for the entire ACT (10–20 min) than for the AAT (60–90 min). Taken together, the current findings suggest that communicative-pragmatic methods in speech-language testing provide a sensitive and time-effective measure to determine the outcome of aphasia therapy. PMID:28579951

  19. Communicative-Pragmatic Assessment Is Sensitive and Time-Effective in Measuring the Outcome of Aphasia Therapy

    Directory of Open Access Journals (Sweden)

    Benjamin Stahl

    2017-05-01

    Full Text Available A range of methods in clinical research aim to assess treatment-induced progress in aphasia therapy. Here, we used a crossover randomized controlled design to compare the suitability of utterance-centered and dialogue-sensitive outcome measures in speech-language testing. Fourteen individuals with post-stroke chronic non-fluent aphasia each received two types of intensive training in counterbalanced order: conventional confrontation naming, and communicative-pragmatic speech-language therapy (Intensive Language-Action Therapy, an expanded version of Constraint-Induced Aphasia Therapy. Motivated by linguistic-pragmatic theory and neuroscience data, our dependent variables included a newly created diagnostic instrument, the Action Communication Test (ACT. This diagnostic instrument requires patients to produce target words in two conditions: (i utterance-centered object naming, and (ii communicative-pragmatic social interaction based on verbal requests. In addition, we administered a standardized aphasia test battery, the Aachen Aphasia Test (AAT. Composite scores on the ACT and the AAT revealed similar patterns of changes in language performance over time, irrespective of the treatment applied. Changes in language performance were relatively consistent with the AAT results also when considering both ACT subscales separately from each other. However, only the ACT subscale evaluating verbal requests proved to be successful in distinguishing between different types of training in our patient sample. Critically, testing duration was substantially shorter for the entire ACT (10–20 min than for the AAT (60–90 min. Taken together, the current findings suggest that communicative-pragmatic methods in speech-language testing provide a sensitive and time-effective measure to determine the outcome of aphasia therapy.

  20. Communicative-Pragmatic Assessment Is Sensitive and Time-Effective in Measuring the Outcome of Aphasia Therapy.

    Science.gov (United States)

    Stahl, Benjamin; Mohr, Bettina; Dreyer, Felix R; Lucchese, Guglielmo; Pulvermüller, Friedemann

    2017-01-01

    A range of methods in clinical research aim to assess treatment-induced progress in aphasia therapy. Here, we used a crossover randomized controlled design to compare the suitability of utterance-centered and dialogue-sensitive outcome measures in speech-language testing. Fourteen individuals with post-stroke chronic non-fluent aphasia each received two types of intensive training in counterbalanced order: conventional confrontation naming, and communicative-pragmatic speech-language therapy (Intensive Language-Action Therapy, an expanded version of Constraint-Induced Aphasia Therapy). Motivated by linguistic-pragmatic theory and neuroscience data, our dependent variables included a newly created diagnostic instrument, the Action Communication Test (ACT). This diagnostic instrument requires patients to produce target words in two conditions: (i) utterance-centered object naming, and (ii) communicative-pragmatic social interaction based on verbal requests. In addition, we administered a standardized aphasia test battery, the Aachen Aphasia Test (AAT). Composite scores on the ACT and the AAT revealed similar patterns of changes in language performance over time, irrespective of the treatment applied. Changes in language performance were relatively consistent with the AAT results also when considering both ACT subscales separately from each other. However, only the ACT subscale evaluating verbal requests proved to be successful in distinguishing between different types of training in our patient sample. Critically, testing duration was substantially shorter for the entire ACT (10-20 min) than for the AAT (60-90 min). Taken together, the current findings suggest that communicative-pragmatic methods in speech-language testing provide a sensitive and time-effective measure to determine the outcome of aphasia therapy.

  1. The use of hormone therapy and its alternatives in women with a history of hormone dependent cancer.

    Science.gov (United States)

    Sekar, Hashviniya; Singhal, Tasneem; Holloway, Debra; Rymer, Janice

    2013-03-01

    Treating the effects of menopause in women with history of oestrogen-dependent cancers presents a clinical dilemma. Endocrine adjuvant agents like tamoxifen and other cancer treatments, often induce premature menopause. Vasomotor, psychological and somatic symptoms may be more severe in these women. The risk of hormone therapy (HT) and its efficacy must be balanced. Currently, there are no consensus guidelines for the management of these patients. This is a retrospective study carried out between 10/01/2011 and 27/01/2012 in a tertiary referral menopausal clinic. Data was collected about cancer type and treatment, symptoms, prior use of T, bone density analyses and menopause treatments. 590 patient records were scanned and 146 patients (24.7%) had a history of cancer. Of these, 45.9% were younger than 50 years old. 67.1% comprised breast cancer patients, of which 69.4% were on adjuvant endocrine agents. 24.7% consisted of gynaecological cancer patients who were predominantly treated with surgery in conjunction with adjuvant therapies. 90.4% of the women had at least one menopause-related symptom, vasomotor symptoms being most prevalent, followed by psychological and vaginal symptoms. Women used a variety of HT and non-HRT therapies for their symptoms. Of the 77 women who had a personal history of oestrogen receptor positive cancers, 19.5% chose to take HT in spite of it being contraindicated. Prescribing HT to women with a history of hormone dependent cancer remains controversial. Patient 'Quality of Life' must be considered. More research is required in this area. 2013 © The Author(s).

  2. YB-1 dependent virotherapy in combination with temozolomide as a multimodal therapy approach to eradicate malignant glioma.

    Science.gov (United States)

    Holzmüller, Regina; Mantwill, Klaus; Haczek, Cornelia; Rognoni, Emanuel; Anton, Martina; Kasajima, Atsuko; Weichert, Wilko; Treue, Denise; Lage, Hermann; Schuster, Tibor; Schlegel, Jürgen; Gänsbacher, Bernd; Holm, Per S

    2011-09-01

    The human Y-box binding protein 1 (YB-1) is known to be a promising target for cancer therapy. We have demonstrated that YB-1 plays an important role in the adenoviral life cycle by regulating the adenoviral E2-gene expression. Thus, we studied the oncolytic effect of the recombinant adenovirus Ad-Delo3-RGD, in which the transactivation domain CR3 of the E1A protein is ablated to enable viral replication only in YB-1 positive cancer cells. In vitro Southern Blot analysis and cytopathic effect assays demonstrate high anti-glioma potency, which was significantly increased in combination with temozolomide (TMZ), daunorubicin and cisplatin. Since vascular endothelial growth factor (VEGF) is thought to promote the hypervascular phenotype of primary, malignant brain tumors, we also tested Ad-Delo3-RGD in regard to the inhibition of VEGF expression. Indeed, we found that Ad-Delo3-RGD induced VEGF down regulation, which was even amplified under hypoxic conditions. Tumor-bearing nudemice treated with the YB-1 dependent oncolytic adenovirus showed significantly smaller tumors than untreated controls. Furthermore, combination therapy with TMZ led to a regression in all treated animals with complete tumor regression in 33 % of analyzed mice, which was verified by bioluminescence imaging and histological studies. In addition, histopathological evaluation revealed enhanced apoptosis and a reduction in tumor vessel formation, indicating that Ad-Delo3-RGD has an anti-angiogenic effect in addition to its oncolytic capacity in vivo. Hence, our results demonstrate that the combination therapy of YB-1 dependent virotherapy and TMZ is effective in a xenograft glioma mouse model and might be useful in a YB-1 based clinical setting. Copyright © 2010 UICC.

  3. Addressing dependability by applying an approach for model-based risk assessment

    Energy Technology Data Exchange (ETDEWEB)

    Gran, Bjorn Axel [Institutt for energiteknikk, OECD Halden Reactor Project, NO-1751 Halden (Norway)]. E-mail: bjorn.axel.gran@hrp.no; Fredriksen, Rune [Institutt for energiteknikk, OECD Halden Reactor Project, NO-1751 Halden (Norway)]. E-mail: rune.fredriksen@hrp.no; Thunem, Atoosa P.-J. [Institutt for energiteknikk, OECD Halden Reactor Project, NO-1751 Halden (Norway)]. E-mail: atoosa.p-j.thunem@hrp.no

    2007-11-15

    This paper describes how an approach for model-based risk assessment (MBRA) can be applied for addressing different dependability factors in a critical application. Dependability factors, such as availability, reliability, safety and security, are important when assessing the dependability degree of total systems involving digital instrumentation and control (I and C) sub-systems. In order to identify risk sources their roles with regard to intentional system aspects such as system functions, component behaviours and intercommunications must be clarified. Traditional risk assessment is based on fault or risk models of the system. In contrast to this, MBRA utilizes success-oriented models describing all intended system aspects, including functional, operational and organizational aspects of the target. The EU-funded CORAS project developed a tool-supported methodology for the application of MBRA in security-critical systems. The methodology has been tried out within the telemedicine and e-commerce areas, and provided through a series of seven trials a sound basis for risk assessments. In this paper the results from the CORAS project are presented, and it is discussed how the approach for applying MBRA meets the needs of a risk-informed Man-Technology-Organization (MTO) model, and how methodology can be applied as a part of a trust case development.

  4. Multigroup Ethnic Identity Measure with Art Therapy Students: Assessing Preservice Students after One Multicultural Self-Reflection Course.

    Science.gov (United States)

    Cherry, Laura A.

    2002-01-01

    Graduate art therapy students enrolled in a multicultural art therapy course were given the Multigroup Ethnic Identity Measure as a pretest and posttest to assess their own cultural identity. Results indicate that stronger cultural identification is possible following the completion of one multicultural art therapy course. (Contains 25 references…

  5. In vitro assessment of the efficacy of thermal therapy in human benign prostatic hyperplasia

    NARCIS (Netherlands)

    Bhowmick, P.; Coad, J. E.; Bhowmick, S.; Pryor, J. L.; Larson, T.; de la Rosette, J.; Bischof, J. C.

    2004-01-01

    The successful management of BPH with minimally invasive thermal therapies requires a firm understanding of the temperature-time relationship for tissue destruction. In order to accomplish this objective, the present in vitro study assesses the cellular viability of human BPH tissue subjected to an

  6. Clinical Practice Guideline for Physical Therapy Assessment and Treatment in Patients With Nonspecific Neck Pain

    NARCIS (Netherlands)

    Bier, Jasper D; Scholten-Peeters, Wendy G M; Staal, J Bart; Pool, Jan; van Tulder, Maurits W; Beekman, Emmylou; Knoop, Jesper; Meerhoff, Guus; Verhagen, Arianne P

    2017-01-01

    The Royal Dutch Society for Physical Therapy (KNGF) issued a clinical practice guideline for physical therapists that addresses the assessment and treatment of patients with nonspecific neck pain, including cervical radiculopathy, in Dutch primary care. Recommendations were based on a review of

  7. Design guidelines for an umbilical cord blood stem cell therapy quality assessment model

    Science.gov (United States)

    Januszewski, Witold S.; Michałek, Krzysztof; Yagensky, Oleksandr; Wardzińska, Marta

    The paper enlists the pivotal guidelines for producing an empirical umbilical cord blood stem cell therapy quality assessment model. The methodology adapted was single equation linear model with domain knowledge derived from MEDAFAR classification. The resulting model is ready for therapeutical application.

  8. [The theory of dependent-care--a conceptual framework for assessing, supporting, and promoting parental competencies].

    Science.gov (United States)

    Holoch, Elisabeth

    2010-02-01

    Parental competencies have influence on the professional health care needs of a child and its caregivers. One reason for this is the influence of parental competencies on the healthy development of the child. This applies especially to infants and young children. In order to develop their inborn abilities to regulate themselves and their behaviour, infants and young children are dependent on the perception of and appropriate response to their behaviour by the persons they are most closely attached to. The differentiation of self-regulating abilities is a precondition for a healthy development. The current rise of sleeping and feeding disorders, as well as interaction problems among infants and young children, indicates that parents are increasingly dependent on support in the perception and development of their parental competencies. Paediatric nurses can make an important contribution to this, where a concept of parental competencies, defined by nursing professionals, is available. The Theory of Dependent-Care and especially the concept of Dependent-Care Agency will be presented in this paper. It will be examined how they can provide a theoretical framework for the systematic assessment, support, and promotion of parental competencies by paediatric nurses. To conclude, issues for further investigation of parental Dependent-Care Agency and the necessity for a more detailed conceptualisation of the Theory of Dependent-Care will be demonstrated.

  9. HElmet therapy Assessment in infants with Deformed Skulls (HEADS: protocol for a randomised controlled trial

    Directory of Open Access Journals (Sweden)

    van Wijk Renske M

    2012-07-01

    Full Text Available Abstract Background In The Netherlands, helmet therapy is a commonly used treatment in infants with skull deformation (deformational plagiocephaly or deformational brachycephaly. However, evidence of the effectiveness of this treatment remains lacking. The HEADS study (HElmet therapy Assessment in Deformed Skulls aims to determine the effects and costs of helmet therapy compared to no helmet therapy in infants with moderate to severe skull deformation. Methods/design Pragmatic randomised controlled trial (RCT nested in a cohort study. The cohort study included infants with a positional preference and/or skull deformation at two to four months (first assessment. At 5 months of age, all children were assessed again and infants meeting the criteria for helmet therapy were asked to participate in the RCT. Participants were randomly allocated to either helmet therapy or no helmet therapy. Parents of eligible infants that do not agree with enrolment in the RCT were invited to stay enrolled for follow up in a non-randomisedrandomised controlled trial (nRCT; they were then free to make the decision to start helmet therapy or not. Follow-up assessments took place at 8, 12 and 24 months of age. The main outcome will be head shape at 24 months that is measured using plagiocephalometry. Secondary outcomes will be satisfaction of parents and professionals with the appearance of the child, parental concerns about the future, anxiety level and satisfaction with the treatment, motor development and quality of life of the infant. Finally, compliance and costs will also be determined. Discussion HEADS will be the first study presenting data from an RCT on the effectiveness of helmet therapy. Outcomes will be important for affected children and their parents, health care professionals and future treatment policies. Our findings are likely to influence the reimbursement policies of health insurance companies. Besides these health outcomes, we will be able to

  10. Dynamic assessment of RBC-transfusion dependency improves the prognostic value of the revised-IPSS in MDS patients.

    Science.gov (United States)

    Hiwase, Devendra K; Singhal, Deepak; Strupp, Corinna; Chhetri, Rakchha; Kutyna, Monika M; Wee, L Amilia; Harrison, Peter B; Nath, Shriram V; Wickham, Nicholas; Hui, Chi-Hung; Gray, James X; Bardy, Peter; Ross, David M; Lewis, Ian D; Reynolds, John; To, L Bik; Germing, Ulrich

    2017-06-01

    RBC-transfusion dependency (RBC-TD) is an independent prognostic factor for poor overall survival (OS) in the WHO classification-based prognostic scoring system (WPSS) for MDS patients. However, WPSS did not include cytopenia, whereas revised International Prognostic Scoring System (IPSS-R) did not include RBC-TD. Thus, neither of these prognostic scoring systems incorporates both cytopenia and RBC-TD. We aimed to test whether RBC-TD adds prognostic value to the IPSS-R. We analyzed MDS patients not treated with disease-modifying therapy, and enrolled in SA-MDS Registry (derivation cohort; n = 295) and Dusseldorf registry (Germany; validation cohort; n = 113) using time-dependent Cox proportional regression and serial landmark analyses. In the derivation cohort, RBC-TD patients had inferior OS compared to RBC transfusion-independent (RBC-TI) patients (P MDS is associated with poor OS, independent of IPSS-R. This study demonstrates that dynamic assessment of RBC-TD provides additional prognostic value to IPSS-R and should be included in treatment decision algorithms for MDS patients. © 2017 Wiley Periodicals, Inc.

  11. Colon-targeted delivery of budesonide using dual pH- and time-dependent polymeric nanoparticles for colitis therapy

    Directory of Open Access Journals (Sweden)

    Naeem M

    2015-07-01

    Full Text Available Muhammad Naeem,1 Moonjeong Choi,1 Jiafu Cao,1 Yujeong Lee,1 Muhammad Ikram,2 Sik Yoon,2 Jaewon Lee,1 Hyung Ryong Moon,1 Min-Soo Kim,1 Yunjin Jung,1 Jin-Wook Yoo11College of Pharmacy, Pusan National University, Busan, 2Pusan National University School of Medicine, Yangsan, South KoreaAbstract: Single pH-dependent drug delivery systems have been widely used for colon-targeted delivery, but their efficiency is often hampered by the variation in gut pH. To overcome the limitation of single pH-dependent delivery systems, in this study, we developed and evaluated the therapeutic potential of budesonide-loaded dual pH/time-dependent nanoparticles (NPs for the treatment of colitis. Eudragit FS30D was used as a pH-dependent polymer, and Eudragit RS100 as a time-dependent controlled release polymer. Single pH-dependent NPs (pH_NPs, single time-dependent NPs (Time_NPs, and dual pH/time-dependent NPs (pH/Time_NPs were prepared using the oil-in-water emulsion method. The physicochemical properties and drug release profiles of these NPs in gastrointestinal (GI tract conditions were investigated. The therapeutic potential and in vivo distribution of the NPs were evaluated in a dextran sulfate sodium (DSS-induced colitis mice model. The pH/Time_NPs prevented a burst drug release in acidic pH conditions and showed sustained release at a colonic pH. The in vivo distribution study in the mice GI tract demonstrated that pH/Time_NPs were more efficiently delivered to the inflamed colon than pH_NPs were. Compared to the single pH_NPs-treated group, the pH/Time_NPs-treated group showed increased body weight and colon length and markedly decreased disease activity index, colon weight/length ratios, histological damage, and inflammatory cell infiltration in colon tissue. Our results demonstrate that the dual pH/time-dependent NPs are an effective oral colon-targeted delivery system for colitis therapy.Keywords: colon-specific delivery, dual-sensitive delivery

  12. Efficacy of melody-based aphasia therapy may strongly depend on rhythm and conversational speech formulas

    Directory of Open Access Journals (Sweden)

    Benjamin Stahl

    2014-04-01

    Full Text Available Left-hemisphere stroke patients suffering from language and speech disorders are often able to sing entire pieces of text fluently. This finding has inspired a number of melody-based rehabilitation programs – most notable among them a treatment known as Melodic Intonation Therapy – as well as two fundamental research questions. When the experimental design focuses on one point in time (cross section, one may determine whether or not singing has an immediate effect on syllable production in patients with language and speech disorders. When the design focuses on changes over several points in time (longitudinal section, one may gain insight as to whether or not singing has a long-term effect on language and speech recovery. The current work addresses both of these questions with two separate experiments that investigate the interplay of melody, rhythm and lyric type in 32 patients with non-fluent aphasia and apraxia of speech (Stahl et al., 2011; Stahl et al., 2013. Taken together, the experiments deliver three main results. First, singing and rhythmic pacing proved to be equally effective in facilitating immediate syllable production and long-term language and speech recovery. Controlling for various influences such as prosody, syllable duration and phonetic complexity, the data did not reveal any advantage of singing over rhythmic speech. This result was independent of lesion size and lesion location in the patients. Second, patients with extensive left-sided basal ganglia lesions produced more correct syllables when their speech was paced by rhythmic drumbeats. This observation is consistent with the idea that regular auditory cues may partially compensate for corticostriatal damage and thereby improve speech-motor planning (Grahn & Watson, 2013. Third, conversational speech formulas and well-known song lyrics yielded higher rates of correct syllable production than novel word sequences – whether patients were singing or speaking

  13. Going beyond the Millennium Ecosystem Assessment: an index system of human dependence on ecosystem services.

    Science.gov (United States)

    Yang, Wu; Dietz, Thomas; Liu, Wei; Luo, Junyan; Liu, Jianguo

    2013-01-01

    The Millennium Ecosystem Assessment (MA) estimated that two thirds of ecosystem services on the earth have degraded or are in decline due to the unprecedented scale of human activities during recent decades. These changes will have tremendous consequences for human well-being, and offer both risks and opportunities for a wide range of stakeholders. Yet these risks and opportunities have not been well managed due in part to the lack of quantitative understanding of human dependence on ecosystem services. Here, we propose an index of dependence on ecosystem services (IDES) system to quantify human dependence on ecosystem services. We demonstrate the construction of the IDES system using household survey data. We show that the overall index and sub-indices can reflect the general pattern of households' dependences on ecosystem services, and their variations across time, space, and different forms of capital (i.e., natural, human, financial, manufactured, and social capitals). We support the proposition that the poor are more dependent on ecosystem services and further generalize this proposition by arguing that those disadvantaged groups who possess low levels of any form of capital except for natural capital are more dependent on ecosystem services than those with greater control of capital. The higher value of the overall IDES or sub-index represents the higher dependence on the corresponding ecosystem services, and thus the higher vulnerability to the degradation or decline of corresponding ecosystem services. The IDES system improves our understanding of human dependence on ecosystem services. It also provides insights into strategies for alleviating poverty, for targeting priority groups of conservation programs, and for managing risks and opportunities due to changes of ecosystem services at multiple scales.

  14. Going beyond the Millennium Ecosystem Assessment: an index system of human dependence on ecosystem services.

    Directory of Open Access Journals (Sweden)

    Wu Yang

    Full Text Available The Millennium Ecosystem Assessment (MA estimated that two thirds of ecosystem services on the earth have degraded or are in decline due to the unprecedented scale of human activities during recent decades. These changes will have tremendous consequences for human well-being, and offer both risks and opportunities for a wide range of stakeholders. Yet these risks and opportunities have not been well managed due in part to the lack of quantitative understanding of human dependence on ecosystem services. Here, we propose an index of dependence on ecosystem services (IDES system to quantify human dependence on ecosystem services. We demonstrate the construction of the IDES system using household survey data. We show that the overall index and sub-indices can reflect the general pattern of households' dependences on ecosystem services, and their variations across time, space, and different forms of capital (i.e., natural, human, financial, manufactured, and social capitals. We support the proposition that the poor are more dependent on ecosystem services and further generalize this proposition by arguing that those disadvantaged groups who possess low levels of any form of capital except for natural capital are more dependent on ecosystem services than those with greater control of capital. The higher value of the overall IDES or sub-index represents the higher dependence on the corresponding ecosystem services, and thus the higher vulnerability to the degradation or decline of corresponding ecosystem services. The IDES system improves our understanding of human dependence on ecosystem services. It also provides insights into strategies for alleviating poverty, for targeting priority groups of conservation programs, and for managing risks and opportunities due to changes of ecosystem services at multiple scales.

  15. The Music Therapy Session Assessment Scale (MT-SAS): Validation of a new tool for music therapy process evaluation.

    Science.gov (United States)

    Raglio, Alfredo; Gnesi, Marco; Monti, Maria Cristina; Oasi, Osmano; Gianotti, Marta; Attardo, Lapo; Gontero, Giulia; Morotti, Lara; Boffelli, Sara; Imbriani, Chiara; Montomoli, Cristina; Imbriani, Marcello

    2017-11-01

    Music therapy (MT) interventions are aimed at creating and developing a relationship between patient and therapist. However, there is a lack of validated observational instruments to consistently evaluate the MT process. The purpose of this study was the validation of Music Therapy Session Assessment Scale (MT-SAS), designed to assess the relationship between therapist and patient during active MT sessions. Videotapes of a single 30-min session per patient were considered. A pilot study on the videotapes of 10 patients was carried out to help refine the items, define the scoring system and improve inter-rater reliability among the five raters. Then, a validation study on 100 patients with different clinical conditions was carried out. The Italian MT-SAS was used throughout the process, although we also provide an English translation. The final scale consisted of 7 binary items accounting for eye contact, countenance, and nonverbal and sound-music communication. In the pilot study, raters were found to share an acceptable level of agreement in their assessments. Explorative factorial analysis disclosed a single homogeneous factor including 6 items (thus supporting an ordinal total score), with only the item about eye contact being unrelated to the others. Moreover, the existence of 2 different archetypal profiles of attuned and disattuned behaviours was highlighted through multiple correspondence analysis. As suggested by the consistent results of 2 different analyses, MT-SAS is a reliable tool that globally evaluates sonorous-musical and nonverbal behaviours related to emotional attunement and empathetic relationship between patient and therapist during active MT sessions. Copyright © 2017 John Wiley & Sons, Ltd.

  16. Subjective evaluation of running footwear depends on country and assessment method: a bi-national study.

    Science.gov (United States)

    Kong, Pui W; Lim, Chen Y; Ding, Rui; Sterzing, Thorsten

    2015-01-01

    This study examined (1) the perception of running shoes between China (Beijing) and Singapore and (2) whether running shoe preference depended on assessment methods. One hundred (n = 50 each country) Chinese males subjectively evaluated four shoe models during running by using two assessment procedures. Procedure 1 used a visual analogue scale (VAS) to assess five perception variables. Procedure 2 was a 'head-to-head' comparison of two shoes simultaneously (e.g. left foot: A and right foot: B) to decide which model was preferred. VAS scores were consistently higher in Beijing participants (p shoe discrimination. Moderate agreement was seen between the VAS and 'head-to-head' procedures, with only 14 out of 100 participants matched all 6 pairwise comparisons (median = 4 matches). Footwear companies and researchers should be aware that subjective shoe preference may vary with assessment methods. Practitioner Summary: Footwear preference depends on country and assessment methods. Running shoe perception differed between Beijing and Singapore Chinese, suggesting that footwear recommendation should be country-specific. Individuals' shoe preference measured by visual analogue scale when wearing complete pairs may not reflect that when directly comparing different models in left and right feet.

  17. Assessment of Photodynamic Therapy (PDT) in Disinfection of Deeper Dentinal Tubules in a Root Canal System: An In Vitro Study.

    Science.gov (United States)

    Bumb, Swapnil Sunil; Bhaskar, Dara John; Agali, Chandan R; Punia, Himanshu; Gupta, Vipul; Singh, Vikas; Kadtane, Safalya; Chandra, Sneha

    2014-11-01

    The success of endodontic treatment therapy depends on how well we eliminate pathogenic microflora from the root canal system as micro organism as the major cause of root canal infection. Conventional root canal treatment can fail if microorganisms cannot be removed sufficiently by thorough cleaning, shaping of root canal. Newer modalities such as photodynamic therapy are being tried now a days for disinfection of root canals. Aim & Objectives: The basic aim of this study was assessment of the antimicrobial efficacy of Photodynamic Therapy in deeper dentinal tubules for effective disinfection of root canals using microbiological and scanning electron microscopic examination in vitro. The study was conducted at Teerthanker Mahaveer Dental College & Research Centre. The teeth required for study was collected from Department of Oral and Maxillofacial Surgery. Only freshly extracted 20 intact, non carious single rooted teeth which were indicated for orthodontic treatment were taken for this study. Statistical analysis was done using Student's Unpaired t-test were at (pPDT group as compared to control group. The results of the present study indicate that PDT can be effectively used during antimicrobial procedures along with conventional disinfection procedure for sterilization of root canals.

  18. Diagnostic accuracy of the MMPI-2 to assess imbalances emphasising in people with substance dependence

    Directory of Open Access Journals (Sweden)

    Pablo González-Romero

    2017-07-01

    Full Text Available The acceptance and respect of the rules governing society and the family unit are essential pillars for the development of a therapeutic program for people with substance dependence disorders. This study proposes a double objective using the scales of the MMPI-2 detectors of mismatches emphasising: what information can provide and what the diagnostic accuracy of the MMPI-2 is to assess these mismatches. As a reference, psychopathic deviation (Pd, social introversion (Si, antisocial practices (ASP, social responsibility (Re, social unrest (SOD, introversion/low positive emotion (PSY-INTR, family problems (FAM, and conjugal stress (MDS were taken. Of the 226 participants, 113 are people with substance dependence and 113 have no dependence or any pathology. Their differences and diagnostic accuracy through the ROC curve were analysed. The results showed different contribution and diagnostic accuracy of the scales.

  19. [Why does nutrition therapy so often fail in non-insulin-dependent diabetes? What measures bring success?].

    Science.gov (United States)

    Keller, U

    1995-08-01

    It is a common belief among physicians that nutritional therapy in type II diabetic subjects is inefficient because the patients do not comply with the recommendations. Failure of a therapeutic response leads to feelings of guilt in patients, followed by frustration, and refusal of further treatment. The physician rapidly starts with drug or insulin therapy before the effects of diet treatment are assessable. Nutritional recommendations for diabetics are basically the same as for non-diabetics. Successful dietary treatment of obese type II diabetic subjects requires realistic goals regarding weight loss. Frequent mistakes are that an ideal body weight is aimed for, and that the patients are asked to omit only carbohydrates in the diet. Splitting of the meals, and distribution of carbohydrate-containing foods to individual meals during the day are important components of a meal plan. The patient should also be counciled how to avoid visible and invisible dietary fats. Exchange lists are frequently administered, but they fail, because they are too complicated. Only a part of decompensated type II diabetic subjects respond to weight loss. The response is evident already after a few [2.3 kg] weight loss. Other diabetic subjects fail to improve their glucose control after weight loss. These patients require an alternative treatment, i.e. oral antidiabetic agents or insulin. Frequently behavior therapy is of advantage in obese type II diabetic subjects, in addition to longterm dietary treatment. Dieticians should be involved in all difficult cases since they have the necessary experience to perform this longterm treatment.

  20. Size-dependent radiosensitization of PEG-coated gold nanoparticles for cancer radiation therapy

    CERN Document Server

    Zhang, Xiao-Dong; Shen, Xiu; Chen, Jie; Sun, Yuan-Ming; Liu, Pei-Xun; Liang, Xing-Jie

    2012-01-01

    Gold nanoparticles have been conceived as a radiosensitizer in cancer radiation therapy, but one of the important questions for primary drug screening is what size of gold nanoparticles can optimally enhance radiation effects. Herein, we perform in vitro and in vivo radiosensitization studies of 4.8, 12.1, 27.3, and 46.6 nm PEG-coated gold nanoparticles. In vitro results show that all sizes of the PEG-coated gold nanoparticles can cause a significant decrease in cancer cell survival after gamma radiation. 12.1 and 27.3 nm PEG-coated gold nanoparticles have dispersive distributions in the cells and have stronger sensitization effects than 4.8 and 46.6 nm particles by both cell apoptosis and necrosis. Further, in vivo results also show all sizes of the PEG-coated gold nanoparticles can decrease tumor volume and weight after 5 Gy radiations, and 12.1 and 27.3 nm PEG-coated gold nanoparticles have greater sensitization effects than 4.8 and 46.6 nm particles, which can lead to almost complete disappearance of the ...

  1. Efficacy Dependence of Photodynamic Therapy Mediated by Upconversion Nanoparticles: Subcellular Positioning and Irradiation Productivity.

    Science.gov (United States)

    Chen, Dexin; Tao, Ran; Tao, Ke; Chen, Biqiong; Choi, Seok Ki; Tian, Qing; Xu, Yawen; Zhou, Guangdong; Sun, Kang

    2017-04-01

    Singlet oxygen (1 O2 ), as an important kind of reactive oxygen species (ROS) and main therapeutic agent in photodynamic therapy (PDT), only have a half-life of 40 ns and an effective radius of 20 nm, which cause significant obstacles for improving PDT efficacy. In this work, novel upconversion nanoparticle (UCN)-based nanoplatforms are developed with a minimized distance between UCNs and a photosensitizer, protoporphyrin IX (PpIX), and a controllable payload of PpIX, to enhance and control ROS production. The ability of the nanoplatform to target different subcellular organelles such as cell membrane and mitochondria is demonstrated via surface modification of the nanoplatform with different targeting ligands. The results show that the mitochondria-targeting nanoplatforms result in significantly increased capability of both tumor cell killing and inhibition of tumor growth. Subcellular targeting of nanoparticles leads to the death of cancer cells in different manners. However, the efficiency of ROS generation almost have no influence on the tumor cell viability during the period of evaluation. These findings suggest that specific subcellular targeting of the nanoplatforms enhances the PDT efficacy more effectively than the increase of ROS production, and may shed light on future novel designs of effective and controllable PDT nanoplatforms. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  2. Singlet oxygen in antimicrobial photodynamic therapy: photosensitizer-dependent production and decay in E. coli.

    Science.gov (United States)

    Ragàs, Xavier; He, Xin; Agut, Montserrat; Roxo-Rosa, Mónica; Gonsalves, António Rocha; Serra, Arménio C; Nonell, Santi

    2013-02-28

    Several families of photosensitizers are currently being scrutinized for antimicrobial photodynamic therapy applications. Differences in physical and photochemical properties can lead to different localization patterns as well as differences in singlet oxygen production and decay when the photosensitizers are taken up by bacterial cells. We have examined the production and fate of singlet oxygen in Escherichia coli upon photosensitization with three structurally-different cationic photosensitizers, namely New Methylene Blue N (NMB), a member of the phenothiazine family, ACS268, a hydrophobic porphyrin with a single cationic alkyl chain, and zinc(II)-tetramethyltetrapyridinoporphyrazinium salt, a phthalocyanine-like photosensitizer with four positive charges on the macrocycle core. The kinetics of singlet oxygen production and decay indicate different localization for the three photosensitizers, whereby NMB appears to localize in an aqueous-like microenvironment, whereas ACS268 localizes in an oxygen-shielded site, highly reactive towards singlet oxygen. The tetracationic zinc(II) tetrapyridinoporphyrazine is extensively aggregated in the bacteria and fails to produce any detectable singlet oxygen.

  3. Singlet Oxygen in Antimicrobial Photodynamic Therapy: Photosensitizer-Dependent Production and Decay in E. coli

    Directory of Open Access Journals (Sweden)

    Arménio C. Serra

    2013-02-01

    Full Text Available Several families of photosensitizers are currently being scrutinized for antimicrobial photodynamic therapy applications. Differences in physical and photochemical properties can lead to different localization patterns as well as differences in singlet oxygen production and decay when the photosensitizers are taken up by bacterial cells. We have examined the production and fate of singlet oxygen in Escherichia coli upon photosensitization with three structurally-different cationic photosensitizers, namely New Methylene Blue N (NMB, a member of the phenothiazine family, ACS268, a hydrophobic porphyrin with a single cationic alkyl chain, and zinc(II-tetramethyltetrapyridinoporphyrazinium salt, a phthalocyanine-like photosensitizer with four positive charges on the macrocycle core. The kinetics of singlet oxygen production and decay indicate different localization for the three photosensitizers, whereby NMB appears to localize in an aqueous-like microenvironment, whereas ACS268 localizes in an oxygen-shielded site, highly reactive towards singlet oxygen. The tetracationic zinc(II tetrapyridinoporphyrazine is extensively aggregated in the bacteria and fails to produce any detectable singlet oxygen.

  4. Assessment of tumor response to radiation and vascular targeting therapy in mice using quantitative ultrasound spectroscopy

    Energy Technology Data Exchange (ETDEWEB)

    El Kaffas, Ahmed; Sadeghi-Naini, Ali; Falou, Omar; Tran, William Tyler; Czarnota, Gregory J., E-mail: gregory.czarnota@sunnybrook.ca [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5 (Canada); Imaging Research and Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5 (Canada); Departments of Medical Biophysics and Radiation Oncology, Faculty of Medicine, University of Toronto, Toronto, Ontario M5G 1L7 (Canada); Zhou, Stephanie; Fernandes, Jason; Giles, Anoja [Imaging Research and Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5 (Canada); Hashim, Amr [Department of Radiation Oncology, Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5, Canada and Imaging Research and Physical Sciences, Sunnybrook Health Sciences Centre, Toronto, Ontario M4N 3M5 (Canada)

    2015-08-15

    Purpose: It is now recognized that the tumor vasculature is in part responsible for regulating tumor responses to radiation therapy. However, the extent to which radiation-based vascular damage contributes to tumor cell death remains unknown. In this work, quantitative ultrasound spectroscopy (QUS) methods were used to investigate the acute responses of tumors to radiation-based vascular treatments. Methods: Tumor xenografts (MDA-MB-231) were treated with single radiation doses of 2 or 8 Gy alone, or in combination with pharmacological agents that modulate vascular radiosensitivity. The midband fit, the slope, and the 0-MHz intercept QUS parameters were obtained from a linear-regression fit to the averaged power spectrum of frequency-dependent ultrasound backscatter and were used to quantify acute tumor responses following treatment administration. Power spectrums were extracted from raw volumetric radio-frequency ultrasound data obtained before and 24 h following treatment administration. These parameters have previously been correlated to tumor cell death. Staining using in situ end labeling, carbonic anhydrase 9 and cluster of differentiation 31 of tumor sections were used to assess cell death, oxygenation, and vasculature distributions, respectively. Results: Results indicate a significant midband fit QUS parameter increases of 3.2 ± 0.3 dBr and 5.4 ± 0.5 dBr for tumors treated with 2 and 8 Gy radiation combined with the antiangiogenic agent Sunitinib, respectively. In contrast, tumors treated with radiation alone demonstrated a significant midband fit increase of 4.4 ± 0.3 dBr at 8 Gy only. Preadministration of basic fibroblast growth factor, an endothelial radioprotector, acted to minimize tumor response following single large doses of radiation. Immunohistochemical analysis was in general agreement with QUS findings; an R{sup 2} of 0.9 was observed when quantified cell death was correlated with changes in midband fit. Conclusions: Results from QUS

  5. Dependent Prior: An Application in Spinal Anaesthesia Drug Therapy on SBP in Cesarean patients.

    Directory of Open Access Journals (Sweden)

    Atanu Bhattacharjee

    2013-12-01

    Full Text Available Cesarean section is widely used operation procedure in the world. The regional anesthesia is preferred than general anesthesia. The risk of fetus is higher in general than in regional anesthesia. The drug treatment effect on regional anesthesia plays an important role to control the systolic blood pressure (SBP during the surgery. The goal of this work is to know the effective drug to control the SBP among cesarean anesthetic patients. The dependent prior with Bayesian approach is applied in the binary response data set. The secondary data in anesthesia has been applied to compare the two drug treatments, viz. (1 Phenylephrine and (2 Ephedrine, in cesarean patients with spinal anesthesia. In both drug groups the mean of SBP has been found controlled over the duration of the surgery. No rapid changes of SBP level among the patients are observed. At the end of study it is found that the means of SBP cesarean anesthetic patients are found higher in Phenylephrine group. The Bayesian dependent prior is found to offer effective tool for drug treatment effect comparison. The drug treatment effect Ephedrine is found to be more effective to control the SBP over the duration of surgery than Phenylephrine.

  6. Assessing the utility of frequency dependent nudging for reducing biases in biogeochemical models

    Science.gov (United States)

    Lagman, Karl B.; Fennel, Katja; Thompson, Keith R.; Bianucci, Laura

    2014-09-01

    Bias errors, resulting from inaccurate boundary and forcing conditions, incorrect model parameterization, etc. are a common problem in environmental models including biogeochemical ocean models. While it is important to correct bias errors wherever possible, it is unlikely that any environmental model will ever be entirely free of such errors. Hence, methods for bias reduction are necessary. A widely used technique for online bias reduction is nudging, where simulated fields are continuously forced toward observations or a climatology. Nudging is robust and easy to implement, but suppresses high-frequency variability and introduces artificial phase shifts. As a solution to this problem Thompson et al. (2006) introduced frequency dependent nudging where nudging occurs only in prescribed frequency bands, typically centered on the mean and the annual cycle. They showed this method to be effective for eddy resolving ocean circulation models. Here we add a stability term to the previous form of frequency dependent nudging which makes the method more robust for non-linear biological models. Then we assess the utility of frequency dependent nudging for biological models by first applying the method to a simple predator-prey model and then to a 1D ocean biogeochemical model. In both cases we only nudge in two frequency bands centered on the mean and the annual cycle, and then assess how well the variability in higher frequency bands is recovered. We evaluate the effectiveness of frequency dependent nudging in comparison to conventional nudging and find significant improvements with the former.

  7. Improving the scalability of psychological treatments in developing countries: an evaluation of peer-led therapy quality assessment in Goa, India.

    Science.gov (United States)

    Singla, Daisy R; Weobong, Benedict; Nadkarni, Abhijit; Chowdhary, Neerja; Shinde, Sachin; Anand, Arpita; Fairburn, Christopher G; Dimijdan, Sona; Velleman, Richard; Weiss, Helen; Patel, Vikram

    2014-09-01

    Psychological treatments delivered by lay therapists, with little or no previous mental health training, have been shown to be effective in treating a range of mental health problems. In low resource settings, the dearth of available experts to assess therapy quality potentially leads to a bottleneck in scaling up lay therapist delivered psychological treatments. Peer-led supervision and the assessment of therapy quality may be one solution to address this barrier. The purpose of this study was two-fold: 1) to assess lay therapist quality ratings compared to expert supervisors in a multisite study where lay therapists delivered two locally developed, psychological treatments for harmful and dependent drinking and severe depression; 2) assess the acceptability and feasibility of peer-led supervision compared to expert-led supervision. We developed two scales, one for each treatment, to compare lay therapist and expert ratings on audio-taped treatment sessions (n = 189). Our findings confirmed our primary hypothesis of increased levels of agreement between peer and expert ratings over three consecutive time periods as demonstrated by a decrease in the differences in mean therapy quality rating scores. This study highlights that lay therapists can be trained to effectively assess each other's therapy sessions as well as experts, and that peer-led supervision is acceptable for lay therapists, thus, enhancing the scalability of psychological treatments in low-resource settings. Copyright © 2014 The Authors. Published by Elsevier Ltd.. All rights reserved.

  8. Fostering reflective practice: self-assessment abilities of physical therapy students and entry-level graduates.

    Science.gov (United States)

    Musolino, Gina Maria

    2006-01-01

    Adopting the American Physical Therapy Association Clinical Performance Instrument, physical therapy (PT) interns are required to self-assess, hence the need for development of self-assessment abilities. The purpose of this research was threefold: (1) to develop an interview guide instrument to gather qualitative data, (2) to investigate the experience of self-assessment of PT students and new graduates, and (3) to identify training needs and propose a plan to incorporate self-assessment for PT lifelong learners. This study evaluated the self-assessment abilities of PT learners by investigating the following self-assessment components: (1) abilities and skills, (2) barriers and/or support, (3) training needs, and (4) essential elements for development. The sample consisted of 11 PT learners and internal and external evaluative committee members. Qualitative and evaluative methods were implemented to generate data addressing research questions related to (1) interview instrumentation; (2) self-assessment, with data gathering through semistructured interviews; and (3) evaluative examination of the plan to incorporate self-assessment. Data were analyzed for emerging codes and themes, synthesized, and recontextualized. Formative and summative evaluative committees validated the interview guide instrument and proposed plan for incorporation of self-assessment. Core themes emerged pertaining to specific aspects of self-assessment, including requirements, areas for improvement, motivational and promotion factors, and activities that facilitate self-assessment. Participants exhibited self-assessment abilities, encountering obstacles and support, important to health care professionals, educators, and clinical faculty. Training needs were identified for PT learners and for clinical and academic faculty. These findings parallel with Schön's concept of reflective practice and Bandura's social learning theory. The self-assessment plan includes practice improvement components

  9. Construction of an Occupational Therapy Screenings Assessment for elderly medical patients

    DEFF Research Database (Denmark)

    Holsbæk, Jonas

    there for demands a validated Occupational Therapy Screening Assessment, that fast and easy can tell if more Occupational Therapy is needed. Aim: The aim of the study is to develop a Screening Assessment which can be used in the Occupational Therapist practice screening Hospitalized Elderly medical inpatients......Background: Occupational Therapist working with Elderly Medical inpatients at hospitals in Denmark, are under pressure due to an increasing patients, demands for validated interventions and best practice and economically effectually solutions at the same time. Occupational Therapists in Denmark...... by means of the Content Validity Index (CVI) – Questionaire. Result: The result was a Screening Assessment and a Manual, which was built up using ICF and the ADL-Taxonomy as References. The Screening Instrument should be a support for the working Occupational Therapist in their Clinical Reasoning. CVI...

  10. Therapy assessment in prostate cancer using choline and PSMA PET/CT

    Energy Technology Data Exchange (ETDEWEB)

    Ceci, Francesco; Castellucci, Paolo; Fanti, Stefano [University of Bologna, Nuclear Medicine Unit, S. Orsola-Malpighi University Hospital, Bologna (Italy); Herrmann, Ken [University Hospital Essen, Department of Nuclear Medicine, Essen (Germany); University of California Los Angeles, Department of Molecular and Medical Pharmacology, David Geffen School of Medicine, Los Angeles, CA (United States); Hadaschik, Boris [University Hospital Essen, Department of Urology, Essen (Germany)

    2017-08-15

    While PET with non-FDG tracers (mainly choline and Ga-PSMA) has commonly been used for restaging in men with biochemically recurrent prostate cancer, as well as for primary staging, it is only recently that a few preliminary studies have addressed the possible use of PET for monitoring the response to systemic therapy of metastatic disease, especially innovative treatments such as abiraterone and enzalutamide. This article aims to evaluate the role of PET imaging with different non-FDG radiotracers for assessment of therapy in advanced prostate cancer patients. (orig.)

  11. Therapy assessment in prostate cancer using choline and PSMA PET/CT.

    Science.gov (United States)

    Ceci, Francesco; Herrmann, Ken; Hadaschik, Boris; Castellucci, Paolo; Fanti, Stefano

    2017-08-01

    While PET with non-FDG tracers (mainly choline and Ga-PSMA) has commonly been used for restaging in men with biochemically recurrent prostate cancer, as well as for primary staging, it is only recently that a few preliminary studies have addressed the possible use of PET for monitoring the response to systemic therapy of metastatic disease, especially innovative treatments such as abiraterone and enzalutamide. This article aims to evaluate the role of PET imaging with different non-FDG radiotracers for assessment of therapy in advanced prostate cancer patients.

  12. Dose Assessment of Eye and Its Components in Proton Therapy by Monte Carlo Method

    OpenAIRE

    Marzieh Tavakol; Alireza Karimian; Sayyed Mojtaba Mostajab Aldaavati

    2014-01-01

    Introduction Proton therapy is used to treat malignant tumors such as melanoma inside the eye. Proton particles are adjusted according to various parameters such as tumor size and position and patient’s distance from the proton source. The purpose of this study was to assess absorbed doses in eyes and various tumors found in the area of sclera and choroid and the adjacent tissues in radiotherapy while changing most important proton therapy parameters such as moderators thickness (1.5-1.9 cm),...

  13. Beneficial Outcome of Losartan Therapy Depends on Type of FBN1 Mutation in Marfan Syndrome.

    Science.gov (United States)

    Franken, Romy; den Hartog, Alexander W; Radonic, Teodora; Micha, Dimitra; Maugeri, Alessandra; van Dijk, Fleur S; Meijers-Heijboer, Hanne E; Timmermans, Janneke; Scholte, Arthur J; van den Berg, Maarten P; Groenink, Maarten; Mulder, Barbara J M; Zwinderman, Aeilko H; de Waard, Vivian; Pals, Gerard

    2015-04-01

    It has been shown that losartan reduces aortic dilatation in patients with Marfan syndrome. However, treatment response is highly variable. This study investigates losartan effectiveness in genetically classified subgroups. In this predefined substudy of COMPARE, Marfan patients were randomized to daily receive losartan 100 mg or no losartan. Aortic root dimensions were measured by MRI at baseline and after 3 years. FBN1 mutations were classified based on fibrillin-1 protein effect into (1) haploinsufficiency, decreased amount of normal fibrillin-1, or (2) dominant negative, normal fibrillin-1 abundance with mutant fibrillin-1 incorporated in the matrix. A pathogenic FBN1 mutation was found in 117 patients, of whom 79 patients were positive for a dominant negative mutation (67.5%) and 38 for a mutation causing haploinsufficiency (32.5%). Baseline characteristics between treatment groups were similar. Overall, losartan significantly reduced aortic root dilatation rate (no losartan, 1.3±1.5 mm/3 years, n=59 versus losartan, 0.8±1.4 mm/3 years, n=58; P=0.009). However, losartan reduced only aortic root dilatation rate in haploinsufficient patients (no losartan, 1.8±1.5 mm/3 years, n=21 versus losartan 0.5±0.8 mm/3 years, n=17; P=0.001) and not in dominant negative patients (no losartan, 1.2±1.7 mm/3 years, n=38 versus losartan 0.8±1.3 mm/3 years, n=41; P=0.197). Marfan patients with haploinsufficient FBN1 mutations seem to be more responsive to losartan therapy for inhibition of aortic root dilatation rate compared with dominant negative patients. Additional treatment strategies are needed in Marfan patients with dominant negative FBN1 mutations. http://www.trialregister.nl/trialreg/index.asp; Unique Identifier: NTR1423. © 2015 American Heart Association, Inc.

  14. Outcomes of myocardial infarction hydrogel injection therapy in the human left ventricle dependent on injectate distribution.

    Science.gov (United States)

    Miller, Renee; Davies, Neil H; Kortsmit, Jeroen; Zilla, Peter; Franz, Thomas

    2013-08-01

    Myocardial infarction therapies involving biomaterial injections have shown benefits in inhibiting progression towards heart failure. However, the underlying mechanisms remain unclear. A finite element model of the human left ventricle was developed from magnetic resonance images. An anteroapical infarct was represented at acute (AI) and fibrotic (FI) stage. Hydrogel injections in the infarct region were modelled with layered (L) and bulk (B) distribution. In the FI, injectates reduced end-systolic myofibre stresses from 291.6% to 117.6% (FI-L) and 115.3% (FI-B) of the healthy value, whereas all AI models exhibited sub-healthy stress levels (AI: 90.9%, AI-L: 20.9%, AI-B: 30.5%). Reduction in end-diastolic infarct stress were less pronounced for both FI (FI: 294.1%, FI-L: 176.5%, FI-B: 188.2%) and AI (AI: 94.1%, AI-L: 35.3%, AI-B: 41.2%). In the border zone, injectates reduced end-systolic fibre stress by 8-10% and strain from positive (AI) and zero (FI) to negative. Layered and bulk injectates increased ejection fraction by 7.4% and 8.4% in AI and 14.1% and 13.7% in FI. The layered injectate had a greater impact on infarct stress and strain at acute stage, whereas the bulk injectate exhibited greater benefits at FI stage. These findings were confirmed by our previous in vivo results. Copyright © 2013 John Wiley & Sons, Ltd.

  15. A VALIDATION STUDY OF THE FACIAL-ORAL TRACT THERAPY SWALLOWING ASSESSMENT OF SALIVA

    DEFF Research Database (Denmark)

    Mortensen, Jesper; Jensen, Ditte; Kjærsgaard, Annette

    Introduction Facial-Oral Tract Therapy (F.O.T.T.) (1) is an approach that provides both clinical assessment and treatment of oropharyngeal dysphagia. In the F.O.T.T. approach, a prerequisite for the initiation of oral intake is safe swallowing of saliva. A recent randomized controlled trial (2......) showed that patients assessed for initiation of oral intake with an F.O.T.T. based clinical assessment, hereinafter referred to as the Swallowing Assessment of Saliva (SAS), were no more likely to develop aspiration pneumonia that patients who were assessed with an endoscopic evaluation. The objective...... coefficient of 0.87 ±0.17 in detection of aspiration risk. Furthermore, analyses showed that experienced and inexperienced occupational therapists performed equally in detection of aspiration risk. Conclusion The F.O.T.T.-SAS is a simple, sensitive and reliable assessment for detecting aspiration risk...

  16. [Complete and detailed critiques of medical criteria for assessing the degree of dependence for the care allowance].

    Science.gov (United States)

    Čeledová, Libuše; Čevela, Rostislav

    In 2012 it was applied to medical practice assessor new criteria for assessing the degree of dependence for the care allowance. After four years by the Ministry of Labour and Social Affairs proposed expansion of the existing activities and at the other activities, it is proposed to refine the text. New activities refine or complement the existing framework defining the basic needs of life and should lead to a more objective and personally assessment of the degree of dependence. With the change in legislation expected a growth in the number of applicants for assessment General assessment principles and policies remain unchanged.Key words: medical assessment service, dependence degree, basic living needs.

  17. Retention of adolescents with substance dependence and coexisting mental health disorders in outpatient alcohol and drug group therapy.

    Science.gov (United States)

    Pagey, Bronwyn; Deering, Daryle; Sellman, Doug

    2010-12-01

    The aim of this study was to investigate characteristics that might enhance retention among adolescents attending outpatient alcohol and drug group therapy within a youth mental health setting. An important goal was to provide information for nurses and other clinicians who work with adolescents with coexisting substance use and mental health disorders. A retrospective file audit reviewed the files of 64 adolescents who attended a weekly alcohol and drug group between 2002 and 2004. Five characteristics were shown to have a significant impact on enhancing participant group retention. These were Māori and Pacific Island ethnicity, past or current legal charges, youth drug court (YDC) involvement, having a diagnosis of cannabis dependence, and a diagnosis of conduct disorder. Logistic regression found that YDC involvement on its own significantly predicted treatment retention. In an area of limited research, the findings from this study expand the literature on enhancing treatment retention for a vulnerable and hard-to-engage adolescent group with complex treatment needs, and highlight the need for further investigation of the potential role of the YDC. From a practice perspective, the findings support group therapy interventions as a cost-effective treatment modality for assisting adolescents with coexisting substance use and mental health issues, including those with conduct disorder and YDC involvement. © 2010 The Authors. International Journal of Mental Health Nursing © 2010 Australian College of Mental Health Nurses Inc.

  18. Impact of DCS-facilitated cue exposure therapy on brain activation to cocaine cues in cocaine dependence.

    Science.gov (United States)

    Prisciandaro, James J; Myrick, Hugh; Henderson, Scott; McRae-Clark, Aimee L; Santa Ana, Elizabeth J; Saladin, Michael E; Brady, Kathleen T

    2013-09-01

    The development of addiction is marked by a pathological associative learning process that imbues incentive salience to stimuli associated with drug use. Recent efforts to treat addiction have targeted this learning process using cue exposure therapy augmented with d-cycloserine (DCS), a glutamatergic agent hypothesized to enhance extinction learning. To better understand the impact of DCS-facilitated extinction on neural reactivity to drug cues, the present study reports fMRI findings from a randomized, double-blind, placebo-controlled trial of DCS-facilitated cue exposure for cocaine dependence. Twenty-five participants completed two MRI sessions (before and after intervention), with a cocaine-cue reactivity fMRI task. The intervention consisted of 50mg of DCS or placebo, combined with two sessions of cocaine cue exposure and skills training. Participants demonstrated cocaine cue activation in a variety of brain regions at baseline. From the pre- to post-study scan, participants experienced decreased activation to cues in a number of regions (e.g., accumbens, caudate, frontal poles). Unexpectedly, placebo participants experienced decreases in activation to cues in the left angular and middle temporal gyri and the lateral occipital cortex, while DCS participants did not. Three trials of DCS-facilitated cue exposure therapy for cocaine dependence have found that DCS either increases or does not significantly impact response to cocaine cues. The present study adds to this literature by demonstrating that DCS may prevent extinction to cocaine cues in temporal and occipital brain regions. Although consistent with past research, results from the present study should be considered preliminary until replicated in larger samples. Copyright © 2013 Elsevier Ireland Ltd. All rights reserved.

  19. CFTR-dependent chloride efflux in cystic fibrosis mononuclear cells is increased by ivacaftor therapy.

    Science.gov (United States)

    Guerra, Lorenzo; D'Oria, Susanna; Favia, Maria; Castellani, Stefano; Santostasi, Teresa; Polizzi, Angela M; Mariggiò, Maria A; Gallo, Crescenzio; Casavola, Valeria; Montemurro, Pasqualina; Leonetti, Giuseppina; Manca, Antonio; Conese, Massimo

    2017-07-01

    The Cystic Fibrosis Transmembrane Conductance Regulator (CFTR) potentiator ivacaftor (Kalydeco®) improves clinical outcome in G551D cystic fibrosis (CF) patients. Here, we have investigated whether ivacaftor has a clinical impact on non-G551D gating mutations and function of circulating leukocytes as well. Seven patients were treated with ivacaftor and evaluated at baseline, and at 1-3 and 6 months. Besides clinical and systemic inflammatory parameters, circulating mononuclear cells (MNC) were evaluated for CFTR-dependent chloride efflux by spectrofluorimetry, neutrophils for oxidative burst by cytofluorimetry and HVCN1 mRNA expression by real time PCR. Ivacaftor determined a significant decrease in sweat chloride concentrations at all time points during treatment. Body mass index (BMI), FEV1 , and FVC showed an increasing trend. While C-reactive protein decreased significantly at 2 months, the opposite behavior was noticed for circulating monocytes. CFTR activity in MNC was found to increase significantly at 3 and 6 months. Neutrophil oxidative burst peaked at 2 months and then decreased to baseline. HVCN1 mRNA expression was significantly higher than baseline at 1-3 months and decreased after 6 months of treatment. The chloride efflux in MNC correlated positively with both FEV1 and FVC. On the other hand, sweat chloride correlated positively with CRP and WBC, and negatively with both respiratory function tests. A cluster analysis confirmed that sweat chloride, FEV1 , FVC, BMI, and MNC chloride efflux behaved as a single entity over time. In patients with non-G551D mutations, ivacaftor improved both chloride transport in sweat ducts and chloride efflux in MNC, that is, functions directly imputed to CFTR. © 2017 Wiley Periodicals, Inc.

  20. How to apply the dependence structure analysis to extreme temperature and precipitation for disaster risk assessment

    Science.gov (United States)

    Feng, Jieling; Li, Ning; Zhang, Zhengtao; Chen, Xi

    2017-06-01

    IPCC reports that a changing climate can affect the frequency and the intensity of extreme events. However, the extremes appear in the tail of the probability distribution. In order to know the relationship between extreme events in the tail of temperature and precipitation, an important but previously unobserved dependence structure is analyzed in this paper. Here, we examine the dependence structure by building a bivariate joint of Gumbel copula model for temperature and precipitation using monthly average temperature (T) and monthly precipitation (P) data from Beijing station in China covering a period of 1951-2015 and find the dependence structure can be divided into two sections, they are the middle part and the upper tail. We show that T and P have a strong positive correlation in the high tail section (T > 25.85 °C and P > 171.1 mm) (=0.66, p < 0.01) while they do not demonstrate the same relation in the other section, which suggests that the identification of a strong influence of T on extreme P needs help from the dependence structure analysis. We also find that in the high tail section, every 1 °C increase in T is associated with 73.45 mm increase in P. Our results suggested that extreme precipitation fluctuations by changes in temperature will allow the data dependence structure to be included in extreme affect for the disaster risk assessment under future climate change scenarios. Copula bivariate jointed probability distribution is useful to the dependence structure analysis.

  1. Development and validation of the functional assessment of cancer therapy-antiangiogenesis subscale.

    Science.gov (United States)

    Kaiser, Karen; Beaumont, Jennifer L; Webster, Kimberly; Yount, Susan E; Wagner, Lynne I; Kuzel, Timothy M; Cella, David

    2015-05-01

    The Functional Assessment of Cancer Therapy (FACT)-Antiangiogenesis (AntiA) Subscale was developed and validated to enhance treatment decision-making and side effect management for patients receiving anti-angiogenesis therapies. Side effects related to anti-angiogenesis therapies were identified from the literature, clinician input, and patient input. Fifty-nine possible patient expressions of side effects were generated. Patient and clinician ratings of the importance of these expressions led us to develop a 24-item questionnaire with clinical and research potential. To assess the scale's reliability and validity, 167 patients completed the AntiA Subscale, the Functional Assessment of Cancer Therapy-general (FACT-G), the FACT-Kidney Symptom Index (FKSI), the FACIT-Fatigue Subscale, the Global Rating of Change Scale (GRC), and the PROMIS Global Health Scale. Patient responses to the AntiA were analyzed for internal consistency, test-retest reliability, convergent and discriminant validity, and responsiveness to change in clinical status. All tested scales were found to have good internal consistency reliability (Cronbach's alpha 0.70-0.92). Test-retest reliability was also good (0.72-0.88) for total and subscale scores and lower for individual items. The total score, subscale scores, and all single items (except nosebleeds) significantly differentiated between groups defined by level of side effect bother. Evaluation of responsiveness to change in this study was not conclusive, suggesting an area for further research. The AntiA is a reliable and valid measure of side effects from anti-angiogenesis therapy. © 2014 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.

  2. Effects of cigarette smoking and nicotine dependence on adherence to antiretroviral therapy among HIV-positive patients in Vietnam.

    Science.gov (United States)

    Nguyen, Nhung T P; Tran, Bach X; Hwang, Lu Y; Markham, Christine M; Swartz, Michael D; Vidrine, Jennifer I; Phan, Huong T T; Latkin, Carl A; Vidrine, Damon J

    2016-01-01

    Cigarette smoking is increasingly recognized as an indicator for inferior adherence to antiretroviral therapy (ART) among HIV-positive patients. Given the limited body of work on this issue, we aimed to explore the relations between cigarette smoking, nicotine dependence, and ART adherence in Vietnam. A cross-sectional study of 1050 HIV-positive people was conducted from January to September 2013 in Hanoi (the capital) and Nam Dinh (a rural city). Adherence to ART during the last 30 days was measured by the 100-point visual analog scale (VAS). Smoking history and nicotine dependence (Fagerstrom Test of Nicotine Dependence) were self-reported by participants. Multiple logistic regression was performed to examine the association of current smoking and nicotine dependence with ART nonadherence. Using the established VAS cut point of 95 to indicate adequate adherence, the prevalence of ART nonadherence was 30.9%. Approximately 35.5% of the sample reported current smoking. No association between smoking status and ART nonadherence was found. However, participants with greater nicotine dependence (OR = 1.1, 95%CI = 1.0-1.2 per unit increase) were more likely to be nonadherent. Also, individuals who were female (OR = 1.70, 95%CI = 1.19-2.42), receiving ART in Nam Dinh (OR = 1.6, 95%CI = 1.1-2.4), and currently feeling anxiety (OR = 1.6, 95% CI = 1.2-2.1) had a higher likelihood of ART nonadherence. Additionally, current smokers reporting current pain (OR = 1.9, 95%CI = 1.2-3.1) were more likely to be nonadherent. Conversely, protective factors included living with a spouse/partner (OR = 0.5, 95%CI = 0.3-0.7) and having more than a high school education (OR = 0.4, 95%CI = 0.1-1.0). Given the high prevalence of suboptimal adherence and current smoking among HIV-positive patients, screening for smoking status and nicotine dependence during ART treatment may help to improve patients' adherence to medication. More efforts

  3. Time-dependent probabilistic seismic hazard assessment and its application to Hualien City, Taiwan

    Directory of Open Access Journals (Sweden)

    C.-H. Chan

    2013-05-01

    Full Text Available Here, we propose a time-dependent probabilistic seismic hazard assessment and apply it to Hualien City, Taiwan. A declustering catalog from 1940 to 2005 was used to build up a long-term seismicity rate model using a smoothing Kernel function. We also evaluated short-term seismicity rate perturbations according to the rate-and-state friction model, and the Coulomb stress changes imparted by earthquakes from 2006 to 2010. We assessed both long-term and short-term probabilistic seismic hazards by considering ground motion prediction equations for crustal and subduction earthquakes. The long-term seismic hazard in Hualien City gave a PGA (peak ground acceleration of 0.46 g for the 2.1‰ annual exceedance probability. The result is similar to the levels determined in previous studies. Seismic hazards were significantly elevated following the 2007 ML =5.8 earthquake that occurred approximately 10 km from Hualien City. This work presents an assessment of a suitable mechanism for time-dependent probabilistic seismic hazard determinations using an updated earthquake catalog. Using minor model assumptions, our approach provides a suitable basis for rapid re-evaluations and will benefit decision-makers and public officials regarding seismic hazard mitigation.

  4. Understanding the neurobiology, assessment, and treatment of substances of abuse and dependence: a guide for the critical care nurse.

    Science.gov (United States)

    Genung, Vanessa

    2012-03-01

    therapies. 8. An individual's treatment and services plan must be assessed continually and modified as necessary to ensure it meets his or her changing needs. 9. Many drug-addicted individuals also have other mental disorders that need treatment. 10. Medically assisted detoxification in the first stage of addiction treatment and by itself does little to change long-term drug abuse. 11. Treatment does not need to be voluntary to be effective. 12. Drug use during treatment must be monitored continuously, because lapses during treatment do occur. 13. Treatment programs should assess patients for the presence of HIV/AIDS, hepatitis B and C, tuberculosis, and other infectious diseases, as well as provide targeted risk-reduction counseling to help patients modify or change behaviors that place them at risk of contracting or spreading infectious diseases. To truly impact this disease, there needs to be improvement in the identification of risk factors and early identification and early intervention with children and adolescents. The future of neuroscience is in objective brain scans and genetic testing. Out of these approaches can come more objective measures of addiction and dependence using brain scans and genetic testing. These measures would potentially allow for the development of vaccines for specific drugs of abuse and dependence, as well as increasingly selective and effective pharmacologic approaches for treatment and a new consensus on standard of care for substance dependence.

  5. An Automatic Framework for Assessing Breast Cancer Risk Due to Various Hormone Replacement Therapies (HRT)

    DEFF Research Database (Denmark)

    Karemore, Gopal Raghunath; Brandt, Sami; Nielsen, Mads

    Background: It is well known that Menopausal Hormone therapy increases mammographic density. Increase in breast density may relate to breast cancer risk. Several computer assisted automatic methods for assessing mammographic density have been suggested by J.W. Byng (1996), N. Karssemeijer (1998), J...... measurements of breast density changes related to HRT. 2) To investigate whether transdermal low dose estradiol treatment induces changes in mammographic density compared to raloxifene and if these findings indicate elevation of breast cancer risk by treatment. Material and Methods: Digitised mammographies...... of 2x135 completers of a two year, randomised, trial formed the base of the present analysis. Active treatments were transdermal estradiol releasing 0.014mg E2/week and orally administered raloxifene hydrochloride, 60mg/day respectively. Influence of the therapies on breast density was assessed...

  6. Assessing an Intergenerational Horticulture Therapy Program for Elderly Adults and Preschool Children

    OpenAIRE

    Predny, Mary Lorraine

    1999-01-01

    ASSESSING AN INTERGENERATIONAL HORTICULTURE THERAPY PROGRAM FOR ELDERLY ADULTS AND PRESCHOOL CHILDREN by Mary Lorraine Predny Dr. Diane Relf, Chair Horticulture Department ABSTRACT The goal of this research project was to determine if introducing intergenerational interactions would supplement or detract from the use of horticulture as a therapeutic tool when working with elderly adults and preschool children. The program was set up to compare ind...

  7. Assessment of Adherence to Prescribed Therapy in Patients with Chronic Hepatitis B.

    Science.gov (United States)

    Abreu, Rodrigo Martins; da Silva Ferreira, Camila; Ferreira, Aline Siqueira; Remor, Eduardo; Nasser, Paulo Dominguez; Carrilho, Flair José; Ono, Suzane Kioko

    2016-03-01

    Evidence shows that treatment for hepatitis B virus (HBV) can suppress viral load. Among the factors directly linked to therapeutic success is adherence to the treatment. Several instruments to assess adherence are available, but they are not validated for use in chronic hepatitis B. The purpose of this paper was to adapt and validate the "Assessment of Adherence to Antiretroviral Therapy Questionnaire-HIV" (CEAT-VIH) for patients with chronic hepatitis B (referred to herein as CEAT-HBV). The validity of the adapted questionnaire evidence was established through concurrent, criterion, and construct validities. We found negative and significant correlation between the domain "degree of compliance to antiviral therapy" assessed by CEAT-HBV and the Morisky test (r = -0.62, P < 0.001) and between the domain "barriers to adherence" and HBV viral load (r = -0.42, P < 0.001). In terms of the construct's discriminative capacity, scores greater than or equal to 80 detected antiviral therapy success, which are necessary for the prediction of an undetectable HBV viral load. Thus, a cutoff value of 80.5 was set with a value of 81% for sensitivity and 67% for specificity. The CEAT-HBV identified 43% (n = 79) non-adherent patients and was shown to be a useful tool in clinical practice.

  8. [Quality of life of patients with breast cancer receiving hormonal therapy, depending on age and marital status].

    Science.gov (United States)

    Trishikina, E A; Orlova, R V; Roman, L D

    2009-01-01

    Our study involved 247 patients with histologically verified breast tumors, aged 48-89, who had received hormones - tamoxifen as first-line therapy, exemestan (second-line) for 12 months. FACT-B and FACT-G questionnaires were used to assess quality of life. Worse results were reported in tamoxifen-treated patients older than 60 years. Indices of emotional and social security in the two groups: 60-70 year-olds (10.8+/-0.96% and 14.3+/-1.27% vis-à-vis 14.8+/-1.31% and 15.6+/-1.42%, respectively) and over 70 year-olds (15.2+/-1.46% and 15.8+/-1.48%, respectively). Our evidence suggested that a large-seale complex of effective psychological rehabilitation be given, particularly, to those under 60, married andlor with minors, right from the very beginning of treatment.

  9. Assessment of Nifedipine Therapy in Hyperinsulinemic Hypoglycemia due to Mutations in the ABCC8 Gene.

    Science.gov (United States)

    Güemes, Maria; Shah, Pratik; Silvera, Shavel; Morgan, Kate; Gilbert, Clare; Hinchey, Louise; Hussain, Khalid

    2017-03-01

    Previous case reports have documented the effectiveness of l-type calcium channel blockers (such as nifedipine and verapamil) for treating different forms of hyperinsulinemic hypoglycemia (HH). To systematically assess the glycemic response to nifedipine therapy in 11 patients with HH due to mutations in the ABCC8 gene. Dose escalation of nifedipine therapy. Eleven children who were inpatients at a tertiary hospital and had diazoxide unresponsive HH due to mutations in the ABCC8 gene. Nifedipine was administered orally at an escalating dose up to a maximum of 2.5 mg/kg/d. Improvement in glycemic control, avoidance of hypoglycemic episodes, reduction of intravenous glucose infusion, and reduction in the requirements of other medical therapies. The median age of the patients was 0.44 years (range 0.14 to 3.77). The ABCC8 gene mutations were homozygous in 3 cases, paternally inherited heterozygous in 4, and compound heterozygous in 4. 18F-DOPA PET/CT scan demonstrated a focal lesion in 2 cases and the rest were diffuse HH disease. One subject had nifedipine as monotherapy, whereas the rest had it in combination with octreotide/glucagon/diazoxide or cornstarch. After a median of 6.5 (3 to 23) days of maximal (2.5 mg/kg/d) dose of nifedipine therapy, none of the patients showed any improvement in glycemic control and patients continued to have hypoglycemic episodes. HH due to mutations in the ABCC8 gene does not respond to nifedipine therapy. Mutations in the KATP channel genes might render the l-type calcium channel ineffective to therapy with nifedipine.

  10. Assessment of potential advantages of relevant ions for particle therapy: A model based study

    Energy Technology Data Exchange (ETDEWEB)

    Grün, Rebecca, E-mail: r.gruen@gsi.de [Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt 64291 (Germany); Institute of Medical Physics and Radiation Protection, University of Applied Sciences Gießen, Gießen 35390 (Germany); Medical Faculty of Philipps-University Marburg, Marburg 35032 (Germany); Friedrich, Thomas; Krämer, Michael; Scholz, Michael [Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt 64291 (Germany); Zink, Klemens [Institute of Medical Physics and Radiation Protection, University of Applied Sciences Gießen, Gießen 35390, Germany and Department of Radiotherapy and Radiation Oncology, University Medical Center Giessen and Marburg, Marburg 35043 (Germany); Durante, Marco [Department of Biophysics, GSI Helmholtzzentrum für Schwerionenforschung, Darmstadt 64291, Germany and Department of Condensed Matter Physics, Darmstadt University of Technology, Darmstadt 64289 (Germany); Engenhart-Cabillic, Rita [Medical Faculty of Philipps-University Marburg, Marburg 35032, Germany and Department of Radiotherapy and Radiation Oncology, University Medical Center Giessen and Marburg, Marburg 35043 (Germany)

    2015-02-15

    Purpose: Different ion types offer different physical and biological advantages for therapeutic applications. The purpose of this work is to assess the advantages of the most commonly used ions in particle therapy, i.e., carbon ({sup 12}C), helium ({sup 4}He), and protons ({sup 1}H) for different treatment scenarios. Methods: A treatment planning analysis based on idealized target geometries was performed using the treatment planning software TRiP98. For the prediction of the relative biological effectiveness (RBE) that is required for biological optimization in treatment planning the local effect model (LEM IV) was used. To compare the three ion types, the peak-to-entrance ratio (PER) was determined for the physical dose (PER{sub PHY} {sub S}), the RBE (PER{sub RBE}), and the RBE-weighted dose (PER{sub BIO}) resulting for different dose-levels, field configurations, and tissue types. Further, the dose contribution to artificial organs at risk (OAR) was assessed and a comparison of the dose distribution for the different ion types was performed for a patient with chordoma of the skull base. Results: The study showed that the advantages of the ions depend on the physical and biological properties and the interplay of both. In the case of protons, the consideration of a variable RBE instead of the clinically applied generic RBE of 1.1 indicates an advantage in terms of an increased PER{sub RBE} for the analyzed configurations. Due to the fact that protons show a somewhat better PER{sub PHY} {sub S} compared to helium and carbon ions whereas helium shows a higher PER{sub RBE} compared to protons, both protons and helium ions show a similar RBE-weighted dose distribution. Carbon ions show the largest variation of the PER{sub RBE} with tissue type and a benefit for radioresistant tumor types due to their higher LET. Furthermore, in the case of a two-field irradiation, an additional gain in terms of PER{sub BIO} is observed when using an orthogonal field configuration

  11. Assessment of potential advantages of relevant ions for particle therapy: a model based study.

    Science.gov (United States)

    Grün, Rebecca; Friedrich, Thomas; Krämer, Michael; Zink, Klemens; Durante, Marco; Engenhart-Cabillic, Rita; Scholz, Michael

    2015-02-01

    Different ion types offer different physical and biological advantages for therapeutic applications. The purpose of this work is to assess the advantages of the most commonly used ions in particle therapy, i.e., carbon ((12)C), helium ((4)He), and protons ((1)H) for different treatment scenarios. A treatment planning analysis based on idealized target geometries was performed using the treatment planning software TRiP98. For the prediction of the relative biological effectiveness (RBE) that is required for biological optimization in treatment planning the local effect model (LEM IV) was used. To compare the three ion types, the peak-to-entrance ratio (PER) was determined for the physical dose (PERPHY S), the RBE (PERRBE), and the RBE-weighted dose (PERBIO) resulting for different dose-levels, field configurations, and tissue types. Further, the dose contribution to artificial organs at risk (OAR) was assessed and a comparison of the dose distribution for the different ion types was performed for a patient with chordoma of the skull base. The study showed that the advantages of the ions depend on the physical and biological properties and the interplay of both. In the case of protons, the consideration of a variable RBE instead of the clinically applied generic RBE of 1.1 indicates an advantage in terms of an increased PERRBE for the analyzed configurations. Due to the fact that protons show a somewhat better PERPHY S compared to helium and carbon ions whereas helium shows a higher PERRBE compared to protons, both protons and helium ions show a similar RBE-weighted dose distribution. Carbon ions show the largest variation of the PERRBE with tissue type and a benefit for radioresistant tumor types due to their higher LET. Furthermore, in the case of a two-field irradiation, an additional gain in terms of PERBIO is observed when using an orthogonal field configuration for carbon ions as compared to opposing fields. In contrast, for protons, the PERBIO is almost

  12. Alexithymia level and response to computer-based training in cognitive behavioral therapy among cocaine-dependent methadone maintained individuals.

    Science.gov (United States)

    Morie, Kristen P; Nich, Charla; Hunkele, Karen; Potenza, Marc N; Carroll, Kathleen M

    2015-07-01

    Alexithymia, a characteristic marked by poor ability to identify, define and communicate emotions, has been associated with poorer treatment outcome, including traditional clinician delivered CBT. Computerized cognitive behavioral therapy (CBT4CBT), an effective adjunct to treatment, may provide a means of conveying skills without requiring interaction with a clinician. Seventy-three methadone maintained, cocaine dependent individuals participating in an 8-week randomized clinical trial comparing standard methadone maintenance to methadone maintenance plus CBT4CBT completed the Toronto Alexithymia Scale (TAS-20) at pretreatment, post-treatment, and follow-ups conducted one, two, and 6 months after treatment. There were no statistically significant differences on baseline TAS-20 scores by multiple demographic and substance use variables including gender and substance use severity. Higher TAS-20 scores were associated with somewhat higher levels of distress as measured by the Beck Depression Inventory and multiple Brief Severity Index scales. TAS-20 scores remained relatively stable throughout the duration of treatment and follow-up. Indicators of treatment process, including treatment retention, adherence and therapeutic alliance, were not significantly correlated with TAS-20 scores. There was a significant interaction of alexithymia and treatment condition, such that individuals with higher baseline scores on the TAS-20 submitted significantly higher percentages of cocaine-negative urine toxicology specimens and reported a higher percentage of abstinence days, and longer periods of consecutive abstinence within treatment when assigned to CBT4CBT compared with treatment as usual. These findings suggest that individuals with increased alexithymia may benefit from computerized CBT; possibly via reduced demands on interpersonal skills and interactions associated with computerized therapies. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  13. [New possibilities in therapy and rehabilitation of alcohol dependent patients. Catamnestic study of the efficacy of ambulatory withdrawal therapy exemplified by a model facility].

    Science.gov (United States)

    Soyka, M; Kirchmayer, C; Kotter, G; John, C; Löhnert, E; Möller, H J

    1997-09-01

    We report on catamnestic and clinical results of a 18-24 month follow-up study of 65 alcohol-dependent patients who in 1992-1994 took part in an 8-month outpatient treatment programme. The psychotherapeutic concept of this treatment facility is described. 51 of the 65 patients who had participated in the programme could be subsequently personally interviewed, 7 patients refused to take part, 6 could not be reached and 1 had died. 40 of the 51 patients had properly completed the outpatient treatment. Assuming that all patients who could not be interviewed or refused, were relapsers the abstinence rate was found to be 48% (n = 31). Although selective factors may contribute to this result, the clinical findings so far seem to indicate that outpatient treatment for alcoholics is a promising new therapeutic approach in the treatment of alcoholism. Further studies are needed to assess the possible benefits and the indications for this outpatient treatment in greater detail.

  14. Revealing model dependencies in "Assessing the RAFT equilibrium constant via model systems: an EPR study".

    Science.gov (United States)

    Junkers, Thomas; Barner-Kowollik, Christopher; Coote, Michelle L

    2011-12-01

    In a recent article (W. Meiser, M. Buback, Assessing the RAFT Equilibrium Constant via Model Systems: An EPR Study, Macromol. Rapid Commun. 2011, 18, 1490-1494), it is claimed that evidence is found that unequivocally proves that quantum mechanical calculations assessing the equilibrium constant and fragmentation rate coefficients in dithiobenzoate-mediated reversible addition fragmentation transfer (RAFT) systems are beset with a considerable uncertainty. In the present work, we show that these claims made by Meiser and Buback are beset with a model dependency, as a critical key parameter in their data analysis - the addition rate coefficient of the radicals attacking the C=S double bond in the dithiobenzoate - induces a model insensitivity into the data analysis. Contrary to the claims made by Meiser and Buback, their experimental results can be brought into agreement with the quantum chemical calculations if a lower addition rate coefficient of cyanoisopropyl radicals (CIP) to the CIP dithiobenzoate (CPDB) is assumed. To resolve the model dependency, the addition rate coefficient of CIP radicals to CPDB needs to be determined as a matter of priority. Copyright © 2011 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  15. Identifying patients at risk of nursing home admission: The Leeds Elderly Assessment Dependency Screening tool (LEADS

    Directory of Open Access Journals (Sweden)

    Fear Jon

    2006-03-01

    Full Text Available Abstract Background Discharge from hospital to a nursing home represents a major event in the life of an older person and should only follow a comprehensive functional and medical assessment. A previous study identified 3 dependency scales able to discriminate across outcomes for older people admitted to an acute setting. We wished to determine if a single dependency scale derived from the 3 scales could be created. In addition could this new scale with other predictors be used as a comprehensive tool to identify patients at risk of nursing home admission. Methods Items from the 3 scales were combined and analysed using Rasch Analysis. Sensitivity and specificity analysis and ROC curves were applied to identify the most appropriate cut score. Binary logistic regression using this cut-off, and other predictive variables, were used to create a predictive algorithm score. Sensitivity, specificity and likelihood ratio scores of the algorithm scores were used to identify the best predictive score for risk of nursing home placement. Results A 17-item (LEADS scale was derived, which together with four other indicators, had a sensitivity of 88% for patients at risk of nursing home placement, and a specificity of 85% for not needing a nursing home placement, within 2 weeks of admission. Conclusion A combined short 17-item scale of dependency plus other predictive variables can assess the risk of nursing home placement for older people in an acute care setting within 2 weeks of admission. This gives an opportunity for either early discharge planning, or therapeutic intervention to offset the risk of placement.

  16. Thermography Improves Clinical Assessment in Patients with Systemic Sclerosis Treated with Ozone Therapy

    Directory of Open Access Journals (Sweden)

    Danuta Nowicka

    2017-01-01

    Full Text Available Objective. Treatment of scleroderma is challenging and limited. The aim of our study was to evaluate the usefulness of thermography in assessment of the clinical condition (joints movability and skin thickness in clinically advanced patients with systemic sclerosis before and after ozone therapy. Method. The study included 42 patients aged 32 to 73 years with advanced systemic sclerosis hospitalized in the university clinic between 2003 and 2006. Thermography and clinical examinations were conducted at baseline and after two series of bath in water with ozone. Results. The comparison of results showed significant increase in skin temperature by 2.5°C, significant increase in interphalangeal joints movability by 18 degrees, and significant decrease in skin score by 14.7 points. The skin temperature was correlated with skin score (r=-0.59 and joints movability (r=+0.8. Conclusions. Ozone therapy shows positive effect on clinical parameters and skin temperature as measured with thermography. The study indicated possibility of introducing ozonotherapy as an independent therapy in cases with low level of progression or during remission periods and as additional treatment in patients with advanced disease requiring immunosuppressive treatment. Thermography is useful in assessment of skin condition showing strong correlation between skin temperature and clinical parameters.

  17. Assessing women's sexuality after cancer therapy: checking assumptions with the focus group technique.

    Science.gov (United States)

    Bruner, D W; Boyd, C P

    1999-12-01

    Cancer and cancer therapies impair sexual health in a multitude of ways. The promotion of sexual health is therefore vital for preserving quality of life and is an integral part of total or holistic cancer management. Nursing, to provide holistic care, requires research that is meaningful to patients as well as the profession to develop educational and interventional studies to promote sexual health and coping. To obtain meaningful research data instruments that are reliable, valid, and pertinent to patients' needs are required. Several sexual functioning instruments were reviewed for this study and found to be lacking in either a conceptual foundation or psychometric validation. Without a defined conceptual framework, authors of the instruments must have made certain assumptions regarding what women undergoing cancer therapy experience and what they perceive as important. To check these assumptions before assessing women's sexuality after cancer therapies in a larger study, a pilot study was designed to compare what women experience and perceive as important regarding their sexuality with what is assessed in several currently available research instruments, using the focus group technique. Based on the focus group findings, current sexual functioning questionnaires may be lacking in pertinent areas of concern for women treated for breast or gynecologic malignancies. Better conceptual foundations may help future questionnaire design. Self-regulation theory may provide an acceptable conceptual framework from which to develop a sexual functioning questionnaire.

  18. Therapy assessment of bone metastatic disease in the era of {sup 223}radium

    Energy Technology Data Exchange (ETDEWEB)

    Etchebehere, Elba; Brito, Ana Emilia [The University of Campinas, Division of Nuclear Medicine, Campinas (Brazil); Rezaee, Alireza; Langsteger, Werner [St. Vincent' s Hospital, Department of Nuclear Medicine and Endocrinology, PET - CT Center LINZ, Ordensklinikum, Linz (Austria); Beheshti, Mohsen [St. Vincent' s Hospital, Department of Nuclear Medicine and Endocrinology, PET - CT Center LINZ, Ordensklinikum, Linz (Austria); Paracelsus Medical University, Department of Nuclear Medicine and Endocrinology, Salzburg (Austria)

    2017-08-15

    Defining an optimal imaging modality for assessment of therapy and the best time of evaluation are pivotal for ideal patient's management. {sup 223}Ra (Xofigo registered, formerly Alpharadin) has been approved by the FDA and European Medicines Agency for treatment of metastatic castration-resistant prostate cancer with painful osseous involvement. PET/CT imaging using various radiotracers such as {sup 18}F-FDG, {sup 18}F-FCH, {sup 68}Ga-PSMA and {sup 18}F-NaF have been investigated to mitigate the limitations of conventional imaging modalities. Diagnostic radiotracers that have properties similar to a therapeutic radiotracer will precisely assess of the possibility and efficacy of a treatment; this is the theranostic concept. An example of a diagnostic test employed for selecting targeted therapy is the combined use of {sup 18}F-fluoride PET/CT for evaluation of possible therapy with {sup 223}Ra. This review examines the most recent publications related to this topic. (orig.)

  19. Thermography Improves Clinical Assessment in Patients with Systemic Sclerosis Treated with Ozone Therapy.

    Science.gov (United States)

    Nowicka, Danuta

    2017-01-01

    Objective. Treatment of scleroderma is challenging and limited. The aim of our study was to evaluate the usefulness of thermography in assessment of the clinical condition (joints movability and skin thickness) in clinically advanced patients with systemic sclerosis before and after ozone therapy. Method. The study included 42 patients aged 32 to 73 years with advanced systemic sclerosis hospitalized in the university clinic between 2003 and 2006. Thermography and clinical examinations were conducted at baseline and after two series of bath in water with ozone. Results. The comparison of results showed significant increase in skin temperature by 2.5°C, significant increase in interphalangeal joints movability by 18 degrees, and significant decrease in skin score by 14.7 points. The skin temperature was correlated with skin score (r = -0.59) and joints movability (r = +0.8). Conclusions. Ozone therapy shows positive effect on clinical parameters and skin temperature as measured with thermography. The study indicated possibility of introducing ozonotherapy as an independent therapy in cases with low level of progression or during remission periods and as additional treatment in patients with advanced disease requiring immunosuppressive treatment. Thermography is useful in assessment of skin condition showing strong correlation between skin temperature and clinical parameters.

  20. D-cycloserine combined with cue exposure therapy fails to attenuate subjective and physiological craving in cocaine dependence.

    Science.gov (United States)

    Santa Ana, Elizabeth J; Prisciandaro, James J; Saladin, Michael E; McRae-Clark, Aimee L; Shaftman, Stephanie R; Nietert, Paul J; Brady, Kathleen T

    2015-04-01

    Based on preclinical studies showing that the partial N-methyl-D-aspartate (NMDA) agonist D-cycloserine (DCS) facilitates extinction of cocaine self-administration and cocaine-induced conditioned place preference, we evaluated whether 50 mg of DCS would reduce craving to cocaine cues when combined with cue exposure (CE) in cocaine dependent humans. In this double-blind placebo-controlled pilot study, 47 cocaine dependent participants were randomized to DCS or placebo (PBO), plus CE. Participants received DCS or PBO 30 minutes prior to two CE sessions, conducted one day apart. Craving and heart rate was assessed prior to CE sessions, during CE trials, and after CE trials. These measures were assessed again at a 1-week follow-up (session 3) after the second CE session. DCS failed to significantly attenuate cocaine cue reactivity based on subjective craving and physiological reactivity (heart rate) compared to PBO. The CE protocol, consisting of repeated exposure to drug cues combined with skills training, resulted in extinction to cocaine cues as suggested by decreased craving within and between sessions in both treatment conditions. All participants exhibited elevated heart rate with repeated exposures, demonstrating a potentiation in heart rate between sessions. 50 mg of DCS may not be effective for extinguishing reactivity to drug cues for individuals with cocaine dependence. Future studies examining the effect of DCS on facilitating extinction to drug cues should examine variations in cue exposure length, number of CE presentations, and timing of DCS dose administration prior to cue exposures, which may differentially impact drug cue reactivity. © American Academy of Addiction Psychiatry.

  1. Blood oxygen-level dependent functional assessment of cerebrovascular reactivity: Feasibility for intraoperative 3 Tesla MRI.

    Science.gov (United States)

    Fierstra, Jorn; Burkhardt, Jan-Karl; van Niftrik, Christiaan Hendrik Bas; Piccirelli, Marco; Pangalu, Athina; Kocian, Roman; Neidert, Marian Christoph; Valavanis, Antonios; Regli, Luca; Bozinov, Oliver

    2017-02-01

    To assess the feasibility of functional blood oxygen-level dependent (BOLD) MRI to evaluate intraoperative cerebrovascular reactivity (CVR) at 3 Tesla field strength. Ten consecutive neurosurgical subjects scheduled for a clinical intraoperative MRI examination were enrolled in this study. In addition to the clinical protocol a BOLD sequence was implemented with three cycles of 44 s apnea to calculate CVR values on a voxel-by-voxel basis throughout the brain. The CVR range was then color-coded and superimposed on an anatomical volume to create high spatial resolution CVR maps. Ten subjects (mean age 34.8 ± 13.4; 2 females) uneventfully underwent the intraoperative BOLD protocol, with no complications occurring. Whole-brain CVR for all subjects was (mean ± SD) 0.69 ± 0.42, whereas CVR was markedly higher for tumor subjects as compared to vascular subjects, 0.81 ± 0.44 versus 0.33 ± 0.10, respectively. Furthermore, color-coded functional maps could be robustly interpreted for a whole-brain assessment of CVR. We demonstrate that intraoperative BOLD MRI is feasible in creating functional maps to assess cerebrovascular reactivity throughout the brain in subjects undergoing a neurosurgical procedure. Magn Reson Med 77:806-813, 2017. © 2016 International Society for Magnetic Resonance in Medicine. © 2016 International Society for Magnetic Resonance in Medicine.

  2. A pilot study assessing art therapy as a mental health intervention for subfertile women.

    Science.gov (United States)

    Hughes, Edward G; da Silva, Alicia Mann

    2011-03-01

    BACKGROUND Subfertility is a common but hidden source of anxiety, depressive symptoms and hopelessness. Counselling reduces this emotional burden and may even enhance the likelihood of pregnancy. Art therapy may be a useful intervention, because it facilitates the expression of feelings, both visually and verbally, and may ease emotional distress. METHODS Weekly 2-h art therapy group courses were held for a total of 21 subfertile women. The impact of subfertile women's support systems and barriers to coping were all explored. The effectiveness of art therapy was assessed using Beck Hopelessness, Depression and Anxiety Inventories, administered before and after participation, as well as a qualitative exit questionnaire. RESULTS The mean age of participants was 35.7 (SD 2.1) years and duration of infertility was 64 (12.0) months. Mean Beck Hopelessness Scale fell from 6.1 (3.8) to 3.5 (3.1, P = 0.01) after therapy. Beck Depression Inventory-II Score fell from 19.8 (11.0) to 12.5 (10.2, P = 0.01) and Beck Anxiety Inventory Score changed from 12.4 (8.4) to 8.4 (5.2, P = 0.3). Based on the exit questionnaire, women felt the course was insightful, powerful and enjoyable. CONCLUSIONS Art therapy is an inexpensive, non-pharmacological intervention, which was associated with decreased levels of hopelessness and depressed mood in subfertile women. It also provides insight into the meaning and emotional implications of subfertility for patients and caregivers. This pilot study highlights the need for further research in this field.

  3. Dose Assessment of Eye and Its Components in Proton Therapy by Monte Carlo Method

    Directory of Open Access Journals (Sweden)

    Marzieh Tavakol

    2014-04-01

    Full Text Available Introduction Proton therapy is used to treat malignant tumors such as melanoma inside the eye. Proton particles are adjusted according to various parameters such as tumor size and position and patient’s distance from the proton source. The purpose of this study was to assess absorbed doses in eyes and various tumors found in the area of sclera and choroid and the adjacent tissues in radiotherapy while changing most important proton therapy parameters such as moderators thickness (1.5-1.9 cm, exposure radius (0.5-0.8 cm, and proton energy beam (53.5-65 MeV. Materials and Methods A proton therapy system of Laboratori Nazionali del Sud-INFNwas simulated by Monte Carlo method. Moreover, the eye and its components were simulated using concentric spheres. To obtain a more accurate results, real density of eye components such as cornea and lens, were applied for simulation. Then, the absorbed dose of eye and eye tumor, in choroid and sclera areas, were calculated by Monte Carlo method. Results The absorbed dose in tumoral region of eye was calculated to be about 12.5 ±0.006Gy in one day with energy 62 MeV for a therapy session, which is suitable for treatment. However, normal eye cells received at most 11.01 Gy which is high. Conclusion The amount of absorbed dose in tumoral cells is noticeable. Therefore, accurate treatment planning, patient immobility and fine calibration of proton-therapy system and its simulator are very important to reduce the absorbed dose of healthy cells.

  4. Neonatal helper-dependent adenoviral vector gene therapy mediates correction of hemophilia A and tolerance to human factor VIII.

    Science.gov (United States)

    Hu, Chuhong; Cela, Racel G; Suzuki, Masataka; Lee, Brendan; Lipshutz, Gerald S

    2011-02-01

    Neonatal gene therapy is a promising strategy for treating a number of congenital diseases diagnosed shortly after birth as expression of therapeutic proteins during postnatal life may limit the pathologic consequences and result in a potential "cure." Hemophilia A is often complicated by the development of antibodies to recombinant protein resulting in treatment failure. Neonatal administration of vectors may avoid inhibitory antibody formation to factor VIII (FVIII) by taking advantage of immune immaturity. A helper-dependent adenoviral vector expressing human factor VIII was administered i.v. to neonatal hemophilia A knockout mice. Three days later, mice produced high levels of FVIII. Levels declined rapidly with animal growth to 5 wk of age with stable factor VIII expression thereafter to >1 y of age. Decline in factor VIII expression was not related to cell-mediated or humoral responses with lack of development of antibodies to capsid or human factor VIII proteins. Subsequent readministration and augmentation of expression was possible as operational tolerance was established to factor VIII without development of inhibitors; however, protective immunity to adenovirus remained.

  5. Identifying items to assess methodological quality in physical therapy trials: a factor analysis.

    Science.gov (United States)

    Armijo-Olivo, Susan; Cummings, Greta G; Fuentes, Jorge; Saltaji, Humam; Ha, Christine; Chisholm, Annabritt; Pasichnyk, Dion; Rogers, Todd

    2014-09-01

    Numerous tools and individual items have been proposed to assess the methodological quality of randomized controlled trials (RCTs). The frequency of use of these items varies according to health area, which suggests a lack of agreement regarding their relevance to trial quality or risk of bias. The objectives of this study were: (1) to identify the underlying component structure of items and (2) to determine relevant items to evaluate the quality and risk of bias of trials in physical therapy by using an exploratory factor analysis (EFA). A methodological research design was used, and an EFA was performed. Randomized controlled trials used for this study were randomly selected from searches of the Cochrane Database of Systematic Reviews. Two reviewers used 45 items gathered from 7 different quality tools to assess the methodological quality of the RCTs. An exploratory factor analysis was conducted using the principal axis factoring (PAF) method followed by varimax rotation. Principal axis factoring identified 34 items loaded on 9 common factors: (1) selection bias; (2) performance and detection bias; (3) eligibility, intervention details, and description of outcome measures; (4) psychometric properties of the main outcome; (5) contamination and adherence to treatment; (6) attrition bias; (7) data analysis; (8) sample size; and (9) control and placebo adequacy. Because of the exploratory nature of the results, a confirmatory factor analysis is needed to validate this model. To the authors' knowledge, this is the first factor analysis to explore the underlying component items used to evaluate the methodological quality or risk of bias of RCTs in physical therapy. The items and factors represent a starting point for evaluating the methodological quality and risk of bias in physical therapy trials. Empirical evidence of the association among these items with treatment effects and a confirmatory factor analysis of these results are needed to validate these items.

  6. Assessment of empirical antibiotic therapy optimisation in six hospitals: an observational cohort study.

    Science.gov (United States)

    Braykov, Nikolay P; Morgan, Daniel J; Schweizer, Marin L; Uslan, Daniel Z; Kelesidis, Theodoros; Weisenberg, Scott A; Johannsson, Birgir; Young, Heather; Cantey, Joseph; Srinivasan, Arjun; Perencevich, Eli; Septimus, Edward; Laxminarayan, Ramanan

    2014-12-01

    Modification of empirical antimicrobials when warranted by culture results or clinical signs is recommended to control antimicrobial overuse and resistance. We aimed to assess the frequency with which patients were started on empirical antimicrobials, characteristics of the empirical regimen and the clinical characteristics of patients at the time of starting antimicrobials, patterns of changes to empirical therapy at different timepoints, and modifiable factors associated with changes to the initial empirical regimen in the first 5 days of therapy. We did a chart review of adult inpatients receiving one or more antimicrobials in six US hospitals on 4 days during 2009 and 2010. Our primary outcome was the modification of antimicrobial regimen on or before the 5th day of empirical therapy, analysed as a three-category variable. Bivariate analyses were used to establish demographic and clinical variables associated with the outcome. Variables with p values below 0·1 were included in a multivariable generalised linear latent and mixed model with multinomial logit link to adjust for clustering within hospitals and accommodate a non-binary outcome variable. Across the six study sites, 4119 (60%) of 6812 inpatients received antimicrobials. Of 1200 randomly selected patients with active antimicrobials, 730 (61%) met inclusion criteria. At the start of therapy, 220 (30%) patients were afebrile and had normal white blood cell counts. Appropriate cultures were collected from 432 (59%) patients, and 250 (58%) were negative. By the 5th day of therapy, 12·5% of empirical antimicrobials were escalated, 21·5% were narrowed or discontinued, and 66·4% were unchanged. Narrowing or discontinuation was more likely when cultures were collected at the start of therapy (adjusted OR 1·68, 95% CI 1·05-2·70) and no infection was noted on an initial radiological study (1·76, 1·11-2·79). Escalation was associated with multiple infection sites (2·54, 1·34-4·83) and a positive

  7. Pupillometric analysis for assessment of gene therapy in Leber Congenital Amaurosis patients

    Directory of Open Access Journals (Sweden)

    Melillo Paolo

    2012-07-01

    Full Text Available Abstract Background Objective techniques to assess the amelioration of vision in patients with impaired visual function are needed to standardize efficacy assessment in gene therapy trials for ocular diseases. Pupillometry has been investigated in several diseases in order to provide objective information about the visual reflex pathway and has been adopted to quantify visual impairment in patients with Leber Congenital Amaurosis (LCA. In this paper, we describe detailed methods of pupillometric analysis and a case study on three Italian patients affected by Leber Congenital Amaurosis (LCA involved in a gene therapy clinical trial at two follow-up time-points: 1 year and 3 years after therapy administration. Methods Pupillary light reflexes (PLR were measured in patients who had received a unilateral subretinal injection in a clinical gene therapy trial. Pupil images were recorded simultaneously in both eyes with a commercial pupillometer and related software. A program was generated with MATLAB software in order to enable enhanced pupil detection with revision of the acquired images (correcting aberrations due to the inability of these severely visually impaired patients to fixate, and computation of the pupillometric parameters for each stimulus. Pupil detection was performed through Hough Transform and a non-parametric paired statistical test was adopted for comparison. Results The developed program provided correct pupil detection also for frames in which the pupil is not totally visible. Moreover, it provided an automatic computation of the pupillometric parameters for each stimulus and enabled semi-automatic revision of computerized detection, eliminating the need for the user to manually check frame by frame. With reference to the case study, the amplitude of pupillary constriction and the constriction velocity were increased in the right (treated eye compared to the left (untreated eye at both follow-up time-points, showing stability of

  8. Pupillometric analysis for assessment of gene therapy in Leber Congenital Amaurosis patients.

    Science.gov (United States)

    Melillo, Paolo; Pecchia, Leandro; Testa, Francesco; Rossi, Settimio; Bennett, Jean; Simonelli, Francesca

    2012-07-19

    Objective techniques to assess the amelioration of vision in patients with impaired visual function are needed to standardize efficacy assessment in gene therapy trials for ocular diseases. Pupillometry has been investigated in several diseases in order to provide objective information about the visual reflex pathway and has been adopted to quantify visual impairment in patients with Leber Congenital Amaurosis (LCA). In this paper, we describe detailed methods of pupillometric analysis and a case study on three Italian patients affected by Leber Congenital Amaurosis (LCA) involved in a gene therapy clinical trial at two follow-up time-points: 1 year and 3 years after therapy administration. Pupillary light reflexes (PLR) were measured in patients who had received a unilateral subretinal injection in a clinical gene therapy trial. Pupil images were recorded simultaneously in both eyes with a commercial pupillometer and related software. A program was generated with MATLAB software in order to enable enhanced pupil detection with revision of the acquired images (correcting aberrations due to the inability of these severely visually impaired patients to fixate), and computation of the pupillometric parameters for each stimulus. Pupil detection was performed through Hough Transform and a non-parametric paired statistical test was adopted for comparison. The developed program provided correct pupil detection also for frames in which the pupil is not totally visible. Moreover, it provided an automatic computation of the pupillometric parameters for each stimulus and enabled semi-automatic revision of computerized detection, eliminating the need for the user to manually check frame by frame. With reference to the case study, the amplitude of pupillary constriction and the constriction velocity were increased in the right (treated eye) compared to the left (untreated) eye at both follow-up time-points, showing stability of the improved PLR in the treated eye. Our method

  9. The RNA Template Channel of the RNA-Dependent RNA Polymerase as a Target for Development of Antiviral Therapy of Multiple Genera within a Virus Family

    NARCIS (Netherlands)

    van der Linden, Lonneke; Vives-Adrián, Laia; Selisko, Barbara; Ferrer-Orta, Cristina; Liu, Xinran; Lanke, Kjerstin; Ulferts, Rachel; de Palma, Armando M.; Tanchis, Federica; Goris, Nesya; Lefebvre, David; de Clercq, Kris; Leyssen, Pieter; Lacroix, Céline; Pürstinger, Gerhard; Coutard, Bruno; Canard, Bruno; Boehr, David D.; Arnold, Jamie J.; Cameron, Craig E.; Verdaguer, Nuria; Neyts, Johan; van Kuppeveld, Frank J. M.

    2015-01-01

    The genus Enterovirus of the family Picornaviridae contains many important human pathogens (e.g., poliovirus, coxsackievirus, rhinovirus, and enterovirus 71) for which no antiviral drugs are available. The viral RNA-dependent RNA polymerase is an attractive target for antiviral therapy.

  10. T1 and T2 temperature dependence of female human breast adipose tissue at 1.5 T : groundwork for monitoring thermal therapies in the breast

    NARCIS (Netherlands)

    Baron, Paul; Deckers, RHR; Knuttel, Floor M.; Bartels, LW

    2015-01-01

    The T-1 and T-2 temperature dependence of female breast adipose tissue was investigated at 1.5 T in order to evaluate the applicability of relaxation-based MR thermometry in fat for the monitoring of thermal therapies in the breast. Relaxation times T-1, T-2 and T-2TSE (the apparent T-2 measured

  11. Development of an effective therapy and objective assessment for children with birth injuries.

    Science.gov (United States)

    Jobbágy, Ákos; Schultheisz, Judit; Horváth, Márk; Réfy Vraskóné, Hanna

    2016-12-01

    Sitting in a Huple, a patented hemisphere-like tool, permanently stimulates the vestibular system, thus improving the balancing ability of children with movement disorders. The Gézengúz Foundation for Children with Birth Injuries has been successfully applying this tool in therapy. By attaching x-Inertial Measurement Unit, a wireless three-dimensional orientation sensor, to the Huple, it can serve as an input peripheral for simple PC games. Children are thus motivated; they willingly perform balance training as well as participate in the game-like test. This improves the accuracy and reproducibility of the assessment. Knowing the actual state of the participants is an important element of feedback for the therapy. This paper describes in detail the development of the therapeutic and assessment method on the basis of the Huple: the definition of the movement pattern, the parameters characterizing the movement, and the algorithms used to rank children. Measurement series of 10 children with movement disorders validate the effectiveness of the game-like assessment.

  12. [Cerebral blood flow assessment of preterm infants during respiratory therapy with the expiratory flow increase technique].

    Science.gov (United States)

    Bassani, Mariana Almada; Caldas, Jamil Pedro Siqueira; Netto, Abimael Aranha; Marba, Sérgio Tadeu Martins

    2016-06-01

    To assess the impact of respiratory therapy with the expiratory flow increase technique on cerebral hemodynamics of premature newborns. This is an intervention study, which included 40 preterm infants (≤34 weeks) aged 8-15 days of life, clinically stable in ambient air or oxygen catheter use. Children with heart defects, diagnosis of brain lesion and/or those using vasoactive drugs were excluded. Ultrasonographic assessments with transcranial Doppler flowmetry were performed before, during and after the increase in expiratory flow session, which lasted 5minutes. Cerebral blood flow velocity and resistance and pulsatility indices in the pericallosal artery were assessed. Respiratory physical therapy did not significantly alter flow velocity at the systolic peak (p=0.50), the end diastolic flow velocity (p=0.17), the mean flow velocity (p=0.07), the resistance index (p=0.41) and the pulsatility index (p=0.67) over time. The expiratory flow increase technique did not affect cerebral blood flow in clinically-stable preterm infants. Copyright © 2015 Sociedade de Pediatria de São Paulo. Publicado por Elsevier Editora Ltda. All rights reserved.

  13. Cerebral blood flow assessment of preterm infants during respiratory therapy with the expiratory flow increase technique

    Directory of Open Access Journals (Sweden)

    Mariana Almada Bassani

    2016-06-01

    Full Text Available Abstract Objective: To assess the impact of respiratory therapy with the expiratory flow increase technique on cerebral hemodynamics of premature newborns. Methods: This is an intervention study, which included 40 preterm infants (≤34 weeks aged 8-15 days of life, clinically stable in ambient air or oxygen catheter use. Children with heart defects, diagnosis of brain lesion and/or those using vasoactive drugs were excluded. Ultrasonographic assessments with transcranial Doppler flowmetry were performed before, during and after the increase in expiratory flow session, which lasted 5min. Cerebral blood flow velocity and resistance and pulsatility indices in the pericallosal artery were assessed. Results: Respiratory physical therapy did not significantly alter flow velocity at the systolic peak (p=0.50, the end diastolic flow velocity (p=0.17, the mean flow velocity (p=0.07, the resistance index (p=0.41 and the pulsatility index (p=0.67 over time. Conclusions: The expiratory flow increase technique did not affect cerebral blood flow in clinically-stable preterm infants.

  14. Exaggerated Interventricular Dependence Among Patients With Pectus Excavatum: Combined Assessment With Cardiac MRI and Chest CT.

    Science.gov (United States)

    Deviggiano, Alejandro; Vallejos, Javier; Vina, Natalia; Martinez-Ferro, Marcelo; Bellia-Munzon, Gaston; Carrascosa, Patricia; Rodríguez-Granillo, Gaston A

    2017-04-01

    We sought to explore whether patients with pectus excavatum have exaggerated interventricular dependence and to evaluate the impact of the malformation severity (assessed on CT) on both anatomic and functional cardiac parameters (assessed on cardiac MRI). The current study involved consecutive patients with a diagnosis of pectus excavatum who were referred to undergo cardiac MRI and chest CT to establish surgical candidacy or to define treatment strategies. Sixty-two patients with pectus excavatum underwent cardiac MRI and chest CT. Fifty (81%) patients were male, and the median age was 17.5 years (range, 14.0-23.0 years). Forty-seven (76%) patients had evidence of right ventricular compression. The left ventricle showed a significantly decreased end-diastolic volume (inspiration vs expiration: 70.4 ± 11.6 vs 76.1 ± 13.7 mL/m(2), respectively; p = 0.01) and a significantly higher eccentricity index (1.52 ± 0.2 vs 1.20 ± 0.1, p pectus excavatum severity index than patients without pericardial effusion (6.3 ± 3.4 vs 4.4 ± 1.3, respectively; p = 0.003). Patients with a relative septal excursion equal to or larger than 11.8% showed a significantly higher pectus excavatum severity index than patients with a relative septal excursion of less than 11.8% (6.3 ± 2.6 vs 4.7 ± 2.4, respectively; p = 0.05). In this study, patients with pectus excavatum showed significant alterations of cardiac morphology and function that were related to the deformation severity and that manifest as an exaggerated interventricular dependence.

  15. Extension of biomass estimates to pre-assessment periods using density dependent surplus production approach

    Science.gov (United States)

    Horbowy, Jan

    2017-01-01

    Biomass reconstructions to pre-assessment periods for commercially important and exploitable fish species are important tools for understanding long-term processes and fluctuation on stock and ecosystem level. For some stocks only fisheries statistics and fishery dependent data are available, for periods before surveys were conducted. The methods for the backward extension of the analytical assessment of biomass for years for which only total catch volumes are available were developed and tested in this paper. Two of the approaches developed apply the concept of the surplus production rate (SPR), which is shown to be stock density dependent if stock dynamics is governed by classical stock-production models. The other approach used a modified form of the Schaefer production model that allows for backward biomass estimation. The performance of the methods was tested on the Arctic cod and North Sea herring stocks, for which analytical biomass estimates extend back to the late 1940s. Next, the methods were applied to extend biomass estimates of the North-east Atlantic mackerel from the 1970s (analytical biomass estimates available) to the 1950s, for which only total catch volumes were available. For comparison with other methods which employs a constant SPR estimated as an average of the observed values, was also applied. The analyses showed that the performance of the methods is stock and data specific; the methods that work well for one stock may fail for the others. The constant SPR method is not recommended in those cases when the SPR is relatively high and the catch volumes in the reconstructed period are low. PMID:29131850

  16. Temperature dependence of the shear modulus of soft tissues assessed by ultrasound

    Energy Technology Data Exchange (ETDEWEB)

    Sapin-de Brosses, E; Gennisson, J-L; Pernot, M; Fink, M; Tanter, M [Langevin Institute (CNRS UMR 7587), INSERM ERL U979, ESPCI ParisTech, 10 rue Vauquelin, 75 005 Paris (France)], E-mail: emilie.sapin@espci.fr

    2010-03-21

    Soft tissue stiffness was shown to significantly change after thermal ablation. To better understand this phenomenon, the study aims (1) to quantify and explain the temperature dependence of soft tissue stiffness for different organs, (2) to investigate the potential relationship between stiffness changes and thermal dose and (3) to study the reversibility or irreversibility of stiffness changes. Ex vivo bovine liver and muscle samples (N = 3 and N = 20, respectively) were slowly heated and cooled down into a thermally controlled saline bath. Temperatures were assessed by thermocouples. Sample stiffness (shear modulus) was provided by the quantitative supersonic shear imaging technique. Changes in liver stiffness are observed only after 45 deg. C. In contrast, between 25 deg. C and 65 deg. C, muscle stiffness varies in four successive steps that are consistent with the thermally induced proteins denaturation reported in the literature. After a 6 h long heating and cooling process, the final muscle stiffness can be either smaller or bigger than the initial one, depending on the stiffness at the end of the heating. Another important result is that stiffness changes are linked to thermal dose. Given the high sensitivity of ultrasound to protein denaturation, this study gives promising prospects for the development of ultrasound-guided HIFU systems.

  17. Feasibility of Ecological Momentary Assessment Using Cellular Telephones in Methamphetamine Dependent Subjects

    Directory of Open Access Journals (Sweden)

    John Mendelson

    2008-01-01

    Full Text Available Background: Predictors of relapse to methamphetamine use are poorly understood. State variables may play an important role in relapse, but they have been difficult to measure at frequent intervals in outpatients.Methods: We conducted a feasibility study of the use of cellular telephones to collect state variable data from outpatients. Six subjects in treatment for methamphetamine dependence were called three times per weekday for approximately seven weeks. Seven questionnaires were administered that assessed craving, stress, affect and current type of location and social environment.Results: 395/606 (65% of calls attempted were completed. The mean time to complete each call was 4.9 (s.d. 1.8 minutes and the mean time to complete each item was 8.4 (s.d. 4.8 seconds. Subjects rated the acceptability of the procedures as good. All six cellular phones and battery chargers were returned undamaged.Conclusion: Cellular telephones are a feasible method for collecting state data from methamphetamine dependent outpatients.

  18. Feasibility of Ecological Momentary Assessment Using Cellular Telephones in Methamphetamine Dependent Subjects

    Directory of Open Access Journals (Sweden)

    Gantt P. Galloway

    2008-01-01

    Full Text Available Background Predictors of relapse to methamphetamine use are poorly understood. State variables may play an important role in relapse, but they have been difficult to measure at frequent intervals in outpatients. Methods We conducted a feasibility study of the use of cellular telephones to collect state variable data from outpatients. Six subjects in treatment for methamphetamine dependence were called three times per weekday for approximately seven weeks. Seven questionnaires were administered that assessed craving, stress, affect and current type of location and social environment. Results 395/606 (65% of calls attempted were completed. The mean time to complete each call was 4.9 (s.d. 1.8 minutes and the mean time to complete each item was 8.4 (s.d. 4.8 seconds. Subjects rated the acceptability of the procedures as good. All six cellular phones and battery chargers were returned undamaged. Conclusion Cellular telephones are a feasible method for collecting state data from methamphetamine dependent outpatients.

  19. Time-dependent resilience assessment and improvement of urban infrastructure systems.

    Science.gov (United States)

    Ouyang, Min; Dueñas-Osorio, Leonardo

    2012-09-01

    This paper introduces an approach to assess and improve the time-dependent resilience of urban infrastructure systems, where resilience is defined as the systems' ability to resist various possible hazards, absorb the initial damage from hazards, and recover to normal operation one or multiple times during a time period T. For different values of T and its position relative to current time, there are three forms of resilience: previous resilience, current potential resilience, and future potential resilience. This paper mainly discusses the third form that takes into account the systems' future evolving processes. Taking the power transmission grid in Harris County, Texas, USA as an example, the time-dependent features of resilience and the effectiveness of some resilience-inspired strategies, including enhancement of situational awareness, management of consumer demand, and integration of distributed generators, are all simulated and discussed. Results show a nonlinear nature of resilience as a function of T, which may exhibit a transition from an increasing function to a decreasing function at either a threshold of post-blackout improvement rate, a threshold of load profile with consumer demand management, or a threshold number of integrated distributed generators. These results are further confirmed by studying a typical benchmark system such as the IEEE RTS-96. Such common trends indicate that some resilience strategies may enhance infrastructure system resilience in the short term, but if not managed well, they may compromise practical utility system resilience in the long run.

  20. ASSESSMENT OF MICRONEEDLING THERAPY IN THE MANAGEMENT OF ATROPHIC FACIAL ACNE SCARS

    Directory of Open Access Journals (Sweden)

    Ajay

    2015-12-01

    Full Text Available STUDY BACKGROUND Post acne scars are always a challenge to treat, especially the ones which are deep seated. There are many treatment options like laser resurfacing, dermabrasion, microdermabrasion and non-ablative laser resurfacing but with considerable morbidity and interference with the daily activities of the patient in the post-treatment period. Microneedling or dermaroller therapy is one of the new treatment options in the management of acne scars with satisfactory improvement and no significant side effect. The aim of the present study is to perform an objective evaluation the efficacy of microneedling in the treatment of atrophic acne scars. MATERIALS AND METHODS Thirty patients of skin type III-V having atrophic facial acne scars presenting to our dermatology OPD. were received multiple sittings of microneedling (dermaroller treatment with an interval of 6 weeks between each session. Goodman & Baron’s acne scar grading system was used for assessment of their scars and was evaluated clinically by serial photography at the start as well as at two months after the conclusion of the treatment. Patients on anticoagulant therapy, of keloidal tendency, with bleeding disorders, vitiligo patients, pregnant and lactating mothers and patients with active acne lesions were excluded from the study. The duration of this study was for ten months-from January 2014 to October 2014. RESULTS Any change in the grading of scars after the end of treatment and follow-up period was noted down. The efficacy and improvement of dermaroller treatment was assessed by Goodman and Baron’s Global Acne Scarring System. Out of 30 patients, 26(80.64% patients achieved a reduction in the severity of their scarring by one or two grades. Quantitative assessment showed that 13.3% of patients had minimal, 16.6% had good and 70% showed very good improvement. Adverse effects were limited to transient pain, erythema and edema. CONCLUSION Microneedling therapy seems to be

  1. Computed tomography assessment of early response to neoadjuvant therapy in colon cancer

    DEFF Research Database (Denmark)

    Dam, Claus; Lund-Rasmussen, Vera; Pløen, John

    2015-01-01

    INTRODUCTION: Using multidetector computed tomography, we aimed to assess the early response of neoadjuvant drug therapy for locally advanced colon cancer. METHODS: Computed tomography with IV contrast was acquired from 67 patients before and after up to three cycles of preoperative treatment. All...... patients had histologically confirmed colon cancer, a T4 or T3 tumour with extramural invasion ≥ 5 mm and no distant metastases or peritoneal nodules. The patients were treated with oxaliplatin and capecitabine. In addition, those with no mutations in the KRAS, BRAF and PIK3CA genes were also treated...

  2. Photoacoustic tomography assessment of vascular targeted therapy to determine vessel regrowth following treatment

    Science.gov (United States)

    Johnson, S. P.; Ogunlade, O.; Zhang, E.; Laufer, J.; Rajkumar, V.; Walker-Samuel, S.; Lythgoe, M. F.; Pedley, R. B.; Beard P., P.

    2013-06-01

    Photoacoustic tomography (PAT) is ideally suited to image tissue vasculature and is therefore able to provide functional response data for the pharmacodynamic time course of vascular targeted therapies. We show in a preclinical model of colorectal carcinoma that 40mg/kg of the vascular disrupting agent OXi4503 causes central tumour blood vessel destruction that can be assessed by PAT at 48 hours. This is confirmed with histological haematoxylin and eosin staining. Outward growth of solid tumours is then static until 16 days post-dose whilst vessel regrowth occurs inwardly to repopulate the necrotic core.

  3. Assessment of peritrochanteric high T2 signal depending on the age and gender of the patients

    Energy Technology Data Exchange (ETDEWEB)

    Haliloglu, Nuray, E-mail: nurayunsal2@hotmail.co [Ankara University School of Medicine, Department of Radiology (Turkey); Inceoglu, Deniz; Sahin, Gulden [Ankara University School of Medicine, Department of Radiology (Turkey)

    2010-07-15

    Introduction: The aim of this study is to evaluate the incidence of peritrochanteric high T2 signal (peritrochanteric edema, peritendinitis) on routine MR imaging studies and to determine whether reporting peritrochanteric edema is always clinically relevant depending on the age and gender of the patients. Materials and methods: We evaluated 79 consecutive bilateral hip MR images performed in our department between January 2006 and December 2006 (57 female, 22 male patients, mean age 49 years). Each study was evaluated for areas of T2 hyperintensity representing edema around the greater trochanter. Patients with a known fracture, tumor, history of radiation therapy, history of hip surgery and prothesis were excluded from the study. Patients with signal intensity alterations within the thickened gluteus medius/minimus tendons (tendinitis) or peritrochanteric bursal fluid accumulation (bursitis) were also excluded. All patients were scanned with our routine MR imaging protocol for hip imaging. Results: In 55 of the 79 patients (70%) peritrochanteric edema was detected on MR images and 52 of these 55 patients (95%) had these changes on both hips. The median age was 56 years for the patients with peritrochanteric edema and 35.5 years for the patients without peritrochanteric edema. There was statistical significance between the median ages of the patients and a significant increased risk of peritrochanteric edema was found over 40 years of age. There was no significant difference between male and female patients. Conclusion: Bilateral peritrochanteric high T2 signal may be a part of the degeneration process and we suggest that it may not be necessarily reported if the clinical findings do not support greater trochanteric pain syndrome.

  4. Music Therapy for children with special needs - clinical practice and assessment in the light of developmental psychology and communicative musicality

    DEFF Research Database (Denmark)

    Holck, Ulla

    ). An Ethnographic Descriptive Approach to Video Micro Analysis. In: Wosch, T. & Wigram, T. (Eds.). Microanalysis in music therapy. London: Jessica Kingsley Publishers. Jacobsen, S. L. (2012). Music Therapy Assessment and Development of Parental Competences in Families Where Children Have Experienced Emotional...... Neglect. PhD thesis, Department of Communication, Aalborg University. See chapter 2.5.5-6. For download: http://vbn.aau.dk/files/68298796/42798_jacobsen2012.pdf Priestley, M. (1994). Essays on Analytical Music Therapy. Phoenixville PA: Barcelona Pub¬lishers. Wigram, T. (1999). Assessment Methods in Music...

  5. Blood oxygenation level-dependent MRI for assessment of renal oxygenation

    Directory of Open Access Journals (Sweden)

    Neugarten J

    2014-11-01

    Full Text Available Joel Neugarten, Ladan Golestaneh Renal Division, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA Abstract: Blood oxygen level-dependent magnetic resonance imaging (BOLD MRI has recently emerged as an important noninvasive technique to assess intrarenal oxygenation under physiologic and pathophysiologic conditions. Although this tool represents a major addition to our armamentarium of methodologies to investigate the role of hypoxia in the pathogenesis of acute kidney injury and progressive chronic kidney disease, numerous technical limitations confound interpretation of data derived from this approach. BOLD MRI has been utilized to assess intrarenal oxygenation in numerous experimental models of kidney disease and in human subjects with diabetic and nondiabetic chronic kidney disease, acute kidney injury, renal allograft rejection, contrast-associated nephropathy, and obstructive uropathy. However, confidence in conclusions based on data derived from BOLD MRI measurements will require continuing advances and technical refinements in the use of this technique. Keywords: kidney, hypoxia, oxygenation, diabetes mellitus, chronic kidney disease, acute kidney injury, contrast-associated nephropathy, BOLD MRI

  6. Objective assessment of biomagnetic devices and alternative clinical therapies using infrared thermal imaging

    Science.gov (United States)

    Rockley, Graham J.

    2001-03-01

    The overwhelming introduction of magnetic devices and other alternative therapies into the health care market prompts the need for objective evaluation of these techniques through the use of infrared thermal imaging. Many of these therapies are reported to promote the stimulation of blood flow or the relief of pain conditions. Infrared imaging is an efficient tool to assess such changes in the physiological state. Therefore, a thermal imager can help document and substantiate whether these therapies are in fact providing an effective change to the local circulation. Thermal images may also indicate whether the change is temporary or sustained. As a specific case example, preliminary findings will be presented concerning the use of magnets and the effect they have on peripheral circulation. This will include a discussion of the recommended protocols for this type of infrared testing. This test model can be applied to the evaluation of other devices and therapeutic procedures which are reputed to affect circulation such as electro acupuncture, orthopedic footwear and topical ointments designed to relieve pain or inflammation.

  7. Challenge models to assess new therapies in chronic obstructive pulmonary disease

    Directory of Open Access Journals (Sweden)

    van der Merwe R

    2012-09-01

    Full Text Available René van der Merwe,1 Nestor A Molfino2,31Respiratory Clinical Development, MedImmune Ltd, Cambridge, UK; 2Respiratory Clinical Development, MedImmune, LLC, Gaithersburg, MD, USA, 3KaloBios Pharmaceuticals, South San Francisco, CA, USAAbstract: Chronic obstructive pulmonary disease (COPD is a major cause of morbidity and mortality. Current therapies confer partial benefits either by incompletely improving airflow limitation or by reducing acute exacerbations, hence new therapies are desirable. In the absence of robust early predictors of clinical efficacy, the potential success of novel therapeutic agents in COPD will not entirely be known until the drugs enter relatively large and costly clinical trials. New predictive models in humans, and new study designs are being sought to allow for confirmation of pharmacodynamic and potentially clinically meaningful effects in early development. This review focuses on human challenge models with lipopolysaccharide endotoxin, ozone, and rhinovirus, in the early clinical development phases of novel therapeutic agents for the treatment and reduction of exacerbations in COPD.Keywords: chronic obstructive pulmonary disease, challenge models, therapy assessment

  8. Assessing the feasibility of injectable growth-promoting therapy in Crohn's disease.

    Science.gov (United States)

    Altowati, Mabrouka A; Jones, Ashley P; Hickey, Helen; Williamson, Paula R; Barakat, Farah M; Plaatjies, Nicolene C; Hardwick, Ben; Russell, Richard K; Jaki, Thomas; Ahmed, S Faisal; Sanderson, Ian R

    2016-01-01

    Despite optimal therapy, many children with Crohn's disease (CD) experience growth retardation. The objectives of the study are to assess the feasibility of a randomised control trial (RCT) of injectable forms of growth-promoting therapy and to survey the attitudes of children with CD and their parents to it. A feasibility study was carried out to determine study arms, sample size and numbers of eligible patients. A face-to-face questionnaire surveyed willingness to consent to future participation in the RCT. Eligibility to the survey was any child under 18 (with their parent/guardian) with CD whose height standard deviation score (HtSDS) was ≤+1. Of 118 questionnaires, 94 (80%) were returned (48 by children and 46 by parents). The median age of the patients in the survey was 14.3 years (range 7.0 to 17.7), and 35 (73%) were male. Their median HtSDS was -1.2 (-3.01, 0.23), and it was lower than the median mid-parental HtSDS of -0.6 (-3.1, 1.4). We analysed the willingness of the children whose HtSDS promoting therapy. Allaying fears about injections may result in higher recruitment rates.

  9. Concise Review: Workshop Review: Understanding and Assessing the Risks of Stem Cell-Based Therapies

    Science.gov (United States)

    Heslop, James A.; Hammond, Thomas G.; Santeramo, Ilaria; Tort Piella, Agnès; Hopp, Isabel; Zhou, Jing; Baty, Roua; Graziano, Enrique I.; Proto Marco, Bernabé; Caron, Alexis; Sköld, Patrik; Andrews, Peter W.; Baxter, Melissa A.; Hay, David C.; Hamdam, Junnat; Sharpe, Michaela E.; Patel, Sara; Jones, David R.; Reinhardt, Jens; Danen, Erik H.J.; Ben-David, Uri; Stacey, Glyn; Björquist, Petter; Piner, Jacqueline; Mills, John; Rowe, Cliff; Pellegrini, Giovanni; Sethu, Swaminathan; Antoine, Daniel J.; Cross, Michael J.; Murray, Patricia; Williams, Dominic P.; Kitteringham, Neil R.; Park, B. Kevin

    2015-01-01

    The field of stem cell therapeutics is moving ever closer to widespread application in the clinic. However, despite the undoubted potential held by these therapies, the balance between risk and benefit remains difficult to predict. As in any new field, a lack of previous application in man and gaps in the underlying science mean that regulators and investigators continue to look for a balance between minimizing potential risk and ensuring therapies are not needlessly kept from patients. Here, we attempt to identify the important safety issues, assessing the current advances in scientific knowledge and how they may translate to clinical therapeutic strategies in the identification and management of these risks. We also investigate the tools and techniques currently available to researchers during preclinical and clinical development of stem cell products, their utility and limitations, and how these tools may be strategically used in the development of these therapies. We conclude that ensuring safety through cutting-edge science and robust assays, coupled with regular and open discussions between regulators and academic/industrial investigators, is likely to prove the most fruitful route to ensuring the safest possible development of new products. PMID:25722427

  10. Hemodynamic effects of vacuum-assisted closure therapy in cardiac surgery: assessment using magnetic resonance imaging.

    Science.gov (United States)

    Petzina, Rainer; Ugander, Martin; Gustafsson, Lotta; Engblom, Henrik; Sjögren, Johan; Hetzer, Roland; Ingemansson, Richard; Arheden, Håkan; Malmsjö, Malin

    2007-05-01

    The hemodynamic effects of vacuum-assisted closure therapy in cardiac surgery are debated. The aim of the present study was to quantify cardiac output and left ventricular chamber volumes after vacuum-assisted closure using magnetic resonance imaging, which is known to be the most accurate method for quantifying these measures. Six pigs had median sternotomy followed by vacuum-assisted closure treatment in the presence and absence of a paraffin gauze interface dressing. Cardiac output and stroke volume were examined using magnetic resonance imaging flow quantification (breath-hold and real-time). Chamber volumes were assessed using cine magnetic resonance imaging. Cardiac output and stroke volume decreased immediately after application of negative pressures of 75, 125, and 175 mm Hg (13% +/- 1% decrease in cardiac output). Interposition of 4 layers of paraffin gauze dressing over the heart during vacuum-assisted closure therapy resulted in a smaller decrease in cardiac output (8% +/- 1%). Vacuum-assisted closure therapy results in an immediate decrease in cardiac output, although to a lesser extent than shown previously. Covering the heart with a wound interface dressing lessens the hemodynamic effects of vacuum-assisted closure.

  11. Music Therapy in Special Schools: The Assessment of the Quality of Relationship

    Directory of Open Access Journals (Sweden)

    Aspasia Fragkouli

    2013-12-01

    Full Text Available This qualitative scientific study – by means of analysing recorded therapeutic sessions with children with autism or mental disability in a special school – examines the process of creating a relationship between the therapist and the child in the context of music-therapeutic moments. The analysis of therapeutic moments was carried out through the AQR-instrument (Assessment of the Quality of Relationship and led to a the evaluation of the quality of relationship between the therapist and the child with autism or mental disability during therapy, b the evaluation of the correspondence of the therapeutic intervention to each child’s developmental level (modus, and c the appreciation of the differentiation in the relationship between the therapist and the child with autism or mental disability, as well as the size of that differentiation. Regardless of the pathology, it was observed that music therapy with children is advisable when the child shows disorders in his/her emotional development and in the ability to create a relationship. Music-therapeutic interventions that use the child itself as a starting point and follow the concept of elemental music, succeed in mobilising children’s healthy part and promote their development, in many areas. Research data are based on the author’s dissertation thesis: “Music therapy for children with psychological disorders in special education” (Fragkouli 2012.

  12. Computational modeling of 915 MHz microwave ablation: Comparative assessment of temperature-dependent tissue dielectric models.

    Science.gov (United States)

    Deshazer, Garron; Hagmann, Mark; Merck, Derek; Sebek, Jan; Moore, Kent B; Prakash, Punit

    2017-09-01

    The objective of this study is to develop a computational model for simulating 915 MHz microwave ablation (MWA), and verify the simulation predictions of transient temperature profiles against experimental measurements. Due to the limited experimental data characterizing temperature-dependent changes of tissue dielectric properties at 915 MHz, we comparatively assess two temperature-dependent approaches of modeling of dielectric properties: model A- piecewise linear temperature dependencies based on existing, but limited, experimental data, and model B- similar to model A, but augmented with linear decrease in electrical conductivity above 95 °C, as guided by our experimental measurements. The finite element method was used to simulate MWA procedures in liver with a clinical 915 MHz ablation applicator. A coupled electromagnetic-thermal solver incorporating temperature-dependent tissue biophysical properties of liver was implemented. Predictions of the transient temperature profiles and ablation zone dimensions for both model A and model B were compared against experimental measurements in ex vivo bovine liver tissue. Broadband dielectric properties of tissue within different regions of the ablation zone were measured and reported at 915 MHz and 2.45 GHz. Model B yielded peak tissue temperatures in closer agreement with experimental measurements, attributed to the inclusion of decrease in electrical conductivity at elevated temperature. The simulated transverse diameters of the ablation zone predicted by both models were greater than experimental measurements, which may be in part due to the lack of a tissue shrinkage model. At both considered power levels, predictions of transverse ablation zone diameters were in closer agreement with measurements for model B (max. discrepancy of 5 mm at 60 W, and 3 mm at 30 W), compared to model A (max. discrepancy of 9 mm at 60 W, and 6 mm at 30 W). Ablation zone lengths with both models were within 2 mm at 30 W, but

  13. Efficacy and safety of iron-chelation therapy with deferoxamine, deferiprone, and deferasirox for the treatment of iron-loaded patients with nontransfusion-dependent thalassemia syndromes

    Directory of Open Access Journals (Sweden)

    Taher AT

    2016-12-01

    Full Text Available Ali T Taher,1 John B Porter,2 Antonis Kattamis,3 Vip Viprakasit,4 M Domenica Cappellini51Department of Internal Medicine, American University of Beirut, Beirut, Lebanon; 2Department of Haematology, University College London, London, UK; 3First Department of Pediatrics, University of Athens, Athens, Greece; 4Department of Pediatrics and Thalassemia Center, Siriraj Hospital, Mahidol University, Bangkok, Thailand; 5Department of Internal Medicine, Università di Milano, Ca Granda Foundation IRCCS, Milan, ItalyAs the scientific steering committee for THALASSA (an assessment of Exjade in nontransfusion-dependent thalassemia [NTDT], we read with interest the review by Kontoghiorghe and Kontoghiorghes entitled “Efficacy and safety of iron-chelation therapy with deferoxamine, deferiprone, and deferasirox for the treatment of iron-loaded patients with non-transfusion-dependent thalassemia syndromes” published in January 2016.1 While this review provides a detailed overview of available iron chelators for the treatment of NTDT patients, there remain some factual inaccuracies and misrepresentations of data related to deferasirox. Therefore, we believe that the current article may be misleading to readers of Drug Design, Development and Therapy.Author’s replyGeorge J KontoghiorghesPostgraduate Research Institute of Science, Technology, Environment and Medicine, Limassol, CyprusThere are many murky areas and marketing, legal, ethical, and other conflicts in the pharmaceutical industry, some of which involve physicians and academics. These activities and related ethical issues affect the safety and treatment of millions of patients.1–11 Irregular and sometimes illegal activities for new patented drugs carried out by pharmaceutical companies, such as secrecy agreements with academics/academic institutions, can lead to biased reporting of the results of clinical trials and cover ups or underreporting of toxic side effects, as well as doctor’s bribes

  14. Using the methods of ecological momentary assessment in substance dependence research--smoking cessation as a case study.

    Science.gov (United States)

    Ferguson, Stuart G; Shiffman, Saul

    2011-01-01

    Ecological momentary assessment (EMA) is the name applied to any of a range of research methodologies that aim to assess participants in near real time as they go about their regular day-to-day activities. Such methods have particular utility for studying drug use and drug dependence. Using the area of nicotine dependence as a case study, this review highlights how EMA can be used to build upon the findings from more traditional research methods to enhance our understanding of drug use. Particular attention is given to the role that advances in technology have played in the adoption of EMA in drug dependence research.

  15. Just showing up is not enough: Homework adherence and outcome in cognitive-behavioral therapy for cocaine dependence.

    Science.gov (United States)

    Decker, Suzanne E; Kiluk, Brian D; Frankforter, Tami; Babuscio, Theresa; Nich, Charla; Carroll, Kathleen M

    2016-10-01

    Homework in cognitive-behavioral therapy (CBT) provides opportunities to practice skills. In prior studies, homework adherence was associated with improved outcome across a variety of disorders. Few studies have examined whether the relationship between homework adherence and outcome is maintained after treatment end or is independent of treatment attendance. This study combined data from 4 randomized clinical trials of CBT for cocaine dependence to examine relationships among homework adherence, participant variables, and cocaine use outcomes during treatment and at follow-up. The data set included only participants who attended at least 2 CBT sessions to allow for assignment and return of homework (N = 158). Participants returned slightly less than half (41.1%) of assigned homework. Longitudinal random effects regression suggested a greater reduction in cocaine use during treatment and through 12-month follow-up for participants who completed half or more of assigned homework (3-way interaction), F(2, 910.69) = 4.28, p = .01. In multiple linear regression, the percentage of homework adherence was associated with greater number of cocaine-negative urine toxicology screens during treatment, even when accounting for baseline cocaine use frequency and treatment attendance; at 3 months follow-up, multiple logistic regression indicated homework adherence was associated with cocaine-negative urine toxicology screen, controlling for baseline cocaine use and treatment attendance. These results extend findings from prior studies regarding the importance of homework adherence by demonstrating associations among homework and cocaine use outcomes during treatment and up to 12 months after, independent of treatment attendance and baseline cocaine use severity. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

  16. Pulsed estrogen therapy prevents post-OVX porcine dura mater microvascular network weakening via a PDGF-BB-dependent mechanism.

    Directory of Open Access Journals (Sweden)

    Olga V Glinskii

    Full Text Available In postmenopausal women, estrogen (E2 deficiencies are frequently associated with higher risk of intracranial hemorrhage, increased incidence of stroke, cerebral aneurysm, and decline in cognitive abilities. In younger postpartum women and those using oral contraceptives, perturbations in E2 are associated with higher risk of cerebral venous thrombosis. A number of serious intracranial pathologic conditions linked to E2 deficiencies, such as dural sinus thrombosis, dural fistulae, non-parenchymal intracranial hemorrhages, migraines, and spontaneous cerebrospinal fluid leaks, involve the vessels not of the brain itself, but of the outer fibrous membrane of the brain, the dura mater (DM. The pathogenesis of these disorders remains mysterious and how estrogen regulates structural and functional integrity of DM vasculature is largely unknown. Here, we demonstrate that post ovariectomy (OVX DM vascular remodeling is manifested by microvessel destabilization, capillary rarefaction, increased vascular permeability, and aberrant angio-architecture, and is the result of disrupted E2-regulated PDGF-BB signaling within dura microvasculature. These changes, associated with the reduction in systemic PDGF-BB levels, are not corrected by a flat-dose E2 hormone replacement therapy (HRT, but are largely prevented using HRT schedules mimicking physiological E2 fluctuations. We demonstrate that 1 E2 regulates PDGF-BB production by endothelial cells in a dose-dependent manner and 2 optimization of PDGF-BB levels and induction of robust PDGF-mediated endothelial cell-vascular pericyte interactions require high (estrous E2 concentrations. We conclude that high (estrous levels of E2 are important in controlling PDGF-mediated crosstalk between endothelial cells and pericytes, a fundamental mechanism governing microvessel stability and essential for preserving intracranial homeostasis.

  17. Pituitary size alteration and adverse effects of radiation therapy performed in 9 dogs with pituitary-dependent hypercortisolism.

    Science.gov (United States)

    Sawada, Harumi; Mori, Akihiro; Lee, Peter; Sugihara, Shiho; Oda, Hitomi; Sako, Toshinori

    2018-01-10

    The purpose of this study was to determine the therapeutic and/or adverse effects of radiation therapy (RT) against pituitary tumors in dogs with pituitary-dependent hypercortisolism, as monitored by frequent post-RT detailed MRI examinations, clinical signs, and changes in hormone concentrations. Nine dogs with an adrenocorticotropic hormone (ACTH)-secreting pituitary mass diagnosed by magnetic resonance imaging (MRI) underwent RT for 4weeks (total of 48Gy in 4-Gy fractions). Pituitary height/brain area (P/B) value, clinical signs, basal plasma ACTH concentrations, serum cortisol concentrations (pre- and post-ACTH stimulation test) and adverse effects of RT were evaluated before and post-RT. The P/B value was significantly lower in all nine dogs post-RT. One dog lacking any neurological signs demonstrated no change in clinical signs pre and post-RT. Out of 8 dogs which exhibited neurological signs pre-RT, half of them demonstrated complete resolution of their signs, whereas the other half showed transient resolution. In all animals with recurrence of neurological signs, pituitary tumor regrowth was not observed; however, MRI revealed moderate to severe pituitary hemorrhage. Late adverse effect (bilateral otitis media) was observed in three of nine dogs post-RT. RT did not induce any significant changes in the dogs' basal plasma ACTH concentration and pre- and post-ACTH serum cortisol concentrations. In conclusion, RT is effective to reduce pituitary size and the mass effect, but does not appear to affect blood hormone concentrations, necessitating additional medical treatment against hypercortisolism. Periodic MRI imaging post-RT enables early detection of adverse effects of RT. Copyright © 2018 Elsevier Ltd. All rights reserved.

  18. Just showing up is not enough: Homework adherence and outcome in cognitive-behavioral therapy for cocaine dependence

    Science.gov (United States)

    Decker, Suzanne E.; Kiluk, Brian. D.; Frankforter, Tami; Babuscio, Theresa; Nich, Charla; Carroll, Kathleen M.

    2017-01-01

    Objective Homework in cognitive behavioral therapy (CBT) provides opportunities to practice skills. In prior studies, homework adherence was associated with improved outcome across a variety of disorders. Few studies have examined whether the relationship between homework adherence and outcome is maintained after treatment end or is independent of treatment attendance. Method This study combined data from four randomized clinical trials of CBT for cocaine dependence to examine relationships among homework adherence, participant variables, and cocaine use outcomes during treatment and at follow-up. The dataset included only participants who attended at least two CBT sessions to allow for assignment and return of homework (N = 158). Results Participants returned slightly less than half (41.1%) of assigned homework. Longitudinal random effects regression suggested a greater reduction in cocaine use during treatment and through 12 month follow-up for participants who completed half or more of assigned homework (3 way interaction F(2, 910.69) = 4.28, p = .01). In multiple linear regression, the percentage of homework adherence was associated with greater number of cocaine-negative urine toxicology screens during treatment, even when accounting for baseline cocaine use frequency and treatment attendance; at three-months follow-up, multiple logistic regression indicated homework adherence was associated with cocaine-negative urine toxicology screen, controlling for baseline cocaine use and treatment attendance. Conclusions These results extend findings from prior studies regarding the importance of homework adherence by demonstrating associations among homework and cocaine use outcomes during treatment and up to 12 months after, independent of treatment attendance and baseline cocaine use severity. PMID:27454780

  19. Occupational therapy-based and evidence-supported recommendations for assessment and exercises in hand osteoarthritis.

    Science.gov (United States)

    Kjeken, Ingvild

    2011-12-01

    The aims of this study were to develop recommendations for occupational therapy assessment and design of hand exercise programmes in patients with hand osteoarthritis. An expert group followed a Delphi procedure to reach consensus for up to 10 recommendations for assessment and exercises, respectively. Thereafter, an evidence-based approach was used to identify and appraise research evidence supporting each recommendation, before the recommendations were validated by the expert group. The process resulted in 10 recommendations for assessment and eight for design of exercise programmes. The literature search revealed that there is a paucity of clinical trials to guide recommendations for hand osteoarthritis, and the evidence for the majority of the recommendations was based on expert opinions. Also, even if a systematic review demonstrates some evidence for the efficacy of strength training exercises in hand OA, the evidence for any specific exercise is limited to expert opinions. A first set of recommendations for assessment and exercise in hand osteoarthritis has been developed. For many of the recommendations there is a paucity of research evidence. High-quality studies are therefore needed to establish a high level of evidence concerning functional assessment and the effect of hand exercises in hand osteoarthritis.

  20. A Rasch and factor analysis of the Functional Assessment of Cancer Therapy-General (FACT-G

    Directory of Open Access Journals (Sweden)

    Selby Peter J

    2007-04-01

    Full Text Available Abstract Background Although the Functional Assessment of Cancer Therapy – General questionnaire (FACT-G has been validated few studies have explored the factor structure of the instrument, in particular using non-sample dependent measurement techniques, such as Rasch Models. Furthermore, few studies have explored the relationship between item fit to the Rasch Model and clinical utility. The aim of this study was to investigate the dimensionality and measurement properties of the FACT-G with Rasch Models and Factor analysis. Methods A factor analysis and Rasch analysis (Partial Credit Model was carried out on the FACT-G completed by a heterogeneous sample of cancer patients (n = 465. For the Rasch analysis item fit (infit mean squares ≥ 1.30, dimensionality and item invariance were assessed. The impact of removing misfitting items on the clinical utility of the subscales and FACT-G total scale was also assessed. Results The factor analysis demonstrated a four factor structure of the FACT-G which broadly corresponded to the four subscales of the instrument. Internal consistency for these four scales was very good (Cronbach's alpha 0.72 – 0.85. The Rasch analysis demonstrated that each of the subscales and the FACT-G total scale had misfitting items (infit means square ≥ 1.30. All these scales with the exception of the Social & Family Well-being Scale (SFWB were unidimensional. When misfitting items were removed, the effect sizes and the clinical utility of the instrument were maintained for the subscales and the total FACT-G scores. Conclusion The results of the traditional factor analysis and Rasch analysis of the FACT-G broadly agreed. Caution should be exercised when utilising the Social & Family Well-being scale and further work is required to determine whether this scale is best represented by two factors. Additionally, removing misfitting items from scales should be performed alongside an assessment of the impact on clinical utility.

  1. Clinical and radiological assessment of effects of long-term corticosteroid therapy on oral health

    Directory of Open Access Journals (Sweden)

    Swapna Sridevi Beeraka

    2013-01-01

    Full Text Available Background: Corticosteroids (Cs are used widely for their anti-inflammatory and immunosuppressive properties. They have the potential to cause dramatic improvement as well as produce equally dramatic adverse effects. The clinical misuse like over prescription of the drug should be avoided. Long-term administration may cause many adverse effects leading to impaired oral health. Oral health is usually not considered during management of patients on long-term corticosteroid therapy. The aim of this study was to assess the oral health status and radiological changes in the jaw bones of the patients under long-term corticosteroid therapy. Materials and Methods: Oral health of 100 patients under long-term corticosteroid therapy with a minimum of 3 months duration was compared with sex- and age-matched 100 healthy controls. The clinical examination included complete examination of the mouth and periodontal status. Radiographic evaluation of bone with the help of intra oral periapical radiograph and digital orthopantomograph and levels of serum calcium, alkaline phosphatase, and random blood sugar were assessed. ′Chi-square test′, ′Kolmogorov-Smirnov test′ and ′Mann-Whitney U test′ were used for statistical analysis. P < 0.05 was considered significant. Results: Patients on steroids exhibited significantly higher levels of candidiasis and clinical attachment loss of the periodontal ligament, probing pocket depth. Bone density was significantly lower in the study group than that in the control group. Random blood glucose was significantly higher and significant lower levels of calcium were observed in patients on steroids. Conclusion: Long-term use of Cs may affect oral health adversely leading to candidiasis as well as impair bone metabolism leading to a considerable decrease in the mandibular bone mineral density.

  2. Impact of a Respiratory Therapy Assess-and-Treat Protocol on Adult Cardiothoracic ICU Readmissions.

    Science.gov (United States)

    Dailey, Robert T; Malinowski, Thomas; Baugher, Mitchel; Rowley, Daniel D

    2017-05-01

    The purpose of this retrospective medical record review was to report on recidivism to the ICU among adult postoperative cardiac and thoracic patients managed with a respiratory therapy assess-and-treat (RTAT) protocol. Our primary null hypothesis was that there would be no difference in all-cause unexpected readmissions and escalations between the RTAT group and the physician-ordered respiratory care group. Our secondary null hypothesis was that there would be no difference in primary respiratory-related readmissions, ICU length of stay, or hospital length of stay. We reviewed 1,400 medical records of cardiac and thoracic postoperative subjects between January 2015 and October 2016. The RTAT is driven by a standardized patient assessment tool, which is completed by a registered respiratory therapist. The tool develops a respiratory severity score for each patient and directs interventions for bronchial hygiene, aerosol therapy, and lung inflation therapy based on an algorithm. The protocol period commenced on December 1, 2015, and continued through October 2016. Data relative to unplanned admissions to the ICU for all causes as well as respiratory-related causes were evaluated. There was a statistically significant difference in the all-cause unplanned ICU admission rate between the RTAT (5.8% [95% CI 4.3-7.9]) and the physician-ordered respiratory care (8.8% [95% CI 6.9-11.1]) groups (P = .034). There was no statistically significant difference in respiratory-related unplanned ICU admissions with RTAT (36% [95% CI 22.7-51.6]) compared with the physician-ordered respiratory care (53% [95% CI 41.1-64.8]) group (P = .09). The RTAT protocol group spent 1 d less in the ICU (P respiratory-related ICU readmissions did not reach statistical significance. Copyright © 2017 by Daedalus Enterprises.

  3. Assessing Adherence to Antihypertensive Therapy in Primary Health Care in Namibia: Findings and Implications.

    Science.gov (United States)

    Nashilongo, M M; Singu, B; Kalemeera, F; Mubita, M; Naikaku, E; Baker, A; Ferrario, A; Godman, B; Achieng, L; Kibuule, D

    2017-12-01

    Namibia has the highest burden and incidence of hypertension in sub-Sahara Africa. Though non-adherence to antihypertensive therapy is an important cardiovascular risk factor, little is known about potential ways to improve adherence in Namibia following universal access. The objective of this study is to validate the Hill-Bone compliance scale and determine the level and predictors of adherence to antihypertensive treatment in primary health care settings in sub-urban townships of Windhoek, Namibia. Reliability was determined by Cronbach's alpha. Principal component analysis (PCA) was used to assess construct validity. The PCA was consistent with the three constructs for 12 items, explaining 24.1, 16.7 and 10.8% of the variance. Cronbach's alpha was 0.695. None of the 120 patients had perfect adherence to antihypertensive therapy, and less than half had acceptable levels of adherence (≥ 80%). The mean adherence level was 76.7 ± 8.1%. Three quarters of patients ever missed their scheduled clinic appointment. Having a family support system (OR = 5.4, 95% CI 1.687-27.6, p = 0.045) and attendance of follow-up visits (OR = 3.1, 95% CI 1.1-8.7, p = 0.03) were significant predictors of adherence. Having HIV/AIDs did not lower adherence. The modified Namibian version of the Hill-Bone scale is reliable and valid for assessing adherence to antihypertensives in Namibia. There is sub-optimal adherence to antihypertensive therapy among primary health cares in Namibia. This needs standardized systems to strengthen adherence monitoring as well as investigation of other factors including transport to take full advantage of universal access.

  4. Phd study of reliability and validity: One step closer to a standardized music therapy assessment model

    DEFF Research Database (Denmark)

    Jacobsen, Stine Lindahl

    The paper will present a phd study concerning reliability and validity of music therapy assessment model “Assessment of Parenting Competences” (APC) in the area of families with emotionally neglected children. This study had a multiple strategy design with a philosophical base of critical realism...... of the interrater reliability analysis, test re-test analysis, and internal consistency analysis will be presented to open a discussion on the possibility of standardized music therapy models....... and pragmatism. The fixed design for this study was a between and within groups design in testing the APCs reliability and validity. The two different groups were parents with neglected children and parents with non-neglected children. The flexible design had a multiple case study strategy specifically......, communication patterns between parent and child, and type of parental response. This included a comparison with a nonclinical group and the presentation will elaborate on the advantages and disadvanteges of this in building models or tests with high degrees of reliability and validity. Promising results...

  5. SU-F-J-178: A Computer Simulation Model Observer for Task-Based Image Quality Assessment in Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Dolly, S; Mutic, S; Anastasio, M; Li, H [Washington University School of Medicine, Saint Louis, MO (United States); Yu, L [Mayo Clinic, Rochester, MN (United States)

    2016-06-15

    Purpose: Traditionally, image quality in radiation therapy is assessed subjectively or by utilizing physically-based metrics. Some model observers exist for task-based medical image quality assessment, but almost exclusively for diagnostic imaging tasks. As opposed to disease diagnosis, the task for image observers in radiation therapy is to utilize the available images to design and deliver a radiation dose which maximizes patient disease control while minimizing normal tissue damage. The purpose of this study was to design and implement a new computer simulation model observer to enable task-based image quality assessment in radiation therapy. Methods: A modular computer simulation framework was developed to resemble the radiotherapy observer by simulating an end-to-end radiation therapy treatment. Given images and the ground-truth organ boundaries from a numerical phantom as inputs, the framework simulates an external beam radiation therapy treatment and quantifies patient treatment outcomes using the previously defined therapeutic operating characteristic (TOC) curve. As a preliminary demonstration, TOC curves were calculated for various CT acquisition and reconstruction parameters, with the goal of assessing and optimizing simulation CT image quality for radiation therapy. Sources of randomness and bias within the system were analyzed. Results: The relationship between CT imaging dose and patient treatment outcome was objectively quantified in terms of a singular value, the area under the TOC (AUTOC) curve. The AUTOC decreases more rapidly for low-dose imaging protocols. AUTOC variation introduced by the dose optimization algorithm was approximately 0.02%, at the 95% confidence interval. Conclusion: A model observer has been developed and implemented to assess image quality based on radiation therapy treatment efficacy. It enables objective determination of appropriate imaging parameter values (e.g. imaging dose). Framework flexibility allows for incorporation

  6. Comparative study of aggregations under different dependency assumptions for assessment of undiscovered recoverable oil resources in the world

    Science.gov (United States)

    Crovelli, R.A.

    1985-01-01

    The U.S. Geological Survey assessed all significant sedimentary basins in the world for undiscovered conventionally recoverable crude-oil resources. Probabilistic methodology was applied to each basin assessment to produce estimates in the form of probability distributions. Basin probability distributions were computer aggregated to produce resource estimates for the entire world. Aggregation was approximated by a three-parameter lognormal distribution by combining the first three central moments of basin distributions. For purposes of experiment and study, world aggregation was conducted under four different sets of assumptions. The four cases are (1) dependent assessments of all basins, (2) dependent assessments within continental areas, but independent assessments among continental areas, (3) dependent assessments within countries, but independent assessments among countries, and (4) independent assessments of all basins. Mean estimate remained the same in all four cases, but the width of interval estimate formed using the 95th and 5th fractiles decreased with reduced dependency in going from first to fourth case. ?? 1985 Plenum Publishing Corporation.

  7. A targeted complement-dependent strategy to improve the outcome of mAb therapy, and characterization in a murine model of metastatic cancer

    Science.gov (United States)

    Elvington, Michelle; Huang, Yuxiang; Morgan, B. Paul; Qiao, Fei; van Rooijen, Nico; Atkinson, Carl

    2012-01-01

    Complement inhibitors expressed on tumor cells provide an evasion mechanism against mAb therapy and may modulate the development of an acquired antitumor immune response. Here we investigate a strategy to amplify mAb-targeted complement activation on a tumor cell, independent of a requirement to target and block complement inhibitor expression or function, which is difficult to achieve in vivo. We constructed a murine fusion protein, CR2Fc, and demonstrated that the protein targets to C3 activation products deposited on a tumor cell by a specific mAb, and amplifies mAb-dependent complement activation and tumor cell lysis in vitro. In syngeneic models of metastatic lymphoma (EL4) and melanoma (B16), CR2Fc significantly enhanced the outcome of mAb therapy. Subsequent studies using the EL4 model with various genetically modified mice and macrophage-depleted mice revealed that CR2Fc enhanced the therapeutic effect of mAb therapy via both macrophage-dependent FcγR-mediated antibody-dependent cellular cytotoxicity, and by direct complement-mediated lysis. Complement activation products can also modulate adaptive immunity, but we found no evidence that either mAb or CR2Fc treatment had any effect on an antitumor humoral or cellular immune response. CR2Fc represents a potential adjuvant treatment to increase the effectiveness of mAb therapy of cancer. PMID:22442351

  8. Time-dependent vs stationary seismic hazard assessment: an application to Mt. Etna volcano (Southern Italy)

    Science.gov (United States)

    Tuvè, T.; Azzaro, R.; D'Amico, S.; Peruzza, L.

    2009-12-01

    Hazard estimations based on the characteristic earthquake model and time-dependent renewal process are applied to the seismogenic faults at Mt. Etna volcano. Most of them are characterised by a long record of historically well-documented earthquakes occurred in the last 200 years (CMTE catalogue, Azzaro et al., 2000), often associated with coseismic surface faulting. We analyse the main seismic sequences associated to the seismotectonic domain of the Timpe system, in the eastern flank of the volcano (Azzaro, 2004). Intertimes computed for all the events which have occurred in this sector, with an epicentral intensity Io ≥ VIII EMS, show an aperiodicity coefficient (standard deviation over mean value) near to the one, typical of a stationary process; the mean recurrence time is about 17.2 years. The same analysis is also applied to a declustered catalogue, obtaining a recurrence time of 19.6 years, consistent with the value obtained by the historical rate from the catalogue. Conversely, by calculating the intertimes for each individual fault, the aperiodicity coefficient falls at ca. 0.33, depicting a quasi-periodic behaviour. For these reasons, a time-dependent approach to seismic hazard assessment by using a renewal model based on the Brownian Passage Time (BPT) distribution, is applied. Mean recurrence time of major events is calibrated by merging the inter-event times observed at each fault; aperiodicity is tuned on b-values from instrumental data, according to the approach proposed by Zoeller et al. (2008). Finally we compare these mean recurrence times with the values obtained by using only geometrical and kinematic information, as defined in Peruzza et al. (2008) for faults in Italy. Time-dependent hazard assessment is compared with the stationary assumption of seismicity, and validated in a retrospective forward model. Seismic hazard estimates is given in terms of earthquake rupture forecast: impending events are expected on the S. Tecla Fault and

  9. Estimated work ability in warm outdoor environments depends on the chosen heat stress assessment metric

    Science.gov (United States)

    Bröde, Peter; Fiala, Dusan; Lemke, Bruno; Kjellstrom, Tord

    2017-04-01

    With a view to occupational effects of climate change, we performed a simulation study on the influence of different heat stress assessment metrics on estimated workability (WA) of labour in warm outdoor environments. Whole-day shifts with varying workloads were simulated using as input meteorological records for the hottest month from four cities with prevailing hot (Dallas, New Delhi) or warm-humid conditions (Managua, Osaka), respectively. In addition, we considered the effects of adaptive strategies like shielding against solar radiation and different work-rest schedules assuming an acclimated person wearing light work clothes (0.6 clo). We assessed WA according to Wet Bulb Globe Temperature (WBGT) by means of an empirical relation of worker performance from field studies (Hothaps), and as allowed work hours using safety threshold limits proposed by the corresponding standards. Using the physiological models Predicted Heat Strain (PHS) and Universal Thermal Climate Index (UTCI)-Fiala, we calculated WA as the percentage of working hours with body core temperature and cumulated sweat loss below standard limits (38 °C and 7.5% of body weight, respectively) recommended by ISO 7933 and below conservative (38 °C; 3%) and liberal (38.2 °C; 7.5%) limits in comparison. ANOVA results showed that the different metrics, workload, time of day and climate type determined the largest part of WA variance. WBGT-based metrics were highly correlated and indicated slightly more constrained WA for moderate workload, but were less restrictive with high workload and for afternoon work hours compared to PHS and UTCI-Fiala. Though PHS showed unrealistic dynamic responses to rest from work compared to UTCI-Fiala, differences in WA assessed by the physiological models largely depended on the applied limit criteria. In conclusion, our study showed that the choice of the heat stress assessment metric impacts notably on the estimated WA. Whereas PHS and UTCI-Fiala can account for

  10. [Dependent patient and interpersonal dependency: psychotherapeutic strategies].

    Science.gov (United States)

    Versaevel, C

    2012-04-01

    This article is a review of psychotherapies for patients suffering from dependent personality and interpersonal dependency. We synthesized articles making reference to this question, notably those written by Bornstein, author who refers to the dependent personality. We highlighted the psychotherapies that have been the object of an evaluation. The research on the subject is sparse: only eight studies permitting assessment of psychotherapies in this indication in 2005. Besides these psychotherapies, we detailed other approaches which are used by practitioners in these indications. The therapy does not aim at autonomy "at all costs", but that the patient finds a dependence "adapted" to his/her environment. Before starting a therapy, an evaluation is useful to specify the type of dependence. First of all, is there a "pathological" dependence? Is the suffering of the patient secondary to his personality or not supportive enough? Does insight exist? What is the reaction of the patient if we suggest the hypothesis of a dependence on his/her part? Does he/she consider this idea or reject it? Finally, is the dependence primary or secondary? For that purpose, it is necessary to study the biography of the patient and the appearance of the comorbidity over time. The primary dependence is seen in childhood and precedes the other psychological disorders. The secondary dependence follows after the comorbidity and events of life that alter self-esteem (depression, for example). Various therapeutic strategies arise from various currents. The therapies of analytical inspiration recommend replaying the relationship of object and explicitly evoking the transfer. The behavioural and cognitive psychotherapies aim at making the patient identify the cognitions which underlie the dependence, then leading the patient to modify his/her cognition and to behave in a more autonomous way, using the theory of learning. The humanist therapies aim at a therapeutic relationship of acceptance and

  11. Time-dependent Variation in Life Cycle Assessment of Microalgal Biorefinery Co-products

    Science.gov (United States)

    Montazeri, Mahdokht

    Microalgae can serve as a highly productive biological feedstock for fuels and chemicals. The lipid fraction of algal seeds has been the primary target of research for biofuel production. However, numerous assessments have found that valorization of co-products is essential to achieve economic and environmental goals. The relative proportion of co-products depends on the biomolecular composition of algae at the time of harvesting. In the present study the productivity of lipid, starch, and protein fractions were shown through growth experiments to vary widely with species, feeding regime, and harvesting time. Four algae species were cultivated under nitrogen-replete and -deplete conditions and analyzed at regular harvesting intervals. Dynamic growth results were then used for life cycle assessment using the U.S. Department of Energy's GREET model to determine optimal growth scenarios that minimize life cycle greenhouse gas (GHG) emissions, eutrophication, and cumulative energy demand (CED), while aiming for an energy return on investment (EROI) greater than unity. Per kg of biodiesel produced, C. sorokiniana in N-replete conditions harvested at 12 days was most favorable for GHG emissions and CED, despite having a lipid content of <20%. N. oculata under the same conditions had the lowest life cycle eutrophication impacts, driven by efficient nutrient cycling and valorization of microalgal protein and anaerobic digester residue co-products. The results indicate that growth cycle times that maximize a single fraction do not necessarily result in the most favorable environmental performance on a life cycle basis, underscoring the importance of designing biorefinery systems that simultaneously optimize for lipid and non-lipid fractions.

  12. Defense Automated Neurobehavioral Assessment Accurately Measures Cognition in Patients Undergoing Electroconvulsive Therapy for Major Depressive Disorder.

    Science.gov (United States)

    Hollinger, Kristen R; Woods, Steven R; Adams-Clark, Alexis; Choi, So Yung; Franke, Caroline L; Susukida, Ryoko; Thompson, Carol; Reti, Irving M; Kaplin, Adam I

    2017-10-03

    The Defense Automated Neurobehavioral Assessment (DANA) is an electronic cognitive test battery. The present study compares DANA to the standard Mini-Mental State Examination (MMSE) in subjects undergoing electroconvulsive therapy for the treatment of major depressive disorder. Seventeen inpatient subjects in the Johns Hopkins Hospital Department of Psychiatry were administered longitudinal paired DANA and MMSE tests (7.6 ± 4.1 per patient) from January 10, 2014 to September 26, 2014. Regression analyses were conducted (with or without MMSE scores of 30) to study the impact of the MMSE upper limit, and within-subject regression analyses were conducted to compare MMSE and DANA scores over time. Statistically significant relationships were measured between DANA and MMSE scores. Relationships strengthened when MMSE scores of 30 were omitted from analyses, demonstrating a ceiling effect of the MMSE. Within-subject analyses revealed relationships between MMSE and DANA scores over the duration of the inpatient stay. Defense Automated Neurobehavioral Assessment is an electronic, mobile, repeatable, sensitive, and valid method of measuring cognition over time in depressed patients undergoing electroconvulsive therapy treatment. Automation of the DANA allows for more frequent cognitive testing in a busy clinical setting and enhances cognitive assessment sensitivity with a timed component to each test.This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

  13. Dependence of samarium-soil interaction on samarium concentration: Implications for environmental risk assessment.

    Science.gov (United States)

    Ramírez-Guinart, Oriol; Salaberria, Aitor; Vidal, Miquel; Rigol, Anna

    2018-03-01

    The sorption and desorption behaviour of samarium (Sm), an emerging contaminant, was examined in soil samples at varying Sm concentrations. The obtained sorption and desorption parameters revealed that soil possessed a high Sm retention capacity (sorption was higher than 99% and desorption lower than 2%) at low Sm concentrations, whereas at high Sm concentrations, the sorption-desorption behaviour varied among the soil samples tested. The fractionation of the Sm sorbed in soils, obtained by sequential extractions, allowed to suggest the soil properties (pH and organic matter solubility) and phases (organic matter, carbonates and clay minerals) governing the Sm-soil interaction. The sorption models constructed in the present work along with the sorption behaviour of Sm explained in terms of soil main characteristics will allow properly assessing the Sm-soil interaction depending on the contamination scenario under study. Moreover, the sorption and desorption K d values of radiosamarium in soils were strongly correlated with those of stable Sm at low concentrations (r = 0.98); indicating that the mobility of Sm radioisotopes and, thus, the risk of radioactive Sm contamination can be predicted using data from low concentrations of stable Sm. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Liquid organic foams for formulation optimization: an assessment of foam linear viscoelasticity and its temporal dependence

    Science.gov (United States)

    Kropka, Jamie; Mondy, Lisa; Celina, Mat

    2010-03-01

    Liquid foams are viscoelastic liquids, exhibiting a fast relaxation attributed to local bubble motions and a slow response due to structural evolution of the intrinsically unstable system. In this work, these processes are examined in unique organic foams that differ from the typically investigated aqueous systems in two major ways: the organic foams (1) posses a much higher continuous phase viscosity and (2) exhibit a coarsening response that involves coalescence of cells. The transient and dynamic relaxation responses of the organic foams are evaluated and discussed in relation to the response of aqueous foams. The change in the foam response with increasing gas fraction, from that of a Newtonian liquid to one that is strongly viscoelastic, is also presented. In addition, the temporal dependencies of the linear viscoelastic response are assessed in the context of the foam structural evolution. These foams and characterization techniques provide a basis for testing stabilization mechanisms in epoxy-based foams for encapsulation applications. Sandia is a multi-program laboratory operated by Sandia Corporation, a Lockheed Martin Company, for the United States Department of Energy's National Nuclear Security Administration under Contract DE-AC04-94AL85000.

  15. CYP3A time-dependent inhibition risk assessment validated with 400 reference drugs.

    Science.gov (United States)

    Zimmerlin, Alfred; Trunzer, Markus; Faller, Bernard

    2011-06-01

    Although reversible CYP3A inhibition testing is well established for predicting the drug-drug interaction potential of clinical candidates, time-dependent inhibition (TDI) has become the focus of drug designers only recently. Failure of several late-stage clinical candidates has been attributed to TDI, and this mechanism is also suspected to play a role in liver toxicities often observed in preclinical species. Measurement of enzyme inactivation rates (k(inact) and K(I)) is technically challenging, and a great deal of variability can be found in the literature. In this article, we have evaluated the TDI potential for 400 registered drugs using a high-throughput assay format based on determination of the inactivation rate (k(obs)) at a single concentration of test compound (10 μM). The advantages of this new assay format are highlighted by comparison with data generated using the IC₅₀ shift assay, a current standard approach for preliminary assessment of TDI. With use of an empirically defined positive/negative k(obs) bin of 0.02 min⁻¹, only 4% of registered drugs were found to be positive. This proportion increased to more than 20% when in-house lead optimization molecules were considered, emphasizing the importance of identifying this property in selection of promising drug candidates. Finally, it is suggested that the data and technology described here may be a good basis for building structure-activity relationships and in silico modeling.

  16. Assessing Adverse Events of Postprostatectomy Radiation Therapy for Prostate Cancer: Evaluation of Outcomes in the Regione Emilia-Romagna, Italy

    Energy Technology Data Exchange (ETDEWEB)

    Showalter, Timothy N., E-mail: tns3b@virginia.edu [Department of Radiation Oncology, University of Virginia, Charlottesville, Virginia (United States); Hegarty, Sarah E. [Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Division of Biostatistics, Department of Pharmacology and Experimental Therapeutics, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Rabinowitz, Carol [Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Maio, Vittorio [Jefferson School of Population Health, Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Hyslop, Terry [Department of Biostatistics & Bioinformatics, Duke University School of Medicine, Durham, North Carolina (United States); Dicker, Adam P. [Department of Radiation Oncology, Kimmel Cancer Center & Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (United States); Louis, Daniel Z. [Center for Research in Medical Education and Health Care, Sidney Kimmel Medical College at Thomas Jefferson University, Philadelphia, Pennsylvania (United States)

    2015-03-15

    Purpose: Although the likelihood of radiation-related adverse events influences treatment decisions regarding radiation therapy after prostatectomy for eligible patients, the data available to inform decisions are limited. This study was designed to evaluate the genitourinary, gastrointestinal, and sexual adverse events associated with postprostatectomy radiation therapy and to assess the influence of radiation timing on the risk of adverse events. Methods: The Regione Emilia-Romagna Italian Longitudinal Health Care Utilization Database was queried to identify a cohort of men who received radical prostatectomy for prostate cancer during 2003 to 2009, including patients who received postprostatectomy radiation therapy. Patients with prior radiation therapy were excluded. Outcome measures were genitourinary, gastrointestinal, and sexual adverse events after prostatectomy. Rates of adverse events were compared between the cohorts who did and did not receive postoperative radiation therapy. Multivariable Cox proportional hazards models were developed for each class of adverse events, including models with radiation therapy as a time-varying covariate. Results: A total of 9876 men were included in the analyses: 2176 (22%) who received radiation therapy and 7700 (78%) treated with prostatectomy alone. In multivariable Cox proportional hazards models, the additional exposure to radiation therapy after prostatectomy was associated with increased rates of gastrointestinal (rate ratio [RR] 1.81; 95% confidence interval [CI] 1.44-2.27; P<.001) and urinary nonincontinence events (RR 1.83; 95% CI 1.83-2.80; P<.001) but not urinary incontinence events or erectile dysfunction. The addition of the time from prostatectomy to radiation therapy interaction term was not significant for any of the adverse event outcomes (P>.1 for all outcomes). Conclusion: Radiation therapy after prostatectomy is associated with an increase in gastrointestinal and genitourinary adverse events. However

  17. 77 FR 71194 - Draft Guidance for Industry: Preclinical Assessment of Investigational Cellular and Gene Therapy...

    Science.gov (United States)

    2012-11-29

    ... Investigational Cellular and Gene Therapy Products; Availability AGENCY: Food and Drug Administration, HHS. ACTION... for Biologics Research and Evaluation (CBER), Office of Cellular, Tissue, and Gene Therapies (OCTGT). The product areas covered by this guidance are cellular therapy, gene therapy, therapeutic vaccination...

  18. Heterogeneity of myocardial iron distribution in response to chelation therapy in patients with transfusion-dependent anemias.

    Science.gov (United States)

    Hanneman, Kate; Raju, Vikram M; Moshonov, Hadas; Ward, Richard; Wintersperger, Bernd J; Crean, Andrew M; Ross, Heather; Nguyen, Elsie T

    2013-10-01

    The purpose of this study is to examine the effect of different iron chelation regimens on the distribution of myocardial iron in patients with transfusion-dependent anemias. Institutional review board approval was obtained. Patients treated with iron chelation therapy who had undergone baseline and 1-year follow-up cardiac T2* MR studies in a four-year period were identified retrospectively. One hundred and eight patients (44 % male, mean age 31.6 ± 9.7 years) were included. The interventricular septum on three short-axis slices (basal, mid and apical) was divided into anterior and inferior regions of interest for T2* analysis. Cardiac iron concentration (CIC) was calculated from T2* values. Statistical analysis included analysis of variance and paired t-test, using Bonferroni adjustment in all pairwise comparisons. At baseline, T2* measurements varied significantly across all six regions (p < 0.001): lowest in the mid anteroseptum (mean 22.3 ± 10.1 ms) and highest in the apical inferoseptum (mean 26.2 ± 12.8 ms). At follow-up, T2* and CIC values improved significantly in all segments [mean change of 3.78 ms (95 % CI (2.93, 4.62), p < 0.001) and 0.23 mg/g (95 % CI (0.16, 0.29), p < 0.001), respectively]. Change in T2* values varied significantly between segments (p < 0.001) with greatest improvement in the apical inferoseptum [4.26 ms, 95 % CI (2.42, 6.11)] and least improvement in the basal anteroseptum [2.95 ms, 95 % CI (1.37, 4.54)]. The largest improvement in T2* values was noted in patients treated with deferiprone [4.96 ms, 95 % CI (2.34, 7.58)]. There was a statistically significant difference in improvement in CIC values between chelation regimens (p = 0.016). This is the first study to report heterogeneity in response to iron chelating drugs with variable segmental changes in T2* values.

  19. Clinical Practice Guideline for Physical Therapy Assessment and Treatment in Patients With Nonspecific Neck Pain.

    Science.gov (United States)

    Bier, Jasper D; Scholten-Peeters, Wendy G M; Staal, J Bart; Pool, Jan; van Tulder, Maurits W; Beekman, Emmylou; Knoop, Jesper; Meerhoff, Guus; Verhagen, Arianne P

    2018-03-01

    The Royal Dutch Society for Physical Therapy (KNGF) issued a clinical practice guideline for physical therapists that addresses the assessment and treatment of patients with nonspecific neck pain, including cervical radiculopathy, in Dutch primary care. Recommendations were based on a review of published systematic reviews.During the intake, the patient is screened for serious pathologies and corresponding patterns. Patients with cervical radiculopathy can be included or excluded through corresponding signs and symptoms and possibly diagnostic tests (Spurling test, traction/distraction test, and Upper Limb Tension Test). History taking is done to gather information about patients' limitations, course of pain, and prognostic factors (eg, coping style) and answers to health-related questions.In case of a normal recovery (treatment profile A), management should be hands-off, and patients should receive advice from the physical therapist and possibly some simple exercises to supplement "acting as usual."In case of a delayed/deviant recovery (treatment profile B), the physical therapist is advised to use, in addition to the recommendations for treatment profile A, forms of mobilization and/or manipulation in combination with exercise therapy. Other interventions may also be considered. The physical therapist is advised not to use dry needling, low-level laser, electrotherapy, ultrasound, traction, and/or a cervical collar.In case of a delayed/deviant recovery with clear and/or dominant psychosocial prognostic factors (treatment profile C), these factors should first be addressed by the physical therapist, when possible, or the patient should be referred to a specialist, when necessary.In case of neck pain grade III (treatment profile D), the therapy resembles that for profile B, but the use of a cervical collar for pain reduction may be considered. The advice is to use it sparingly: only for a short period per day and only for a few weeks.

  20. Towards a myocardial contraction force reconstruction technique for heart disease assessment and therapy planning

    Science.gov (United States)

    Haddad, Seyyed M. H.; Drangova, Maria; White, James A.; Samani, Abbas

    2014-03-01

    Cardiac ischemic injuries can be classified into two main categories: reversible and irreversible. Treatment of reversible damages is possible through revascularization therapies. Clinically, it is quite vital to determine the reversibility of ischemic injuries and local efficiency using accurate diagnostics techniques. For this purpose, a number of imaging techniques have been developed. To our knowledge, while some of these techniques are capable of assessing tissue viability which is believed to be correlated with ischemic injuries reversibility, none of them are capable of providing information about local myocardial tissue efficiency. Note that this efficiency indicates the local tissue contribution to the overall (global) heart mechanical function which is characterized by parameters such as ejection fraction. While contraction force generation of the myocardium is a reliable and straightforward mechanical measure for the local myocardium functionality, it is also hypothesized that the level of damage reversibility expected from therapy is proportional to the intensity and distribution of these forces. As such this research involves developing a new imaging technique for cardiac contraction force quantification. This work is also geared towards another application, namely Cardiac Resynchronization Therapy (CRT), specifically for electrode leads configuration optimization. The latter has not been tackled through a systematic technique thus far. In the proposed method, contraction force reconstruction is accomplished by an inverse problem algorithm solved through an optimization framework which uses forward mechanical modelling of the myocardium iteratively to obtain the contraction forces field. As a result, the method requires a forward mechanical model of the myocardium which is computationally efficient and robust against divergence. Therefore, we developed such a model which considers all aspects of the myocardial mechanics including hyperelasticity

  1. Communicative-Pragmatic Assessment Is Sensitive and Time-Effective in Measuring the Outcome of Aphasia Therapy

    OpenAIRE

    Stahl, Benjamin; Mohr, Bettina; Dreyer, Felix R.; Lucchese, Guglielmo; Pulverm?ller, Friedemann

    2017-01-01

    A range of methods in clinical research aim to assess treatment-induced progress in aphasia therapy. Here, we used a crossover randomized controlled design to compare the suitability of utterance-centered and dialogue-sensitive outcome measures in speech-language testing. Fourteen individuals with post-stroke chronic non-fluent aphasia each received two types of intensive training in counterbalanced order: conventional confrontation naming, and communicative-pragmatic speech-language therapy ...

  2. Generation of a new transgenic mouse model for assessment of tau gene silencing therapies.

    Science.gov (United States)

    Fromholt, Susan; Reitano, Christian; Brown, Hilda; Lewis, Jada; Borchelt, David R

    2016-09-05

    Targeting the expression of genes has emerged as a potentially viable therapeutic approach to human disease. In Alzheimer's disease, therapies that silence the expression of tau could be a viable strategy to slow disease progression. We produced a novel strain of transgenic mice that could be used to assess the efficacy of gene knockdown therapies for human tau, in live mice. We designed a tetracycline-regulated transgene construct in which the cDNA for human tau was fused to ubiquitin and to luciferase to create a single fusion polyprotein, termed TUL. When expressed in brain, the TUL polyprotein was cleaved by ubiquitin-processing enzymes to release the luciferase as an independent protein, separating the half-life of luciferase from the long-lived tau protein. Treatment of bigenic tTA/TUL mice with doxycycline produced rapid declines in luciferase levels visualized by in vivo imaging and ex vivo enzyme measurement. This new mouse model can be used as a discovery tool in optimizing gene targeting therapeutics directed to reduce human tau mRNA levels.

  3. Heart rate Variability and Efficiency Assessment of Graves' Disease Radioiodine Therapy

    Directory of Open Access Journals (Sweden)

    M L Budkina

    2009-03-01

    Full Text Available Time of the transformation to the euthyroid condition after radioiodine therapy of Grave’s disease is individual and deviates from weeks to months, what requires frequent hormones control. The aim of this study was the assessment of possibility to use HRV parameters in dynamic control after the radioiodine therapy. 77 patients were examined with 114 fT4 measurement and HRV parameters recording (before radioiodine administration and in 1, 3, 6, 12 months after. From HRV parameters two were chosen as characterizing the closest correlation with fT4 and relatively independent from each other. The whole sample was divided into the teaching set (86 measurements and the test set (28 measurements. The decision rule was found by support vector machine in the teaching set asf(HR,SDNN = 0.995 lg(HR – 0.104 lg(SDNN – 1.703, where f is the indicator of the thyroid gland function, HR – heart rate during 5-minute ECG recording; SDNN – standard deviation of RR intervals; 0.995 , 0.104 and 1.703 – correcting coefficients. If f > 0, the thyrotoxicosis takes place in a patient. If f < 0 – there is no thyrotoxicosis. The analysis of diagnostic method precision in testing set gave the following results: diagnostic sensitivity was 71%, the diagnostic specificity 79%. This method can predict thyrotoxicosis elimination or relapse with high possibility. Its use can optimize thyroid function control and refuse from fixed time hormone measurement.

  4. Hyperbaric Oxygen Therapy Alleviates Carbon Monoxide Poisoning-Induced Delayed Memory Impairment by Preserving Brain-Derived Neurotrophic Factor-Dependent Hippocampal Neurogenesis.

    Science.gov (United States)

    Liu, Wen-Chung; Yang, San-Nan; Wu, Chih-Wei J; Chen, Lee-Wei; Chan, Julie Y H

    2016-01-01

    To test the hypothesis that hyperbaric oxygen therapy ameliorates delayed cognitive impairment after acute carbon monoxide poisoning by promoting neurogenesis through upregulating the brain-derived neurotrophic factor in the hippocampus. Laboratory animal experiments. University/Medical center research laboratory. Adult, male Sprague-Dawley rats. Rats were divided into five groups: (1) non-carbon monoxide-treated control, (2) acute carbon monoxide poisoning, (3) acute carbon monoxide poisoning followed by 7-day hyperbaric oxygen treatment, (4) carbon monoxide + hyperbaric oxygen with additional intracerebroventricular infusion of Fc fragment of tyrosine kinase receptor B protein (TrkB-Fc) chimera, and (5) acute carbon monoxide poisoning followed by intracerebroventricular infusion of brain-derived neurotrophic factor. Acute carbon monoxide poisoning was achieved by exposing the rats to carbon monoxide at 2,500 ppm for 40 minutes, followed by 3,000 ppm for 20 minutes. Hyperbaric oxygen therapy (at 2.5 atmospheres absolute with 100% oxygen for 60 min) was conducted during the first 7 days after carbon monoxide poisoning. Recombinant human TrkB-Fc chimera or brain-derived neurotrophic factor was infused into the lateral ventricle via the implanted osmotic minipump. For labeling of mitotic cells in the hippocampus, bromodeoxyuridine was injected into the peritoneal cavity. Distribution of bromodeoxyuridine and two additional adult neurogenesis markers, Ki-67 and doublecortin, in the hippocampus was evaluated by immunohistochemistry or immunofluorescence staining. Tissue level of brain-derived neurotrophic factor was assessed by enzyme-linked immunosorbent assay. Cognitive behavior was evaluated by the use of eight-arm radial maze. Acute carbon monoxide poisoning significantly suppressed adult hippocampal neurogenesis evident by the reduction in number of bromodeoxyuridine-positive, Ki-67⁺, and doublecortin⁺ cells in the subgranular zone of the dentate gyrus. This

  5. Lumbar segmental instability: a criterion-related validity study of manual therapy assessment

    Directory of Open Access Journals (Sweden)

    Chapple Cathy

    2005-11-01

    Full Text Available Abstract Background Musculoskeletal physiotherapists routinely assess lumbar segmental motion during the clinical examination of a patient with low back pain. The validity of manual assessment of segmental motion has not, however, been adequately investigated. Methods In this prospective, multi-centre, pragmatic, diagnostic validity study, 138 consecutive patients with recurrent or chronic low back pain (R/CLBP were recruited. Physiotherapists with post-graduate training in manual therapy performed passive accessory intervertebral motion tests (PAIVMs and passive physiological intervertebral motion tests (PPIVMs. Consenting patients were referred for flexion-extension radiographs. Sagittal angular rotation and sagittal translation of each lumbar spinal motion segment was measured from these radiographs, and compared to a reference range derived from a study of 30 asymptomatic volunteers. Motion beyond two standard deviations from the reference mean was considered diagnostic of rotational lumbar segmental instability (LSI and translational LSI. Accuracy and validity of the clinical assessments were expressed using sensitivity, specificity, and likelihood ratio statistics with 95% confidence intervals (CI. Results Only translation LSI was found to be significantly associated with R/CLBP (p Conclusion This study provides the first evidence reporting the concurrent validity of manual tests for the detection of abnormal sagittal planar motion. PAIVMs and PPIVMs are highly specific, but not sensitive, for the detection of translation LSI. Likelihood ratios resulting from positive test results were only moderate. This research indicates that manual clinical examination procedures have moderate validity for detecting segmental motion abnormality.

  6. Comprehensive assessment of vascular health in patients; towards endothelium-guided therapy.

    Science.gov (United States)

    Frolow, Marzena; Drozdz, Agata; Kowalewska, Agata; Nizankowski, Rafal; Chlopicki, Stefan

    2015-08-01

    Endothelial function has diagnostic, prognostic and therapeutic significance. A number of non-invasive techniques were introduced for its assessment, including flow-mediated dilation (FMD), finger plethysmography (RH-PAT) and digital thermal monitoring (DTM). All these methods can be performed simultaneously. In addition, various methods for measuring arterial wall stiffness are available such as: pulse wave analysis (PWA), pulse wave velocity (PWV), pulse contour analysis (PCA) and carotid wall distensibility coefficient (DC). Finally, carotid intima-media thickness (cIMT) and ankle brachial index (ABI) are used as surrogate read-outs of atherosclerosis. Here, we briefly describe the advantages, limitations and interrelationships of various methods used for the assessment of endothelial function, arterial stiffness, and present the concept of an integrated evaluation of vascular health based on multiple methods. This strategy may be useful to stratify cardiovascular risk and represents a step towards multiparametric assessment of endothelium for effective endothelium-guided therapy in patients with cardiovascular diseases. Copyright © 2015. Published by Elsevier Urban & Partner Sp. z o.o.

  7. Assessment of skin blood flow following spinal manual therapy: a systematic review.

    Science.gov (United States)

    Zegarra-Parodi, Rafael; Park, Peter Yong Soo; Heath, Deborah M; Makin, Inder Raj S; Degenhardt, Brian F; Roustit, Matthieu

    2015-04-01

    Skin blood flow (SBF) indexes have been used to describe physiological mechanisms associated with spinal manual therapy (SMT). The aims of the current review were to assess methods for data collection, assess how investigators interpreted SBF changes, and formulate recommendations to advance manual medicine research. A database search was performed in PubMed, Cochrane Library, the Physiotherapy Evidence Database, and the Cumulative Index to Nursing and Allied Health Literature through April 2014. Articles were included if at least 1 outcome measure was changes in 1 SBF index following SMT. The database search yielded 344 records. Two independent authors applied the inclusion criteria. Twenty studies met the inclusion criteria. Selected studies used heterogeneous methods to assess short-term post-SMT changes in SBF, usually vasoconstriction, which was interpreted as a general sympathoexcitatory effect through central mechanisms. However, this conclusion might be challenged by the current understanding of skin sympathetic nervous activity over local endothelial mechanisms that are specifically controlling SBF. Evaluation of SBF measurements in peripheral tissues following SMT may document physiological responses that are beyond peripheral sympathetic function. Based on the current use of SBF indexes in clinical and physiological research, 14 recommendations for advancing manual medicine research using laser Doppler flowmetry are presented. Copyright © 2014 Elsevier Ltd. All rights reserved.

  8. Elimination of hand-wrist radiographs for maturity assessment in children needing orthodontic therapy

    Energy Technology Data Exchange (ETDEWEB)

    Al Khal, Hessa A.; Wong, Ricky W.K.; Rabie, A.B.M. [University of Hong Kong, Orthodontics, Faculty of Dentistry, Prince Philip Dental Hospital, Hong Kong (China)

    2008-03-15

    Our aim was to evaluate the validity of the cervical vertebra maturation (CVM) method as an indicator of skeletal age during the circumpubertal period by correlating the CVM method with the hand-wrist maturation (HWM) method in an attempt to eliminate the need for hand-wrist radiographs for maturity assessment. Hand-wrist and lateral cephalometric radiographs of 400 Chinese were randomly selected. The age for girls was between 10 years and 15 years and for boys it was between 12 years and 17 years, so that they were within the circumpubertal period. The CVM was assessed by a method developed by Baccetti and co-workers, whereas hand-wrist maturation was assessed by Fishman's method. The CVM was significantly correlated with HWM skeletal age. (Spearman's r boys = 0.9206, girls = 0.9363). All the patients in cervical vertebra stage 3 (CVS3) of CVM corresponded to skeletal maturation indicator 2 (SMI2) or SMI3 stages of HWM (around the peak of the growth spurt). The method error was insignificant. CVM is a valid indicator of skeletal growth during the circumpubertal period. This work will provide dental practitioners with information on jaw growth modification therapy. (orig.)

  9. Functional Assessment of Cancer Therapy-Brain questionnaire: translation and linguistic adaptation to Brazilian Portuguese

    Directory of Open Access Journals (Sweden)

    Mariana Rodrigues Gazzotti

    Full Text Available CONTEXT AND OBJECTIVE: Quality of life assessment among patients with brain tumors is important, given that new treatments have increased patient survival. The aim of this study was to translate the Functional Assessment of Cancer Therapy-Brain (FACT-Br questionnaire (version 4 into Portuguese, carry out cross-cultural adaptation and assess its reproducibility. DESIGN AND SETTING: Cohort at the Universidade Federal de São Paulo (Unifesp. METHODS: Forty patients with a brain tumor seen at the neuro-oncology outpatient clinic participated in the study. The process of translation and back-translation was carried out, along with adaptation to the Portuguese language and Brazilian culture. The intraclass correlation coefficient (ICC was used to test the reproducibility of the FACT-Br (version 4. RESULTS: The reproducibility of the questionnaire was excellent (ICC = 0.95; 95% confidence interval, CI: 0.89-0.97. The ICC with a mean interval of 15 days between applications of the questionnaire was very good in all domains (ICC = 0.87 to 0.95. The mean time taken to answer the questionnaire was 6.27 ± 2.26 minutes, ranging from 3 to 11 minutes. CONCLUSION: The translated version of the FACT-Br questionnaire (version 4 adapted to the Portuguese language and Brazilian culture proved to be easily understood and achieved very good reproducibility among patients with diagnoses of brain tumors.

  10. Cotransplantation of Adipose Tissue-Derived Insulin-Secreting Mesenchymal Stem Cells and Hematopoietic Stem Cells: A Novel Therapy for Insulin-Dependent Diabetes Mellitus

    OpenAIRE

    A V Vanikar; Dave, S. D.; Thakkar, U. G.; H L Trivedi

    2010-01-01

    Aims. Insulin dependent diabetes mellitus (IDDM) is believed to be an autoimmune disorder with disturbed glucose/insulin metabolism, requiring life-long insulin replacement therapy (IRT), 30% of patients develop end-organ failure. We present our experience of cotransplantation of adipose tissue derived insulin-secreting mesenchymal stem cells (IS-AD-MSC) and cultured bone marrow (CBM) as IRT for these patients. Methods. This was a prospective open-labeled clinical trial to test efficacy and s...

  11. Methodology for assessment of low level laser therapy (LLLT) irradiation parameters in muscle inflammation treatment

    Science.gov (United States)

    Mantineo, M.; Pinheiro, J. P.; Morgado, A. M.

    2013-11-01

    Several studies in human and animals show the clinical effectiveness of low level laser therapy (LLLT) in reducing some types of pain, treating inflammation and wound healing. However, more scientific evidence is required to prove the effectiveness of LLLT since many aspects of the cellular and molecular mechanisms triggered by irradiation of injured tissue with laser remain unknown. Here, we present a methodology that can be used to evaluate the effect of different LLLT irradiation parameters on the treatment of muscle inflammation on animals, through the quantification of four cytokines (TNF-α, IL-1β, IL-2 and IL-6) in systemic blood and histological analysis of muscle tissue. We have used this methodology to assess the effect of LLLT parameters (wavelength, dose, power and type of illumination) in the treatment of inflammation induced in the gastrocnemius muscle of Wistar rats. Results obtained for laser dose evaluation with continuous illumination are presented.

  12. CT assessment of early response to neoadjuvant therapy in colon cancer

    DEFF Research Database (Denmark)

    Rafaelsen, Søren Rafael; Dam, Claus; Lund-Rasmussen, Vera

    Objectives: Using multidetector computed tomography, we aimed to assess the early response of neoadjuvant drug therapy for locally advanced colon cancer. Methods: Computed tomography with IV contrast was acquired from 67 patients before and after up to three cycles of preoperative treatment. All...... patients had histologically confirmed colon cancer, a T4 or T3 tumour with extramural invasion ≥ 5 mm and no distant metastases or peritoneal nodules. The patients were treated with oxaliplatin and capecitabine. In addition, those with no mutations in the KRAS, BRAF and PIK3CA genes were also treated...... nodes following neoadjuvant treatment of locally advanced colon cancer. NEC may induce not only tumour down-sizing, but may bring about a significant prolongation of disease-free survival and eventually improve overall survival. The shown early response to NEC leads to hope for improvement...

  13. Promoting remyelination: utilizing a viral model of demyelination to assess cell-based therapies.

    Science.gov (United States)

    Marro, Brett S; Blanc, Caroline A; Loring, Jeanne F; Cahalan, Michael D; Lane, Thomas E

    2014-10-01

    Multiple sclerosis (MS) is a chronic inflammatory disease of the CNS. While a broad range of therapeutics effectively reduce the incidence of focal white matter inflammation and plaque formation for patients with relapse-remitting forms of MS, a challenge within the field is to develop therapies that allow for axonal protection and remyelination. In the last decade, growing interest has focused on utilizing neural precursor cells (NPCs) to promote remyelination. To understand how NPCs function in chronic demyelinating environments, several excellent pre-clinical mouse models have been developed. One well accepted model is infection of susceptible mice with neurotropic variants of mouse hepatitis virus (MHV) that undergo chronic demyelination exhibiting clinical and histopathologic similarities to MS patients. Combined with the possibility that an environmental agent such as a virus could trigger MS, the MHV model of demyelination presents a relevant mouse model to assess the therapeutic potential of NPCs transplanted into an environment in which inflammatory-mediated demyelination is established.

  14. Danish translation and adaptation of Loewenstein Occupational Therapy Cognitive Assessment 2nd Edition (LOTCA-II).

    Science.gov (United States)

    Lund, Karina; Oestergaard, Lisa Gregersen; Maribo, Thomas

    2013-07-01

    To translate and adapt the English version of the Loewenstein Occupational Therapy Cognitive Assessment 2nd Edition (LOTCA-II) to Danish. The translation process followed the overall guidelines of the World Health Organization (WHO) with forward translation, expert panel discussion, pre-tests and interviews with patients and laymen, and back-translation. The translation was successful and minor corrections and adaptations were made. In total three versions were produced before the final Danish version LOTCA-II/D was drafted. The Danish version of LOTCA-II was successfully translated and adapted based on the WHO guidelines. Before implementation in clinical practice further research of the reliability and validity of the LOTCA-II/D are needed.

  15. Electromyography in the assessment and therapy of lower urinary tract dysfunction in adults

    DEFF Research Database (Denmark)

    Krhut, Jan; Zachoval, Roman; Rosier, Peter F W M

    2017-01-01

    AIM: To present the teaching module "Electromyography in the assessment and therapy of lower urinary tract dysfunction in adults." This teaching module embodies a presentation, in combination with this manuscript. This manuscript serves as a scientific background review; the evidence base made...... available on ICS website to summarize current knowledge and recommendations. METHODS: This review has been prepared by a Working Group of The ICS Urodynamics Committee. The methodology used included comprehensive literature review, consensus formation by the members of the Working Group, and review...... by members of the ICS Urodynamics Committee core panel. RESULTS: Electromyography (EMG) is a method to record spontaneous or artificially induced electrical activity of the nerve-muscle unit or to test nerve conductivity. EMG of the anal sphincter using surface electrode is most widely used screening...

  16. To what extent does ozone therapy need a real biochemical control system? Assessment and importance of oxidative stress.

    Science.gov (United States)

    Hernández, Frank Antonio

    2007-07-01

    Ozone therapy is not officially allowed in many countries, but private medical services are using this therapy worldwide. However, appropriate control systems to assess the benefits and risks of systemic ozone therapy are not always used and in such cases the treatment is based on anecdotal reports. Oxidative stress phenomenon is becoming a highlighted biological process for ozone therapy because it is deeply involved in its mechanism of action. On the contrary, ozone therapy is an efficient regulator of the oxidative stress processes. In terms of therapeutic effects, it is convenient to know the metabolic status of the organism to face new oxidative challenges before and during ozone therapy applications. Oxidative stress is also important because it is involved as a cause or effect of many diseases. Since the 1990s, there has been the necessity of developing reliable systems for measuring oxidative stress in humans. In this sense, we have proposed a system for oxidative stress diagnosis that can serve as a control system for systemic ozone therapy applications. The system is based on the blood measurement of eight biomarkers (GSH, GPx, GST, SOD, CAT, DC, SRATB, and HPT) and the interpretation of these values by a computer-developed algorithm yielding four new indices (total antioxidant activity, total prooxidant activity, redox index and grade of oxidative stress). The system shows the patient's redox status and estimation of the oxidative stress level, with this information being relevant regarding implications on dosage and therapeutic effectiveness of ozone therapy.

  17. Assessment of the setup dependence of detector response functions for mega-voltage linear accelerators

    Energy Technology Data Exchange (ETDEWEB)

    Fox, Christopher; Simon, Tom; Simon, Bill; Dempsey, James F.; Kahler, Darren; Palta, Jatinder R.; Liu Chihray; Yan Guanghua [Sun Nuclear Inc., 425-A Pineda Court, Melbourne, Florida 32940 and Department of Radiation Oncology, University of Florida, P.O. Box 100385, Gainesville, Florida 32610-0385 (United States); NRE, 202 Nuclear Science Building, University of Florida, P.O. Box 118300, Gainesville, Florida 32611-8300 and Sun Nuclear Inc., 425-A Pineda Court, Melbourne, Florida 32940 (United States); Sun Nuclear Inc., 425-A Pineda Court, Melbourne, Florida 32940 (United States); ViewRay Inc., 2 Thermo Fisher Way, Oakwood Village, Ohio 44146 (United States); Department of Radiation Oncology, University of Florida, P.O. Box 100385, Gainesville, Florida 32610-0385 (United States)

    2010-02-15

    Purpose: Accurate modeling of beam profiles is important for precise treatment planning dosimetry. Calculated beam profiles need to precisely replicate profiles measured during machine commissioning. Finite detector size introduces perturbations into the measured profiles, which, in turn, impact the resulting modeled profiles. The authors investigate a method for extracting the unperturbed beam profiles from those measured during linear accelerator commissioning. Methods: In-plane and cross-plane data were collected for an Elekta Synergy linac at 6 MV using ionization chambers of volume 0.01, 0.04, 0.13, and 0.65 cm{sup 3} and a diode of surface area 0.64 mm{sup 2}. The detectors were orientated with the stem perpendicular to the beam and pointing away from the gantry. Profiles were measured for a 10x10 cm{sup 2} field at depths ranging from 0.8 to 25.0 cm and SSDs from 90 to 110 cm. Shaping parameters of a Gaussian response function were obtained relative to the Edge detector. The Gaussian function was deconvolved from the measured ionization chamber data. The Edge detector profile was taken as an approximation to the true profile, to which deconvolved data were compared. Data were also collected with CC13 and Edge detectors for additional fields and energies on an Elekta Synergy, Varian Trilogy, and Siemens Oncor linear accelerator and response functions obtained. Response functions were compared as a function of depth, SSD, and detector scan direction. Variations in the shaping parameter were introduced and the effect on the resulting deconvolution profiles assessed. Results: Up to 10% setup dependence in the Gaussian shaping parameter occurred, for each detector for a particular plane. This translated to less than a {+-}0.7 mm variation in the 80%-20% penumbral width. For large volume ionization chambers such as the FC65 Farmer type, where the cavity length to diameter ratio is far from 1, the scan direction produced up to a 40% difference in the shaping

  18. Assessment of cholecalciferol and antihypertensive therapy concominant use in people with arterial hypertension

    Directory of Open Access Journals (Sweden)

    L.V. Yankouskaya

    2017-04-01

    Full Text Available Background. The purpose of the study was to assess the effect of cholecalciferol intake at a daily dose of 2,000 IU on the serum level of 25(ОНD total and blood pressure (BP against the background of antihypertensive therapy in people with arterial hypertension(AH stage II. Materials and methods. We performed a prospective, single-center study of 115 individuals with AH stage II (91 females and 24 males, mean age 50.7 ± 7.1 years. The duration of the follow-up period averaged 15.8 ± 1.8 months (from 12 to 18 months. The patients were receiving antihypertensive therapy according to the European guidelines: angiotensin-converting enzyme inhibitors or angiotensin receptor antagonists — losartan, or diuretics (hydrochlorothiazide or indapamide as a part of combination therapy, or calcium antagonists — amlodipine, or beta-adrenergic blockers, or their combination. Every second patient was recommended to take vitamin D in the form of cholecalciferol at a dose of 2000 IU/d daily. All subjects were performed full blood count, clinical urine examination, measure of fasting blood sugar, serum urea, serum creatinine, office systolic and diastolic blood pressure, anthropometric data, electrocardiography. Serum level of total vitamin D was determined using immunoenzymatic assay. Statistical analysis was done by using software package STATISTICA 10.0 (SN AXAR207F394425FA-Q. Results. It was found that intake of diuretics (hydrochlorothiazide at a dose of 12.5–25.0 mg or indapamide 1.5 mg as part of combination antihypertensive therapy influenced the dynamics of serum 25(OHD (F = 5.35; p = 0.02 and its level (F = 11.8; p = 0.0009. Dynamic SBP value was highest (–27.4 ± 17.9 in the group receiving a diuretic and cholecalciferol, which was significantly (p < 0.001 different from the comparison group. In the same group, we established a correlation relationship between dynamic SBP and length of cholecalciferol intake (R = 0.42; p = 0.023. A

  19. Use of FRAX®-based fracture risk assessments to identify patients who will benefit from osteoporosis therapy.

    Science.gov (United States)

    Silverman, Stuart L; Komm, Barry S; Mirkin, Sebastian

    2014-11-01

    Several pharmacological interventions, including selective estrogen receptor modulators (SERMs), bisphosphonates, denosumab, and strontium ranelate have demonstrated efficacy in reducing the incidence of osteoporotic fractures, the most severe consequence of postmenopausal osteoporosis. Until recently, bone mineral density (BMD) was the primary factor used to determine which postmenopausal women may require osteoporosis treatment. However, clinical guidelines now recommend the use of the Fracture Risk Assessment Tool (FRAX(®)), a computer-based algorithm introduced by the World Health Organization, to help primary care physicians identify postmenopausal women who may be candidates for pharmacological osteoporosis therapy based on the level of fracture risk. Beyond its utility as a resource for determining whether or not to initiate osteoporosis treatment, clinical studies have begun to evaluate the correlation between FRAX(®)-based 10-year fracture probability and efficacy of different osteoporosis treatments. Bazedoxifene, clodronate, and denosumab have shown greater fracture risk reduction at higher FRAX(®)-based 10-year fracture probabilities, but the efficacy of raloxifene, alendronate, and strontium ranelate were relatively stable regardless of fracture probability. In summary, these data suggest that the relationship between FRAX(®)-based fracture probability and efficacy of different osteoporosis treatments varies depending upon the agent in question. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. Stabilometric assessment of context dependent balance recovery in persons with multiple sclerosis: a randomized controlled study.

    Science.gov (United States)

    Cattaneo, Davide; Jonsdottir, Johanna; Regola, Alberto; Carabalona, Roberta

    2014-06-10

    Balance control relies on accurate perception of visual, somatosensory and vestibular cues. Sensory flow is impaired in Multiple Sclerosis (MS) and little is known about the ability of the sensory systems to adapt after neurological lesions reducing sensory impairment. The aims of the present study were to verify whether: 1. Balance rehabilitation administered in a challenging sensory conditions would improve stability in upright posture. 2. The improvement in a treated sensory condition would transfer to a non treated sensory condition. Fifty three persons with MS, median (min-max) EDSS score of 5 (2.5-6.5), participated in a RCT and were randomly assigned to two groups. The Experimental group received balance rehabilitation aimed at improving motor and sensory strategies. The Control group received rehabilitation treatment which did not include training of sensory strategies. Persons with MS were blindly assessed by means of a stabilometric platform with eyes open, eyes closed and dome, on both firm surface and foam. Anterior-posterior and medio-lateral sway, velocity of sway and the length of Center of Pressure (CoP) trajectory were calculated in the six sensory conditions. Experimental group showed statistically significant improvement (P stability in upright posture in eyes closed condition on firm surface, and in eyes open, closed, and dome conditions on foam. No differences were observed between groups in the eyes open condition on firm surface nor in the sensory condition not addressed during the treatment. After rehabilitation people with MS can recover from sensory impairments thus improving upright balance. Further, the improvement seems to be context-dependent and present just in the treated sensory conditions. ClinicalTrials NCT02131285.

  1. Assessment of dietary habits and nutritional status of depressive patients, depending on place of residence.

    Science.gov (United States)

    Stefanska, Ewa; Wendołowicz, Agnieszka; Cwalina, Urszula; Kowzan, Urszula; Konarzewska, Beata; Szulc, Agata; Ostrowska, Lucyna

    2017-12-23

    An increased incidence of depressive disorders observed in recent years in the Polish and world population is a serious health problem. The aim of the study was to compare dietary habits and nutritional status of patients with recurrent depressive disorders, depending on their place of residence. Their impact on selected metabolic parameters was also considered. The study group comprised 96 women and 84 men reporting to the Outpatient Mental Health Clinic at the Department of Psychiatry, Medical University of Bialystok in north-eastern Poland. The average age of the women was 46.7±11.7 years, and of men 47.0±11.3 years. In the quantitative assessmentof diets, 24-hour food recall interviews were conducted. Assessment of the nutritional status of the respondents consisted of anthropometric measurements, body composition analysis and biochemical parameters. It was show that the diets of female urban inhabitants were characterized by a significantly lower energy value and total fat content, compared to their rural counterparts. The food rations of men living in the city had a significantly higher energy value, protein content and total FAT, compared to rural residents. It was also noted that urban residents of both genders were characterized by a lower percentage of body fat, both visceral and subcutaneous (women), and a higher water content than rural residents. The study showed dietary errors in all compared groups, regardless of place of residence, which was reflected in the nutritional status of the respondents. The results also indicated that during the declared change in dietary habits, the treatment of depressive patients should include dietary instructions in order to ensure an optimum supply of nutrients.

  2. Effectiveness of Hope Therapy on Reducing Depressive Symptoms and Preventing of Relapse in Cure-Seeker Women with Dependency to Narcotic Drugs

    Directory of Open Access Journals (Sweden)

    Akram S Raesian

    2011-05-01

    Full Text Available Introduction: The aim of the present research was the investigation of the effectiveness of hope therapy on reduction of the degree of depression symptoms and prevention of relapse in cure-seeker women with dependency to narcotic drugs. Method: In semi-experimental research method 20 clients who diagnosed as substance abuse disorder that completed detoxification period successfully, and they were scored more than 14 in depression symptoms (Beck depression questionnaire, second edition selected by available sampling and assigned to two experimental (n=10 and witness (n=10 groups randomly. Experimental group was trained for 8 sessions under training of hope therapy and witness group was not under any training. The experimental peple were evaluated by Snyder Hope scale and Beck depression questionnaire and morphine test before beginning of therapy. After it and after the completition of the two months follow-up period. For analyzing of data chi square test, Z test, and ANCOVA were applied. Results: The results showed that hope therapy education could create considerable reduction in degree of depression symptoms of women suffering from addiction. In addition, results of chi square test indicated significant difference between the number of relapsed women in experimental and witness groups. Conclusion: in general, results of this survey show that hope therapy education is effective in reduction of degree of depression symptoms and prediction of relapse in cure-seeker women suffering from addiction.

  3. Assessment of the time-dependent need for stay in a high dependency unit (HDU) after major surgery by using data from an anesthesia information management system.

    Science.gov (United States)

    Betten, Jan; Roness, Aleksander Kirkerud; Endreseth, Birger Henning; Trønnes, Håkon; Tyvold, Stig Sverre; Klepstad, Pål; Nordseth, Trond

    2016-04-01

    Admittance to a high dependency unit (HDU) is expensive. Patients who receive surgical treatment with 'low anterior resection of the rectum' (LAR) or 'abdominoperineal resection of the rectum' (APR) at our hospital are routinely treated in an HDU the first 16-24 h of the postoperative (PO) period. The aim of this study was to describe the extent of HDU-specific interventions given. We included patients treated with LAR or APR at the St. Olav University Hospital (Trondheim, Norway) over a 1-year period. Physiologic data and HDU-interventions recorded during the PO-period were obtained from the anesthesia information management system (AIMS). HDU-specific interventions were defined as the need for respiratory support, fluid replacement therapy >500 ml/h, vasoactive medications, or a need for high dose opioids (morphine >7.5 mg/h i.v.). Sixty-two patients were included. Most patients needed HDU-specific interventions during the first 6 h of the PO period. After this, one-third of the patients needed one or more of the HDU-specific interventions for shorter periods of time. Another one-third of the patients had a need for HDU-specific therapies for more than ten consecutive hours, primarily an infusion of nor-epinephrine. Most patients treated with LAR or APR was in need of an HDU-specific intervention during the first 6 h of the PO-period, with a marked decline after this time period. The applied methodology, using an AIMS, demonstrates that there is great variability in individual patients' postoperative needs after major surgery, and that these needs are dynamic in their nature.

  4. [Speech therapy assessment: field study on psychometric properties, practicability, acceptance and process quality].

    Science.gov (United States)

    Voigt-Radloff, S; Leonhart, R; Schwer, B; Junde, I; Heiss, H W

    2005-01-01

    to investigate the internal consistency, responsiveness, discriminative validity, practicability, acceptance and process quality of a recently developed Speech Therapy Assessment (STA) under routine work conditions of speech and language therapists in German speaking countries. Since standardised, generic and ICF-oriented assessment tools for documentation and evaluation of speech therapy interventions for adult clients are missing in German speaking countries and existing tests cover only sub-areas, the STA has been developed in the years 1995 to 2002. By means of different domains, speech and language therapists assess client (1) communication, (2) aphasia, (3) speech apraxia, (4) dysarthria and (5) dysphagia as well as (6) her or his dealing with corresponding disabilities. 17 therapists from 14 institutions applied the STA to 260 adult clients with language, speaking or swallowing disorders. The clients were included in the study consecutively over a period of 7 month. After this period, the therapists completed a questionnaire regarding the benefit and practicability of the STA. Cronbach alpha was calculated as indicator for internal consistency, effect sizes (standardised response means) for responsiveness and ROC values for discriminative validity. The answers of the questionnaire about the benefit of the STA were evaluated both, quantitatively and qualitatively. The internal consistency and discriminative validity were high (Cronbach alpha: 0.79 to 0.95; ROC-values: 0.84 to 0.98). Effect sizes regarding responsiveness were moderate (standardised response means: 0.46 to 0.78). On a 5-step Likert scale (1 = very good, 5 = inadequate), the therapists rated the average (standard deviation) benefit of the STA with: practicability 2.6 (1.2), acceptance 2.8 (1.3), impact on diagnostics 2.8 (1.3), impact on finding therapeutic goals 3.5 (1.2), impact on communication with other rehabilitation partners 2.7 (1.5) and overall judgement 2.6 (0.9). The STA fulfils

  5. [Ultrasound duplex scanning in the assessment of the effectiveness of gravitation therapy and conservative treatment of patients with atherosclerosis obliterans of the lower extremities].

    Science.gov (United States)

    Galkin, R A; Makarov, I V; Preobrazhenskaia, N M

    2004-01-01

    Ultrasound duplex scanning was used to compare the results of the treatment of 162 patients suffering from atherosclerosis obliterans of the lower extremities. It is to be noted that 50 patients were administered only gravitation therapy, 72 patients underwent a complex of treatment measures including, in addition to gravitation therapy, physiotherapy and drug treatment, and 40 patients received conservative treatment alone. The assessment criteria were the maximal systolic velocity of blood flow (V(max)), end diastolic mean, velocity (V(min)), mean maximal velocity (V(mean)), volume velocity of blood flow (V(vol)), ankle/brachial index (ABI), and index of regional perfusion (IRP), proposed by us and representing the percent ratio of the volume velocity of blood flow to the minute heart volume (MHV). It has been revealed in the course of the treatment that the best clinical outcome was recorded in patients who received a complex of treatment measures. The use of gravitation therapy alone provided better treatment results as compared to those obtained in patients administered standard conservative therapy. Of all the indicators used, only V(mean), V(vol), ABI and IRP are of the clinical significance. However, the most significant information on the segmental blood flow was obtained on the assessment of the IRP whose values did not depend on the changes in central hemodynamics. In contrast to the ABI, the advantage of the IRP lies in the possibility of blood flow assessment in different segments and arteries of the extremities. So, the use of the quantitative indicators of ultrasound duplex scanning and, first of all, of the IRP, allows an objective evaluation of the segmental blood flow and may serve one of the significant criteria of the treatment effectiveness.

  6. Face Validity of the Functional Assessment of Cancer Therapy-Breast Symptom Index (FACT- B into Formal Arabic

    Directory of Open Access Journals (Sweden)

    Loulou Kobeissi

    2014-06-01

    Full Text Available Background: Breast cancer affects over one million women annually and is the most common global malignancy among women. Extensive improvements have taken place in the management of breast cancer in recent years and a higher percentage of women are cured from this disease. A proper assessment of the quality of life of women with breast cancer is an essential component in disease management. The Functional Assessment of Cancer Therapy- Breast Symptom Index has been commonly used and well-validated among English speaking populations as well as other populations. To date, no formal translation and evaluation of the Functional Assessment of Cancer Therapy-Breast System Index exists in Arabic. Therefore, this study intends to translate, adapt and face-validate the Functional Assessment of Cancer Therapy-Breast System Index into Arabic, specifically in the context of the Lebanese culture. Methods: We conducted forward and backward translation in Arabic, combined with face validity by clinicians. This was followed by pre-testing to ensure the instrument’s adequacy and cultural sensitivity conducted by the administration of face-to-face interviews with individual breast cancer patients (n=33 and two focus groups (4 women/group to evaluate the relevance and appropriateness of each item and words used in the questionnaire. Results: Study results reinforced the value of the Arabic translated version of the Functional Assessment of Cancer Therapy-Breast System Index in capturing the quality of life of women with breast cancer in Lebanon. Conclusion: The instrument was perceived to be adequate, appropriate for use, culturally sensitive, simple as well as exhaustive. Suggestions have been made to enrich the instruments’ ability to incorporate other quality of life dimensions not captured, as well to enhance the cultural specificity of the Functional Assessment of Cancer Therapy-Breast System Index, when administered among Lebanese women diagnosed with

  7. Cryo-thermal therapy elicits potent anti-tumor immunity by inducing extracellular Hsp70-dependent MDSC differentiation

    Science.gov (United States)

    Zhu, Jun; Zhang, Yan; Zhang, Aili; He, Kun; Liu, Ping; Xu, Lisa X.

    2016-01-01

    Achieving control of metastatic disease is a long-sought goal in cancer therapy. Treatments that encourage a patient’s own immune system are bringing new hopes in reaching such a goal. In clinic, local hyperthermia and cryoablation have been explored to induce anti-tumor immune responses against tumors. We have also developed a novel therapeutic modality of cryo-thermal treatment by alternating liquid nitrogen (LN2) cooling and radio frequency (RF) heating, and better therapeutic effect was achieved in treating metastatic cancer in animal model. In this study, we investigated the mechanism of systemic immune response elicited by cryo-thermal therapy. In the 4T1 murine mammary carcinoma model, we found that local cryo-thermal therapy resulted in a considerable reduction of distant lung metastases, and improved long-term survival. Moreover, results of tumor re-challenge experiments indicated generation of a strong tumor-specific immune memory after the local treatment of primary tumors. Our further study indicated that cryo-thermal therapy caused an elevated extracellular release of Hsp70. Subsequently, Hsp70 induced differentiation of MDSCs into mature DCs, contributing to the relief of MDSCs-mediated immunosuppression and ultimately the activation of strong anti-tumor immune response. Our findings reveal new insight into the mechanism of robust therapeutic effects of cryo-thermal therapy against metastatic cancers. PMID:27256519

  8. Cryo-thermal therapy elicits potent anti-tumor immunity by inducing extracellular Hsp70-dependent MDSC differentiation

    Science.gov (United States)

    Zhu, Jun; Zhang, Yan; Zhang, Aili; He, Kun; Liu, Ping; Xu, Lisa X.

    2016-06-01

    Achieving control of metastatic disease is a long-sought goal in cancer therapy. Treatments that encourage a patient’s own immune system are bringing new hopes in reaching such a goal. In clinic, local hyperthermia and cryoablation have been explored to induce anti-tumor immune responses against tumors. We have also developed a novel therapeutic modality of cryo-thermal treatment by alternating liquid nitrogen (LN2) cooling and radio frequency (RF) heating, and better therapeutic effect was achieved in treating metastatic cancer in animal model. In this study, we investigated the mechanism of systemic immune response elicited by cryo-thermal therapy. In the 4T1 murine mammary carcinoma model, we found that local cryo-thermal therapy resulted in a considerable reduction of distant lung metastases, and improved long-term survival. Moreover, results of tumor re-challenge experiments indicated generation of a strong tumor-specific immune memory after the local treatment of primary tumors. Our further study indicated that cryo-thermal therapy caused an elevated extracellular release of Hsp70. Subsequently, Hsp70 induced differentiation of MDSCs into mature DCs, contributing to the relief of MDSCs-mediated immunosuppression and ultimately the activation of strong anti-tumor immune response. Our findings reveal new insight into the mechanism of robust therapeutic effects of cryo-thermal therapy against metastatic cancers.

  9. Design and implementation of a factorial randomized controlled trial of methadone maintenance therapy and an evidence-based behavioral intervention for incarcerated people living with HIV and opioid dependence in Malaysia.

    Science.gov (United States)

    Bazazi, Alexander R; Wickersham, Jeffrey A; Wegman, Martin P; Culbert, Gabriel J; Pillai, Veena; Shrestha, Roman; Al-Darraji, Haider; Copenhaver, Michael M; Kamarulzaman, Adeeba; Altice, Frederick L

    2017-08-01

    Incarcerated people living with HIV and opioid dependence face enormous challenges to accessing evidence-based treatment during incarceration and after release into the community, placing them at risk of poor HIV treatment outcomes, relapse to opioid use and accompanying HIV transmission risk behaviors. Here we describe in detail the design and implementation of Project Harapan, a prospective clinical trial conducted among people living with HIV and opioid dependence who transitioned from prison to the community in Malaysia from 2010 to 2014. This trial involved 2 interventions: within-prison initiation of methadone maintenance therapy and an evidence-based behavioral intervention adapted to the Malaysian context (the Holistic Health Recovery Program for Malaysia, HHRP-M). Individuals were recruited and received the interventions while incarcerated and were followed for 12months after release to assess post-release HIV transmission risk behaviors and a range of other health-related outcomes. Project Harapan was designed as a fully randomized 2×2 factorial trial where individuals would be allocated in equal proportions to methadone maintenance therapy and HHRP-M, methadone maintenance therapy alone, HHRP-M alone, or control. Partway through study implementation, allocation to methadone maintenance therapy was changed from randomization to participant choice; randomization to HHRP-M continued throughout. We describe the justification for this study; the development and implementation of these interventions; changes to the protocol; and screening, enrollment, treatment receipt, and retention of study participants. Logistical, ethical, and analytic issues associated with the implementation of this study are discussed. Copyright © 2017 Elsevier Inc. All rights reserved.

  10. Alteration in the concentrations of Interleukin-7 (IL-7), Interleukin-10 (IL-10) and Granulocyte Colony Stimulating Factor (G-CSF) in alcohol-dependent individuals without liver disease, during detoxification therapy.

    Science.gov (United States)

    Nikou, Thomas; Ioannidis, Anastasios; Zoga, Margarita; Tzavellas, Elias; Paparrigopoulos, Thomas; Magana, Maria; Pliatsika, Paraskevi; Nikolaou, Chryssoula; Chatzipanagiotou, Stylianos

    2016-06-01

    The course of Interleukin-7 (IL-7), Interleukin-10 (IL-10) and Granulocyte Colony Stimulating Factor (G-CSF) was investigated in alcohol-dependent individuals without liver disease in order to ascertain the use of these cytokines as markers for the follow-up testing and the outcome of the detoxification treatment. Forty-eight alcohol-dependent individuals were admitted for alcohol detoxification. Blood was obtained upon admission, two weeks later and after the completion of the detoxification period (4-5 weeks). Serum IL-7, IL-10 and G-CSF were measured with a commercially available sandwich enzyme immunoassay. IL-7 concentration was steadily high from admission up to two weeks later and then showed a fall, yet still remaining significantly higher than in the control group at the end of the detoxification treatment. IL-10 concentration was significantly low on admission, presenting a linear increase during therapy and remained insignificantly low at the end. G-CSF was significantly elevated on admission and presented a linear fall ending up in almost normal values at the end of the detoxification therapy. The alterations in the concentration of IL-7, IL-10 and G-CSF and their trend to normalization during the detoxification therapy are indicative of the generalized immune system disorder, caused by alcohol abuse. Further studies will help in further elucidating the pathophysiology of the immune system function in alcohol abuse, while immunological parameters might serve as biological markers and diagnostic tools for the assessment of the course and the outcome of the detoxification therapy. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

  11. Assessing frequency-dependent site polarisabilities in linear response polarisable embedding

    DEFF Research Database (Denmark)

    Nørby, Morten S.; Vahtras, Olav; Norman, Patrick

    2017-01-01

    In this paper, we discuss the impact of using a frequency-dependent embedding potential in quantum chemical embedding calculations of response properties. We show that the introduction of a frequency-dependent embedding potential leads to further model complications upon solving the central...

  12. Limitations of Murine Models for Assessment of Antibody-Mediated Therapies or Vaccine Candidates against Staphylococcus epidermidis Bloodstream Infection

    Science.gov (United States)

    Zhang, Jinrong; Kesselly, Augustus; Lam, Hubert; Kleanthous, Harry; Yethon, Jeremy A.

    2016-01-01

    Staphylococcus epidermidis is normally a commensal colonizer of human skin and mucus membranes, but, due to its ability to form biofilms on indwelling medical devices, it has emerged as a leading cause of nosocomial infections. Bacteremia or bloodstream infection is a frequent and costly complication resulting from biofilm fouling of medical devices. Our goal was to develop a murine model of S. epidermidis infection to identify potential vaccine targets for the prevention of S. epidermidis bacteremia. However, assessing the contribution of adaptive immunity to protection against S. epidermidis challenge was complicated by a highly efficacious innate immune response in mice. Naive mice rapidly cleared S. epidermidis infections from blood and solid organs, even when the animals were immunocompromised. Cyclophosphamide-mediated leukopenia reduced the size of the bacterial challenge dose required to cause lethality but did not impair clearance after a nonlethal challenge. Nonspecific innate immune stimulation, such as treatment with a Toll-like receptor 4 (TLR4) agonist, enhanced bacterial clearance. TLR2 signaling was confirmed to accelerate the clearance of S. epidermidis bacteremia, but TLR2−/− mice could still resolve a bloodstream infection. Furthermore, TLR2 signaling played no role in the clearance of bacteria from the spleen. In conclusion, these data suggest that S. epidermidis bloodstream infection is cleared in a highly efficient manner that is mediated by both TLR2-dependent and -independent innate immune mechanisms. The inability to establish a persistent infection in mice, even in immunocompromised animals, rendered these murine models unsuitable for meaningful assessment of antibody-mediated therapies or vaccine candidates. PMID:26857577

  13. Substrate-dependent risk stratification for implantable cardioverter defibrillator therapies using cardiac magnetic resonance imaging: The importance of T1 mapping in nonischemic patients.

    Science.gov (United States)

    Claridge, Simon; Mennuni, Silvia; Jackson, Thomas; Behar, Jonathan M; Porter, Bradley; Sieniewicz, Benjamin; Bostock, Julian; O'Neill, Mark; Murgatroyd, Francis; Gill, Jaswinder; Carr-White, Gerald; Chiribiri, Amedeo; Razavi, Reza; Chen, Zhong; Rinaldi, Christopher Aldo

    2017-07-01

    The role of implantable cardioverter defibrillators (ICDs) in nonischemic cardiomyopathy is unclear and better risk-stratification is required. We sought to determine if T1 mapping predicts appropriate defibrillator therapy in patients with nonischemic cardiomyopathy. We studied a mixed cohort of ischemic and nonischemic patients to determine whether different cardiac magnetic resonance (CMR) applications (T1 mapping, late gadolinium enhancement, and Grayzone) were selectively predictive of therapies for the different arrhythmic substrates. We undertook a prospective longitudinal study of consecutive patients receiving defibrillators in a tertiary cardiac center. Participants underwent CMR myocardial tissue characterization using T1 mapping and conventional CMR scar assessment before device implantation. QRS duration and fragmentation on the surface electrocardiogram were also assessed. The primary endpoint was appropriate defibrillator therapy. One-hundred thirty patients were followed up for a median of 31 months (IQR ± 9 months). In nonischemic patients, T1(_native) was the sole predictor of the primary endpoint (hazard ratio [HR] 1.12 per 10 millisecond increment in value [95% confidence interval [CI] 1.04-1.21; P ≤ 0.01]). In ischemic patients, Grayzone(_2SD-3SD) was the strongest predictor of appropriate therapy (HR 1.34 per 1% left ventricular increment in value [95% CI 1.03-1.76; P = 0.03]). QRS fragmentation correlated well with myocardial scar core (receiver operating characteristic area under the curve [ROC AUC] 0.64; P = 0.02) but poorly with T1(_native) (ROC AUC 0.4) and did not predict appropriate therapy. In the medium-long term, T1(_native) mapping was the only independent predictor of therapy in nonischemic patients, whereas Grayzone was a better predictor in ischemic patients. These findings suggest a potential role for T1(_native) mapping in the selection of patients for ICDs in a nonischemic population. © 2017 Wiley Periodicals, Inc.

  14. Nutritional assessment and therapy in COPD: a European Respiratory Society statement.

    Science.gov (United States)

    Schols, Annemie M; Ferreira, Ivone M; Franssen, Frits M; Gosker, Harry R; Janssens, Wim; Muscaritoli, Maurizio; Pison, Christophe; Rutten-van Mölken, Maureen; Slinde, Frode; Steiner, Michael C; Tkacova, Ruzena; Singh, Sally J

    2014-12-01

    Nutrition and metabolism have been the topic of extensive scientific research in chronic obstructive pulmonary disease (COPD) but clinical awareness of the impact dietary habits, nutritional status and nutritional interventions may have on COPD incidence, progression and outcome is limited. A multidisciplinary Task Force was created by the European Respiratory Society to deliver a summary of the evidence and description of current practice in nutritional assessment and therapy in COPD, and to provide directions for future research. Task Force members conducted focused reviews of the literature on relevant topics, advised by a methodologist. It is well established that nutritional status, and in particular abnormal body composition, is an important independent determinant of COPD outcome. The Task Force identified different metabolic phenotypes of COPD as a basis for nutritional risk profile assessment that is useful in clinical trial design and patient counselling. Nutritional intervention is probably effective in undernourished patients and probably most when combined with an exercise programme. Providing evidence of cost-effectiveness of nutritional intervention is required to support reimbursement and thus increase access to nutritional intervention. Overall, the evidence indicates that a well-balanced diet is beneficial to all COPD patients, not only for its potential pulmonary benefits, but also for its proven benefits in metabolic and cardiovascular risk. ©ERS 2014.

  15. Assessing treatment motivation among patients receiving antiretroviral therapy: A multidimensional approach

    Science.gov (United States)

    Houston, Eric; McKirnan, David J.; Cervone, Daniel; Johnson, Matthew S.; Sandfort, Theo G.M.

    2011-01-01

    Using multidimensional scaling analysis (MDS), this study examined how patient conceptualisations of treatment motivation compare with theoretically-based assumptions used in current assessment approaches. Patients undergoing antiretroviral therapy for HIV/AIDS (n = 39) rated for similarity all possible pairings of 23 treatment descriptions, including descriptors of intrinsic, extrinsic, approach, and avoidance motivation. MDS analyses revealed that patient perceptions of intrinsic and extrinsic motivation often differ from those based on definitions derived from common interpretations of self-determination theory. Findings also showed that patients reported motivation for avoiding treatment when they associated their medication regimens with side effects and other negatively-valenced outcomes. The study describes new applications of MDS in assessing how patients perceive the relationship between treatment behaviours and specific forms of motivation, such as intrinsic and extrinsic motivation. In addition, the study suggests how MDS may be used to develop behavioural strategies aimed at helping patients follow their regimens consistently by identifying treatment conceptualisations and contexts that facilitate or impede adherence. PMID:21942538

  16. Assessing treatment motivation among patients receiving antiretroviral therapy: a multidimensional approach.

    Science.gov (United States)

    Houston, Eric; McKirnan, David J; Cervone, Daniel; Johnson, Matthew S; Sandfort, Theo G M

    2012-01-01

    Using multidimensional scaling (MDS) analysis, this study examined how patient conceptualisations of treatment motivation compare with theoretically based assumptions used in current assessment approaches. Patients undergoing antiretroviral therapy for HIV/AIDS (n=39) rated for similarity between all possible pairings of 23 treatment descriptions, including descriptors of intrinsic, extrinsic, approach and avoidance motivation. MDS analyses revealed that patient perceptions of intrinsic and extrinsic motivations often differ from those based on definitions derived from common interpretations of self-determination theory. Findings also showed that patients reported motivation for avoiding treatment when they associated their medication regimens with side effects and other negatively valenced outcomes. The study describes new applications of MDS in assessing how patients perceive the relationship between treatment behaviours and specific forms of motivation, such as intrinsic and extrinsic motivations. In addition, the study suggests how MDS may be used to develop behavioural strategies aimed at helping patients follow their regimens consistently by identifying treatment conceptualisations and contexts that facilitate or impede adherence.

  17. Assessment of Predictive Response Factors to Intragastric Balloon Therapy for the Treatment of Obesity.

    Science.gov (United States)

    Madeira, Eduardo; Madeira, Miguel; Guedes, Erika Paniago; Mafort, Thiago Thomaz; Neto, Leonardo Vieira; de Oliveira Moreira, Rodrigo; de Pinho, Paulo Roberto Alves; Lopes, Agnaldo José; Farias, Maria Lucia Fleiuss

    2016-03-01

    Obesity is a worldwide epidemic that is difficult to control with non-invasive treatments, which usually present poor results. In this context, the intragastric balloon (IGB) is an important tool that presents a mean body weight loss (BWL) estimated at approximately 12%, although individual responses are highly variable. This study assesses whether there are factors that can predict responses to IGB therapy either before or early after placement of the device. A total of 50 obese patients underwent insertion of IGB placed endoscopically, and patients were monitored for 6 months. The evaluated predictive factors involved general characteristics and psychological, social, and dyspeptic aspects, and the preliminary results obtained in the first month after balloon placement. The mean weight loss was 11.5%, and 48% of the participants presented BWL >10%. Among the factors analyzed before IGB placement, only advanced age (P = .04) and higher scores obtained in the social relationships domain of a shorter version of the World Health Organization's Quality of Life questionnaire (P = .02) were significant. Analysis of the factors evaluated after IGB placement revealed that the BWL amounts observed in week 2 (P = .001) and week 4 (P < .001) and the intensity of dyspeptic symptoms in week 2 (P < .001) were positive predictive factors. The assessment of predictive factors may help to manage patients with IGB.

  18. Feasibility study of a game integrating assessment and therapy of tinnitus.

    Science.gov (United States)

    Wise, K; Kobayashi, K; Searchfield, G D

    2015-07-15

    Tinnitus, head and ear noise, is due to maladaptive plastic changes in auditory and associated neural networks. Tinnitus has been traditionally managed through the use of sound to passively mask or facilitate habituation to tinnitus, a process that may take 6-12 months. A game-based perceptual training method, requiring localisation and selective attention to sounds, was developed and customised to the individual's tinnitus perception. Eight participants tested the games usability at home. Each participant successfully completed 30 min of training, for 20 days, along with daily psychoacoustic assessment of tinnitus pitch and loudness. The training period and intensity of training appears sufficient to reduce tinnitus handicap. The training approach used may be a viable alternative to frequency discrimination based training for treating tinnitus (Hoare et al., 2014) and a useful tool in exploring learning mechanisms in the auditory system. Integration of tinnitus assessment with therapy in a game is feasible, and the method(s) warrant further investigation. Copyright © 2015 Elsevier B.V. All rights reserved.

  19. Hyperbaric Oxygen Therapy for the Treatment of Diabetic Foot Ulcers: A Health Technology Assessment

    Science.gov (United States)

    Lambrinos, Anna; Chan, Brian; Wells, David; Holubowich, Corinne

    2017-01-01

    Background About 15% to 25% of people with diabetes will develop a foot ulcer. These wounds are often resistant to healing; therefore, people with diabetes experience lower limb amputation at about 20 times the rate of people without diabetes. If an ulcer does not heal with standard wound care, other therapeutic interventions are offered, one of which is hyperbaric oxygen therapy (HBOT). However, the effectiveness of this therapy is not clearly known. The objectives of this health technology assessment were to assess the safety, clinical effectiveness, and cost-effectiveness of standard wound care plus HBOT versus standard wound care alone for the treatment of diabetic foot ulcers. We also investigated the preferences and perspectives of people with diabetic foot ulcers through lived experience. Methods We performed a review of the clinical and economic literature for the effectiveness and cost-effectiveness of hyperbaric oxygen therapy, as well as the budget impact of HBOT from the perspective of the Ministry of Health and Long-Term Care. We assessed the quality of the body of clinical evidence using the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) Working Group criteria. To better understand the preferences, perspectives, and values of patients with diabetic foot ulcers and their experience with HBOT, we conducted interviews and administered an online survey. Results Seven randomized controlled trials and one nonrandomized controlled trial met the inclusion criteria. Comparing standard wound care plus HBOT with standard wound care alone, we found mixed results for major amputation rates (GRADE quality of evidence: low), a significant difference in favour of standard wound care plus HBOT on ulcers healed (GRADE quality of evidence: low), and no difference in terms of adverse events (GRADE quality of evidence: moderate). There is a large degree of uncertainty associated with the evaluation of the cost-effectiveness of standard wound

  20. Assessment of dependence and anxiety among benzodiazepine users in a provincial municipality in Rio Grande do Sul, Brazil.

    Science.gov (United States)

    Schallemberger, Janaína Barden; Colet, Christiane de Fátima

    2016-06-27

    Benzodiazepines are among the most prescribed drugs for anxiety and one of the most used drug classes in the world and have a high potential for addiction. The objective of this study was to assess levels of dependence and anxiety among users of these drugs in the public health system. This was a cross-sectional, descriptive and quantitative study. Benzodiazepine users treated on the public health system were selected. Anxiety levels were assessed with the Hamilton Anxiety Scale and dependency with the Benzodiazepine Dependence Self-Report Questionnaire. Benzodiazepine use was higher among women and in older age groups. Duration of benzodiazepine use was greater than 1 year for all respondents. The dependence assessment indicated that more than half of users were dependent on taking benzodiazepines and most had a severe degree of anxiety. This study found evidence of prolonged and inappropriate use of benzodiazepines. It is necessary to educate users about the risks of these drugs and to develop strategies to rationalize use of these drugs by working with prescribers and dispensers.

  1. Assessment of dependence and anxiety among benzodiazepine users in a provincial municipality in Rio Grande do Sul, Brazil

    Directory of Open Access Journals (Sweden)

    Janaína Barden Schallemberger

    Full Text Available Abstract Introduction: Benzodiazepines are among the most prescribed drugs for anxiety and one of the most used drug classes in the world and have a high potential for addiction. The objective of this study was to assess levels of dependence and anxiety among users of these drugs in the public health system. Methods: This was a cross-sectional, descriptive and quantitative study. Benzodiazepine users treated on the public health system were selected. Anxiety levels were assessed with the Hamilton Anxiety Scale and dependency with the Benzodiazepine Dependence Self-Report Questionnaire. Results: Benzodiazepine use was higher among women and in older age groups. Duration of benzodiazepine use was greater than 1 year for all respondents. The dependence assessment indicated that more than half of users were dependent on taking benzodiazepines and most had a severe degree of anxiety. Conclusion: This study found evidence of prolonged and inappropriate use of benzodiazepines. It is necessary to educate users about the risks of these drugs and to develop strategies to rationalize use of these drugs by working with prescribers and dispensers.

  2. A Comparison between Two Instruments for Assessing Dependency in Daily Activities: Agreement of the Northwick Park Dependency Score with the Functional Independence Measure

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    Siv Svensson

    2012-01-01

    Full Text Available Background. There is a need for tools to assess dependency among persons with severe impairments. Objectives. The aim was to compare the Functional Independence Measure (FIM and the Northwick Park Dependency Score (NPDS, in a sample from in-patient rehabilitation. Material and Methods. Data from 115 persons (20 to 65 years of age with neurological impairments was gathered. Analyses were made of sensitivity, specificity, positive predictive value, and negative predictive value. Agreement of the scales was assessed with kappa and concordance with Goodman-Kruskal’s gamma. Scale structures were explored using the Rank-Transformable Pattern of Agreement (RTPA. Content validation was performed. Results. The sensitivity of the NPDS as compared to FIM varied between 0.53 (feeding and 1.0 (mobility and specificity between 0.64 (mobility and 1.0 (bladder. The positive predictive value varied from 0.62 (mobility to 1.0 (bladder, and the negative predictive value varied from 0.48 (bowel to 1.0 (mobility. Agreement between the scales was moderate to good (four items and excellent (three items. Concordance was good, with a gamma of −.856, an asymptotic error (ase of .025, and P<.000. The parallel reliability between the FIM and the NPDS showed a tendency for NPDS to be more sensitive (having more categories when dependency is high. Conclusion. FIM and NPDS complement each other. NPDS can be used as a measure for severely injured patients who are sensitive when there is a high need of nursing time.

  3. Lead-based paint health risk assessment in dependent children living in military housing.

    Science.gov (United States)

    Stroop, Davis M.; Dietrich, Kim N.; Hunt, Allen N.; Suddendorf, Lawrence R.; Giangiacomo, Mark

    2002-01-01

    OBJECTIVE: In children, lead can cause serious permanent damage as a neurotoxicant. The objectives of the study were to evaluate potential exposure to lead-based paint in family housing units at a typical U.S. military installation and determine blood lead (PbB) levels in children ages 6 years or younger residing in these housing units. METHODS: The authors conducted a risk assessment of 1,723 housing units and occupants at Fort Devens in Massachusetts. Data from the military dependent cohort was compared to estimates for the U.S. national population as reported from Phase 1 of the Third National Health and Nutrition Examination Survey (NHANES III). RESULTS: A total of 1992 individuals (1,009 males and 983 females) were screened for PbB, stratified into age groups, and separated into racial/ethnic categories. Four (0.3%) dust samples and 59 (11.6%) internal and 298 (77.8%) external paint chip samples contained hazardous levels of lead. The geometric mean PbB concentration for people ages 1 year and older reported by NHANES III was 2.8 micro g/dL, compared with 1.5 microg/dL for the military installation cohort (p10 microg/dL for all age groups was 1.6% in the military cohort, compared with 4.5% for the general population. For ages 1-2.9 years, no blacks or Hispanics and 0.6% of whites had PbB levels >10 micro g/dL, compared with 21.6% of blacks, 10.1% of Hispanics, and 8.5% of whites for the general population. For ages 3-5.99 years, 0.15% of blacks, 0% of Hispanics, and 0.3% of whites had PbB levels > or = 10 microg/dL, compared with 20.0% of blacks, 6.8% of Hispanics, and 3.7% of whites for the general population. CONCLUSION: Lead exposure for occupants of on-post military housing is much less than for those residing in the civilian sector. PMID:12500961

  4. Multidimensional family therapy lowers the rate of cannabis dependence in adolescents: A randomised controlled trial in Western European outpatient settings

    NARCIS (Netherlands)

    H. Rigter (Henk); C.E. Henderson (Craig); I. Pelc (Isidore); P. Tossmann (Peter); O. Phan (Olivier); V. Hendriks (Vincent); M. Schaub (Michael); C. Rowe (Cindy)

    2013-01-01

    textabstractBackground: Noticing a lack of evidence-based programmes for treating adolescents heavily using cannabis in Europe, government representatives from Belgium, France, Germany, The Netherlands, and Switzerland decided to have U.S.-developed multidimensional family therapy (MDFT) tested in

  5. Task-based image quality assessment in radiation therapy: initial characterization and demonstration with CT simulation images

    Science.gov (United States)

    Dolly, Steven R.; Anastasio, Mark A.; Yu, Lifeng; Li, Hua

    2017-03-01

    In current radiation therapy practice, image quality is still assessed subjectively or by utilizing physically-based metrics. Recently, a methodology for objective task-based image quality (IQ) assessment in radiation therapy was proposed by Barrett et al.1 In this work, we present a comprehensive implementation and evaluation of this new IQ assessment methodology. A modular simulation framework was designed to perform an automated, computer-simulated end-to-end radiation therapy treatment. A fully simulated framework was created that utilizes new learning-based stochastic object models (SOM) to obtain known organ boundaries, generates a set of images directly from the numerical phantoms created with the SOM, and automates the image segmentation and treatment planning steps of a radiation therapy work ow. By use of this computational framework, therapeutic operating characteristic (TOC) curves can be computed and the area under the TOC curve (AUTOC) can be employed as a figure-of-merit to guide optimization of different components of the treatment planning process. The developed computational framework is employed to optimize X-ray CT pre-treatment imaging. We demonstrate that use of the radiation therapy-based-based IQ measures lead to different imaging parameters than obtained by use of physical-based measures.

  6. Tumor T1 Relaxation Time for Assessing Response to Bevacizumab Anti-Angiogenic Therapy in a Mouse Ovarian Cancer Model.

    Directory of Open Access Journals (Sweden)

    Murali K Ravoori

    Full Text Available To assess whether T1 relaxation time of tumors may be used to assess response to bevacizumab anti-angiogenic therapy.12 female nude mice bearing subcutaneous SKOV3ip1-LC ovarian tumors were administered bevacizumab (6.25ug/g, n=6 or PBS (control, n=6 therapy twice a week for two weeks. T1 maps of tumors were generated before, two days, and 2 weeks after initiating therapy. Tumor weight was assessed by MR and at necropsy. Histology for microvessel density, proliferation, and apoptosis was performed.Bevacizumab treatment resulted in tumor growth inhibition (p<0.04, n=6, confirming therapeutic efficacy. Tumor T1 relaxation times increased in bevacizumab treated mice 2 days and 2 weeks after initiating therapy (p<.05, n=6. Microvessel density decreased 59% and cell proliferation (Ki67+ decreased 50% in the bevacizumab treatment group (p<.001, n=6, but not apoptosis.Findings suggest that increased tumor T1 relaxation time is associated with response to bevacizumab therapy in ovarian cancer model and might serve as an early indicator of response.

  7. Accuracy and Utility of Deformable Image Registration in {sup 68}Ga 4D PET/CT Assessment of Pulmonary Perfusion Changes During and After Lung Radiation Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Hardcastle, Nicholas, E-mail: nick.hardcastle@gmail.com [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne (Australia); Centre for Medical Radiation Physics, University of Wollongong, Wollongong (Australia); Hofman, Michael S. [Molecular Imaging, Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); Hicks, Rodney J. [Molecular Imaging, Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); Department of Medicine, University of Melbourne, Melbourne (Australia); Callahan, Jason [Molecular Imaging, Centre for Cancer Imaging, Peter MacCallum Cancer Centre, Melbourne (Australia); Kron, Tomas [Department of Medical Imaging and Radiation Sciences, Monash University, Clayton (Australia); The Sir Peter MacCallum Department of Oncology, Melbourne University, Victoria (Australia); MacManus, Michael P.; Ball, David L. [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia); The Sir Peter MacCallum Department of Oncology, University of Melbourne, Melbourne (Australia); Jackson, Price [Department of Physical Sciences, Peter MacCallum Cancer Centre, East Melbourne (Australia); Siva, Shankar [Division of Radiation Oncology and Cancer Imaging, Peter MacCallum Cancer Centre, East Melbourne (Australia)

    2015-09-01

    . Conclusions: DIR accuracy in the data sets studied was variable depending on anatomic changes resulting from radiation therapy; caution must be exercised when using DIR in regions of low contrast or radiation pneumonitis. Lung perfusion reduces with increasing radiation therapy dose; however, DIR did not translate into significant changes in dose–response assessment.

  8. Assessing phage therapy against Pseudomonas aeruginosa using a Galleria mellonella infection model.

    Science.gov (United States)

    Beeton, M L; Alves, D R; Enright, M C; Jenkins, A T A

    2015-08-01

    The Galleria mellonella infection model was used to assess the in vivo efficacy of phage therapy against laboratory and clinical strains of Pseudomonas aeruginosa. In a first series of experiments, Galleria were infected with the laboratory strain P. aeruginosa PAO1 and were treated with varying multiplicity of infection (MOI) of phages either 2h post-infection (treatment) or 2h pre-infection (prevention) via injection into the haemolymph. To address the kinetics of infection, larvae were bled over a period of 24h for quantification of bacteria and phages. Survival rates at 24h when infected with 10 cells/larvae were greater in the prevention versus treatment model (47% vs. 40%, MOI=10; 47% vs. 20%, MOI=1; and 33% vs. 7%, MOI=0.1). This pattern held true when 100 cells/larvae were used (87% vs. 20%, MOI=10; 53% vs. 13%, MOI=1; 67% vs. 7%, MOI=0.1). By 24h post-infection, phages kept bacterial cell numbers in the haemolymph 1000-fold lower than in the non-treated group. In a second series of experiments using clinical strains to further validate the prevention model, phages protected Galleria when infected with both a bacteraemia (0% vs. 85%) and a cystic fibrosis (80% vs. 100%) isolate. Therefore, this study validates the use of G. mellonella as a simple, robust and cost-effective model for initial in vivo examination of P. aeruginosa-targeted phage therapy, which may be applied to other pathogens with similarly low infective doses. Crown Copyright © 2015. Published by Elsevier B.V. All rights reserved.

  9. Ultrasonographic assessment of the cutaneous changes induced by topical flavonoid therapy

    Directory of Open Access Journals (Sweden)

    Crisan D

    2012-01-01

    Full Text Available Diana Crisan1, Maria Crisan2, Mirela Moldovan3, Monica Lupsor4, Radu Badea41Student, Faculty of Medicine, 2Department of Histology, 3Department of Dermopharmacy and Cosmetics, 4Department of Ultrasonography, University of Medicine and Pharmacy “Iuliu Hatieganu” Cluj-Napoca, RomaniaAbstract: Ultrasonography allows the quantification of dermal density and echogenicity changes during the physiological senescence process. Some active ingredients are able to slow down the tissular degeneration and disorganization process. The purpose of this study was to assess the cutaneous changes induced by the topical use of products containing Viniferol® as active ingredient, using high-frequency ultrasound. The study was performed over 12 weeks and included 80 healthy Caucasian female subjects, aged 22–75 years, divided into two groups: the study group and the control group. The product was applied according to a predetermined protocol. The measurements performed for each subject were: the thickness of the epidermis and dermis (mm, the number of low, medium, and high echogenic pixels, and the number of low echogenic pixels in the upper dermis/number of low echogenic pixels in the lower dermis. All the parameters showed a significant improvement. Ultrasound measurements showed an increase of the mean thickness of the epidermis (P < 0.0001 and dermis (P < 0.0001 following the application of the Viniferol product as compared to the control group. The changes in the dermal echogenicity confirm the efficacy and direct action of Viniferol upon the cutaneous fibroblasts. No side effects related to the treatment were recorded. The study proves the efficacy of this active ingredient in the cutaneous senescence process as well, as the fact that anti-aging prophylaxis should be initiated in the 20–40 year critical age group. This interval involves specific changes in dermal echogenicity that quantify intense molecular, biochemical and structural changes, being

  10. Original article Determinants of personality in the scope of motivation for maintaining abstinence in the case of male alcohol-dependent individuals concluding therapy

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    Jan Chodkiewicz

    2014-12-01

    Full Text Available Background The results of numerous studies indicate strong associations of personality with the occurrence, and also with the treatment, of alcohol dependence. However, there is no agreement regarding the role of particular dimensions of temperament and character in the course of, and for the results of, alcohol rehabilitation therapy. The objective of the present research was to investigate the relationships between the dimensions of temperament and character as they are presented by Robert Cloninger and motivation for maintaining abstinence in the case of male alcohol-dependent individuals concluding the therapy. Participants and procedure Eighty-nine male alcohol-dependent individuals, concluding alcohol rehabilitation therapy in an outpatient setting, were studied. The following research tools were applied: the Temperament and Character Inventory (TCI of R. Clo­ninger in the Polish adaptation of E. Hornowska (2003, and the Motivation for Maintaining Abstinence Inventory, the author of which is M. Ziółkowski. Results Two clusters, differing in the aspect of motivation for maintaining abstinence after the conclusion of the treatment, were distinguished: of individuals manifesting weaker motivation (n = 39 and those manifesting stronger motivation (n = 50. The patients with stronger motivation manifested the following major features: a lower level of harm avoidance, a higher level of reward dependence, and a higher level of cooperativeness. Conclusions Personality as it is presented by Cloninger manifests connections with motivation for maintaining abstinence. The research confirms the need for diagnosing addicted patients in the scope of temperament and character traits.

  11. Validity and Reliability Assessment of the Persian Version of Therapy-Related Symptom Checklist.

    Science.gov (United States)

    Mansouri, Ava; Motaghedi, Rozita; Rashidian, Arash; Ashouri, Asieh; Kagrar, Mona; Hajibabaei, Moluk; Gholami, Kheirollah; Ansari, Shahla

    2017-05-01

    Therapy-related symptom checklist for children (TRSC-C) was developed as a symptom assessment tool in children receiving chemotherapy. The objective of the present study was to evaluate the validity and reliability of the Persian version of TRSC-C. This cross-sectional study was conducted in 2013-2014 in Tehran, Iran. TRSC-C was translated using backward-forward approach. The content validity, face validity, and comprehensiveness were investigated based on the opinion of experts. The item content validity index (I-CVI) and scale content validity index (S-CVI) were calculated by the mean approach and inter-rater agreement. The scale was revised based on the comments from a team of five experts, after which it was evaluated by an additional group of four experts. To assess the inter-rater reliability, two raters filled the scale with 29 and 30 patients in the outpatient clinic of Hazrat-e Ali Asghar Hospital. The Cronbach's alpha was calculated and factor analysis was performed. The scores of content validity were analyzed in Excel. Other statistical analyses were performed using the SPSS software version 20.0. Based on the initial assessment, the S-CVI with less conservative approach was 60% for clarity, 33% for relevancy, and 60% for simplicity. After revising the scale, the S-CVI reached 100%. The comprehensiveness and face validity of the scale were appropriate. The scale was inter-rater reliable and the Cronbach's alpha was 0.803. Eleven subscales were found in the TRSC-C. It is concluded that the Persian TRSC-C is a valid and reliable tool for measuring children symptoms. Availability of a valid and reliable checklist is a fundamental step in monitoring the symptoms of patients while receiving chemotherapy.

  12. Validity and Reliability Assessment of the Persian Version of Therapy-Related Symptom Checklist

    Directory of Open Access Journals (Sweden)

    Ava Mansouri

    2017-05-01

    Full Text Available Therapy-related symptom checklist for children (TRSC-C was developed as a symptom assessment tool in children receiving chemotherapy. The objective of the present study was to evaluate the validity and reliability of the Persian version of TRSC-C. This cross-sectional study was conducted in 2013-2014 in Tehran, Iran. TRSC-C was translated using backward-forward approach. The content validity, face validity, and comprehensiveness were investigated based on the opinion of experts. The item content validity index (I-CVI and scale content validity index (S-CVI were calculated by the mean approach and inter-rater agreement. The scale was revised based on the comments from a team of five experts, after which it was evaluated by an additional group of four experts. To assess the inter-rater reliability, two raters filled the scale with 29 and 30 patients in the outpatient clinic of Hazrat-e Ali Asghar Hospital. The Cronbach’s alpha was calculated and factor analysis was performed. The scores of content validity were analyzed in Excel. Other statistical analyses were performed using the SPSS software version 20.0. Based on the initial assessment, the S-CVI with less conservative approach was 60% for clarity, 33% for relevancy, and 60% for simplicity. After revising the scale, the S-CVI reached 100%. The comprehensiveness and face validity of the scale were appropriate. The scale was inter-rater reliable and the Cronbach’s alpha was 0.803. Eleven subscales were found in the TRSC-C. It is concluded that the Persian TRSC-C is a valid and reliable tool for measuring children symptoms. Availability of a valid and reliable checklist is a fundamental step in monitoring the symptoms of patients while receiving chemotherapy.

  13. Assessment of disease burden among army personnel and dependents in Lucknow city

    OpenAIRE

    Anil Ahuja; Brig Narinder Singh

    2015-01-01

    Introduction: Oral health is a valuable asset for an individual. The oral cavity has a significant role to play in providing a satisfactory lifestyle including proper mastication, phonetics, esthetics, appearance, communication abilities and an overall emotional well-being. Very fewer studies have been carried out in the past on disease burden of army personnel and their dependents. Materials and Methods: This study was carried out on 2160 army personnel and their dependents reporting to Comm...

  14. Anastrozole versus tamoxifen as first-line therapy in postmenopausal patients with hormone-dependent advanced breast cancer: a prospective, randomized, phase III study.

    Science.gov (United States)

    Milla-Santos, Alfredo; Milla, Lidon; Portella, Jordi; Rallo, Lidon; Pons, Maria; Rodes, Esther; Casanovas, Jose; Puig-Gali, Margarita

    2003-06-01

    A prospective phase III trial comparing anastrozole with tamoxifen as first-line therapy in postmenopausal, hormone-dependent, advanced breast cancer (ABC). Patients were randomized to anastrozole 1 mg daily (n = 121) or tamoxifen 40 mg daily (n = 117). Efficacy and tolerability were evaluated after 3 months' therapy, and survival was evaluated at median time of follow-up. At a median follow-up of 13.3 months, clinical benefit (CB) was achieved in 83% and 56% of anastrozole and tamoxifen patients, respectively (p < 0.001); median time to disease progression (TTP) in patients achieving CB was 18.0 months and 7.0 months, respectively, (hazard ratio [HR] = 0.13, 95% CI = 0.08-0.20, p < 0.01). At data cutoff, 89% of tamoxifen patients had died, compared with 60% of anastrozole patients; median time to death was 17.4 months and 16.0 months, respectively (HR = 0.64, 95% CI = 0.47-0.86, p = 0.003). Therapy was well tolerated in both groups. Anastrozole showed significant advantages over tamoxifen for CB, median TTP in patients gaining CB, and survival. These data further support routine use of anastrozole as first-line treatment for postmenopausal hormone-dependent ABC.

  15. Early apoptosis and cell death induced by ATX-S10Na (II)-mediated photodynamic therapy are Bax- and p53-dependent in human colon cancer cells.

    Science.gov (United States)

    Mitsunaga, Makoto; Tsubota, Akihito; Nariai, Kohichi; Namiki, Yoshihisa; Sumi, Makoto; Yoshikawa, Tetsuya; Fujise, Kiyotaka

    2007-02-07

    To investigate the roles of Bax and p53 proteins in photosensitivity of human colon cancer cells by using lysosome-localizing photosensitizer, ATX-S10Na (II). HCT116 human colon cancer cells and Bax-null or p53-null isogenic derivatives were irradiated with a diode laser. Early apoptosis and cell death in response to photodynamic therapy were determined by MTT assays, annexin V assays, transmission electron microscopy assays, caspase assays and western blotting. Induction of early apoptosis and cell death was Bax- and p53-dependent. Bax and p53 were required for caspase-dependent apoptosis. The levels of anti-apoptotic Bcl-2 family proteins, Bcl-2 and Bcl-x(L), were decreased in Bax- and p53-independent manner. Our results indicate that early apoptosis and cell death of human colon cancer cells induced by photodynamic therapy with lysosome-localizing photosensitizer ATX-S10Na (II) are mediated by p53-Bax network and low levels of Bcl-2 and Bcl-x(L) proteins. Our results might help in formulating new therapeutic approaches in photodynamic therapy.

  16. Assessment of abstract reasoning abilities in alcohol-dependent subjects: an fMRI study

    Energy Technology Data Exchange (ETDEWEB)

    Bagga, Deepika; Singh, Namita; Singh, Sadhana; Modi, Shilpi; Kumar, Pawan [Institute of Nuclear Medicine and Allied Sciences (INMAS), NMR Research Centre, Delhi (India); Bhattacharya, D. [Base Hospital, Department of Psychiatry, Delhi Cantt (India); Garg, Mohan L. [Panjab University, Department of Biophysics, Chandigarh (India); Khushu, Subash [Institute of Nuclear Medicine and Allied Sciences (INMAS), NMR Research Centre, Delhi (India); INMAS, DRDO, NMR Research Centre, Delhi (India)

    2014-01-15

    Chronic alcohol abuse has been traditionally associated with impaired cognitive abilities. The deficits are most evident in higher order cognitive functions, such as abstract reasoning, problem solving and visuospatial processing. The present study sought to increase current understanding of the neuropsychological basis of poor abstract reasoning abilities in alcohol-dependent subjects using functional magnetic resonance imaging (fMRI). An abstract reasoning task-based fMRI study was carried out on alcohol-dependent subjects (n = 18) and healthy controls (n = 18) to examine neural activation pattern. The study was carried out using a 3-T whole-body magnetic resonance scanner. Preprocessing and post processing was performed using SPM 8 software. Behavioral data indicated that alcohol-dependent subjects took more time than controls for performing the task but there was no significant difference in their response accuracy. Analysis of the fMRI data indicated that for solving abstract reasoning-based problems, alcohol-dependent subjects showed enhanced right frontoparietal neural activation involving inferior frontal gyrus, post central gyrus, superior parietal lobule, and occipito-temporal gyrus. The extensive activation observed in alcohol dependents as compared to controls suggests that alcohol dependents recruit additional brain areas to meet the behavioral demands for equivalent task performance. The results are consistent with previous fMRI studies suggesting decreased neural efficiency of relevant brain networks or compensatory mechanisms for the execution of task for showing an equivalent performance. (orig.)

  17. Evaluation of the efficacyof aminolevulinic acid-dependent photodynamic therapy on melanoma cancer cells treated with tocopherol succinate (in-vitro

    Directory of Open Access Journals (Sweden)

    Homa Kouchesfahani

    2012-01-01

    Full Text Available Background: Photodynamic therapy (PDT using 5-aminolevulinic acid (ALA to produce an intracellular photo-sensitizer, a protoporphyrin molecule IX (PPIX which absorbs light and targets cells, is a promising cancer treatment. Unfortunately, treatment failures are still a common occurrence when ALA is used. In this study, in order to enhance the efficacy of ALA-dependent photodynamic therapy, the effects of photodynamic therapy on melanoma cancer cells were studied after treating them with tocopherol succinate.Materials and Methods: In this experimental study melanoma cells were cultured in RPMI 1640 medium for 24 h. then, cells were treated with tocopherol succinate (6μm/ml. After 48 and 72 hours, the mediums were replaced by serum-free medium in the darkness, with ALA, 0.1mg/ml and then cells incubated for 4h. After that, cells were irradiated by using Nd: YAG laser (532 nm. After 24h, cell survival was measured by the MTT assay.Results: Twenty-four hours after PDT, among compared groups, pretreated cells with tocopherol succinate showed significant lower cell viability than control group. Conclusion: Induction of differentiation by using tocopherol succinate augmented intracellular PPIX accumulation in cells treated with ALA. Therefore phototoxic cell death after exposure to 532nm light enhances significantly in tocopherol succinate-pretreated cells. This study suggests that tocopherol succinate may act as a biological enhancer of ALA based photodynamic therapy

  18. Prescription refill, patient self-report and physician report in assessing adherence to oral endocrine therapy in early breast cancer patients: a retrospective cohort study in Catalonia, Spain

    Science.gov (United States)

    Font, R; Espinas, J A; Gil-Gil, M; Barnadas, A; Ojeda, B; Tusquets, I; Segui, M A; Margelí, M; Arcusa, A; Prat, A; Garcia, M; Borras, J M

    2012-01-01

    Aims: To compare different methods in order to assess adherence and persistence with oral endocrine therapy in women diagnosed with breast cancer (BC) in Catalonia. Materials and methods: This study covered all women newly diagnosed with stage I, II or IIIa BC and positive hormone receptors at six hospitals in Catalonia (Spain) in 2004. Adherence was assessed on the basis of physician report and patient self-report using a telephone questionnaire. Persistence was measured by refill prescriptions. We used the Kappa index to compare adherence measures and logistic regression to evaluate adherence-related risk factors. Results: The study covered a total of 692 women. Adherence ranged from 92% (self-report) to 94.7% (physician report), depending on the measure used; persistence was 74.7% at 5 years of follow-up. Low concordance between measures was observed (Kappa range: 0.018–0.267). Patients aged 50–74 years showed higher adherence than those aged <50 years. Adherence was also associated with: adjuvant chemotherapy and sequential hormonal therapy. Conclusions: Concordance between the different measures was remarkably low, indicating the need for further research. Adherence is an issue in the management of BC patients taking oral drugs, and should be assessed in clinical practice. PMID:22955858

  19. Intricate Assessment and Evaluation of Dental Implants in Patients on Bisphosphonate Therapy: A Retrospective Analysis.

    Science.gov (United States)

    Suvarna, Suraj; Dutt, Poonam; Misra, Animesh; Usmani, Nausheen; Singh, Abhishek; Suvarna, Chandini

    2016-05-01

    Osteonecrosis is one of the prevalent side effects of bisphosphonate (BP) therapy in oral cancer patients. In case of patients with various oncologic lesions, standard guidelines contraindicate the use of dental implants if the patients are on BP therapy. Literature also quotes studies that emphasize on the safety of dental implants in patients on BP therapy. Hence, this study aimed to retrospectively evaluate the clinical outcome of dental implants in patients on BP therapy. In this retrospective analysis, a total of 140 dental implants in 112 patients were included. Inclusion criteria included only those patients who were on or had history of BP therapy. Calculation of implant failure and survival rate was done. Ten cases of implant failure occurred, giving a success rate of above 92%, which was comparable to the results found in previous studies in patients who were not on BP therapy. No significant risk of implant failure is seen in patients on BP therapy compared with other patients.

  20. Assessing the Dosimetric Impact of Real-Time Prostate Motion During Volumetric Modulated Arc Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Azcona, Juan Diego, E-mail: jdazcona@stanford.edu [Department of Radiation Oncology, Stanford University, Stanford, California (United States); Division of Radiation Physics, Department of Oncology, Clínica Universidad de Navarra, Pamplona (Spain); Xing, Lei; Chen, Xin; Bush, Karl; Li, Ruijiang [Department of Radiation Oncology, Stanford University, Stanford, California (United States)

    2014-04-01

    Purpose: To develop a method for dose reconstruction by incorporating the interplay effect between aperture modulation and target motion, and to assess the dosimetric impact of real-time prostate motion during volumetric modulated arc therapy (VMAT). Methods and Materials: Clinical VMAT plans were delivered with the TrueBeam linac for 8 patients with prostate cancer. The real-time target motion during dose delivery was determined based on the 2-dimensional fiducial localization using an onboard electronic portal imaging device. The target shift in each image was correlated with the control point with the same gantry angle in the VMAT plan. An in-house-developed Monte Carlo simulation tool was used to calculate the 3-dimensional dose distribution for each control point individually, taking into account the corresponding real-time target motion (assuming a nondeformable target with no rotation). The delivered target dose was then estimated by accumulating the dose from all control points in the plan. On the basis of this information, dose–volume histograms and 3-dimensional dose distributions were calculated to assess their degradation from the planned dose caused by target motion. Thirty-two prostate motion trajectories were analyzed. Results: The minimum dose to 0.03 cm{sup 3} of the gross tumor volume (D{sub 0.03cc}) was only slightly degraded after taking motion into account, with a minimum value of 94.1% of the planned dose among all patients and fractions. However, the gross tumor volume receiving prescription dose (V{sub 100%}) could be largely affected by motion, dropping below 60% in 1 trajectory. We did not observe a correlation between motion magnitude and dose degradation. Conclusions: Prostate motion degrades the delivered dose to the target in an unpredictable way, although its effect is reduced over multiple fractions, and for most patients the degradation is small. Patients with greater prostate motion or those treated with stereotactic body

  1. Radiation binary targeted therapy for HER-2 positive breast cancers: assumptions, theoretical assessment and future directions

    Energy Technology Data Exchange (ETDEWEB)

    Mundy, Daniel W [School of Nuclear Engineering, Purdue University, 400 Central Drive, West Lafayette, IN 47909 (United States); Harb, Wael [Horizon Oncology, The Care Group, Unity Medical Center, Lafayette, IN 47901 (United States); Jevremovic, Tatjana [School of Nuclear Engineering, Purdue University, 400 Central Drive, West Lafayette, IN 47909 (United States)

    2006-03-21

    A novel radiation targeted therapy is investigated for HER-2 positive breast cancers. The proposed concept combines two known approaches, but never used together for the treatment of advanced, relapsed or metastasized HER-2 positive breast cancers. The proposed radiation binary targeted concept is based on the anti HER-2 monoclonal antibodies (MABs) that would be used as vehicles to transport the nontoxic agent to cancer cells. The anti HER-2 MABs have been successful in targeting HER-2 positive breast cancers with high affinity. The proposed concept would utilize a neutral nontoxic boron-10 predicting that anti HER-2 MABs would assure its selective delivery to cancer cells. MABs against HER-2 have been a widely researched strategy in the clinical setting. The most promising antibody is Trastuzumab (Herceptin (registered) ). Targeting HER-2 with the MAB Trastuzumab has been proven to be a successful strategy in inducing tumour regression and improving patient survival. Unfortunately, these tumours become resistant and afflicted women succumb to breast cancer. In the proposed concept, when the tumour region is loaded with boron-10 it is irradiated with neutrons (treatment used for head and neck cancers, melanoma and glioblastoma for over 40 years in Japan and Europe). The irradiation process takes less than an hour producing minimal side effects. This paper summarizes our recent theoretical assessments of radiation binary targeted therapy for HER-2 positive breast cancers on: the effective drug delivery mechanism, the numerical model to evaluate the targeted radiation delivery and the survey study to find the neutron facility in the world that might be capable of producing the radiation effect as needed. A novel method of drug delivery utilizing Trastuzumab is described, followed by the description of a computational Monte Carlo based breast model used to determine radiation dose distributions. The total flux and neutron energy spectra of five currently available

  2. Assessment of health care by children and adolescents depends on when they respond to the questionnaire

    DEFF Research Database (Denmark)

    Jensen, Hanne Irene; Ammentorp, Jette; Kofoed, Poul-Erik

    2010-01-01

    The aim of this study was to examine the assessments and priorities by children and adolescents of health care in a paediatric outpatient clinic, to examine the influence of the time factor on the assessments and priorities by children and adolescents of health care, and to determine their prefer......The aim of this study was to examine the assessments and priorities by children and adolescents of health care in a paediatric outpatient clinic, to examine the influence of the time factor on the assessments and priorities by children and adolescents of health care, and to determine...

  3. Can virtual reality exposure therapy gains be generalized to real life? A meta-analysis of studies applying behavioral assessments

    NARCIS (Netherlands)

    Morina, N.; Ijntema, H.; Meyerbröker, K.; Emmelkamp, P.M.G.

    2015-01-01

    In virtual reality exposure therapy (VRET), patients are exposed to virtual environments that resemble feared real-life situations. The aim of the current study was to assess the extent to which VRET gains can be observed in real-life situations. We conducted a meta-analysis of clinical trials

  4. Assessing Morphological Awareness as a Predictor of Academic Performance and Performance on the National Physical Therapy Examination

    Science.gov (United States)

    Moran, Kelley A.

    2012-01-01

    The primary purpose of this study was to validate a method for assessing Morphological Awareness (MA) using multimorphemic words commonly used in the academic and clinical practice settings of physical therapy. The Medical Morphology Test (MMT) was developed for this study and was compared to scores on the Nelson-Denny Reading Test (NDRT©). The…

  5. Assessment of the Prerequisite Skills for Cognitive Behavioral Therapy in Children with and without Autism Spectrum Disorders

    Science.gov (United States)

    Lickel, Athena; MacLean, William E., Jr.; Blakeley-Smith, Audrey; Hepburn, Susan

    2012-01-01

    The purpose of this study was to assess the cognitive skills of children with autism spectrum disorders (ASD) thought to be necessary for Cognitive Behavioral Therapy (CBT). Forty children with ASD and forty age-matched typically developing children between the ages of 7-12 years participated. Groups were comparable with regard to nonverbal IQ,…

  6. Multidimensional family therapy lowers the rate of cannabis dependence in adolescents: A randomised controlled trial in Western European outpatient settings

    OpenAIRE

    Rigter, Henk; Henderson, Craig; Pelc, Isidore; Tossmann, Peter; Phan, Olivier; Hendriks, Vincent; Schaub, Michael; Rowe, Cindy

    2013-01-01

    textabstractBackground: Noticing a lack of evidence-based programmes for treating adolescents heavily using cannabis in Europe, government representatives from Belgium, France, Germany, The Netherlands, and Switzerland decided to have U.S.-developed multidimensional family therapy (MDFT) tested in their countries in a trans-national trial, called the International Need for Cannabis Treatment (INCANT) study. Methods: INCANT was a 2 (treatment condition) × 5 (time) repeated measures intent-to-t...

  7. Dependence on Tobacco and Nicotine Products: A Case for Product-Specific Assessment

    Science.gov (United States)

    Eissenberg, Thomas

    2012-01-01

    The International Classification of Diseases and the Diagnostic and Statistical Manual for diagnosing tobacco/nicotine dependence emphasize the dependence-producing drug nicotine. These diagnostic tools have been challenged on grounds of poor predictive validity, and they do not differentiate across various forms of nicotine-containing products. In fact, nicotine-containing products (e.g., tobacco cigarettes, smokeless tobacco [ST], waterpipe, electronic cigarettes [ECIGs], and nicotine replacement [NR] products) have very different characteristics both in terms of sensory and behavioral involvement and also in pharmacokinetic and pharmacodynamic effects. For example, a cigarette and a nicotine patch are very different on almost every one of these dimensions. When ability to stop using a nicotine/tobacco product is used as a criterion for dependence, success rates vary considerably across products: Tobacco cigarette cessation is more difficult than ST cessation that in turn is more difficult than NR product cessation. Based on these results, we hypothesize that there is a continuum of dependence as much as there is a continuum of harm, with tobacco cigarettes and NR products on opposite ends of both continua and other products (waterpipe and ECIGs) somewhere in between. In order to capture more precisely the dependence produced by both nicotine and its administration forms, product-specific instruments may be required. The pros and cons of this approach are discussed. PMID:22459798

  8. Graphene quantum dots with nitrogen-doped content dependence for highly efficient dual-modality photodynamic antimicrobial therapy and bioimaging.

    Science.gov (United States)

    Kuo, Wen-Shuo; Chen, Hua-Han; Chen, Shih-Yao; Chang, Chia-Yuan; Chen, Pei-Chi; Hou, Yung-I; Shao, Yu-Ting; Kao, Hui-Fang; Lilian Hsu, Chih-Li; Chen, Yi-Chun; Chen, Shean-Jen; Wu, Shang-Rung; Wang, Jiu-Yao

    2017-03-01

    Reactive oxygen species is the main contributor to photodynamic therapy. The results of this study show that a nitrogen-doped graphene quantum dot, serving as a photosensitizer, was capable of generating a higher amount of reactive oxygen species than a nitrogen-free graphene quantum dot in photodynamic therapy when photoexcited for only 3 min of 670 nm laser exposure (0.1 W cm -2 ), indicating highly improved antimicrobial effects. In addition, we found that higher nitrogen-bonding compositions of graphene quantum dots more efficiently performed photodynamic therapy actions than did the lower compositions that underwent identical treatments. Furthermore, the intrinsically emitted luminescence from nitrogen-doped graphene quantum dots and high photostability simultaneously enabled it to act as a promising contrast probe for tracking and localizing bacteria in biomedical imaging. Thus, the dual modality of nitrogen-doped graphene quantum dots presents possibilities for future clinical applications, and in particular multidrug resistant bacteria. Copyright © 2016 Elsevier Ltd. All rights reserved.

  9. Development and validation of the functional assessment of chronic illness therapy treatment satisfaction (FACIT TS) measures.

    Science.gov (United States)

    Peipert, John D; Beaumont, Jennifer L; Bode, Rita; Cella, Dave; Garcia, Sofia F; Hahn, Elizabeth A

    2014-04-01

    To develop and validate a new functional assessment of chronic illness therapy (FACIT) measure of satisfaction with treatment for chronic illnesses such as cancer and HIV/AIDS. To define domains and generate items, a literature review informed creation of semi-structured interview guides for patients and an international expert panel of clinicians and researchers. Patients and experts also rated 15 areas of satisfaction for relevance. The final list of items underwent further refinement by the original expert panel and a new group of clinical experts. Items were tested in four studies (primarily lung cancer) and data were pooled for analysis. Exploratory and confirmatory factor analyses (CFA), and item response theory modeling were conducted to evaluate dimensionality. Internal consistency reliability and test-retest reliability were both evaluated. Validity was evaluated by correlating the FACIT subscale scores and measures of comparable concepts and by testing the scales' ability to distinguish people according to their overall treatment satisfaction. Two instruments were created: the FACIT TS-general (G), an overall evaluation of current treatment, and the FACIT TS-patient satisfaction (PS), a measure of patient satisfaction. CFA results were not optimal for a five-factor solution for PS. Internal consistency reliability met psychometric standards (≥0.70) for all PS subscales. Construct validity was established for the PS subscales: Physician Communication, Treatment Staff Communication, Technical Competence, Confidence and Trust, and Nurse Communication. The two instruments generated here offer a new way to assess several key dimensions of patient satisfaction with treatment, especially for people with lung cancer.

  10. Cardiovascular risk assessment with oxidised LDL measurement in postmenopausal women receiving intranasal estrogen replacement therapy.

    Science.gov (United States)

    Kurdoglu, Mertihan; Yildirim, Mulazim; Kurdoglu, Zehra; Erdem, Ahmet; Erdem, Mehmet; Bilgihan, Ayse; Goktas, Bulent

    2011-08-01

    To investigate the effect of intranasal estrogen replacement therapy administered to postmenopausal women alone or in combination with progesterone on markers of cardiovascular risk. The study was conducted with 44 voluntary postmenopausal women. In group I (n = 15), the patients were treated with only intranasal estradiol (300 μg/day estradiol hemihydrate). In group II (n = 11), the patients received cyclic progesterone (200 mg/day micronized progesterone) for 12 days in each cycle in addition to continuous intranasal estradiol. Group III (n = 18) was the controls. Serum lipid profiles, oxidised low-density lipoprotein (LDL) and other markers of cardiovascular risk were assessed at baseline and at the 3rd month of the treatment. Lipid profile, LDL apolipoprotein B, lipoprotein a, homocysteine, oxidised LDL values and oxidised LDL/LDL cholesterol ratio were not observed to change after 3 months compared to baseline values within each group (p > 0.016). In comparison to changes between the groups after the treatment, only oxidised LDL levels and oxidised LDL/LDL cholesterol ratios of group II were increased compared to control group (p cardiovascular risk in healthy postmenopausal women. However, the addition of cyclic oral micronized progesterone to intranasal estradiol influenced the markers of cardiovascular risk negatively in comparison to non-users in healthy postmenopausal women.

  11. Influence of shoulder pain on muscle function: implications for the assessment and therapy of shoulder disorders.

    Science.gov (United States)

    Struyf, Filip; Lluch, Enrique; Falla, Deborah; Meeus, Mira; Noten, Suzie; Nijs, Jo

    2015-02-01

    Shoulder pain is often a challenging clinical phenomenon because of the potential mismatch between pathology and the perception of pain. Current evidence clearly emphasizes an incomplete understanding of the nature of shoulder pain. Indeed, the effective diagnosis and treatment of shoulder pain should not only rely upon a detailed knowledge of the peripheral pathologies that may be present in the shoulder, but also on current knowledge of pain neurophysiology. To assess and treat shoulder pain, a comprehensive understanding of the way in which pain is processed is essential. This review reflects modern pain neurophysiology to the shoulder and aims to answer the following questions: why does my shoulder hurt? What is the impact of shoulder pain on muscle function? What are the implications for the clinical examination of the shoulder? And finally, what are the clinical implications for therapy? Despite the increasing amount of research in this area, an in-depth understanding of the bidirectional nociception-motor interaction is still far from being achieved. Many questions remain, especially related to the treatment of nociception-motor interactions.

  12. Influence of human nail etching for the assessment of topical onychomycosis therapies.

    Science.gov (United States)

    Repka, Michael A; Mididoddi, Praveen K; Stodghill, Steven P

    2004-09-10

    The purpose of this investigation was to study the physico-chemical properties of hot-melt extruded films containing ketoconazole and to determine the influence of 'nail etching' on film bioadhesion and drug permeability for the assessment of topical onychomycosis therapies. Hot-melt extrusion (HME) was used to prepare films containing 20% w/w ketoconazole. Ketoconazole 0.125% gel was also prepared using Carbopol 974P NF. Films were processed at a temperature range of 115-120 degrees C utilizing a Killion extruder (KLB-100), and were evaluated for post-extrusion drug content, content uniformity, bioadhesion, thermal behavior and nail drug permeation. The extruded films demonstrated excellent content uniformity and post-processing drug content. Tensile and peel tests were recorded to determine the bioadhesive profiles. In this study, work of adhesion and peak adhesive force determinations using the peel tests provided more sensitive results for evaluating the bioadhesivity of the HME films than the tensile tests. The in vitro permeability profiles have demonstrated, that nail samples treated with an 'etchant' demonstrated a significant increase in drug permeability compared to control. Differential scanning calorimetry (DSC) thermograms indicated that ketoconazole was in solid solution within the HME films. These findings are encouraging for the future design and formulation of novel drug delivery systems for the topical treatment of onychomycosis.

  13. Needs assessment of runaway females in Iran from an occupational therapy perspective.

    Science.gov (United States)

    Malekpour, Maryam

    2008-01-01

    The purpose of this descriptive study was to assess, from an occupational therapy perspective, the occupational performance needs of runaway females between 15 and 33 years old, residing in the state-run shelters in Mashhad, Iran. The inclusion criteria were: (1) participants who were 15 years old or above; (2) participants who resided in one of the state-run shelters in Mashhad; and (3) participants who could read, comprehend and write in Farsi. A written survey was completed by 44 runaway females (response rate: 36.6%). The findings revealed the occupational needs of this population to be as follows: vocational needs to find a meaningful job, emotional needs to manage depression and hopelessness, social participation needs to manage family and peer/friend relationships and peer interactions with the opposite sex to find an appropriate mate and educational needs to continue their education. Participants were from one area of Iran, so the results of the study cannot be generalized to runaway females residing in shelters in other areas of the country. Future research could include a qualitative design to explore more in-depth needs of this population. Also, a larger population of runaway females nationwide should be included in a study to increase generalizability. (c) 2008 John Wiley & Sons, Ltd.

  14. Radiographic assessment of photodynamic therapy as an adjunctive treatment on induced periodontitis in immunosuppressed rats

    Science.gov (United States)

    FERNANDES, Leandro Araújo; MARTINS, Thiago Marchi; de ALMEIDA, Juliano Milanezi; THEODORO, Letícia Helena; GARCIA, Valdir Gouveia

    2010-01-01

    Objective The aim of this study was to assess radiographically the effect of photodynamic therapy (PDT) as an adjunctive treatment to scaling and root planing (SRP) on induced periodontitis in dexamethasone-induced immunosuppressed rats. Material and Methods The animals were divided into 2 groups: ND group (n=60): saline treatment; D group (n=60): dexamethasone treatment. In both ND and D groups, periodontal disease was induced by the placement of a ligature in the left first mandibular molar. After 7 days, ligature was removed and all animals received SRP, being divided according to the following treatments: SRP: saline and PDT: phenothiazinium dye (TBO) plus laser irradiation. Ten animals per treatment were killed at 7, 15 and 30 days. The distance between the cementoenamel junction and the height of the alveolar bone crest in the mesial surface of the mandibular left first molars was determined in millimeters in each radiograph. The radiographic values were analyzed statistically by ANOVA and Tukey's test at a p value periodontitis in dexamethasone-induced immunosuppressed rats. PMID:20857000

  15. Longitudinal assessment of carotid atherosclerosis after Radiation Therapy using Computed Tomography: A case control Study

    Energy Technology Data Exchange (ETDEWEB)

    Anzidei, Michele [Rome Univ. ' ' La Sapienza' ' (Italy). Dept. of Radiology; Suri, Jasjit S.; Piga, Mario [AtheroPoint TM LLC, Roseville, CA (United States). Monitoring and Diagnostic Div.; Global Biomedical Technologies, Inc., CA (United States). Point of Care Devices; Idaho Univ., Moscow, ID (United States). Electrical Engineering Dept.; Saba, Luca [Azienda Ospedaliero Universitaria (A.O.U.), Cagliari (Italy). Dept. of Radiology; Sanfilippo, Roberto; Montisci, Roberto [Azienda Ospedaliero Universitaria (A.O.U.), Cagliari (Italy). Dept. of Vascular Surgery; Laddeo, Giancarlo [New York Univ. Langone Medical Center, New York, NY (United States). Dept. of Radiology; Argiolas, Giovanni Maria [Azienda Ospedaliera Brotzu, Cagliari (Italy). Dept. of Radiology; Raz, Eytan [Rome Univ. ' ' La Sapienza' ' (Italy). Dept. of Radiology; New York Univ. Langone Medical Center, New York, NY (United States). Dept. of Radiology

    2016-01-15

    To study the carotid artery plaque composition and its volume changes in a group of patients at baseline and 2 years after head and neck radiation therapy treatment (HNXRT). In this retrospective study, 62 patients (41 males; mean age 63 years; range 52-81) who underwent HNXRT and 40 patients (24 males; mean age 65) who underwent surgical resection of neoplasm and did not undergo HNXRT were assessed, with 2-year follow-up. The carotid artery plaque volumes, as well as the volume of the sub-components (fatty-mixed-calcified), were semiautomatically quantified. Mann-Whitney and Wilcoxon tests were used to test the hypothesis. In the HNXRT group, there was a statistically significant increase in the total volume of the carotid artery plaques (from 533 to 746 mm{sup 3}; p = 0.001), in the fatty plaques (103 vs. 202 mm{sup 3}; p = 0.001) and mixed plaque component volume (328 vs. 419 mm{sup 3}; p = 0.034). A statistically significant variation (from 21.8 % to 27.6 %) in the percentage of the fatty tissue was found. of this preliminary study suggest that HNXRT promotes increased carotid artery plaque volume, particularly the fatty plaque component. (orig.)

  16. The emerging molecular pathogenesis of neuroblastoma: implications for improved risk assessment and targeted therapy.

    Science.gov (United States)

    Van Roy, Nadine; De Preter, Katleen; Hoebeeck, Jasmien; Van Maerken, Tom; Pattyn, Filip; Mestdagh, Pieter; Vermeulen, Joëlle; Vandesompele, Jo; Speleman, Frank

    2009-07-27

    Neuroblastoma is one of the most common solid tumors of childhood, arising from immature sympathetic nervous system cells. The clinical course of patients with neuroblastoma is highly variable, ranging from spontaneous regression to widespread metastatic disease. Although the outcome for children with cancer has improved considerably during the past decades, the prognosis of children with aggressive neuroblastoma remains dismal. The clinical heterogeneity of neuroblastoma mirrors the biological and genetic heterogeneity of these tumors. Ploidy and MYCN amplification have been used as genetic markers for risk stratification and therapeutic decision making, and, more recently, gene expression profiling and genome-wide DNA copy number analysis have come into the picture as sensitive and specific tools for assessing prognosis. The applica tion of new genetic tools also led to the discovery of an important familial neuroblastoma cancer gene, ALK, which is mutated in approximately 8% of sporadic tumors, and genome-wide association studies have unveiled loci with risk alleles for neuroblastoma development. For some of the genomic regions that are deleted in some neuroblastomas, on 1p, 3p and 11q, candidate tumor suppressor genes have been identified. In addition, evidence has emerged for the contribution of epigenetic disturbances in neuroblastoma oncogenesis. As in other cancer entities, altered microRNA expression is also being recognized as an important player in neuroblastoma. The recent successes in unraveling the genetic basis of neuroblastoma are now opening opportunities for development of targeted therapies.

  17. Miniature CNT-based X-ray tube: assessment for use in intraoperative radiation therapy

    Directory of Open Access Journals (Sweden)

    Mahmoud-Pashazadeh Ali

    2017-09-01

    Full Text Available Carbon nanotube (CNT is a new technology used to generate gamma photons in X-ray tubes. CNTs, in comparison to other small X-ray sources, produce high X-ray intensities and as they are not based on a thermionic principle they considered cold electron sources with a very high conversion of electrical to photon energy. Their small size and other interesting properties could make them feasible for use in intraoperative radiation therapy applications. In this study, physical characteristics of the photon beam generated by the CNT-based X-ray source were assessed. A soft X-ray ionization chamber and a flat panel detector was used to measure dose and photon counts, respectively. The repetitively produced pulses had almost the same photon intensities with differences of less than 1% between them. For a typical selected pulse, the variation in the pulse amplitude was also insignificant, which shows a stable radiation exposure of the tube during the ON-mode. When moving from the center of the beam profile to the lateral distance of 25 mm, both intensity profile and dose profile showed a falling trend by a factor of almost 3 in the measured values.

  18. Assessment of pulsed electromagnetic field therapy with Serum YKL-40 and ultrasonography in patients with knee osteoarthritis.

    Science.gov (United States)

    Dündar, Ümit; Aşık, Gülşah; Ulaşlı, Alper Murat; Sınıcı, Şükrü; Yaman, Fatima; Solak, Özlem; Toktaş, Hasan; Eroğlu, Selma

    2016-03-01

    The use of biomarkers of osteoarthritis (OA) have potential for early diagnosis, evaluation of disease severity and monitoring treatment. Serum and synovial fluid YKL-40 levels are increased in severe knee OA. Pulsed electromagnetic field (PEMF) therapy is a novel treatment method for OA. However, studies evaluating the PEMF therapy in treatment of knee OA revealed conflicting results. This study was conducted to objectively assess the effect of PEMF therapy in patients with knee OA, by using ultrasonographic measurements and a novel biomarker, YKL-40. Forty patients were randomized into two treatment groups. Both groups received conventional physical therapy, while Group 1 received additional PEMF therapy. The patients were asked to rate their pain on a visual analogue scale (VAS) and complete a Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire. Serum YKL-40 levels were measured, and knee effusion and cartilage degeneration level were evaluated with ultrasonography before and after treatment. Pre-treatment YKL-40 level was correlated with WOMAC pain subscale (P = 0.032, r = 0.339). VAS and WOMAC scores significantly improved in both treatment groups (P therapy has no additional effect on pain in patients with knee OA. Serum YKL-40 level seems to be unuseful for monitoring the treatment in knee OA. © 2015 Asia Pacific League of Associations for Rheumatology and Wiley Publishing Asia Pty Ltd.

  19. Gold Nanowires : A Time-Dependent Density Functional Assessment of Plasmonic Behavior

    NARCIS (Netherlands)

    Piccini, GiovanniMaria; Havenith, Remco W. A.; Broer, Ria; Stener, Mauro

    2013-01-01

    The surface plasmon resonance has been theoretically investigated in gold nanowires by means of time-dependent density functional theory. Linear chains of Au atoms and nanowires with the structure of the fcc bulk gold grown along the <110 > and <111 > directions have been considered. The effects of

  20. Assessment of the impact of individual therapy on upper limb function in patients diagnosed with painful shoulder syndrome.

    Science.gov (United States)

    Wnuk, Agnieszka; Świtoń, Anna; Juszczak, Aleksej; Mizia, Ewa

    2017-01-01

    Functional disorders of the shoulder girdle affect 1/3 of the population. The diagnosis of "painful shoulder" or shoulder impingement syndrome is vague and imprecise. It can relay to so tissue pathology as well as to limitation of mobility of the joint. In this case an appropriate diagnosis, followed by a quick and effective treatment, is crucial. A physiotherapy assessment, performed during an individual therapy session sets out a way forward for targeted rehabilitation. Objectives and purpose of the article: The aim of this publication is to assess the impact of individual therapy on the function of the shoulder girdle in patients subject to health resort treatment. The study included 30 patients diagnosed with shoulder joint conditions before and a er individual therapy with a physical therapist. The clinical study involved basic measurements of the range of mobility and standardized functional tests. The patients were surveyed to evaluate changes in the performance of daily activities before and a er the therapy. Pain assessment was conducted using the Visual Analogue Scale (VAS). The results were subjected to statistical analysis. The use of individual health resort treatment therapy significantly improved individual functional capacity of the patients. Self-evaluation of the patients on the performance of daily activities has shown improvement of the quality of those activities. According to VAS scale, a difference between the level of perceived pain before (mean = 6.2) and a er physical therapy treatment (mean = 3.7) as well as an improvement of the range of mobility have been observed. The results of the study confirmed that the treatment has significantly reduced the pain. Individual work with a physical therapist, focused on the improvement of the range of mobility of the shoulder girdle and functional tasks, clearly reduces limitations of daily activities of the patients and can improve the quality of their life.

  1. Assessing client self-narrative change in emotion-focused therapy of depression: an intensive single case analysis.

    Science.gov (United States)

    Angus, Lynne E; Kagan, Fern

    2013-12-01

    Personality researchers use the term self-narrative to refer to the development of an overall life story that places life events in a temporal sequence and organizes them in accordance to overarching themes. In turn, it is often the case that clients seek out psychotherapy when they can no longer make sense of their life experiences, as a coherent story. Angus and Greenberg (L. Angus and L. Greenberg, 2011, Working with narrative in emotion-focused therapy: Changing stories, healing lives. Washington, DC: American Psychological Association Press) view the articulation and consolidation of an emotionally integrated self-narrative account as an important part of the therapeutic change process that is essential for sustained change in emotion-focused therapy of depression. The purpose of the present study was to investigate client experiences of change, and self-narrative reconstruction, in the context of one good outcome emotion-focused therapy dyad drawn from the York II Depression Study. Using the Narrative Assessment Interview (NAI) method, client view of self and experiences of change were assessed at three points in time--after session one, at therapy termination, and at 6 months follow-up. Findings emerging from an intensive narrative theme analyses of the NAI transcripts--and 1 key therapy session identified by the client--are reported and evidence for the contributions of narrative and emotion processes to self-narrative change in emotion-focused therapy of depression are discussed. Finally, the implications of assessing clients' experiences of self-narrative change for psychotherapy research and practice are addressed.

  2. The effects of verb retrieval therapy for people with non-fluent aphasia: evidence from assessment tasks and conversation.

    Science.gov (United States)

    Carragher, Marcella; Sage, Karen; Conroy, Paul

    2013-01-01

    Despite often impressive improvements on linguistic assessments, there is a lack of evidence of significant generalisation from impairment-focused aphasia therapy to everyday communication. The aim of the current study was to investigate the effect of a verb retrieval therapy across a range of levels of language production. Nine participants with chronic non-fluent stroke aphasia were recruited into this case series. Baseline assessment included naming a range of verbs (i.e., action verbs, semantically light verbs and personally relevant verbs) and sentence production. Multiple samples of conversation were collected from each participant and his/her partner. Consecutively failed verbs were divided across treatment and control sets; these sets were matched for salient psycholinguistic variables such as frequency, imageability and argument structure. A multi-component verb retrieval therapy was delivered, consisting of semantic feature analysis, gesture production and phonemic cueing. Following therapy, participants demonstrated significant and sustained gains in naming treated verbs; more modest effects were seen in untreated verbs. Mixed patterns of generalisation were evident in assessment of sentence production. In conversation, while group analysis suggested a lack of change, individual analyses indicated increased verb retrieval for three participants and qualitative changes related to the syntactic contexts of verbs retrieved.

  3. Reliability and accuracy assessment of radiation therapy oncology group-endorsed guidelines for brachial plexus contouring

    Energy Technology Data Exchange (ETDEWEB)

    Velde, Joris van de [Ghent University, Department of Anatomy, Ghent (Belgium); Ghent University, Department of Radiotherapy, Ghent (Belgium); Vercauteren, Tom; Gersem, Werner de; Vandecasteele, Katrien; Vuye, Philippe; Vanpachtenbeke, Frank; Neve, Wilfried de [Ghent University, Department of Radiotherapy, Ghent (Belgium); Wouters, Johan; Herde, Katharina d' ; Kerckaert, Ingrid; Hoof, Tom van [Ghent University, Department of Anatomy, Ghent (Belgium)

    2014-07-15

    The goal of this work was to validate the Radiation Therapy Oncology Group (RTOG)-endorsed guidelines for brachial plexus (BP) contouring by determining the intra- and interobserver agreement. Accuracy of the delineation process was determined using anatomically validated imaging datasets as a gold standard. Five observers delineated the right BP on three cadaver computed tomography (CT) datasets. To assess intraobserver variation, every observer repeated each delineation three times with a time interval of 2 weeks. The BP contours were divided into four regions for detailed analysis. Inter- and intraobserver variation was verified using the Computerized Environment for Radiation Research (CERR) software. Accuracy was measured using anatomically validated fused CT-magnetic resonance imaging (MRI) datasets by measuring the BP inclusion of the delineations. The overall kappa (κ) values were rather low (mean interobserver overall κ: 0.29, mean intraobserver overall κ: 0.45), indicating poor inter- and intraobserver reliability. In general, the κ coefficient decreased gradually from the medial to lateral BP regions. The total agreement volume (TAV) was much smaller than the union volume (UV) for all delineations, resulting in a low Jaccard index (JI; interobserver agreement 0-0.124; intraobserver agreement 0.004-0.636). The overall accuracy was poor, with an average total BP inclusion of 38 %. Inclusions were insufficient for the most lateral regions (region 3: 21.5 %; region 4: 12.6 %). The inter- and intraobserver reliability of the RTOG-endorsed BP contouring guidelines was poor. BP inclusion worsened from the medial to lateral regions. Accuracy assessment of the contours showed an average BP inclusion of 38 %. For the first time, this was assessed using the original anatomically validated BP volume. The RTOG-endorsed BP guidelines have insufficient accuracy and reliability, especially for the lateral head-and-neck regions. (orig.) [German] Ziel der Studie war

  4. The Impact of Library Tutorials on the Information Literacy Skills of Occupational Therapy and Physical Therapy Students in an Evidence-Based Practice Course: A Rubric Assessment.

    Science.gov (United States)

    Schweikhard, April J; Hoberecht, Toni; Peterson, Alyssa; Randall, Ken

    2018-01-01

    This study measures how online library instructional tutorials implemented into an evidence-based practice course have impacted the information literacy skills of occupational and physical therapy graduate students. Through a rubric assessment of final course papers, this study compares differences in students' search strategies and cited sources pre- and post-implementation of the tutorials. The population includes 180 randomly selected graduate students from before and after the library tutorials were introduced into the course curriculum. Results indicate a statistically significant increase in components of students' searching skills and ability to find higher levels of evidence after completing the library tutorials.

  5. [Assessment of antibacterial efficacy of ozone therapy in treatment of caries at the white spot stage].

    Science.gov (United States)

    Makeeva, I M; Turkina, A Yu; Margaryan, E G; Paramonov, Yu O; Polyakova, M A

    Effect on cariogenic flora is the key toremineralizing therapy efficacy in treatment of initial caries (at the white spot stage). Ozone in dentistry is used as a highly effective antibacterial agent. Treatment of white spot lesions with the ozone-air mixture leads to significant increase of efficacy in non-invasive treatment of initial caries. clinical and microbiological assessment of antibacterial efficacy of ozone therapy in treatment of caries at the white spot stage. The trial recruited 86 patients for non-invasive treatment of caries at the white spot stage which included the complex of professional oral hygiene, medicamental treatment of white spot lesions with hydrogen peroxide 3% and chlorhexidinedigluconate 0,2%, treatment with the ozone-air mixture and application of hydroxyapatite Са2+. Material for microbiological study was received before the treatment, after the complex of professional oral hygiene and medicamental treatment of white spot lesions conducted as well as after the treatment with the ozone-air mixture. Before the treatment up to 16 kinds of microorganisms on the surface of white spot lesion were detected with the following shares: S. mutans (19.9%), S. salivarius (15.1%), S. epidermidis (8.7%), S. mitis (6.5%), Lactobacillus (6.5%) and different kinds of staphylococci (10.8%). After the complex of professional oral hygiene and medicamental treatment conducted decrease in number of cariogenic microorganisms was indicated as follows: S. mutans - from 1·105 to 1·104, S. salivarius - from 1·107 to 1·106, S. epidermidis - from 1·105 to 1·104, S. mitis - from 1·104 to 1·103, Lactobacillus - from 1·104 tо 1·103. After the treatment of tooth enamel with the ozone-air mixture increase in microorganisms was not observed. The efficacy of ozone on cariogenic microorganisms exceeds significantly the efficacy of 3% hydrogen peroxide and 0,2% chlorhexidinedigluconate. It is strongly advisable to include ozone in protocol of non

  6. Reproducibility of mRECIST in assessing response to transarterial radioembolization therapy in hepatocellular carcinoma.

    Science.gov (United States)

    Seyal, Adeel R; Gonzalez-Guindalini, Fernanda D; Arslanoglu, Atilla; Harmath, Carla B; Lewandowski, Robert J; Salem, Riad; Yaghmai, Vahid

    2015-10-01

    The purpose of our study was to evaluate the reproducibility of Modified Response Evaluation Criteria in Solid Tumors (mRECIST) in hepatocellular carcinoma (HCC) lesions undergoing transarterial radioembolization (TARE) therapy and to determine whether mRECIST reproducibility is affected by the enhancement pattern of HCC. One hundred and three HCC lesions from 103 patients treated with TARE were evaluated. The single longest diameter of viable tumor tissue was measured by two radiologists at baseline; response to therapy was evaluated according to mRECIST. The enhancement pattern of HCC lesions was correlated with their mRECIST response. The response rate between mRECIST and RECIST 1.1 was compared. Wilcoxon signed-rank test, paired t test, Lin's concordance correlation coefficient (ρc ), Bland-Altman plot, kappa statistics, and Fisher's exact test were used to assess intra- and interobserver reproducibilities and to compare response rates. There were better intra- than interobserver agreements in the measurement of single longest diameter of viable tumor tissue (bias = 0 cm intraobserver versus bias = 0.3 cm interobserver). For mRECIST, good intraobserver (ĸ = 0.70) and moderate interobserver (ĸ = 0.56) agreements were noted. The mRECIST response for HCC lesions with homogeneous enhancement at both baseline and follow-up imaging showed better intra- and interobserver agreements (ĸ = 0.77 and 0.60, respectively) than lesions with heterogeneous enhancement at both scans (ĸ = 0.54 and 0.40, respectively). In the early follow-up period mRECIST showed a significantly higher response rate than RECIST (40.8% versus 3.9%; P = 0.025). In HCC patients treated with TARE, mRECIST captures a significantly higher response rate compared with RECIST; it also demonstrates acceptable intra- and interobserver reproducibilities for HCC lesions treated with TARE, and mRECIST reproducibility may be lower for HCC lesions with heterogeneous distribution

  7. Effectiveness of peer assessment for implementing a dutch physical therapy low back pain guideline: cluster randomized controlled trial

    NARCIS (Netherlands)

    Dulmen, S.A. van; Maas, Marjo; Staal, J.B.; Rutten, G.; Kiers, H.; Nijhuis-Van der Sanden, M.W.G.; Wees, P. van der

    2014-01-01

    BACKGROUND: Clinical practice guidelines are considered important instruments to improve quality of care. However, success is dependent on adherence, which may be improved using peer assessment, a strategy in which professionals assess performance of their peers in a simulated setting. OBJECTIVE:

  8. Longitudinal assessment of thrombin generation potential in response to alteration of antiplatelet therapy after TIA or ischaemic stroke.

    LENUS (Irish Health Repository)

    Tobin, W O

    2013-02-01

    The impact of changing antiplatelet therapy on thrombin generation potential in patients with ischaemic cerebrovascular disease (CVD) is unclear. We assessed patients within 4 weeks of TIA or ischaemic stroke (baseline), and then 14 days (14d) and >90 days (90d) after altering antiplatelet therapy. Thrombin generation was assessed in platelet poor plasma. Ninety-one patients were recruited. Twenty-four were initially assessed on no antiplatelet therapy, and then after 14d (N = 23) and 90d (N = 8) on aspirin monotherapy; 52 were assessed on aspirin monotherapy, and after 14 and 90 days on aspirin and dipyridamole combination therapy; 21 patients were assessed on aspirin and after 14 days (N = 21) and 90 days (N = 19) on clopidogrel. Peak thrombin generation and endogenous thrombin potential were reduced at 14 and 90 days (p ≤ 0.04) in the overall cohort. We assessed the impact of individual antiplatelet regimens on thrombin generation parameters to investigate the cause of this effect. Lag time and time-to-peak thrombin generation were unchanged at 14 days, but reduced 90 days after commencing aspirin (p ≤ 0.009). Lag time, peak thrombin generation and endogenous thrombin potential were reduced at both 14 and 90 days after adding dipyridamole to aspirin (p ≤ 0.01). Lag time was reduced 14 days after changing from aspirin to clopidogrel (p = 0.045), but this effect was not maintained at 90 days (p = 0.2). This pilot study did not show any consistent effects of commencing aspirin, or of changing from aspirin to clopidogrel on thrombin generation potential during follow-up. The addition of dipyridamole to aspirin led to a persistent reduction in peak and total thrombin generation ex vivo, and illustrates the diverse, potentially beneficial, newly recognised \\'anti-coagulant\\' effects of dipyridamole in ischaemic CVD.

  9. Assessment of antiretroviral therapy knowledge and willingness of persons with HIV to support its uptake in Uganda

    Directory of Open Access Journals (Sweden)

    Batamwita R

    2011-10-01

    Full Text Available Richard Batamwita1, David M Moore2, Rachel King3, Edward Mills4, Anne L Stangl5 1Mildmay Centre, Kampala, Uganda; 2British Columbia Centre for Excellence in HIV/AIDS, Vancouver, Canada; 3Karolinska Institute, Stockholm, Sweden; 4University of Ottawa, Ottawa, Canada; 5International Center for Research on Women, Washington, DC, USA Background: Access to care and treatment services for human immunodeficiency virus (HIV/acquired immunodeficiency syndrome (AIDS are hampered by human resource constraints and knowledge gaps about antiretroviral therapy. Training people with HIV/AIDS (PWA as educators on antiretroviral therapy may help in the expansion of antiretroviral therapy-related knowledge in Africa. The aim of this study was to assess the antiretroviral therapy-specific knowledge, beliefs, and attitudes of PWA as well as their proactive communication with community members and to explore their willingness to serve as support personnel. Methods: Data were obtained from a large randomized trial of PWA. We analyzed qualitative and quantitative data from 524 PWA aged 18 years and over who initiated home-based antiretroviral therapy in 2003. We assessed knowledge and communication of HIV prevention and treatment messages by PWA to communities using structured messages complemented with other knowledge questions and the willingness of PWA to serve as support persons. Descriptive bivariate associations and logistic regression statistical methods were performed. In addition, qualitative data analysis was used. Results: The level of knowledge about antiretroviral therapy was high among all PWA on several technical attributes. Overall, 90% of PWA reported that they had been consulted by community members for informed opinions on antiretroviral therapy, 70% felt they were opinion leaders on aspects of antiretroviral therapy within the communities, and approximately 70% were willing to be engaged as community support persons. Those who were classified as

  10. Homework in Cognitive Behavioral Therapy: A Systematic Review of Adherence Assessment in Anxiety and Depression (2011-2016).

    Science.gov (United States)

    Kazantzis, Nikolaos; Brownfield, Nicole R; Mosely, Livia; Usatoff, Alexsandra S; Flighty, Andrew J

    2017-12-01

    Treatment adherence has posed a substantial challenge not only for patients but also for the health profession for many decades. The last 5 years has witnessed significant attention toward adherence with cognitive behavioral therapy (CBT) homework for anxiety and depressive disorders, and adherence assessment methods have diversified. However, there remains a large component of the adherence process not assessed in CBT, with patient effort, engagement, and the known role for treatment appraisals and beliefs necessitating the pursuit of improved adherence assessment methods. Copyright © 2017 Elsevier Inc. All rights reserved.

  11. ASSESSMENT OF FREQUENCY OF ALLOIMMUNIZATION AND ERYTHROCYTE AUTOIMMUNIZATION IN TRANSFUSION DEPENDENT THALASSEMIA PATIENTS

    Directory of Open Access Journals (Sweden)

    S. Ansari

    2008-05-01

    Full Text Available Life-long red blood transfusion remains the main treatment for severe thalassemia. The development of hemolytic alloantibodies and erythrocyte autoantibodies complicated transfusion therapy in thalassemia patients. The frequency causes and prevention of this phenomenon among 80 transfused thalassemia patients were evaluated in Ali Asghar Children's Hospital during 1998-2004 in a cross-sectional study. In our study the mean age at the initiation of transfusion was 1.7 years (SD = 1.94 and mean interval of transfusion 33.73 day (SD = 20.74. Autoimmunization in 15 patients was positive and 8 patients had hemolytic reaction in transfusion. Our data show that alloimmunization to minor erythrocyte antigens and erythrocyte autoimmunization of significant clinical variables, are frequent findings in transfused thalassemia patients. However data suggest that prevalence of immunization in our patients is less than other Asian countries.

  12. Assessment of enhanced endothelium-dependent vasodilation by intermittent fasting in Wistar albino rats.

    Science.gov (United States)

    Razzak, Rima L Abdul; Abu-Hozaifa, Bodour M; Bamosa, Abdullah O; Ali, Nemah M

    2011-01-01

    Intermittent fasting (IF), a type of feeding regimen where the frequency of eating is reduced enhances cardiovascular stress adaptation and improves cardiovascular risk factors in rats. Data on the effect of IF on the endothelium is not common, so we examined whether IF showed similarity to documented beneficial effects of caloric restriction on endothelium-dependent vasodilatory responses of rat aortic rings. 25 young male Wistar rats had ad libitum (AL) access to food and 25 others were provided with food every other day for 2 months, during which their weight was measured every 2 weeks. Vascular reactivity of abdominal aorta was simultaneously evaluated using dual wire myographs. Weight gain was greater in the AL group (P<0.001) at all weighing intervals. Acetylcholine (ACh; 10(-10)-10(-5)M) produced greater (P<0.05) vasorelaxation in IF rats at the two highest concentrations. IF reduces weight gain in young male rats and improves their aortic endothelium-dependent vasorelaxation.

  13. Time-dependent prediction degredation assessment of neural-networks-based TEC forecasting models

    Directory of Open Access Journals (Sweden)

    Th. D. Xenos

    2003-01-01

    Full Text Available An estimation of the difference in TEC prediction accuracy achieved when the prediction varies from 1 h to 7 days in advance is described using classical neural networks. Hourly-daily Faraday-rotation derived TEC measurements from Florence are used. It is shown that the prediction accuracy for the examined dataset, though degrading when time span increases, is always high. In fact, when a relative prediction error margin of ± 10% is considered, the population percentage included therein is almost always well above the 55%. It is found that the results are highly dependent on season and the dataset wealth, whereas they highly depend on the foF2 - TEC variability difference and on hysteresis-like effect between these two ionospheric characteristics.

  14. COMPliance and Arthralgia in Clinical Therapy: the COMPACT trial, assessing the incidence of arthralgia, and compliance within the first year of adjuvant anastrozole therapy.

    Science.gov (United States)

    Hadji, P; Jackisch, C; Bolten, W; Blettner, M; Hindenburg, H J; Klein, P; König, K; Kreienberg, R; Rief, W; Wallwiener, D; Zaun, S; Harbeck, N

    2014-02-01

    This prospective study evaluated the relationship between arthralgia and compliance during the first year of adjuvant anastrozole therapy in postmenopausal women with hormone receptor-positive early breast cancer. COMPliance and Arthralgia in Clinical Therapy (COMPACT) was an open-label, multicenter, noninterventional study conducted in Germany. Patients had started adjuvant anastrozole 3-6 months before the study start. The primary end points were arthralgia, compliance, and the relationship between compliance and arthralgia, assessed at specific time points. Overall, 1916 patients received upfront anastrozole. Mean arthralgia scores were increased from baseline at each visit up to 9 months. Compliance with anastrozole therapy gradually decreased over time from baseline to 9 months (P95% of patients were compliant versus patient reports of <70%. There was a significant association between arthralgia mean scores and noncompliance at 6 months (P<0.0001), 9 months (P<0.0001), and overall (P<0.0001). Over time, new events or impairment of existing arthralgias were reported in 14% (3 months), 11% (6 months), and 9% (9 months) of patients. Arthralgia is important in the clinical management of women with early breast cancer and may contribute to noncompliance and clinical outcomes. NCT00857012.

  15. Education of Military Dependent Students: Better Information Needed to Assess Student Performance

    Science.gov (United States)

    2011-03-01

    services, reside on federal property with a parent who is an accredited foreign military officer, reside on Indian lands, reside in low-rent housing, or...DOD to establish a 3 year pilot program to promote early childhood education for dependent children affected by military deployment or relocation of...training sessions on discipline with the at-home parent. Military parents we interviewed at one school district explained that sometimes the stigma

  16. Assessment of disease burden among army personnel and dependents in Lucknow city

    Directory of Open Access Journals (Sweden)

    Anil Ahuja

    2015-01-01

    Full Text Available Introduction: Oral health is a valuable asset for an individual. The oral cavity has a significant role to play in providing a satisfactory lifestyle including proper mastication, phonetics, esthetics, appearance, communication abilities and an overall emotional well-being. Very fewer studies have been carried out in the past on disease burden of army personnel and their dependents. Materials and Methods: This study was carried out on 2160 army personnel and their dependents reporting to Command Military Dental Center, Lucknow. The study population was screened for caries, periodontal status and prosthetic status and treatment need, oral hygiene practice and prevalence of the tobacco habit. All relevant information was noted into a Proforma. Statistical analysis was performed using SPSS 16.0 version (Chicago, Inc., USA. The results are presented in percentage and mean (±standard deviation. The unpaired t-test and Chi-square test were used. The P < 0.05 was considered as significant. Results: The oral hygiene awareness is adequate among serving, and dependents and practices of oral hygiene were also adequate. The higher prevalence of the tobacco habit was found among young army personnel than older. There was a significant association of smoking and periodontal disease. Leukoplakia was common oral mucosal lesion between smokers. Conclusion: This study will help to access dental disease occurrence rate and evaluate treatment needs and also to formulate a plan for augmentation of resources. The study will also create awareness about oral hygiene practices and oral habits among army personnel and their dependents.

  17. Culture-dependent bacteria in commercial fishes: Qualitative assessment and molecular identification using 16S rRNA gene sequencing

    OpenAIRE

    Nabeel M. Alikunhi; Batang, Zenon B.; AlJahdali, Haitham A.; Aziz, Mohammed A.M.; Abdulaziz M. Al-Suwailem

    2016-01-01

    Fish contamination has been extensively investigated along the Saudi coasts, but studies pertaining to bacterial pathogens are scarce. We conducted qualitative assessment and molecular identification of culture-dependent bacteria in 13 fish species from three coastal sites and a local fish market in Jeddah, Saudi Arabia. Bacterial counts of gills, skin, gut and muscle were examined on agar plates of Macconkey’s (Mac), Eosin Methylene Blue (EMB) and Thiosulfate Citrate Bile Salts (TCBS) cultur...

  18. BINARY: an optical freezing array for assessing temperature and time dependence of heterogeneous ice nucleation

    Directory of Open Access Journals (Sweden)

    C. Budke

    2015-02-01

    Full Text Available A new optical freezing array for the study of heterogeneous ice nucleation in microliter-sized droplets is introduced, tested and applied to the study of immersion freezing in aqueous Snomax® suspensions. In the Bielefeld Ice Nucleation ARraY (BINARY ice nucleation can be studied simultaneously in 36 droplets at temperatures down to −40 °C (233 K and at cooling rates between 0.1 and 10 K min−1. The droplets are separated from each other in individual compartments, thus preventing a Wegener–Bergeron–Findeisen type water vapor transfer between droplets as well as avoiding the seeding of neighboring droplets by formation and surface growth of frost halos. Analysis of freezing and melting occurs via an automated real-time image analysis of the optical brightness of each individual droplet. As an application ice nucleation in water droplets containing Snomax® at concentrations from 1 ng mL−1 to 1 mg mL−1 was investigated. Using different cooling rates, a small time dependence of ice nucleation induced by two different classes of ice nucleators (INs contained in Snomax® was detected and the corresponding heterogeneous ice nucleation rate coefficient was quantified. The observed time dependence is smaller than those of other types of INs reported in the literature, suggesting that the BINARY setup is suitable for quantifying time dependence for most other INs of atmospheric interest, making it a useful tool for future investigations.

  19. Land need assessment for the project of common facilities and its dependence

    Directory of Open Access Journals (Sweden)

    Richard Filip

    2010-01-01

    Full Text Available The project of common facilities is a very important part of the process of land arrangement. It helps to ensure a lot of public functions, for example permeability of landscape, to preserve fertility of soil, to decrease surface outflow and prevention from floods, the protection and production of environment etc. It is essential to ensure sufficient land area to be able to suggest and carry out such plans of common facilities. It will be more and more difficult to ensure this plan due to the fact that the state-owned land is still decreasing. In the areas where the state-owned land still exists, it could be possible to reserve the part of these areas for this objective. This study analyses projects of common facilities in 33 cadastral areas and series of another variable values with the aim to find or to exclude different dependences. It could also help to estimate the extent of reserve areas. The most of examined values did not show any dependence but some of the tested values show the certain dependence.

  20. Deficits in Emotion-Regulation Skills Predict Alcohol Use during and after Cognitive-Behavioral Therapy for Alcohol Dependence

    Science.gov (United States)

    Berking, Matthias; Margraf, Matthias; Ebert, David; Wupperman, Peggilee; Hofmann, Stefan G.; Junghanns, Klaus

    2011-01-01

    Objective: As emotion regulation is widely considered to be a primary motive in the misuse of alcohol, our aim in the study was to investigate whether deficits in adaptive emotion-regulation skills maintain alcohol dependence (AD). Method: A prospective study investigated whether emotion-regulation skills were associated with AD and whether these…

  1. Placebo-controlled comparison of captopril, metoprolol, and hydrochlorothiazide therapy in non-insulin-dependent diabetic patients with primary hypertension

    DEFF Research Database (Denmark)

    Gall, M A; Rossing, P; Skøtt, P

    1992-01-01

    The antihypertensive effect of captopril, metoprolol, and hydrochlorothiazide was compared in 23 non-insulin-dependent (NIDDM) diabetic patients less than or equal to 75 years of age, with borderline to moderate primary hypertension. In a double blind, placebo-controlled cross-over trial the pati...

  2. Development of a Quantitative Tool to Assess the Content of Physical Therapy for Infants

    NARCIS (Netherlands)

    Blauw-Hospers, Cornill H.; Dirks, Tineke; Hulshof, Lily J.; Hadders-Algra, Mijna

    2010-01-01

    Purpose: The study aim was to describe and quantify physical therapy interventions for infants at high risk for developmental disorders. Methods: An observation protocol was developed based on knowledge about infant physical therapy and analysis of directly observable physiotherapeutic (PT) actions.

  3. Molecular targeted therapy in modern oncology: Imaging assessment of treatment response and toxicities

    Energy Technology Data Exchange (ETDEWEB)

    Krajewski, Katherine M.; Braschi-Amirfarzan, Marta; DiPiro, Pamela J.; Jagannathan, Jyothi P.; Shinagare, Atul B. [Dept. of of Imaging, Dana Farber Cancer Institute, Boston (United States)

    2017-01-15

    Oncology is a rapidly evolving field with a shift toward personalized cancer treatment. The use of therapies targeted to the molecular features of individual tumors and the tumor microenvironment has become much more common. In this review, anti-angiogenic and other molecular targeted therapies are discussed, with a focus on typical and atypical response patterns and imaging manifestations of drug toxicities.

  4. [Assessment of the use of music therapy with nursing home residents].

    Science.gov (United States)

    Sanchez, Stéphane; Le Guillou, Adrien; Messaoudi, Yasmine; Letty, Aude; Denormandie, Philippe

    A study analysed, on the one hand, the efficacy of the use of music therapy with residents and, on the other, the feasibility of the implementation of such a technique in nursing homes and in follow-up and rehabilitation units. In this context, music therapy seems to be an effective alternative to traditional approaches. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

  5. National Survey Assessing Perceived Multicultural Competence in Art Therapy Graduate Students

    Science.gov (United States)

    Robb, Megan

    2014-01-01

    Multicultural competence is essential to contemporary art therapy practice. Current education standards require that culturally sound theories and practices be taught along with self-awareness, but there is little research on the effects of such training in art therapy. The current study examined data from the Multicultural Awareness, Knowledge,…

  6. Assessing the Effectiveness of Parent-Child Interaction Therapy with Language Delayed Children: A Clinical Investigation

    Science.gov (United States)

    Falkus, Gila; Tilley, Ciara; Thomas, Catherine; Hockey, Hannah; Kennedy, Anna; Arnold, Tina; Thorburn, Blair; Jones, Katie; Patel, Bhavika; Pimenta, Claire; Shah, Rena; Tweedie, Fiona; O'Brien, Felicity; Leahy, Ruth; Pring, Tim

    2016-01-01

    Parent-child interaction therapy (PCIT) is widely used by speech and language therapists to improve the interactions between children with delayed language development and their parents/carers. Despite favourable reports of the therapy from clinicians, little evidence of its effectiveness is available. We investigated the effects of PCIT as…

  7. Music Therapy Assessment and Development of Parental Competences in Families Where Children Have Experienced Emotional Neglect

    DEFF Research Database (Denmark)

    Jacobsen, Stine Lindahl

    2012-01-01

    -Child Interaction in Music as measured by APC. Music therapy did have significant effect on the how stressful parents perceived their children and particular how stressful the children’s mood was to the parents as measured by the PSI. Furthermore results showed that parents in the music therapy treatment condition...

  8. Assessing Treatment Integrity in Acceptance and Commitment Therapy: Strategies and Suggestions

    Science.gov (United States)

    Plumb, Jennifer C.; Vilardaga, Roger

    2010-01-01

    In this paper, we briefly review the current literature on treatment integrity and discuss the relevance of this procedure for detecting, measuring and ensuring that the proposed mechanisms of change in cognitive behavior therapy, in this case of acceptance and commitment therapy (ACT; S.C. Hayes, Strosahl, & Wilson, 1999), take place. We discuss…

  9. Human Health Risk Assessment Applied to Rural Populations Dependent on Unregulated Drinking Water Sources: A Scoping Review.

    Science.gov (United States)

    Ford, Lorelei; Bharadwaj, Lalita; McLeod, Lianne; Waldner, Cheryl

    2017-07-28

    Safe drinking water is a global challenge for rural populations dependent on unregulated water. A scoping review of research on human health risk assessments (HHRA) applied to this vulnerable population may be used to improve assessments applied by government and researchers. This review aims to summarize and describe the characteristics of HHRA methods, publications, and current literature gaps of HHRA studies on rural populations dependent on unregulated or unspecified drinking water. Peer-reviewed literature was systematically searched (January 2000 to May 2014) and identified at least one drinking water source as unregulated (21%) or unspecified (79%) in 100 studies. Only 7% of reviewed studies identified a rural community dependent on unregulated drinking water. Source water and hazards most frequently cited included groundwater (67%) and chemical water hazards (82%). Most HHRAs (86%) applied deterministic methods with 14% reporting probabilistic and stochastic methods. Publications increased over time with 57% set in Asia, and 47% of studies identified at least one literature gap in the areas of research, risk management, and community exposure. HHRAs applied to rural populations dependent on unregulated water are poorly represented in the literature even though almost half of the global population is rural.

  10. Assessment of PET tracer uptake in hormone-independent and hormone-dependent xenograft prostate cancer mouse models.

    Science.gov (United States)

    Kukuk, Damaris; Reischl, Gerald; Raguin, Olivier; Wiehr, Stefan; Judenhofer, Martin S; Calaminus, Carsten; Honndorf, Valerie S; Quintanilla-Martinez, Leticia; Schönberger, Tanja; Duchamp, Olivier; Machulla, Hans-Jürgen; Pichler, Bernd J

    2011-10-01

    The pharmacokinetics of (18)F-fluorodeoxythymidine (FLT), (18)F-FDG, (11)C-choline, and (18)F-fluoroethylcholine (FEC) in 2 hormone-independent (PC-3, DU145) and 2 hormone-dependent (CWR22, PAC120) prostate cancer xenograft mouse models were evaluated by PET and compared by immunohistochemistry. Further investigation was performed to determine whether PET can detect early changes in tumor metabolism after androgen ablation therapy through surgical castration. PET was performed on 4 consecutive days. In addition, the CWR22 and PAC120 tumor models were surgically castrated after the baseline measurement and imaged again after castration. The tracer uptake was analyzed using time-activity curves, percentage injected dose per volume (%ID/cm(3)), and tumor-to-muscle ratio (T/M). Regarding the hormone-independent prostate tumor models, (18)F-FLT showed the best T/M and highest %ID/cm(3) in PC-3 (2.97 ± 0.63 %ID/cm(3)) and DU145 (2.06 ± 0.75 %ID/cm(3)) tumors. (18)F-FDG seemed to be the tracer of choice for delineation of the PC-3 tumors but not for the DU145 tumors. Using (11)C-choline (PC-3: 1.33 ± 0.29 %ID/cm(3), DU145: 1.60 ± 0.27 %ID/cm(3)) and (18)F-FEC, we did not find any significant uptake in the tumors, compared with muscle tissue. Regarding the hormone-dependent prostate tumor models, the CWR22 model showed a highly significant (P < 0.01) decrease in tumor (18)F-FDG uptake from 4.11 ± 1.29 %ID/cm(3) to 2.19 ± 1.45 %ID/cm(3) after androgen ablation therapy. However, the (18)F-FLT, (11)C-choline, or (18)F-FEC tracers did not provide sufficient uptake or reliable information about therapy response in CWR22 tumors. The PAC120 model showed a significant increase in (18)F-FLT tumor uptake (P = 0.015) after androgen ablation therapy. The accumulation of (18)F-FEC (before: 2.32 ± 1.01 %ID/cm(3), after: 1.36 ± 0.39 %ID/cm(3)) was found to be the next highest after (18)F-FDG (before: 2.45 ± 0.93 %ID/cm(3), after: 2.18 ± 0.65 %ID/cm(3)) in PAC120 tumors before

  11. Combination Therapy with c-Met and Src Inhibitors Induces Caspase-Dependent Apoptosis of Merlin-Deficient Schwann Cells and Suppresses Growth of Schwannoma Cells.

    Science.gov (United States)

    Fuse, Marisa A; Plati, Stephani Klingeman; Burns, Sarah S; Dinh, Christine T; Bracho, Olena; Yan, Denise; Mittal, Rahul; Shen, Rulong; Soulakova, Julia N; Copik, Alicja J; Liu, Xue Zhong; Telischi, Fred F; Chang, Long-Sheng; Franco, Maria Clara; Fernandez-Valle, Cristina

    2017-11-01

    Neurofibromatosis type 2 (NF2) is a nervous system tumor disorder caused by inactivation of the merlin tumor suppressor encoded by the NF2 gene. Bilateral vestibular schwannomas are a diagnostic hallmark of NF2. Mainstream treatment options for NF2-associated tumors have been limited to surgery and radiotherapy; however, off-label uses of targeted molecular therapies are becoming increasingly common. Here, we investigated drugs targeting two kinases activated in NF2-associated schwannomas, c-Met and Src. We demonstrated that merlin-deficient mouse Schwann cells (MD-MSC) treated with the c-Met inhibitor, cabozantinib, or the Src kinase inhibitors, dasatinib and saracatinib, underwent a G 1 cell-cycle arrest. However, when MD-MSCs were treated with a combination of cabozantinib and saracatinib, they exhibited caspase-dependent apoptosis. The combination therapy also significantly reduced growth of MD-MSCs in an orthotopic allograft mouse model by greater than 80% of vehicle. Moreover, human vestibular schwannoma cells with NF2 mutations had a 40% decrease in cell viability when treated with cabozantinib and saracatinib together compared with the vehicle control. This study demonstrates that simultaneous inhibition of c-Met and Src signaling in MD-MSCs triggers apoptosis and reveals vulnerable pathways that could be exploited to develop NF2 therapies. Mol Cancer Ther; 16(11); 2387-98. ©2017 AACR . ©2017 American Association for Cancer Research.

  12. Significant and sustaining elevation of blood oxygen induced by Chinese cupping therapy as assessed by near-infrared spectroscopy.

    Science.gov (United States)

    Li, Ting; Li, Yaoxian; Lin, Yu; Li, Kai

    2017-01-01

    Cupping therapy has been used in traditional Chinese medicine for thousands of years to relieve muscle pain/tendency/fatigue and to cure or reduce symbols of other diseases. However, its therapeutic effect is sparsely interpreted in the language of modern physiology. To objectively evaluate its therapeutic effect, we focused on dry cupping treatment and utilized near-infrared spectroscopy (NIRS) to assess the concentration change in oxy-hemoglobin ([HbO2]), deoxy-hemoglobin ([Hb]), and blood volume in the course of cupping therapy over 13 volunteers on the infraspinatus muscle, where is usually applied for shoulder pains. Both a prominent drop in [Hb] and a significant elevation in [HbO2] in the tissue surrounding the cupping site were observed during both cupping and post-treatment, manifesting the enhancement of oxygen uptake. This resulting promotion indicates potential positive therapeutic effect of cupping therapy in hemodynamics for facilitating muscular functions.

  13. Significant and sustaining elevation of blood oxygen induced by Chinese cupping therapy as assessed by near-infrared spectroscopy

    Science.gov (United States)

    Li, Ting; Li, Yaoxian; Lin, Yu; Li, Kai

    2016-01-01

    Cupping therapy has been used in traditional Chinese medicine for thousands of years to relieve muscle pain/tendency/fatigue and to cure or reduce symbols of other diseases. However, its therapeutic effect is sparsely interpreted in the language of modern physiology. To objectively evaluate its therapeutic effect, we focused on dry cupping treatment and utilized near-infrared spectroscopy (NIRS) to assess the concentration change in oxy-hemoglobin ([HbO2]), deoxy-hemoglobin ([Hb]), and blood volume in the course of cupping therapy over 13 volunteers on the infraspinatus muscle, where is usually applied for shoulder pains. Both a prominent drop in [Hb] and a significant elevation in [HbO2] in the tissue surrounding the cupping site were observed during both cupping and post-treatment, manifesting the enhancement of oxygen uptake. This resulting promotion indicates potential positive therapeutic effect of cupping therapy in hemodynamics for facilitating muscular functions. PMID:28101413

  14. Early response assessment in patients with multiple myeloma during anti-angiogenic therapy using arterial spin labelling: first clinical results

    Energy Technology Data Exchange (ETDEWEB)

    Fenchel, Michael [Eberhard-Karls University, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany); Eberhard-Karls University, Department of Diagnostic and Interventional Neuroradiology, Tuebingen (Germany); Konaktchieva, Marina [Eberhard-Karls University, Department of Internal Medicine, Gastroenterology, Tuebingen (Germany); Weisel, Katja; Kraus, Sabina [Eberhard-Karls University, Department of Internal Medicine, Hematology, Tuebingen (Germany); Brodoefel, Harald; Claussen, Claus D.; Horger, Marius [Eberhard-Karls University, Department of Diagnostic and Interventional Radiology, Tuebingen (Germany)

    2010-12-15

    To determine if arterial-spin-labelling (ASL) MRI can reliably detect early response to anti-angiogenic therapy in patients with multiple myeloma by comparison with clinical/haematological response. Nineteen consecutive patients (10 men; mean age 63.5 {+-} 9.1 years) were included in the present study. Inclusion criteria were diagnosis of stage III multiple myeloma and clinical indication for therapeutical administration of bortezomib or lenalidomide. We performed MRI on 3.0T MR in the baseline setting, 3 weeks after onset of therapy and after 8 weeks. Clinical responses were determined on the basis of international uniform response criteria in correlation with haematological parameters and medium-term patient outcome. MRI studies were performed after approval by the local institutional review board. Fifteen patients responded to anti-myeloma therapy; 4/19 patients were non-responders to therapy. Mean tumour perfusion assessed by ASL-MRI in a reference lesion was 220.7 {+-} 132.5 ml min{sup -1} 100 g{sup -1} at baseline, and decreased to 125.7 {+-} 86.3 (134.5 {+-} 150.9) ml min{sup -1} 100 g{sup -1} 3 (8) weeks after onset of therapy (P < 0.02). The mean decrease in paraproteinaemia at week 3 (8) was 52.3 {+-} 47.7% (58.2 {+-} 58.7%), whereas {beta}2-microglobulinaemia decreased by 20.3 {+-} 53.1% (23.3 {+-} 57.0%). Correlation of ASL perfusion with outcome was significant (P = 0.0037). ASL tumour perfusion measurements are a valuable surrogate parameter for early assessment of response to novel anti-angiogenic therapy. (orig.)

  15. Assessment of Residual Disease With Molecular Breast Imaging in Patients Undergoing Neoadjuvant Therapy: Association With Molecular Subtypes.

    Science.gov (United States)

    Menes, Tehillah S; Golan, Orit; Vainer, Gilead; Lerman, Hedva; Schneebaum, Schlomo; Klausner, Joseph; Even-Sapir, Einat

    2016-10-01

    Assessment of residual disease after neoadjuvant therapy for breast cancer is an ongoing challenge of breast imaging. This study evaluates the accuracy of a novel dedicated system for molecular breast imaging (MBI) composed of the new generation of cadmium zinc telluride detectors in assessing residual disease after neoadjuvant therapy in patients with breast cancer. Clinical data, imaging, surgical, and pathological findings of 51 women with breast cancer undergoing neoadjuvant therapy were recorded. MBI findings were correlated with surgical pathology results. Accuracy of MBI in predicting complete pathological response and size of residual disease was assessed according to molecular subtypes. The size of the largest focus of uptake on MBI correlated with the largest dimension measured on pathology (r = 0.55; P < .001). This correlation was stronger for triple negative and HER2/neu positive subtypes (r = 0.92 and 0.62, respectively). Sixteen patients (31%) had complete pathological response. The sensitivity and specificity of MBI for detecting residual disease were 83% (95% confidence interval [CI], 66-93) and 69% (95% CI, 42-88), respectively. For triple negative or HER2/neu positive disease the sensitivity and specificity were 88% (95% CI, 62-98) and 75% (95% CI, 43-93), respectively. The accuracy of MBI in assessing residual disease after neoadjuvant treatment might be related to the molecular subtype. Accuracy is highest in the triple negative and HER2/neu positive subtypes. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. Assessment of the changes in alveolar bone quality after fixed orthodontic therapy: A trabecular structure analysis

    Directory of Open Access Journals (Sweden)

    Abdolaziz Haghnegahdar

    2016-12-01

    Full Text Available Background. Tooth displacement changes the periodontium. The aim of orthodontic treatment is desired tooth movement with minimum side effects on the alveolar bone quality. The aim of the present study was to assess changes of alveolar trabeculation in children, young adults and adults and the two genders. Methods. In this cross-sectional study, 63 patients who had been treated in Department of Orthodontics, School of Dentistry, Shiraz University of Medical Sciences, Shiraz, Iran, were chosen with convenient sampling method. They were divided into three groups based on their age. Their digitized panoramic radiographs (PRs were evaluated at six interdental sites from the mesial aspect of the mandibular second molars to the distal aspect of the mandibular first premolars using a visual index. The trabeculation pattern was assigned as either dense (score 3, dense-sparse (score 2 or sparse (score 1. Data were imported to SPSS. Mean of the scores before treatment (score B and mean of them after treatment (score A were compared for each group with paired t-test. Changes between score B and sore A of the groups were compared using one-way ANOVA and post hoc tests. Results. Mean score A was significantly higher than mean score B in children (P = 0.001. In contrast, mean score A was significantly lower than mean score B in young adults (P = 0.003. Conclusion. Orthodontists should be cautious when treating young adults and adults regarding the probable, yet possibly temporary, negative effects of orthodontic therapy on the alveolar bone quality.

  17. Ultrasonographic assessment of the cutaneous changes induced by topical flavonoid therapy.

    Science.gov (United States)

    Crisan, Diana; Crisan, Maria; Moldovan, Mirela; Lupsor, Monica; Badea, Radu

    2012-01-01

    Ultrasonography allows the quantification of dermal density and echogenicity changes during the physiological senescence process. Some active ingredients are able to slow down the tissular degeneration and disorganization process. The purpose of this study was to assess the cutaneous changes induced by the topical use of products containing Viniferol(®) as active ingredient, using high-frequency ultrasound. The study was performed over 12 weeks and included 80 healthy Caucasian female subjects, aged 22-75 years, divided into two groups: the study group and the control group. The product was applied according to a predetermined protocol. The measurements performed for each subject were: the thickness of the epidermis and dermis (mm), the number of low, medium, and high echogenic pixels, and the number of low echogenic pixels in the upper dermis/number of low echogenic pixels in the lower dermis. All the parameters showed a significant improvement. Ultrasound measurements showed an increase of the mean thickness of the epidermis (P < 0.0001) and dermis (P < 0.0001) following the application of the Viniferol product as compared to the control group. The changes in the dermal echogenicity confirm the efficacy and direct action of Viniferol upon the cutaneous fibroblasts. No side effects related to the treatment were recorded. The study proves the efficacy of this active ingredient in the cutaneous senescence process as well, as the fact that anti-aging prophylaxis should be initiated in the 20-40 year critical age group. This interval involves specific changes in dermal echogenicity that quantify intense molecular, biochemical and structural changes, being thus mostly and highly responsive to the anti-aging therapy.

  18. An assessment of early Child Life Therapy pain and anxiety management: A prospective randomised controlled trial.

    Science.gov (United States)

    Hyland, Ela J; D'Cruz, Rachel; Harvey, John G; Moir, Jordyn; Parkinson, Christina; Holland, Andrew J A

    2015-12-01

    Burns remain extremely painful and distressing in young children. The consequences of poorly managed pain and anxiety can be life-long. Whilst Child Life Therapy (CLT) has been shown to be effective in many situations, few studies have looked at the effectiveness of CLT in regard to reducing pain and anxiety in children undergoing burn dressing changes. A prospective, randomised controlled trial was conducted, comparing CLT versus standard care in relation to pain and anxiety scores of children undergoing their initial burn dressing change. Pain and anxiety were assessed by an independent observer and questionnaires completed by the child, parent/caregiver and nursing staff. 50 subjects were recruited in each treatment group; median age 2.3 years (CLT) and 2.2 years (standard care). The median total body surface area (TBSA) burnt was 0.8% (CLT) and 0.5% (standard care). The majority were partial thickness dermal burns (88% CLT, 94% standard care). Rates of parent anxiety and pre-procedural child pain and anxiety were similar. Combined and scaled pain and anxiety scores in the CLT group were significantly less than in the standard treatment group (p=0.03). Whilst pain was significantly better in the CLT group (p=0.02), fear scores, wound outcomes and the need for skin grafting were not statistically different in either group. The presence of a Child Life Therapist, with their ability to adapt to the environment, the child and their family, significantly reduced the experience of pain during paediatric burn dressings. Copyright © 2015 Elsevier Ltd and ISBI. All rights reserved.

  19. Trauma-focused cognitive-behavioral therapy for children and adolescents: assessing the evidence.

    Science.gov (United States)

    de Arellano, Michael A Ramirez; Lyman, D Russell; Jobe-Shields, Lisa; George, Preethy; Dougherty, Richard H; Daniels, Allen S; Ghose, Sushmita Shoma; Huang, Larke; Delphin-Rittmon, Miriam E

    2014-05-01

    Trauma-Focused Cognitive-Behavioral Therapy (TF-CBT) is a conjoint parent-child treatment developed by Cohen, Mannarino, and Deblinger that uses cognitive-behavioral principles and exposure techniques to prevent and treat posttraumatic stress, depression, and behavioral problems. This review defined TF-CBT, differentiated it from other models, and assessed the evidence base. Authors reviewed meta-analyses, reviews, and individual studies (1995 to 2013). Databases surveyed were PubMed, PsycINFO, Applied Social Sciences Index and Abstracts, Sociological Abstracts, Social Services Abstracts, PILOTS, the ERIC, and the CINAHL. They chose from three levels of research evidence (high, moderate, and low) on the basis of benchmarks for number of studies and quality of their methodology. They also described the evidence of effectiveness. The level of evidence for TF-CBT was rated as high on the basis of ten RCTs, three of which were conducted independently (not by TF-CBT developers). TF-CBT has demonstrated positive outcomes in reducing symptoms of posttraumatic stress disorder, although it is less clear whether TF-CBT is effective in reducing behavior problems or symptoms of depression. Limitations of the studies include concerns about investigator bias and exclusion of vulnerable populations. TF-CBT is a viable treatment for reducing trauma-related symptoms among some children who have experienced trauma and their nonoffending caregivers. Based on this evidence, TF-CBT should be available as a covered service in health plans. Ongoing research is needed to further identify best practices for TF-CBT in various settings and with individuals from various racial and ethnic backgrounds and with varied trauma histories, symptoms, and stages of intellectual, social, and emotional development.

  20. Supervised exercise therapy in the management of peripheral arterial disease - an assessment of compliance.

    Science.gov (United States)

    Aherne, Thomas M; Kheirelseid, Elrasheid A H; Boland, Michael; Carr, Shane; Al-Zabi, Thekra; Bashar, Khalid; Moneley, Daragh; Leahy, Austin; McCaffrey, Noel; Naughton, Peter

    2017-05-01

    Supervised exercise therapy (SET) is an effective option in the management of peripheral arterial disease (PAD). Unfortunately, poor compliance remains prevalent. This study aimed to assess patient exercise compliance and to identify factors influencing symptomatic improvement and SET participation. Data regarding attendance at SET for this cohort study were extracted from a prospectively maintained database of patients with claudication attending SET at Dublin City University. All patients had ankle brachial index confirmed PAD with associated intermittent claudication. Exercise performance and symptomatic data were gathered retrospectively using patient charts and interviews. Ninety-eight patients were referred for SET during the study period. The mean age was 69.2 (± 10.1) with 18 % being female. Median follow-up was 25.1 months (IQ range 17.0-31.6). Overall, the mean number of sessions attended per patient was 19.5. Exercise compliance was associated with a significant improvement in symptoms (p = 0.001). Other factors including anatomical level of claudication (P = 0.042) and educational level (p = 0.007) were found to affect the outcome of SET. Multivariate analysis revealed hypertension as a predictor of symptomatic outcome after SET (p = 0.045). Furthermore, ex-smokers (p = 0.021) and those previously diagnosed with hypercholesterolaemia (p = 0.020) or ischaemic heart disease (p = 0.029) had superior exercise compliance. Using linear regression, smoking history (p = 0.024) was identified as a predictor of compliance to SET. Establishing exercise compliance remains challenging in the PAD cohort. Pre-exercise patient education and personalised exercise prescriptions may result in improvements in function and compliance.

  1. Assessment of volumetric-modulated arc therapy for constant and variable dose rates

    Directory of Open Access Journals (Sweden)

    Mariluz De Ornelas-Couto

    2017-01-01

    Full Text Available Purpose: The aim of this study is to compare the effects of dose rate on volumetric-modulated arc therapy plans to determine optimal dose rates for prostate and head and neck (HN cases. Materials and Methods: Ten prostate and ten HN cases were retrospectively studied. For each case, seven plans were generated: one variable dose rate (VDR and six constant dose rate (CDR (100–600 monitor units [MUs]/min plans. Prescription doses were: 80 Gy to planning target volume (PTV for the prostate cases, and 70, 60, and 54 Gy to PTV1, PTV2, and PTV3, respectively, for HN cases. Plans were normalized to 95% of the PTV and PTV1, respectively, with the prescription dose. Plans were assessed using Dose-Volume-Histogram metrics, homogeneity index, conformity index, MUs, and delivery time. Results: For the prostate cases, significant differences were found for rectum D35 between VDR and all CDR plans, except CDR500. Furthermore, VDR was significantly different than CDR100 and 200 for bladder D50. Delivery time for all CDR plans and MUs for CDR400–600 were significantly higher when compared to VDR. HN cases showed significant differences between VDR and CDR100, 500 and 600 for D2 to the cord and brainstem. Significant differences were found for delivery time and MUs for all CDR plans, except CDR100 for number of MUs. Conclusion: The most significant differences were observed in delivery time and number of MUs. All-in-all, the best CDR for prostate cases was found to be 300 MUs/min and 200 or 300 MUs/min for HN cases. However, VDR plans are still the choice in terms of MU efficiency and plan quality.

  2. GERD assessment including pH metry predicts a high response rate to PPI standard therapy

    Directory of Open Access Journals (Sweden)

    Kandulski Arne

    2013-01-01

    Full Text Available Abstract Background Inadequate response to proton pump inhibitor (PPI therapy in patients with gastroesophageal reflux disease (GERD is reported in up to 40%. Patients with non erosive reflux disease (NERD have lower response rates compared to patients with erosive reflux disease (ERD; pH metry contributes to GERD diagnosis and is critical for proper diagnosis of NERD. Aim of the study was to assess the need for doubling esomeprazole standard dose (40 mg for 4 weeks in PPI naive patients with typical reflux symptoms and diagnosis of GERD based on endoscopy and 48 hours, wireless pH metry. Methods All patients underwent upper GI endoscopy. Symptoms were recorded with a structured questionnaire (RDQ and acid exposure was determined by 48 hours, wireless pH monitoring (BRAVO. In case of abnormal acid exposure, patients received a short term treatment with esomeprazole 40 mg q.d. for 4 weeks. If symptoms persisted, patients underwent a second pH metry on PPI and the dose was increased to 40 mg b.i.d. Results 31 consecutive patients with typical reflux symptoms underwent 48 hours pH monitoring. 22 patients (71% had abnormal acid exposure, 9 patients had normal pH metry (29%. Of the 9 patients with normal pH metry, 2 were found with erosive esophagitis and 7 without endoscopic abnormalities. 24 patients with documented GERD received esomeprazole treatment. 21 patients achieved complete symptom resolution with 40 mg q.d. after 4 weeks (88%. Only 2 patients required doubling the dose of esomeprazole for complete symptom resolution, 1 patient remained with symptoms. Conclusions Patients with typical reflux symptoms and abnormal acid exposure have a high response rate to standard dose esomeprazole regardless of whether they have ERD or NERD.

  3. Ultrasonographic assessment of the cutaneous changes induced by topical flavonoid therapy

    Science.gov (United States)

    Crisan, Diana; Crisan, Maria; Moldovan, Mirela; Lupsor, Monica; Badea, Radu

    2012-01-01

    Ultrasonography allows the quantification of dermal density and echogenicity changes during the physiological senescence process. Some active ingredients are able to slow down the tissular degeneration and disorganization process. The purpose of this study was to assess the cutaneous changes induced by the topical use of products containing Viniferol® as active ingredient, using high-frequency ultrasound. The study was performed over 12 weeks and included 80 healthy Caucasian female subjects, aged 22–75 years, divided into two groups: the study group and the control group. The product was applied according to a predetermined protocol. The measurements performed for each subject were: the thickness of the epidermis and dermis (mm), the number of low, medium, and high echogenic pixels, and the number of low echogenic pixels in the upper dermis/number of low echogenic pixels in the lower dermis. All the parameters showed a significant improvement. Ultrasound measurements showed an increase of the mean thickness of the epidermis (P < 0.0001) and dermis (P < 0.0001) following the application of the Viniferol product as compared to the control group. The changes in the dermal echogenicity confirm the efficacy and direct action of Viniferol upon the cutaneous fibroblasts. No side effects related to the treatment were recorded. The study proves the efficacy of this active ingredient in the cutaneous senescence process as well, as the fact that anti-aging prophylaxis should be initiated in the 20–40 year critical age group. This interval involves specific changes in dermal echogenicity that quantify intense molecular, biochemical and structural changes, being thus mostly and highly responsive to the anti-aging therapy. PMID:22291475

  4. A randomized clinical trial of behavioral couples therapy versus individually based treatment for women with alcohol dependence.

    Science.gov (United States)

    Schumm, Jeremiah A; O'Farrell, Timothy J; Kahler, Christopher W; Murphy, Marie M; Muchowski, Patrice

    2014-12-01

    Multiple studies show that behavioral couples therapy (BCT) is more efficacious than individually based therapy (IBT) for substance use and relationship outcomes among men with alcohol use disorder (AUD). The present study compared BCT with IBT for women with AUD. Participants were women with AUD (N = 105) and their male partners without substance use disorder. Participants were mostly White and in their 40s. Women were randomized to equally intensive treatments consisting of either BCT plus 12-step-oriented IBT or IBT only. Primary outcomes included time line follow-back interview percentage days abstinent (PDA) and Inventory of Drug Use Consequences measure of substance-related problems. Secondary outcomes included the Dyadic Adjustment Scale (DAS), Relationship Happiness Scale (RHS), and Revised Conflict Tactics Scales measure of intimate partner violence (IPV). Outcome data were collected at baseline, posttreatment, and quarterly for 1-year follow-up. Compared with IBT only, BCT plus IBT had significantly better primary outcomes of higher PDA and fewer substance-related problems during the 1-year follow-up period. Compared with IBT only, BCT had significantly higher male RHS during the 1-year follow-up. Women with lower pretreatment DAS had significantly higher DAS following BCT versus IBT, and there was an increasing advantage for BCT on female DAS over the follow-up. IPV was significantly reduced from pretreatment to follow-up, with no differences between treatment conditions. RESULTS showed that BCT for women with AUD was more efficacious than IBT in reducing substance use and substance-related problems and improving partner relationships.

  5. A Randomized Clinical Trial of Behavioral Couples Therapy versus Individually-Based Treatment for Women with Alcohol Dependence

    Science.gov (United States)

    Schumm, Jeremiah A.; O’Farrell, Timothy J.; Kahler, Christopher W.; Murphy, Marie M.; Muchowski, Patrice

    2014-01-01

    Objective: Multiple studies show that behavioral couples therapy (BCT) is more efficacious than individually-based therapy (IBT) for substance use and relationship outcomes among men with alcohol use disorder (AUD). The present study compared BCT with IBT for women with AUD. Method: Participants were women with AUD (N = 105) and their male partners without SUD. Participants were mostly White and in their forties. Women were randomized to equally intensive treatments consisting of either BCT plus 12-step-oriented IBT or IBT only. Primary outcomes included: Timeline Followback Interview percentage days abstinent (PDA) and Inventory of Drug Use Consequences measure of substance-related problems. Secondary outcomes included: Dyadic Adjustment Scale (DAS), Relationship Happiness Scale (RHS), and Revised Conflict Tactics Scales measure of intimate partner violence (IPV). Outcome data were collected at baseline, post-treatment, and quarterly for 1-yr follow-up. Results: Compared to IBT only, BCT plus IBT had significantly better primary outcomes of higher PDA and fewer substance-related problems during the 1-yr follow-up period. Compared to IBT only, BCT had significantly higher male RHS during the 1-yr follow-up. Women with lower pretreatment DAS had significantly higher DAS following BCT versus IBT, and there was an increasing advantage for BCT on female DAS over the follow-up. IPV was significantly reduced from pretreatment to follow-up, with no differences between treatment conditions. Conclusion: Results showed that BCT for women with AUD was more efficacious than IBT in reducing substance use and substance-related problems and improving partner relationships. PMID:25045910

  6. Assessment of (10)B concentration in boron neutron capture therapy: potential of image-guided therapy using (18)FBPA PET.

    Science.gov (United States)

    Shimosegawa, Eku; Isohashi, Kayako; Naka, Sadahiro; Horitsugi, Genki; Hatazawa, Jun

    2016-12-01

    In boron neutron capture therapy (BNCT) for cancer, the accurate estimation of (10)B tissue concentrations, especially in neighboring normal organs, is important to avoid adverse effects. The (10)B concentration in normal organs after loading with (10)B, however, has not been established in humans. In this study, we performed 4-borono-2-[(18)F]-fluoro-phenylalanine ((18)FBPA) PET in healthy volunteers and estimated the chronological changes in the (10)B concentrations of normal organs. In 6 healthy volunteers, whole-body (18)FBPA PET scans were repeated 7 times during 1 h, and the mean (18)FBPA distributions of 13 organs were measured. Based on the (18)FBPA PET data, we then estimated the changes in the (10)B concentrations of the organs when the injection of a therapeutic dose of (10)BPA-fructose complex ((10)BPA-fr; 30 g, 500 mg/kg body weight) was assumed. The maximum mean (18)FBPA concentrations were reached at 2-6 min after injection in all the organs except the brain and urinary bladder. The mean (18)FBPA concentration in normal brain plateaued at 24 min after injection. When the injection of a therapeutic dose of (10)BPA-fr was assumed, the estimated mean (10)B concentration in the kidney increased to 126.1 ± 24.2 ppm at 3 min after injection and then rapidly decreased to 30.9 ± 7.4 ppm at 53 min. The estimated mean (10)B concentration in the bladder gradually increased and reached 383.6 ± 214.7 ppm at 51 min. The mean (10)B concentration in the brain was estimated to be 7.6 ± 1.5 ppm at 57 min. (18)FBPA PET has a potential to estimate (10)B concentration of normal organs before neutron irradiation of BNCT when several assumptions are validated in the future studies.

  7. ATL response to arsenic/interferon therapy is triggered by SUMO/PML/RNF4-dependent Tax degradation.

    Science.gov (United States)

    Dassouki, Zeina; Sahin, Umut; El Hajj, Hiba; Jollivet, Florence; Kfoury, Youmna; Lallemand-Breitenbach, Valérie; Hermine, Olivier; de Thé, Hugues; Bazarbachi, Ali

    2015-01-15

    The human T-cell lymphotropic virus type I (HTLV-1) Tax transactivator initiates transformation in adult T-cell leukemia/lymphoma (ATL), a highly aggressive chemotherapy-resistant malignancy. The arsenic/interferon combination, which triggers degradation of the Tax oncoprotein, selectively induces apoptosis of ATL cell lines and has significant clinical activity in Tax-driven murine ATL or human patients. However, the role of Tax loss in ATL response is disputed, and the molecular mechanisms driving degradation remain elusive. Here we demonstrate that ATL-derived or HTLV-1-transformed cells are dependent on continuous Tax expression, suggesting that Tax degradation underlies clinical responses to the arsenic/interferon combination. The latter enforces promyelocytic leukemia protein (PML) nuclear body (NB) formation and partner protein recruitment. In arsenic/interferon-treated HTLV-1 transformed or ATL cells, Tax is recruited onto NBs and undergoes PML-dependent hyper-sumoylation by small ubiquitin-like modifier (SUMO)2/3 but not SUMO1, ubiquitination by RNF4, and proteasome-dependent degradation. Thus, the arsenic/interferon combination clears ATL through degradation of its Tax driver, and this regimen could have broader therapeutic value by promoting degradation of other pathogenic sumoylated proteins. © 2015 by The American Society of Hematology.

  8. A Retrospective Assessment of Return to Function in Dance After Physical Therapy for Common Dance Injuries.

    Science.gov (United States)

    Junck, Emily; Richardson, Megan; Dilgen, Faye; Liederbach, Marijeanne

    2017-12-15

    An injury that causes a dancer to take time away from training or performance can be career ending, and thus it is important for dancers to have accurate expectations when considering treatment options. Thus far, few studies have reported functional outcomes after injury in dancers, which may be different than for the general athletic population. Therefore, our study sought to determine functional outcomes in dancers after operative and non-operative treatment for common dance injuries. Our outcome measures included a subjective assessment of the degree to which a dancer had returned to his or her previous level of dance, the SF-12 survey, and the WHO functional outcome scale modified for dance. We also compared these as outcome measurement tools for return to full function in dance. Secondarily, we sought to assess factors that may have contributed to poorer functional outcomes. We reviewed the charts of 675 dancers seen at our physical therapy facilities between 2006 and 2010 and identified 416 adult dancers who had experienced a dance-related injury that we categorized as "common," based on surveys of injuries among dancers (with back injuries excluded). One hundred and sixty-four dancers completed a tele- phone survey about their recovery after injury. Descriptive statistics, correlation, and linear regression were then used to identify factors associated with poor functional outcomes. Sixty-three percent of the participants had a full return to their pre-injury level. No variables were found to be significantly correlated (p < 0.05) with poorer outcomes by linear re- gression. However, there was a trend to- ward better outcomes when dancers were younger, their injuries were not chronic, and their recovery was not limited by fear. The three measurement tools were all highly correlated with one another (p = 0.000) and found to be useful determinants of functional return to dance. Given that there were few strongly correlated outcome factors, we concluded that

  9. Mandibular advancement splint (MAS) therapy for obstructive sleep apnoea--an overview and quality assessment of systematic reviews.

    Science.gov (United States)

    Johal, Ama; Fleming, Padhraig S; Manek, Seema; Marinho, Valeria C C

    2015-09-01

    To conduct an overview of existing systematic reviews concerning management of obstructive sleep apnoea-hypopnoea syndrome (OSAHS) with mandibular advancement splint (MAS) and assess their methodological quality. PubMed and relevant Cochrane Library databases (CDSR, DARE, HTA) searches were performed (09.13) to identify systematic reviews investigating the response of adults with OSAHS to MAS therapy. The methodological quality of the included systematic reviews was assessed using AMSTAR, a validated tool for assessing quality. Eight systematic reviews, four incorporating meta-analyses, were identified evaluating both objective and subjective outcome measures. The effectiveness of MAS therapy was compared to no treatment (n = 1), non-active appliance (n = 6), continuous positive airway pressure (CPAP; n = 5), surgical intervention (n = 3) and a different MAS intervention (n = 4). The quality of the reviews was variable (median = 7, range = 3 to 11), with only two of higher quality (AMSTAR scores >10), one of them a Cochrane review. In this high quality and current review, the overall (pooled) effects for comparison of MAS therapy with inactive appliances, revealed significant benefits of MAS therapy in terms of both daytime sleepiness and objective apnoea-hypopnoea index (AHI) outcomes. In general, the results from the higher quality reviews concerning the effectiveness of MAS therapy for OSAHS highlight the ability of the intervention to improve OSAHS. Current reporting guidelines for systematic reviews (e.g. PRISMA) and sources of high-quality existing reviews should be closely followed to enhance the validity and relevance of future reviews.

  10. A time-dependent risk assessment for broken compact fluorescent lamps.

    Science.gov (United States)

    Clear, Robert; Rubinstein, Francis

    2014-10-01

    Environmental Protection Agency (EPA) ambient air quality guidelines are meant to limit long-term exposures of toxins to safe levels. Unfortunately, there is little guidance for what constitutes a safe level from a one-time (or very infrequent) short exposure(s). In the case of mercury, a review of the derivation of the EPA ambient air quality standard shows that it implicitly assumes a tissue burden model. The time dependence of the tissue burden is commonly described in terms of a half-life, a modeling assumption that presumes that the decline in the tissue burden after a single exposure can be approximately described as an exponential decay. In this article, we use a simple exponential tissue burden model to derive a time-dependent no observable adverse effect level (NOAEL) for mercury concentrations in air. The model predicts that tissue body burden will asymptotically approach the EPA air quality level for long exposure times, and reach workplace standard levels for exposures of a few hours. The model was used along with data on mercury levels from experimental work done by the Maine Department of Environmental Protection to evaluate the risks from a broken compact fluorescent lamp in a residential setting. Mercury levels approached the NOAEL only when the debris was left in an almost sealed room. Normal common-sense cleaning measures: removal of debris to an outside area, and ventilation of the room for several minutes, reduced exposures to less than 1% of the NOAEL. © 2014 Society for Risk Analysis.

  11. Assessment of microbial diversity in biofilms recovered from endotracheal tubes using culture dependent and independent approaches.

    Science.gov (United States)

    Vandecandelaere, Ilse; Matthijs, Nele; Van Nieuwerburgh, Filip; Deforce, Dieter; Vosters, Peter; De Bus, Liesbet; Nelis, Hans J; Depuydt, Pieter; Coenye, Tom

    2012-01-01

    Ventilator-associated pneumonia (VAP) is a common nosocomial infection in mechanically ventilated patients. Biofilm formation is one of the mechanisms through which the endotracheal tube (ET) facilitates bacterial contamination of the lower airways. In the present study, we analyzed the composition of the ET biofilm flora by means of culture dependent and culture independent (16 S rRNA gene clone libraries and pyrosequencing) approaches. Overall, the microbial diversity was high and members of different phylogenetic lineages were detected (Actinobacteria, beta-Proteobacteria, Candida spp., Clostridia, epsilon-Proteobacteria, Firmicutes, Fusobacteria and gamma-Proteobacteria). Culture dependent analysis, based on the use of selective growth media and conventional microbiological tests, resulted in the identification of typical aerobic nosocomial pathogens which are known to play a role in the development of VAP, e.g. Staphylococcus aureus and Pseudomonas aeruginosa. Other opportunistic pathogens were also identified, including Staphylococcus epidermidis and Kocuria varians. In general, there was little correlation between the results obtained by sequencing 16 S rRNA gene clone libraries and by cultivation. Pyrosequencing of PCR amplified 16 S rRNA genes of four selected samples resulted in the identification of a much wider variety of bacteria. The results from the pyrosequencing analysis suggest that these four samples were dominated by members of the normal oral flora such as Prevotella spp., Peptostreptococcus spp. and lactic acid bacteria. A combination of methods is recommended to obtain a complete picture of the microbial diversity of the ET biofilm.

  12. Assessment of microbial diversity in biofilms recovered from endotracheal tubes using culture dependent and independent approaches.

    Directory of Open Access Journals (Sweden)

    Ilse Vandecandelaere

    Full Text Available Ventilator-associated pneumonia (VAP is a common nosocomial infection in mechanically ventilated patients. Biofilm formation is one of the mechanisms through which the endotracheal tube (ET facilitates bacterial contamination of the lower airways. In the present study, we analyzed the composition of the ET biofilm flora by means of culture dependent and culture independent (16 S rRNA gene clone libraries and pyrosequencing approaches. Overall, the microbial diversity was high and members of different phylogenetic lineages were detected (Actinobacteria, beta-Proteobacteria, Candida spp., Clostridia, epsilon-Proteobacteria, Firmicutes, Fusobacteria and gamma-Proteobacteria. Culture dependent analysis, based on the use of selective growth media and conventional microbiological tests, resulted in the identification of typical aerobic nosocomial pathogens which are known to play a role in the development of VAP, e.g. Staphylococcus aureus and Pseudomonas aeruginosa. Other opportunistic pathogens were also identified, including Staphylococcus epidermidis and Kocuria varians. In general, there was little correlation between the results obtained by sequencing 16 S rRNA gene clone libraries and by cultivation. Pyrosequencing of PCR amplified 16 S rRNA genes of four selected samples resulted in the identification of a much wider variety of bacteria. The results from the pyrosequencing analysis suggest that these four samples were dominated by members of the normal oral flora such as Prevotella spp., Peptostreptococcus spp. and lactic acid bacteria. A combination of methods is recommended to obtain a complete picture of the microbial diversity of the ET biofilm.

  13. Long-term combination therapy with infliximab plus azathioprine predicts sustained steroid-free clinical benefit in steroid-dependent ulcerative colitis.

    Science.gov (United States)

    Armuzzi, Alessandro; Pugliese, Daniela; Danese, Silvio; Rizzo, Gianluca; Felice, Carla; Marzo, Manuela; Andrisani, Gianluca; Fiorino, Gionata; Nardone, Olga Maria; De Vitis, Italo; Papa, Alfredo; Rapaccini, Gian Lodovico; Guidi, Luisa

    2014-08-01

    Infliximab (IFX) has demonstrated effectiveness for inducing 12-month steroid-free clinical remission in patients with steroid-dependent ulcerative colitis (UC), but long-term data are lacking. The aim of the study was to describe the long-term outcome of IFX treatment in steroid-dependent UC and investigate if predictors of sustained clinical response and colectomy could be identified. Consecutive patients with steroid-dependent UC treated with IFX were studied. The coprimary prespecified outcomes were sustained clinical response in patients who achieved clinical remission or response after IFX induction and colectomy-free survival. Secondary analyses were addressed to look for predictors of sustained clinical response and colectomy. After induction, 76% (96/126) of patients achieved clinical benefit. The median duration of follow-up on IFX maintenance therapy was 41.5 months (interquartile range, 26-45). Sixty-four percent (46/96) of patients had sustained clinical response at median follow-up. Colectomy-free survival was 77% at median follow-up. Combination therapy of IFX with thiopurines was an independent predictor of sustained clinical response (P < 0.0001; hazard ratio [HR], 3.98; 95% confidence interval [CI], 1.73-9.14). Independent predictors of colectomy were Mayo endoscopic subscore of 3 at baseline (P = 0.04; HR, 2.77; 95% CI, 1.09-7.05) and high C-reactive protein after induction (P = 0.001; HR, 5.65; 95% CI, 2.03-15.7). Thiopurine naive status (P = 0.025; HR, 0.34; 95% CI, 0.13-0.87) was protective from colectomy. Long-term IFX treatment is effective in inducing sustained clinical response in patients with steroid-dependent UC. Combination therapy is predictive of sustained clinical response in the long-term. Patients with more severe endoscopic lesions at baseline and high C-reactive protein after induction are at higher risk of colectomy. Conversely, thiopurine naive status is protective from colectomy.

  14. A Methodology for Assessing Islanding of Microgrids: Between Utility Dependence and Off-Grid Systems

    Directory of Open Access Journals (Sweden)

    Antonio Colmenar-Santos

    2015-05-01

    Full Text Available This paper presents a novel methodology for assessing islanding microgrids from the economical and functional perspective, for various stakeholders. The paper proposes the triggers for competitive deployment of microgeneration, storage, microgrid islanding, the market conditions that apply, and discusses the future tendencies and the policy recommendations to foster microgrid benefits. The validation of the proposed scheme is based on real market cases, where the triggers for autogeneration and islanding microgrids are present. Additionally, the new concept of grid independence cycle is presented and analyzed. The policy implications of a situation where grid consumption reduction leads to higher energy prices are presented and discussed. The paper concludes with a summary of prioritized technical and regulatory recommendations, proposed as a result of the assessment.

  15. Time-dependent influence on assessment of contaminated environmental surfaces in operating rooms.

    Science.gov (United States)

    Saito, Yuhei; Yasuhara, Hiroshi; Murakoshi, Satoshi; Komatsu, Takami; Fukatsu, Kazuhiko; Uetera, Yushi

    2015-09-01

    There is no established method to assess the contamination of environmental surfaces because the results change with time. We evaluated current methods for assessment of contamination of environmental surfaces in the operating room (OR). Contamination of environmental surfaces in the OR was assessed using an adenosine triphosphate (ATP) test and bacterial culture. We collected 480 ATP test samples from 17 surfaces in 6 ORs to determine the influence of surface features, including frequency of touching and surface orientation on contamination, after completion of daily scheduled operations. Another 54 pairs of ATP and microbial samples were taken from 3 surfaces in each of the same OR except 1 to determine the time course of the results of ATP and microbial tests when ORs were not used. Multivariate analysis demonstrated that the ATP results were strongly influenced by frequency of touching and orientation of environmental surfaces. The microbial counts declined over time, whereas the ATP results remained at a high level. The ATP test result could be used as a relatively stable trace of contamination of environmental surfaces; however, it is not a surrogate indicator of the number of viable microbes which declines over time. Copyright © 2015 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  16. Co-relationship between sexual dysfunction and high-risk sexual behavior in patients receiving buprenorphine and naltrexone maintenance therapy for opioid dependence

    Directory of Open Access Journals (Sweden)

    Santosh Ramdurg

    2015-01-01

    Full Text Available Introduction: People suffering from substance dependence suffer from various sexual dysfunctions and are at risk for indulging in various high-risk sexual behaviors and thus are vulnerable to acquire various infections such as HIV/AIDS and other sexually transmitted infections. AIM: The aim of the study was to evaluate the correlation between sexual dysfunction and high-risk sexual behavior in opioid-dependent men receiving buprenorphine and naltrexone maintenance therapy. Materials and Methods: Semi-structured questionnaire, brief male sexual functioning inventory and HIV-risk taking behavior scale was administered to a sample of 60 sexually active men, receiving buprenorphine (n = 30 and naltrexone (n = 30 maintenance therapy for opioid dependence. Results: The main outcomes are correlation between severity of sexual dysfunction and HIV-risk taking behavior. The study results showed 83% of the men on buprenorphine and 90% on naltrexone reported at least one of the sexual dysfunction symptoms. There was a negative correlation between sexual dysfunction and HIV-risk taking behavior that suggest severe the dysfunction, higher the risk taking behavior. Significant correlation was present with overall sexual dysfunction and HIV-risk taking behavior (P = 0.028 and in naltrexone receiving group premature ejaculation versus HIV-risk taking behavior however, (P = 0.022, P < 0.05 there were no significant differences among both the groups except above findings. Conclusion: Conclusion was treatment is associated with sexual dysfunctions and HIV-risk taking behavior, which has clinical implication. Future research should explore this further using biochemical analyses.

  17. Salivary cortisol day curves in assessing glucocorticoid replacement therapy in Addison's disease

    NARCIS (Netherlands)

    Smans, L.; Lentjes, E.G.W.M.; Hermus, A.R.; Zelissen, P.

    2013-01-01

    OBJECTIVE: Patients with Addison's disease require lifelong treatment with glucocorticoids. At present, no glucocorticoid replacement therapy (GRT) can exactly mimic normal physiology. As a consequence, under- and especially overtreatment can occur. Suboptimal GRT may lead to various side effects.

  18. 188(P12) Assessment of manual therapy by analysis of hip rotation trajectory diagrams

    National Research Council Canada - National Science Library

    TARUMOTO N; TAKEUCHI K; ICHIKAWA K; SANO K; TAKANO K; TAKANO M; TAKEDA Y; MIZUNO Y; MATSUMURA A

    2011-01-01

    ... the circumnutation of the both hip joints. In this study, we report that the effects of new manual therapy, therapeutic exercises by Major Tarumoto, a bonesetter, usually used for treatment of foot joint troubles...

  19. Preclinical imaging methods for assessing the safety and efficacy of regenerative medicine therapies

    Science.gov (United States)

    Scarfe, Lauren; Brillant, Nathalie; Kumar, J. Dinesh; Ali, Noura; Alrumayh, Ahmed; Amali, Mohammed; Barbellion, Stephane; Jones, Vendula; Niemeijer, Marije; Potdevin, Sophie; Roussignol, Gautier; Vaganov, Anatoly; Barbaric, Ivana; Barrow, Michael; Burton, Neal C.; Connell, John; Dazzi, Francesco; Edsbagge, Josefina; French, Neil S.; Holder, Julie; Hutchinson, Claire; Jones, David R.; Kalber, Tammy; Lovatt, Cerys; Lythgoe, Mark F.; Patel, Sara; Patrick, P. Stephen; Piner, Jacqueline; Reinhardt, Jens; Ricci, Emanuelle; Sidaway, James; Stacey, Glyn N.; Starkey Lewis, Philip J.; Sullivan, Gareth; Taylor, Arthur; Wilm, Bettina; Poptani, Harish; Murray, Patricia; Goldring, Chris E. P.; Park, B. Kevin

    2017-10-01

    Regenerative medicine therapies hold enormous potential for a variety of currently incurable conditions with high unmet clinical need. Most progress in this field to date has been achieved with cell-based regenerative medicine therapies, with over a thousand clinical trials performed up to 2015. However, lack of adequate safety and efficacy data is currently limiting wider uptake of these therapies. To facilitate clinical translation, non-invasive in vivo imaging technologies that enable careful evaluation and characterisation of the administered cells and their effects on host tissues are critically required to evaluate their safety and efficacy in relevant preclinical models. This article reviews the most common imaging technologies available and how they can be applied to regenerative medicine research. We cover details of how each technology works, which cell labels are most appropriate for different applications, and the value of multi-modal imaging approaches to gain a comprehensive understanding of the responses to cell therapy in vivo.

  20. Quantitative assessment of barriers to the clinical development and adoption of cellular therapies: A pilot study

    Directory of Open Access Journals (Sweden)

    Benjamin M Davies

    2014-09-01

    Full Text Available There has been a large increase in basic science activity in cell therapy and a growing portfolio of cell therapy trials. However, the number of industry products available for widespread clinical use does not match this magnitude of activity. We hypothesize that the paucity of engagement with the clinical community is a key contributor to the lack of commercially successful cell therapy products. To investigate this, we launched a pilot study to survey clinicians from five specialities and to determine what they believe to be the most significant barriers to cellular therapy clinical development and adoption. Our study shows that the main concerns among this group are cost-effectiveness, efficacy, reimbursement, and regulation. Addressing these concerns can best be achieved by ensuring that future clinical trials are conducted to adequately answer the questions of both regulators and the broader clinical community.

  1. Identifying Priority Areas for Conservation: A Global Assessment for Forest-Dependent Birds

    Science.gov (United States)

    Buchanan, Graeme M.; Donald, Paul F.; Butchart, Stuart H. M.

    2011-01-01

    Limited resources are available to address the world's growing environmental problems, requiring conservationists to identify priority sites for action. Using new distribution maps for all of the world's forest-dependent birds (60.6% of all bird species), we quantify the contribution of remaining forest to conserving global avian biodiversity. For each of the world's partly or wholly forested 5-km cells, we estimated an impact score of its contribution to the distribution of all the forest bird species estimated to occur within it, and so is proportional to the impact on the conservation status of the world's forest-dependent birds were the forest it contains lost. The distribution of scores was highly skewed, a very small proportion of cells having scores several orders of magnitude above the global mean. Ecoregions containing the highest values of this score included relatively species-poor islands such as Hawaii and Palau, the relatively species-rich islands of Indonesia and the Philippines, and the megadiverse Atlantic Forests and northern Andes of South America. Ecoregions with high impact scores and high deforestation rates (2000–2005) included montane forests in Cameroon and the Eastern Arc of Tanzania, although deforestation data were not available for all ecoregions. Ecoregions with high impact scores, high rates of recent deforestation and low coverage by the protected area network included Indonesia's Seram rain forests and the moist forests of Trinidad and Tobago. Key sites in these ecoregions represent some of the most urgent priorities for expansion of the global protected areas network to meet Convention on Biological Diversity targets to increase the proportion of land formally protected to 17% by 2020. Areas with high impact scores, rapid deforestation, low protection and high carbon storage values may represent significant opportunities for both biodiversity conservation and climate change mitigation, for example through Reducing Emissions from

  2. Assessing the Impacts of Climate Change on Tourism-Dependent Communities in the Great Lakes

    Science.gov (United States)

    Chin, N.; Day, J.; Sydnor, S.; Cherkauer, K. A.

    2013-12-01

    Tourism is an essential element of the Laurentian Great Lakes economy as well as one of the sectors expected to be affected most by climate change, particularly through extreme weather events. While studies looking at climate change impacts on the Great Lakes tourism, specifically, are limited, the results of other studies suggest that both summer tourism activities, such as beach-going, and winter tourism activities, such as skiing and snowboarding, could feel the effects of a changing climate. The purpose of this study was to determine how existing data and models might be used to predict the potential impacts of climate change on tourism-dependent communities at the local scale. Future climate projections and variable infiltration capacity (VIC) model simulations based on historical climate data were used to quantify trends in environmental metrics with a potential influence on tourism for several tourism-dependent Great Lakes communities. The results of this research show that the potential impacts of climate change vary at the local scale and could require different adaptation strategies for different communities and for different sectors of the tourism industry. For example, communities in the northern parts of the Great Lakes may find benefit in a greater diversification of their tourism industries, given that warming temperatures could be beneficial for summer tourism activities, while communities in the southern parts of the Great Lakes may have to find other ways to cope with climate conditions that are less conducive to summer tourism activities. Stakeholder input could also help inform the process of producing scientific information that is useful to policymakers when it comes to tourism sector-related decision making.

  3. An Emergy-Based Hybrid Method for Assessing Sustainability of the Resource-Dependent Region

    Directory of Open Access Journals (Sweden)

    Lulu Qu

    2017-01-01

    Full Text Available As the natural resources are getting exhausted, the concept of sustainable development of regions has received increasing attention, especially for resource-dependent cities. In this paper, an innovative method based on emergy analysis and the Human Impact Population Affluence Technology (IPAT model is developed to analyze the quantitative relationship of economic growth, energy consumption and its overall sustainability level. Taiyuan, a traditional, resource-dependent city in China, is selected as the case study region. The main results show that the total emergy of Taiyuan increased from 9.023 × 1023 sej in 2007 to 9.116 × 1023 sej in 2014, with a 38% decline in non-renewable emergy and an increase of imported emergy up to 125%. The regional emergy money ratio (EMB was reduced by 48% from 5.31 × 1013 sej/$ in 2007 to 2.74 × 1013 sej/$ in 2014, indicating that the increasing speed of consuming resources and energy was faster than the increase of GDP, and that Taiyuan’s money purchasing power declined. The lower emergy sustainability index (ESI indicates that Taiyuan was explored and produced large quantities of mineral resources, which puts more stress on the environment as a consequence, and that this is not sustainable in the long run. The IPAT analysis demonstrates that Taiyuan sticks to the efforts of energy conservation and environmental protection. In order to promote regional sustainable development, it is necessary to have an integrated effort. Policy insights suggest that resourceful regions should improve energy and resource efficiency, optimize energy and resourceful structure and carry out extensive public participation.

  4. Identifying priority areas for conservation: a global assessment for forest-dependent birds.

    Directory of Open Access Journals (Sweden)

    Graeme M Buchanan

    Full Text Available Limited resources are available to address the world's growing environmental problems, requiring conservationists to identify priority sites for action. Using new distribution maps for all of the world's forest-dependent birds (60.6% of all bird species, we quantify the contribution of remaining forest to conserving global avian biodiversity. For each of the world's partly or wholly forested 5-km cells, we estimated an impact score of its contribution to the distribution of all the forest bird species estimated to occur within it, and so is proportional to the impact on the conservation status of the world's forest-dependent birds were the forest it contains lost. The distribution of scores was highly skewed, a very small proportion of cells having scores several orders of magnitude above the global mean. Ecoregions containing the highest values of this score included relatively species-poor islands such as Hawaii and Palau, the relatively species-rich islands of Indonesia and the Philippines, and the megadiverse Atlantic Forests and northern Andes of South America. Ecoregions with high impact scores and high deforestation rates (2000-2005 included montane forests in Cameroon and the Eastern Arc of Tanzania, although deforestation data were not available for all ecoregions. Ecoregions with high impact scores, high rates of recent deforestation and low coverage by the protected area network included Indonesia's Seram rain forests and the moist forests of Trinidad and Tobago. Key sites in these ecoregions represent some of the most urgent priorities for expansion of the global protected areas network to meet Convention on Biological Diversity targets to increase the proportion of land formally protected to 17% by 2020. Areas with high impact scores, rapid deforestation, low protection and high carbon storage values may represent significant opportunities for both biodiversity conservation and climate change mitigation, for example through Reducing

  5. Identifying priority areas for conservation: a global assessment for forest-dependent birds.

    Science.gov (United States)

    Buchanan, Graeme M; Donald, Paul F; Butchart, Stuart H M

    2011-01-01

    Limited resources are available to address the world's growing environmental problems, requiring conservationists to identify priority sites for action. Using new distribution maps for all of the world's forest-dependent birds (60.6% of all bird species), we quantify the contribution of remaining forest to conserving global avian biodiversity. For each of the world's partly or wholly forested 5-km cells, we estimated an impact score of its contribution to the distribution of all the forest bird species estimated to occur within it, and so is proportional to the impact on the conservation status of the world's forest-dependent birds were the forest it contains lost. The distribution of scores was highly skewed, a very small proportion of cells having scores several orders of magnitude above the global mean. Ecoregions containing the highest values of this score included relatively species-poor islands such as Hawaii and Palau, the relatively species-rich islands of Indonesia and the Philippines, and the megadiverse Atlantic Forests and northern Andes of South America. Ecoregions with high impact scores and high deforestation rates (2000-2005) included montane forests in Cameroon and the Eastern Arc of Tanzania, although deforestation data were not available for all ecoregions. Ecoregions with high impact scores, high rates of recent deforestation and low coverage by the protected area network included Indonesia's Seram rain forests and the moist forests of Trinidad and Tobago. Key sites in these ecoregions represent some of the most urgent priorities for expansion of the global protected areas network to meet Convention on Biological Diversity targets to increase the proportion of land formally protected to 17% by 2020. Areas with high impact scores, rapid deforestation, low protection and high carbon storage values may represent significant opportunities for both biodiversity conservation and climate change mitigation, for example through Reducing Emissions from

  6. Bacterial ecology of artisanal Minas cheeses assessed by culture-dependent and -independent methods.

    Science.gov (United States)

    Perin, Luana Martins; Savo Sardaro, Maria Luisa; Nero, Luís Augusto; Neviani, Erasmo; Gatti, Monica

    2017-08-01

    Artisanal Minas cheese is produced in Minas Gerais state, Brazil and its varieties are named according to their geographical origin (Serro, Canastra, Serra do Salitre, Araxá and Campo das Vertentes). The cheese is produced with raw cow's milk and the whey from the previous cheese production ("pingo"). The high economic and cultural importance of artisanal cheese in Brazil justifies the efforts to ensure its safety, quality and provenance. This study aimed to characterize the microbial diversity composition, and geographical distribution of artisanal Minas cheese, focusing on the characterization of its autochthonous lactic acid bacteria (LAB) microbiota. Artisanal Minas cheese varieties from Serro, Canastra, Serra do Salitre, Araxá and Campo das Vertentes were analyzed by culture-dependent (culturing and LAB sequencing) and -independent (repetitive extragenic palindromic-PCR (rep-PCR) and length heterogeneity-PCR, LH-PCR) methods to characterize the microbiota. The microbial counts were variable between cheese samples, and some samples presented high number of coagulase positive bacteria and coliforms that may be associated with hygienic issues. In all samples was observed a prevalence of LAB. 16S rRNA sequencing and rep-PCR of the LAB strains identified four genus (Lactobacillus, Lactococcus, Enterococcus and Weissella), ten species and more than one strain per species. Lactobacillus was the most prevalent genera in all the cheeses. LH-PCR revealed a further six genera and ten species that were not identified by culturing, highlighting the importance of combining both culture-dependent and -independent methods to fully characterize microbiota diversity. Principal component analysis of the LH-PCR data and cluster analysis of rep-PCR data revealed that the artisanal Minas cheese microbiota was influenced not only by their geographical origin but also by the cheese farm. The lack of standardization in the milking and cheese manufacturing procedures between

  7. Using video-annotation software to identify interactions in group therapies for schizophrenia: assessing reliability and associations with outcomes.

    Science.gov (United States)

    Orfanos, Stavros; Akther, Syeda Ferhana; Abdul-Basit, Muhammad; McCabe, Rosemarie; Priebe, Stefan

    2017-02-10

    Research has shown that interactions in group therapies for people with schizophrenia are associated with a reduction in negative symptoms. However, it is unclear which specific interactions in groups are linked with these improvements. The aims of this exploratory study were to i) develop and test the reliability of using video-annotation software to measure interactions in group therapies in schizophrenia and ii) explore the relationship between interactions in group therapies for schizophrenia with clinically relevant changes in negative symptoms. Video-annotation software was used to annotate interactions from participants selected across nine video-recorded out-patient therapy groups (N = 81). Using the Individual Group Member Interpersonal Process Scale, interactions were coded from participants who demonstrated either a clinically significant improvement (N = 9) or no change (N = 8) in negative symptoms at the end of therapy. Interactions were measured from the first and last sessions of attendance (>25 h of therapy). Inter-rater reliability between two independent raters was measured. Binary logistic regression analysis was used to explore the association between the frequency of interactive behaviors and changes in negative symptoms, assessed using the Positive and Negative Syndrome Scale. Of the 1275 statements that were annotated using ELAN, 1191 (93%) had sufficient audio and visual quality to be coded using the Individual Group Member Interpersonal Process Scale. Rater-agreement was high across all interaction categories (>95% average agreement). A higher frequency of self-initiated statements measured in the first session was associated with improvements in negative symptoms. The frequency of questions and giving advice measured in the first session of attendance was associated with improvements in negative symptoms; although this was only a trend. Video-annotation software can be used to reliably identify interactive behaviors in groups

  8. Challenge models to assess new therapies in chronic obstructive pulmonary disease

    OpenAIRE

    van der Merwe R; Molfino NA

    2012-01-01

    René van der Merwe,1 Nestor A Molfino2,31Respiratory Clinical Development, MedImmune Ltd, Cambridge, UK; 2Respiratory Clinical Development, MedImmune, LLC, Gaithersburg, MD, USA, 3KaloBios Pharmaceuticals, South San Francisco, CA, USAAbstract: Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. Current therapies confer partial benefits either by incompletely improving airflow limitation or by reducing acute exacerbations, hence new therapies ar...

  9. Thin Slice Ratings of Client Characteristics in Intake Assessments: Predicting Symptom Change and Dropout in Cognitive Therapy for Depression

    OpenAIRE

    Sasso, Katherine E.; Strunk, Daniel R.

    2013-01-01

    Thin slice ratings of personality have been shown to predict a number of outcomes, but have yet to be examined in the context of psychotherapy. In a sample of 66 clients participating in cognitive therapy for depression, we examined the predictive utility of thin slice rated pre-treatment client traits. On the basis of short video clip excerpts (i.e., thin slices) of intake assessments, trained observers rated clients on personality characteristics and specific personality disorder (PD) trait...

  10. Assessment of the efficacy of laser hyperthermia and nanoparticle-enhanced therapies by heat shock protein analysis

    OpenAIRE

    Fei Tang; Ye Zhang; Juan Zhang; Junwei Guo; Ran Liu

    2014-01-01

    Tumor thermotherapy is a method of cancer treatment wherein cancer cells are killed by exposing the body tissues to high temperatures. Successful clinical implementation of this method requires a clear understanding and assessment of the changes of the tumor area after the therapy. In this study, we evaluated the effect of near-infrared laser tumor thermotherapy at the molecular, cellular, and physical levels. We used single-walled carbon nanotubes (SWNTs) in combination with this thermothera...

  11. Significant and sustaining elevation of blood oxygen induced by Chinese cupping therapy as assessed by near-infrared spectroscopy

    OpenAIRE

    Li, Ting; Li, Yaoxian; Lin, Yu; Li, Kai

    2016-01-01

    Cupping therapy has been used in traditional Chinese medicine for thousands of years to relieve muscle pain/tendency/fatigue and to cure or reduce symbols of other diseases. However, its therapeutic effect is sparsely interpreted in the language of modern physiology. To objectively evaluate its therapeutic effect, we focused on dry cupping treatment and utilized near-infrared spectroscopy (NIRS) to assess the concentration change in oxy-hemoglobin ([HbO2]), deoxy-hemoglobin ([Hb]), and blood ...

  12. Assessment of neurologists' knowledge regarding intravenous fibrinolytic therapy for acute stroke in Shanxi province in China.

    Science.gov (United States)

    Ma, Liansheng; Niu, Xiaoyuan; Zhang, Wei; Fang, Yalan; Wang, Jie

    2017-05-18

    Limitations in physicians' knowledge regarding fibrinolytic therapy for acute ischemic stroke may contribute to low rate of fibrinolytic therapy in China. Here physicians' knowledge was surveyed on intravenous fibrinolytic therapy for acute ischemic stroke. Neurologists (n = 175) from 27 major general hospitals in Shanxi province, P. R. China, were invited to complete questionnaires regarding their basic knowledge of intravenous fibrinolytic therapy for acute ischemic stroke. The questionnaire contained 12 multiple-choice questions. One point was assigned for a correct answer and zero point for a false or unanswered question. One hundred and thirty-one neurologists (74.9%) responded to the questionnaires. The mean accuracy rate of 12 questions was 54.9 ± 25.01% (range 0.8-96.2%). The mean total score for respondents was 6.59 ± 2.03 (range 2-11). More years of experience and higher academic degrees were independent factors related to the total scores (P = 0.000 and P = 0.004, respectively). The neurologists in this study were knowledge deficient in the area of intravenous fibrinolytic therapy for acute ischemic stroke. This partially accounts for the low rate of fibrinolytic therapy in China.

  13. Timing matters: change depends on the stage of treatment in cognitive behavioral therapy for panic disorder with agoraphobia.

    Science.gov (United States)

    Gloster, Andrew T; Klotsche, Jens; Gerlach, Alexander L; Hamm, Alfons; Ströhle, Andreas; Gauggel, Siegfried; Kircher, Tilo; Alpers, Georg W; Deckert, Jürgen; Wittchen, Hans-Ulrich

    2014-02-01

    The mechanisms of action underlying treatment are inadequately understood. This study examined 5 variables implicated in the treatment of panic disorder with agoraphobia (PD/AG): catastrophic agoraphobic cognitions, anxiety about bodily sensations, agoraphobic avoidance, anxiety sensitivity, and psychological flexibility. The relative importance of these process variables was examined across treatment phases: (a) psychoeducation/interoceptive exposure, (b) in situ exposure, and (c) generalization/follow-up. Data came from a randomized controlled trial of cognitive behavioral therapy for PD/AG (n = 301). Outcomes were the Panic and Agoraphobia Scale (Bandelow, 1995) and functioning as measured in the Clinical Global Impression scale (Guy, 1976). The effect of process variables on subsequent change in outcome variables was calculated using bivariate latent difference score modeling. Change in panic symptomatology was preceded by catastrophic appraisal and agoraphobic avoidance across all phases of treatment, by anxiety sensitivity during generalization/follow-up, and by psychological flexibility during exposure in situ. Change in functioning was preceded by agoraphobic avoidance and psychological flexibility across all phases of treatment, by fear of bodily symptoms during generalization/follow-up, and by anxiety sensitivity during exposure. The effects of process variables on outcomes differ across treatment phases and outcomes (i.e., symptomatology vs. functioning). Agoraphobic avoidance and psychological flexibility should be investigated and therapeutically targeted in addition to cognitive variables. PsycINFO Database Record (c) 2014 APA, all rights reserved.

  14. [AGE-SPECIFIC METABOLIC THERAPY FOR ALCOHOL DEPENDENCE IN ELDERLY PATIENTS WITH REGARD TO THEIR AKMEOLOGICAL FEATURES].

    Science.gov (United States)

    Zaplutanov, V A; Spikina, A A; Belov, V G; Parfyonov, U A; Ermishin, Ye V

    2015-01-01

    Aocoholism in the elderly determines tne protracted nature or tne pathological craving for etnanol in post-abstinence syndrome period, restricts arsenal of active pharmacotherapy and updates the search for new pharmacological therapeutic strategies. The results showed that the inclusion of the drug "Remaxol" in the treatment of clinical manifestations of craving for ethanol in post-abstinence syndrome period of associated forms of alcoholism in the elderly provides better in relation to conventional therapy dynamics of reduction of somatovegetative and neurological manifestations of alcohol withdrawal syndrome, as well as the main components of craving for alcohol, will increase the efficiency of outpatient treatment at the stage of remission. The duration of remission of mental and behavioral disorders caused by alcohol use in elderly patients is, apart from pharmacotherapy, due to such social and psychological factors and akmeological features as education, leadership potential, high social activity, a high level of social intelligence and its implementation, lack of intense intrapersonal conflict, high ductility and activity.

  15. Graves' disease and radioiodine therapy. Is success of ablation dependent on the choice of thyreostatic medication?

    Energy Technology Data Exchange (ETDEWEB)

    Kobe, C.; Weber, I.; Eschner, W.; Sudbrock, F.; Schmidt, M.; Dietlein, M.; Schicha, H. [Dept. of Nuclear Medicine, Univ. of Cologne (Germany)

    2008-07-01

    Aim: this study was performed to analyse the impact of the choice of antithyroid drugs (ATD) on the outcome of ablative radioiodine therapy (RIT) in patients with Graves' disease. Patients, material, methods: a total of 571 consecutive patients were observed for 12 months after RIT between July 2001 and June 2004. Inclusion criteria were the confirmed diagnosis of Graves' disease, compensation of hyperthyroidism and withdrawal of ATD two days before preliminary radioiodine-testing and RIT. The intended dose of 250 Gy was calculated from the results of the radioiodine test and the therapeutically achieved dose was measured by serial uptake measurements. The end-point measure was thyroid function 12 months offer RIT; success was defined as elimination of hyperthyroidism. The pretreatment ATD was retrospectively correlated with the results achieved. Results: relief from hyperthyroidism was achieved in 96% of patients. 472 patients were treated with carbimazole or methimazole (CMI) and 61 with propylthiouracil (PTU). 38 patients had no thyrostatic drugs (ND) prior to RIT. The success rate was equal in all groups (CMI 451/472; PTU 61/61; ND 37/38; p = 0.22). Conclusion: thyrostatic treatment with PTU achieves excellent results in ablative RIT, using an accurate dosimetric approach with an achieved post-therapeutic dose of more than 200 Gy. (orig.)

  16. Limitations of serum ferritin to predict liver iron concentration responses to deferasirox therapy in patients with transfusion-dependent thalassaemia.

    Science.gov (United States)

    Porter, John B; Elalfy, Mohsen; Taher, Ali; Aydinok, Yesim; Lee, Szu-Hee; Sutcharitchan, Pranee; El-Ali, Ali; Han, Jackie; El-Beshlawy, Amal

    2017-03-01

    In transfusion-dependent anaemias, while absolute serum ferritin levels broadly correlate with liver iron concentration (LIC), relationships between trends in these variables are unclear. These relationships are important because serum ferritin changes are often used to adjust or switch chelation regimens when liver magnetic resonance imaging (MRI) is unavailable. This post hoc analysis of the EPIC study compared serum ferritin and LIC in 317 patients with transfusion-dependent thalassaemia before and after 1 yr of deferasirox. Serum ferritin responses (decreases) occurred in 73% of patients, 80% of whom also have decreased LIC. However, 52% of patients without a serum ferritin response did decrease LIC and by >1 mg Fe/g dw (median 3.9) in 77% of cases. Absolute serum ferritin and LIC values correlated significantly only when serum ferritin was <4000 ng/mL (r = 0.59; P < 0.0001) and not at higher levels (≥4000 ng/mL; r = 0.19). Serum ferritin response was accompanied by decreased LIC in 89% and 70% of cases when serum ferritin was <4000 or ≥4000 ng/mL, respectively. As serum ferritin non-response was associated with LIC decrease in over half of patients, use of liver MRI may be particularly useful for differentiating true from apparent non-responders to deferasirox based on serum ferritin trends alone. © 2016 The Authors. European Journal of Haematology Published by John Wiley & Sons Ltd.

  17. [Withdrawal therapy of patients with alcoholism and nicotine dependence with carcinomas in the area of the head and neck. Luxury or necessity?].

    Science.gov (United States)

    Dammer, R; Neiderdellmann, H; Friesenecker, J; Fleischmann, H; Herrmann, J; Kreft, M

    1998-03-01

    Alcohol and nicotine abuse play a major role in the etiology of oral squamous cell carcinomas. In the present study, we investigated the number of patients with oral/oropharyngeal carcinomas who regularly consume alcohol and nicotine and what type of specific treatment should be prescribed for the addiction. A total of 105 patients (90 men, 15 women) with oral/oropharyngeal squamous cell carcinomas were studied based on catamnestic data as well as a special questionnaire designed to assess drinking and smoking habits (40 g alcohol/day for men and 20 g alcohol/day for women was taken as the standard measure for those considered at risk for alcoholism). For smokers, the number of packs smoked per year was determined and compared to clinical data (i.e., tumor size, location) and laboratory data (gamma-GT). Particular attention was given to the addiction behavior before and after tumor therapy (recorded at least 1 year after successful tumor treatment). At the time of diagnosis, 83.1% regularly drank alcohol (71.9% reported drinking over 40 g/ 20 g of alcohol per day). Another 17.9% stopped drinking after therapy. Of the alcoholics 59.8% had been exposed to a daily consumption level above the threshold amount for more than 20 years. Some 70% of the patients reported that they exclusively drank beer. Tobacco consumption came from cigarette smoking 92.7% and 89.7% reported that they smoked before therapy--after therapy only 37.8% smoked. Carcinomas of the floor of the mouth indicated a prevalence toward alcohol and nicotine abuse. Of the patients with a T3 and T4 carcinoma 84% had daily alcohol consumption levels over the threshold value stated above. None of the 105 patients underwent specific alcohol treatment therapy. In light of the high prevalence of carcinomas of the oral cavity in patients with alcohol and nicotine addiction, mandatory withdrawal therapy should be offered in the form of postoperative treatment to prevent recurrence or the development of second

  18. An Integrated Assessment of Location-Dependent Scaling for Microalgae Biofuel Production Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Coleman, Andre M.; Abodeely, Jared; Skaggs, Richard; Moeglein, William AM; Newby, Deborah T.; Venteris, Erik R.; Wigmosta, Mark S.

    2014-06-19

    Successful development of a large-scale microalgae-based biofuels industry requires comprehensive analysis and understanding of the feedstock supply chain—from facility siting/design through processing/upgrading of the feedstock to a fuel product. The evolution from pilot-scale production facilities to energy-scale operations presents many multi-disciplinary challenges, including a sustainable supply of water and nutrients, operational and infrastructure logistics, and economic competitiveness with petroleum-based fuels. These challenges are addressed in part by applying the Integrated Assessment Framework (IAF)—an integrated multi-scale modeling, analysis, and data management suite—to address key issues in developing and operating an open-pond facility by analyzing how variability and uncertainty in space and time affect algal feedstock production rates, and determining the site-specific “optimum” facility scale to minimize capital and operational expenses. This approach explicitly and systematically assesses the interdependence of biofuel production potential, associated resource requirements, and production system design trade-offs. The IAF was applied to a set of sites previously identified as having the potential to cumulatively produce 5 billion-gallons/year in the southeastern U.S. and results indicate costs can be reduced by selecting the most effective processing technology pathway and scaling downstream processing capabilities to fit site-specific growing conditions, available resources, and algal strains.

  19. Earthquake Magnitude and Shaking Intensity Dependent Fragility Functions for Rapid Risk Assessment of Buildings

    Directory of Open Access Journals (Sweden)

    Marie-José Nollet

    2018-01-01

    Full Text Available An integrated web application, referred to as ER2 for rapid risk evaluator, is under development for a user-friendly seismic risk assessment by the non-expert public safety community. The assessment of likely negative consequences is based on pre-populated databases of seismic, building inventory and vulnerability parameters. To further accelerate the computation for near real-time analyses, implicit building fragility curves were developed as functions of the magnitude and the intensity of the seismic shaking defined with a single intensity measure, input spectral acceleration at 1.0 s implicitly considering the epicentral distance and local soil conditions. Damage probabilities were compared with those obtained with the standard fragility functions explicitly considering epicentral distances and local site classes in addition to the earthquake magnitudes and respective intensity of the seismic shaking. Different seismic scenarios were considered first for 53 building classes common in Eastern Canada, and then a reduced number of 24 combined building classes was proposed. Comparison of results indicate that the damage predictions with implicit fragility functions for short (M ≤ 5.5 and medium strong motion duration (5.5 < M ≤ 7.5 show low variation with distance and soil class, with average error of less than 3.6%.

  20. Scale-Dependent Assessment of Relative Disease Resistance to Plant Pathogens

    Directory of Open Access Journals (Sweden)

    Peter Skelsey

    2014-03-01

    Full Text Available Phenotyping trials may not take into account sufficient spatial context to infer quantitative disease resistance of recommended varieties in commercial production settings. Recent ecological theory—the dispersal scaling hypothesis—provides evidence that host heterogeneity and scale of host heterogeneity interact in a predictable and straightforward manner to produce a unimodal (“humpbacked” distribution of epidemic outcomes. This suggests that the intrinsic artificiality (scale and design of experimental set-ups may lead to spurious conclusions regarding the resistance of selected elite cultivars, due to the failure of experimental efforts to accurately represent disease pressure in real agricultural situations. In this model-based study we investigate the interaction of host heterogeneity and scale as a confounding factor in the inference from ex-situ assessment of quantitative disease resistance to commercial production settings. We use standard modelling approaches in plant disease epidemiology and a number of different agronomic scenarios. Model results revealed that the interaction of heterogeneity and scale is a determinant of relative varietal performance under epidemic conditions. This is a previously unreported phenomenon that could provide a new basis for informing the design of future phenotyping platforms, and optimising the scale at which quantitative disease resistance is assessed.

  1. The hormone therapy, Premarin, impairs hippocampus-dependent spatial learning and memory and reduces activation of new granule neurons in response to memory in female rats.

    Science.gov (United States)

    Barha, Cindy K; Galea, Liisa A M

    2013-03-01

    Estrogens have been implicated as possible therapeutic agents for improving cognition in postmenopausal women and have been linked to neurodegenerative disorders such as Alzheimer's disease. However, the utility of Premarin (Wyeth Pharmaceuticals, Markham, ON, Canada), a conjugated equine estrogen and the most commonly prescribed hormone therapy, has recently been questioned. The purpose of this study was to investigate the effects of Premarin at 2 different doses (10 or 20 μg) on hippocampus-dependent spatial learning and memory, hippocampal neurogenesis, and new neuronal activation using a rodent model of surgical menopause. Rats were treated daily with subcutaneous injections of Premarin and trained on the spatial working/reference memory version of the radial arm maze. Premarin impaired spatial reference and working learning and memory, increased hippocampal neurogenesis, but either decreased or increased activation of new neurons in response to memory retrieval as indexed by the expression of the immediate early gene product zif268, depending on the maturity of cells examined. This activation of new neurons was related to impaired performance in Premarin-treated but not control-treated female rats. These results indicate that Premarin may be impairing hippocampus-dependent learning and memory by negatively altering the neurogenic environment in the dentate gyrus thus disrupting normal activity of new neurons. Copyright © 2013 Elsevier Inc. All rights reserved.

  2. Effects of temperature-dependent optical properties on the fluence rate and temperature of biological tissue during low-level laser therapy.

    Science.gov (United States)

    Kim, Soogeun; Jeong, Sungho

    2014-03-01

    The effects of temperature-dependent optical properties on the change of fluence rate and temperature distribution within biological tissues during low-level laser therapy (LLLT) were investigated by experimental and numerical methods. The fluence rate and temperature within a porcine skin were measured in vitro using an optical fiber sensor and a thermocouple, respectively, while irradiating the sample with a continuous wave laser (IPG Laser GmbH, Burbach, Germany, 1,064 nm, 3.14 W/cm(2)). The absorption and reduced scattering coefficients of porcine skin were estimated using an inverse adding-doubling algorithm from the total reflectance and transmittance measured with a double-integrating sphere. It was shown that the reduced scattering coefficient of porcine skin decreased significantly as the skin temperature increased within the range of 26-40 °C. To incorporate the temperature dependency of tissue optical properties in the simulation, a mathematical model that adopted coupled equations for fluence rate and bioheat transfer was developed. It was shown that the predicted fluence rate and temperature by the proposed mathematical model agreed closely with the measured values of porcine skin. The calculation of human skin temperature using the developed model revealed that the skin temperature could be significantly underestimated if the temperature dependency of optical properties of human skin were ignored during LLLT simulation.

  3. Threshold-dependent sample sizes for selenium assessment with stream fish tissue.

    Science.gov (United States)

    Hitt, Nathaniel P; Smith, David R

    2015-01-01

    Natural resource managers are developing assessments of selenium (Se) contamination in freshwater ecosystems based on fish tissue concentrations. We evaluated the effects of sample size (i.e., number of fish per site) on the probability of correctly detecting mean whole-body Se values above a range of potential management thresholds. We modeled Se concentrations as gamma distributions with shape and scale parameters fitting an empirical mean-to-variance relationship in data from southwestern West Virginia, USA (63 collections, 382 individuals). We used parametric bootstrapping techniques to calculate statistical power as the probability of detecting true mean concentrations up to 3 mg Se/kg above management thresholds ranging from 4 to 8 mg Se/kg. Sample sizes required to achieve 80% power varied as a function of management thresholds and Type I error tolerance (α). Higher thresholds required more samples than lower thresholds because populations were more heterogeneous at higher mean Se levels. For instance, to assess a management threshold of 4 mg Se/kg, a sample of eight fish could detect an increase of approximately 1 mg Se/kg with 80% power (given α=0.05), but this sample size would be unable to detect such an increase from a management threshold of 8 mg Se/kg with more than a coin-flip probability. Increasing α decreased sample size requirements to detect above-threshold mean Se concentrations with 80% power. For instance, at an α-level of 0.05, an 8-fish sample could detect an increase of approximately 2 units above a threshold of 8 mg Se/kg with 80% power, but when α was relaxed to 0.2, this sample size was more sensitive to increasing mean Se concentrations, allowing detection of an increase of approximately 1.2 units with equivalent power. Combining individuals into 2- and 4-fish composite samples for laboratory analysis did not decrease power because the reduced number of laboratory samples was compensated for by increased precision of composites

  4. Threshold-dependent sample sizes for selenium assessment with stream fish tissue

    Science.gov (United States)

    Hitt, Nathaniel P.; Smith, David R.

    2015-01-01

    Natural resource managers are developing assessments of selenium (Se) contamination in freshwater ecosystems based on fish tissue concentrations. We evaluated the effects of sample size (i.e., number of fish per site) on the probability of correctly detecting mean whole-body Se values above a range of potential management thresholds. We modeled Se concentrations as gamma distributions with shape and scale parameters fitting an empirical mean-to-variance relationship in data from southwestern West Virginia, USA (63 collections, 382 individuals). We used parametric bootstrapping techniques to calculate statistical power as the probability of detecting true mean concentrations up to 3 mg Se/kg above management thresholds ranging from 4 to 8 mg Se/kg. Sample sizes required to achieve 80% power varied as a function of management thresholds and Type I error tolerance (α). Higher thresholds required more samples than lower thresholds because populations were more heterogeneous at higher mean Se levels. For instance, to assess a management threshold of 4 mg Se/kg, a sample of eight fish could detect an increase of approximately 1 mg Se/kg with 80% power (given α = 0.05), but this sample size would be unable to detect such an increase from a management threshold of 8 mg Se/kg with more than a coin-flip probability. Increasing α decreased sample size requirements to detect above-threshold mean Se concentrations with 80% power. For instance, at an α-level of 0.05, an 8-fish sample could detect an increase of approximately 2 units above a threshold of 8 mg Se/kg with 80% power, but when α was relaxed to 0.2, this sample size was more sensitive to increasing mean Se concentrations, allowing detection of an increase of approximately 1.2 units with equivalent power. Combining individuals into 2- and 4-fish composite samples for laboratory analysis did not decrease power because the reduced number of laboratory samples was compensated for by increased

  5. Assessment of bacterial diversity in breast milk using culture-dependent and culture-independent approaches.

    Science.gov (United States)

    Jost, Ted; Lacroix, Christophe; Braegger, Christian; Chassard, Christophe

    2013-10-01

    Initial neonatal gut colonisation is a crucial stage for developing a healthy physiology, beneficially influenced by breast-feeding. Breast milk has been shown not only to provide nutrients and bioactive/immunological compounds, but also commensal bacteria, including gut-associated anaerobic Bifidobacterium spp. The aim of the present study was to investigate bacterial diversity in breast milk, with emphasis on identifying gut-associated obligate anaerobes. Breast milk collected from seven mothers at three sampling points (days 3-6, 9-14 and 25-30 postpartum) was analysed by combined culture-dependent and state-of-the-art, culture-independent methods (Sanger sequencing and 454-pyrosequencing). In addition to the predominance of facultative anaerobes such as Staphylococcus, Streptococcus and Propionibacterium (>90% of isolated strains and 23·7% relative abundance using pyrosequencing), significant populations of obligate anaerobes, including Bifidobacterium and Veillonella, were detected using pyrosequencing and confirmed by the isolation of viable strains (3·4% of isolates and 1·4% relative abundance). Pyrosequencing also revealed the presence of DNA of multiple major gut-associated obligate anaerobes (6·2% relative abundance) such as Bacteroides and, for the first time, several members of the Clostridia, including butyrate producers, such as Faecalibacterium and Roseburia, which are important for colonic health. The present study suggests that breast milk may be a major source of bacterial diversity to the neonatal gut, including gut-associated obligate anaerobes, and may thus significantly influence gut colonisation and maturation of the immune system.

  6. Assessment of Size-Dependent Antimicrobial and Cytotoxic Properties of Silver Nanoparticles

    Directory of Open Access Journals (Sweden)

    Yoon Jeong

    2014-01-01

    Full Text Available Nanoscale silver has been increasingly applied to commercial products for their antimicrobial function as antibiotics and disinfectants. In this work, the different sizes of silver nanoparticles (AgNPs were studied not only in Methylobacterium spp. for their antimicrobial potential but also in human peripheral blood mononuclear cells (PBMCs for their cytotoxicity in order to determine responses dependent on their particle size. Size controlled silver particles were prepared by chemical reduction of silver cations (Ag+ and then dispersed in water for their physicochemical characterization using transmission electron microscopy (TEM, dynamic light scattering (DLS, and zeta potential measurements. To ascertain antimicrobial response, water-soluble silver nanoparticles were mixed into Methylobacterium spp. cultured for two days and the sample from the broth was spread on the agar plate for colony counting. 10 nm nanoparticles showed more antimicrobial activity than 100 nm particles at which concentrations were equivalently controlled. Increased cytotoxic effect of smaller silver nanoparticles was also observed in PBMCs cocultured with particles. Silver ions released from 10 nm particles might be correlated with upregulated antimicrobial and cytotoxic properties of AgNPs.

  7. Sex-dependent effects on tasks assessing reinforcement learning and interference inhibition

    Directory of Open Access Journals (Sweden)

    Kelly L Evans

    2015-07-01

    Full Text Available Increasing evidence suggests that the prefrontal cortex (PFC is influenced by sex steroids and that some cognitive functions dependent on the PFC may be sexually differentiated in humans. Past work has identified a male advantage on certain complex reinforcement learning tasks, but it is unclear which latent task components are important to elicit the sex difference. The objective of the current study was to investigate whether there are sex differences on measures of response inhibition and valenced feedback processing, elements that are shared by previously studied reinforcement learning tasks. Healthy young adults (90 males, 86 females matched in general intelligence completed the Probabilistic Selection Task (PST, a Simon task, and the Stop-Signal task. On the PST, females were more accurate than males in learning from positive (but not negative feedback. On the Simon task, males were faster than females, especially in the face of incongruent stimuli. No sex difference was observed in Stop-Signal reaction time. The current findings provide preliminary support for a sex difference in the processing of valenced feedback and in interference inhibition.

  8. High-throughput assessment of context-dependent effects of chromatin proteins.

    Science.gov (United States)

    Brueckner, Laura; van Arensbergen, Joris; Akhtar, Waseem; Pagie, Ludo; van Steensel, Bas

    2016-01-01

    Chromatin proteins control gene activity in a concerted manner. We developed a high-throughput assay to study the effects of the local chromatin environment on the regulatory activity of a protein of interest. The assay combines a previously reported multiplexing strategy based on barcoded randomly integrated reporters with Gal4-mediated tethering. We applied the assay to Drosophila heterochromatin protein 1a (HP1a), which is mostly known as a repressive protein but has also been linked to transcriptional activation. Recruitment to over 1000 genomic locations revealed that HP1a is a potent repressor able to silence even highly expressing reporter genes. However, the local chromatin context can modulate HP1a function. In pericentromeric regions, HP1a-induced repression was enhanced by twofold. In regions marked by a H3K36me3-rich chromatin signature, HP1a-dependent silencing was significantly decreased. We found no evidence for an activating function of HP1a in our experimental system. Furthermore, we did not observe stable transmission of repression over mitotic divisions after loss of targeted HP1a. The multiplexed tethered reporter assay should be applicable to a large number of chromatin proteins and will be a useful tool to dissect combinatorial regulatory interactions in chromatin.

  9. Assessment of Time-dependent Unrestricted Hartree-Fock Method for Electron Dynamics in Intense Laser Fields

    Science.gov (United States)

    Sato, Takeshi; Ishikawa, Kenichi L.

    Time-dependent restricted and unrestricted Hartree-Fock (TD-RHF and TD-UHF) methods are comparatively assessed for the description of the electron dynamics in intense laser fields. These methods are applied to the one-dimensional H2 molecule exposed to an intense laser field, and compared to the results from the time-dependent Schrödinger (TDSE) equation. Around the equilibrium interatomic distance, where the initial RHF and UHF wavefunctions coincide, TD-UHF keeps an initial closed-shell, thus underestimates large amplitude electron motions. At a longer interatomic distance, where the UHF wavefunction differs from the RHF one, TD-UHF better reprodeces the TDSE result than TD-RHF does.

  10. TH-C-19A-07: Output Factor Dependence On Range and Modulation for a New Proton Therapy System

    Energy Technology Data Exchange (ETDEWEB)

    Sun, B; Zhao, T; Grantham, K; Goddu, S; Santanam, L; Klein, E [Washington University, St. Louis, MO (United States)

    2014-06-15

    Purpose: Proton treatment planning systems are not able to accurately predict output factors and do not calculate monitor units (MU) for proton fields. Output factors (cGy/MU) for patient-specific fields are usually measured in phantoms or modeled empirically. The purpose of this study is to predict the output factors (OFs) for a given proton (R90) and modulation width (Mod) for the first Mevion S250 proton therapy system. Methods: Using water phantoms and a calibrated ionization chamber-electrometer, over 100 OFs were measured for various R90 and Mod combinations for 24 different options. OFs were measured at the center of the Mod, which coincided with the isocenter. The measured OFs were fitted using an analytic model developed by Kooy (Phys.Med.Biol. 50, 2005) for each option and a derived universal empirical-based polynomial as a function of R90 and Mod for all options. Options are devised for ranges of R90 and Mod. The predicted OFs from both models were compared to measurements. Results: Using the empirical-based model, the values could be predicted to within 3% for at least 90% of measurements and within 5% for 98% of the measurements. Using the analytic model to fit each option with the same effective source position, the prediction is much more accurate. The maximal uncertainty between measured and predicted is within 2% and the averaged root-mean-square is 1.5%. Conclusion: Although the measured data was not exhaustive, both models predicted OFs within acceptable uncertainty. Both models are currently used for a sanity check of our continual patient field OF measurements. As we acquire more patient-field OFs, the model will be refined with an ultimate goal of eliminating the time-consuming patient-specific OF measurements.

  11. SU-E-T-604: Dosimetric Dependence On the Collimator Angle in Prostate Volumetric Modulated Arc Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Khan, M; Rehman, J; Khan, M [The Islaimia University of Bahawalpur, Bahawalpur, Punjab (Pakistan); Chow, J [Princess Margaret Cancer Center, Toronto, ON (Canada)

    2014-06-01

    Purpose: The purpose of this study is to investigate the dose-volume variations of planning target volume (PTV) and organs-at-risk (OARs) in prostate volumetric modulated arc therapy (VMAT) when using different collimator angles. It is because collimator angle awareness is essential for planner to produce an optimal prostate VMAT plan in a rational time. Methods: Single-arc VMAT plans at different collimator angles (0o, 15o, 30o, 45o, 60o, 75o and 90o) were created systematically using a Harold heterogeneous pelvis phantom. For each change of collimator angle, a new plan was re-optimized for that angle. The prescription dose was 78 Gy per 39 fractions. Conformity index (CI), homogeneity index (HI), gradient index, machine monitor unit, dose-volume histogram, the mean and maximum doses of the PTV were calculated and analyzed. On the other hand, dose-volume histogram, the mean and maximum doses of the OARs such as bladder, rectum and femoral heads for different collimator angles were determined from the plans. Results: There was no significance difference, based on the plan dose-volume evaluation criteria, found in the VMAT optimizations for all studied collimator angles. Higher CI and lower HI were found for the 45o collimator angle. In addition, the 15o collimator angle provided lower HI similar to the 45o collimator angle. The 75o and 90o collimator angle were found good for the rectum sparing, and the 75o and 30o collimator angle were found good for the right and left femur sparing, respectively. The PTV dose coverage for each plan was comparatively independent of the collimator angle. Conclusion: The dosimetric results in this study are useful to the planner to select different collimator angles to improve the PTV coverage and OAR sparing in prostate VMAT.

  12. Graves' disease and radioiodine therapy. Is success of ablation dependent on the achieved dose above 200 Gy?

    Energy Technology Data Exchange (ETDEWEB)

    Kobe, C.; Eschner, W.; Sudbrock, F.; Weber, I.; Marx, K.; Dietlein, M.; Schicha, H. [Dept. of Nuclear Medicine, Univ. of Cologne (Germany)

    2008-07-01

    Aim: this study was performed to determine the results of ablative radioiodine therapy (RIT) when the achieved dose in the thyroid was above 200 Gy and to characterize predictive factors for treatment outcome. Patients, methods: a total of 571 consecutive patients were observed for 12 months between July 2001 and June 2004. Inclusion criteria were a confirmed diagnosis Groves' disease, compensation of hyperthyroidism and withdrawal of antithyroid drugs two days before preliminary radioiodine-testing and RIT. The intended dose was 250 Gy and the therapeutically achieved dose was calculated from serial uptake measurements. The end-point measure was thyroid function 12 months after RIT; success was defined as elimination of hyperthyroidism. The relation between success rate and the achieved dose, thyroid volume, age and sex of patients, TSH- and TRAb-values and presence of ophthalmopathy was analysed. Results: relief from hyperthyroidism was achieved in 96% of patients who received more than 200 Gy, even for thyroid volumes >40 ml. The success of ablative RIT was not influenced by age or sex of patients, or by TSH- or TRAb values or concomitant ophthalmopathy. The mean achieved dose in the thyroid was 298 Gy with a standard deviation of 74.6 Gy. Conclusion: to achieve a dose of over 200 Gy with the above standard deviation, we recommend calculating on intended dose of 250 Gy and using a dosimetric approach with early and late uptake values in the radioiodine test, to allow early therapeutic intervention should the posttherapeutic thyroid dose fall unexpectedly below 200 Gy. (orig.)

  13. Terapias Cognitiva e Cognitivo-Comportamental em dependência química Cognitive and Cognitive-Behavioral Therapy for substance abuse disorders

    Directory of Open Access Journals (Sweden)

    Cláudio Jerônimo da Silva

    2004-05-01

    Full Text Available Este artigo descreve o estado atual da Terapia Cognitiva, Comportamental, Prevenção de Recaída e Treinamento de Habilidades no tratamento de usuários de drogas. O objetivo é apresentar uma revisão sobre teorias e técnicas da Terapia Cognitiva e outras abordagens que dela derivam. Terapias Cognitiva e Comportamental, bem como Prevenção da Recaída e Treinamento de Habilidades, são tratamentos limitados no tempo, orientados em uma meta, e que utilizam sessões estruturadas, assumindo, assim, uma postura diretiva e ativa. Nós salientamos algumas diferenças entre Terapia Cognitiva, Prevenção de Recaída e Treinamento de Habilidades. A Terapia Cognitiva tem seu foco prioritariamente nos pensamentos, crenças, sentimentos e circunstâncias, como base do comportamento disfuncional. A Prevenção de Recaída e o Treinamento de Habilidades baseiam-se nas teorias comportamentais, além da teoria Cognitiva. Esperamos apresentar os últimos achados científicos para ajudar o psiquiatra geral a melhorar o tratamento da dependência química.This article describes the current status of Cognitive and Behavioral Therapy as well Relapse Prevention and Coping Skill approaches applied in drug abuse treatments. The objective is show a review about theories and technique used by Cognitive Therapy and others approaches derived that, specifically Relapse Prevention and Coping Skill Treatments. Cognitive and Behavioral Therapy, Coping Skill, and Relapse Prevention are a short-time, goal-oriented and structured treatments. Thus, they assume a posture directive and active. We pointed out some difference between the theories about Cognitive Therapy, Relapse Prevention and Coping Skill. The Cognitive Therapy accentuated the focus in patient’s thought, feeling and circumstances that get in a dysfunctional behavioral. Relapse Prevention and Coping Skill are based in behavioral theories besides of the Cognitive. We, finally, look forward to introduce the

  14. [Patient first - The impact of characteristics of target populations on decisions about therapy effectiveness of complex interventions: Psychological variables to assess effectiveness in interdisciplinary multimodal pain therapy].

    Science.gov (United States)

    Kaiser, Ulrike; Sabatowski, Rainer; Balck, Friedrich

    2017-08-01

    The assessment of treatment effectiveness in public health settings is ensured by indicators that reflect the changes caused by specific interventions. These indicators are also applied in benchmarking systems. The selection of constructs should be guided by their relevance for affected patients (patient reported outcomes). The interdisciplinary multimodal pain therapy (IMPT) is a complex intervention based on a biopsychosocial understanding of chronic pain. For quality assurance purposes, psychological parameters (depression, general anxiety, health-related quality of life) are included in standardized therapy assessment in pain medicine (KEDOQ), which can also be used for comparative analyses in a benchmarking system. The aim of the present study was to investigate the relevance of depressive symptoms, general anxiety and mental quality of life in patients undergoing IMPT under real life conditions. In this retrospective, one-armed and exploratory observational study we used secondary data of a routine documentation of IMST in routine care, applying several variables of the German Pain Questionnaire and the facility's comprehensive basic documentation. 352 participants with IMPT (from 2006 to 2010) were included, and the follow-up was performed over two years with six assessments. Because of statistically heterogeneous characteristics a complex analysis consisting of factor and cluster analyses was applied to build subgroups. These subgroups were explored to identify differences in depressive symptoms (HADS-D), general anxiety (HADS-A), and mental quality of life (SF 36 PSK) at the time of therapy admission and their development estimated by means of effect sizes. Analyses were performed using SPSS 21.0®. Six subgroups were derived and mainly proved to be clinically and psychologically normal, with the exception of one subgroup that consistently showed psychological impairment for all three parameters. The follow-up of the total study population revealed medium

  15. Dependence and risk assessment for oil prices and exchange rate portfolios: A wavelet based approach

    Science.gov (United States)

    Aloui, Chaker; Jammazi, Rania

    2015-10-01

    In this article, we propose a wavelet-based approach to accommodate the stylized facts and complex structure of financial data, caused by frequent and abrupt changes of markets and noises. Specifically, we show how the combination of both continuous and discrete wavelet transforms with traditional financial models helps improve portfolio's market risk assessment. In the empirical stage, three wavelet-based models (wavelet-EGARCH with dynamic conditional correlations, wavelet-copula, and wavelet-extreme value) are considered and applied to crude oil price and US dollar exchange rate data. Our findings show that the wavelet-based approach provides an effective and powerful tool for detecting extreme moments and improving the accuracy of VaR and Expected Shortfall estimates of oil-exchange rate portfolios after noise is removed from the original data.

  16. Assessing patient dose in interventional fluoroscopy using patient-dependent hybrid phantoms

    Science.gov (United States)

    Johnson, Perry Barnett

    Interventional fluoroscopy uses ionizing radiation to guide small instruments through blood vessels or other body pathways to sites of clinical interest. The technique represents a tremendous advantage over invasive surgical procedures, as it requires only a small incision, thus reducing the risk of infection and providing for shorter recovery times. The growing use and increasing complexity of interventional procedures, however, has resulted in public health concerns regarding radiation exposures, particularly with respect to localized skin dose. Tracking and documenting patient-specific skin and internal organ dose has been specifically identified for interventional fluoroscopy where extended irradiation times, multiple projections, and repeat procedures can lead to some of the largest doses encountered in radiology. Furthermore, inprocedure knowledge of localized skin doses can be of significant clinical importance to managing patient risk and in training radiology residents. In this dissertation, a framework is presented for monitoring the radiation dose delivered to patients undergoing interventional procedures. The framework is built around two key points, developing better anthropomorphic models, and designing clinically relevant software systems for dose estimation. To begin, a library of 50 hybrid patient-dependent computational phantoms was developed based on the UF hybrid male and female reference phantoms. These phantoms represent a different type of anthropomorphic model whereby anthropometric parameters from an individual patient are used during phantom selection. The patient-dependent library was first validated and then used in two patient-phantom matching studies focused on cumulative organ and local skin dose. In terms of organ dose, patient-phantom matching was shown most beneficial for estimating the dose to large patients where error associated with soft tissue attenuation differences could be minimized. For small patients, inherent difference

  17. Assessment of vocal intensity in lecturers depending on acoustic properties of lecture rooms

    Directory of Open Access Journals (Sweden)

    Witold Mikulski

    2015-08-01

    Full Text Available Background: Lombard’s effect increases the level of vocal intensity in the environment, in which noise occurs. This article presents the results of the author’s own study of vocal intensity level and A-weighted sound pressure level of background noise during normal lectures. The aim of the study was to define whether above-mentioned parameters depend on acoustic properties of rooms (classrooms or lecture rooms and to define how many lectors speak with raised voice. Material and Methods: The study was performed in a group of 50 teachers and lecturers in 10 classrooms with cubature of 160–430 m3 and reverberation time of 0.37–1.3 s (group A consisted of 3 rooms which fulfilled, group B consisted of 3 rooms which almost fulfilled and group C consisted of 4 rooms which did not fulfill criteria based on reverberation time (maximum permissible value is 0.6–0.8 s according to PN-B-02151-4:2015. Criteria of raising voice were based on vocal intensity level (maximum value: 65 dB according to EN ISO 9921:2003. The values of above-mentioned parameters were determined from modes of A-weighted sound pressure level distributions during lectures. Results: Great differentiation of vocal intensity level between lectors was found. In classrooms of group A lectors were not using raised voice, in group B – 21%, and in group C – 60% of lectors were using raised voice. Conclusions: It was observed that acoustic properties of classrooms (defined by reverberation time exert their effect on lecturer’s vocal intensity level (i.e., raising voice, which may contribute to the increased risk of vocal tract illnesses. The occurrence of Lombard’s effect in groups of teachers and lecturers, conducting lectures in rooms, was evidenced. Med Pr 2015;66(4:487–496

  18. [Assessment of vocal intensity in lecturers depending on acoustic properties of lecture rooms].

    Science.gov (United States)

    Mikulski, Witold

    2015-01-01

    Lombard's effect increases the level of vocal intensity in the environment, in which noise occurs. This article presents the results of the author's own study of vocal intensity level and A-weighted sound pressure level of background noise during normal lectures. The aim of the study was to define whether above-mentioned parameters depend on acoustic properties of rooms (classrooms or lecture rooms) and to define how many lectors speak with raised voice. The study was performed in a group of 50 teachers and lecturers in 10 classrooms with cubature of 160-430 m3 and reverberation time of 0.37-1.3 s (group A consisted of 3 rooms which fulfilled, group B consisted of 3 rooms which almost fulfilled and group C consisted of 4 rooms which did not fulfill criteria based on reverberation time (maximum permissible value is 0.6-0.8 s according to PN-B-02151-4:2015). Criteria of raising voice were based on vocal intensity level (maximum value: 65 dB according to EN ISO 9921:2003). The values of above-mentioned parameters were determined from modes of A--weighted sound pressure level distributions during lectures. Great differentiation of vocal intensity level between lectors was found. In classrooms of group A lectors were not using raised voice, in group B--21%, and in group C--60% of lectors were using raised voice. It was observed that acoustic properties of classrooms (defined by reverberation time) exert their effect on lecturer's vocal intensity level (i.e., raising voice), which may contribute to the increased risk of vocal tract illnesses. The occurrence of Lombard's effect in groups of teachers and lecturers, conducting lectures in rooms, was evidenced. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  19. Genetic heterogeneity in uveal melanoma assessed by multiplex ligation-dependent probe amplification.

    Science.gov (United States)

    Dopierala, Justyna; Damato, Bertil E; Lake, Sarah L; Taktak, Azzam F G; Coupland, Sarah E

    2010-10-01

    To determine intratumor genetic heterogeneity in uveal melanoma (UM) by multiplex ligation-dependent probe amplification (MLPA) in formalin-fixed, paraffin-embedded (FFPE) tumor tissues. DNA was extracted from whole tumor sections and from two to nine different areas microdissected from 32 FFPE UMs. Thirty-one loci on chromosomes 1, 3, 6, and 8 were tested with MLPA for copy number changes. The tumor was considered heterogeneous at a locus if (1) the difference in dosage quotients (DQs) of any two areas was 0.2 or more, and (2) the DQs of the areas belonged to different ranges. Comparison of MLPA data obtained from microdissected areas of the UMs showed heterogeneity in 1 to 26 examined loci in 24 (75%) tumors, with only 25% of the tumors being homogeneous. Intratumor heterogeneity of 3p12.2, 6p21.2, and 8q11.23 was most common, occurring in >30% of the UMs. Gains of chromosome 3 were observed in four UMs, with three of these tumors showing the highest degree of heterogeneity. Copy number variation was associated with differences in tumor cell type, but not with differences in tumor pigmentation or reactive inflammation. UMs with genetic heterogeneity across multiple sample sites showed equivocal MLPA results when the whole tumor section was examined. These results suggest that different clones dilute MLPA results. Heterogeneity of chromosomal abnormalities of chromosomes 1, 3, 6, and 8 is present in most UMs. This heterogeneity causes equivocal MLPA results. One random tumor sample may not be representative of the whole tumor and, therefore, may be insufficient for prognostic testing.

  20. Assessment of management-dependent nutrient losses in tropical industrial tree plantations.

    Science.gov (United States)

    Mackensen, Jens; Klinge, Rudolf; Ruhiyat, Daddy; Fölster, Horst

    2003-03-01

    Industrial tree plantations in the tropics usually follow short rotations and intensive site management including slash and burn, and the use of heavy machinery. We attempt to quantify the implied nutrient losses (harvest export, erosion, slash and burn, leaching) in order to give plantation managers a chance to understand the significance of their planning and decisions. We used the scarce globally available information and a case study plantation in East Kalimantan, Indonesia (Acacia mangium and Eucalyptus deglupta). Adaptation involves problems and is discussed in some detail. Results are approximate only. Assuming a harvest volume of 200 m3 ha(-1), we assessed a loss of 427-680 kg ha(-1) N, 12-13 kg ha(-1) P, 178-252 kg ha(-1) Ca, 276-370 kg ha(-1) K, and 45-57 kg ha(-1) Mg per rotation. Of this overall loss, stand harvest accounted for 18-29% (N), 21-30% (P), 56-26% (K), 48-64% (Ca) and 22-37% (Mg). This means that the cumulative loss by erosion, slash and burn, and leaching exceeds that of the harvest. These losses can be influenced by management.

  1. The Frequency of Nonmotor Symptoms among Advanced Parkinson Patients May Depend on Instrument Used for Assessment

    Directory of Open Access Journals (Sweden)

    Nelson Hwynn

    2011-01-01

    Full Text Available Background. Nonmotor symptoms (NMS of Parkinson's disease (PD may be more debilitating than motor symptoms. The purpose of this study was to determine the frequency and corecognition of NMS among our advanced PD cohort (patients considered for deep brain stimulation (DBS and caregivers. Methods. NMS-Questionnaire (NMS-Q, a self-administered screening questionnaire, and NMS Assessment-Scale (NMS-S, a clinician-administered scale, were administered to PD patients and caregivers. Results. We enrolled 33 PD patients (23 males, 10 females and caregivers. The most frequent NMS among patients using NMS-Q were gastrointestinal (87.9%, sleep (84.9%, and urinary (72.7%, while the most frequent symptoms using NMS-S were sleep (90.9%, gastrointestinal (75.8%, and mood (75.8%. Patient/caregiver scoring correlations for NMS-Q and NMS-S were 0.670 (<0.0001 and 0.527 (=0.0016, respectively. Conclusion The frequency of NMS among advanced PD patients and correlation between patients and caregivers varied with the instrument used. The overall correlation between patient and caregiver was greater with NMS-Q than NMS-S.

  2. Prospective assessment of pituitary size and shape on MR imaging after suppressive hormonal therapy in central precocious puberty

    Energy Technology Data Exchange (ETDEWEB)

    Beek, J.T. van; Sharafuddin, M.J.A.; Kao, S.C.S. [Department of Radiology-JPP 3889, University of Iowa Hospitals and Clinics, 200 Hawkins Drive, Iowa City, IA 52246 (United States); Luisiri, A. [Cardinal Glennon Children' s Hospital, St. Louis, Missouri (United States); Garibaldi, L.R. [Children' s Hospital of New Jersey, Newark Beth Israel Medical Center, Newark, New Jersey (United States); St. Barnabas Medical Center, Livingston, New Jersey (United States)

    2000-07-01

    Objective. The diagnostic significance of an enlarged pituitary gland regarding both shape and size parameters on MR imaging has previously been demonstrated in children with central precocious puberty. This study was designed to assess changes in these parameters following successful suppressive therapy of central precocious puberty with the gonadotropin-releasing hormone (GnRH) analogue. Materials and methods. Twelve girls (mean age 7.3 years) with central precocious puberty were prospectively enrolled in our study protocol. Sagittal and coronal MR images of the pituitary region were obtained in all patients before treatment and after at least 6 months of GnRH analogue therapy (mean 18.0 months). Parameters measured included pituitary gland height, length, width, sagittal cross-sectional area, and volume. Results. All patients had excellent clinical response to treatment with arrest of secondary sexual development, normalization of serum estradiol levels, and complete obliteration of the LH response to diagnostic GnRH stimulation. No significant change occurred in any pituitary size or shape parameter following GnRH analogue therapy. Conclusion. Favorable clinical response to GnRH analogue therapy in central precocious puberty is not accompanied by significant a change in pituitary gland size and shape. (orig.)

  3. HIV-Specific Antibody-Dependent Cellular Cytotoxicity (ADCC) - Mediating Antibodies Decline while NK Cell Function Increases during Antiretroviral Therapy (ART)

    DEFF Research Database (Denmark)

    Jensen, Sanne Skov; Fomsgaard, Anders; Borggren, Marie

    2015-01-01

    Understanding alterations in HIV-specific immune responses during antiretroviral therapy (ART), such as antibody-dependent cellular cytotoxicity (ADCC), is important in the development of novel strategies to control HIV-1 infection. This study included 53 HIV-1 positive individuals. We evaluated...... the ability of effector cells and antibodies to mediate ADCC separately and in combination using the ADCC-PanToxiLux assay. The ability of the peripheral blood mononuclear cells (PBMCs) to mediate ADCC was significantly higher in individuals who had been treated with ART before seroconversion, compared...... to the individuals initiating ART at a low CD4+ T cell count (ART-naïve individuals. The frequency of CD16 expressing natural killer (NK) cells correlated with both the duration of ART and Granzyme B (GzB) activity. In contrast, the plasma titer of antibodies mediating ADCC declined...

  4. Micro-computed tomography (CT) based assessment of dental regenerative therapy in the canine mandible model

    Science.gov (United States)

    Khobragade, P.; Jain, A.; Setlur Nagesh, S. V.; Andreana, S.; Dziak, R.; Sunkara, S. K.; Sunkara, S.; Bednarek, D. R.; Rudin, S.; Ionita, C. N.

    2015-03-01

    High-resolution 3D bone-tissue structure measurements may provide information critical to the understanding of the bone regeneration processes and to the bone strength assessment. Tissue engineering studies rely on such nondestructive measurements to monitor bone graft regeneration area. In this study, we measured bone yield, fractal dimension and trabecular thickness through micro-CT slices for different grafts and controls. Eight canines underwent surgery to remove a bone volume (defect) in the canine's jaw at a total of 44 different locations. We kept 11 defects empty for control and filled the remaining ones with three regenerative materials; NanoGen (NG), a FDA-approved material (n=11), a novel NanoCalcium Sulfate (NCS) material (n=11) and NCS alginate (NCS+alg) material (n=11). After a minimum of four and eight weeks, the canines were sacrificed and the jaw samples were extracted. We used a custombuilt micro-CT system to acquire the data volume and developed software to measure the bone yield, fractal dimension and trabecular thickness. The software used a segmentation algorithm based on histograms derived from volumes of interest indicated by the operator. Using bone yield and fractal dimension as indices we are able to differentiate between the control and regenerative material (pregeneration process and quality of bone were dependent upon the position of defect and time period of healing. This study presents one of the first quantitative comparisons using non-destructive Micro-CT analysis for bone regenerative material in a large animal with a critical defect model. Our results indicate that Micro-CT measurement could be used to monitor invivo bone regeneration studies for greater regenerative process understanding.

  5. Assessment of the cardiovascular effects of electroconvulsive therapy in individuals older than 50 years

    Directory of Open Access Journals (Sweden)

    Takada J.Y.

    2005-01-01

    Full Text Available To evaluate the impact of electroconvulsive therapy on arterial blood pressure, heart rate, heart rate variability, and the occurrence of ischemia or arrhythmias, 38 (18 men depressive patients free from systemic diseases, 50 to 83 years old (mean: 64.7 ± 8.6 underwent electroconvulsive therapy. All patients were studied with simultaneous 24-h ambulatory blood pressure and Holter monitoring, starting 18 h before and continuing for 3 h after electroconvulsi