WorldWideScience

Sample records for treatment application strategy

  1. Treatment strategies in mastocytosis

    DEFF Research Database (Denmark)

    Siebenhaar, Frank; Akin, Cem; Bindslev-Jensen, Carsten

    2014-01-01

    Treatment recommendations for mastocytosis are based mostly on expert opinion rather than evidence obtained from controlled clinical trials. In this article, treatment options for mastocytosis are presented, with a focus on the control of mediator-related symptoms in patients with indolent disease....

  2. Treatment strategies for acromegaly

    NARCIS (Netherlands)

    Roelfsema, Ferdinand; Biermasz, Nienke R.; Romijn, Johannes A.; Pereira, Alberto M.

    2005-01-01

    Acromegaly is a chronic debilitating disorder caused by a growth hormone (GH)-producing pituitary adenoma. Active acromegaly is associated with a two- to fourfold increased mortality risk, mainly from cardiovascular disease. Transsphenoidal surgery is considered as the treatment of choice because of

  3. Newer antiatherosclerosis treatment strategies.

    Science.gov (United States)

    Aggarwal, Amitesh; Singh, Safal

    2011-01-01

    Atherosclerosis has been a target of much clinical and molecular research. As a result of this extensive research, it is amply clear that atherogenesis is a multifactorial process involving an interplay of metabolic, immune and inflammatory mechanisms. Antiatherosclerotic strategies are today aiming for a multipronged approach targeting each arm of this multifactorial process. The newer agents under development can be divided into three broad categories: anti-inflammatory agents, modulators of intermediary metabolism and antiatherosclerosis vaccines. Potential targets for anti-inflammatory agents include inhibition of conversion of low-density lipoprotein (LDL) to oxidised LDL, blocking or downregulation of cell adhesion molecules, chemokine modulation and macrophage receptor blockade. Beyond inhibition of plaque formation, efforts are also ongoing to develop agents which stabilise the plaque by increasing its fibrous content and inhibiting its disruption. So far as research in the sphere of intermediary metabolism is concerned, the focus is now primarily on raising high-density lipoprotein and promoting reverse cholesterol transport; potential targets include cholesteryl ester transfer protein, liver X-receptor, lecithin cholesterol acyltransferase and high-density lipoprotein mimetics. Acyl-coenzymeA: cholesterol acyltransferase is another enzyme whose selective and differential inhibition is under active investigation. The concept of immunisation against a non-communicable disease such as atherosclerosis is still in its nascent stages. However, with increasing evidence to suggest the role of antigen-specific T-cell-mediated immunity in atherogenesis, this approach is potentially promising. Possible antigens under evaluation include oxidised LDL and its subparticles, heat-shock proteins and cholesteryl ester transfer protein. With cardiovascular disease being the single leading cause of death worldwide, the development of a safe and successful antiatherosclerosis

  4. Obesity Treatment Strategies

    Directory of Open Access Journals (Sweden)

    Simona Ianosi Edith

    2015-12-01

    Full Text Available Obesity is a disease with severe health consequences and increased risk of mortality. The most commonly used criteria to assess the presence and the severity of obesity are body mass index, waist circumference, waist-to-height ratio and the presence of the health conditions caused or worsened by obesity. Worldwide obesity has more than doubled in the last 4 decades. Obesity is the second of the leading preventable causes of death worldwide (after smoking. Obesity has a plurifactorial pathogenesis. The central perturbation consists in the imbalance between calories intake and calories consumption (by inappropriate diet and sedentary lifestyle. Identification of all the ethiological factors is important for treatment and prophylaxis. Weight loss benefits are multiple and important: improvement in glicemic control and in plasma lipid levels, blood presure control, obstructiv sleep apneea reduction, improvement in management of daily activities and profesional performances, increase quality of life, reduction in mortality. Overweight or obese patient will complete a diagnostic and a treatment program. Treatment of obesity claims a targeted multidimensional therapy: weight and lifestyle management, diet, sustained physical activity in daily life, exercise, decrease life stressors, smoking cessation, drug therapy, bariatric surgery psichological, familial and social suport. Weight loss program must be carefully planned, adapted to the patient’s abilities and comorbidities and supervised by a nutritionist and a physiotherapist.

  5. Treatment strategies for transuranic wastes

    International Nuclear Information System (INIS)

    Schneider, K.J.; Swanson, J.L.; Ross, W.A.; Allen, R.P.; Yasutake, K.M.

    1986-01-01

    This paper presents an analysis of treatment options or strategies for transuranic wastes expected to be generated at a commercial nuclear fuel reprocessing plant. Six potential options were analyzed, ranging from no treatment to maximum volume reduction and high quality waste forms. Economics for the total management of these (treatment, transportation, disposal) indicate life-cycle savings for extensive treatment are as high as $1.7 billion for 70,000 MTU. Evaluations of the waste processing and waste forms support the selection of a number of the extensive waste treatments. It is concluded that there are significant incentives for extensive treatment of transuranic wastes

  6. Treatment strategies for transuranic wastes

    International Nuclear Information System (INIS)

    Schneider, K.J.; Ross, W.A.; Swanson, J.L.; Allen, R.P.; Yasutake, K.M.

    1986-01-01

    This paper presents an analysis of treatment options or strategies for transuranic wastes expected to be generated at a commercial nuclear fuel reprocessing plant. Six potential options were analyzed, ranging from no treatment to maximum volume reduction and high quality waste forms. Economics for the total management of these wastes (treatment, transportation, disposal) indicate life-cycle savings for extensive treatment are as high as $1.7 billion for 70,000 MTU. Evaluations of the waste processing and waste forms support the selection of a number of the extensive waste treatments. It is concluded that there are significant incentives for extensive treatment of transuranic wastes

  7. Treatment Strategies for Chronic Cases

    Directory of Open Access Journals (Sweden)

    Susan M Lord

    2003-01-01

    Full Text Available The treatment of chronic somatic pain, including pain referred to the head, neck, shoulder girdle and upper limb from somatic structures, is addressed. Levels of evidence for the various treatments that have been prescribed for chronic whiplash associated disorders are considered. The challenge to find a treatment strategy for chronic pain after whiplash that completely relieves the condition and prevents its sequelae is reviewed.

  8. Are value of information methods ready for prime time? An application to alternative treatment strategies for NSTEMI patients.

    Science.gov (United States)

    Kent, Seamus; Briggs, Andrew; Eckermann, Simon; Berry, Colin

    2013-10-01

    The use of value of information methods to inform trial design has been widely advocated but there have been few empirical applications of these methods and there is little evidence they are widely used in decision making. This study considers the usefulness of value of information models in the context of a real clinical decision problem relating to alternative diagnostic strategies for patients with a recent non-ST elevated myocardial infarction. A pretrial economic model is constructed to consider the cost-effectiveness of two competing strategies: coronary angiography alone or in conjunction with fractional flow reserve measurement. A closed-form solution to the expected benefits of information is used with optimal sample size estimated for a range of models reflecting increasingly realistic assumptions and alternative decision contexts. Fractional flow reserve measurement is expected to be cost-effective with an incremental cost-effectiveness ratio of GBP 1,621, however, there is considerable uncertainty in this estimate and consequently a large expected value to reducing this uncertainty via a trial. The recommended sample size is strongly affected by the reality of the assumptions of the expected value of information (EVI) model and the decision context. Value of information models can provide a simple and flexible approach to clinical trial design and are more consistent with the constraints and objectives of the healthcare system than traditional frequentist approaches. However, the variation in sample size estimates demonstrates that it is essential that appropriate model parameters and decision contexts are used in their application.

  9. Potential Application of Curcumin and Its Analogues in the Treatment Strategy of Patients with Primary Epithelial Ovarian Cancer

    Science.gov (United States)

    Terlikowska, Katarzyna M.; Witkowska, Anna M.; Zujko, Malgorzata E.; Dobrzycka, Bozena; Terlikowski, Slawomir J.

    2014-01-01

    Recent findings on the molecular basis of ovarian cancer development and progression create new opportunities to develop anticancer medications that would affect specific metabolic pathways and decrease side systemic toxicity of conventional treatment. Among new possibilities for cancer chemoprevention, much attention is paid to curcumin—A broad-spectrum anticancer polyphenolic derivative extracted from the rhizome of Curcuma longa L. According to ClinicalTrials.gov at present there are no running pilot studies, which could assess possible therapeutic benefits from curcumin supplementation to patients with primary epithelial ovarian cancer. Therefore, the goal of this review was to evaluate potential preclinical properties of curcumin and its new analogues on the basis of in vivo and in vitro ovarian cancer studies. Curcumin and its different formulations have been shown to display multifunctional mechanisms of anticancer activity, not only in platinum-resistant primary epithelial ovarian cancer, but also in multidrug resistant cancer cells/xenografts models. Curcumin administered together with platinum-taxane chemotherapeutics have been reported to demonstrate synergistic effects, sensitize resistant cells to drugs, and decrease their biologically effective doses. An accumulating body of evidence suggests that curcumin, due to its long-term safety and an excellent profile of side effects should be considered as a beneficial support in ovarian cancer treatment strategies, especially in patients with platinum-resistant primary epithelial recurrent ovarian cancer or multidrug resistant disease. Although the prospect of curcumin and its formulations as anticancer agents in ovarian cancer treatment strategy appears to be challenging, and at the same time promising, there is a further need to evaluate its effectiveness in clinical studies. PMID:25429431

  10. Treatment Strategies in Childhood Craniopharyngioma

    Directory of Open Access Journals (Sweden)

    Stephanie ePuget

    2012-06-01

    Full Text Available The surgical management of craniopharyngioma in children has been one of the most controversial topics in pediatric neurosurgery. In theory, based on its benign histology total surgical excision could provide a cure. However, the therapeutic goals for pediatric craniopharyngioma are not only the cure of the disease but also the preservation of function. It has been widely established that in some particular cases total excision could leads to inacceptable damages, especially those linked to hypothalamic functions. During the last 15 years, we observed worldwide a growing advocacy for less-invasive pediatric craniopharyngioma resection supported by international consensus conferences. The state-of-the-art in the surgical management of some craniopharyngioma is now turning to multi-modality treatment strategies (combination surgery and radiotherapy aiming to limit morbidiy. Recent literature and our own experience helped to develop risk-adapted treatment strategies at initial diagnosis, respecting hypothalamic structures to provide optimal quality of life for these children. Following new algorithms of treatment, preliminary results with intention to spare the hypothalamus seem to be encouraging but the long-term clinical outcome in terms of post irradiation complications and relapse management is currently unknown.

  11. The application of digital surgical diagnosis and treatment technology: a promising strategy for surgical reconstruction of craniomaxillofacial defect and deformity.

    Science.gov (United States)

    Wang, Li-ya; Du, Hong-ming; Zhang, Gang; Tang, Wei; Liu, Lei; Jing, Wei; Long, Jie

    2011-12-01

    The craniomaxillofacial defect and deformity always leads to serious dysfunction in mastication and facial contour damage, significantly reducing patients' quality of life. However, surgical reconstruction of a craniomaxillofacial hard tissue defect or deformity is extremely complex and often does not result in desired facial morphology. Improving the result for patients with craniomaxillofacial defect and deformity remains a challenge for surgeons. Using digital technology for surgical diagnosis and treatment may help solve this problem. Computer-assisted surgical technology and surgical navigation technology are included in the accurate digital diagnosis and treatment system we propose. These technologies will increase the accuracy of the design of the operation plan. In addition, the intraoperative real-time navigating location system controlling the robotic arm or advanced intelligent robot will provide accurate, individualized surgical treatment for patients. Here we propose the hypothesis that a digital surgical diagnosis and treatment technology may provide a new approach for precise surgical reconstruction of complicated craniomaxillofacial defect and deformity. Our hypothesis involves modern digital surgery, a three-dimensional navigation surgery system and modern digital imaging technology, and our key aim is to establish a technological platform for customized digital surgical design and surgical navigation for craniomaxillofacial defect and deformity. If the hypothesis is proven practical, this novel therapeutic approach could improve the result of surgical reconstruction for craniomaxillofacial defect and deformity for many patients. Copyright © 2011 Elsevier Ltd. All rights reserved.

  12. Moving beyond the treatment package approach to developing behavioral interventions: addressing questions that arose during an application of the Multiphase Optimization Strategy (MOST).

    Science.gov (United States)

    Wyrick, David L; Rulison, Kelly L; Fearnow-Kenney, Melodie; Milroy, Jeffrey J; Collins, Linda M

    2014-09-01

    Given current pressures to increase the public health contributions of behavioral interventions, intervention scientists may wish to consider moving beyond the classical treatment package approach that focuses primarily on achieving statistical significance. They may wish also to focus on goals directly related to optimizing public health impact. The Multiphase Optimization Strategy (MOST) is an innovative methodological framework that draws on engineering principles to achieve more potent behavioral interventions. MOST is increasingly being adopted by intervention scientists seeking a systematic framework to engineer an optimized intervention. As with any innovation, there are challenges that arise with early adoption. This article describes the solutions to several critical questions that we addressed during the first-ever iterative application of MOST. Specifically, we describe how we have applied MOST to optimize an online program (myPlaybook) for the prevention of substance use among college student-athletes. Our application of MOST can serve as a blueprint for other intervention scientists who wish to design optimized behavioral interventions. We believe using MOST is feasible and has the potential to dramatically improve program effectiveness thereby advancing the public health impact of behavioral interventions.

  13. Application of a drug-induced apoptosis assay to identify treatment strategies in recurrent or metastatic breast cancer.

    Directory of Open Access Journals (Sweden)

    Linda Bosserman

    Full Text Available A drug-induced apoptosis assay has been developed to determine which chemotherapy drugs or regimens can produce higher cell killing in vitro. This study was done to determine if this assay could be performed in patients with recurrent or metastatic breast cancer patients, to characterize the patterns of drug-induced apoptosis, and to evaluate the clinical utility of the assay. A secondary goal was to correlate assay use with clinical outcomes.In a prospective, non-blinded, multi institutional controlled trial, 30 evaluable patients with recurrent or metastatic breast cancer who were treated with chemotherapy had tumor samples submitted for the MiCK drug-induced apoptosis assay. After receiving results within 72 hours after biopsy, physicians could use the test to determine therapy (users, or elect to not use the test (non-users.The assay was able to characterize drug-induced apoptosis in tumor specimens from breast cancer patients and identified which drugs or combinations gave highest levels of apoptosis. Patterns of drug activity were also analyzed in triple negative breast cancer. Different drugs from a single class of agents often produced significantly different amounts of apoptosis. Physician frequently (73% used the assay to help select chemotherapy treatments in patients, Patients whose physicians were users had a higher response (CR+PR rate compared to non-users (38.1% vs 0%, p = 0.04 and a higher disease control (CR+PR+Stable rate (81% vs 25%, p<0.01. Time to relapse was longer in users 7.4 mo compared to non-users 2.2 mo (p<0.01.The MiCK assay can be performed in breast cancer specimens, and results are often used by physicians in breast cancer patients with recurrent or metastatic disease. These results from a good laboratory phase II study can be the basis for a future larger prospective multicenter study to more definitively establish the value of the assay.Clinicaltrials.gov NCT00901264.

  14. Estimation of dynamic treatment strategies for maintenance therapy of children with acute lymphoblastic leukaemia: an application of history-adjusted marginal structural models

    DEFF Research Database (Denmark)

    Rosthøj, Susanne; Keiding, Niels; Schmiegelow, Kjeld

    2012-01-01

    Childhood acute lymphoblastic leukaemia is treated with long-term intensive chemotherapy. During the latter part of the treatment, the maintenance therapy, the patients receive oral doses of two cytostatics. The doses are tailored to blood counts measured on a weekly basis, and the treatment is t...... of the methods in relation to the formulation of alternative dosing strategies for the maintenance therapy....

  15. [Oligometastasized colorectal cancer-modern treatment strategies].

    Science.gov (United States)

    Binnebösel, M; Lambertz, A; Dejong, K; Neumann, U P

    2018-06-05

    The prognosis of colorectal cancer in UICC stage IV has been improved in the last decades by improvements in interdisciplinary treatment. Treatment strategies for oligometastasized colorectal cancer are developing more and more into an individualized treatment. An overview of the current literature of modern treatment concepts in oligometastasized colorectal cancer UICC stage IV is given. Surgery still has the supreme mandate in resectable colorectal liver metastases, as neoadjuvant and adjuvant treatment strategies to not provide any benefits for these patients. In marginal or non-resectable stages systemic treatment is superior in these patients depending on the prognostic parameters. Also in curative settings local treatment options should be considered as a reasonable additive tool. An interesting treatment approach for isolated liver metastases and non-resectable colorectal cancer is liver transplantation. Irrespective of new developments in treatment strategies for metastasized colorectal cancer, resection of colorectal liver metastases remains the gold standard whenever possible.

  16. Multibeam radiation therapy treatment application

    International Nuclear Information System (INIS)

    Manens, J.P.; Le Gall, G.; Chenal, C.; Ben Hassel, M.; Fresne, F.; Barillot, C.; Gibaud, B.; Lemoine, D.; Bouliou, A.; Scarabin, J.M.

    1991-01-01

    A software package has been developed for multibeam radiation therapy treatment application. We present in this study a computer-assisted dosimetric planning procedure which includes: i), an analytical stage for setting up the large volume via 2D and 3D displays; ii), a planning stage for issue of a treatment strategy including dosimetric simulations; and iii), a treatment stage to drive the target volume to the radiation unit isocenter. The combined use of stereotactic methods and multimodality imagery ensures spatial coherence and makes target definition and cognition of structure environment more accurate. The dosimetric planning suited to the spatial reference (the stereotactic frame) guarantees optimal distribution of the dose, computed by the original 3D volumetric algorithm. A computer-driven chair-framework cluster was designed to position the target volume at the radiation unit isocenter [fr

  17. Diabetes Prevention and Treatment Strategies

    OpenAIRE

    Backholer, Kathryn; Peeters, Anna; Herman, William H.; Shaw, Jonathan E.; Liew, Danny; Ademi, Zanfina; Magliano, Dianna J.

    2013-01-01

    OBJECTIVE Effective interventions to prevent, delay, or remit diabetes are currently available. However, their impact on the prevalence of diabetes at the population level is unknown. This study aimed to estimate the impact of a range of diabetes interventions on the population prevalence of diabetes for Australian adults between 2010 and 2025. RESEARCH DESIGN AND METHODS We used the Australian Diabetes Projection Model to estimate the impact of a population-wide strategy, high-risk preventio...

  18. Strategies of temozolomide in future glioblastoma treatment

    Directory of Open Access Journals (Sweden)

    Lee CY

    2017-01-01

    Full Text Available Chooi Yeng Lee School of Pharmacy, Monash University Malaysia, Selangor, Malaysia Abstract: Glioblastoma multiforme (GBM may be one of the most challenging brain tumors to treat, as patients generally do not live more than 2 years. This review aimed to give a timely review of potential future treatments for GBM by looking at the latest strategies, involving mainly the use of temozolomide (TMZ. Although these studies were carried out either in vitro or in rodents, the findings collectively suggested that we are moving toward developing a more efficacious therapy for GBM patients. Nanoparticles preparation was, by far, the most extensively studied strategy for targeted brain delivery. Therefore, the first section of this review presents a treatment strategy using TMZ-loaded nanocarriers, which encompassed nanoparticles, nanoliposomes, and nanosponges. Besides nanocarriers, new complexes that were formed between TMZ and another chemical agent or molecule have shown increased cytotoxicity and antitumor activity. Another approach was by reducing GBM cell resistance to TMZ, and this was achieved either through the suppression of metabolic change occurring in the cells, inhibition of the DNA repair protein, or up-regulation of the protein that mediates autophagy. Finally, the review collates a list of substances that have demonstrated the ability to suppress tumor cell growth. Keywords: cellular resistance, glioblastoma multiforme, nanoparticles, targeted delivery, temozolomide

  19. Closed Fuel Cycle Waste Treatment Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Vienna, J. D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Collins, E. D. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Crum, J. V. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Ebert, W. L. [Argonne National Lab. (ANL), Argonne, IL (United States); Frank, S. M. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Garn, T. G. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Gombert, D. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Jones, R. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Jubin, R. T. [Oak Ridge National Lab. (ORNL), Oak Ridge, TN (United States); Maio, V. C. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Marra, J. C. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL); Matyas, J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Nenoff, T. M. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Riley, B. J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Sevigny, G. J. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Soelberg, N. R. [Idaho National Lab. (INL), Idaho Falls, ID (United States); Strachan, D. M. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Thallapally, P. K. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States); Westsik, J. H. [Pacific Northwest National Lab. (PNNL), Richland, WA (United States)

    2015-02-01

    This study is aimed at evaluating the existing waste management approaches for nuclear fuel cycle facilities in comparison to the objectives of implementing an advanced fuel cycle in the U.S. under current legal, regulatory, and logistical constructs. The study begins with the Global Nuclear Energy Partnership (GNEP) Integrated Waste Management Strategy (IWMS) (Gombert et al. 2008) as a general strategy and associated Waste Treatment Baseline Study (WTBS) (Gombert et al. 2007). The tenets of the IWMS are equally valid to the current waste management study. However, the flowsheet details have changed significantly from those considered under GNEP. In addition, significant additional waste management technology development has occurred since the GNEP waste management studies were performed. This study updates the information found in the WTBS, summarizes the results of more recent technology development efforts, and describes waste management approaches as they apply to a representative full recycle reprocessing flowsheet. Many of the waste management technologies discussed also apply to other potential flowsheets that involve reprocessing. These applications are occasionally discussed where the data are more readily available. The report summarizes the waste arising from aqueous reprocessing of a typical light-water reactor (LWR) fuel to separate actinides for use in fabricating metal sodium fast reactor (SFR) fuel and from electrochemical reprocessing of the metal SFR fuel to separate actinides for recycle back into the SFR in the form of metal fuel. The primary streams considered and the recommended waste forms include; Tritium in low-water cement in high integrity containers (HICs); Iodine-129: As a reference case, a glass composite material (GCM) formed by the encapsulation of the silver Mordenite (AgZ) getter material in a low-temperature glass is assumed. A number of alternatives with distinct advantages are also considered including a fused silica waste form

  20. Sustainable strategies for treatment of bacterial infections

    DEFF Research Database (Denmark)

    Molin, Søren

    2014-01-01

    Resistance to antibiotics and the consequential failures of treatment based on antibiotics makes microbial infections a major threat to human health. This problem combined with rapidly increasing life-style disease problems challenge our healtcare system as well as the pharma industry, and if we do...... not in a foreseeable future develop novel approaches and strategies to combat bacterial infections, many people will be at risk of dying from even trivial infections for which we until recently had highly effective antibiotics. We have for a number of years investigated chronic bacterial lung infections in patients...... suffering from cystic fibrosis. These infections are optimal model scenarios for studies of antibiotic resistance development and microbial adaptation, and we suggest that this information should be useful when designing new anti-microbial strategies. In this respect it will be important to choose...

  1. Amblyopia treatment strategies and new drug therapies.

    Science.gov (United States)

    Pescosolido, Nicola; Stefanucci, Alessio; Buomprisco, Giuseppe; Fazio, Stefano

    2014-01-01

    Amblyopia is a unilateral or bilateral reduction of visual acuity secondary to abnormal visual experience during early childhood. It is one of the most common causes of vision loss and monocular blindness and is commonly associated with strabismus, anisometropia, and visual deprivation (in particular congenital cataract and ptosis). It is clinically defined as a two-line difference of best-corrected visual acuity between the eyes. The purpose of this study was to understand the neural mechanisms of amblyopia and summarize the current therapeutic strategies. In particular, the authors focused on the concept of brain plasticity and its implication for new treatment strategies for children and adults with amblyopia. Copyright 2014, SLACK Incorporated.

  2. [Treatment strategy and planning for pilon fractures].

    Science.gov (United States)

    Mittlmeier, Thomas; Wichelhaus, Alice

    2017-08-01

    Pilon fractures are mainly severe and prognostically serious injuries with a high rate of relevant soft tissue involvement. The adequate decision making and choice of treatment in the early phase of trauma are of paramount importance for the final outcome. This essentially encompasses the management of the soft tissue damage, the surgical planning and the differentiated selection of procedures. Most concepts of staged treatment nowadays offer a wide range of options which are integrated into expert-based algorithms. The aim of the present analysis was to display the strategy variations for the treatment of pilon fractures taking into account the advantages and disadvantages of the corresponding treatment concepts. A staged procedure including primary closed reduction employing ligamentotaxis and fixation of the joints of the hindfoot via tibiocalcaneal metatarsal fixation offers a safe basis for consecutive imaging and the selection of specific approaches for definitive reconstruction. A simultaneous reconstruction and fixation of the fibula during the primary intervention are generally not recommended in order to avoid any limitations for subsequent reconstructive procedures. A time frame for definitive reconstruction covers a period of up to 3 weeks after trauma and allows a detailed planning considering the individual dynamics of the soft tissue situation and any logistic requirements. For the choice of the definitive treatment concept a wide range of procedures and implants are available. There are also valid concepts for primary treatment of defined fracture constellations while primary arthrodesis represents a solution in cases of major destruction of the joint surface. Knowledge of the multiple procedural variations for pilon fracture treatment creates the basis to optimize the treatment modalities and to take into account individual parameters of the fracture.

  3. Communication strategies to improve HIV treatment adherence.

    Science.gov (United States)

    Rochon, Donna; Ross, Michael W; Looney, Carol; Nepal, Vishnu P; Price, Andrea J; Giordano, Thomas P

    2011-01-01

    Although antiretroviral therapy has increased the survival of HIV-positive patients, traditional approaches to improving medication adherence have failed consistently. Acknowledging the role of communication in health behavior, we conducted a qualitative study to learn about patients' HIV treatment adherence experiences and to identify which communication strategies might influence adherence. Findings indicate that five constructs--cultural beliefs/language, stigma, cues to action, self-efficacy, and mood state--are potentially modifiable by improved communication. Results will be used to create a direct marketing campaign targeted to HIV-infected patients. Copyright © Taylor & Francis Group, LLC

  4. Effective treatment strategies against Ebola virus

    Directory of Open Access Journals (Sweden)

    Amina Yaqoob

    2015-08-01

    Full Text Available Ebola virus (EBOV, a member of order Mononegavirales is most famous for causing the endemics of hemorrhagic fever in different countries of the world. Various effective treatment for EBOV are available presently but different clinical trials and experimental studies on animal models are ongoing for this purpose. Results from different studies showed that selective vaccines and therapeutic drugs have potential to interfere the viral life events within host cell in order to inhibit its replication. Various pre-clinical trials in this regard are proved successful on non-human primates (NHPs and found to be significant in inhibiting EBOV infections. It is the need of hour to develop effective vaccines against Ebola virus to combat this problem as soon as possible. The present article is a brief review on potential treatment strategies against Ebola virus.

  5. Nanobodies: Chemical Functionalization Strategies and Intracellular Applications

    Science.gov (United States)

    Schumacher, Dominik; Helma, Jonas; Schneider, Anselm F. L.; Leonhardt, Heinrich

    2018-01-01

    Abstract Nanobodies can be seen as next‐generation tools for the recognition and modulation of antigens that are inaccessible to conventional antibodies. Due to their compact structure and high stability, nanobodies see frequent usage in basic research, and their chemical functionalization opens the way towards promising diagnostic and therapeutic applications. In this Review, central aspects of nanobody functionalization are presented, together with selected applications. While early conjugation strategies relied on the random modification of natural amino acids, more recent studies have focused on the site‐specific attachment of functional moieties. Such techniques include chemoenzymatic approaches, expressed protein ligation, and amber suppression in combination with bioorthogonal modification strategies. Recent applications range from sophisticated imaging and mass spectrometry to the delivery of nanobodies into living cells for the visualization and manipulation of intracellular antigens. PMID:28913971

  6. Nanobodies: Chemical Functionalization Strategies and Intracellular Applications.

    Science.gov (United States)

    Schumacher, Dominik; Helma, Jonas; Schneider, Anselm F L; Leonhardt, Heinrich; Hackenberger, Christian P R

    2018-02-23

    Nanobodies can be seen as next-generation tools for the recognition and modulation of antigens that are inaccessible to conventional antibodies. Due to their compact structure and high stability, nanobodies see frequent usage in basic research, and their chemical functionalization opens the way towards promising diagnostic and therapeutic applications. In this Review, central aspects of nanobody functionalization are presented, together with selected applications. While early conjugation strategies relied on the random modification of natural amino acids, more recent studies have focused on the site-specific attachment of functional moieties. Such techniques include chemoenzymatic approaches, expressed protein ligation, and amber suppression in combination with bioorthogonal modification strategies. Recent applications range from sophisticated imaging and mass spectrometry to the delivery of nanobodies into living cells for the visualization and manipulation of intracellular antigens. © 2017 The Authors. Published by Wiley-VCH Verlag GmbH & Co. KGaA.

  7. Optimization strategies for complex engineering applications

    Energy Technology Data Exchange (ETDEWEB)

    Eldred, M.S.

    1998-02-01

    LDRD research activities have focused on increasing the robustness and efficiency of optimization studies for computationally complex engineering problems. Engineering applications can be characterized by extreme computational expense, lack of gradient information, discrete parameters, non-converging simulations, and nonsmooth, multimodal, and discontinuous response variations. Guided by these challenges, the LDRD research activities have developed application-specific techniques, fundamental optimization algorithms, multilevel hybrid and sequential approximate optimization strategies, parallel processing approaches, and automatic differentiation and adjoint augmentation methods. This report surveys these activities and summarizes the key findings and recommendations.

  8. Chemical application strategies to protect water quality.

    Science.gov (United States)

    Rice, Pamela J; Horgan, Brian P; Barber, Brian L; Koskinen, William C

    2018-07-30

    Management of turfgrass on golf courses and athletic fields often involves application of plant protection products to maintain or enhance turfgrass health and performance. However, the transport of fertilizer and pesticides with runoff to adjacent surface waters can enhance algal blooms, promote eutrophication and may have negative impacts on sensitive aquatic organisms and ecosystems. Thus, we evaluated the effectiveness of chemical application setbacks to reduce the off-site transport of chemicals with storm runoff. Experiments with water soluble tracer compounds confirmed an increase in application setback distance resulted in a significant increase in the volume of runoff measured before first off-site chemical detection, as well as a significant reduction in the total percentage of applied chemical transported with the storm runoff. For example, implementation of a 6.1 m application setback reduced the total percentage of an applied water soluble tracer by 43%, from 18.5% of applied to 10.5% of applied. Evaluation of chemographs revealed the efficacy of application setbacks could be observed with storms resulting in lesser (e.g. 100 L) and greater (e.g. > 300 L) quantities of runoff. Application setbacks offer turfgrass managers a mitigation approach that requires no additional resources or time inputs and may serve as an alternative practice when buffers are less appropriate for land management objectives or site conditions. Characterizing potential contamination of surface waters and developing strategies to safeguard water quality will help protect the environment and improve water resource security. This information is useful to grounds superintendents for designing chemical application strategies to maximize environmental stewardship. The data will also be useful to scientists and regulators working with chemical transport and risk models. Copyright © 2018. Published by Elsevier Inc.

  9. Treatment strategy for ruptured abdominal aortic aneurysms.

    Science.gov (United States)

    Davidovic, L

    2014-07-01

    Rupture is the most serious and lethal complication of the abdominal aortic aneurysm. Despite all improvements during the past 50 years, ruptured abdominal aortic aneurysms are still associated with very high mortality. Namely, including patients who die before reaching the hospital, the mortality rate due to abdominal aortic aneurysm rupture is 90%. On the other hand, during the last twenty years, the number of abdominal aortic aneurysms significantly increased. One of the reasons is the fact that in majority of countries the general population is older nowadays. Due to this, the number of degenerative AAA is increasing. This is also the case for patients with abdominal aortic aneurysm rupture. Age must not be the reason of a treatment refusal. Optimal therapeutic option ought to be found. The following article is based on literature analysis including current guidelines but also on my Clinics significant experience. Furthermore, this article show cases options for vascular medicine in undeveloped countries that can not apply endovascular procedures at a sufficient level and to a sufficient extent. At this moment the following is evident. Thirty-day-mortality after repair of ruptured abdominal aortic aneurysms is significantly lower in high-volume hospitals. Due to different reasons all ruptured abdominal aortic aneurysms are not suitable for EVAR. Open repair of ruptured abdominal aortic aneurysm should be performed by experienced open vascular surgeons. This could also be said for the treatment of endovascular complications that require open surgical conversion. There is no ideal procedure for the treatment of AAA. Each has its own advantages and disadvantages, its own limits and complications, as well as indications and contraindications. Future reductions in mortality of ruptured abdominal aortic aneurysms will depend on implementation of population-based screening; on strategies to prevent postoperative organ injury and also on new medical technology

  10. Design strategies for irregularly adapting parallel applications

    International Nuclear Information System (INIS)

    Oliker, Leonid; Biswas, Rupak; Shan, Hongzhang; Sing, Jaswinder Pal

    2000-01-01

    Achieving scalable performance for dynamic irregular applications is eminently challenging. Traditional message-passing approaches have been making steady progress towards this goal; however, they suffer from complex implementation requirements. The use of a global address space greatly simplifies the programming task, but can degrade the performance of dynamically adapting computations. In this work, we examine two major classes of adaptive applications, under five competing programming methodologies and four leading parallel architectures. Results indicate that it is possible to achieve message-passing performance using shared-memory programming techniques by carefully following the same high level strategies. Adaptive applications have computational work loads and communication patterns which change unpredictably at runtime, requiring dynamic load balancing to achieve scalable performance on parallel machines. Efficient parallel implementations of such adaptive applications are therefore a challenging task. This work examines the implementation of two typical adaptive applications, Dynamic Remeshing and N-Body, across various programming paradigms and architectural platforms. We compare several critical factors of the parallel code development, including performance, programmability, scalability, algorithmic development, and portability

  11. A new strategy for improvement of the corrosion resistance of a green cerium conversion coating through thermal treatment procedure before and after application of epoxy coating

    Energy Technology Data Exchange (ETDEWEB)

    Mahidashti, Z. [Department of Materials Engineering, Faculty of Engineering, Tarbiat Modares University, P.O. Box: 14115-143, Tehran (Iran, Islamic Republic of); Shahrabi, T., E-mail: tshahrabi34@modares.ac.ir [Department of Materials Engineering, Faculty of Engineering, Tarbiat Modares University, P.O. Box: 14115-143, Tehran (Iran, Islamic Republic of); Ramezanzadeh, B., E-mail: ramezanzadeh-bh@icrc.ac.ir [Department of Surface Coatings and Corrosion, Institute for Color Science and Technology (ICST), P.O. 16765-654, Tehran (Iran, Islamic Republic of)

    2016-12-30

    Highlights: • The Ce conversion coating was post-heated at various conditions. • The corrosion resistance of post-heated Ce films was evaluated. • A crack free and denser Ce film were obtained after post-heating. • The corrosion resistance of Ce film noticeably increased. • Post-heated Ce film resulted better protection performance of epoxy coating. - Abstract: The effect of post-heating of CeCC on its surface morphology and chemistry has been studied by scanning electron microscopy (SEM), energy dispersive spectroscopy (EDS) and contact angle (CA) measurements. The corrosion protection performance of the coatings was investigated by electrochemical impedance spectroscopy (EIS). The effect of thermal treatment of CeCC on the corrosion protection performance of epoxy coating was investigated by EIS. Results showed that the heat treatment of Ce film noticeably improved its corrosion resistance and adhesion properties compared to that of untreated samples. The CeCC deposited on the steel substrate at room temperature had a highly cracked structure, while the amount of micro-cracks significantly reduced after post-heating procedure. Results obtained from EIS analysis confirmed the effect of post-heating of CeCC on its corrosion protection performance enhancement. The increase of post-heating temperature and time up to 140 °C and 3 h led to better results.

  12. Present and New Treatment Strategies in the Management of Glaucoma

    DEFF Research Database (Denmark)

    Kolko, Miriam

    2015-01-01

    risk factor for progression of the disease. However, it is clear that a significant number of glaucoma patients show disease progression despite of pressure lowering treatments. Much attention has been given to the development of neuroprotective treatment strategies, but the identification of such has...... of RGCs. In this matter, recent approaches aim to rescue RGCs and regenerate axons in order to restore visual function in glaucoma. The present review seeks to provide an overview of the present and new treatment strategies in the management of glaucoma. The treatment strategies are divided into current...

  13. Osteoarthritis: detection, pathophysiology, and current/future treatment strategies.

    Science.gov (United States)

    Sovani, Sujata; Grogan, Shawn P

    2013-01-01

    Osteoarthritis (OA) is a disease of the joint, and age is the major risk factor for its development. Clinical manifestation of OA includes joint pain, stiffness, and loss of mobility. Currently, no pharmacological treatments are available to treat this specific joint disease; only symptom-modifying drugs are available. Improvement in imaging technology, identification of biomarkers, and increased understanding of the molecular basis of OA will aid in detecting the early stages of disease. Yet the development of interventional strategies remains elusive and will be critical for effective prevention of OA-associated joint destruction. The potential of cell-based therapies may be applicable in improving joint function in mild to more advanced cases of OA. Ongoing studies to understand the basis of this disease will eventually lead to prevention and treatment strategies and will also be a key in reducing the social and economic burden of this disease. Nurses are advised to provide an integrative approach of disease assessment and management in OA patients' care with a focus on education and implementation. Knowledge and understanding of OA and how this affects the individual patient form the basis for such an integrative approach to all-round patient care and disease management.

  14. Application of Metacognitive Strategy to Primary Listening Teaching

    Science.gov (United States)

    Zheng, Jie

    2017-12-01

    It is of vital importance that our students should be taught to listen effectively and critically. This essay focuses the metacognitive strategy in listening and an empirical study of the application of metacognitive strategy to primary listening teaching is made.

  15. New treatment strategies for hidradenitis suppurativa

    DEFF Research Database (Denmark)

    Andersen, R.; Jemec, G. B.E.

    2016-01-01

    and pathogenesis are only partially understood at present. Recent research has, however, identified possible targets for specific intervention using biologicals. In addition, classical clinically driven developments of new treatments continue to evolve, leading to several interesting new therapies for HS patients...... included. A total of 365 papers were identified, 79 of which were retained for analysis following exclusions. The following treatments are discussed in detail: infliximab, adalimumab, ustekinumab, anakinra, alitretinoin, metformin and Vitamin D. HS is a disease with a considerable morbidity and a great...

  16. Treatment strategies for tics in Tourette syndrome

    Science.gov (United States)

    Eddy, Clare M.; Rickards, Hugh E.; Cavanna, Andrea E.

    2011-01-01

    Tourette syndrome (TS) is a chronic neurodevelopmental disorder characterized by tics: repetitive, involuntary movements and vocalizations. These symptoms can have a significant impact on patients’ daily functioning across many domains. Tics tend to be most severe in child and adolescent sufferers, so their presence has the potential to impact a period of life that is both critical for learning and is often associated with the experience of greater social tension and self-consciousness than adulthood. Furthermore, control over tics that lead to physical impairment or self-injurious behaviour is of vital importance in maintaining health and quality of life. There are numerous complicating factors in the prescription of treatment for tics, due to both the side effects associated with alleviating agents and patient characteristics, such as age and comorbid conditions. This review summarizes literature pertaining to the efficacy and safety of both traditionally prescribed and more modern medications. We also discuss the merits of behavioural and surgical techniques and highlight newer emerging treatments. Although treatment response is to some extent variable, there are a number of agents that are clearly useful as first-line treatments for TS. Other interventions may be of most benefit to patients exhibiting refractory tics or more specific symptom profiles. PMID:21339906

  17. Therapeutic strategies in the treatment of periodontitis

    Directory of Open Access Journals (Sweden)

    Liljana Bogdanovska

    2012-04-01

    Full Text Available Periodontitis is a chronic inflammatory process which affects the tooth - supporting structures of the teeth. The disease is initiated by subgingival periopathogenic bacteria in susceptible periodontal sites. The host immune response towards periodontal pathogens helps to sustain periodontal disease and eventual alveolar bone loss. Although scaling and root planing is the standard treatment modality for periodontitis, it suffers from several drawbacks such as the inability to reach the base of deep pockets and doesn’t arrest migration of periodontal pathogens from other sites in the oral cavity. In order to overcome the limitations of scaling and root planning, adjunctive chemotherapeutics and host modulatory agents to the treatment are used. These therapeutic agents show substantial beneficial effects when compared to scaling and root planning alone. This review will cover an update on chemotherapeutic and past and future host immune modulatory agents used adjunctively to treat and manage periodontal diseases.

  18. SECONDARY WASTE MANAGEMENT STRATEGY FOR EARLY LOW ACTIVITY WASTE TREATMENT

    Energy Technology Data Exchange (ETDEWEB)

    TW, CRAWFORD

    2008-07-17

    This study evaluates parameters relevant to River Protection Project secondary waste streams generated during Early Low Activity Waste operations and recommends a strategy for secondary waste management that considers groundwater impact, cost, and programmatic risk. The recommended strategy for managing River Protection Project secondary waste is focused on improvements in the Effiuent Treatment Facility. Baseline plans to build a Solidification Treatment Unit adjacent to Effluent Treatment Facility should be enhanced to improve solid waste performance and mitigate corrosion of tanks and piping supporting the Effiuent Treatment Facility evaporator. This approach provides a life-cycle benefit to solid waste performance and reduction of groundwater contaminants.

  19. HDT mixtures treatment strategies by gas chromatography

    Energy Technology Data Exchange (ETDEWEB)

    Laquerbe, C.; Contreras, S.; Demoment, J. [Commissariat a l' Energie Atomique - CEA/Valduc, F-21121 Is sur Tille (France)

    2008-07-15

    Gas phase chromatographic processes are of interest for the separation of hydrogen isotopes from an HDT mixture. For a certain quantity, they are very competitive and present several benefits. Nevertheless no active packing material allows to have simultaneously good enrichment performances for tritium production and high decontamination capabilities for HD gases. The influence of the packing material is first described in this article. Then two specific processes (TCAP and Reverse Chromatography), each well adapted to perform one target, are presented. Finally, the problematic to propose an optimized treatment scheme associating these two processes is formulated. (authors)

  20. HDT mixtures treatment strategies by gas chromatography

    International Nuclear Information System (INIS)

    Laquerbe, C.; Contreras, S.; Demoment, J.

    2008-01-01

    Gas phase chromatographic processes are of interest for the separation of hydrogen isotopes from an HDT mixture. For a certain quantity, they are very competitive and present several benefits. Nevertheless no active packing material allows to have simultaneously good enrichment performances for tritium production and high decontamination capabilities for HD gases. The influence of the packing material is first described in this article. Then two specific processes (TCAP and Reverse Chromatography), each well adapted to perform one target, are presented. Finally, the problematic to propose an optimized treatment scheme associating these two processes is formulated. (authors)

  1. Nanotechnology-based water treatment strategies.

    Science.gov (United States)

    Kumar, Sandeep; Ahlawat, Wandit; Bhanjana, Gaurav; Heydarifard, Solmaz; Nazhad, Mousa M; Dilbaghi, Neeraj

    2014-02-01

    The most important component for living beings on the earth is access to clean and safe drinking water. Globally, water scarcity is pervasive even in water-rich areas as immense pressure has been created by the burgeoning human population, industrialization, civilization, environmental changes and agricultural activities. The problem of access to safe water is inevitable and requires tremendous research to devise new, cheaper technologies for purification of water, while taking into account energy requirements and environmental impact. This review highlights nanotechnology-based water treatment technologies being developed and used to improve desalination of sea and brackish water, safe reuse of wastewater, disinfection and decontamination of water, i.e., biosorption and nanoadsorption for contaminant removal, nanophotocatalysis for chemical degradation of contaminants, nanosensors for contaminant detection, different membrane technologies including reverse osmosis, nanofiltration, ultrafiltration, electro-dialysis etc. This review also deals with the fate and transport of engineered nanomaterials in water and wastewater treatment systems along with the risks associated with nanomaterials.

  2. Management strategy 3: fixed rate fertilizer applications

    Science.gov (United States)

    Previous chapters outlined management strategies for pond fertilization that take into account specific individual pond nutrient needs. Those methods would most likely be more ecologically efficient than a pre-determined fixed-rate nutrient addition strategy. However, the vast majority of available ...

  3. Supporting Knowledge Mobilization and Research Impact Strategies in Grant Applications

    Science.gov (United States)

    Phipps, David; Jensen, Krista E.; Johnny, Michael; Poetz, Anneliese

    2016-01-01

    Each application to the National Science Foundation (NSF) must contain a Broader Impact (BI) strategy. Similarly, grant applications for most research funders in Canada and the UK require strategies to support the translation of research into impacts on society; however, the guidance provided to researchers is too general to inform the specific…

  4. Immunotherapeutic Strategies for Alzheimer's Disease Treatment

    Directory of Open Access Journals (Sweden)

    Beka Solomon

    2009-01-01

    Full Text Available Naturally occurring antibodies against amyloid-β peptides have been found in human cerebrospinal fluid and in the plasma of healthy individuals, but were significantly lower in Alzheimer's disease (AD patients, suggesting that AD may be an immunodeficient disorder. The performance of anti-amyloid-β antibodies in transgenic mice models of AD showed that they are delivered to the central nervous system, preventing and dissolving amyloid-β plaques. Moreover, these antibodies protected the mice from learning and age-related memory deficits. Active and/or passive immunization against the amyloid-β peptide has been proposed as a method for preventing and/or treating AD. Immunotherapy represents fascinating ways to test the amyloid hypothesis and offers genuine opportunities for AD treatment, but requires careful antigen and antibody selection to maximize efficacy and minimize adverse events.

  5. Invasive strategy for treatment of myocardial infarction.

    Science.gov (United States)

    Höfling, B; von Pölnitz, A

    1990-01-01

    The classical approach to the treatment of acute myocardial infarction (MI) has been one of stabilization and complication management. In an effort to optimize treatment, the initiation of the cardiac care unit and the use of antiarrhythmic therapy have succeeded in lowering the mortality rate substantially. More modern concepts are aimed at limiting infarct size and preserving myocardial function. These aims can be achieved medically using intravenous (i.v.) thrombolysis or invasively either with intracoronary (i.c.) thrombolysis, percutaneous transluminal coronary angioplasty (PTCA), or bypass surgery. Although i.c. thrombolysis is more effective than the i.v. route, the necessity for acute coronary catheterization makes it incompatible and difficult for routine use, and thus is usually reserved for cases in which i.v. lysis has failed. Intravenous thrombolysis is becoming the standard approach to MI, and the remaining questions are those of which drug and dosage are optimal and how to approach the patient after thrombolysis. In this regard, we favor a symptom-guided approach, as shown by the TIMI-IIA and European cooperative studies. In patients with ongoing ischemia postlysis, heart catheterization is indicated and a decision regarding PTCA or surgery is then made, depending on anatomy. In patients remaining stable after acute lysis, a predischarge stress may help in selecting patients requiring catheterization. As an alternative invasive approach to acute MI, PTCA may be the quickest and most effective method to recanalize a vessel, but, again, logistical problems make it incompatible in the acute setting. The same is true for bypass surgery, and although extensive improvements have been made in intraoperative myocardial preservation so that a 2% mortality is achievable, it is reserved for patients with extensive ischemia and anatomy unsuitable for PTCA (extensive multivessel or left main disease).

  6. Endovascular Treatment Strategies in Aortoiliac Occlusion

    International Nuclear Information System (INIS)

    Ozkan, Ugur; Oguzkurt, Levent; Tercan, Fahri; Gumus, Burcak

    2009-01-01

    The aim of this study was to report our experience in endovascular treatment of total aortoiliac occlusion. Five patients who underwent endovascular recanalization procedures including manual aspiration thrombectomy, balloon angioplasty, and stent placement for total aortoiliac occlusion in a 4-year period were reviewed retrospectively. The mean age of patients was 51 years (range, 43 to 58 years). All patients had abdominal aorta and bilateral common iliac artery occlusion with or without external iliac artery occlusion. All patients either had a contraindication to surgery or refused it. Initial technical success was obtained in four of five (80%) patients. Endovascular techniques were successful in four patients who had good distal runoff and short-segment aortoiliac occlusion, but failed in a patient who had the worst distal runoff and long-segment aortoiliac occlusion. We observed two major complications, one of which was bilateral rupture of the common iliac arteries treated with covered stent placement. Another patient had extension of intra-aortic thrombus into the iliac stent after primary stenting. This was successfully treated with manual aspiration thrombectomy. Aortic and iliac stents remained patent during the follow-up period (median, 18 months; range, 3 to 26 months) in four patients. Primary patency rates at 6, 12, and 24 months were all 80%. In conclusion, endovascular treatment can be an alternative for aortoiliac occlusion in selected patients. Short- to midterm follow-up so far is satisfactory. Removal of intra-aortic thrombus with manual aspiration thrombectomy before balloon angioplasty and/or stenting is possible and a good alternative to thrombolysis.

  7. Hospital electronic medical record enterprise application strategies: do they matter?

    Science.gov (United States)

    Fareed, Naleef; Ozcan, Yasar A; DeShazo, Jonathan P

    2012-01-01

    Successful implementations and the ability to reap the benefits of electronic medical record (EMR) systems may be correlated with the type of enterprise application strategy that an administrator chooses when acquiring an EMR system. Moreover, identifying the most optimal enterprise application strategy is a task that may have important linkages with hospital performance. This study explored whether hospitals that have adopted differential EMR enterprise application strategies concomitantly differ in their overall efficiency. Specifically, the study examined whether hospitals with a single-vendor strategy had a higher likelihood of being efficient than those with a best-of-breed strategy and whether hospitals with a best-of-suite strategy had a higher probability of being efficient than those with best-of-breed or single-vendor strategies. A conceptual framework was used to formulate testable hypotheses. A retrospective cross-sectional approach using data envelopment analysis was used to obtain efficiency scores of hospitals by EMR enterprise application strategy. A Tobit regression analysis was then used to determine the probability of a hospital being inefficient as related to its EMR enterprise application strategy, while moderating for the hospital's EMR "implementation status" and controlling for hospital and market characteristics. The data envelopment analysis of hospitals suggested that only 32 hospitals were efficient in the study's sample of 2,171 hospitals. The results from the post hoc analysis showed partial support for the hypothesis that hospitals with a best-of-suite strategy were more likely to be efficient than those with a single-vendor strategy. This study underscores the importance of understanding the differences between the three strategies discussed in this article. On the basis of the findings, hospital administrators should consider the efficiency associations that a specific strategy may have compared with another prior to moving toward

  8. Strategies for Prevention and Treatment of Trichomonas vaginalis Infections.

    Science.gov (United States)

    Bouchemal, Kawthar; Bories, Christian; Loiseau, Philippe M

    2017-07-01

    The last estimated annual incidence of Trichomonas vaginalis worldwide exceeds that of chlamydia and gonorrhea combined. This critical review updates the state of the art on advances in T. vaginalis diagnostics and strategies for treatment and prevention of trichomoniasis. In particular, new data on treatment outcomes for topical administration of formulations are reviewed and discussed. Copyright © 2017 American Society for Microbiology.

  9. A Mobile Application Development Strategy-Finding Model

    OpenAIRE

    MBAYEN MBAYEN, GHISLAIN EDGARD

    2013-01-01

    Nowadays there are several different types of ways to build a mobile application, through web technologies, or through mobile manufacturers’ languages. Thus, in this study we focus on the three major mobile application development strategies: Native, Hybrid, and Web to Native. This plurality of solutions renders the selection of a mobile application development strategy complex. Hence, this study aims at understanding how developers deal with the selection of a mobile development approach. Th...

  10. Diagnostic and treatment strategies in mucopolysaccharidosis VI

    Directory of Open Access Journals (Sweden)

    Vairo F

    2015-10-01

    . Specific treatment with enzyme replacement has been available since 2005. It is safe and effective, bringing measurable benefits and increased survival to patients. As several evidences indicate that early initiation of therapy may lead to a better outcome, newborn screening is being considered for this condition, and it is already in place in selected areas where the incidence of MPS VI is increased. However, as enzyme replacement therapy is not curative, associated therapies should be considered, and research on innovative therapies continues. The management of affected patients by a multidisciplinary team with experience in MPS diseases is highly recommended.Keywords: mucopolysaccharidosis VI, Maroteaux–Lamy syndrome, dermatan sulfate, arylsulfatase b, enzyme replacement therapy, lysosomal storage diseases

  11. Regenerative strategies for the treatment of knee joint disabilities

    CERN Document Server

    Reis, Rui

    2017-01-01

    This book presents regenerative strategies for the treatment of knee joint disabilities. The book is composed of four main sections totaling 19 chapters which review the current knowledge on the clinical management and preclinical regenerative strategies. It examines the role of different natural-based biomaterials as scaffolds and implants for addressing different tissue lesions in the knee joint. Section one provides an updated and comprehensive discussion on articular cartilage tissue regeneration. Section two focuses on the important contributions for bone and osteochondral tissue engineering. Section three overview the recent advances on meniscus repair/regeneration strategies. Finally, section four further discusses the current strategies for treatment of ligament lesions. Each chapter is prepared by world know expert on their fields, so we do firmly believe that the proposed book will be a reference in the area of biomaterials for regenerative medicine.

  12. Current and emerging somatic treatment strategies in psychotic major depression.

    Science.gov (United States)

    Dannon, Pinhas N; Lowengrub, Katherine; Gonopolski, Yehudit; Kotler, Moshe

    2006-01-01

    Psychotic major depressive disorder (MDD) is a mood disorder characterized by severe affective and neurovegetative symptoms together with the presence of delusions and/or hallucinations. It is a common disorder seen in a quarter of consecutively admitted depressed patients and is often associated with severe symptomatology, increased suicide risk, poor acute response to antidepressants and poor acute and long-term treatment outcome. It is possible that poor response in psychotic depression is caused by the fact that we have yet to identify the most efficacious treatment protocol for psychotic MDD. Multiple studies have shown that modifications in the treatment paradigm may increase treatment efficacy in psychotic MDD. It has been generally accepted that, during the acute treatment phase, antidepressant-antipsychotic drug combination therapy is more effective than either treatment alone, although this strategy has recently been challenged. The question of the optimal duration of pharmacotherapy in order to prevent relapse and improve long-term (i.e., 5-year) outcome is a focus of current investigation. This article will review currently recommended treatment strategies for the acute, continuation and maintenance phases of therapy. In particular, it will address the role of newer-generation antidepressants, the role of second-generation antipsychotics, the use of mood stabilizers and indications for electroconvulsive therapy. Other possible treatment strategies such as transcranial magnetic stimulation, vagus nerve stimulation, deep-brain stimulation and glucocorticoid receptor antagonists will be discussed. Current recommendations for the prevention of relapse and improvement of long-term outcome will be reviewed.

  13. Definition of storage strategy effective application conditions

    OpenAIRE

    Nefedov, N.; Zahartzev, A.

    2008-01-01

    The matter concerning the definition of order flow characteristics influencing on warehouse order process performance parameters and on storekeeping total expanses has been considered. On the basis of total expenses criterion the approach to various nomenclature groups of goods storekeeping strategy choice has been offered.

  14. Bacteriophages-potential for application in wastewater treatment processes

    International Nuclear Information System (INIS)

    Withey, S.; Cartmell, E.; Avery, L.M.; Stephenson, T.

    2005-01-01

    Bacteriophages are viruses that infect and lyse bacteria. Interest in the ability of phages to control bacterial populations has extended from medical applications into the fields of agriculture, aquaculture and the food industry. Here, the potential application of phage techniques in wastewater treatment systems to improve effluent and sludge emissions into the environment is discussed. Phage-mediated bacterial mortality has the potential to influence treatment performance by controlling the abundance of key functional groups. Phage treatments have the potential to control environmental wastewater process problems such as: foaming in activated sludge plants; sludge dewaterability and digestibility; pathogenic bacteria; and to reduce competition between nuisance bacteria and functionally important microbial populations. Successful application of phage therapy to wastewater treatment does though require a fuller understanding of wastewater microbial community dynamics and interactions. Strategies to counter host specificity and host cell resistance must also be developed, as should safety considerations regarding pathogen emergence through transduction

  15. Applicability Analysis of Bidding Strategy in Electricity Market

    Directory of Open Access Journals (Sweden)

    Zhou Suyan

    2017-01-01

    Full Text Available With the development of the electricity market, competition has been introduced in the generation side. It is the overall development trend of the electricity market reformulation to optimize the allocation of different resources through bidding. Therefore, it is significant to research the bidding strategies of the generation companies and the large consumers. This paper reviews the existing research methods of bidding strategy. According to the different market mechanisms, the market participators will choose different bidding strategies based on their own cases. We analyze the applicability of bidding strategies under the different conditions, and give suggestions on how to select bidding strategy for the different market participators under different conditions.

  16. Radiation treatment of brain tumors: Concepts and strategies

    International Nuclear Information System (INIS)

    Marks, J.E.

    1989-01-01

    Ionizing radiation has demonstrated clinical value for a multitude of CNS tumors. Application of the different physical modalities available has made it possible for the radiotherapist to concentrate the radiation in the region of the tumor with relative sparing of the surrounding normal tissues. Correlation of radiation dose with effect on cranial soft tissues, normal brain, and tumor has shown increasing effect with increasing dose. By using different physical modalities to alter the distribution of radiation dose, it is possible to increase the dose to the tumor and reduce the dose to the normal tissues. Alteration of the volume irradiated and the dose delivered to cranial soft tissues, normal brain, and tumor are strategies that have been effective in improving survival and decreasing complications. The quest for therapeutic gain using hyperbaric oxygen, neutrons, radiation sensitizers, chemotherapeutic agents, and BNCT has met with limited success. Both neoplastic and normal cells are affected simultaneously by all modalities of treatment, including ionizing radiation. Consequently, one is unable to totally depopulate a tumor without irreversibly damaging the normal tissues. In the case of radiation, it is the brain that limits delivery of curative doses, and in the case of chemical additives, it is other organ systems, such as bone marrow, liver, lung, kidneys, and peripheral nerves. Thus, the major obstacle in the treatment of malignant gliomas is our inability to preferentially affect the tumor with the modalities available. Until it is possible to directly target the neoplastic cell without affecting so many of the adjacent normal cells, the quest for therapeutic gain will go unrealized.72 references

  17. Delayed onset muscle soreness : treatment strategies and performance factors.

    Science.gov (United States)

    Cheung, Karoline; Hume, Patria; Maxwell, Linda

    2003-01-01

    Delayed onset muscle soreness (DOMS) is a familiar experience for the elite or novice athlete. Symptoms can range from muscle tenderness to severe debilitating pain. The mechanisms, treatment strategies, and impact on athletic performance remain uncertain, despite the high incidence of DOMS. DOMS is most prevalent at the beginning of the sporting season when athletes are returning to training following a period of reduced activity. DOMS is also common when athletes are first introduced to certain types of activities regardless of the time of year. Eccentric activities induce micro-injury at a greater frequency and severity than other types of muscle actions. The intensity and duration of exercise are also important factors in DOMS onset. Up to six hypothesised theories have been proposed for the mechanism of DOMS, namely: lactic acid, muscle spasm, connective tissue damage, muscle damage, inflammation and the enzyme efflux theories. However, an integration of two or more theories is likely to explain muscle soreness. DOMS can affect athletic performance by causing a reduction in joint range of motion, shock attenuation and peak torque. Alterations in muscle sequencing and recruitment patterns may also occur, causing unaccustomed stress to be placed on muscle ligaments and tendons. These compensatory mechanisms may increase the risk of further injury if a premature return to sport is attempted.A number of treatment strategies have been introduced to help alleviate the severity of DOMS and to restore the maximal function of the muscles as rapidly as possible. Nonsteroidal anti-inflammatory drugs have demonstrated dosage-dependent effects that may also be influenced by the time of administration. Similarly, massage has shown varying results that may be attributed to the time of massage application and the type of massage technique used. Cryotherapy, stretching, homeopathy, ultrasound and electrical current modalities have demonstrated no effect on the alleviation of

  18. Choice and Application of Marketing Strategies of Selected Book ...

    African Journals Online (AJOL)

    The study was designed to identity the type of marketing strategies employed by book publishers in Nigeria, the criteria for the choice and application of marketing strategies, being used to reach each segment of the market. The survey research method was adopted for the study. Forty market managers and 60 sales ...

  19. Facebook Marketing Strategy : Case: Pint Please Mobile Application

    OpenAIRE

    Pasma, Melissa

    2017-01-01

    This thesis was made to develop a Facebook marketing strategy for a mobile application start-up company Pint Please Ltd in order to improve their Facebook marketing in the United Kingdom. The aim of this thesis is to help the commissioner plan, implement, measure and improve their marketing activities in Facebook and support their marketing efforts in acquiring users for their craft beer application. The theory introduces marketing strategy development process and focuses on describing Facebo...

  20. Benchmarking of Control Strategies for Wastewater Treatment Plants

    DEFF Research Database (Denmark)

    Wastewater treatment plants are large non-linear systems subject to large perturbations in wastewater flow rate, load and composition. Nevertheless these plants have to be operated continuously, meeting stricter and stricter regulations. Many control strategies have been proposed in the literature...

  1. Plant-wide Control Strategy for Improving Produced Water Treatment

    DEFF Research Database (Denmark)

    Yang, Zhenyu; Pedersen, Simon; Løhndorf, Petar Durdevic

    2016-01-01

    This work focuses on investigation and development of an innovative Produced Water Treatment (PWT) technology for offshore oil & gas production by employing the model-based plant-wide control strategy. The key contributions lie in two folds: (i) the advanced anti-slug analysis and control...

  2. Coping Strategies of Women Seeking Infertility Treatment in ...

    African Journals Online (AJOL)

    Infertility is a health problem faced by an estimated 15% of women of childbearing age in Ghana. This study explores the coping strategies adopted by 615 women seeking infertility treatment in southern Ghana. Both closed and open-ended questions were used through a survey conducted using face-to-face interviews in ...

  3. Mobile application as a business strategy

    OpenAIRE

    Dordonne, Rudy

    2013-01-01

    The mobile phone market has gone through a revolution with the increase of power of the devices and the popularization of smartphones. Similarly to the change operated into the IT business more than two decades ago, the mobile phone market switched from hardware oriented to software oriented. The redistribution of powers over the market has generated new opportunities and mobile applications have become a major stake for the market's actors. The purpose of this research is to assess the va...

  4. Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies.

    Science.gov (United States)

    Solé, Brisa; Jiménez, Esther; Torrent, Carla; Reinares, Maria; Bonnin, Caterina Del Mar; Torres, Imma; Varo, Cristina; Grande, Iria; Valls, Elia; Salagre, Estela; Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Carvalho, André F; Vieta, Eduard

    2017-08-01

    Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it persists in remission periods. Evidence indicates that neurocognitive dysfunction may significantly influence patients' psychosocial outcomes. An ever-increasing body of research seeks to achieve a better understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments. This review provides an overview of the available data from studies examining treatments for cognitive dysfunction in bipolar disorder as well as potential novel treatments, from both pharmacological and psychological perspectives. All these data encourage the development of further studies to find effective strategies to prevent and treat cognitive impairment associated with bipolar disorder. These efforts may ultimately lead to an improvement of psychosocial functioning in these patients. © The Author 2017. Published by Oxford University Press on behalf of CINP.

  5. Cognitive Impairment in Bipolar Disorder: Treatment and Prevention Strategies

    Science.gov (United States)

    Solé, Brisa; Jiménez, Esther; Torrent, Carla; Reinares, Maria; Bonnin, Caterina del Mar; Torres, Imma; Varo, Cristina; Grande, Iria; Valls, Elia; Salagre, Estela; Sanchez-Moreno, Jose; Martinez-Aran, Anabel; Carvalho, André F

    2017-01-01

    Abstract Over the last decade, there has been a growing appreciation of the importance of identifying and treating cognitive impairment associated with bipolar disorder, since it persists in remission periods. Evidence indicates that neurocognitive dysfunction may significantly influence patients’ psychosocial outcomes. An ever-increasing body of research seeks to achieve a better understanding of potential moderators contributing to cognitive impairment in bipolar disorder in order to develop prevention strategies and effective treatments. This review provides an overview of the available data from studies examining treatments for cognitive dysfunction in bipolar disorder as well as potential novel treatments, from both pharmacological and psychological perspectives. All these data encourage the development of further studies to find effective strategies to prevent and treat cognitive impairment associated with bipolar disorder. These efforts may ultimately lead to an improvement of psychosocial functioning in these patients. PMID:28498954

  6. Mobile Learning: Pedagogical Strategies for Using Applications in the Classroom

    Science.gov (United States)

    Silveira Sonego, Anna Helena; Rocha Machado, Leticia; Wildt Torrezzan, Cristina Alba; Behar, Patricia Alejandra

    2016-01-01

    This article aims to outline different pedagogical strategies with applications (apps) in the classroom. Every year the use of mobile devices like tablets and smartphones increases. At the same time, applications are being developed to meet this demand. It is therefore essential that educators investigate their use as an motivational technological…

  7. Strategies to Combat Antibiotic Resistance in the Wastewater Treatment Plants

    Directory of Open Access Journals (Sweden)

    Fateme Barancheshme

    2018-01-01

    Full Text Available The main goal of this manuscript is to review different treatment strategies and mechanisms for combating the antibiotic resistant bacteria (ARB and antibiotic resistant genes (ARGs in the wastewater environment. The high amount of antibiotics is released into the wastewater that may promote selection of ARB and ARGs which find their way into natural environments. Emerging microbial pathogens and increasing antibiotic resistance among them is a global public health issue. The propagation and spread of ARB and ARGs in the environment may result in an increase of antibiotic resistant microbial pathogens which is a worldwide environmental and public health concern. A proper treatment of wastewater is essential before its discharge into rivers, lake, or sewage system to prevent the spread of ARB and ARGs into the environment. This review discusses various treatment options applied for combating the spread of ARB and ARGs in wastewater treatment plants (WWTPs. It was reported that low-energy anaerobic–aerobic treatment reactors, constructed wetlands, and disinfection processes have shown good removal efficiencies. Nanomaterials and biochar combined with other treatment methods and coagulation process are very recent strategies regarding ARB and ARGs removal and need more investigation and research. Based on current studies a wide-ranging removal efficiency of ARGs can be achieved depending on the type of genes present and treatment processes used, still, there are gaps that need to be further investigated. In order to find solutions to control dissemination of antibiotic resistance in the environment, it is important to (1 study innovative strategies in large scale and over a long time to reach an actual evaluation, (2 develop risk assessment studies to precisely understand occurrence and abundance of ARB/ARGs so that their potential risks to human health can be determined, and (3 consider operating and environmental factors that affect the

  8. Education Strategies Through Simulation For Training In Cardiopulmonary Resuscitation Treatment

    Directory of Open Access Journals (Sweden)

    Regimar Carla Machado

    2017-01-01

    Full Text Available Theoretical and reflective study based on scientific literature and critical analysis of authors related to teaching strategies through simulation for training in cardiopulmonary resuscitation (CPR. Current teaching methodologies CPR involve realistic simulation strategies and simulations in virtual environments, but the first method provides the best results, allowing proactivity of individuals in their teaching-learning process and bringing them the experience of a life threatening situation. It is noteworthy that health professionals need to be able to assist a victim in cardiac arrest, but even  existing effective teaching methodologies to enable them in this subject, is not fully applicable in the Brazilian context of health education.

  9. eHealth Applications Promising Strategies for Behavior Change

    CERN Document Server

    Noar, Seth M

    2012-01-01

    eHealth Applications: Promising Strategies for Behavior Change provides an overview of technological applications in contemporary health communication research, exploring the history and current uses of eHealth applications in disease prevention and management. This volume focuses on the use of these technology-based interventions for public health promotion and explores the rapid growth of an innovative interdisciplinary field. The chapters in this work discuss key eHealth applications by presenting research examining a variety of technology-based applications. Authors Seth M. Noar and Nancy

  10. Multimodality treatment strategies have changed prognosis of peritoneal metastases

    Science.gov (United States)

    Lungoci, Corneliu; Mironiuc, Aurel Ion; Muntean, Valentin; Oniu, Traian; Leebmann, Hubert; Mayr, Max; Piso, Pompiliu

    2016-01-01

    For a long time, treatment of peritoneal metastases (PM) was mostly palliative and thus, this status was link with “terminal status/despair”. The current multimodal treatment strategy, consisting of cytoreductive surgery (CRS) and hyperthermic intraperitoneal chemotherapy (HIPEC), has been strenuously achieved over time, but seems to be the best treatment option for PM patients. As we reviewed the literature data, we could emphasize some milestones and also, controversies in the history of proposed multimodal treatment and thus, outline the philosophy of this approach, which seems to be an unusual one indeed. Initially marked by nihilism and fear, but benefiting from a remarkable joint effort of human and material resources (multi-center and -institutional research), over a period of 30 years, CRS and HIPEC found their place in the treatment of PM. The next 4 years were dedicated to the refinement of the multimodal treatment, by launching research pathways. In selected patients, with requires training, it demonstrated a significant survival results (similar to the Hepatic Metastases treatment), with acceptable risks and costs. The main debates regarding CRS and HIPEC treatment were based on the oncologists’ perspective and the small number of randomized clinical trials. It is important to statement the PM patient has the right to be informed of the existence of CRS and HIPEC, as a real treatment resource, the decision being made by multidisciplinary teams. PMID:26798438

  11. Strategies for maximizing clinical effectiveness in the treatment of schizophrenia.

    Science.gov (United States)

    Tandon, Rajiv; Targum, Steven D; Nasrallah, Henry A; Ross, Ruth

    2006-11-01

    The ultimate clinical objective in the treatment of schizophrenia is to enable affected individuals to lead maximally productive and personally meaningful lives. As with other chronic diseases that lack a definitive cure, the individual's service/recovery plan must include treatment interventions directed towards decreasing manifestations of the illness, rehabilitative services directed towards enhancing adaptive skills, and social support mobilization aimed at optimizing function and quality of life. In this review, we provide a conceptual framework for considering approaches for maximizing the effectiveness of the array of treatments and other services towards promoting recovery of persons with schizophrenia. We discuss pharmacological, psychological, and social strategies that decrease the burden of the disease of schizophrenia on affected individuals and their families while adding the least possible burden of treatment. In view of the multitude of treatments necessary to optimize outcomes for individuals with schizophrenia, effective coordination of these services is essential. In addition to providing best possible clinical assessment and pharmacological treatment, the psychiatrist must function as an effective leader of the treatment team. To do so, however, the psychiatrist must be knowledgeable about the range of available services, must have skills in clinical-administrative leadership, and must accept the responsibility of coordinating the planning and delivery of this multidimensional array of treatments and services. Finally, the effectiveness of providing optimal individualized treatment/rehabilitation is best gauged by measuring progress on multiple effectiveness domains. Approaches for efficient and reliable assessment are discussed.

  12. Treatment strategies for locally advanced rectal cancer with synchronous resectable liver metastasis

    Directory of Open Access Journals (Sweden)

    Youn Young Park

    2018-01-01

    Full Text Available Approximately one-third of patients with colorectal cancer are estimated to be diagnosed with synchronous liver metastasis (LM. The only method to get cured is to achieve curative resection for both primary and LM. When it comes to locally advanced rectal cancer with synchronous LM, determination of the treatment strategy for each individual is a quite complex procedure, because it demands sophisticated consideration for both local and systemic control. Timing for the application of systemic chemotherapy (CTx, determination of a chemotherapeutic agent, radiation dose and fractions, and sequencing of preoperative treatment and surgeries are all essential components for establishing optimal treatment strategies for the patients with this disease. In this article, treatment strategies proposed in the literature will be reviewed in the light of oncologic outcomes and treatment toxicity with their possible advantages and disadvantages. Owing to a lack of concrete evidences for the best strategy, this article can guide authors to a better way of determining more tailored treatment for each individual.

  13. [Cotard's syndrome. Different treatment strategies according to subclassification].

    Science.gov (United States)

    Madani, Y; Sabbe, B G C

    2007-01-01

    After performing an exploratory factor analysis, Berrios & Luque (1995) identified three subcategories in the Cotard's syndrome: Cotard type I, Cotard type II and Cotard type psychotic depression. The article, which is based on two case studies and an examination of the relevant literature since 1995, explores whether there are different treatment strategies for Cotard type I and the Cotard type psychotic depression. For the Cotard type psychotic depression, electroconvulsive therapy proves to be an effective method of treatment. For Cotard type I, antipsychotic therapy seems to be sufficient.

  14. Assessment and treatment strategies for rotator cuff tears

    Science.gov (United States)

    Al-Hakim, Wisam; Noorani, Ali

    2014-01-01

    Tears of the rotator cuff are common and becoming an increasingly frequent problem. There is a vast amount of literature on the merits and limitations of the various methods of clinical and radiological assessment of rotator cuff tears. This is also the case with regard to treatment strategies. Certain popular beliefs and principles practiced widely and the basis upon which they are derived may be prone to inaccuracy. We provide an overview of the historical management of rotator cuff tears, as well as an explanation for how and why rotator cuff tears should be managed, and propose a structured methodology for their assessment and treatment. PMID:27582960

  15. Cost-effectiveness analysis of optimal strategy for tumor treatment

    International Nuclear Information System (INIS)

    Pang, Liuyong; Zhao, Zhong; Song, Xinyu

    2016-01-01

    We propose and analyze an antitumor model with combined immunotherapy and chemotherapy. Firstly, we explore the treatment effects of single immunotherapy and single chemotherapy, respectively. Results indicate that neither immunotherapy nor chemotherapy alone are adequate to cure a tumor. Hence, we apply optimal theory to investigate how the combination of immunotherapy and chemotherapy should be implemented, for a certain time period, in order to reduce the number of tumor cells, while minimizing the implementation cost of the treatment strategy. Secondly, we establish the existence of the optimality system and use Pontryagin’s Maximum Principle to characterize the optimal levels of the two treatment measures. Furthermore, we calculate the incremental cost-effectiveness ratios to analyze the cost-effectiveness of all possible combinations of the two treatment measures. Finally, numerical results show that the combination of immunotherapy and chemotherapy is the most cost-effective strategy for tumor treatment, and able to eliminate the entire tumor with size 4.470 × 10"8 in a year.

  16. New strategies for local treatment of vaginal infections.

    Science.gov (United States)

    Palmeira-de-Oliveira, Rita; Palmeira-de-Oliveira, Ana; Martinez-de-Oliveira, José

    2015-09-15

    Vaginal infections are extremely prevalent, particularly among women of reproductive age. Although they do not result in high mortality rates, these infections are associated with high levels of anxiety and reduction of quality of life. In most cases, topical treatment of vaginal infections has been shown to be at least as effective as oral treatment, resulting in higher local drug concentrations, with fewer drug interactions and adverse effects. Furthermore, the emergence of microbial resistance to chemotherapeutics and the difficulties in managing infection recurrences sustain the need for more effective local treatments. However, conventional dosage forms have been associated with low retention in the vagina and discomfort. Formulation strategies such as the development of bioadhesive, thermogelling systems and microtechnological or nanotechnological approaches have been proposed to improve delivery of traditional drugs, and other treatment modalities such as new drugs, plant extracts, and probiotics are being studied. This article reviews the recent strategies studied to improve the treatment and prevention of the commonest vaginal infections-namely, vaginal bacteriosis, aerobic vaginitis, vulvovaginal candidosis, and trichomoniasis-through the intravaginal route. Copyright © 2015 Elsevier B.V. All rights reserved.

  17. Multistrain models predict sequential multidrug treatment strategies to result in less antimicrobial resistance than combination treatment

    DEFF Research Database (Denmark)

    Ahmad, Amais; Zachariasen, Camilla; Christiansen, Lasse Engbo

    2016-01-01

    generated by a mathematical model of the competitive growth of multiple strains of Escherichia coli.Results: Simulation studies showed that sequential use of tetracycline and ampicillin reduced the level of double resistance, when compared to the combination treatment. The effect of the cycling frequency...... frequency did not play a role in suppressing the growth of resistant strains, but the specific order of the two antimicrobials did. Predictions made from the study could be used to redesign multidrug treatment strategies not only for intramuscular treatment in pigs, but also for other dosing routes.......Background: Combination treatment is increasingly used to fight infections caused by bacteria resistant to two or more antimicrobials. While multiple studies have evaluated treatment strategies to minimize the emergence of resistant strains for single antimicrobial treatment, fewer studies have...

  18. Achieving Workplace Health through Application of Wellness Strategies

    Science.gov (United States)

    Robinson, Judith L.

    2008-01-01

    Purpose: 1) Understand and measure JSC workplace health: a) levels, sources, indicators & effects of negative, work-related stress; b) define leading indicators of emerging issues. 2 Provide linkage to outcomes: a) Focus application of wellness strategies & HR tools; b) Increase quality of work life and productivity. 3) Current effort will result in: a) Online assessment tool; b) Assessment of total JSC population (civil service & contractors); c) Application of mitigation tools and strategies. 4) Product of the JSC Employee Wellness Program. 5) Collaboration with Corporate Health Improvement Program/University of Arizona.

  19. Application of graphene oxide in water treatment

    Science.gov (United States)

    Liu, Yongchen

    2017-11-01

    Graphene oxide has good hydrophilicity and has been tried to use it into thin films for water treatment in recent years. In this paper, the preparation methods of graphene oxide membrane are reviewed, including vacuum suction filtration, spray coating, spin coating, dip coating and the layer by layer method. Secondly, the mechanism of mass transfer of graphene membrane is introduced in detail. The application of the graphene oxide membrane, modified graphene oxide membrane and graphene hybrid membranes were discussed in RO, vaporization, nanofiltration and other aspects. Finally, the development and application of graphene membrane in water treatment were discussed.

  20. Treatment strategy for a multidrug-resistant Klebsiella UTI.

    Science.gov (United States)

    Fleming, Erin; Heil, Emily L; Hynicka, Lauren M

    2014-01-01

    To describe the management strategy for a multidrug-resistant (MDR) Klebsiella urinary tract infection (UTI). A 69-year-old Caucasian woman with a past medical history of recurrent UTIs and a right-lung transplant presented with fever to 101.4°F, chills, malaise, and cloudy, foul-smelling urine for approximately 1 week. She was found to have a MDR Klebsiella UTI that was sensitive to tigecycline and cefepime. To further evaluate the degree of resistance Etest minimum inhibitory concentrations were requested for cefepime, amikacin, meropenem, and ertapenem. The patient received a 14-day course of amikacin, which resulted in resolution of her symptoms. One month later, the patient's UTI symptoms returned. The urine culture again grew MDR Klebsiella, sensitive only to tigecycline. Fosfomycin was initiated and resulted in limited resolution of her symptoms. Colistin was started, however, therapy was discontinued on day 5 secondary to the development of acute kidney injury. Despite the short course of therapy, the patient's symptoms resolved. The case presented lends itself well to numerous discussion items that are important to consider when determining optimal treatment for MDR Gram-negative bacilli (GNBs). Susceptibility testing is an important tool for optimizing antibiotic therapy, however, automated systems may overestimate the susceptibility profile for a MDR GNB. Treatment strategies evaluated to treat MDR GNB, include combination therapy with a carbepenem and synergy using polymyxin. We have described the management strategy for a MDR Klebsiella UTI, the consequences of the initial management strategy, and potential strategies to manage these types of infections in future patients.

  1. 4D Proton treatment planning strategy for mobile lung tumors

    International Nuclear Information System (INIS)

    Kang Yixiu; Zhang Xiaodong; Chang, Joe Y.; Wang He; Wei Xiong; Liao Zhongxing; Komaki, Ritsuko; Cox, James D.; Balter, Peter A.; Liu, Helen; Zhu, X. Ronald; Mohan, Radhe; Dong Lei

    2007-01-01

    Purpose: To investigate strategies for designing compensator-based 3D proton treatment plans for mobile lung tumors using four-dimensional computed tomography (4DCT) images. Methods and Materials: Four-dimensional CT sets for 10 lung cancer patients were used in this study. The internal gross tumor volume (IGTV) was obtained by combining the tumor volumes at different phases of the respiratory cycle. For each patient, we evaluated four planning strategies based on the following dose calculations: (1) the average (AVE) CT; (2) the free-breathing (FB) CT; (3) the maximum intensity projection (MIP) CT; and (4) the AVE CT in which the CT voxel values inside the IGTV were replaced by a constant density (AVE R IGTV). For each strategy, the resulting cumulative dose distribution in a respiratory cycle was determined using a deformable image registration method. Results: There were dosimetric differences between the apparent dose distribution, calculated on a single CT dataset, and the motion-corrected 4D dose distribution, calculated by combining dose distributions delivered to each phase of the 4DCT. The AVE R IGTV plan using a 1-cm smearing parameter had the best overall target coverage and critical structure sparing. The MIP plan approach resulted in an unnecessarily large treatment volume. The AVE and FB plans using 1-cm smearing did not provide adequate 4D target coverage in all patients. By using a larger smearing value, adequate 4D target coverage could be achieved; however, critical organ doses were increased. Conclusion: The AVE R IGTV approach is an effective strategy for designing proton treatment plans for mobile lung tumors

  2. Modeling Test and Treatment Strategies for Presymptomatic Alzheimer Disease

    Science.gov (United States)

    Burke, James F.; Langa, Kenneth M.; Hayward, Rodney A.; Albin, Roger L.

    2014-01-01

    Objectives In this study, we developed a model of presymptomatic treatment of Alzheimer disease (AD) after a screening diagnostic evaluation and explored the circumstances required for an AD prevention treatment to produce aggregate net population benefit. Methods Monte Carlo simulation methods were used to estimate outcomes in a simulated population derived from data on AD incidence and mortality. A wide variety of treatment parameters were explored. Net population benefit was estimated in aggregated QALYs. Sensitivity analyses were performed by individually varying the primary parameters. Findings In the base-case scenario, treatment effects were uniformly positive, and net benefits increased with increasing age at screening. A highly efficacious treatment (i.e. relative risk 0.6) modeled in the base-case is estimated to save 20 QALYs per 1000 patients screened and 221 QALYs per 1000 patients treated. Conclusions Highly efficacious presymptomatic screen and treat strategies for AD are likely to produce substantial aggregate population benefits that are likely greater than the benefits of aspirin in primary prevention of moderate risk cardiovascular disease (28 QALYS per 1000 patients treated), even in the context of an imperfect treatment delivery environment. PMID:25474698

  3. Thymic epithelial tumours: from basic principles to individualised treatment strategies

    Directory of Open Access Journals (Sweden)

    Nicolas Girard

    2013-03-01

    Full Text Available Thymic epithelial tumours represent a wide range of anatomical, clinical, histological and molecular malignant entities that may be aggressive and difficult to treat. The histopathological classification distinguishes thymomas from thymic carcinomas. Thymomas may be associated with autoimmune disorders. The management of thymic epithelial tumours is a paradigm of co-operation between clinicians, surgeons and pathologists, from establishing the diagnosis to organising the multimodal therapeutic strategy. Surgery is the mainstay of the curative-intent treatment, as complete resection represents the most significantly favourable prognostic factor on overall survival. In case of invasion of intra-thoracic structures and/or dissemination to the pleura and the pericardium, precluding complete resection to be achieved, primary chemotherapy has been used to reduce the tumour burden, possibly allowing subsequent surgery and/or radiotherapy. Novel strategies are needed, especially for refractory, recurrent tumours and thymic carcinomas, which carry a poor prognosis. Personalised approaches are currently being developed, as potentially “druggable” molecular targets are emerging from recent integrated genomic analyses. Along with the large variety of questions relative to the treatment strategy, thymic epithelial tumours represent a model of therapeutic implementation and achievement in orphan thoracic oncology, showing how the advent of new results induces new questions, as well as diversifies further clinical research directions and international collaborative initiatives.

  4. Withholding and withdrawing treatment: practical applications of ...

    African Journals Online (AJOL)

    Withholding and withdrawing treatment: practical applications of ethical principles in end-of-life care. L Gwyther. Abstract. No Abstract South African Journal of Bioethics and Law Vol. 1 (1) 2008: pp. 24-26. Full Text: EMAIL FREE FULL TEXT EMAIL FREE FULL TEXT · DOWNLOAD FULL TEXT DOWNLOAD FULL TEXT.

  5. Nitrate control strategies in an activated sludge wastewater treatment process

    Energy Technology Data Exchange (ETDEWEB)

    Shen, Wenhao; Tao, Erpan; Chen, Xiaoquan; Liu, Dawei [South China University of Technology, Guangzhou (China); Liu, Hongbin [Kyung Hee University, Yongin (Korea, Republic of)

    2014-03-15

    We studied nitrate control strategies in an activated sludge wastewater treatment process (WWTP) based on the activated sludge model. Two control strategies, back propagation for proportional-integral-derivative (BP-PID) and adaptive-network based fuzzy inference systems (ANFIS), are applied in the WWTP. The simulation results show that the simple local constant setpoint control has poor control effects on the nitrate concentration control. However, the ANFIS (4*1) controller, which considers not only the local constant setpoint control of the nitrate concentration, but also three important indices in the effluent--ammonia concentration, total suspended sludge concentration and total nitrogen concentration--demonstrates good control performance. The results also prove that ANFIS (4*1) controller has better control performance than that of the controllers PI, BP-PID and ANFIS (2*1), and that the ANFIS (4*1) controller is effective in improving the effluent quality and maintaining the stability of the effluent quality.

  6. HPV-Based Screening, Triage, Treatment, and Followup Strategies in the Management of Cervical Intraepithelial Neoplasia

    Directory of Open Access Journals (Sweden)

    Oscar Peralta-Zaragoza

    2013-01-01

    Full Text Available Cervical cancer is the second most common cause of death from cancer in women worldwide, and the development of new diagnostic, prognostic, and treatment strategies merits special attention. Many efforts have been made to design new drugs and develop immunotherapy and gene therapy strategies to treat cervical cancer. HPV genotyping has potentially valuable applications in triage of low-grade abnormal cervical cytology, assessment of prognosis and followup of cervical intraepithelial neoplasia, and in treatment strategies for invasive cervical cancer. It is known that during the development of cervical cancer associated with HPV infection, a cascade of abnormal events is induced, including disruption of cellular cycle control, alteration of gene expression, and deregulation of microRNA expression. Thus, the identification and subsequent functional evaluation of host proteins associated with HPV E6 and E7 oncoproteins may provide useful information in understanding cervical carcinogenesis, identifying cervical cancer molecular markers, and developing specific targeting strategies against tumor cells. Therefore, in this paper, we discuss the main diagnostic methods, management strategies, and followup of HPV-associated cervical lesions and review clinical trials applying gene therapy strategies against the development of cervical cancer.

  7. Oligometastatic non-small-cell lung cancer: current treatment strategies

    Directory of Open Access Journals (Sweden)

    Richard PJ

    2016-11-01

    Full Text Available Patrick J Richard, Ramesh Rengan Department of Radiation Oncology, University of Washington, Seattle, WA, USA Abstract: The oligometastatic disease theory was initially described in 1995 by Hellman and Weichselbaum. Since then, much work has been performed to investigate its existence in many solid tumors. This has led to subclassifications of stage IV cancer, which could redefine our treatment approaches and the therapeutic outcomes for this historically “incurable” entity. With a high incidence of stage IV disease, non-small-cell lung cancer (NSCLC remains a difficult cancer to treat and cure. Recent work has proven the existence of an oligometastatic state in NSCLC in terms of properly selecting patients who may benefit from aggressive therapy and experience long-term overall survival. This review discusses the current treatment approaches used in oligometastatic NSCLC and provides the evidence and rationale for each approach. The prognostic factors of many trials are discussed, which can be used to properly select patients for aggressive treatment regimens. Future advances in both molecular profiling of NSCLC to find targetable mutations and investigating patient selection may increase the number of patients diagnosed with oligometastatic NSCLC. As this disease entity increases, it is of utmost importance for oncologists treating NSCLC to be aware of the current treatment strategies that exist and the potential advantages/disadvantages of each. Keywords: oligometastatic, non-small-cell lung cancer, oligoprogressive, treatment

  8. Energy Efficiency Strategies for Municipal Wastewater Treatment Facilities

    Energy Technology Data Exchange (ETDEWEB)

    Daw, J.; Hallett, K.; DeWolfe, J.; Venner, I.

    2012-01-01

    Water and wastewater systems are significant energy consumers with an estimated 3%-4% of total U.S. electricity consumption used for the movement and treatment of water and wastewater. Water-energy issues are of growing importance in the context of water shortages, higher energy and material costs, and a changing climate. In this economic environment, it is in the best interest for utilities to find efficiencies, both in water and energy use. Performing energy audits at water and wastewater treatment facilities is one way community energy managers can identify opportunities to save money, energy, and water. In this paper the importance of energy use in wastewater facilities is illustrated by a case study of a process energy audit performed for Crested Butte, Colorado's wastewater treatment plant. The energy audit identified opportunities for significant energy savings by looking at power intensive unit processes such as influent pumping, aeration, ultraviolet disinfection, and solids handling. This case study presents best practices that can be readily adopted by facility managers in their pursuit of energy and financial savings in water and wastewater treatment. This paper is intended to improve community energy managers understanding of the role that the water and wastewater sector plays in a community's total energy consumption. The energy efficiency strategies described provide information on energy savings opportunities, which can be used as a basis for discussing energy management goals with water and wastewater treatment facility managers.

  9. [The clinical features and surgical treatment strategies of cervical kyphosis].

    Science.gov (United States)

    Fang, Jia-hu; Jia, Lian-shun; Zhou, Xu-hui; Song, Li-jun; Cai, Wei-hua; Li, Xiang

    2010-10-15

    To analyze the clinical characteristics and the surgical treatment strategy of cervical kyphosis. From March 2006 to October 2009, 31 cases of cervical kyphosis were treated. According to the clinical features and imaging findings, different treatment methods were used. There were 9 patients in operation group, including 4 male and 5 female patients, aged from 17 to 72 years (average age of 35 years). Among them, 5 cases were idiopathic kyphosis and 4 cases were caused by laminectomy or other reasons. There were 22 patients in conservative treatment group, including 11 male and 11 female patients, aged from 14 to 40 years (average age of 29 years), who were all idiopathic cervical kyphosis. Before and 1 week after operation, clinical assessment were taken for the patients in operation group using Spinal Cord Injuries Classification Standard of American Spinal Injury Association (AISA). During the periodic review, the anteroposterior, normal sagittal films of cervical spine were taken. At 1 week and every 6 months after operation, MRI films were also taken. These films were studied to evaluate the effects of the operations. In the conservative group, assessment of treatment results by studying anteroposterior and normal lateral views of cervical spine were were taken every month. The clinical characteristics and the surgical treatment strategies of these patients were analyzed. In operation group, 9 cases were followed up for 6 to 18 months, all patients did not failed in internal fixation and fusion. AISA neurological score and neurological function significantly improved. Three days after operation the average Cobb angle was -1.29 ° (preoperative 54.24 °). In conservative group, the average Cobb angle was -5.41 ° (before treatment 11.20 °) 4 months after the treatment. The symptoms of neck shoulder and back pain disappeared, and all patients were followed up for 3 to 24 months, with no recurrence of symptoms. In the early period of cervical kyphosis, adopt

  10. Treatment strategy for trigeminal neuralgia: a thirty years experience.

    Science.gov (United States)

    Broggi, Giovanni; Ferroli, Paolo; Franzini, Angelo

    2008-05-01

    Trigeminal neuralgia is an invalidating disease when become drug-resistant. The only possible treatment is surgery with different modalities, percutaneous, open surgery or radiosurgery. The thirty years experience at the Fondazione Istituto Neurologico C. Besta, Milano, Italy suggests that these surgical strategies are successful in pain control in short and long term period in more than 90% of cases, with a low rate of side effects and high improvement of quality of life. The type of surgery should be tailored on the particular patient considering age, general physical condition, neuroradiological assessment in which MRI with dedicated sequences are mandatory, and also patient's attitude.

  11. Long range personalized cancer treatment strategies incorporating evolutionary dynamics.

    Science.gov (United States)

    Yeang, Chen-Hsiang; Beckman, Robert A

    2016-10-22

    Current cancer precision medicine strategies match therapies to static consensus molecular properties of an individual's cancer, thus determining the next therapeutic maneuver. These strategies typically maintain a constant treatment while the cancer is not worsening. However, cancers feature complicated sub-clonal structure and dynamic evolution. We have recently shown, in a comprehensive simulation of two non-cross resistant therapies across a broad parameter space representing realistic tumors, that substantial improvement in cure rates and median survival can be obtained utilizing dynamic precision medicine strategies. These dynamic strategies explicitly consider intratumoral heterogeneity and evolutionary dynamics, including predicted future drug resistance states, and reevaluate optimal therapy every 45 days. However, the optimization is performed in single 45 day steps ("single-step optimization"). Herein we evaluate analogous strategies that think multiple therapeutic maneuvers ahead, considering potential outcomes at 5 steps ahead ("multi-step optimization") or 40 steps ahead ("adaptive long term optimization (ALTO)") when recommending the optimal therapy in each 45 day block, in simulations involving both 2 and 3 non-cross resistant therapies. We also evaluate an ALTO approach for situations where simultaneous combination therapy is not feasible ("Adaptive long term optimization: serial monotherapy only (ALTO-SMO)"). Simulations utilize populations of 764,000 and 1,700,000 virtual patients for 2 and 3 drug cases, respectively. Each virtual patient represents a unique clinical presentation including sizes of major and minor tumor subclones, growth rates, evolution rates, and drug sensitivities. While multi-step optimization and ALTO provide no significant average survival benefit, cure rates are significantly increased by ALTO. Furthermore, in the subset of individual virtual patients demonstrating clinically significant difference in outcome between

  12. Strategies for prevention and treatment of staphylococcal biofilms

    DEFF Research Database (Denmark)

    Meyer, Rikke Louise

    Biofilm formation by bacteria that colonize biomedical implants cause infections that cannot be eradicated by antibiotic therapy. Bacteria in biofilms are tolerant to every antibiotic known today, and this tolerance is partly due to their low metabolic activity, the occurrence of persister cells...... in biofilms. Innovative biomaterials may at best delay biofilm formation and an important question in this context is to understand how the material can contribute to more successful antibiotic treatment by not providing the cues that trigger the onset of antibiotic tolerance in the attached bacteria...... treatments that more effectively tackle biofilm infections. We have explored how the combination of antibiotic therapy with matrix-targeting enzymes can enhance the efficacy of antibiotics. The matrix composition is highly variable among different bacterial species, and this strategy will not produce a one...

  13. Plasma treatment: A Novel Medical Application

    International Nuclear Information System (INIS)

    Boonyawan, Dheerawan

    2015-01-01

    Cold atmospheric plasma (CAP) for the medical treatment is a new field in plasma application, called plasma medicine. CAP contrains mix of excited atoms and molecules, UV photons, charged particles as well as reactive oxygen species (ROS) and reactive nitrogen species (RNS). Typical species in air CAPs are O 3 , OH, N x , and HNO x . Two cold atomospheric plasma devices were utiized (either in an indirect or a direct way) for the treatment of physiologically healthy volunterrs, The results show that CAP is effective againts chronic wound infections and/ or for skin treatment in clinical trials. The current developments in this field have fuelled the hope that CAP could be, and interesting new therapeutic apptoach in the treatment of cancer.

  14. Treatment strategies for childhood noninfectious chronic uveitis: an update.

    Science.gov (United States)

    Cantarini, Luca; Simonini, Gabriele; Frediani, Bruno; Pagnini, Ilaria; Galeazzi, Mauro; Cimaz, Rolando

    2012-01-01

    Uveitis is an inflammatory disorder involving inflammation of the uveal tract. It is classified as anterior, intermediate, posterior or panuveitis, depending on the part of eye affected by the inflammatory process. In children, noninfectious, chronic uveitis is a relatively uncommon but serious disease, with the potential for significant long-term complications and possible blindness. Although frequently associated with an underlying systemic disease, for example, juvenile idiopathic arthritis, a significant number of cases in children show no associated signs or symptoms and are labeled as idiopathic. We reviewed the available literature. Taking into account this evidence, an anti-inflammatory therapy based on an immunomodulatory approach seems a reasonable strategy for noninfectious chronic uveitis, in children as well as in adults. Due to a lack of controlled studies regarding uveitis in children, immunosuppressive strategy is supported only at evidence level III. Our aim is to review the currently available medical strategies for the treatment of childhood sight-threatening chronic uveitis. Uveitis in children can be severe. Methotrexate is the drug of choice for recalcitrant cases, and biologic therapies can be useful in selected situations.

  15. Noninfectious uveitis: strategies to optimize treatment compliance and adherence

    Directory of Open Access Journals (Sweden)

    Dolz-Marco R

    2015-08-01

    Full Text Available Rosa Dolz-Marco,1 Roberto Gallego-Pinazo,1 Manuel Díaz-Llopis,2 Emmett T Cunningham Jr,3–6 J Fernando Arévalo7,8 1Unit of Macula, Department of Ophthalmology, University and Polytechnic Hospital La Fe, 2Faculty of Medicine, University of Valencia, Spain; 3Department of Ophthalmology, California Pacific Medical Center, San Francisco, 4Department of Ophthalmology, Stanford University School of Medicine, Stanford, 5The Francis I Proctor Foundation, University of California San Francisco Medical Center, 6West Coast Retina Medical Group, San Francisco, CA, USA; 7Vitreoretina Division, King Khaled Eye Specialist Hospital, Riyadh, Saudi Arabia; 8Retina Division, Wilmer Eye Institute, Johns Hopkins University School of Medicine, Baltimore, MD, USA Abstract: Noninfectious uveitis includes a heterogenous group of sight-threatening ocular and systemic disorders. Significant progress has been made in the treatment of noninfectious uveitis in recent years, particularly with regard to the effective use of corticosteroids and non-corticosteroid immunosuppressive drugs, including biologic agents. All of these therapeutic approaches are limited, however, by any given patient’s ability to comply with and adhere to their prescribed treatment. In fact, compliance and adherence are among the most important patient-related determinants of treatment success. We discuss strategies to optimize compliance and adherence. Keywords: noninfectious uveitis, intraocular inflammation, immunosuppressive treatment, adherence, compliance, therapeutic failure

  16. Advances in Risk Classification and Treatment Strategies for Neuroblastoma

    Science.gov (United States)

    Pinto, Navin R.; Applebaum, Mark A.; Volchenboum, Samuel L.; Matthay, Katherine K.; London, Wendy B.; Ambros, Peter F.; Nakagawara, Akira; Berthold, Frank; Schleiermacher, Gudrun; Park, Julie R.; Valteau-Couanet, Dominique; Pearson, Andrew D.J.

    2015-01-01

    Risk-based treatment approaches for neuroblastoma have been ongoing for decades. However, the criteria used to define risk in various institutional and cooperative groups were disparate, limiting the ability to compare clinical trial results. To mitigate this problem and enhance collaborative research, homogenous pretreatment patient cohorts have been defined by the International Neuroblastoma Risk Group classification system. During the past 30 years, increasingly intensive, multimodality approaches have been developed to treat patients who are classified as high risk, whereas patients with low- or intermediate-risk neuroblastoma have received reduced therapy. This treatment approach has resulted in improved outcome, although survival for high-risk patients remains poor, emphasizing the need for more effective treatments. Increased knowledge regarding the biology and genetic basis of neuroblastoma has led to the discovery of druggable targets and promising, new therapeutic approaches. Collaborative efforts of institutions and international cooperative groups have led to advances in our understanding of neuroblastoma biology, refinements in risk classification, and stratified treatment strategies, resulting in improved outcome. International collaboration will be even more critical when evaluating therapies designed to treat small cohorts of patients with rare actionable mutations. PMID:26304901

  17. Multistrain models predict sequential multidrug treatment strategies to result in less antimicrobial resistance than combination treatment

    DEFF Research Database (Denmark)

    Ahmad, Amais; Zachariasen, Camilla; Christiansen, Lasse Engbo

    2016-01-01

    Background: Combination treatment is increasingly used to fight infections caused by bacteria resistant to two or more antimicrobials. While multiple studies have evaluated treatment strategies to minimize the emergence of resistant strains for single antimicrobial treatment, fewer studies have...... the sensitive fraction of the commensal flora.Growth parameters for competing bacterial strains were estimated from the combined in vitro pharmacodynamic effect of two antimicrobials using the relationship between concentration and net bacterial growth rate. Predictions of in vivo bacterial growth were...... (how frequently antibiotics are alternated in a sequential treatment) of the two drugs was dependent upon the order in which the two drugs were used.Conclusion: Sequential treatment was more effective in preventing the growth of resistant strains when compared to the combination treatment. The cycling...

  18. Atomized scan strategy for high definition for VR application

    Science.gov (United States)

    Huang, Shuping; Ran, Feng; Ji, Yuan; Chen, Wendong

    2017-10-01

    Silicon-based OLED (Organic Light Emitting Display) microdisplay technology begins to attract people's attention in the emerging VR and AR devices. The high display frame refresh rate is an important solution to alleviate the dizziness in VR applications. Traditional display circuit drivers use the analog method or the digital PWM method that follow the serial scan order from the first pixel to the last pixel by using the shift registers. This paper proposes a novel atomized scan strategy based on the digital fractal scan strategy using the pseudo-random scan order. It can be used to realize the high frame refresh rate with the moderate pixel clock frequency in the high definition OLED microdisplay. The linearity of the gray level is also improved compared with the Z fractal scan strategy.

  19. Bromelain: an overview of industrial application and purification strategies.

    Science.gov (United States)

    Arshad, Zatul Iffah Mohd; Amid, Azura; Yusof, Faridah; Jaswir, Irwandi; Ahmad, Kausar; Loke, Show Pau

    2014-09-01

    This review highlights the use of bromelain in various applications with up-to-date literature on the purification of bromelain from pineapple fruit and waste such as peel, core, crown, and leaves. Bromelain, a cysteine protease, has been exploited commercially in many applications in the food, beverage, tenderization, cosmetic, pharmaceutical, and textile industries. Researchers worldwide have been directing their interest to purification strategies by applying conventional and modern approaches, such as manipulating the pH, affinity, hydrophobicity, and temperature conditions in accord with the unique properties of bromelain. The amount of downstream processing will depend on its intended application in industries. The breakthrough of recombinant DNA technology has facilitated the large-scale production and purification of recombinant bromelain for novel applications in the future.

  20. Branded smart phone applications: an efficient marketing strategy?

    OpenAIRE

    Vaddé, Mathilde

    2012-01-01

    Advertising through smart phone applications is one of the fastest growing categories in advertising nowadays. Branded game-apps on mobile phones have several very innovative and attractive aspects, they physically engage their customers into a game, creating on a first level an entertainment but mainly they are advertising their products and the brand’s name. Many studies have been written on gaming, customer engagement and marketing strategies, but only few studies has been written on the c...

  1. Strategies and techniques to enhance constructed wetland performance for sustainable wastewater treatment.

    Science.gov (United States)

    Wu, Haiming; Fan, Jinlin; Zhang, Jian; Ngo, Huu Hao; Guo, Wenshan; Liang, Shuang; Hu, Zhen; Liu, Hai

    2015-10-01

    Constructed wetlands (CWs) have been used as an alternative to conventional technologies for wastewater treatment for more than five decades. Recently, the use of various modified CWs to improve treatment performance has also been reported in the literature. However, the available knowledge on various CW technologies considering the intensified and reliable removal of pollutants is still limited. Hence, this paper aims to provide an overview of the current development of CW strategies and techniques for enhanced wastewater treatment. Basic information on configurations and characteristics of different innovations was summarized. Then, overall treatment performance of those systems and their shortcomings were further discussed. Lastly, future perspectives were also identified for specialists to design more effective and sustainable CWs. This information is used to inspire some novel intensifying methodologies, and benefit the successful applications of potential CW technologies.

  2. Current knowledge and treatment strategies for grade II gliomas

    International Nuclear Information System (INIS)

    Narita, Yoshitaka

    2013-01-01

    World Health Organization grade II gliomas (GIIGs) include diffuse astrocytoma, oligodendroglioma, and oligoastrocytoma. GIIG is a malignant brain tumor for which the treatment outcome can still be improved. Review of previous clinical trials found the following: GIIG increased in size by 3-5 mm per year when observed or treated with surgery alone; after pathological diagnosis, the survival rate was increased by early aggressive tumor removal at an earlier stage compared to observation alone; although the prognosis after total tumor removal was significantly better than that after partial tumor removal, half of the patients relapsed within 5 years; comparing postoperative early radiotherapy (RT) and non-early RT after relapse, early RT prolonged progression-free survival (PFS) but did not affect overall survival (OS); local RT of 45 to 64.8 Gy did not impact PFS or OS; in patients with residual tumors, RT combined with chemotherapy (procarbazine plus lomustine plus vincristine) prolonged PFS compared with RT alone but did not affect OS; and poor prognostic factors included astrocytoma, non-total tumor removal, age ≥40 years, largest tumor diameter ≥4-6 cm, tumor crossing the midline, and neurological deficit. To improve treatment outcomes, surgery with functional brain mapping or intraoperative magnetic resonance imaging or chemoradiotherapy with temozolomide is important. In this review, current knowledge regarding GIIG is described and treatment strategies are explored. (author)

  3. Recommendations for severe hypertriglyceridemia treatment, are there new strategies?

    Science.gov (United States)

    Filippatos, Theodosios D; Elisaf, Moses S

    2014-01-01

    This review considers drug combinations and newer treatment strategies for patients with severe hypertriglyceridemia. Hypertriglyceridemia is associated with an atherogenic metabolic profile and in most studies with increased cardiovascular disease risk. Patients with severe hypertriglyceridemia also have increased incidence of pancreatitis. All types of severe hypertriglyceridemia are associated with a reduction in lipoprotein lipase activity. Patients with severe hypertriglyceridemia and abdominal pain or pancreatitis should be hospitalized and treated with hypolipidemic drugs and, if needed, with insulin/dextrose infusion or therapeutic apheresis. Fibrates are the first-line treatment in patients with severe hypertriglyceridemia. Omega-3 fatty acids and niacin are very useful drugs for patients with hypertriglyceridemia. Statins in high doses exhibit a significant hypotriglyceridemic activity. Drugs that interfere with chylomicron production such as orlistat are also useful for hypertriglyceridemic patients. In most patients with severe hypertriglyceridemia drug combinations are needed to maintain an acceptable triglyceride concentration. Gene therapy is under development for patients with known genetic abnormalities of triglyceride metabolism. Clinicians should be vigilant for the recognition and prompt treatment of patients with severe hypertriglyceridemia aimed to avoid the serious complication of pancreatitis and to reduce their cardiovascular risk.

  4. Application of new control strategy for sun tracking

    International Nuclear Information System (INIS)

    Rubio, F.R.; Ortega, M.G.; Gordillo, F.; Lopez-Martinez, M.

    2007-01-01

    The application of high concentration solar cells technology allows a significant increase in the amount of energy collected by solar arrays per unit area. However, to make it possible, more severe specifications on the sun pointing error are required. In fact, the performance of solar cells with concentrators decreases drastically if this error is greater than a small value. These specifications are not fulfilled by simple tracking systems due to different sources of errors (e.g., small misalignments of the structure with respect to geographical north) that appear in practice in low cost, domestic applications. This paper presents a control application of a sun tracker that is able to follow the sun with high accuracy without the necessity of either a precise procedure of installation or recalibration. A hybrid tracking system that consists of a combination of open loop tracking strategies based on solar movement models and closed loop strategies using a dynamic feedback controller is presented. Energy saving factors are taken into account, which implies that, among other factors, the sun is not constantly tracked with the same accuracy, to prevent energy overconsumption by the motors. Simulation and experimental results with a low cost two axes solar tracker are exposed, including a comparison between a classical open loop tracking strategy and the proposed hybrid one

  5. Management of Hyposalivation and Xerostomia: Criteria for Treatment Strategies.

    Science.gov (United States)

    Epstein, Joel B; Beier Jensen, Siri

    2015-09-01

    Saliva management in patients with hyposalivation is potentially complex. Future development of oral care products and treatment strategies requires attention to the biology of saliva and the best means of providing a continuum of relief for people with xerostomia--the sensation of dry mouth--and hyposalivation--documented reduction in saliva flow. Improvement in patient care requires that clinicians be aware of approaches to management, desirable qualities of methods and products, and that they seek the development of products that support the functions of saliva and promote comfort and health. In this brief review of the epidemiology of hyposalivation, the biology and functions of saliva are presented in order to guide clinical decision-making to address the needs of patients with dry mouth.

  6. Emerging treatment strategies for trauma-induced coagulopathy.

    Science.gov (United States)

    Sorensen, B; Fries, D

    2012-01-01

    Trauma-induced coagulopathy has a multifactorial aetiology. Coagulopathy is related to blood loss including consumption of clotting factors and platelets and haemodilution. Additionally hyperfibrinolysis, hypothermia, acidosis and metabolic changes affect the coagulation system. This is a review of pathophysiology and new treatment strategies for trauma-induced coagulopathy. Paradigms are actively changing and there is still a shortage of data. The aim of any haemostatic therapy is to control bleeding and minimize blood loss and transfusion requirements. Transfusion of allogeneic blood products as well as trauma-induced coagulopathy cause increased morbidity and mortality. Current opinion is based on present studies and results from small case series, combined with findings from experimental studies in animals, in vitro studies and expert opinions, as opposed to large, randomized, placebo-controlled studies. A summary of new and emerging strategies, including medical infusion and blood products, to beneficially manipulate the coagulation system in the critically injured patient is suggested. Future treatment of trauma-induced coagulopathy may be based on systemic antifibrinolytics, local haemostatics and individualized point-of-care-guided rational use of coagulation factor concentrates such as fibrinogen, prothrombin complex concentrate, recombinant factor VIIa and factor XIII. The authors speculate that timely and rational use of coagulation factor concentrates will be more efficacious and safer than ratio-driven use of transfusion packages of allogeneic blood products. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd. Copyright © 2011 British Journal of Surgery Society Ltd. Published by John Wiley & Sons, Ltd.

  7. Applications of NTCP calculations to treatment planning

    International Nuclear Information System (INIS)

    Kutcher, G.J.

    1995-01-01

    A fundamental step in the treatment decision process is the evaluation of a treatment plan. Most often treatment plans are judged by tradition using guidelines like target homogeneity and maximum dose to non-target tissues. While such judgments implicitly assume a relationship between dose distribution parameters and patient response, the judgment process is essentially supported by clinical outcomes from previous treatments. With the development of conformal therapy, new and unusual dose distributions and escalated doses are possible, while the clinical consequences are unknown. this situation has instigated attempts to place plan evaluation on a more systematic platform. One such endeavor has centered around attempts to calculate normal tissue complication probability (NTCP) and its sibling, tumor control probability (TCP). This lecture will be composed of two parts. The first will begin with a review of two categories of NTCP models: (1) an 'empirical' approach, based upon a power-law relationship between partial organ tolerance and irradiated volume, and histogram reduction to account for inhomogeneous irradiation: (2) a 'statistical' approach in which local responses are combined according to the underlying tissue architecture. Since both rely upon clinical data - often of limited and questionable validity - we will review some examples from the clinical and biological literature. The second part of the lecture will review clinical applications of biological-index based models: ranking competing treatment plans; design of dose escalation protocols; optimization of treatment plans with intensity modulation. We will also demonstrate how biological indices can be used to derive dose-volume histograms which account for treatment uncertainty

  8. Grout Treatment Facility dangerous waste permit application

    International Nuclear Information System (INIS)

    1992-07-01

    The Grout Treatment Facility (GTF) is an existing treatment, storage, and/or disposal (TSD) unit located in the 200 East Area and the adjacent 600 Area of the Hanford Site. The GTF mixes dry cementitious solids with liquid mixed waste (containing both dangerous and radioactive constituents) produced by Hanford Site operations. The GTF consists of the following: The 241-AP-02D and 241-AP-04D waste pump pits and transfer piping; Dry Materials Facility (DMF); Grout Disposal Facility (GDF), consisting of the disposal vault and support and monitoring equipment; and Grout Processing Facility (GPF) and Westinghouse Hanford Company on the draft Hanford Facility Dangerous Waste Permit and may not be read to conflict with those comments. The Grout Treatment Facility Dangerous Waste Permit Application consists of both a Part A and a Part B permit application. An explanation of the Part A revisions associated with this TSD unit, including the current revision, is provided at the beginning of the Part A section. The Part B consists of 15 chapters addressing the organization and content of the Part B checklist prepared by the Washington State Department of Ecology (Ecology 1987). For ease of reference, the checklist section numbers, in brackets, follow chapter headings and subheadings

  9. Modern strategy and prospects in pharmacological treatment of Parkinson's disease

    Directory of Open Access Journals (Sweden)

    А. V. Kutsak

    2017-02-01

    Full Text Available Aim – to analyze scientific literature to summarize data about contemporary views on the pharmacological therapy of Parkinson's disease (PD. PD is a chronic, neurodegenerative steadily progressive disease of the central nervous system, primarily associated with the degeneration of dopamine-producing neurons in the cerebral pulp, manifested by motor and non-motor disorders and leading to permanent disability. The duration of patient’s life with PD, provided with adequate treatment, can be closer to the one of the general population. At the same time, the course of the disease may change with the increase of life expectancy of the patients. And as the result, in the clinical picture, non-motor disorders and motor complications caused by a further degeneration of dopaminergic neurons and adverse reactions of pharmacological therapy, come out in the first place. The apropos and rational correction of which improves the course of the disease and patients' quality of life. Within the age PD frequency in the population is increasing; taking into account the global trend to an increase in the duration of human life, this disease performs even bigger medical and social problem. And the need for further development of pharmacotherapy practices becomes more relevant. This review presents the current recommendations for the pharmacological treatment of PD. The attention is directed to the need for evidence when assessing the effectiveness of any treatment strategy. The data on the ongoing development of pharmaceuticals. Conclusions. At this time the existing therapeutic tactics in the pharmacological therapy of BP, despite the fact that they are quite successful in leveling manifestations of the disease, do not stop the disease, and are in fact symptomatic treatment. All successful clinical development, for the time being, are the emergence of new drugs belonging to the group of BP symptomatic therapy with the best bioavailability and tolerability

  10. Synthetic Strategies and Applications of GaN Nanowires

    Directory of Open Access Journals (Sweden)

    Guoquan Suo

    2014-01-01

    Full Text Available GaN is an important III-V semiconductor material with a direct band gap of 3.4 eV at 300 K. The wide direct band gap makes GaN an attractive material for various applications. GaN nanowires have demonstrated significant potential as fundamental building blocks for nanoelectronic and nanophotonic devices and also offer substantial promise for integrated nanosystems. In this paper, we provide a comprehensive review on the general synthetic strategies, characterizations, and applications of GaN nanowires. We first summarize several growth techniques of GaN nanowires. Subsequently, we discuss mechanisms involved to generate GaN nanowires from different synthetic schemes and conditions. Then we review some characterization methods of GaN nanowires. Finally, several kinds of main applications of GaN nanowires are discussed.

  11. Land Disposal Restrictions Treatment Standards: Compliance Strategies for Four Types of Mixed Wastes

    International Nuclear Information System (INIS)

    Fortune, W.B.; Ranek, N.L.

    2006-01-01

    This paper describes the unique challenges involved in achieving compliance with the Resource Conservation and Recovery Act (Public Law 94-580) Land Disposal Restrictions (LDR) treatment standards for four types of mixed wastes generated throughout the U.S. Department of Energy (DOE) complex: (1) radioactively contaminated lead acid batteries; (2) radioactively contaminated cadmium-, mercury-, and silver-containing batteries; (3) mercury-bearing mixed wastes; and (4) radioactive lead solids. For each of these mixed waste types, the paper identifies the strategy pursued by DOE's Office of Pollution Prevention and Resource Conservation Policy and Guidance (EH-43) in coordination with other DOE elements and the U.S. Environmental Protection Agency (EPA) to meet the compliance challenge. Specifically, a regulatory interpretation was obtained from EPA agreeing that the LDR treatment standard for wastes in the D008 'Radioactive Lead Solids' sub-category applies to radioactively contaminated lead acid batteries. For cadmium-, mercury-, and silver-containing batteries, generically applicable treatability variances were obtained from EPA approving macro-encapsulation as the alternative LDR treatment standard for all three battery types. Joint DOE/EPA technology demonstrations were pursued for mercury-bearing mixed wastes in an effort to justify revising the LDR treatment standards, which focus on thermal recovery of mercury for reuse. Because the demonstrations failed to produce enough supporting data for a rulemaking, however, EPA has recommended site-specific treatability variances for particular mercury-bearing mixed waste streams. Finally, DOE has filed an application for a determination of equivalent treatment requesting approval of container-based macro-encapsulation technologies as an alternative LDR treatment standard for radioactive lead solids. Information is provided concerning the length of time required to implement each of these strategies, and suggestions for

  12. Using Chemical Reaction Kinetics to Predict Optimal Antibiotic Treatment Strategies.

    Science.gov (United States)

    Abel Zur Wiesch, Pia; Clarelli, Fabrizio; Cohen, Ted

    2017-01-01

    Identifying optimal dosing of antibiotics has proven challenging-some antibiotics are most effective when they are administered periodically at high doses, while others work best when minimizing concentration fluctuations. Mechanistic explanations for why antibiotics differ in their optimal dosing are lacking, limiting our ability to predict optimal therapy and leading to long and costly experiments. We use mathematical models that describe both bacterial growth and intracellular antibiotic-target binding to investigate the effects of fluctuating antibiotic concentrations on individual bacterial cells and bacterial populations. We show that physicochemical parameters, e.g. the rate of drug transmembrane diffusion and the antibiotic-target complex half-life are sufficient to explain which treatment strategy is most effective. If the drug-target complex dissociates rapidly, the antibiotic must be kept constantly at a concentration that prevents bacterial replication. If antibiotics cross bacterial cell envelopes slowly to reach their target, there is a delay in the onset of action that may be reduced by increasing initial antibiotic concentration. Finally, slow drug-target dissociation and slow diffusion out of cells act to prolong antibiotic effects, thereby allowing for less frequent dosing. Our model can be used as a tool in the rational design of treatment for bacterial infections. It is easily adaptable to other biological systems, e.g. HIV, malaria and cancer, where the effects of physiological fluctuations of drug concentration are also poorly understood.

  13. Hybrid Curcumin Compounds: A New Strategy for Cancer Treatment

    Directory of Open Access Journals (Sweden)

    Marie-Hélène Teiten

    2014-12-01

    Full Text Available Cancer is a multifactorial disease that requires treatments able to target multiple intracellular components and signaling pathways. The natural compound, curcumin, was already described as a promising anticancer agent due to its multipotent properties and huge amount of molecular targets in vitro. Its translation to the clinic is, however, limited by its reduced solubility and bioavailability in patients. In order to overcome these pharmacokinetic deficits of curcumin, several strategies, such as the design of synthetic analogs, the combination with specific adjuvants or nano-formulations, have been developed. By taking into account the risk-benefit profile of drug combinations, as well as the knowledge about curcumin’s structure-activity relationship, a new concept for the combination of curcumin with scaffolds from different natural products or components has emerged. The concept of a hybrid curcumin molecule is based on the incorporation or combination of curcumin with specific antibodies, adjuvants or other natural products already used or not in conventional chemotherapy, in one single molecule. The high diversity of such conjugations enhances the selectivity and inherent biological activities and properties, as well as the efficacy of the parental compound, with particular emphasis on improving the efficacy of curcumin for future clinical treatments.

  14. Current Research Therapeutic Strategies for Alzheimer’s Disease Treatment

    Directory of Open Access Journals (Sweden)

    Jaume Folch

    2016-01-01

    Full Text Available Alzheimer’s disease (AD currently presents one of the biggest healthcare issues in the developed countries. There is no effective treatment capable of slowing down disease progression. In recent years the main focus of research on novel pharmacotherapies was based on the amyloidogenic hypothesis of AD, which posits that the beta amyloid (Aβ peptide is chiefly responsible for cognitive impairment and neuronal death. The goal of such treatments is (a to reduce Aβ production through the inhibition of β and γ secretase enzymes and (b to promote dissolution of existing cerebral Aβ plaques. However, this approach has proven to be only modestly effective. Recent studies suggest an alternative strategy centred on the inhibition of the downstream Aβ signalling, particularly at the synapse. Aβ oligomers may cause aberrant N-methyl-D-aspartate receptor (NMDAR activation postsynaptically by forming complexes with the cell-surface prion protein (PrPC. PrPC is enriched at the neuronal postsynaptic density, where it interacts with Fyn tyrosine kinase. Fyn activation occurs when Aβ is bound to PrPC-Fyn complex. Fyn causes tyrosine phosphorylation of the NR2B subunit of metabotropic glutamate receptor 5 (mGluR5. Fyn kinase blockers masitinib and saracatinib have proven to be efficacious in treating AD symptoms in experimental mouse models of the disease.

  15. Various Strategies for Pain-Free Root Canal Treatment

    Science.gov (United States)

    Parirokh, Masoud; V. Abbott, Paul

    2014-01-01

    Introduction: Achieving successful anesthesia and performing pain-free root canal treatment are important aims in dentistry. This is not always achievable and therefore, practitioners are constantly seeking newer techniques, equipments, and anesthetic solutions for this very purpose. The aim of this review is to introduce strategies to achieve profound anesthesia particularly in difficult cases. Materials and Methods: A review of the literature was performed by electronic and hand searching methods for anesthetic agents, techniques, and equipment. The highest level of evidence based investigations with rigorous methods and materials were selected for discussion. Results: Numerous studies investigated to pain management during root canal treatment; however, there is still no single technique that will predictably provide profound pulp anesthesia. One of the most challenging issues in endodontic practice is achieving a profound anesthesia for teeth with irreversible pulpitis especially in mandibular posterior region. Conclusion: According to most investigations, achieving a successful anesthesia is not always possible with a single technique and practitioners should be aware of all possible alternatives for profound anesthesia. PMID:24396370

  16. A review of current treatment strategies for gestational diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Kristi W Kelley

    2015-07-01

    Full Text Available Approximately 90% of diabetes cases in pregnant women are considered gestational diabetes mellitus (GDM. It is well known that uncontrolled glucose results in poor pregnancy outcomes in both the mother and fetus. Worldwide there are many guidelines with recommendations for appropriate management strategies for GDM once lifestyle modifications have been instituted and failed to achieve control. The efficacy and particularly the safety of other treatment modalities for GDM has been the source of much debate in recent years. Studies that have demonstrated the safety and efficacy of both glyburide and metformin in the management of patients with GDM will be reviewed. There is a lack of evidence with other oral and injectable non-insulin agents to control blood glucose in GDM. The role of insulin will be discussed, with emphasis on insulin analogs. Ideal patient characteristics for each treatment modality will be reviewed. In addition, recommendations for postpartum screening of patients will be described as well as recommendations for use of agents to manage subsequent type 2 diabetes in patients who are breastfeeding.

  17. Application of Laser Irradiation for Restorative Treatments.

    Science.gov (United States)

    Davoudi, Amin; Sanei, Maryam; Badrian, Hamid

    2016-01-01

    Nowadays, lasers are widely used in many fields of medicine. Also, they can be applied at many branches of dental practice such as diagnosis, preventive procedures, restorative treatments, and endodontic therapies. Procedures like caries removal, re-mineralization, and vital pulp therapy are the most noticeable effects of laser irradiation which has gained much attention among clinicians. With controlled and appropriate wavelength, they can help stimulating dentinogenesis, controlling pulpal hemorrhage, sterilization, healing of collagenic proteins, formation of a fibrous matrix, and inducing hard tissue barrier. Nevertheless, there are many controversies in literatures regarding their effects on the quality of bonded restorations. It hampered a wide application of lasers in some aspects of restorative dentistry and requirements to identify the best way to use this technology. The aim of this mini review is to explain special characteristics of laser therapy and to introduce the possible applications of laser devices for dental purposes.

  18. Current and emerging treatment strategies for Duchenne muscular dystrophy

    Science.gov (United States)

    Mah, Jean K

    2016-01-01

    Duchenne muscular dystrophy (DMD) is the most common form of muscular dystrophy in childhood. It is caused by mutations of the DMD gene, leading to progressive muscle weakness, loss of independent ambulation by early teens, and premature death due to cardiorespiratory complications. The diagnosis can usually be made after careful review of the history and examination of affected boys presenting with developmental delay, proximal weakness, and elevated serum creatine kinase, plus confirmation by muscle biopsy or genetic testing. Precise characterization of the DMD mutation is important for genetic counseling and individualized treatment. Current standard of care includes the use of corticosteroids to prolong ambulation and to delay the onset of secondary complications. Early use of cardioprotective agents, noninvasive positive pressure ventilation, and other supportive strategies has improved the life expectancy and health-related quality of life for many young adults with DMD. New emerging treatment includes viral-mediated microdystrophin gene replacement, exon skipping to restore the reading frame, and nonsense suppression therapy to allow translation and production of a modified dystrophin protein. Other potential therapeutic targets involve upregulation of compensatory proteins, reduction of the inflammatory cascade, and enhancement of muscle regeneration. So far, data from DMD clinical trials have shown limited success in delaying disease progression; unforeseen obstacles included immune response against the generated mini-dystrophin, inconsistent evidence of dystrophin production in muscle biopsies, and failure to demonstrate a significant improvement in the primary outcome measure, as defined by the 6-minute walk test in some studies. The long-term safety and efficacy of emerging treatments will depend on the selection of appropriate clinical end points and sensitive biomarkers to detect meaningful changes in disease progression. Correction of the underlying

  19. Complexity Science Applications to Dynamic Trajectory Management: Research Strategies

    Science.gov (United States)

    Sawhill, Bruce; Herriot, James; Holmes, Bruce J.; Alexandrov, Natalia

    2009-01-01

    The promise of the Next Generation Air Transportation System (NextGen) is strongly tied to the concept of trajectory-based operations in the national airspace system. Existing efforts to develop trajectory management concepts are largely focused on individual trajectories, optimized independently, then de-conflicted among each other, and individually re-optimized, as possible. The benefits in capacity, fuel, and time are valuable, though perhaps could be greater through alternative strategies. The concept of agent-based trajectories offers a strategy for automation of simultaneous multiple trajectory management. The anticipated result of the strategy would be dynamic management of multiple trajectories with interacting and interdependent outcomes that satisfy multiple, conflicting constraints. These constraints would include the business case for operators, the capacity case for the Air Navigation Service Provider (ANSP), and the environmental case for noise and emissions. The benefits in capacity, fuel, and time might be improved over those possible under individual trajectory management approaches. The proposed approach relies on computational agent-based modeling (ABM), combinatorial mathematics, as well as application of "traffic physics" concepts to the challenge, and modeling and simulation capabilities. The proposed strategy could support transforming air traffic control from managing individual aircraft behaviors to managing systemic behavior of air traffic in the NAS. A system built on the approach could provide the ability to know when regions of airspace approach being "full," that is, having non-viable local solution space for optimizing trajectories in advance.

  20. Evolutionary engineering of industrial microorganisms-strategies and applications.

    Science.gov (United States)

    Zhu, Zhengming; Zhang, Juan; Ji, Xiaomei; Fang, Zhen; Wu, Zhimeng; Chen, Jian; Du, Guocheng

    2018-06-01

    Microbial cells have been widely used in the industry to obtain various biochemical products, and evolutionary engineering is a common method in biological research to improve their traits, such as high environmental tolerance and improvement of product yield. To obtain better integrate functions of microbial cells, evolutionary engineering combined with other biotechnologies have attracted more attention in recent years. Classical laboratory evolution has been proven effective to letting more beneficial mutations occur in different genes but also has some inherent limitations such as a long evolutionary period and uncontrolled mutation frequencies. However, recent studies showed that some new strategies may gradually overcome these limitations. In this review, we summarize the evolutionary strategies commonly used in industrial microorganisms and discuss the combination of evolutionary engineering with other biotechnologies such as systems biology and inverse metabolic engineering. Finally, we prospect the importance and application prospect of evolutionary engineering as a powerful tool especially in optimization of industrial microbial cell factories.

  1. iPhone application development strategies for efficient mobile design and delivery

    CERN Document Server

    Hahn, Jim

    2011-01-01

    iPhone application development is explained here in an accessible treatment for the generalist Library and Information Science (LIS) practitioner. Future information-seeking practices by users will take place across a diverse array of ubiquitous computing devices. iPhone applications represent one of the most compelling new platforms for which to remediate and re-engineer library service. Strategies of efficient mobile design and delivery include adapting computing best practices of data independence and adhering to web standards as articulated by the W3C. These best practices apply across the

  2. Optimizing Implementation of Hepatitis C Birth-Cohort Screening and Treatment Strategies

    Directory of Open Access Journals (Sweden)

    Yuankun Li MS

    2017-01-01

    Full Text Available Background: Chronic hepatitis C (HCV is a significant public health problem affecting more than three million Americans. The US health care systems are ramping up costly HCV screening and treatment efforts with limited budget. We determine the optimal implementation of HCV birth-cohort screening and treatment strategies under budget constraints and health care payer’s perspective. Methods: Markov model and scenario-based simulation optimization. The target population is birth cohort born between 1945 and 1975. The interventions are allocating annual budget to screen a proportion of the target population and treat a proportion of the identified chronic HCV-positive patients over 10 years. Outcomes measure is to maximize lifetime discounted quality-adjusted life-years. Results: Allocate a percentage of the annual budget to screening, then treat patients with the remaining budget and prioritize the sickest patients. When the budget is $1 billion/year, the best strategy is to allocate the entire budget to treatment. When the budget is $5 billion/year, it is optimal to allocate 60% of the budget to screening in the first 2 years and 0% thereafter for age cohort 40 to 49; and allocate 20% of the budget to screening starting in year 3 for age cohorts 50 to 59 and 60 to 69. Health benefits are sensitive to budget in the first 2 years. Results are not sensitive to distribution of fibrosis stages by awareness of HCV. Conclusion: When budget is limited, all efforts should be focused on early treatment. With higher budget, better population health outcomes are achieved by reserving some budget for HCV screening while implementing a priority-based treatment strategy. This work has broad applicability to diverse health care systems and helps determine how much effort should be devoted to screening versus treatment under resource limitations.

  3. Strategies in the treatment for intracranial venous sinus thrombosis

    Directory of Open Access Journals (Sweden)

    JIA Qiang

    2013-03-01

    Full Text Available Background Cerebral venous sinus thrombosis (CVST is a special type of cerebrovascular disease with high morbidity and mortality which often has an unpredictable outcome. It is usually misdiagnosed because of different causes and variable clinical manifestations. How to improve the diagnosis and therapy of CVST is always the hotspot in clinic. This article aims to investigate the effective and safe strategies in the treatment for CVST. Methods Clinical data of 52 patients diagnosed with CVST were retrospectively analyzed. These patients were subdivided into mild type and severe type according to the features of symptoms, signs, lumbar puncture pressure and imaging. The patients with mild type were treated with systemic anticoagulant therapy combined with intravenous thrombolysis [continuous intravenous infusion of heparin (12.50-25 × 103 U/d for 7-10 d followed by a continuous infusion of urokinase (0.50-0.75 ×106 U/d for 5-7d]. The patients with severe type were treated with endovascular thrombolysis [injection of urokinase (0.50-1 × 106 U, 0.10 × 106 U/min via carotid or vertebral artery; or intravenous infusion of urokinase 1 ×106 U/d and heparin 25 ×103 U/d for 5-7 d], and superior sagittal sinus cut-open/ intrasinus thrombolysis separately. All the patients took oral warfarin for 6-12 months, and follow-up was performed after operation by the method of magnetic resonance venography (MRV. Results Among the 27 cases of mild type receiving systemic anticoagulant agents and intravenous thrombolysis, 14 were cured; 9 were improved; 4 were ineffective. Among the 22 cases of severe type receiving systemic anticoagulant drugs and endovascular thrombolysis, 18 were cured; 3 were improved; 1 was dead. The left 3 cases with gravis type received superior sagittal sinus cut-open/intrasinus thrombolysis and were cured. The period of follow-up was between 6 months and 60 months (the median time was 36 months, and no recurrence happened. Conclusion

  4. Molecular mechanisms of depression: perspectives on new treatment strategies.

    Science.gov (United States)

    Lang, Undine E; Borgwardt, Stefan

    2013-01-01

    observed by ketamine, which acts via the glutamatergic system. Hence, GABA, AMPA, EAAT, NMDA- and metabotropic glutamate receptors (mGluR1 to mGluR8) have gained interest in depression recently. Alternative, causative or also easy available treatment strategies beyond serotonin and noradrenaline reuptake inhibition might be a major topic of future psychiatric care. In this review, an attempt is made to overview concepts of the disease and search for perspectives on antidepressant treatment strategies beyond approved medications. Copyright © 2013 S. Karger AG, Basel.

  5. Molecular Mechanisms of Depression: Perspectives on New Treatment Strategies

    Directory of Open Access Journals (Sweden)

    Undine E. Lang

    2013-05-01

    effect has also been observed by ketamine, which acts via the glutamatergic system. Hence, GABA, AMPA, EAAT, NMDA- and metabotropic glutamate receptors (mGluR1 to mGluR8 have gained interest in depression recently. Alternative, causative or also easy available treatment strategies beyond serotonin and noradrenaline reuptake inhibition might be a major topic of future psychiatric care. In this review, an attempt is made to overview concepts of the disease and search for perspectives on antidepressant treatment strategies beyond approved medications.

  6. Investigation of treatment strategy for advanced cancer according to treatment of pancreatic cancer

    Directory of Open Access Journals (Sweden)

    XU Kecheng

    2013-10-01

    Full Text Available The majority of pancreatic cancer diagnoses are made at the advanced stage and when metastasis has already occurred, and the 1- and 5-year survival rates are extremely low. Cemcitabine remains the most frequently applied treatment option, yet the most effective chemotherapeutic agents and combinations with multiple agents and/or radiotherapy only marginally improve patient survival and may even establish an environment conducive to cancer cells with stem cell-like characteristics. An alternative treatment modality, cryoablation, is available and has been applied at our institute to patients with unresectable pancreatic cancer since 2001. In this article, we present our collective experience with patient outcome using cryoablation, alone or combined with other treatment modalities such as brachytherapy (125iodine seed implantation. The overall outcomes have been encouraging, suggesting that comprehensive therapy including cryoablation may prolong the survival of patients with advanced or metastatic pancreatic cancer, and we are achieving particular success with a novel combination of percutaneous cryoablation, cancer microvascular intervention with 125iodine seed implantation, and combined immunotherapy (3C applied using an individualized patient strategy (P. The 1- through 10-year survival rates of 145 patients treated with the so-called “3C+P model” are presented in support of this new strategy as a promising new treatment for advanced and metastatic cancer

  7. Comparison of treatment strategies for Space Motion Sickness

    Science.gov (United States)

    Davis, J. R.; Jennings, R. T.; Beck, B. G.

    1992-01-01

    Treatment strategies for Space Motion Sickness were compared using the results of postflight oral debriefings. Standardized questionnaires were administered to all crewmembers immediately following Space Shuttle flights by NASA flight surgeons. Cases of Space Motion Sickness were graded as mild, moderate or severe based on published criteria, and medication effectiveness was judged based on subjective reports of symptom relief. Since October 1989, medication effectiveness is reported inflight through Private Medical Conferences with the crew. A symptom matrix was analyzed for 19 crewmembers treated with an oral combination of scopolamine and dextroamphetamine (scopdex) and 15 crewmembers treated with promethazine delivered by intramuscular (IM) or suppository routes. Scopdex has been given preflight as prophaxis for Space Motion Sickness but analysis showed delayed symptom presentation in 9 crewmembers or failed to prevent symptoms in 7. Only three crewmembers who took scopdex had no symptoms inflight. Fourteen out of 15 crewmembers treated with IM promethazine and 6 of 8 treated with promethazine suppositories after symptom development had immediate (within 12 h) symptom relief and required no additional medication. There were no cases of delayed symptom presentation in the crewmembers treated with promethazine. This response is in contrast to untreated crewmembers who typically have slow symptom resolution over 72-96 h. We conclude that promethazine is an effective treatment of Space Motion Sickness symptoms inflight. NASA policy currently recommends treating crewmembers with Space Motion Sickness after symptom development, and no longer recommends prophylaxis with scopdex due to delayed symptom development and apparent variable absorption of oral medications during early flight days.

  8. Secondary Low-Level Waste Treatment Strategy Analysis

    International Nuclear Information System (INIS)

    D.M. LaRue

    1999-01-01

    The objective of this analysis is to identify and review potential options for processing and disposing of the secondary low-level waste (LLW) that will be generated through operation of the Monitored Geologic Repository (MGR). An estimate of annual secondary LLW is generated utilizing the mechanism established in ''Secondary Waste Treatment Analysis'' (Reference 8.1) and ''Secondary Low-Level Waste Generation Rate Analysis'' (Reference 8.5). The secondary LLW quantities are based on the spent fuel and high-level waste (HLW) arrival schedule as defined in the ''Controlled Design Assumptions Document'' (CDA) (Reference 8.6). This analysis presents estimates of the quantities of LLW in its various forms. A review of applicable laws, codes, and standards is discussed, and a synopsis of those applicable laws, codes, and standards and their impacts on potential processing and disposal options is presented. The analysis identifies viable processing/disposal options in light of the existing laws, codes, and standards, and then evaluates these options in regard to: (1) Process and equipment requirements; (2) LLW disposal volumes; and (3) Facility requirements

  9. Nanomedicine strategies for treatment of secondary spinal cord injury

    Directory of Open Access Journals (Sweden)

    White-Schenk D

    2015-01-01

    Full Text Available Désirée White-Schenk,1,4 Riyi Shi,1–3 James F Leary1–4 1Interdisciplinary Biomedical Sciences Program, 2Weldon School of Biomedical Engineering, 3Department of Basic Medical Sciences, Lynn School of Veterinary Medicine, 4Birck Nanotechnology Center, Discovery Park, Purdue University, West Lafayette, IN, USA Abstract: Neurological injury, such as spinal cord injury, has a secondary injury associated with it. The secondary injury results from the biological cascade after the primary injury and affects previous uninjured, healthy tissue. Therefore, the mitigation of such a cascade would benefit patients suffering a primary injury and allow the body to recover more quickly. Unfortunately, the delivery of effective therapeutics is quite limited. Due to the inefficient delivery of therapeutic drugs, nanoparticles have become a major field of exploration for medical applications. Based on their material properties, they can help treat disease by delivering drugs to specific tissues, enhancing detection methods, or a mixture of both. Incorporating nanomedicine into the treatment of neuronal injury and disease would likely push nanomedicine into a new light. This review highlights the various pathological issues involved in secondary spinal cord injury, current treatment options, and the improvements that could be made using a nanomedical approach. Keywords: spinal cord injury, acrolein, drug delivery, methylprednisolone, secondary injury

  10. Diagnosis and treatment strategies of thrombophilic risk factors

    Directory of Open Access Journals (Sweden)

    Murat Albayrak

    2010-09-01

    Full Text Available Thrombophilia is defined as the general name for a group of genetic and acquired situations, arising from defects of hemostasis mechanism and generating tendency to thrombosis. Examples of the acquired risk factors that increase the tendency to thrombosis are venous catheters, sepsis, surgery, hyperlipidemia, congestive heart disease, increased lipoprotein a, old age, antiphospholipid syndrome, nephrotic syndrome, hyperviscosity, chronic myeloproliferative neoplasms, paroxysmal nocturnal hemoglobinuria, heparin induced thrombocytopenia, vasculitis, immobility, obesity, major surgery, trauma, burns, malignancy, pregnancy and oral contraceptive usage. Genetic tendency to venous thromboembolism in early ages, even without any known cause, is named as thrombophilia. Factor V Leiden, prothrombin G20210A, methylenetetrahydrofolate reductase gene mutations, factor VIII elevation, protein C, protein S and antithrombin deficiency parameters are suggested for evaluation, in patient groups suspected of inherited thrombophilia. Detection of inherited thrombophilic factors in selected patient groups is a guide in developing treatment strategies and in establishing prognosis. Due to the genetic heterogeneities, each society should determine their thrombophilic risk pool. Thus, with the determination of the risk factors, unnecessary assessments will be prevented and a cost-effective approach can be developed.

  11. WEEE recovery strategies and the WEEE treatment status in China

    International Nuclear Information System (INIS)

    He Wenzhi; Li Guangming; Ma Xingfa; Wang Hua; Huang Juwen; Xu Min; Huang Chunjie

    2006-01-01

    The electric and electronic equipment has been developed, applied, and consumed world wide at a very high speed. Subsequently, the ever-increasing amount of waste electric and electronic equipment (WEEE) has become a common problem facing the world. In view of the deleterious effects of WEEE on the environment and the valuable materials that can be reused in them, legislations in many countries have focused their attention on the management of WEEE, and new techniques have been developed for the recovery of WEEE. In China, rapid economic growth, coupled with urbanization and growing demand for consumer goods, has increased the consumption of EEE in large quantity, thus made the WEEE manifold rapidly, posing a severe threat to the environment and the sustainable economic growth as well. This article reviewed the implementation of strategies of WEEE treatment and the recovery technologies of WEEE. It presented the current status of WEEE and corresponding responses adopted so far in China. The concept and implementation of scientific development is critical to the sector of electronics, one of the important industrial sectors in China's economy. To achieve this objective, it is significant to recycle WEEE sufficiently to comply with regulations regarding WEEE management, and to implement green design and cleaner production concepts within the electronics industry to comply with the upcoming EU and China legislation in a proactive manner

  12. Decision making in treatment strategy of AVMs. Treatment board system at Tohoku University

    International Nuclear Information System (INIS)

    Jokura, Hidefumi; Yoshimoto, Takashi

    1999-01-01

    Treatment of some large, deep-seated arteriovenous malformations is still a challenge to neurosurgeons. The recent development of non-invasive imaging modalities has increased the chance of finding asymptomatic AVM's, for which evaluation for treatment is more complicated than in symptomatic cases. Currently there are 3 major treatment options for AVM: microsurgical removal, radiosurgery, and intravascular embolization. It is not easy to choose the best single modality or combination of modalities for individual patients, who have different types of onset, neurological deficits, size and location, and social background. After the installation of the Gamma Knife in November 1991, we established an 'AVM Treatment Board.' It comprises vascular neurosurgeons, endovascular neurosurgeons, and radio-neurosurgeons, and meetings are held twice a month. Every AVM case referred to us is presented to the board, and treatment strategy is selected after a discussion among experts who know the advantages and drawbacks of each treatment modality. We describe this board system in detail and emphasize the importance of gathering expertise in decision making. (author)

  13. Treatment strategies in the management of jejunoileal and colonic atresia

    Directory of Open Access Journals (Sweden)

    Chadha Rajiv

    2006-01-01

    Full Text Available BACKGROUND/PURPOSE: The purpose of this prospective study was to review the operative findings, treatment strategies, as well as the results of management of 46 consecutive cases of jejunoileal and colonic atresia, managed over a 2-year period. MATERIALS AND METHODS: There were 42 patients with jejunoileal atresia (JIA and 4 with colonic atresia (CA. The 4 group types were: type I-membranous (n=20, type II- blind ends separated by a fibrous cord (n=6, type IIIa- blind ends with a V-shaped mesenteric defect (n=10, type IIIb- apple-peel atresia (n=4 and type IV- multiple atresias (n=6. Primary surgery for JIA consisted of resection with a single anastomosis (n=37, anastomosis after tapering jejunoplasty (n=3, multiple anastomosis (n=1 and a Bishop-Koop ileostomy (n=1. For CA, resection with primary anastomosis was performed. A single end-to-oblique anastomosis after adequate resection of dilated proximal bowel, was the preferred surgical procedure. In the absence of facilities for administering TPN, early oral/nasogastric (NG tube feeding was encouraged. In patients with anastomotic dysfunction, conservative treatment of the obstruction followed after its resolution by gradually increased NG feeds, was the preferred treatment protocol. RESULTS: Late presentation or diagnosis with hypovolemia, electrolyte imbalance, unconjugated hyperbilirubinemia (n=25 and sepsis (n=6, were significant preoperative findings. After resection and anastomosis, significant shortening of bowel length was seen in 16 patients (34.7%. Postoperative complications included an anastomotic leak (n=3, a perforation proximal to the anastomosis in 1 and anastomotic dysfunction in 5 patients. Full oral or NG tube feeding was possible only by the 13th to 31st postoperative day (POD, after the primary surgery in patients with anastomotic dysfunction and those undergoing reoperation. Overall, 38 patients survived (82.6%. Mortality was highest in patients with type IIIb or type IV

  14. Dentin biomodification: strategies, renewable resources and clinical applications.

    Science.gov (United States)

    Bedran-Russo, Ana K; Pauli, Guido F; Chen, Shao-Nong; McAlpine, James; Castellan, Carina S; Phansalkar, Rasika S; Aguiar, Thaiane R; Vidal, Cristina M P; Napotilano, José G; Nam, Joo-Won; Leme, Ariene A

    2014-01-01

    The biomodification of dentin is a biomimetic approach, mediated by bioactive agents, to enhance and reinforce the dentin by locally altering the biochemistry and biomechanical properties. This review provides an overview of key dentin matrix components, targeting effects of biomodification strategies, the chemistry of renewable natural sources, and current research on their potential clinical applications. The PubMed database and collected literature were used as a resource for peer-reviewed articles to highlight the topics of dentin hierarchical structure, biomodification agents, and laboratorial investigations of their clinical applications. In addition, new data is presented on laboratorial methods for the standardization of proanthocyanidin-rich preparations as a renewable source of plant-derived biomodification agents. Biomodification agents can be categorized as physical methods and chemical agents. Synthetic and naturally occurring chemical strategies present distinctive mechanism of interaction with the tissue. Initially thought to be driven only by inter- or intra-molecular collagen induced non-enzymatic cross-linking, multiple interactions with other dentin components are fundamental for the long-term biomechanics and biostability of the tissue. Oligomeric proanthocyanidins show promising bioactivity, and their chemical complexity requires systematic evaluation of the active compounds to produce a fully standardized intervention material from renewable resource, prior to their detailed clinical evaluation. Understanding the hierarchical structure of dentin and the targeting effect of the bioactive compounds will establish their use in both dentin-biomaterials interface and caries management. Copyright © 2013 Academy of Dental Materials. Published by Elsevier Ltd. All rights reserved.

  15. Application of Multivariable Statistical Techniques in Plant-wide WWTP Control Strategies Analysis

    DEFF Research Database (Denmark)

    Flores Alsina, Xavier; Comas, J.; Rodríguez-Roda, I.

    2007-01-01

    The main objective of this paper is to present the application of selected multivariable statistical techniques in plant-wide wastewater treatment plant (WWTP) control strategies analysis. In this study, cluster analysis (CA), principal component analysis/factor analysis (PCA/FA) and discriminant...... analysis (DA) are applied to the evaluation matrix data set obtained by simulation of several control strategies applied to the plant-wide IWA Benchmark Simulation Model No 2 (BSM2). These techniques allow i) to determine natural groups or clusters of control strategies with a similar behaviour, ii......) to find and interpret hidden, complex and casual relation features in the data set and iii) to identify important discriminant variables within the groups found by the cluster analysis. This study illustrates the usefulness of multivariable statistical techniques for both analysis and interpretation...

  16. Optimizing molluscicide treatment strategies in different control stages of schistosomiasis in the People's Republic of China.

    Science.gov (United States)

    Yang, Guo-Jing; Sun, Le-Ping; Hong, Qing-Biao; Zhu, Hong-Ru; Yang, Kun; Gao, Qi; Zhou, Xiao-Nong

    2012-11-14

    The application of chemical molluscicides is still one of the most effective measures for schistosomiasis control in P. R. China. By applying diverse molluscicide treatment scenarios on different snail densities in the field, we attempted to understand the cost-effectiveness of molluscicide application so as to prescribe an optimal management approach to control intermediate host snail Oncomelania hupensis under acceptable thresholds based on the goal of the National Schistosomiasis Control Programme. The molluscicidal field trial was carried out in the marshland of an island along the Yangtze River, Jiangsu province, P.R. China in October 2010. Three plots in the island representing low-density, medium-density and high-density groups were identified after the baseline survey on snail density. Each snail density plot was divided into four experimental units in which molluscicide (50% niclosamide ethanolamine salt wettable powder) was applied once, twice, trice and four times, respectively. The logistic regression model to correlate snail mortality rate with the covariates of number of molluscicidal treatment and snail density, and a linear regression model to investigate the relationship between cost-effectiveness and number of molluscicidal treatment as well as snail density were established. The study revealed that increase in the number of molluscicide treatments led to increased snail mortality across all three population density groups. The most cost-effective regimen was seen in the high snail density group with a single molluscicide treatment. For both high and low density groups, the more times molluscicide were applied, the less cost-effectiveness was. However, for the median density group, the level of cost-effectiveness for two applications was slightly higher than that in one time. We concluded that different stages of the national schistosomiasis control/elimination programme, namely morbidity control, transmission control and transmission interruption

  17. Grout treatment facility dangerous waste permit application

    International Nuclear Information System (INIS)

    1988-01-01

    This section briefly describes the Hanford Site, provides a general description of the site operations and administration, provides an overview of the contents of this Grout Treatment Facility (GTF) Permit Application, and gives a list of acronyms and abbreviations used in the document. The decision was made to use the checklist as a locator reference instead of using the checklist section numbers as paragraph section numbers because several different types of waste management units, some of which are not addressed in the checklists, are part of the GTF. The GTF is a waste management unit within the Hanford Site facility. In May 1988, permit application was filed that identified the GTF as an existing facility. The GTF mixes dry cementitious solids with liquid mixed wastes (containing both dangerous and radioactive constituents) produced by Hanford Site operations. In addition to the design and operating features of the GTF that are intended to meet the requirements of dangerous waste regulations, many additional design and operating features are necessary to comply with radioactive waste management practices. The GTF design features and practices are intended to keep operational exposure to radionuclides and dangerous substances ''as low as reasonably achievable'' (ALARA) and to provide a disposal system that protects the environment for at least 10,000 yr. In some instances, ALARA practices present difficulties when complying with requirements of dangerous waste regulations

  18. Grout treatment facility dangerous waste permit application

    International Nuclear Information System (INIS)

    1988-01-01

    This section briefly describes the Hanford Site, provides a general description of the site operations and administration, provides an overview of the contents of this Grout Treatment Facility (GTF) Permit Application, and gives a list of acronyms and abbreviations used in the document. The decision was made to use the checklist as a locator reference instead of using the checklist section numbers as paragraph section numbers because several different types of waste management units, some of which are not addressed in the checklists, are part of the GTF. The GTF is a waste management unit within the Hanford Site facility. In May 1988, a permit application was filed that identified the GTF as an existing facility. The GTF mixes dry cementitious solids with liquid mixed wastes (containing both dangerous and radioactive constituents) produced by Hanford Site operations. In addition to the design and operating features of the GTF that are intended to meet the requirements of dangerous waste regulations, many additional design and operating features are necessary to comply with radioactive waste management practices. The GTF design features and practices are intended to keep operational exposure to radionuclides and dangerous substances ''as low as reasonably achievable'' (ALARA) and to provide a disposal system that protects the environment for at least 10,000 yr. In some instances, ALARA practices present difficulties when complying with requirements of dangerous waste regulations. This volume contains 2 appendices covering engineering drawings and operating procedures

  19. Grout treatment facility dangerous waste permit application

    International Nuclear Information System (INIS)

    1988-01-01

    This section briefly describes the Hanford Site, provides a general description of the site operations and administration, provides an overview of the contents of this Grout Treatment Facility (GTF) Permit Application, and gives a list of acronyms and abbreviations used in the document. The decision was made to use the checklist as a locator reference instead of using the checklist section numbers as paragraph section numbers because several different types of waste management units, some of which are not addressed in the checklists, are part of the GTF. The GTF is a waste management unit within the Hanford Site facility. In May 1988, a permit application was filed that identified the GTF as an existing facility. The GTF mixes dry cementitious solids with liquid mixed wastes (containing both dangerous and radioactive constitutents) produced by Hanford Site operations. In addition to the design and operating features of the GTF that are intended to meet the requirements of dangerous waste regulations, many additional design and operating features are necessary to comply with radioactive waste management practices. The GTF design features and practices are intended to keep operational exposure to radionuclides and dangerous substances ''as low as reasonably achievable'' (ALARA) and to provide a disposal system that protects the environment for at least 10,000 yr. In some instances, ALARA practices present difficulties when complying with requirements of dangerous waste regulations. This volume contains 2 Appendices covering engineering drawings and operating procedures

  20. Grout Treatment Facility dangerous waste permit application

    International Nuclear Information System (INIS)

    1988-01-01

    This section briefly describes the Hanford Site, provides a general description of the site operations and administration, provides an overview of the contents of this Grout Treatment Facility (GTF) Permit Application, and gives a list of acronyms and abbreviations used in the document. The decision was made to use the checklist as a locator reference instead of using the checklist section numbers as paragraph section numbers because several different types of waste management units, some of which are not addressed in the checklists, are part of the GTF. The GTF is a waste management unit within the Hanford Site facility. In May 1988, a permit application was filed that identified the GTF as an existing facility. The GTF mixes dry cementitious solids with liquid wastes (containing both dangerous and radioactive constituents) produced by Hanford Site operations. In addition to the design and operating features of the GTF that are intended to meet the requirements of dangerous waste regulations, many additional design and operating features are necessary to comply with radioactive waste management practices. The GTF design features and practices are intended to keep operational exposure to radionuclides and dangerous substances ''as low as reasonably achievable'' (ALARA) and to provide a disposal system that protects the environment for at least 10,000 yr. In some instances, ALARA practices present difficulties when complying with requirements of dangerous waste regulations. This volume contains 14 Appendices. Topics include Engineering Drawings, Maps, Roads, Toxicity Testing, and Pilot-Scale Testing

  1. Application of radiation for wastewater treatment

    International Nuclear Information System (INIS)

    Han Bumsoo; Kim Jinkyu; Kim Yuri

    2006-01-01

    Electron beam processing of wastewater is non-chemical, and uses fast formation of short-lived reactive radicals that can interact with a wide range of pollutants. Such reactive radicals are strong oxidizing or reducing agents that can transform the pollutants in the liquids wastes. The first studies on the radiation treatment of wastes were carried out in the 1950s principally for disinfection. In the 1960s, these studies were extended to the purification of water and wastewater. After some laboratory research on industrial wastewaters and polluted groundwater in 1970s and 1980s, several pilot plants were built for extended research in the 1990s. The first full-scale application was reported for the purification of wastewater at the Voronezh synthetic rubber plant in Russia. Two accelerators (50 kW each) were used to convert the non-biodegradable emulsifier, 'nekal', present in the wastewater to a biodegradable form . The installation treats up to 2000 m3 of effluent per day. A pilot plant of 1000 m 3 /d for treating textile-dyeing wastewater has been constructed in Daegu, Korea with 1 MeV, 40 kW electron accelerator. High-energy irradiation produces instantaneous radiolytical transformations by energy transfer from accelerated electrons to orbital electrons of water molecules. Absorbed energy disturbs the electron system of the molecule and results in breakage of inter-atomic bonds. Hydrated electron eaq, H atom, . OH and HO 2 . radicals and hydrogen peroxide H 2 O 2 and H 2 are the most important products of the primary interactions (radiolysis products). Generally, radiation processing of wastewater has maximum efficiency at pollutant concentration less than 10 -3 mol/L (∼100 ppm). The treatment of such wastewater is simple, requires low dose (about 1 kGy or less) and gives almost complete elimination of odor, color, taste and turbidity. The radiation processing of polluted water containing specific contaminants may require creation of special conditions to

  2. Control strategies for nitrous oxide emissions reduction on wastewater treatment plants operation.

    Science.gov (United States)

    Santín, I; Barbu, M; Pedret, C; Vilanova, R

    2017-11-15

    The present paper focused on reducing greenhouse gases emissions in wastewater treatment plants operation by application of suitable control strategies. Specifically, the objective is to reduce nitrous oxide emissions during the nitrification process. Incomplete nitrification in the aerobic tanks can lead to an accumulation of nitrite that triggers the nitrous oxide emissions. In order to avoid the peaks of nitrous oxide emissions, this paper proposes a cascade control configuration by manipulating the dissolved oxygen set-points in the aerobic tanks. This control strategy is combined with ammonia cascade control already applied in the literature. This is performed with the objective to take also into account effluent pollutants and operational costs. In addition, other greenhouse gases emissions sources are also evaluated. Results have been obtained by simulation, using a modified version of Benchmark Simulation Model no. 2, which takes into account greenhouse gases emissions. This is called Benchmark Simulation Model no. 2 Gas. The results show that the proposed control strategies are able to reduce by 29.86% of nitrous oxide emissions compared to the default control strategy, while maintaining a satisfactory trade-off between water quality and costs. Copyright © 2017 Elsevier Ltd. All rights reserved.

  3. Management strategies in the treatment of neonatal and pediatric gastroenteritis

    Directory of Open Access Journals (Sweden)

    Ciccarelli S

    2013-10-01

    Full Text Available Simona Ciccarelli,1 Ilaria Stolfi,1 Giuseppe Caramia2 1Neonatal Intensive Care Unit, Sapienza University of Rome, Rome, Italy; 2Division of Neonatology and Pediatrics, Maternal and Child Hospital "G. Salesi", Ancona, Italy Abstract: Acute gastroenteritis, characterized by the onset of diarrhea with or without vomiting, continues to be a major cause of morbidity and mortality in children in mostly resource-constrained nations. Although generally a mild and self-limiting disease, gastroenteritis is one of the most common causes of hospitalization and is associated with a substantial disease burden. Worldwide, up to 40% of children aged less than 5 years with diarrhea are hospitalized with rotavirus. Also, some microorganisms have been found predominantly in resource-constrained nations, including Shigella spp, Vibrio cholerae, and the protozoan infections. Prevention remains essential, and the rotavirus vaccines have demonstrated good safety and efficacy profiles in large clinical trials. Because dehydration is the major complication associated with gastroenteritis, appropriate fluid management (oral or intravenous is an effective and safe strategy for rehydration. Continuation of breastfeeding is strongly recommended. New treatments such as antiemetics (ondansetron, some antidiarrheal agents (racecadotril, and chemotherapeutic agents are often proposed, but not yet universally recommended. Probiotics, also known as “food supplement,” seem to improve intestinal microbial balance, reducing the duration and the severity of acute infectious diarrhea. The European Society for Paediatric Gastroenterology, Hepatology and Nutrition and the European Society of Paediatric Infectious Diseases guidelines make a stronger recommendation for the use of probiotics for the management of acute gastroenteritis, particularly those with documented efficacy such as Lactobacillus rhamnosus GG, Lactobacillus reuteri, and Saccharomyces boulardii. To date, the

  4. Treatment strategies for inherited optic neuropathies: past, present and future

    Science.gov (United States)

    Yu-Wai-Man, P; Votruba, M; Moore, A T; Chinnery, P F

    2014-01-01

    Bilateral visual loss secondary to inherited optic neuropathies is an important cause of registrable blindness among children and young adults. The two prototypal disorders seen in clinical practice are Leber hereditary optic neuropathy (LHON) and autosomal dominant optic atrophy (DOA). About 90% of LHON cases are due to one of three mitochondrial DNA (mtDNA) point mutations: m.3460G>A, m.11778G>A, and m.14484T>C, which affect critical complex I subunits of the mitochondrial respiratory chain. The majority of patients with DOA harbour pathogenic mutations within OPA1, a nuclear gene that codes for a multifunctional inner mitochondrial membrane protein. Despite their contrasting genetic basis, LHON and DOA share overlapping pathological and clinical features that serve to highlight the striking tissue-specific vulnerability of the retinal ganglion cell (RGC) layer to disturbed mitochondrial function. In addition to severe visual loss secondary to progressive optic nerve degeneration, a subgroup of patients will also develop a more aggressive syndromic phenotype marked by significant neurological deficits. The management of LHON and DOA remains largely supportive, but major advances in our understanding of the mechanisms underpinning RGC loss in these two disorders are paving the way for novel forms of treatment aimed at halting or reversing visual deterioration at different stages of the disease process. In addition to neuroprotective strategies for rescuing RGCs from irreversible cell death, innovative in vitro fertilisation techniques are providing the tantalising prospect of preventing the germline transmission of pathogenic mtDNA mutations, eradicating in so doing the risk of disease in future generations. PMID:24603424

  5. Treatment strategies for inherited optic neuropathies: past, present and future.

    Science.gov (United States)

    Yu-Wai-Man, P; Votruba, M; Moore, A T; Chinnery, P F

    2014-05-01

    Bilateral visual loss secondary to inherited optic neuropathies is an important cause of registrable blindness among children and young adults. The two prototypal disorders seen in clinical practice are Leber hereditary optic neuropathy (LHON) and autosomal dominant optic atrophy (DOA). About 90% of LHON cases are due to one of three mitochondrial DNA (mtDNA) point mutations: m.3460G>A, m.11778G>A, and m.14484T>C, which affect critical complex I subunits of the mitochondrial respiratory chain. The majority of patients with DOA harbour pathogenic mutations within OPA1, a nuclear gene that codes for a multifunctional inner mitochondrial membrane protein. Despite their contrasting genetic basis, LHON and DOA share overlapping pathological and clinical features that serve to highlight the striking tissue-specific vulnerability of the retinal ganglion cell (RGC) layer to disturbed mitochondrial function. In addition to severe visual loss secondary to progressive optic nerve degeneration, a subgroup of patients will also develop a more aggressive syndromic phenotype marked by significant neurological deficits. The management of LHON and DOA remains largely supportive, but major advances in our understanding of the mechanisms underpinning RGC loss in these two disorders are paving the way for novel forms of treatment aimed at halting or reversing visual deterioration at different stages of the disease process. In addition to neuroprotective strategies for rescuing RGCs from irreversible cell death, innovative in vitro fertilisation techniques are providing the tantalising prospect of preventing the germline transmission of pathogenic mtDNA mutations, eradicating in so doing the risk of disease in future generations.

  6. An Antipersister Strategy for Treatment of Chronic Pseudomonas aeruginosa Infections.

    Science.gov (United States)

    Koeva, Martina; Gutu, Alina D; Hebert, Wesley; Wager, Jeffrey D; Yonker, Lael M; O'Toole, George A; Ausubel, Frederick M; Moskowitz, Samuel M; Joseph-McCarthy, Diane

    2017-12-01

    Bacterial persisters are a quasidormant subpopulation of cells that are tolerant to antibiotic treatment. The combination of the aminoglycoside tobramycin with fumarate as an antibacterial potentiator utilizes an antipersister strategy that is aimed at reducing recurrent Pseudomonas aeruginosa infections by enhancing the killing of P. aeruginosa persisters. Stationary-phase cultures of P. aeruginosa were used to generate persister cells. A range of tobramycin concentrations was tested with a range of metabolite concentrations to determine the potentiation effect of the metabolite under a variety of conditions, including a range of pH values and in the presence of azithromycin or cystic fibrosis (CF) patient sputum. In addition, 96-well dish biofilm and colony biofilm assays were performed, and the cytotoxicity of the tobramycin-fumarate combination was determined utilizing a lactate dehydrogenase (LDH) assay. Enhanced killing of up to 6 orders of magnitude of P. aeruginosa persisters over a range of CF isolates, including mucoid and nonmucoid strains, was observed for the tobramycin-fumarate combination compared to killing with tobramycin alone. Furthermore, significant fumarate-mediated potentiation was seen in the presence of azithromycin or CF patient sputum. Fumarate also reduced the cytotoxicity of tobramycin-treated P. aeruginosa to human epithelial airway cells. Finally, in mucoid and nonmucoid CF isolates, complete eradication of P. aeruginosa biofilm was observed in the colony biofilm assay due to fumarate potentiation. These data suggest that a combination of tobramycin with fumarate as an antibacterial potentiator may be an attractive therapeutic for eliminating recurrent P. aeruginosa infections in CF patients through the eradication of bacterial persisters. Copyright © 2017 American Society for Microbiology.

  7. Consensus Recommendations for Treatment Strategies in Indians Using Botulinum Toxin and Hyaluronic Acid Fillers

    Directory of Open Access Journals (Sweden)

    Krishan Mohan Kapoor, MCh, DNB

    2017-12-01

    Conclusions:. These recommendations give physicians treating Indians worldwide a better understanding of their unique facial characteristics and provide treatment strategies to achieve optimal aesthetic outcomes.

  8. Strategies for automatic online treatment plan reoptimization using clinical treatment planning system: A planning parameters study

    International Nuclear Information System (INIS)

    Li, Taoran; Wu, Qiuwen; Zhang, You; Vergalasova, Irina; Lee, W. Robert; Yin, Fang-Fang; Wu, Q. Jackie

    2013-01-01

    Purpose: Adaptive radiation therapy for prostate cancer using online reoptimization provides an improved control of interfractional anatomy variations. However, the clinical implementation of online reoptimization is currently limited by the low efficiency of current strategies and the difficulties associated with integration into the current treatment planning system. This study investigates the strategies for performing fast (∼2 min) automatic online reoptimization with a clinical fluence-map-based treatment planning system; and explores the performance with different input parameters settings: dose-volume histogram (DVH) objective settings, starting stage, and iteration number (in the context of real time planning).Methods: Simulated treatments of 10 patients were reoptimized daily for the first week of treatment (5 fractions) using 12 different combinations of optimization strategies. Options for objective settings included guideline-based RTOG objectives, patient-specific objectives based on anatomy on the planning CT, and daily-CBCT anatomy-based objectives adapted from planning CT objectives. Options for starting stages involved starting reoptimization with and without the original plan's fluence map. Options for iteration numbers were 50 and 100. The adapted plans were then analyzed by statistical modeling, and compared both in terms of dosimetry and delivery efficiency.Results: All online reoptimized plans were finished within ∼2 min with excellent coverage and conformity to the daily target. The three input parameters, i.e., DVH objectives, starting stage, and iteration number, contributed to the outcome of optimization nearly independently. Patient-specific objectives generally provided better OAR sparing compared to guideline-based objectives. The benefit in high-dose sparing from incorporating daily anatomy into objective settings was positively correlated with the relative change in OAR volumes from planning CT to daily CBCT. The use of the

  9. Targeted therapy and personalized medicine in hepatocellular carcinoma: drug resistance, mechanisms, and treatment strategies

    Directory of Open Access Journals (Sweden)

    Galun D

    2017-07-01

    Full Text Available Danijel Galun,1,2 Tatjana Srdic-Rajic,3 Aleksandar Bogdanovic,1 Zlatibor Loncar,2,4 Marinko Zuvela1,2 1Hepato-Pancreato-Biliary Unit, University Clinic for Digestive Surgery, Clinical Center of Serbia, 2Medical School, University of Belgrade, 3Institute for Oncology and Radiology of Serbia/Unit for Experimental Oncology, 4Emergency Center, Clinical Center of Serbia, Belgrade, Serbia Abstract: Hepatocellular carcinoma (HCC is characterized by a growing number of new cases diagnosed each year that is nearly equal to the number of deaths from this cancer. In a majority of the cases, HCC is associated with the underlying chronic liver disease, and it is diagnosed in advanced stage of disease when curative treatment options are not applicable. Sorafenib is a treatment of choice for patients with performance status 1 or 2 and/or macrovascular invasion or extrahepatic spread, and regorafenib is the only systemic treatment found to provide survival benefit in HCC patients progressing on sorafenib treatment. Other drugs tested in different trials failed to demonstrate any benefit. Disappointing results of numerous trials testing the efficacy of various drugs indicate that HCC has low sensitivity to chemotherapy that is in great part caused by multidrug resistance. Immunotherapy for HCC is a new challenging treatment option and involves immune checkpoint inhibitors/antibody-based therapy and peptide-based vaccines. Another challenging approach is microRNA-based therapy that involves two strategies. The first aims to inhibit oncogenic miRNAs by using miRNA antagonists and the second strategy is miRNA replacement, which involves the reintroduction of a tumor-suppressor miRNA mimetic to restore a loss of function. Keywords: hepatocellular carcinoma, drug resistance, multimodal treatment, chemotherapy 

  10. Strategies for application of scientific findings in prevention.

    Science.gov (United States)

    Wei, S H

    1995-07-01

    Dental research in the last 50 years has accomplished numerous significant advances in preventive dentistry, particularly in the area of research in fluorides, periodontal diseases, restorative dentistry, and dental materials, as well as craniofacial development and molecular biology. The transfer of scientific knowledge to clinical practitioners requires additional effort. It is the responsibility of the scientific communities to transfer the fruits of their findings to society through publications, conferences, media, and the press. Specific programs that the International Association for Dental Research (IADR) has developed to transmit science to the profession and the public have included science transfer seminars, the Visiting Lecture Program, and hands-on workshops. The IADR Strategic Plan also has a major outreach goal. In addition, the Federation Dentaire Internationale (FDI) and the World Health Organization (WHO) have initiated plans to celebrate World Health Day and the Year of Oral Health in 1994. These are important strategies for the application of scientific findings in prevention.

  11. Exploring Monte Carlo Simulation Strategies for Geoscience Applications

    Science.gov (United States)

    Blais, J.; Grebenitcharsky, R.; Zhang, Z.

    2008-12-01

    Computer simulations are an increasingly important area of geoscience research and development. At the core of stochastic or Monte Carlo simulations are the random number sequences that are assumed to be distributed with specific characteristics. Computer generated random numbers, uniformly distributed on [0, 1], can be very different depending on the selection of pseudo-random number (PRN), quasi-random number (QRN) or chaotic random number (CRN) generators. In the evaluation of some definite integrals, the expected error variances are generally of different orders for the same number of random numbers. A comparative analysis of these three strategies has been carried out for geodetic and related applications in planar and spherical contexts. Based on these computational experiments, conclusions and recommendations concerning their performance and error variances are included.

  12. Application of ABCD Analysis Model for Black Ocean Strategy

    OpenAIRE

    Sreeramana Aithal; Suresh Kumar P. M.; Shailashree V. T.

    2015-01-01

    Strategic planning and decision making has an important role in organizational development and sustainability. Various types of strategies are used in strategic management such as Red ocean strategy, Blue ocean strategy, Green ocean strategy and Purple ocean strategy. These strategies are used in organizations by top level executive managers for long term sustainability of organization and to face or avoid the competition. Based on organizational analysis, it is observed that some...

  13. Applicability of salt reduction strategies in pizza crust.

    Science.gov (United States)

    Mueller, Eva; Koehler, Peter; Scherf, Katharina Anne

    2016-02-01

    In an effort to reduce population-wide sodium intake from processed foods, due to major health concerns, several different strategies for sodium reduction in pizza crust without any topping were evaluated by sensory analyses. It was possible to reduce sodium by 10% in one single step or to replace 30% of NaCl by KCl without a noticeable loss of salty taste. The late addition of coarse-grained NaCl (crystal size: 0.4-1.4 mm) to pizza dough led to an enhancement of saltiness through taste contrast and an accelerated sodium delivery measured in the mouth and in a model mastication simulator. Likewise, the application of an aqueous salt solution to one side of the pizza crust led to an enhancement of saltiness perception through faster sodium availability, leading to a greater contrast in sodium concentration. Each of these two strategies allowed a sodium reduction of up to 25% while maintaining taste quality. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Radiotracer Applications in Wastewater Treatment Plants

    International Nuclear Information System (INIS)

    2011-01-01

    Wastewater containing pollutants resulting from municipal and industrial activities are normally collected in wastewater treatment plants (WWTPs) for processing before discharge to the environment. The WWTPs are the last barrier against contamination of downstream surface waters such as rivers, lakes and sea. Treated wastewater is reused for irrigation, particularly in arid and semi-arid countries. Therefore, it is very important to maintain optimal operating conditions of WWTPs to eliminate or reduce environmental pollution. Wastewater treatment plants are complicated systems, where the processes of mixing, separation, aeration, biological and chemical reactions occur. A WWTP is basically a multiphase system, and the efficiency of an installation strongly depends on liquid, solid and gas phase flow structures and their residence time distributions (RTDs). However, the fluid dynamic properties of such systems are not yet completely understood, rendering difficult the theoretical prediction of important process parameters such as flow rates, phase distributions, mixing and sediment characteristics. Tracer techniques are very useful tools to investigate the efficiency of purification in WWTPs, aiding both their design and performance optimization. There are many kinds of tracers. Radioactive tracers are the most sensitive and are largely used for on-line diagnosis of various operations in WWTPs. The success of radiotracer applications rests upon their extremely high detection sensitivity, and the strong resistance against severe process conditions. During the last few decades, many radiotracer studies have been conducted worldwide for investigation of various installations for wastewater treatment, such as mixer, aeration tank, clarifiers, digester, filter, wetland and oxidation units. Various radiotracer methods and techniques have been developed by individual tracer groups. However, the information necessary for the preservation of knowledge and transfer of

  15. Clinical treatment strategies and experimental studies in polytrauma

    NARCIS (Netherlands)

    van Wessem, K.J.P.

    2013-01-01

    This thesis describes the clinical treatment of polytrauma patients and the underlying pathophysiological mechanisms causing injury-induced inflammatory response. Even though the treatment of polytrauma patients has improved over the years, trauma is still the leading cause of death

  16. DSC: software tool for simulation-based design of control strategies applied to wastewater treatment plants.

    Science.gov (United States)

    Ruano, M V; Ribes, J; Seco, A; Ferrer, J

    2011-01-01

    This paper presents a computer tool called DSC (Simulation based Controllers Design) that enables an easy design of control systems and strategies applied to wastewater treatment plants. Although the control systems are developed and evaluated by simulation, this tool aims to facilitate the direct implementation of the designed control system to the PC of the full-scale WWTP (wastewater treatment plants). The designed control system can be programmed in a dedicated control application and can be connected to either the simulation software or the SCADA of the plant. To this end, the developed DSC incorporates an OPC server (OLE for process control) which facilitates an open-standard communication protocol for different industrial process applications. The potential capabilities of the DSC tool are illustrated through the example of a full-scale application. An aeration control system applied to a nutrient removing WWTP was designed, tuned and evaluated with the DSC tool before its implementation in the full scale plant. The control parameters obtained by simulation were suitable for the full scale plant with only few modifications to improve the control performance. With the DSC tool, the control systems performance can be easily evaluated by simulation. Once developed and tuned by simulation, the control systems can be directly applied to the full-scale WWTP.

  17. Push and pull strategies: applications for health care marketing.

    Science.gov (United States)

    Kingsley, B R

    1987-08-01

    As health care markets mature and expand, strategies available in other industries become useful. This article examines how traditional push-pull strategies apply to health care. Marketers using a push strategy recognize that the sale of their services or goods is dependent upon the endorsement of a middleman and promote their product through the middleman. Those using a pull strategy market directly to the consumer. In this article, the author outlines the advantages and disadvantages of using each strategy.

  18. Biological Treatment of Drinking Water: Applications, Advantages and Disadvantages

    Science.gov (United States)

    The fundamentals of biological treatment are presented to an audience of state drinking water regulators. The presentation covers definitions, applications, the basics of bacterial metabolism, a discussion of treatment options, and the impact that implementation of these options...

  19. Treatment strategies for the infertile polycystic ovary syndrome patient.

    Science.gov (United States)

    Tannus, Samer; Burke, Yechiel Z; Kol, Shahar

    2015-11-01

    Polycystic ovary syndrome (PCOS) is the most common endocrine disorder in women of reproductive age. Infertility is a prevalent presenting feature of PCOS, and approximately 75% of these women suffer infertility due to anovulation. Lifestyle modification is considered the first-line treatment and is associated with improved endocrine profile. Clomiphene citrate (CC) should be considered as the first line pharmacologic therapy for ovulation induction. In women who are CC resistant, second-line treatment should be considered, as adding metformin, laparoscopic ovarian drilling or treatment with gonadotropins. In CC treatment failure, Letrozole could be an alternative or treatment with gonadotropins. IVF is considered the third-line treatment; the 'short', antagonist-based protocol is the preferred option for PCOS patients, as it is associated with lower risk of developing ovarian hyperstimulation syndrome (specifically by using a gonadotropin--releasing hormone agonist as ovulation trigger), but with comparable outcomes as the long protocol.

  20. Prehospital evaluation and economic analysis of different coronary syndrome treatment strategies - PREDICT - Rationale, Development and Implementation

    Directory of Open Access Journals (Sweden)

    Craig Alan

    2011-03-01

    Full Text Available Abstract Background A standard of prehospital care for patients presenting with ST-segment elevation myocardial infarction (STEMI includes prehospital 12-lead and advance Emergency Department notification or prehospital bypass to percutaneous coronary intervention centres. Implementation of either care strategies is variable across communities and neither may exist in some communities. The main objective is to compare prehospital care strategies for time to treatment and survival outcomes as well as cost effectiveness. Methods/Design PREDICT is a multicentre, prospective population-based cohort study of all chest pain patients 18 years or older presenting within 30 mins to 6 hours of symptom onset and treated with nitroglycerin, transported by paramedics in a number of different urban and rural regions in Ontario. The primary objective of this study is to compare the proportion of study subjects who receive reperfusion within the target door-to-reperfusion times in subjects obtained after four prehospital strategies: 12-lead ECG and advance emergency department (ED notification or 3-lead ECG monitoring and alert to dispatch prior to hospital arrival; either with or without the opportunity to bypass to a PCI centre. Discussion We anticipate four challenges to successful study implementation and have developed strategies for each: 1 diversity in the interpretation of the ethical and privacy issues across 47 research ethics boards/commiittees covering 71 hospitals, 2 remote oversight of data guardian abstraction, 3 timeliness of implementation, and 4 potential interference in the study by concurrent technological advances. Research ethics approvals from academic centres were obtained initially and submitted to non academic centre applications. Data guardians were trained by a single investigator and data entry is informed by a detailed data dictionary including variable definitions and abstraction instrucations and subjected to error and logic

  1. Interactive dose shaping - efficient strategies for CPU-based real-time treatment planning

    International Nuclear Information System (INIS)

    Ziegenhein, P; Kamerling, C P; Oelfke, U

    2014-01-01

    Conventional intensity modulated radiation therapy (IMRT) treatment planning is based on the traditional concept of iterative optimization using an objective function specified by dose volume histogram constraints for pre-segmented VOIs. This indirect approach suffers from unavoidable shortcomings: i) The control of local dose features is limited to segmented VOIs. ii) Any objective function is a mathematical measure of the plan quality, i.e., is not able to define the clinically optimal treatment plan. iii) Adapting an existing plan to changed patient anatomy as detected by IGRT procedures is difficult. To overcome these shortcomings, we introduce the method of Interactive Dose Shaping (IDS) as a new paradigm for IMRT treatment planning. IDS allows for a direct and interactive manipulation of local dose features in real-time. The key element driving the IDS process is a two-step Dose Modification and Recovery (DMR) strategy: A local dose modification is initiated by the user which translates into modified fluence patterns. This also affects existing desired dose features elsewhere which is compensated by a heuristic recovery process. The IDS paradigm was implemented together with a CPU-based ultra-fast dose calculation and a 3D GUI for dose manipulation and visualization. A local dose feature can be implemented via the DMR strategy within 1-2 seconds. By imposing a series of local dose features, equal plan qualities could be achieved compared to conventional planning for prostate and head and neck cases within 1-2 minutes. The idea of Interactive Dose Shaping for treatment planning has been introduced and first applications of this concept have been realized.

  2. Communication strategies in cosmetic surgery websites: an application of Taylor's six-segment message strategy wheel.

    Science.gov (United States)

    Ahn, Ho-Young Anthony; Wu, Lei; Taylor, Ronald E

    2013-01-01

    Using Taylor's six-segment message strategy wheel as a theoretical framework, this study examines the communication approach (transmission or ritual) and message strategy (ego, social, sensory, routine, acute need, or ration) of cosmetic surgery websites. A content analysis revealed a fairly even division between transmission and ritual approaches. Ration strategy was the exclusive strategy in the websites adopting a transmission approach. No routine or acute need strategies were observed. Websites incorporating the ritual approach used ego, social, and sensory strategies. Human female models and natural objects were incorporated to deliver emotional persuasion. Implications for cosmetic surgery web marketers are discussed.

  3. Microbial production strategies and applications of lycopene and other terpenoids.

    Science.gov (United States)

    Ma, Tian; Deng, Zixin; Liu, Tiangang

    2016-01-01

    Terpenoids are a large class of compounds that have far-reaching applications and economic value, particularly those most commonly found in plants; however, the extraction and synthesis of these compounds is often expensive and technically challenging. Recent advances in microbial metabolic engineering comprise a breakthrough that may enable the efficient, cost-effective production of these limited natural resources. Via the engineering of safe, industrial microorganisms that encode product-specific enzymes, and even entire metabolic pathways of interest, microbial-derived semisynthetic terpenoids may soon replace plant-derived terpenoids as the primary source of these valuable compounds. Indeed, the recent metabolic engineering of an Escherichia coli strain that produces the precursor to lycopene, a commercially and medically important compound, with higher yields than those in tomato plants serves as a successful example. Here, we review the recent developments in the metabolic engineering of microbes for the production of certain terpenoid compounds, particularly lycopene, which has been increasingly used in pharmaceuticals, nutritional supplements, and cosmetics. Furthermore, we summarize the metabolic engineering strategies used to achieve successful microbial production of some similar compounds. Based on this overview, there is a reason to believe that metabolic engineering comprises an optimal approach for increasing the production of lycopene and other terpenoids.

  4. A control strategy for PV stand-alone applications

    Science.gov (United States)

    Slouma, S.; Baccar, H.

    2015-04-01

    This paper proposes a stand-alone photovoltaic (PV) system study in domestic applications. Because of the decrease in power of photovoltaic module as a consequence of changes in solar radiation and temperature which affect the photovoltaic module performance, the design and control of DC-DC buck converter was proposed for providing power to the load from a photovoltaic source.In fact, the control of this converter is carried out with integrated MPPT (Maximum Power Point Tracking) algorithm which ensures a maximum energy generated by the PV arrays. Moreover, the output stage is composed by a battery energy storage system, dc-ac inverter, LCL filter which enables higher efficiency, low distortion ac waveforms and low leakage currents. The control strategy adopted is cascade control composed by two regulation loops.Simulations performed with PSIM software were able to validate the control system.The realization and testing of the photovoltaic system were achieved in the Photovoltaic laboratory of the Centre for Research and Energy Technologies at the Technopark Borj Cedria. Experimental results verify the effeciency of the proposed system.

  5. A control strategy for PV stand-alone applications

    International Nuclear Information System (INIS)

    Slouma, S; Baccar, H

    2015-01-01

    This paper proposes a stand-alone photovoltaic (PV) system study in domestic applications. Because of the decrease in power of photovoltaic module as a consequence of changes in solar radiation and temperature which affect the photovoltaic module performance, the design and control of DC-DC buck converter was proposed for providing power to the load from a photovoltaic source.In fact, the control of this converter is carried out with integrated MPPT (Maximum Power Point Tracking) algorithm which ensures a maximum energy generated by the PV arrays. Moreover, the output stage is composed by a battery energy storage system, dc-ac inverter, LCL filter which enables higher efficiency, low distortion ac waveforms and low leakage currents. The control strategy adopted is cascade control composed by two regulation loops.Simulations performed with PSIM software were able to validate the control system.The realization and testing of the photovoltaic system were achieved in the Photovoltaic laboratory of the Centre for Research and Energy Technologies at the Technopark Borj Cedria. Experimental results verify the effeciency of the proposed system

  6. Current strategies for the treatment of aneurysmal bone cysts

    Directory of Open Access Journals (Sweden)

    Panagiotis Tsagozis

    2015-12-01

    Full Text Available Aneurysmal bone cysts are benign bone tumors that usually present in childhood and early adulthood. They usually manifest as expansile osteolytic lesions with a varying potential to be locally aggressive. Since their first description in 1942, a variety of treatment methods has been proposed. Traditionally, these tumors were treated with open surgery. Either intralesional surgical procedures or en bloc excisions have been described. Furthermore, a variety of chemical or physical adjuvants has been utilized in order to reduce the risk for local recurrence after excision. Currently, there is a shift to more minimally invasive procedures in order to avoid the complications of open surgical excision. Good results have been reported during percutaneous surgery, or the use of embolization. Recently, sclerotherapy has emerged as a promising treatment, showing effective consolidation of the lesions and functional results that appear to be superior to the ones of open surgery. Lastly, non-invasive treatment, such as pharmaceutical intervention with denosumab or bisphosphonates has been reported to be effective in the management of the disease. Radiotherapy has also been shown to confer good local control, either alone or in conjunction to other treatment modalities, but is associated with serious adverse effects. Here, we review the current literature on the methods of treatment of aneurysmal bone cysts. The indication for each type of treatment along reported outcome of the intervention, as well as potential complications are systematically presented. Our review aims to increase awareness of the different treatment modalities and facilitate decision-making regarding each individual patient.

  7. Telepsychiatrists' Medication Treatment Strategies in the Children's Attention-Deficit/Hyperactivity Disorder Telemental Health Treatment Study

    Science.gov (United States)

    Tse, Yuet Juhn; Fesinmeyer, Megan D.; Garcia, Jessica; Myers, Kathleen

    2016-01-01

    Abstract Objective: The purpose of this study was to examine the prescribing strategies that telepsychiatrists used to provide pharmacologic treatment in the Children's Attention-Deficit/Hyperactivity Disorder (ADHD) Telemental Health Treatment Study (CATTS). Methods: CATTS was a randomized controlled trial that demonstrated the superiority of a telehealth service delivery model for the treatment of ADHD with combined pharmacotherapy and behavior training (n=111), compared with management in primary care augmented with a telepsychiatry consultation (n=112). A diagnosis of ADHD was established with the Computerized Diagnostic Interview Schedule for Children (CDISC), and comorbidity for oppositional defiant disorder (ODD) and anxiety disorders (AD) was established using the CDISC and the Child Behavior Checklist. Telepsychiatrists used the Texas Children's Medication Algorithm Project (TCMAP) for ADHD to guide pharmacotherapy and the treat-to-target model to encourage their assertive medication management to a predetermined goal of 50% reduction in ADHD-related symptoms. We assessed whether telepsychiatrists' decision making about making medication changes was associated with baseline ADHD symptom severity, comorbidity, and attainment of the treat-to-target goal. Results: Telepsychiatrists showed high fidelity (91%) to their chosen algorithms in medication management. At the end of the trial, the CATTS intervention showed 46.0% attainment of the treat-to-target goal compared with 13.6% for the augmented primary care condition, and significantly greater attainment of the goal by comorbidity status for the ADHD with one and ADHD with two comorbidities groups. Telepsychiatrists' were more likely to decide to make medication adjustments for youth with higher baseline ADHD severity and the presence of disorders comorbid with ADHD. Multiple mixed methods regression analyses controlling for baseline ADHD severity and comorbidity status indicated that the telepsychiatrists

  8. The key role of extinction learning in anxiety disorders: behavioral strategies to enhance exposure-based treatments.

    Science.gov (United States)

    Pittig, Andre; van den Berg, Linda; Vervliet, Bram

    2016-01-01

    Extinction learning is a major mechanism for fear reduction by means of exposure. Current research targets innovative strategies to enhance fear extinction and thereby optimize exposure-based treatments for anxiety disorders. This selective review updates novel behavioral strategies that may provide cutting-edge clinical implications. Recent studies provide further support for two types of enhancement strategies. Procedural enhancement strategies implemented during extinction training translate to how exposure exercises may be conducted to optimize fear extinction. These strategies mostly focus on a maximized violation of dysfunctional threat expectancies and on reducing context and stimulus specificity of extinction learning. Flanking enhancement strategies target periods before and after extinction training and inform optimal preparation and post-processing of exposure exercises. These flanking strategies focus on the enhancement of learning in general, memory (re-)consolidation, and memory retrieval. Behavioral strategies to enhance fear extinction may provide powerful clinical applications to further maximize the efficacy of exposure-based interventions. However, future replications, mechanistic examinations, and translational studies are warranted to verify long-term effects and naturalistic utility. Future directions also comprise the interplay of optimized fear extinction with (avoidance) behavior and motivational antecedents of exposure.

  9. Fetal alcohol spectrum disorders: experimental treatments and strategies for intervention.

    Science.gov (United States)

    Idrus, Nirelia M; Thomas, Jennifer D

    2011-01-01

    Despite the known damaging effects of prenatal alcohol exposure, women continue to drink during pregnancy, creating a need for effective interventions and treatments for fetal alcohol spectrum disorders (FASD). Experimental models can be useful in identifying potential treatments, and this article describes the spectrum of experimental therapeutics that currently are being investigated, including pharmacological, nutritional, and environmental/behavioral interventions. Some treatments target the underlying mechanisms that contribute to alcohol-induced damage, protecting against alcohol's teratogenic effects, whereas other treatments may enhance central nervous system plasticity either during alcohol exposure or long after alcohol exposure has ceased. The insights gained to date from experimental models offer several candidates for attenuating the deficits associated with FASD.

  10. [Effective treatment strategy in elderly breast cancer patients].

    Science.gov (United States)

    Boér, Katalin

    2005-01-02

    High frequency of cancer in older people and the improvements in life expectancy do not allow older age to be a barrier to treatment. The age is one of the risk factors for breast cancer development, one third of all cases occur in women older than 70 years. To provide an overview of the available information on the main issues in the field of surgery, radiotherapy and medical approaches to the treatment of breast cancer in the elderly. The author discusses the treatment of breast cancer in the elderly, based on the data of literature. The assessment of any patient is the first step in the treatment process, performance status is more important than age. In older women a correct evaluation includes not only the basic medical history and the cancer staging, but also a detailed assessment of health and environment that may interfere with the therapeutic approach of the patient. Age is not a limitation for surgery, without any comorbidity it is safe, and operative mortality is low. The body self-image is important for most old women, they also wish to keep their breasts, so a conservative surgery and adjuvant radiotherapy should be offered to all, as long as the stage permits it. The selection of patients who are candidates for axillary dissection is based on selective lymph sentinel node technique which provides an optimal nodal staging with a minimal morbidity. The results of radiotherapy are as good as in younger patients, elderly women tolerate radiotherapy well. The inability to travel to the radiation facility is often the reason for omitting the radiation treatment and to choose a modified mastectomy. A promising alternative to the standard radiation treatment is the concept of intraoperative radiotherapy. Breast cancer in the elderly women is more likely to be well differentiated tumour, containing oestrogen and progesterone receptors. Based on these favourable prognostic factors, endocrine therapy is the standard treatment in adjuvant and metastatic setting

  11. A New Treatment Strategy for Inactivating Algae in Ballast Water Based on Multi-Trial Injections of Chlorine.

    Science.gov (United States)

    Sun, Jinyang; Wang, Junsheng; Pan, Xinxiang; Yuan, Haichao

    2015-06-09

    Ships' ballast water can carry aquatic organisms into foreign ecosystems. In our previous studies, a concept using ion exchange membrane electrolysis to treat ballast water has been proven. In addition to other substantial approaches, a new strategy for inactivating algae is proposed based on the developed ballast water treatment system. In the new strategy, the means of multi-trial injection with small doses of electrolytic products is applied for inactivating algae. To demonstrate the performance of the new strategy, contrast experiments between new strategies and routine processes were conducted. Four algae species including Chlorella vulgaris, Platymonas subcordiformis, Prorocentrum micans and Karenia mikimotoi were chosen as samples. The different experimental parameters are studied including the injection times and doses of electrolytic products. Compared with the conventional one trial injection method, mortality rate time (MRT) and available chlorine concentration can be saved up to about 84% and 40%, respectively, under the application of the new strategy. The proposed new approach has great potential in practical ballast water treatment. Furthermore, the strategy is also helpful for deep insight of mechanism of algal tolerance.

  12. Tank waste remediation system optimized processing strategy with an altered treatment scheme

    International Nuclear Information System (INIS)

    Slaathaug, E.J.

    1996-03-01

    This report provides an alternative strategy evolved from the current Hanford Site Tank Waste Remediation System (TWRS) programmatic baseline for accomplishing the treatment and disposal of the Hanford Site tank wastes. This optimized processing strategy with an altered treatment scheme performs the major elements of the TWRS Program, but modifies the deployment of selected treatment technologies to reduce the program cost. The present program for development of waste retrieval, pretreatment, and vitrification technologies continues, but the optimized processing strategy reuses a single facility to accomplish the separations/low-activity waste (LAW) vitrification and the high-level waste (HLW) vitrification processes sequentially, thereby eliminating the need for a separate HLW vitrification facility

  13. Treatment strategies for high resveratrol induction in Vitis vinifera L. cell suspension culture

    Directory of Open Access Journals (Sweden)

    Thu V. Vuong

    2014-06-01

    Full Text Available Bioprocesses capable of producing large scales of resveratrol at nutraceutical grade are in demand. This study herein investigated treatment strategies to induce the production of resveratrol in Vitis vinifera L. cell suspension cultures. Among seven investigated elicitors, jasmonic acid (JA, salicylic acid, β-glucan (GLU, and chitosan enhanced the production of intracellular resveratrol manyfold. The combined treatment of JA and GLU increased extracellular resveratrol production by up to tenfold. The application of Amberlite XAD-7 resin for in situ removal and artificial storage of secreted resveratrol further increased resveratrol production by up to four orders of magnitude. The level of resveratrol produced in response to the combined treatment with 200 g/L XAD-7, 10 μM JA and 1 mg/mL GLU was approximately 2400 mg/L, allowing the production of resveratrol at an industrial scale. The high yield of resveratrol is due to the involvement of a number of mechanisms working in concert.

  14. Mechanical valve obstruction: Review of diagnostic and treatment strategies

    Science.gov (United States)

    Salamon, Jason; Munoz-Mendoza, Jerson; Liebelt, Jared J; Taub, Cynthia C

    2015-01-01

    Prosthetic valve obstruction (PVO) is a rare but feared complication of mechanical valve replacement. Diagnostic evaluation should focus on differentiating prosthetic valve thrombosis (PVT) from pannus formation, as their treatment options differ. History of sub-optimal anti-coagulation and post-op time course to development of PVO are useful clinical characteristics in differentiating thrombus from pannus formation. Treatment of PVT is influenced by the patient’s symptoms, valve location, degree of obstruction and thrombus size and may include thrombolysis or surgical intervention. Alternatively, pannus formation requires surgical intervention. The purpose of this article is to review the pathophysiology, epidemiology, diagnostic approach and treatment options for aortic and mitral valve PVO. PMID:26730292

  15. Evidence-based evaluation of treatment strategy for multiple sclerosis

    Directory of Open Access Journals (Sweden)

    LI Meng-qiu

    2012-04-01

    Full Text Available Objective To formulate the best treatment plan for multiple sclerosis (MS patients by evaluating the therapeutic efficacy and side effect of various evidence-based programs. Methods Key words were defined as multiple sclerosis, immunomodulatory therapy and therapy, etc. We searched MEDLINE, Cochrane Library, Wanfang data bases for Scientific Journals in China and National Knowledge Infrastructure for Chinese Scientific Journals Database. Additionally, we applied manual searching and screened out conference paper and academic dissertation, etc, from various references. After that we obtained and evaluated by Jadad scales on systematic reviews, randomized controlled trials, controlled clinical trials and observational study cases about glucocorticoids, plasmapheresis, intravenous immunoglobulin, IFN-β, glatiramer acetate, mitoxantrone, natalizumab, fingolimod. Results After screening, all seventeen selected resources included systematic reviews 6 articles, randomized controlled trials 7 articles, controlled clinical trials 2 articles, observational study cases 2 articles, among which fifteen articles were proved to be high quality (according to Jadad scoring system, five score 4, six score 5, four score 7, two chapters were judged to be low quality scoring 3. Finally, we summerize that: 1 The first choice of treatment for acute relapses is glucocorticoids and we suggest that plasmapheresis or intravenous immunoglobulin may be tried as an alternative therapy in acute MS relapse, especially in case of contraindications to intravenous methylprednisolone. 2 Immunomodulatory or immunosuppressive treatment (IFN-β, glatiramer acetate, mitoxantrone, natalizumab can be an option to prevent new relapses and progression of disability. 3 Fingolimod is an oral treatment for multiple sclerosis to improve treatment adherence. Conclusion Using evidence-based medicine methods can provide us best clinical evidence on MS treatment.

  16. Treatment in chronic migraine: choice of reabilitation strategies

    Directory of Open Access Journals (Sweden)

    Ioana STANESCU

    2015-12-01

    Full Text Available Migraine is a disabling neurologic condition with a spontaneous clinical evolution into a chronic form. Migraine progression from an episodic into a chronic form is realized through a period of time involving several months or years, during which an increase attack frequency occurs. .According to the International Classification of Headache Disorders (ICHD-3 chronic migraine is a type of primary headache occurring on 15 or more days per month for more than 3 months, in which more than 8 days per month headache meet criteria for migraine with or without aura or respond to specific migraine treatment. The prevalence of chronic migraine is estimated between 1- 3% of general population. Persons with chronic migraine are more likely to suffer from severe disability; chronic migraine has an important socio-economic impact. Diagnostic approach in chronic migraine includes exclusion of a secondary headache disorder and confirmation of a primary episodic headache. When a patient is found to overuse pain medication, diagnosis of both chronic migraine and MOH should be considered. Treating episodic migraine early and managing attack frequency using preventive medication and behavioural interventions will be benefic in reducing the risk of chronicisation. Lifestyle changes are important for avoiding triggers for migraine attacks; treatment of comorbidities is equally important because these conditions exacerbate patient’s tendency to have headaches. The initial relief step for drug abusers always relies in drug withdrawal. For migraine attacks treatment begins with non-pharmacologic interventions (staying in a quiet, dark room, pressure on painful areas, applying cold compresses , simple OTC analgetics (NSAIDs, paracetamol, aspirin, acetaminophen. If these are not effective, triptans are the drugs of choice. Preventive treatment is always recommended in patients with chronic migraine because the high frequency of headache attacks. Treatment should be

  17. Applications of Classifying Bidding Strategies for the CAT Tournament

    Science.gov (United States)

    Gruman, Mark L.; Narayana, Manjunath

    In the CAT Tournament, specialists facilitate transactions between buyers and sellers with the intention of maximizing profit from commission and other fees. Each specialist must find a well-balanced strategy that allows it to entice buyers and sellers to trade in its market while also retaining the buyers and sellers that are currently subscribed to it. Classification techniques can be used to determine the distribution of bidding strategies used by all traders subscribed to a particular specialist. Our experiments showed that Hidden Markov Model classification yielded the best results. The distribution of strategies, along with other competition-related factors, can be used to determine the optimal action in any given game state. Experimental data shows that the GD and ZIP bidding strategies are more volatile than the RE and ZIC strategies. An MDP framework for determining optimal actions given an accurate distribution of bidding strategies is proposed as a motivator for future work.

  18. Collaborative Learning: Theoretical Foundations and Applicable Strategies to University Teaching

    Directory of Open Access Journals (Sweden)

    Nestor D. Roselli

    2016-04-01

    Full Text Available Collaborative learning is a construct that identifies a current strong field, both in face-to-face and virtual education. Firstly, three converging theoretical sources are analyzed: socio-cognitive conflict theory, intersubjectivity theory and distributed cognition theory. Secondly, a model of strategies that can be implemented by teachers to develop socio-cognitive collaboration is presented. This model integrates and systematizes several academic group animation techniques developed within the collaborative learning field. These integrated techniques, within a coherent and unified didactic intention, allow talking more about strategies than independent and dissociated techniques. Each strategy is specifically described, which refers to six areas: encouragement of dialogue, listening to others and reciprocal assessment; collaboration for negotiation and consensus building; activity organization; study and appropriation of bibliographic information; conceptual development; collective writing. These strategies proposed (designed to stimulate the collaboration between 2, 4 and exceptionally, 6 or 8 students are not the only possible strategies, they can be combined with the ones the teacher might suggest. The strict pattern of each strategy is a characteristic of the proposal. The teacher is also encouraged to benchmark the results obtained using each strategy and those obtained using individual or non-collaborative strategies. Finally, conclusions and recommendations for the implementation of these strategies are discussed.

  19. Orgasm During Intercourse: A Treatment Strategy for Women

    Science.gov (United States)

    Zeiss, Antonette M.; And Others

    1977-01-01

    A six-step treatment program for women who are inorgasmic during intercourse is described. Teaches women to associate orgasms brought on by manual clitoral stimulation with arousing thoughts about intercourse and vaginal containment of a dildo. Learning is generalized to vaginal containment of the partner's penis and thrusting movements. (Author)

  20. Exploring new strategies in diagnosis and treatment of hilar cholangiocarcinoma

    NARCIS (Netherlands)

    Mantel, Hendrik Teunis Johannes

    2016-01-01

    Hilar cholangiocarcinoma is a rare form of cancer arising at the confluence of the right and left bile duct. The disease is known for its difficult diagnosis and treatment. The chapters in this thesis describe different aspects of hilar cholangiocarcinoma with the aim to improve diagnosis and

  1. Current multiple myeloma treatment strategies with novel agents

    DEFF Research Database (Denmark)

    Ludwig, Heinz; Beksac, Meral; Bladé, Joan

    2010-01-01

    in the relapsed/refractory setting, they are also undergoing investigation in the initial treatment of MM. A number of phase III trials have demonstrated the efficacy of novel agent combinations in the transplant and nontransplant settings, and based on these results standard induction regimens are being...

  2. Strategies for the reduction of Legionella in biological treatment systems.

    Science.gov (United States)

    Nogueira, R; Utecht, K-U; Exner, M; Verstraete, W; Rosenwinkel, K-H

    A community-wide outbreak of Legionnaire's disease occurred in Warstein, Germany, in August 2013. The epidemic strain, Legionella pneumophila Serogruppe 1, was isolated from an industrial wastewater stream entering the municipal wastewater treatment plant (WWTP) in Wartein, the WWTP itself, the river Wäster and air/water samples from an industrial cooling system 3 km downstream of the WWTP. The present study investigated the effect of physical-chemical disinfection methods on the reduction of the concentration of Legionella in the biological treatment and in the treated effluent entering the river Wäster. Additionally, to gain insight into the factors that promote the growth of Legionella in biological systems, growth experiments were made with different substrates and temperatures. The dosage rates of silver micro-particles, hydrogen peroxide, chlorine dioxide and ozone and pH stress to the activated sludge were not able to decrease the number of culturable Legionella spp. in the effluent. Nevertheless, the UV treatment of secondary treated effluent reduced Legionella spp. on average by 1.6-3.4 log units. Laboratory-scale experiments and full-scale measurements suggested that the aerobic treatment of warm wastewater (30-35 °C) rich in organic nitrogen (protein) is a possible source of Legionella infection.

  3. Treatment Strategies fir the NMDA Component of Organophosphorous Convulsions

    Science.gov (United States)

    2005-04-01

    28 A ppendices ............................................................ 36 INTRODUCTION This project tested novel treatment...16 Nicotinamide had no effect on neurological deficit as determined by spontaneous activity 24 hours after acute Li-pilo SE. However, repeated...unknown but it is interesting that the mediodorsal thalamus plays a critical role in the development of acute limbic SE (Zhay & Bertram, 2002) and in

  4. [New guidelines on chronic pancreatitis : interdisciplinary treatment strategies].

    Science.gov (United States)

    Lerch, M M; Bachmann, K A; Izbicki, J R

    2013-02-01

    Chronic pancreatitis is a common disorder associated with significant morbidity and mortality. Interdisciplinary consensus guidelines have recently updated the definitions and diagnostic criteria for chronic pancreatitis and provide a critical assessment of therapeutic procedures. Diagnostic imaging relies on endoscopic ultrasound (EUS) as the most sensitive technique, whereas computed tomography (CT) and magnetic resonance imaging (MRI)/magnetic resonance cholangiopancreatography (MRCP) remain a frequent preoperative requirement. Endoscopic retrograde cholangiopancreatography (ERCP) is now used mostly as a therapeutic procedure except for the differential diagnosis of autoimmune pancreatitis. Complications of chronic pancreatitis, such as pseudocysts, duct stricture and intractable pain can be treated with endoscopic interventions as well as open surgery. In the treatment of pseudocysts endoscopic drainage procedures now prevail while pain treatment has greater long-term effectiveness following surgical procedures. Currently, endocopic as well as surgical treatment of chronic pancreatitis require an ever increasing degree of technical and medical expertise and are provided increasingly more often by interdisciplinary centres. Surgical treatment is superior to interventional therapy regarding the outcome of pain control and duodenum-preserving pancreatic head resection is presently the surgical procedure of choice.

  5. New treatment strategies for canine intervertebral disc degeneration

    NARCIS (Netherlands)

    Smolders, L.A.

    2013-01-01

    Degeneration of the intervertebral disc (IVD) is a common problem in dogs and humans. IVD degeneration can lead to herniation of the IVD with subsequent compression of neural structures and various clinical signs, including back pain. Current treatment of IVD disease is conservative or surgical.

  6. VETERINARY PHARMACEUTICALS: POTENTIAL ENVIRONMENTAL IMPACT AND TREATMENT STRATEGIES

    Science.gov (United States)

    In the late 1970s it was recognized that there were increasing occurrences of antibiotic-resistant organisms in Europe and the US. Even in the early stages, concerns were raised that large-scale treatment of farm animals for infectious disease as well as growth enhancement may be...

  7. Femoral head injuries: Which treatment strategy can be recommended?

    NARCIS (Netherlands)

    Henle, Philipp; Kloen, Peter; Siebenrock, Klaus A.

    2007-01-01

    Despite different operative and non-operative treatment regimens, the outcome after femoral head fractures has changed little over the past decades. The initial trauma itself as well as secondary changes such as posttraumatic osteoarthritis, avascular necrosis or heterotopic ossification is often

  8. Rational-Emotive Therapy with Children and Adolescents: Treatment Strategies.

    Science.gov (United States)

    Bernard, Michael E.

    1990-01-01

    Presents rational-emotive therapy (RET) conceptualization of childhood disorders, discussing interaction of child temperament and parenting styles. Discusses RET child treatment goals, which involve modification of negative and inappropriate childhood emotions. Illustrates particular RET cognitive change methods (philosophical disputation;…

  9. Burnout Syndrome: Global Medicine Volunteering as a Possible Treatment Strategy.

    Science.gov (United States)

    Iserson, Kenneth V

    2018-04-01

    In the last few decades, "burnout syndrome" has become more common among clinicians, or at least more frequently recognized. Methods to prevent and treat burnout have had inconsistent results. Simultaneously, clinicians' interest in global medicine has increased dramatically, offering a possible intervention strategy for burnout while providing help to underserved areas. Caused by a variety of stressors, burnout syndrome ultimately results in physicians feeling that their work no longer embodies why they entered the medical field. This attitude harms clinicians, their patients and colleagues, and society. Few consistently successful interventions exist. At the same time, clinicians' interest in global medicine has risen exponentially. This paper reviews the basics of both phenomena and posits that global medicine experiences, although greatly assisting target populations, also may offer a strategy for combating burnout by reconnecting physicians with their love of the profession. Because studies have shown that regular volunteering improves mental health, short-term global medicine experiences may reinvigorate and reengage clinicians on the verge of, or suffering from, persistent burnout syndrome. Fortuitously, this intervention often will greatly benefit medically underserved populations. Copyright © 2018 Elsevier Inc. All rights reserved.

  10. Application of reverse osmosis in radioactive wastewater treatment

    International Nuclear Information System (INIS)

    Kong Jinsong; Guo Weiqun

    2012-01-01

    Considering the disadvantages of the conventional evaporation and ion exchange process for radioactive wastewater treatment, the reverse osmosis is used to treat the low level radioactive wastewater. The paper summarizes the research and application progress of the reverse osmosis in the radioactive wastewater treatment and indicates that the reverse osmosis in the radioactive wastewater treatment is very important. (authors)

  11. 78 FR 14121 - Notice of Availability of Funds and Solicitation for Grant Applications for Strategies Targeting...

    Science.gov (United States)

    2013-03-04

    ... Solicitation for Grant Applications for Strategies Targeting Characteristics Common to Female Ex-Offenders... will be targeted to females, but must also be open to eligible male ex-offenders. Strategies Targeting... period of performance. These grants will include an integrated strategy of recruitment and assessment...

  12. Application of Pricing Strategy in the Management of Recreational Fishery

    OpenAIRE

    Zhang, Chen; Han, Xingyong

    2009-01-01

    This paper analyzes the feasibility of carrying out various pricing strategies in recreational fishery management. It also introduces the four common pricing means, which are time (season) differential pricing, customer differential pricing, quantity discount and two-part tariff system. The effects of pricing strategy of recreational fishery on social welfare are studied taking time (season) differential pricing as an example.

  13. Treatment strategies for different types of teacher burnout.

    Science.gov (United States)

    Farber, B A

    2000-05-01

    Using teachers as a prototype, this article suggests that there are three types of burnout: "wearout," wherein an individual gives up, feeling depleted in confronting stress; "classic" burnout, wherein an individual works increasingly hard in the face of stress; and an "underchallenged" type, wherein an individual is faced not with excessive degrees of stress per se (e.g., overload), but rather with monotonous and unstimulating work conditions. The major arguments put forward are that: a) clinicians should avoid treating teacher burnout as if it were a single phenomenon, and instead tailor their treatment to the specific type of burnout manifested by their client; and b) these treatments, while embodying different elements, should be essentially integrative in nature. Psychoanalytic insight, cognitive restructuring, empathic concern, and stress-reduction techniques may all be necessary, albeit in different combinations, to treat successfully burnout of each type.

  14. Body dysmorphic disorder: Diagnosis, clinical aspects and treatment strategies

    Directory of Open Access Journals (Sweden)

    Rajiv Ahluwalia

    2017-01-01

    Full Text Available Aim: With the increased demand to undertake dental aesthetic and reconstructive procedures, it is imperative for all dental clinicians to have an understanding of body dysmorphic disorder (BDD. Patient's preoccupations with perceived defect in appearance or excessive concern about minimal flaws are among diagnostic criteria of BDD. Such patients are difficult to please and often undergo cosmetic procedures such as orthodontic treatment. Methodology: Literature search in PubMed/MEDLINE was conducted from 1891 to 2015. A manual search of relevant articles and review was done and relevant data was collected and analysed. Results: One of the most common areas of preoccupation is the dento-facial region, with up to 20% of patients diagnosed with BDD expressing specific concern regarding their dental appearance. Conclusion: BDD patients often request multiple aesthetic procedures, but remain unsatisfied with their treatment results.

  15. Novel Preclinical Testing Strategies for Treatment of Metastatic Pheochromocytoma

    Science.gov (United States)

    2015-11-01

    Schleswig-Holstein Lübeck, Lübeck, Germany Abstract There is currently no effective treatment for metastatic pheochromocytomas and paragangliomas. A...Supplementary Fig. S2) and deregulated fatty acid metabolism (Fig. 2b), leading to higher levels of palmitate and linoleate, increased long chain fatty...mitochondria18. This pathway required HIF-1a, which is deregulated in SDHB-mutant tumours, and may potentially contribute to disease maintenance39. The

  16. Hypoxia-regulated therapeutic gene as a preemptive treatment strategy against ischemia/reperfusion tissue injury.

    Science.gov (United States)

    Pachori, Alok S; Melo, Luis G; Hart, Melanie L; Noiseux, Nicholas; Zhang, Lunan; Morello, Fulvio; Solomon, Scott D; Stahl, Gregory L; Pratt, Richard E; Dzau, Victor J

    2004-08-17

    Ischemia and reperfusion represent major mechanisms of tissue injury and organ failure. The timing of administration and the duration of action limit current treatment approaches using pharmacological agents. In this study, we have successfully developed a preemptive strategy for tissue protection using an adenoassociated vector system containing erythropoietin hypoxia response elements for ischemia-regulated expression of the therapeutic gene human heme-oxygenase-1 (hHO-1). We demonstrate that a single administration of this vector several weeks in advance of ischemia/reperfusion injury to multiple tissues such as heart, liver, and skeletal muscle yields rapid and timely induction of hHO-1 during ischemia that resulted in dramatic reduction in tissue damage. In addition, overexpression of therapeutic transgene prevented long-term pathological tissue remodeling and normalized tissue function. Application of this regulatable system using an endogenous physiological stimulus for expression of a therapeutic gene may be a feasible strategy for protecting tissues at risk of ischemia/reperfusion injury.

  17. Hypoxia-regulated therapeutic gene as a preemptive treatment strategy against ischemia/reperfusion tissue injury

    Science.gov (United States)

    Pachori, Alok S.; Melo, Luis G.; Hart, Melanie L.; Noiseux, Nicholas; Zhang, Lunan; Morello, Fulvio; Solomon, Scott D.; Stahl, Gregory L.; Pratt, Richard E.; Dzau, Victor J.

    2004-08-01

    Ischemia and reperfusion represent major mechanisms of tissue injury and organ failure. The timing of administration and the duration of action limit current treatment approaches using pharmacological agents. In this study, we have successfully developed a preemptive strategy for tissue protection using an adenoassociated vector system containing erythropoietin hypoxia response elements for ischemia-regulated expression of the therapeutic gene human heme-oxygenase-1 (hHO-1). We demonstrate that a single administration of this vector several weeks in advance of ischemia/reperfusion injury to multiple tissues such as heart, liver, and skeletal muscle yields rapid and timely induction of hHO-1 during ischemia that resulted in dramatic reduction in tissue damage. In addition, overexpression of therapeutic transgene prevented long-term pathological tissue remodeling and normalized tissue function. Application of this regulatable system using an endogenous physiological stimulus for expression of a therapeutic gene may be a feasible strategy for protecting tissues at risk of ischemia/reperfusion injury.

  18. Treatment strategy in schizophrenia combined with eating disorder.

    Science.gov (United States)

    Dadić-Hero, Elizabeta; Ružić, Klementina; Grahovac, Tanja; Valković, Toni; Petranović, Duška

    2011-03-01

    Like any other patient, a schizophrenic patient can get a physical illness, too. As such patients tend to ignore reality and neglect themselves and are stigmatized by society, due to which their physical symptomatology is often ignored, physical illness can remain undetected. If the schizophrenic patient is observed and adequate care is provided by the family, family doctor and a psychiatrist, it is possible to recognize the physical illness and intervene promptly. We are presenting a case of a female patient who has been treated for schizophrenia for a number of years. The treatment was mostly ambulatory (i.e. the patient was hospitalized twice) and consisted of first-generation antipsychotics. During the past two years, for reasons unknown, the patient stopped taking regular meals and as a result lost significant body weight, became apathetic and withdrawn, started avoiding social contacts and neglected personal hygiene. She reportedly took the psychopharmaca regularly, but rarely attended psychiatric follow-up consultations. Due to substantial weight loss and hypotonia, correction of antipsychotic was made and internist treatment administered. The choice of olanzapine was not an accidental one. We decided to take advantage of its side effect for the treatment of an anorectic syndrome. Interdisciplinary cooperation proved to be a justified decision.

  19. Verification and validation of the decision analysis model for assessment of TWRS waste treatment strategies

    International Nuclear Information System (INIS)

    Awadalla, N.G.; Eaton, S.C.F.

    1996-01-01

    This document is the verification and validation final report for the Decision Analysis Model for Assessment of Tank Waste Remediation System Waste Treatment Strategies. This model is also known as the INSIGHT Model

  20. Insights Into Severe Form of Dwarfism Could Lead to New Treatment Strategies

    Science.gov (United States)

    ... Spotlight on Research Insights Into Severe Form of Dwarfism Could Lead to New Treatment Strategies By Colleen ... a mutation that causes a severe form of dwarfism have led to a better understanding of the ...

  1. Novel Insights Into Causes of Scleroderma Offer Potential New Treatment Strategies

    Science.gov (United States)

    ... Spotlight on Research Novel Insights Into Causes of Scleroderma Offer Potential New Treatment Strategies By Kirstie Saltsman, Ph.D. | December 15, 2013 In scleroderma, immune cells invade the skin, but the role ...

  2. Maximizing cost-effectiveness by adjusting treatment strategy according to glaucoma severity

    Science.gov (United States)

    Guedes, Ricardo Augusto Paletta; Guedes, Vanessa Maria Paletta; Gomes, Carlos Eduardo de Mello; Chaoubah, Alfredo

    2016-01-01

    Abstract Background: The aim of this study is to determine the most cost-effective strategy for the treatment of primary open-angle glaucoma (POAG) in Brazil, from the payer's perspective (Brazilian Public Health System) in the setting of the Glaucoma Referral Centers. Methods: Study design was a cost-effectiveness analysis of different treatment strategies for POAG. We developed 3 Markov models (one for each glaucoma stage: early, moderate and advanced), using a hypothetical cohort of POAG patients, from the perspective of the Brazilian Public Health System (SUS) and a horizon of the average life expectancy of the Brazilian population. Different strategies were tested according to disease severity. For early glaucoma, we compared observation, laser and medications. For moderate glaucoma, medications, laser and surgery. For advanced glaucoma, medications and surgery. Main outcome measures were ICER (incremental cost-effectiveness ratio), medical direct costs and QALY (quality-adjusted life year). Results: In early glaucoma, both laser and medical treatment were cost-effective (ICERs of initial laser and initial medical treatment over observation only, were R$ 2,811.39/QALY and R$ 3,450.47/QALY). Compared to observation strategy, the two alternatives have provided significant gains in quality of life. In moderate glaucoma population, medical treatment presented the highest costs among treatment strategies. Both laser and surgery were highly cost-effective in this group. For advanced glaucoma, both tested strategies were cost-effective. Starting age had a great impact on results in all studied groups. Initiating glaucoma therapy using laser or surgery were more cost-effective, the younger the patient. Conclusion: All tested treatment strategies for glaucoma provided real gains in quality of life and were cost-effective. However, according to the disease severity, not all strategies provided the same cost-effectiveness profile. Based on our findings, there should be a

  3. A Danish national strategy for treatment and rehabilitation after acquired brain injury

    DEFF Research Database (Denmark)

    Engberg, Aase W

    2007-01-01

    This study describes the establishment of a Danish national strategy for treatment and rehabilitation of acquired brain injury, particularly traumatic brain injury, in 1997. The vision was to create a system of tax-financed continuous treatment, restoration of function, and outpatient rehabilitat......This study describes the establishment of a Danish national strategy for treatment and rehabilitation of acquired brain injury, particularly traumatic brain injury, in 1997. The vision was to create a system of tax-financed continuous treatment, restoration of function, and outpatient...

  4. Strategies for the cost effective treatment of Oak Ridge legacy wastes

    International Nuclear Information System (INIS)

    Compere, A.L.; Griffith, W.L.; Huxtable, W.P.; Wilson, D.F.

    1998-03-01

    Research and development treatment strategies for treatment or elimination of several Oak Ridge plant liquid, solid, and legacy wastes are detailed in this report. Treatment strategies for volumetrically contaminated nickel; enriched uranium-contaminated alkali metal fluorides; uranium-contaminated aluminum compressor blades; large, mercury-contaminated lithium isotope separations equipment; lithium process chlorine gas streams; high-concentration aluminum nitrate wastes, and high-volume, low-level nitrate wastes are discussed. Research needed to support engineering development of treatment processes is detailed

  5. Coping Strategies in Bulimia Nervosa Treatment: Impact on Outcome in Group Cognitive-Behavioral Therapy

    Science.gov (United States)

    Binford, Roslyn B.; Mussell, Melissa Pederson; Crosby, Ross D.; Peterson, Carol B.; Crow, Scott J.; Mitchell, James E.

    2005-01-01

    This study's purpose was to examine the extent to which participants (N = 143) receiving cognitive-behavioral therapy for bulimia nervosa (BN) reported implementing therapeutic strategies to abstain from BN behaviors, and to assess whether use of specific strategies predicts outcome at treatment end and 1-and 6-month follow-up. Frequency of…

  6. Grout treatment facility dangerous waste permit application

    International Nuclear Information System (INIS)

    1992-07-01

    The Grout Treatment Facility (GTF) will provide permanent disposal for approximately 43 Mgal of low-level radioactive liquid waste currently being stored in underground tanks on the Hanford Site. The first step in permanent disposal is accomplished by solidifying the liquid waste with cementitious dry materials. The resulting grout is cast within underground vaults. This report on the GTF contains information on the following: Geologic data, hydrologic data, groundwater monitoring program, information, detection monitoring program, groundwater characterization drawings, building emergency plan--grout treatment facility, response action plan for grout treatment facility, Hanford Facility contingency plan, training course descriptions, overview of the Hanford Facility Grout Performance, assessment, bland use and zoning map, waste minimization plan, cover design engineering report, and clay liners (ADMIXTURES) in semiarid environments

  7. Practical treatment strategies for patients with Alzheimer's disease.

    Science.gov (United States)

    Christensen, Daniel D; Lin, Peter

    2007-12-01

    With the "baby boomers" entering retirement and beyond and the life expectancy of the entire population increasing, the burden of Alzheimer's Disease (AD) grows alarmingly greater. Over 5 million people in the United States currently have AD, and that number could triple by 2050. The financial impact of caring for these patients is substantial. Estimates of direct and indirect costs are as high as $148 billion per year. In addition to its substantial economic impact, AD has devastating effects on patients and their families. Alzheimer's disease begins with gradual memory loss and progresses to personality change, behavioral disturbance, loss of executive function, and loss of the ability to perform basic activities of daily living, including eating, walking, dressing, and grooming. These impairments strain families and caregivers and create challenges to the care and safety of the patient as well as threaten the health and well-being of the caregiver. As the number of patients diagnosed with AD increases, there is an ever-growing need for early diagnosis, which often is first observed in the primary care setting. While AD cannot be reversed or stopped, disease progression can be delayed and quality of life enhanced with early diagnosis and treatment. Early and accurate diagnosis has become increasingly important and will become even more so with the anticipated new generation of medications. Though several consensus statements on diagnosis and treatment of AD have been developed, few primary care physicians routinely follow evidence-based guidelines in their clinical practices. A 2006 survey conducted by the American Academy of Family Physicians identified a moderate to high level of need for education on AD in a majority of respondents. This article illustrates the primary care management of AD beginning with diagnosis and concluding with autopsy. Enhancing diagnostic and treatment skills in primary care will promote earlier diagnosis, improved patient management

  8. Specific schistosomiasis treatment as a strategy for disease control

    Directory of Open Access Journals (Sweden)

    José Rodrigues Coura

    2010-07-01

    Full Text Available The great hope for schistosomiasis treatment began with the development of oxamniquine and praziquantel. These drugs can be administered orally in a single dose and have a high curative power with minor side effects. In this study, we carried out a field experiment involving a population of 3,782 people. The population was examined at four localities in Minas Gerais within the valleys of the Doce and Jequitinhonha Rivers. In this cohort, there were 1,790 patients infected with Schistosoma mansoni (47.3% and we showed that only 1,403 (78.4% could be treated with oxamniquine in a single dose of 12.5-20 mg/kg orally. The other 387 (21.6% were not treated during the first stage because of contraindications (pregnancy or impeditive diseases, absences or refusals. It was observed that, on average, 8.8-17% of the infected patients continued to excrete S. mansoni eggs at the end of the 2nd month after treatment and 30-32% of the cohort was infected by the end of the 24th month. In one of the areas that we followed-up for a total of 30 years, the prevalence of the infection with S. mansoni fell from 60.8-19.3% and the hepatosplenic form of the disease dropped from 5.8-1.3%. We conclude that specific treatment of schistosomiasis reduces the prevalence of infection in the short-term and the morbidity due to schistosomiasis in medium to long-term time frames, but does not help to control disease transmission.

  9. Recommended treatment strategies for patients with excessive daytime sleepiness.

    Science.gov (United States)

    Rosenberg, Russell P

    2015-10-01

    Excessive daytime sleepiness (EDS) is a common and bothersome phenomenon. It can be associated with insufficient sleep syndrome, narcolepsy, idiopathic hypersomnia, obstructive sleep apnea, shift work disorder, Kleine-Levin syndrome, or Parkinson's disease. Once the underlying cause of the excessive sleepiness is determined, clinicians must select the most appropriate behavioral and pharmacologic interventions to reduce daytime sleepiness, alleviate other symptoms, improve functioning, and ensure the safety of patients and those around them. Patient history, adverse effects, and efficacy in specific conditions should be considered in pharmacologic treatment options for patients with EDS. © Copyright 2015 Physicians Postgraduate Press, Inc.

  10. Impetigo and scabies - Disease burden and modern treatment strategies.

    Science.gov (United States)

    Yeoh, Daniel K; Bowen, Asha C; Carapetis, Jonathan R

    2016-07-05

    Impetigo and scabies both present different challenges in resource-limited compared with industrialised settings. Severe complications of these skin infections are common in resource-limited settings, where the burden of disease is highest. The microbiology, risk factors for disease, diagnostic approaches and availability and suitability of therapies also vary according to setting. Taking this into account we aim to summarise recent data on the epidemiology of impetigo and scabies and describe the current evidence around approaches to individual and community based treatment. Copyright © 2016. Published by Elsevier Ltd.

  11. Evolving strategies in the treatment of childhood rhabdomyosarcoma. Slovenian experience

    International Nuclear Information System (INIS)

    Pohar-Marinsek, Z.; Anzic, J.; Jereb, B.

    2001-01-01

    Background. Neoadjuvant chemotherapy (Cht) has changed the treatment of rhabdomyosarcoma (RMS) in children. The purpose of our study was to review the children treated for RMS between 1974 and 1996. Patients and methods. Fifty-one children, 1-15 years old, were included. Primary sites of tumour were: head and neck 15, orbit 6, genitourinary 12, extremity 9, torso 5 and paratesticular 4. Twelve patients were in stage I, 10 in stage II, 26 in stage III and 3 in stage IV. Of 43 histologically confirmed RMS 25 were embryonal, 13 alveolar, 1 botryoid, 1 spindle cell and 3 sarcoma NOS. In 8 patients, only fine needle aspiration biopsy (FNAB) was available. All patients had Cht, 29 neoadjuvant, 20 had surgery first, 40 had irradiation (RT), 2 stage IV patients had bone marrow transplant (ABMT). Multidrug Cht varied: VCR, AMD, and cyclophosphamide (VAC) were used in the 1970s, with Adriablastine (T2), methotrexat (MTX) and/or other drugs (T6, T11) in the 1980s, and in the 1990s, cyclophosphamide was replaced by ifosfamide (VAIA). The treatment was started with Cht in orbital and head and neck tumours and in the majority of genitourinary tumours, but surgery was first in paratesticular and in the majority of extremity tumours. Results. The 3 patients with stage IV disease died. Of those with localised tumour, 34 (70%) were alive and well 5 years after treatment, 80% stage I, 75% stage II and 61% stage III. One patient died of heart failure, 3 of Cht toxicity and 1 of intercurrent disease. Conclusions. The survival of our patients has improved during the last 2 decades and increased from 57 % to 70 % for patients treated after 1985. It is now comparable to that in other centres. With the introduction of neoadjuvant Cht, surgery and RT have become more conservative and could sometimes even be abandoned, thereby reducing considerably the risk of late sequels. Orbital, genitourinary and paratesticular embryonal RMS of low stages have very good prognosis. Primary tumours of the

  12. Advances in surface treatments: Technology, applications, effects

    International Nuclear Information System (INIS)

    Niku-Lari, A.

    1987-01-01

    An international handbook has been produced to include all aspects of residual stresses, including the theoretical background, effects of residual stresses, measurement and calculation and quantitative assessment of residual stress effects. Techniques for altering residual stresses, particularly surface treatments, are discussed. Up to date information on the state of the art is presented. (UK)

  13. Up to date knowledge on different treatment strategies for phenylketonuria

    Science.gov (United States)

    Bélanger-Quintana, Amaya; Burlina, Alberto; Harding, Cary O.; Muntau, Ania C.

    2015-01-01

    Dietary management for phenylketonuria was established over half a century ago, and has rendered an immense success in the prevention of the severe mental retardation associated with the accumulation of phenylalanine. However, the strict low-phenylalanine diet has several shortcomings, not the least of which is the burden it imposes on the patients and their families consequently frequent dietary non-compliance. Imperfect neurological outcome of patients in comparison to non-PKU individuals and nutritional deficiencies associated to the PKU diet are other important reasons to seek alternative therapies. In the last decade there has been an impressive effort in the investigation of other ways to treat PKU that might improve the outcome and quality of life of these patients. These studies have lead to the commercialization of sapropterin dihydrochloride, but there are still many questions regarding which patients to challenge with sapropterin what is the best challenge protocol and what could be the implications of this treatment in the long-term. Current human trials of PEGylated phenylalanine ammonia lyase are underway, which might render an alternative to diet for those patients non-responsive to sapropterin dihydrochloride. Preclinical investigation of gene and cell therapies for PKU is ongoing. In this manuscript, we will review the current knowledge on novel pharmacologic approaches to the treatment of phenylketonuria. PMID:21967857

  14. Canine separation anxiety: strategies for treatment and management

    Directory of Open Access Journals (Sweden)

    Sargisson RJ

    2014-10-01

    Full Text Available Rebecca J Sargisson School of Psychology, University of Waikato, Tauranga, New ZealandAbstract: Dogs with separation-related behavior problems engage in unwanted behavior such as destruction of property and excessive vocalization when left alone, causing distress for both the dog and the owner, and often leading to the dog being relinquished or euthanized. I review research on factors likely to predispose dogs to developing separation anxiety and on the treatments available. Although research is equivocal, dogs seem to develop separation-related behavior problems if they are male, sourced from shelters or found, and separated from the litter before they are 60 days old. Protective factors include ensuring a wide range of experiences outside the home and with other people between the ages of 5–10 months, stable household routines and absences from the dog, and the avoidance of punishment. The most successful treatment for canine separation-related problems may be behavior modification that focuses on systematic desensitization and counterconditioning, which can be supplemented with medication in the initial stages. Where individual therapy from an animal behavior expert is not possible, advice to dog owners should be clear, simple, and contain five or fewer instructions to improve adherence. Advice is given for people seeking to adopt a dog, for new dog owners, and for existing dog owners who wish to treat their dog’s separation anxiety.Keywords: systematic desensitization, counterconditioning, medication, separation anxiety

  15. Clear cell odontogenic carcinoma of the mandible: a treatment strategy

    Directory of Open Access Journals (Sweden)

    Sabrina FERREIRA

    2018-01-01

    Full Text Available Abstract Clear cell odontogenic carcinoma (CCOC is a rare odontogenic tumor of the jaws, histologically characterized by the presence of agglomerates of cells with eosinophilic cytoplasm. The patient, a 62-year-old Caucasian woman, presented an intraosseous lesion in the mandibular symphysis. A clinical examination revealed a discrete volumetric increase with a hard consistency, palpable to extraoral and intraoral examinations. Imaging studies revealed an extensive radiolucent area, without defined limits, extending from the region of the right second premolar to the left canine. Incisional biopsy analysis indicated a diagnosis of CCOC. The treatment proposed was segmental resection of the mandible with a safety margin. After six months without recurrence, definitive mandibular reconstruction was performed using an iliac crest graft, followed by rehabilitation with implant-supported denture after five months. After three years of post-resection follow-up, the patient has shown no evidence of recurrence or metastasis. She continues to be under follow-up. To conclude, CCOC must be considered a malignant tumor with aggressive behavior. Previous studies have shown that resection with free margins is a treatment with a lower rate of recurrence. Nevertheless, long-term follow-up is necessary for such patients.

  16. The Relationship between Cost Leadership Strategy, Total Quality Management Applications and Financial Performance

    Directory of Open Access Journals (Sweden)

    Ali KURT

    2016-03-01

    Full Text Available Firms need to implement some competition strategies and total quality management applications to overcome the fierce competition among others. The purpose of this study is to show the relationship between cost leadership strategy, total quality management applications and firms’ financial performance with literature review and empirical analysis. 449 questionnaires were conducted to the managers of 142 big firms. The data gathered was assessed with AMOS. As a result, the relationship between cost leadership strategy, total quality management applications and firms’ financial performance has been gathered. In addition, the relationship between TQM applications and financial performance has also been gathered.

  17. Dialogic leadership: strategies for application in the hospital environment

    Directory of Open Access Journals (Sweden)

    Simone Coelho Amestoy

    2014-04-01

    Full Text Available Objective. To analyze the strategies used by nurses to support the insertion of dialogic leadership in the hospital environment. Methodology. Qualitative study, case study type. Twenty five nurses working in three hospitals in the city of Florianopolis, in the state of Santa Catarina (Brazil participated in the study. Data were collected from May to December 2010. For data collection, semi-structured interviews were performed, non-participant observation and dialogue workshops. Data analysis was performed through Minayo's operational proposal. Results. The strategies mentioned by the study participants were: dialogue, humility, setting an example, resoluteness, meetings and teamwork. It was observed that one strategy completed the other, which contributed to the nurses' leadership. Conclusion. The acceptance of dialogic leadership strategies in hospitals helps nurses strengthen the care provided in their workplace.

  18. Applicability Analysis of Bidding Strategy in Electricity Market

    OpenAIRE

    Zhou Suyan; Chen Fei; Qiao Yahui; Zhang Wenzhe; Zhang Kaifeng; Yuan Kun; Dai Xuemei

    2017-01-01

    With the development of the electricity market, competition has been introduced in the generation side. It is the overall development trend of the electricity market reformulation to optimize the allocation of different resources through bidding. Therefore, it is significant to research the bidding strategies of the generation companies and the large consumers. This paper reviews the existing research methods of bidding strategy. According to the different market mechanisms, the market partic...

  19. Exosomes: A Novel Strategy for Treatment and Prevention of Diseases

    Directory of Open Access Journals (Sweden)

    Jiaqi Wang

    2017-06-01

    Full Text Available An “exosome” is a nanoscale membrane vesicle derived from cell endocytosis that functions as an important intercellular communication mediator regulating the exchange of proteins and genetic materials between donor and surrounding cells. Exosomes secreted by normal and cancer cells participate in tumor initiation, progression, invasion, and metastasis. Furthermore, immune cells and cancer cells exert a two-way bidirectional regulatory effect on tumor immunity by exchanging exosomes. Current studies on exosomes have further expanded their known functions in physiological and pathological processes. The purpose of this review is to describe their discovery and biological functions in the context of their enormous potential in the clinical diagnosis, prevention, and treatment of cancer as well as bacterial and viral infectious diseases.

  20. Targeting oncogenic Myc as a strategy for cancer treatment.

    Science.gov (United States)

    Chen, Hui; Liu, Hudan; Qing, Guoliang

    2018-01-01

    The MYC family oncogene is deregulated in >50% of human cancers, and this deregulation is frequently associated with poor prognosis and unfavorable patient survival. Myc has a central role in almost every aspect of the oncogenic process, orchestrating proliferation, apoptosis, differentiation, and metabolism. Although Myc inhibition would be a powerful approach for the treatment of many types of cancers, direct targeting of Myc has been a challenge for decades owing to its "undruggable" protein structure. Hence, alternatives to Myc blockade have been widely explored to achieve desirable anti-tumor effects, including Myc/Max complex disruption, MYC transcription and/or translation inhibition, and Myc destabilization as well as the synthetic lethality associated with Myc overexpression. In this review, we summarize the latest advances in targeting oncogenic Myc, particularly for cancer therapeutic purposes.

  1. [The lazy eye - contemporary strategies of amblyopia treatment].

    Science.gov (United States)

    Sturm, V

    2011-02-16

    Amblyopia is a condition of decreased monocular or binocular visual acuity caused by form deprivation or abnormal binocular interaction. Amblyopia is the most common cause of monocular vision loss in children with a prevalence of 2 to 5%. During the last decade, several prospective randomized studies have influenced our clinical management. Based on these studies, optimum refractive correction should be prescribed first. However, most patients will need additional occlusion therapy which is still considered the «gold standard» of amblyopia management. Now much lower doses have been shown to be effective. In moderate amblyopia, penalization with atropine is as effective as patching. New treatment modalities including perceptual learning, pharmacotherapy with levodopa and citicholine or transcranial magnetic stimulation have not yet been widely accepted.

  2. [Surgical treatment of Marfan syndrome; late results and new strategy].

    Science.gov (United States)

    Aomi, S; Nonoyama, M; Tomioka, H; Endo, M; Nagashima, H; Sakomura, Y; Aoka, Y; Kasanuki, H; Kurosawa, H

    2002-07-01

    Rapid progress has been made in the treatment of Marfan syndrome. Today, the treatment is relatively established and the results have also improved. Even if surgery is performed, however, vascular lesions may recur late after operation and late prognosis is poor considering the age of patients. Issues such as whether a reoperation should be conducted or how the late results might be improved are subjects of debate. Based on an analysis of recent late data, we have performed operations according to the new treatment policy, and here report the results. A total of 203 consecutive operations were conducted in 141 patients with Marfan syndrome who underwent surgery for aortic aneurysm at our department between February 1973 and August 2001. The mean age of patients was 39 (11 years with a male/female ratio of 95:46. At the first operation, 72 patients were diagnosed with annuloaortic ectasia (AAE), 17 patients with AAE + chronic dissection (DeBakey I), 14 patients with AAE + chronic dissection (DeBakey II), 6 patients with AAE + acute dissection (Stanford A), 11 patients with AAE + dissection (DeBakey III), 9 patients with dissection (DeBakey III) only, 3 patients with AAE + abdominal aortic aneurysm only, and 2 patients with abdominal aortic aneurysm only. The cause of reoperation were a new lesion in 17 patients, dissection in 13 patients and a true aneurysm in 4 patients. In 36 patients, an increase in the remaining lesion occurred or a scheduled stage 2 operation was performed. Reoperation was performed following the Bentall operation in 7 patients, dehiscence of the anastomotic region of the coronary artery in 5 patients, aneurysm of the anastomotic region of the coronary artery in 1 patients, and infection of the artificial valve with aneurysm of the anastomotic region of the coronary artery in 1 patient. Hospital deaths were reported in 8 (6%) patients who underwent composite valve graft replacement (including simultaneous arch replacement) for AAE. Hospital

  3. UNDERSTANDING THE NEUROINFLAMMATORY RESPONSE FOLLOWING CONCUSSION TO DEVELOP TREATMENT STRATEGIES

    Directory of Open Access Journals (Sweden)

    Zachary Robert Patterson

    2012-12-01

    Full Text Available Mild traumatic brain injuries (mTBI have been associated with long-term cognitive deficits relating to trauma-induced neurodegeneration. These long-term deficits include impaired memory and attention, changes in executive function, emotional instability and sensorimotor deficits. Furthermore, individuals with concussions show a high co-morbidity with a host of psychiatric illnesses (e.g. depression, anxiety, addiction and dementia. The neurological damage seen in mTBI patients is the result of the direct impact and mechanical injury, followed by a delayed neuroimmune response that can last hours, days and even months after the injury. As part of the neuroimmune response, a cascade of pro- and anti-inflammatory cytokines are released and can be detected at the site of injury as well as subcortical, and often contralateral, regions. It has been suggested that the delayed neuroinflammatory response to concussions is more damaging then the initial impact itself. However, evidence exists for favourable consequences of cytokine production following traumatic brain injuries as well. In some cases, treatments that reduce the inflammatory response will also hinder the brain's intrinsic repair mechanisms. At present, there is no evidence-based pharmacological treatment for concussions in humans. The ability to treat concussions with drug therapy requires an in-depth understanding of the pathophysiological and neuroinflammatory changes that accompany concussive injuries. The use of neurotrophic factors (e.g. nerve growth factor and anti-inflammatory agents as an adjunct for the management of post-concussion symptomology will be explored in this review.

  4. Recovery of gait and other motor functions after stroke: novel physical and pharmacological treatment strategies.

    Science.gov (United States)

    Hesse, S

    2004-01-01

    The gait-lab at Klinik Berlin developed and evaluated novel physical and pharmacological strategies promoting the repetitive practise of hemiparetic gait in line with the slogan: who wants to relearn walking, has to walk. Areas of research are treadmill training with partial body weight support, enabling wheelchair-bound subjects to repetitively practice gait, the electromechanical gait trainer GT I reducing the effort on the therapists as compared to the manually assisted locomotor therapy, and the future HapticWalker which will allow the additional practise of stair climbing up and down and of perturbations. Further means to promote gait practice after stroke was the application of botulinum toxin A for the treatment of lower limb spasticity and the early use of walking aids. New areas of research are also the study of D-Amphetamine, which failed to promote motor recovery in acute stroke patients as compared to placebo, and the development of a computerized arm trainer, Bi-Manu-T rack, for the bilateral treatment of patients with a severe upper limb paresis.

  5. Application of Laser Irradiation for Restorative Treatments

    OpenAIRE

    Davoudi, Amin; Sanei, Maryam; Badrian, Hamid

    2016-01-01

    Nowadays, lasers are widely used in many fields of medicine. Also, they can be applied at many branches of dental practice such as diagnosis, preventive procedures, restorative treatments, and endodontic therapies. Procedures like caries removal, re-mineralization, and vital pulp therapy are the most noticeable effects of laser irradiation which has gained much attention among clinicians. With controlled and appropriate wavelength, they can help stimulating dentinogenesis, controlling pulpal ...

  6. Grout treatment facility dangerous waste permit application

    International Nuclear Information System (INIS)

    1992-07-01

    The Grout Treatment Facility (GTF) will provide permanent disposal for approximately 43 Mgal of radioactive liquid waste currently being stored in underground tanks on the Hanford Site. The first step in permanent disposal is accomplished by solidifying the liquid waste with cementitious dry materials. The resulting grout is cast within underground vaults. This report on the GTF contains information on the following: Vault design, run-on/run-off control design, and asphalt compatibility with 90-degree celsius double-shell slurry feed

  7. Grout treatment facility dangerous waste permit application

    International Nuclear Information System (INIS)

    1992-07-01

    The Grout Treatment Facility (GTF) will provide permanent disposal for approximately 43 Mgal of radioactive liquid waste currently being stored in underground tanks on the Hanford Site. The first step in permanent disposal is accomplished by solidifying the low-level liquid waste with cementitious dry materials. The resulting grout is cast within underground vaults. This report on the GTF contains information on the following: Hanford Site Maps, road evaluation for the grout treatment facility, Department of Ecology certificate of non-designation for centralia fly ash, double-shell tank waste compositional modeling, laboratory analysis reports for double-shell tank waste, stored in tanks 241-AN-103, 241-AN-106, and 241-AW-101, grout vault heat transfer results for M-106 grout formulation, test results for extraction procedure toxicity testing, test results for toxicity testing of double-shell tank grout, pilot-scale grout production test with a simulated low-level waste, characterization of simulated low-level waste grout produced in a pilot-scale test, description of the procedure for sampling nonaging waste storage tanks, description of laboratory procedures, grout campaign waste composition verification, variability in properties of grouted phosphate/sulfate N-reactor waste, engineering drawings, description of operating procedures, equipment list--transportable grout equipment, grout treatment facility--tank integrity assessment plan, long-term effects of waste solutions on concrete and reinforcing steel, vendor information, grout disposal facilities construction quality assurance plan, and flexible membrane liner/waste compatibility test results

  8. SU-E-T-611: Effective Treatment Volume of the Small Size IORT Applicators

    International Nuclear Information System (INIS)

    Krechetov, A.S.; Goer, D.A.

    2014-01-01

    Purpose Mobile electron linear accelerators are gaining more attention recently, providing a lower cost and simpler way to perform intraoperative treatment. However, the simplicity of the treatment process does not eliminate the need for proper attention to the technical aspects of the treatment. One of the potential pitfalls is incorrect selection of the appropriate applicator size to adequately cover the tumor bed to the prescription dose. When treating tumor beds in the pelvis, the largest applicator that fits into the pelvis is usually selected as there is concern about microscopic extension of the disease along the sidewalls of the pelvis. But when treating early stage breast tumors, there is a natural tendency to select an applicator as small as possible so as not to jeopardize cosmesis. Methods This investigation questions how much of the typical breast treatment volume gets adequate exposure and what is the correct strategy in selecting the proper applicator size. Actual data from isodose scans were analyzed. Results We found that typical treatment dose prescriptions can cover as much as 80% and as little as 20% of the nominal treatment volume depending on the applicator size and energy of the beam and whether the dose is prescribed to the 80 or 90% isodose level. Treatment volume is defined as a cylinder with diameter equal to applicator and height equal to the corresponding D80 or D90 depth. Conclusion If mobile linear accelerators are used, there can be significant amount of “cold volume” depending on the applicator size and this should be taken into account when selecting the applicator that is needed. Using too small of an applicator could result in significant under-dosing to the tissue at risk. Long-term clinical data demonstrates that selecting an adequate field size results in good ontological control as well as excellent cosmesis. Intraop Medical Corp was providing facilities and equipment for this research

  9. Evidence-based treatment strategies for treatment-resistant bipolar depression: a systematic review

    NARCIS (Netherlands)

    Sienaert, P.; Lambrichts, L.; Dols, A.; De Fruyt, J.

    2013-01-01

    Objectives: Treatment resistance in bipolar depression is a common clinical problem that constitutes a major challenge for the treating clinician as there is a paucity of treatment options. The objective of this paper was to review the evidence for treatment options in treatment-resistant bipolar

  10. Degradation of dichlorvos using hydrodynamic cavitation based treatment strategies.

    Science.gov (United States)

    Joshi, Ravi K; Gogate, Parag R

    2012-05-01

    The degradation of an aqueous solution of dichlorvos, a commonly used pesticide in India, has been systematically investigated using hydrodynamic cavitation reactor. All the experiments have been carried out using a 20 ppm solution of commercially available dichlorvos. The effect of important operating parameters such as inlet pressure (over a range 3-6 bar), temperature (31 °C, 36 °C and 39 °C) and pH (natural pH = 5.7 and acidic pH = 3) on the extent of degradation has been investigated initially. It has been observed that an optimum value of pressure gives maximum degradation whereas low temperature and pH of 3 are favorable. Intensification studies have been carried out using different additives such as hydrogen peroxide, carbon tetrachloride, and Fenton's reagent. Use of hydrogen peroxide and carbon tetrachloride resulted in the enhancement of the extent of degradation at optimized conditions but significant enhancement was obtained with the combined use of hydrodynamic cavitation and Fenton's chemistry. The maximum extent of degradation as obtained by using a combination of hydrodynamic cavitation and Fenton's chemistry was 91.5% in 1h of treatment time. The present work has conclusively established that hydrodynamic cavitation in combination with Fenton's chemistry can be effectively used for the degradation of dichlorvos. Copyright © 2011 Elsevier B.V. All rights reserved.

  11. Insights into pathophysiology of punding reveal possible treatment strategies.

    Science.gov (United States)

    Fasano, A; Petrovic, I

    2010-06-01

    Punding is a stereotyped behavior characterized by an intense fascination with a complex, excessive, nongoal oriented, repetitive activity. Men tend to repetitively tinker with technical equipment such as radio sets, clocks, watches and car engines, the parts of which may be analyzed, arranged, sorted and cataloged but rarely put back together. Women, in contrast, incessantly sort through their handbags, tidy continuously, brush their hair or polish their nails. Punders are normally aware of the inapposite and obtuse nature of the behavior; however, despite the consequent self-injury, they do not stop such behavior. The most common causes of punding are dopaminergic replacement therapy in patients affected by Parkinson's disease (PD) and cocaine and amphetamine use in addicts. The vast majority of information about punding comes from PD cases. A critical review of these cases shows that almost all afflicted patients (90%) were on treatment with drugs acting mainly on dopamine receptors D1 and D2, whereas only three cases were reported in association with selective D2 and D3 agonists. Epidemiological considerations and available data from animal models suggest that punding, drug-induced stereotypies, addiction and dyskinesias all share a common pathophysiological process. Punding may be related to plastic changes in the ventral and dorsal striatal structures, including the nucleus accumbens, and linked to psychomotor stimulation and reward mechanisms. Possible management guidelines are proposed.

  12. Bromelain: A potential strategy for the adjuvant treatment of periodontitis

    Directory of Open Access Journals (Sweden)

    Felipe Rodolfo Pereira da Silva

    2016-01-01

    Full Text Available Introduction: Bromelain, a mixture of proteases derived from different parts of pineapple, has been described to have therapeutic benefits in a diversity of inflammatory diseases. Such effects are associated to its proteolytic activity. As one of the most common and multifactorial diseases, periodontitis is a bacterial infection that results from the damage to the integrity of the tissues around the tooth, which includes gingiva, periodontal ligament, and alveolar bone. In periodontitis, the recruitment of defense cells occurs, which releases several pro-inflammatory cytokines. At elevated levels, they can potentiate the alveolar bone loss. Studies have been conducted trying to alleviate the damage to the periodontium, however, the regeneration of the periodontal tissues is still limited. The Hypotheses: Based on previous studies showing that bromelain can act by decreasing the periodontal microorganism growth by proteolytically cleaving important cell surface molecules in leucocytes, by reducing neutrophils migration to periodontal sites, by downregulating the inflammation mediator levels, and by decreasing alveolar bone loss in the periodontitis. Evaluation of the Hypothesis: In a first moment, to evaluate this hypothesis, could be used two animal models: the ligature or bacteria inoculation induced periodontitis. If studies using animal models show encouraging results, appropriate clinical trials should be designed to evaluate the effect of bromelain as a complementary treatment for periodontal disease in humans, during the active phase or after the healing phase of mechanical therapy could be tested; to conduct a placebo-controlled study where health and periodontitis patients could be used.

  13. Genetic heterogeneity in Alzheimer disease and implications for treatment strategies.

    Science.gov (United States)

    Ringman, John M; Goate, Alison; Masters, Colin L; Cairns, Nigel J; Danek, Adrian; Graff-Radford, Neill; Ghetti, Bernardino; Morris, John C

    2014-11-01

    Since the original publication describing the illness in 1907, the genetic understanding of Alzheimer's disease (AD) has advanced such that it is now clear that it is a genetically heterogeneous condition, the subtypes of which may not uniformly respond to a given intervention. It is therefore critical to characterize the clinical and preclinical stages of AD subtypes, including the rare autosomal dominant forms caused by known mutations in the PSEN1, APP, and PSEN2 genes that are being studied in the Dominantly Inherited Alzheimer Network study and its associated secondary prevention trial. Similar efforts are occurring in an extended Colombian family with a PSEN1 mutation, in APOE ε4 homozygotes, and in Down syndrome. Despite commonalities in the mechanisms producing the AD phenotype, there are also differences that reflect specific genetic origins. Treatment modalities should be chosen and trials designed with these differences in mind. Ideally, the varying pathological cascades involved in the different subtypes of AD should be defined so that both areas of overlap and of distinct differences can be taken into account. At the very least, clinical trials should determine the influence of known genetic factors in post hoc analyses.

  14. New strategies for the treatment of acute venous thromboembolism.

    Science.gov (United States)

    Prandoni, Paolo; Lensing, Anthonie W A; Pesavento, Raffaele

    2006-11-01

    In recent years, new opportunities have emerged that have the potential to change rapidly the therapeutic scenario of patients with acute venous thromboembolism (VTE). Selected patients with deep vein thrombosis (DVT) can be treated effectively and safely at home with fixed doses of low molecular weight heparins. The prompt administration of compression elastic stockings in addition to anticoagulant drugs in patients with acute DVT has the potential to halve the rate of late postthrombotic sequelae. The long-term use of low molecular weight heparins is likely to be more effective than oral anticoagulants for the secondary prevention of VTE in patients with advanced malignancy. Patients with pulmonary embolism and right ventricular dysfunction might benefit from the early administration of thrombolytic drugs in combination with heparin to a greater extent than from heparin alone. Despite an impressive amount of clinical information on the proper duration of oral anticoagulants in patients with unprovoked VTE, the optimal long-term treatment of these patients remains undefined. Finally, new categories of drugs are emerging that have the potential to replace conventional anticoagulants in the near future. They include compounds that inhibit factor Xa or thrombin.

  15. Evaluating alternative fuel treatment strategies to reduce wildfire losses in a Mediterranean area

    Science.gov (United States)

    Michele Salis; Maurizio Laconi; Alan A. Ager; Fermin J. Alcasena; Bachisio Arca; Olga Lozano; Ana Fernandes de Oliveira; Donatella Spano

    2016-01-01

    The goal of this work is to evaluate by a modeling approach the effectiveness of alternative fuel treatment strategies to reduce potential losses from wildfires in Mediterranean areas. We compared strategic fuel treatments located near specific human values vs random locations, and treated 3, 9 and 15% of a 68,000 ha study area located in Sardinia, Italy. The...

  16. Current challenges and emerging drug delivery strategies for the treatment of psoriasis.

    Science.gov (United States)

    Hoffman, Melissa B; Hill, Dane; Feldman, Steven R

    2016-10-01

    Psoriasis is a common skin disorder associated with physical, social, psychological and financial burden. Over the past two decades, advances in our understanding of pathogenesis and increased appreciation for the multifaceted burden of psoriasis has led to new treatment development and better patient outcomes. Yet, surveys demonstrate that many psoriasis patients are either undertreated or are dissatisfied with treatment. There are many barriers that need be overcome to optimize patient outcomes and satisfaction. This review covers the current challenges associated with each major psoriasis treatment strategy (topical, phototherapy, oral medications and biologics). It also reviews the challenges associated with the psychosocial aspects of the disease and how they affect treatment outcomes. Patient adherence, inconvenience, high costs, and drug toxicities are all discussed. Then, we review the emerging drug delivery strategies in topical, oral, and biologic therapy. By outlining current treatment challenges and emerging drug delivery strategies, we hope to highlight the deficits in psoriasis treatment and strategies for how to overcome them. Regardless of disease severity, clinicians should use a patient-centered approach. In all cases, we need to balance patients' psychosocial needs, treatment costs, convenience, and effectiveness with patients' preferences in order to optimize treatment outcomes.

  17. Decisional strategy determines whether frame influences treatment preferences for medical decisions.

    Science.gov (United States)

    Woodhead, Erin L; Lynch, Elizabeth B; Edelstein, Barry A

    2011-06-01

    Decision makers are influenced by the frame of information such that preferences vary depending on whether survival or mortality data are presented. Research is inconsistent as to whether and how age impacts framing effects. This paper presents two studies that used qualitative analyses of think-aloud protocols to understand how the type of information used in the decision making process varies by frame and age. In Study 1, 40 older adults, age 65 to 89, and 40 younger adults, age 18 to 24, responded to a hypothetical lung cancer scenario in a within-subject design. Participants received both a survival and mortality frame. Qualitative analyses revealed that two main decisional strategies were used by all participants: one strategy reflected a data-driven decisional process, whereas the other reflected an experience-driven process. Age predicted decisional strategy, with older adults less likely to use a data-driven strategy. Frame interacted with strategy to predict treatment choice; only those using a data-driven strategy demonstrated framing effects. In Study 2, 61 older adults, age 65 to 98, and 63 younger adults, age 18 to 30, responded to the same scenarios as in Study 1 in a between-subject design. The results of Study 1 were replicated, with age significantly predicting decisional strategy and frame interacting with strategy to predict treatment choice. Findings suggest that framing effects may be more related to decisional strategy than to age. (c) 2011 APA, all rights reserved.

  18. Type 4 capitellum fractures: Diagnosis and treatment strategies

    Directory of Open Access Journals (Sweden)

    Suresh S

    2009-01-01

    Full Text Available Background: Fractures of the capitellum are rare injuries of the elbow usually seen in the adolescents. This fracture is often missed in the emergency room if a proper radiograph is not available. Recent reports have described many modalities of treatment favoring headless screw for fixation. The facility for headless screw fixation, however, is not available in most centers. This paper presents the diagnosis and management of type 4 capituller fractures (Mckee with gadgets available in a district hospital. Materials and Methods: Between 2004 and 2007 three patients with right sided type IV capetullar fracture were treated in a district hospital. There were two boys aged 15 and 17 and one 33 years old lady. In one case, the fracture was missed in the emergency room. A double arc sign in the lateral views of the X-rays of the elbow was seen in all the cases. In each case a preoperative CT scan was done and a diagnosis of Mckee type IV fracture of the capitellum was made. Under tourniquet, using extended lateral approach, open reduction and internal fixation was done using 4mm partially threaded AO cancellous screws (n=2 and 2.7 mm AO screws (n=1, under vision from posterior to anterior direction from the posterior aspect of lateral condyle of humerus avoiding articular penetration. Results: All the fractures united uneventfully. At the end of one year follow-up, two cases had excellent elbow function; implants were removed and there were no signs of AVN or arthritis. The third case had good elbow ROM at 11 months without AVN. Conclusion: Double arc sign on lateral X-rays of the elbow along with pre-operative CT scan evaluation is important to avoid a missed diagnosis and analysis of type IV capitellur fracture. Fixation with non-cannulated ordinary AO screws using extended Kocher′s lateral approach has given good results.

  19. Evaluating stormwater micropollutant control strategies by the application of an integrated model

    DEFF Research Database (Denmark)

    Vezzaro, Luca; Sharma, Anitha Kumari; Ledin, Anna

    2011-01-01

    and enhancement of existing treatment) for reducing heavy metals (copper, zinc) and organic MP (fluoranthene). The runoff quality model showed high uncertainty, with prediction bounds strongly affected by the exceptionally high measured concentrations. The model quantified the greater benefits of the source......The estimation of micropollutant (MP) fluxes in stormwater systems is a fundamental task to enable the elaboration of strategies to reduce stormwater MP discharge to natural waters. Dynamic models can represent important tools which can integrate the limited data provided by monitoring campaigns....... This study presents an application of an integrated dynamic model to estimate MP fluxes in stormwater systems in combination with stormwater quality measurements. MP sources were identified by using GIS land usage data. Runoff quality was simulated by using a conceptual accumulation/washoff model...

  20. Optimising treatment strategies for ADHD in adolescence to minimise 'lost in transition' to adulthood.

    Science.gov (United States)

    Buitelaar, J K

    2017-10-01

    The persistence of attention-deficit hyperactivity disorder (ADHD) from adolescence to adulthood is not matched by continuity of care in this transition period. Many adolescents with ADHD have poor medication adherence or even stop medication treatment, and use of behavioural interventions is also suboptimal. The present commentary focuses on treatment strategies that might improve effects of ADHD medication treatment by improving adherence in adolescents with ADHD and/or optimise behavioural interventions for ADHD in adolescence. Most treatment strategies in adolescents with ADHD are merely copied from treatments offered to children. Instead however treatment should be focused on what makes adolescents special and vulnerable, such as poor insight into own functioning and poor decision making. Techniques that offer promise for adolescents are motivational interviewing, use of ecological momentary assessments and interventions, mindfulness-based training and serious games. Systematic studies into the effects of these techniques alone and in combination with medication are lacking.

  1. Application of optimal interation strategies to diffusion theory calculations

    International Nuclear Information System (INIS)

    Jones, R.B.

    1978-01-01

    The geometric interpretation of optimal (minimum computational time) iteration strategies is applied to one- and two-group, two-dimensional diffusion-theory calculations. The method is a ''spectral/time balance'' technique which weighs the convergence enhancement of the inner iteration procedure with that of the outer iteration loop and the time required to reconstruct the source. The diffusion-theory option of the discrete-ordinates transport code DOT3.5 was altered to incorporate the theoretical inner/outer decision logic. For the two-dimensional configuration considered, the optimal strategies reduced the total number of iterations performed for a given error criterion

  2. Comparison of two strategies for the treatment of radiogenic leukopenia using granulocyte colony stimulating factor

    International Nuclear Information System (INIS)

    Adamietz, I.A.; Rosskopf, B.; Dapper, F.D.; Lieven, H. von; Boettcher, H.D.

    1996-01-01

    Purpose: Radiation-induced leukopenia can cause a delay or discontinuation of radiotherapy. This complication can be overcome with the use of granulocyte colony-stimulating factor (G-CSF). However, an uncertainty exists regarding the mode of application of G-CSF in patients treated with radiotherapy. For this reason, the efficacy of two strategies for the administration of G-CSF in irradiated patients was compared in a prospective randomized clinical study. Methods and Materials: Forty-one patients who developed leukopenia ( 9 per liter) while undergoing radiotherapy were treated with G-CSF at a daily dose of 5 μg/kg. The first group received single injections of G-CSF as required (n = 21). The second group received G-CSF on at least 3 consecutive days (n = 20). An analysis was made of the changes in leucocyte counts, the number of days on which radiotherapy had to be interrupted, and the side effects of growth-factor treatment. Results: An increase in leucocyte values in the peripheral blood was observed in all patients treated with G-CSF. In the group which received G-CSF when required, two injections (range: 1-8) were administered in most cases. In the second group, most of the patients received three injections (range: 3-9). The average duration of therapy interruptions due to leukopenia was 4.8 days (0-28) in the first therapy arm and 2.5 (0-20) in the second arm. The variance in the duration of therapy interruptions between the two groups was not significant (p = 0.2). Radiotherapy had to be terminated in two patients due to thrombocytopenia but the application of G-CSF did not seem to be a reason of decreasing platelet counts. Conclusions: Our results reveal that G-CSF is safe and effective in the treatment of radiation-induced leukopenia regardless of the mode of application. Because the calculated difference related to radiation treatment interruptions has no clinical relevance, both approaches examined in our study appear reasonable.

  3. Bioelectric Applications for Treatment of Melanoma

    Energy Technology Data Exchange (ETDEWEB)

    Beebe, Stephen J., E-mail: sbeebe@odu.edu; Schoenbach, Karl H.; Heller, Richard [Frank Reidy Research Center for Bioelectrics/Old Dominion University 4211 Monarch Way, Suite 300, Norfolk, Virginia 23508 (United States)

    2010-09-27

    Two new cancer therapies apply bioelectric principles. These methods target tumor structures locally and function by applying millisecond electric fields to deliver plasmid DNA encoding cytokines using electrogene transfer (EGT) or by applying rapid rise-time nanosecond pulsed electric fields (nsPEFs). EGT has been used to locally deliver cytokines such as IL-12 to activate an immune response, resulting in bystander effects. NsPEFs locally induce apoptosis-like effects and affect vascular networks, both promoting tumor demise and restoration of normal vascular homeostasis. EGT with IL-12 is in melanoma clinical trials and nsPEFs are used in models with B16F10 melanoma in vitro and in mice. Applications of bioelectrics, using conventional electroporation and extensions of it, provide effective alternative therapies for melanoma.

  4. Bioelectric Applications for Treatment of Melanoma

    Directory of Open Access Journals (Sweden)

    Richard Heller

    2010-09-01

    Full Text Available Two new cancer therapies apply bioelectric principles. These methods target tumor structures locally and function by applying millisecond electric fields to deliver plasmid DNA encoding cytokines using electrogene transfer (EGT or by applying rapid rise-time nanosecond pulsed electric fields (nsPEFs. EGT has been used to locally deliver cytokines such as IL-12 to activate an immune response, resulting in bystander effects. NsPEFs locally induce apoptosis-like effects and affect vascular networks, both promoting tumor demise and restoration of normal vascular homeostasis. EGT with IL-12 is in melanoma clinical trials and nsPEFs are used in models with B16F10 melanoma in vitro and in mice. Applications of bioelectrics, using conventional electroporation and extensions of it, provide effective alternative therapies for melanoma.

  5. Bioelectric Applications for Treatment of Melanoma

    International Nuclear Information System (INIS)

    Beebe, Stephen J.; Schoenbach, Karl H.; Heller, Richard

    2010-01-01

    Two new cancer therapies apply bioelectric principles. These methods target tumor structures locally and function by applying millisecond electric fields to deliver plasmid DNA encoding cytokines using electrogene transfer (EGT) or by applying rapid rise-time nanosecond pulsed electric fields (nsPEFs). EGT has been used to locally deliver cytokines such as IL-12 to activate an immune response, resulting in bystander effects. NsPEFs locally induce apoptosis-like effects and affect vascular networks, both promoting tumor demise and restoration of normal vascular homeostasis. EGT with IL-12 is in melanoma clinical trials and nsPEFs are used in models with B16F10 melanoma in vitro and in mice. Applications of bioelectrics, using conventional electroporation and extensions of it, provide effective alternative therapies for melanoma

  6. Nonthermal effects in thermal treatment applications of nonionizing irradiation

    Science.gov (United States)

    Thomsen, Sharon

    2005-04-01

    Several non-thermal factors influence the primary and secondary effects of interstitial thermal treatments using various types of non-ionizing irradiation. Recognition and understanding of the influences of these various factors are important in choice of energy source, the configuration of the application instrument and the design of treatments.

  7. SOLAR ENERGY APPLICATION IN WASTE TREATMENT- A REVIEW

    African Journals Online (AJOL)

    This review is an exposure on the various ways that solar energy can be harnessed for numerous waste treatment processes. Almost all forms of waste treatment require energy which is scarcely available considering the global energy crisis. The objective of this study is to enumerate the solar energy applications in waste ...

  8. Pharmacoeconomic analysis of conservative strategy for the treatment of patients with diabetic foot syndrome in Moscow

    Directory of Open Access Journals (Sweden)

    Marina Fedorovna Kalashnikova

    2011-09-01

    Full Text Available Aim. To perform cost-effectiveness analysis of prescription of pharmaceutical products and dressing materials and their consumption volume for inandout-patient treatment of diabetic foot syndrome (DFS. To analyse efficacy of the treatment in terms of modern therapeutic standards. Materials and methods. This retrospective study is based on the medical documentation of 139 DM1 and DM2 patients with DFS from differentmedical facilities of Moscow (2007. 72 patients were given general out-patient care by surgeons of city polyclinics, 50 ones received specialized aidin the regional Diabetic Foot Cabinet. 67 patients were hospitalized: 20 for general care in the department of purulent surgery of a military hospital,27 for specialized care in the department of purulent surgery of a city hospital, 20 for high-technology care in the endocrinological clinic of the FirstMoscow State Medical University. Results. Therapeutic strategy for DFS patients used in the regional Diabetic Foot Cabinet met the current therapeutic standards. General out-patientcare by surgeons of city polyclinics was at variance with the algorithms adopted in this country. Pharmacoeconomic analysis of the spectrum of pharmaceuticalproducts used for in- and out-patient treatment of DFS patients revealed frequent and ungrounded application of drugs whose woundhealing effect remains to be confirmed (pentoxifylline, thioctoic and alpha-lipoic acids. Conclusion. Additional training courses for surgeons of Moscow polyclinics are needed to improve the quality of medical aid to DFS patients. Suchpatients must be referred to regional Diabetic Foot Cabinets. Pentoxifylline, thioctoic and alpha-lipoic acids need to be substituted by pharmaceuticalswith validated therapeutic efficacy.

  9. Problem Analysis: Application in Developing Marketing Strategies for Colleges.

    Science.gov (United States)

    Martin, John; Moore, Thomas

    1991-01-01

    The problem analysis technique can help colleges understand students' salient needs in a competitive market. A preliminary study demonstrates the usefulness of the approach for developing strategies aimed at maintaining student loyalty and improving word-of-mouth promotion to other prospective students. (Author/MSE)

  10. Collaborative Learning: Theoretical Foundations and Applicable Strategies to University

    Science.gov (United States)

    Roselli, Nestor D.

    2016-01-01

    Collaborative learning is a construct that identifies a current strong field, both in face-to-face and virtual education. Firstly, three converging theoretical sources are analyzed: socio-cognitive conflict theory, intersubjectivity theory and distributed cognition theory. Secondly, a model of strategies that can be implemented by teachers to…

  11. Supporting Alternative Strategies for Learning Chemical Applications of Group Theory

    Science.gov (United States)

    Southam, Daniel C.; Lewis, Jennifer E.

    2013-01-01

    A group theory course for chemists was taught entirely with process oriented guided inquiry learning (POGIL) to facilitate alternative strategies for learning. Students completed a test of one aspect of visuospatial aptitude to determine their individual approaches to solving spatial tasks, and were sorted into groups for analysis on the basis of…

  12. Agriculture Teacher Awareness and Application of Self-Regulation Strategies

    Science.gov (United States)

    McKendree, R. Bud; Washurn, Shannon G.

    2017-01-01

    This qualitative study investigated four rural Kansas high school agriculture teachers' comprehension and implementation of self-regulation strategies in their own professional growth and in their instructional practice. The participants included two males and two females, each one having between five and 20 years of teaching experience.…

  13. Biodegradation of dispersed marine fuel oil in sediment under engineered pre-spill application strategy

    International Nuclear Information System (INIS)

    Hua, J.

    2006-01-01

    Biodegradation of marine fuel oil was studied by monitoring changes in residual oil and populations of microorganisms in marine sediments. Biodegradation rates for dispersant and soap water were 2.09 and 2.27 g/kg per day, respectively, under pre-application strategy, suggesting that the strategy may promote MFO dispersion and provide with sufficient source of food. The effect of temperature on the effectiveness of pre-application strategy is particularly obvious for the growth of fungi and Pseudomonas maltophilia. The effect of pre-application of soap water on the tolerance of aerobic bacteria, Escherichia coli, and P. maltophilia, was gradually diminished within 25-33 days. (author)

  14. Strategies for diagnosis and treatment of suspected leptospirosis: a cost-benefit analysis.

    Directory of Open Access Journals (Sweden)

    Yupin Suputtamongkol

    Full Text Available BACKGROUND: Symptoms and signs of leptospirosis are non-specific. Several diagnostic tests for leptospirosis are available and in some instances are being used prior to treatment of leptospirosis-suspected patients. There is therefore a need to evaluate the cost-effectiveness of the different treatment strategies in order to avoid misuse of scarce resources and ensure best possible health outcomes for patients. METHODS: The study population was adult patients, presented with uncomplicated acute febrile illness, without an obvious focus of infection or malaria or typical dengue infection. We compared the cost and effectiveness of 5 management strategies: 1 no patients tested or given antibiotic treatment; 2 all patients given empirical doxycycline treatment; patients given doxycycline when a patient is tested positive for leptospirosis using: 3 lateral flow; 4 MCAT; 5 latex test. The framework used is a cost-benefit analysis, accounting for all direct medical costs in diagnosing and treating patients suspected of leptospirosis. Outcomes are measured in length of fever after treatment which is then converted to productivity losses to capture the full economic costs. FINDINGS: Empirical doxycycline treatment was the most efficient strategy, being both the least costly alternative and the one that resulted in the shortest duration of fever. The limited sensitivity of all three diagnostic tests implied that their use to guide treatment was not cost-effective. The most influential parameter driving these results was the cost of treating patients with complications for patients who did not receive adequate treatment as a result of incorrect diagnosis or a strategy of no-antibiotic-treatment. CONCLUSIONS: Clinicians should continue treating suspected cases of leptospirosis on an empirical basis. This conclusion holds true as long as policy makers are not prioritizing the reduction of use of antibiotics, in which case the use of the latex test would be

  15. Applicability of ISO 16697 Data to Spacecraft Fire Fighting Strategies

    Science.gov (United States)

    Hirsch, David B.; Beeson, Harold D.

    2012-01-01

    Presentation Agenda: (1) Selected variables affecting oxygen consumption during spacecraft fires, (2) General overview of ISO 16697, (3) Estimated amounts of material consumed during combustion in typical ISS enclosures, (4) Discussion on potential applications.

  16. Lightweight acoustic treatments for aerospace applications

    Science.gov (United States)

    Naify, Christina Jeanne

    2011-12-01

    Increase in the use of composites for aerospace applications has the benefit of decreased structural weight, but at the cost of decreased acoustic performance. Stiff, lightweight structures (such as composites) are traditionally not ideal for acoustic insulation applications because of high transmission loss at low frequencies. A need has thus arisen for effective sound insulation materials for aerospace and automotive applications with low weight addition. Current approaches, such as the addition of mass law dominated materials (foams) also perform poorly when scaled to small thickness and low density. In this dissertation, methods which reduce sound transmission without adding significant weight are investigated. The methods presented are intended to be integrated into currently used lightweight structures such as honeycomb sandwich panels and to cover a wide range of frequencies. Layering gasses of differing acoustic impedances on a panel substantially reduced the amount of sound energy transmitted through the panel with respect to the panel alone or an equivalent-thickness single species gas layer. The additional transmission loss derives from successive impedance mismatches at the interfaces between gas layers and the resulting inefficient energy transfer. Attachment of additional gas layers increased the transmission loss (TL) by as much as 17 dB at high (>1 kHz) frequencies. The location and ordering of the gasses with respect to the panel were important factors in determining the magnitude of the total TL. Theoretical analysis using a transfer matrix method was used to calculate the frequency dependence of sound transmission for the different configurations tested. The method accurately predicted the relative increases in TL observed with the addition of different gas layer configurations. To address low-frequency sound insulation, membrane-type locally resonant acoustic materials (LRAM) were fabricated, characterized, and analyzed to understand their

  17. Nanoparticles for hyperthermic therapy: synthesis strategies and applications in glioblastoma

    NARCIS (Netherlands)

    Verma, Jyoti; Lal, Sumit; van Noorden, Cornelis J. F.

    2014-01-01

    Glioblastoma multiforme (GBM) is the most common and most aggressive malignant primary brain tumor in humans. Current GBM treatment includes surgery, radiation therapy, and chemotherapy, sometimes supplemented with novel therapies. Despite recent advances, survival of GBM patients remains poor.

  18. Labelling strategies for enhanced application of ICPMS in protein analysis

    International Nuclear Information System (INIS)

    Bettmer, J.; Kutscher, D.J.

    2009-01-01

    Full text: Quantitative protein analysis is one of today's challenges in analytical chemistry. Herein, mass spectrometric techniques play an important role with the use of both label-free and labelling approaches. In the field of ICPMS, the latter approach is attractive as it can provide highly sensitive detection of proteins after labelling with metal-containing compounds. Following a brief introduction to the different strategies described in the literature, this presentation will be focussed on protein labelling using a mercury compound (p-hydroxymercuribenzoic acid, pHMB). Besides fundamental studies on the derivatization process itself, a strategy will be presented in which absolute protein quantification can be achieved. Finally, the potential, but also limitations of the technique will be highlighted. (author)

  19. Assessment of Antimicrobial Treatment Strategies in Pig Production Using Mathematical Models

    DEFF Research Database (Denmark)

    Ahmad, Amais

    strategies. Dosing factors, along with the in vivo epidemiological parameters, govern the relation between resistance and antimicrobial use. Mathematical modeling and simulation techniques have been used over the past two decades to evaluate the effect of these factors on the development of resistance......, and are considered to be powerful tools in designing treatment strategies. The overall aim of the thesis was to develop an in vivo bacterial growth model to predict and assess the effect of dosing factor on resistance growth in order to optimize treatment strategies. Specific aims were to a) estimate pharmacodynamic...... concentration (MIC). These parameters along with MIC should be taken into account when studying the effect of antimicrobials on the bacterial growth. These parameters were used as an input to the in vivo growth model of multiple bacterial strains. For almost all treatments, high resistance levels were found...

  20. The effects of the integrated application of BSC and ABM to enterprise strategy and efficiency

    Directory of Open Access Journals (Sweden)

    Violeta Domanovic

    2016-08-01

    Full Text Available The shortcomings of an individual application of some managerial innovation models in the domain of management accounting and strategic management in the modern business environment made research into the complementary and integrated application of managerial innovation models inevitable. The aim of the research is to show that the complementary use of the BSC and the ABM in managing enterprise strategy and efficiency eliminates the shortcomings of their individual application. The paper specifies the effects of the application of the BSC and the ABM on the enterprise strategy, particularly emphasizing the role of ICT in the course of implementation, and presents the results of the empirical research into the correlation of the BSC and the ABM regarding the strategy and efficiency of an enterprise. Despite possible problems and limitations, a proper synergic use of respective managerial innovations enables a better implementation of the defined strategies and improves the efficiency of the enterprise in the long run.

  1. New Developments in Error Detection and Correction Strategies for Critical Applications

    Science.gov (United States)

    Berg, Melanie; Label, Ken

    2017-01-01

    The presentation will cover a variety of mitigation strategies that were developed for critical applications. An emphasis is placed on strengths and weaknesses per mitigation technique as it pertains to different Field programmable gate array (FPGA) device types.

  2. Risk comparison of different treatment and disposal strategies of high level liquid radioactive waste

    International Nuclear Information System (INIS)

    Fang Dong

    1997-01-01

    The risk of different treatment and disposal strategies of high level liquid radioactive waste from spent fuel reprocessing is estimated and compared. The conclusions obtained are that risk difference from these strategies is very small and high level liquid waste can be reduced to middle and low level waste, if the decontamination factor for 99 Tc is large enough, which is the largest risk contributor in the high level radioactive waste from spent fuel reprocessing. It is also shown that the risk of high level radioactive waste could be reduced by the technical strategy of combining partitioning and transmutation

  3. New Strategies for the Treatment of Solid Tumors with CAR-T Cells.

    Science.gov (United States)

    Zhang, Hao; Ye, Zhen-Long; Yuan, Zhen-Gang; Luo, Zheng-Qiang; Jin, Hua-Jun; Qian, Qi-Jun

    2016-01-01

    Recent years, we have witnessed significant progresses in both basic and clinical studies regarding novel therapeutic strategies with genetically engineered T cells. Modification with chimeric antigen receptors (CARs) endows T cells with tumor specific cytotoxicity and thus induce anti-tumor immunity against malignancies. However, targeting solid tumors is more challenging than targeting B-cell malignancies with CAR-T cells because of the histopathological structure features, specific antigens shortage and strong immunosuppressive environment of solid tumors. Meanwhile, the on-target/off-tumor toxicity caused by relative expression of target on normal tissues is another issue that should be reckoned. Optimization of the design of CAR vectors, exploration of new targets, addition of safe switches and combination with other treatments bring new vitality to the CAR-T cell based immunotherapy against solid tumors. In this review, we focus on the major obstacles limiting the application of CAR-T cell therapy toward solid tumors and summarize the measures to refine this new cancer therapeutic modality.

  4. Nanofiltration technology in water treatment and reuse: applications and costs.

    Science.gov (United States)

    Shahmansouri, Arash; Bellona, Christopher

    2015-01-01

    Nanofiltration (NF) is a relatively recent development in membrane technology with characteristics that fall between ultrafiltration and reverse osmosis (RO). While RO membranes dominate the seawater desalination industry, NF is employed in a variety of water and wastewater treatment and industrial applications for the selective removal of ions and organic substances, as well as certain niche seawater desalination applications. The purpose of this study was to review the application of NF membranes in the water and wastewater industry including water softening and color removal, industrial wastewater treatment, water reuse, and desalination. Basic economic analyses were also performed to compare the profitability of using NF membranes over alternative processes. Although any detailed cost estimation is hampered by some uncertainty (e.g. applicability of estimation methods to large-scale systems, labor costs in different areas of the world), NF was found to be a cost-effective technology for certain investigated applications. The selection of NF over other treatment technologies, however, is dependent on several factors including pretreatment requirements, influent water quality, treatment facility capacity, and treatment goals.

  5. Barriers affecting adherence to radiation treatment and strategies to overcome those barriers.

    Science.gov (United States)

    Rangarajan, R; Jayaraman, K

    2017-01-01

    The WHO defines adherence as the extent to which a patient's behavior coincides with recommendations from a health-care provider. Nonadherence to cancer treatment has a major impact on the therapeutic outcome. To assess the prevalence of nonadherence to radiation regimen and to analyze the factors that affect adherence to cancer treatment. Patients receiving radiation treatment in our hospital were screened for adherence to appointment keeping and to the prescribed radiation regimen and patients who had unplanned treatment breaks during treatment were interviewed. Between January and July 2013, we identified 61 patients who had unplanned breaks during treatment. We analyzed the social, emotional, educational, economic, and therapeutic barriers that led to nonadherence. Of the 61 patients who had unplanned breaks during treatment, 54% were males and 46% were females. Fifty-seven percent of patients had head and neck cancers and 25% had gynecological cancers. Seventy-one percent of patients were planned for concurrent chemoradiation. The number of days of unplanned treatment breaks ranged from 3 to 27 days. Social and therapeutic barriers were found to be the most common factor that led to nonadherence in these patients. Identification of barriers that lead to nonadherence, designing strategies to overcome such barriers and effective communication becomes imperative to ensure uninterrupted treatment. Based on the above analysis, we have designed several strategies to improve adherence to treatment among our patients.

  6. Prostate IMRT fractionation strategies. Two-phase treatment versus simultaneous integrated boost

    International Nuclear Information System (INIS)

    Stavrev, P.; Hristov, D.

    2003-01-01

    Background. The purpose of the study was to investigate the radiobiological effect of the number of fractions, position uncertainties and clonogen spread (microscopic disease) on two different inverse treatment planning alternatives: (a) 2-phase strategy; (b) simultaneous integrated boost (SIB). Material and methods. The tumour control probability (TCP) and normal tissue complication probability (NTCP) were calculated for the 2-phase strategy, which has well defined fractionation scheme and compared to the TCP and NTCP for the SIB strategy calculated as a function of the number of fractions. For a 7-beam IMRT prostate treatment, we have performed inverse treatment planning for the two different strategies following the above method. Results. When the position uncertainties and clonogen spread were accounted for in the TCP calculation a drop as large as 10% was found. A drop of 5-7% in the TCP was obtained for the SIB strategy, if delivered in the same number of fractions as the 2-phased one. Conclusions. The potential of inverse planning to design tight conformal dose distributions is fully revealed in the SIB optimization process. The optimized SIB superior dose distributions require modification of the delivered dose per fraction and therefore careful selection of the fractionation regime. Hence physically optimized SIB treatments may not always lead to better tumour control and tissue sparing. (author)

  7. Regional MLEM reconstruction strategy for PET-based treatment verification in ion beam radiotherapy

    International Nuclear Information System (INIS)

    Gianoli, Chiara; Riboldi, Marco; Fattori, Giovanni; Baselli, Giuseppe; Baroni, Guido; Bauer, Julia; Debus, Jürgen; Parodi, Katia; De Bernardi, Elisabetta

    2014-01-01

    In ion beam radiotherapy, PET-based treatment verification provides a consistency check of the delivered treatment with respect to a simulation based on the treatment planning. In this work the region-based MLEM reconstruction algorithm is proposed as a new evaluation strategy in PET-based treatment verification. The comparative evaluation is based on reconstructed PET images in selected regions, which are automatically identified on the expected PET images according to homogeneity in activity values. The strategy was tested on numerical and physical phantoms, simulating mismatches between the planned and measured β + activity distributions. The region-based MLEM reconstruction was demonstrated to be robust against noise and the sensitivity of the strategy results were comparable to three voxel units, corresponding to 6 mm in numerical phantoms. The robustness of the region-based MLEM evaluation outperformed the voxel-based strategies. The potential of the proposed strategy was also retrospectively assessed on patient data and further clinical validation is envisioned. (paper)

  8. Unintended Consequences of Evidence-Based Treatment Policy Reform: Is Implementation the Goal or the Strategy for Higher Quality Care?

    Science.gov (United States)

    Park, Alayna L; Tsai, Katherine H; Guan, Karen; Chorpita, Bruce F

    2018-02-14

    This study examined patterns of evidence-based treatment (EBT) delivery following a county-wide EBT reform initiative. Data were gathered from 60 youth and their 21 providers, who were instructed to deliver therapy as they normally would under the EBT initiative. Results showed limited applicability of county-supported EBTs to this service sample, and that most youth did not receive traditional delivery of EBTs. Findings suggest that it may be unrealistic to expect providers to deliver EBTs with fidelity with all clients, and that EBT implementation may be best thought of as a strategy for improving mental health services rather than a goal.

  9. Present practice and treatment strategies in endourological stone management: results of a survey of the European Society of Uro-technology (ESUT)

    NARCIS (Netherlands)

    Kauer, P. C.; Laguna, M. P.; Alivizatos, G.; Joyce, A.; Muschter, R.; Swartz, R.; Tolley, D.; de la Rosette, J. J. M. C. H.

    2005-01-01

    OBJECTIVES: The European Society of Urological Technology (ESUT) conducted a survey in order to assess and record the current trends between urologists with regard to the application of endourological stone management to identify trends and differences in treatment strategies among urologists.

  10. The Relationship between Cost Leadership Strategy, Total Quality Management Applications and Financial Performance

    OpenAIRE

    Ali KURT; Cemal ZEHİR

    2016-01-01

    Firms need to implement some competition strategies and total quality management applications to overcome the fierce competition among others. The purpose of this study is to show the relationship between cost leadership strategy, total quality management applications and firms’ financial performance with literature review and empirical analysis. 449 questionnaires were conducted to the managers of 142 big firms. The data gathered was assessed with AMOS. As a result, the relationship between ...

  11. State E-Government Strategies: Identifying Best Practices and Applications

    Science.gov (United States)

    2007-07-23

    Internet; ! Developing meaningful online applications for local government, businesses, educators, and other sectors; ! Establishing local “ eCommunity ...state, national, and international levels. However, frequently there is little meaningful coordination or communication between various e-government...weekly with the governor, 13% reported meeting monthly, and 21% reported “other,” meaning that these states have a different meeting schedule

  12. An effective strategy for porting C++ applications on cell

    NARCIS (Netherlands)

    Varbanescu, A.L.; Sips, H.; Ross, K.A.; Liu, Q.; Liu, L.K.; Natsev, A.; Smith, J.R.

    2007-01-01

    In this paper we present a solution for efficient porting of sequential C++ applications on the Cell B.E. processor. We present our step-by-step approach, focusing on its generality, we provide a set of code templates and optimization guidelines to support the porting, and we include a set of

  13. Applications of nanotechnology in wastewater treatment--a review.

    Science.gov (United States)

    Bora, Tanujjal; Dutta, Joydeep

    2014-01-01

    Water on Earth is a precious and finite resource, which is endlessly recycled in the water cycle. Water, whose physical, chemical, or biological properties have been altered due to the addition of contaminants such as organic/inorganic materials, pathogens, heavy metals or other toxins making it unsafe for the ecosystem, can be termed as wastewater. Various schemes have been adopted by industries across the world to treat wastewater prior to its release to the ecosystem, and several new concepts and technologies are fast replacing the traditional methods. This article briefly reviews the recent advances and application of nanotechnology for wastewater treatment. Nanomaterials typically have high reactivity and a high degree of functionalization, large specific surface area, size-dependent properties etc., which makes them suitable for applications in wastewater treatment and for water purification. In this article, the application of various nanomaterials such as metal nanoparticles, metal oxides, carbon compounds, zeolite, filtration membranes, etc., in the field of wastewater treatment is discussed.

  14. A dosimetric treatment planning strategy in radioembolization of hepatocarcinoma with 90Y glass microspheres.

    Science.gov (United States)

    Chiesa, C; Mira, M; Maccauro, M; Romito, R; Spreafico, C; Sposito, C; Bhoori, S; Morosi, C; Pellizzari, S; Negri, A; Civelli, E; Lanocita, R; Camerini, T; Bampo, C; Carrara, M; Seregni, E; Marchianò, A; Mazzaferro, V; Bombardieri, E

    2012-12-01

    Our goal was to limit liver toxicity and to obtain good efficacy by developing a dosimetric treatment planning strategy. While several dosimetric evaluations are reported in literature, the main problem of the safety of the treatment is rarely addressed. Our work is the first proposal of a treatment planning method for glass spheres, including both liver toxicity and efficacy issues. Fifty-two patients (series 1) had been treated for intermediated/advanced hepatocellular carcinoma (HCC) with glass spheres, according to the Therasphere® prescription of 120 Gy averaged on the injected lobe. They were retrospectively evaluated with voxel dosimetry, adopting the local deposition hypothesis. Regions of interest on tumor and non tumor parenchyma were drawn to determine the parenchyma absorbed dose, averaged also on non irradiated voxels, excluding tumor voxels. The relationship between the mean non tumoral parenchyma absorbed dose D and observed liver decompensation was analyzed. Basal Child-Pugh strongly affected the toxicity incidence, which was 22% for A5, 57% for A6, 89% for B7 patients. Restricting the analysis to our numerically richest class (basal Child-Pugh A5 patients), D median values were significantly different between toxic (median 90 Gy) and non toxic treatments (median 58 Gy) at a Mann-Withney test, (P=0.033). Using D as a marker for toxicity, the separation of the two populations in terms of area under ROC curve was 0.75, with 95% C.I. of [0.55-0.95]. The experimental Normal Tissue Complication Probability (NTCP) curve as a function of D resulted in the following values: 0%, 14%, 40%, 67% for D interval of [0-35] Gy, [35-70] Gy, [70-105] Gy, [105-140] Gy. A limit of about 70 Gy for the mean absorbed dose to parenchyma was assumed for A5 patients, corresponding to a 14% risk of liver decompensation. This result is applicable only to our administration conditions: glass spheres after a decay interval of 3.75 days. Different safety limit (40 Gy) are

  15. Biomedical engineering strategies for peripheral nerve repair: surgical applications, state of the art, and future challenges.

    Science.gov (United States)

    Pfister, Bryan J; Gordon, Tessa; Loverde, Joseph R; Kochar, Arshneel S; Mackinnon, Susan E; Cullen, D Kacy

    2011-01-01

    Damage to the peripheral nervous system is surprisingly common and occurs primarily from trauma or a complication of surgery. Although recovery of nerve function occurs in many mild injuries, outcomes are often unsatisfactory following severe trauma. Nerve repair and regeneration presents unique clinical challenges and opportunities, and substantial contributions can be made through the informed application of biomedical engineering strategies. This article reviews the clinical presentations and classification of nerve injuries, in addition to the state of the art for surgical decision-making and repair strategies. This discussion presents specific challenges that must be addressed to realistically improve the treatment of nerve injuries and promote widespread recovery. In particular, nerve defects a few centimeters in length use a sensory nerve autograft as the standard technique; however, this approach is limited by the availability of donor nerve and comorbidity associated with additional surgery. Moreover, we currently have an inadequate ability to noninvasively assess the degree of nerve injury and to track axonal regeneration. As a result, wait-and-see surgical decisions can lead to undesirable and less successful "delayed" repair procedures. In this fight for time, degeneration of the distal nerve support structure and target progresses, ultimately blunting complete functional recovery. Thus, the most pressing challenges in peripheral nerve repair include the development of tissue-engineered nerve grafts that match or exceed the performance of autografts, the ability to noninvasively assess nerve damage and track axonal regeneration, and approaches to maintain the efficacy of the distal pathway and targets during the regenerative process. Biomedical engineering strategies can address these issues to substantially contribute at both the basic and applied levels, improving surgical management and functional recovery following severe peripheral nerve injury.

  16. PREPARING FOR EXASCALE: ORNL Leadership Computing Application Requirements and Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Joubert, Wayne [ORNL; Kothe, Douglas B [ORNL; Nam, Hai Ah [ORNL

    2009-12-01

    In 2009 the Oak Ridge Leadership Computing Facility (OLCF), a U.S. Department of Energy (DOE) facility at the Oak Ridge National Laboratory (ORNL) National Center for Computational Sciences (NCCS), elicited petascale computational science requirements from leading computational scientists in the international science community. This effort targeted science teams whose projects received large computer allocation awards on OLCF systems. A clear finding of this process was that in order to reach their science goals over the next several years, multiple projects will require computational resources in excess of an order of magnitude more powerful than those currently available. Additionally, for the longer term, next-generation science will require computing platforms of exascale capability in order to reach DOE science objectives over the next decade. It is generally recognized that achieving exascale in the proposed time frame will require disruptive changes in computer hardware and software. Processor hardware will become necessarily heterogeneous and will include accelerator technologies. Software must undergo the concomitant changes needed to extract the available performance from this heterogeneous hardware. This disruption portends to be substantial, not unlike the change to the message passing paradigm in the computational science community over 20 years ago. Since technological disruptions take time to assimilate, we must aggressively embark on this course of change now, to insure that science applications and their underlying programming models are mature and ready when exascale computing arrives. This includes initiation of application readiness efforts to adapt existing codes to heterogeneous architectures, support of relevant software tools, and procurement of next-generation hardware testbeds for porting and testing codes. The 2009 OLCF requirements process identified numerous actions necessary to meet this challenge: (1) Hardware capabilities must be

  17. PREPARING FOR EXASCALE: ORNL Leadership Computing Application Requirements and Strategy

    International Nuclear Information System (INIS)

    Joubert, Wayne; Kothe, Douglas B.; Nam, Hai Ah

    2009-01-01

    In 2009 the Oak Ridge Leadership Computing Facility (OLCF), a U.S. Department of Energy (DOE) facility at the Oak Ridge National Laboratory (ORNL) National Center for Computational Sciences (NCCS), elicited petascale computational science requirements from leading computational scientists in the international science community. This effort targeted science teams whose projects received large computer allocation awards on OLCF systems. A clear finding of this process was that in order to reach their science goals over the next several years, multiple projects will require computational resources in excess of an order of magnitude more powerful than those currently available. Additionally, for the longer term, next-generation science will require computing platforms of exascale capability in order to reach DOE science objectives over the next decade. It is generally recognized that achieving exascale in the proposed time frame will require disruptive changes in computer hardware and software. Processor hardware will become necessarily heterogeneous and will include accelerator technologies. Software must undergo the concomitant changes needed to extract the available performance from this heterogeneous hardware. This disruption portends to be substantial, not unlike the change to the message passing paradigm in the computational science community over 20 years ago. Since technological disruptions take time to assimilate, we must aggressively embark on this course of change now, to insure that science applications and their underlying programming models are mature and ready when exascale computing arrives. This includes initiation of application readiness efforts to adapt existing codes to heterogeneous architectures, support of relevant software tools, and procurement of next-generation hardware testbeds for porting and testing codes. The 2009 OLCF requirements process identified numerous actions necessary to meet this challenge: (1) Hardware capabilities must be

  18. Place of surgical resection in the treatment strategy of gastrointestinal neuroendocrine tumors.

    Science.gov (United States)

    Gaujoux, Sébastien; Sauvanet, Alain; Belghiti, Jacques

    2012-09-01

    Neuroendocrine tumors (NET) are usually slow-growing neoplasms carrying an overall favorable prognosis. Surgery, from resection to transplantation, remains the only potential curative option for these patients, and should always be considered. Nevertheless, because of very few randomized controlled trials available, the optimal treatment for these patients remains controversial, especially regarding the place of surgery. We herein discuss the place of surgical resection in the treatment strategy in neuroendocrine tumors of the digestive tract.

  19. Treatment of Source-Separated Blackwater: A Decentralized Strategy for Nutrient Recovery towards a Circular Economy

    OpenAIRE

    Melesse Eshetu Moges; Daniel Todt; Arve Heistad

    2018-01-01

    Using a filter medium for organic matter removal and nutrient recovery from blackwater treatment is a novel concept and has not been investigated sufficiently to date. This paper demonstrates a combined blackwater treatment and nutrient-recovery strategy and establishes mechanisms for a more dependable source of plant nutrients aiming at a circular economy. Source-separated blackwater from a student dormitory was used as feedstock for a sludge blanket anaerobic-baffled reactor. The effluent f...

  20. Gradient Material Strategies for Hydrogel Optimization in Tissue Engineering Applications

    Science.gov (United States)

    2018-01-01

    Although a number of combinatorial/high-throughput approaches have been developed for biomaterial hydrogel optimization, a gradient sample approach is particularly well suited to identify hydrogel property thresholds that alter cellular behavior in response to interacting with the hydrogel due to reduced variation in material preparation and the ability to screen biological response over a range instead of discrete samples each containing only one condition. This review highlights recent work on cell–hydrogel interactions using a gradient material sample approach. Fabrication strategies for composition, material and mechanical property, and bioactive signaling gradient hydrogels that can be used to examine cell–hydrogel interactions will be discussed. The effects of gradients in hydrogel samples on cellular adhesion, migration, proliferation, and differentiation will then be examined, providing an assessment of the current state of the field and the potential of wider use of the gradient sample approach to accelerate our understanding of matrices on cellular behavior. PMID:29485612

  1. Patent prosecution strategies for stem cell related applications.

    Science.gov (United States)

    Kumar, Rajeev; Yeh, Jenny J; Fernandez, Dennis; Hansen, Nels

    2007-09-01

    Stem cell research and the intellectual property derived from it, because of its potential to completely transform health care, demand an especially high level of consideration from business and patent prosecution perspectives. As with other revolutionary technologies, ordinary risks are amplified (e.g., litigation), and ordinarily irrelevant considerations may become important (e.g., heightened level of both domestic and foreign legislative risk). In the first part of this article, general strategies for patent prosecutors such as several prosecution considerations and methods for accelerating patent prosecution process are presented. In the second part, patent prosecution challenges of stem cell-related patents and possible solutions are discussed. In the final part, ethical and public policy issues particular to stem cell-related and other biotechnological inventions are summarized.

  2. Management strategy for patients with gastroesophageal reflux disease: a comparison between empirical treatment with esomeprazole and endoscopy-oriented treatment.

    Science.gov (United States)

    Giannini, Edoardo G; Zentilin, Patrizia; Dulbecco, Pietro; Vigneri, Sergio; Scarlata, Pamela; Savarino, Vincenzo

    2008-02-01

    Whether patients with typical gastroesophageal reflux disease (GERD) symptoms and without alarm features should be treated empirically or undergo endoscopy first is a debated issue. In this study, our aim was to assess the efficacy, and to compare the direct costs and impact on health-related quality of life (HRQL), of two treatment strategies (empirical vs endoscopy-oriented treatment) in a large population of patients with GERD. In total, 612 patients were randomized to either empirical treatment with esomeprazole 40 mg once daily (od) (group 1, N = 309) or endoscopy and treatment according to endoscopic findings (group 2, N = 303, esomeprazole 40 mg od in patients with reflux esophagitis and esomeprazole 20 mg od in patients without esophagitis) for 4 wk, followed by esomeprazole 20 mg od maintenance treatment in both groups. Direct costs and HRQL were analyzed in both treatment arms. At the end of the acute treatment phase (week 4), 267 patients in group 1 (86.4%) and 265 patients in group 2 (87.5%) were considered responders to treatment (intention-to-treat analysis, P= 0.878). Empirical treatment proved to be cost-effective by saving 38.72 euros per treated patient. At the end of the maintenance phase (week 24), a similar proportion of patients responded to treatment in the two groups (71.8%vs 68.3%, P= 0.389). HRQL improved from baseline to week 24 in both groups (difference between study groups not significant). In patients with GERD, empirical treatment with esomeprazole proved to be cost-effective compared with endoscopy-oriented treatment, and did not negatively affect patient HRQL. These results should be taken into account in the management of GERD patients in clinical practice.

  3. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

    Science.gov (United States)

    Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S.

    2015-01-01

    Background: Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods: A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results: The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. Conclusion: There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA

  4. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals.

    Science.gov (United States)

    Aghaei Hashjin, Asgar; Kringos, Dionne; Ravaghi, Hamid; Manoochehri, Jila; Gorji, Hassan Abolghasem; Klazinga, Niek S

    2015-05-20

    Iran has a widespread diagnostics and clinical support services (DCSS) network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA) policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%), pharmacopoeia availability (92%), equipment calibration (87%) and identifying responsibilities (86%). Least reported was external auditing of the DCSS (57%). The clinical chemistry and microbiology laboratories (84%), pharmacies, blood bank services (83%) reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%). There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO) and private-for-profit hospitals than in governmental hospitals. There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits) can be improved. Both the effectiveness of QA strategies in practice, and the application of

  5. Application of Quality Assurance Strategies in Diagnostics and Clinical Support Services in Iranian Hospitals

    Directory of Open Access Journals (Sweden)

    Asgar Aghaei Hashjin

    2015-10-01

    Full Text Available Background Iran has a widespread diagnostics and clinical support services (DCSS network that plays a crucial role in providing diagnostic and clinical support services to both inpatient and outpatient care. However, very little is known on the application of quality assurance (QA policies in DCSS units. This study explores the extent of application of eleven QA strategies in DCSS units within Iranian hospitals and its association with hospital characteristics. Methods A descriptive cross-sectional study was conducted in 2009/2010. Data were collected from 554 DCSS units among 84 hospitals. Results The average reported application rate for the QA strategies ranged from 57%-94% in the DCSS units. Most frequently reported were checking drugs expiration dates (94%, pharmacopoeia availability (92%, equipment calibration (87% and identifying responsibilities (86%. Least reported was external auditing of the DCSS (57%. The clinical chemistry and microbiology laboratories (84%, pharmacies, blood bank services (83% reported highest average application rates across all questioned QA strategies. Lowest application rates were reported in human tissue banks (50%. There was no significant difference between the reported application rates in DCSS in the general/specialized, teaching/research, nonteaching/research hospitals with the exception of pharmacies and radiology departments. They reported availability of a written QA plan significantly more often in research hospitals. Nearly all QA strategies were reported to be applied significantly more often in the DCSS of Social Security Organization (SSO and private-for-profit hospitals than in governmental hospitals. Conclusion There is still room for strengthening the managerial cycle of QA systems and accountability in the DCSS in Iranian hospitals. Getting feedback, change and learning through application of specific QA strategies (eg, external/internal audits can be improved. Both the effectiveness of QA

  6. Coping strategies, hope, and treatment efficacy in pharmacoresistant inpatients with neurotic spectrum disorders

    Directory of Open Access Journals (Sweden)

    Ociskova M

    2015-05-01

    Full Text Available Marie Ociskova,1,2 Jan Prasko,2 Dana Kamaradova,2 Ales Grambal,2 Petra Kasalova,2 Zuzana Sigmundova,2 Klara Latalova,2 Kristyna Vrbova2 1Department of Psychology, Faculty of Arts, 2Department of Psychiatry, Faculty of Medicine and Dentistry, Palacky University Olomouc, University Hospital Olomouc, Olomouc, Czech Republic Background: Approximately 30%–60% of patients with neurotic spectrum disorders remain symptomatic despite treatment. Identifying the predictors of good response to psychiatric and psychotherapeutic treatment may be useful for increasing treatment efficacy in neurotic patients. The objective of this study was to investigate the influence of hope, coping strategies, and dissociation on the treatment response of this group of patients.Methods: Pharmacoresistant patients, who underwent a 6-week psychotherapeutic program, were enrolled in the study. All patients completed the Clinical Global Impression (CGI – both objective and subjective forms, Beck Anxiety Inventory (BAI, and Beck Depression Inventory (BDI-II at baseline and after 6 weeks. The COPE Inventory, the Adult Dispositional Hope Scale (ADHS, and the Dissociative Experiences Scale (DES were completed at the start of the treatment.Results: Seventy-six patients completed the study. The mean scores for all scales measuring the severity of the disorders (BAI, BDI-II, subjective and objective CGI significantly decreased during the treatment. Several subscores of the COPE Inventory, the overall score of ADHS, and the overall score of DES significantly correlated with the treatment outcome. Multiple regression was used to find out which factors were the most significant predictors of the therapeutic outcomes. The most important predictors of the treatment response were the overall levels of hope and dissociation.Conclusion: According to our results, a group of patients with a primary neurotic disorder, who prefer the use of maladaptive coping strategies, feel hopelessness, and

  7. Application of adversarial risk analysis model in pricing strategies with remanufacturing

    Directory of Open Access Journals (Sweden)

    Liurui Deng

    2015-01-01

    Full Text Available Purpose: Purpose: This paper mainly focus on the application of adversarial risk analysis (ARA in pricing strategy with remanufacturing. We hope to obtain more realistic results than classical model. Moreover, we also wish that our research improve the development of ARA in pricing strategy of manufacturing or remanufacturing. Approach: In order to gain more actual research, combining adversarial risk analysis, we explore the pricing strategy with remanufacturing based on Stackelberg model. Especially, we build OEM’s 1-order ARA model and further study on manufacturers and remanufacturers’ pricing strategy. Findings: We find the OEM’s 1-order ARA model for the OEM’s product cost C. Besides, we get according manufacturers and remanufacturers’ pricing strategies. Besides, the pricing strategies based on 1-order ARA model have advantage over than the classical model regardless of OEMs and remanufacturers. Research implications: The research on application of ARA imply that we can get more actual results with this kind of modern risk analysis method and ARA can be extensively in pricing strategies of supply chain. Value: Our research improves the application of ARA in remanufacturing industry. Meanwhile, inspired by this analysis, we can also create different ARA models for different parameters. Furthermore, some results and analysis methods can be applied to other pricing strategies of supply chain.

  8. [Clinical study of integrative medicine in treatment of nephropathy: strategy and innovation].

    Science.gov (United States)

    Chen, Yi-Ping

    2008-05-01

    The author analyzed the main issues in current clinical study of integrative medicine in treatment of renal diseases, and proposed the target-oriented strategy for clinical study of different renal diseases, emphasizing the importance of method improvement for academic innovation.

  9. Multi-criteria evaluation of wastewater treatment plant control strategies under uncertainty

    DEFF Research Database (Denmark)

    Flores Alsina, Xavier; Rodriguez-Roda, Ignasi; Sin, Gürkan

    2008-01-01

    The evaluation of activated sludge control strategies in wastewater treatment plants (WWTP) via mathematical modelling is a complex activity because several objectives; e.g. economic, environmental, technical and legal; must be taken into account at the same time, i.e. the evaluation of the alter...

  10. Inhibition of autophagy as a treatment strategy for p53 wild-type acute myeloid leukemia

    NARCIS (Netherlands)

    Folkerts, Hendrik; Hilgendorf, Susan; Wierenga, Albertus T J; Jaques, Jennifer; Mulder, André B; Coffer, Paul J; Schuringa, Jan Jacob; Vellenga, Edo

    2017-01-01

    Here we have explored whether inhibition of autophagy can be used as a treatment strategy for acute myeloid leukemia (AML). Steady-state autophagy was measured in leukemic cell lines and primary human CD34(+) AML cells with a large variability in basal autophagy between AMLs observed. The autophagy

  11. The psychological impact of IVF failure after two or more cycles of IVF with a mild versus standard treatment strategy

    OpenAIRE

    Klerk, Cora; Macklon, Nick; Heijnen, E.M.; Eijkemans, René; Fauser, Bart; Passchier, Jan; Hunfeld, Joke

    2007-01-01

    textabstractBackground: Failure of IVF treatment after a number of cycles can be devastating for couples. Although mild IVF strategies reduce the psychological burden of treatment, failure may cause feelings of regret that a more aggressive approach, including the transfer of two embryos, was not employed. In this study, the impact of treatment failure after two or more cycles on stress was studied, following treatment with a mild versus a standard treatment strategy. Methods: Randomized cont...

  12. [Treatment Strategy for Liver Metastasis of Colorectal Cancer - Including Treatment for Oligometastasis].

    Science.gov (United States)

    Sato, Takeo; Nakamura, Takatoshi; Yamanashi, Takahiro; Miura, Hirohisa; Tsutsui, Atsuko; Shimazu, Masashi; Watanabe, Masahiko

    2017-10-01

    The mainstay of treatment for metastatic colorectal cancer is surgery. Therefore, colorectal cancer metastasis is distinctive, compared to other cancer types in which chemotherapy is the main treatment. Initially, Japan experienced medical druglag compared with western countries. However, the use of oxaliplatin for unresectable recurrent metastatic colorectal cancer became available in Japan, as well as in western countries, in 2005. We have since shifted chemotherapeutic regimens from monotherapy to combination therapy with molecular targeted agents. The combination therapy has rapidly become a standard therapy for unresectable metastatic colorectal cancer, and prognosis has dramatically increased for patients with this condition. Herein, we describe the treatment of liver metastasis of colorectal cancer, and surgery and adjuvant or neoadjuvant therapy options for resectable cancer. Furthermore, we focus on conversion therapy for unresectable cancer.

  13. Integrating Transition Metals into Nanomaterials: Strategies and Applications

    KAUST Repository

    Fhayli, Karim

    2016-04-14

    Transition metals complexes have been involved in various catalytic, biomedical and industrial applications, but only lately they have been associated with nanomaterials to produce innovative and well-defined new hybrid systems. The introduction of transition metals into nanomaterials is important to bear the advantages of metals to nanoscale and also to raise the stability of nanomaterials. In this dissertation, we study two approaches of associating transition metals into nanomaterials. The first approach is via spontaneous self-organization based assembly of small molecule amphiphiles and bulky hydrophilic polymers to produce organic-inorganic hybrid materials that have nanoscale features and can be precisely controlled depending on the experimental conditions used. These hybrid materials can successfully act as templates to design new porous material with interesting architecture. The second approach studied is via electroless reduction of transition metals on the surface of nanocarbons (nanotubes and nanodiamonds) without using any reducing agents or catalysts. The synthesis of these systems is highly efficient and facile resulting in stable and mechanically robust new materials with promising applications in catalysis.

  14. Integrating Transition Metals into Nanomaterials: Strategies and Applications

    KAUST Repository

    Fhayli, Karim

    2016-01-01

    Transition metals complexes have been involved in various catalytic, biomedical and industrial applications, but only lately they have been associated with nanomaterials to produce innovative and well-defined new hybrid systems. The introduction of transition metals into nanomaterials is important to bear the advantages of metals to nanoscale and also to raise the stability of nanomaterials. In this dissertation, we study two approaches of associating transition metals into nanomaterials. The first approach is via spontaneous self-organization based assembly of small molecule amphiphiles and bulky hydrophilic polymers to produce organic-inorganic hybrid materials that have nanoscale features and can be precisely controlled depending on the experimental conditions used. These hybrid materials can successfully act as templates to design new porous material with interesting architecture. The second approach studied is via electroless reduction of transition metals on the surface of nanocarbons (nanotubes and nanodiamonds) without using any reducing agents or catalysts. The synthesis of these systems is highly efficient and facile resulting in stable and mechanically robust new materials with promising applications in catalysis.

  15. Two strategies for phosphorus removal from reject water of municipal wastewater treatment plant using alum sludge.

    Science.gov (United States)

    Yang, Y; Zhao, Y Q; Babatunde, A O; Kearney, P

    2009-01-01

    In view of the well recognized need of reject water treatment in MWWTP (municipal wastewater treatment plant), this paper outlines two strategies for P removal from reject water using alum sludge, which is produced as by-product in drinking water treatment plant when aluminium sulphate is used for flocculating raw waters. One strategy is the use of the alum sludge in liquid form for co-conditioning and dewatering with the anaerobically digested activated sludge in MWWTP. The other strategy involves the use of the dewatered alum sludge cakes in a fixed bed for P immobilization from the reject water that refers to the mixture of the supernatant of the sludge thickening process and the supernatant of the anaerobically digested sludge. Experimental trials have demonstrated that the alum sludge can efficiently reduce P level in reject water. The co-conditioning strategy could reduce P from 597-675 mg P/L to 0.14-3.20 mg P/L in the supernatant of the sewage sludge while the organic polymer dosage for the conditioning of the mixed sludges would also be significantly reduced. The second strategy of reject water filtration with alum sludge bed has shown a good performance of P reduction. The alum sludge has P-adsorption capacity of 31 mg-P/g-sludge, which was tested under filtration velocity of 1.0 m/h. The two strategies highlight the beneficial utilization of alum sludge in wastewater treatment process in MWWTP, thus converting the alum sludge as a useful material, rather than a waste for landfill.

  16. Real-time piscicide tracking using Rhodamine WT dye for support of application, transport, and deactivation strategies in riverine environments

    Science.gov (United States)

    Jackson, Patrick Ryan; Lageman, Jonathan D.

    2013-01-01

    , these strategies facilitate adjustment of rotenone application and deactivation strategies in real time if necessary based on the observed advection and dispersion of the rotenone plume. Two large-scale and complex applications of rotenone in the Chicago Area Waterway System (CAWS) in 2009 and 2010 to combat invasive Asian carp are documented in this report. The application in Chicago Sanitary and Ship Canal (CSSC) in December 2009 involved more than 1,800 gallons of rotenone injected at multiple stations through a 6.2-mile reach of the canal near Lockport, Illinois. The rotenone plume was encased in Rhodamine WT dye so that two survey boats provided real-time feedback to shore personnel regarding the plume extent as it advected downstream. Real-time tracking of the rotenone was essential in this large-scale application because of the multistage injection strategy and the numerous deactivation points required to minimize collateral damage to fisheries in surrounding and receiving water bodies. All timing of application and deactivation operations relied on dye tracking. A second application of rotenone in May 2010 to the Little Calumet River near O’Brien Lock and Dam (Illinois) provided another opportunity for dye-tracking support operations; however, application and deactivation strategies were designed considering zero-flow conditions within the reach of interest. Therefore, dye was injected at the upstream and downstream boundaries of the rotenone application reach and was used to track movement of water in and out of a treatment reach, allowing proper deactivation to occur and avoiding unnecessary damage to fisheries downstream. The data collected during the real-time tracking operations for both applications allowed full documentation of the rotenone treatment for archival purposes and provided information for future applications. The methods presented in this report for real-time tracking

  17. Industrial waste treatment and application in rubber production

    Science.gov (United States)

    Pugacheva, I. N.; Popova, L. V.; Repin, P. S.; Molokanova, L. V.

    2018-03-01

    The paper provides for the relevance of various industrial waste treatment and application, as well as their secondary commercialization. It considers treatment of secondary polymer materials turning to additives applied in rubber production, in particular, in production of conveyor and V-type belts used in mechanical engineering. It is found that oligomers obtained from petroleum by-products can be used as an impregnating compound for fiber materials. Such adhesive treatment prior to introduction of impregnating compounds into elastomeric materials improves adhesion and complements performance of obtained composites.

  18. [Construction and Application of Innovative Education Technology Strategies in Nursing].

    Science.gov (United States)

    Chao, Li-Fen; Huang, Hsiang-Ping; Ni, Lee-Fen; Tsai, Chia-Lan; Huang, Tsuey-Yuan

    2017-12-01

    The evolution of information and communication technologies has deeply impacted education reform, promoted the development of digital-learning models, and stimulated the development of diverse nursing education strategies in order to better fulfill needs and expand in new directions. The present paper introduces the intelligent-learning resources that are available for basic medical science education, problem-based learning, nursing scenario-based learning, objective structured clinical examinations, and other similar activities in the Department of Nursing at Chang Gung University of Science and Technology. The program is offered in two parts: specialized classroom facilities and cloud computing / mobile-learning. The latter includes high-fidelity simulation classrooms, online e-books, and virtual interactive simulation and augmented reality mobile-learning materials, which are provided through multimedia technology development, learning management systems, web-certificated examinations, and automated teaching and learning feedback mechanisms. It is expected that the teaching experiences that are shared in this article may be used as a reference for applying professional wisdom teaching models into nursing education.

  19. Evaluation and comparison of New 4DCT based strategies for proton treatment planning for lung tumors

    International Nuclear Information System (INIS)

    Wang, Ning; Patyal, Baldev; Ghebremedhin, Abiel; Bush, David

    2013-01-01

    To evaluate different strategies for proton lung treatment planning based on four-dimensional CT (4DCT) scans. Twelve cases, involving only gross tumor volumes (GTV), were evaluated. Single image sets of (1) maximum intensity projection (MIP3) of end inhale (EI), middle exhale (ME) and end exhale (EE) images; (2) average intensity projection (AVG) of all phase images; and (3) EE images from 4DCT scans were selected as primary images for proton treatment planning. Internal target volumes (ITVs) outlined by a clinician were imported into MIP3, AVG, and EE images as planning targets. Initially, treatment uncertainties were not included in planning. Each plan was imported into phase images of 4DCT scans. Relative volumes of GTVs covered by 95% of prescribed dose and mean ipsilateral lung dose of a phase image obtained by averaging the dose in inspiration and expiration phases were used to evaluate the quality of a plan for a particular case. For comparing different planning strategies, the mean of the averaged relative volumes of GTVs covered by 95% of prescribed dose and its standard deviation for each planning strategy for all cases were used. Then, treatment uncertainties were included in planning. Each plan was recalculated in phase images of 4DCT scans. Same strategies were used for plan evaluation except dose-volume histograms of the planning target volumes (PTVs) instead of GTVs were used and the mean and standard deviation of the relative volumes of PTVs covered by 95% of prescribed dose and the ipsilateral lung dose were used to compare different planning strategies. MIP3 plans without treatment uncertainties yielded 96.7% of the mean relative GTV covered by 95% of prescribed dose (standard deviations of 5.7% for all cases). With treatment uncertainties, MIP3 plans yielded 99.5% of mean relative PTV covered by 95% of prescribed dose (standard deviations of 0.7%). Inclusion of treatment uncertainties improved PTV dose coverage but also increased the ipsilateral

  20. Emerging strategies for RNA interference (RNAi) applications in insects.

    Science.gov (United States)

    Nandety, Raja Sekhar; Kuo, Yen-Wen; Nouri, Shahideh; Falk, Bryce W

    2015-01-01

    RNA interference (RNAi) in insects is a gene regulatory process that also plays a vital role in the maintenance and in the regulation of host defenses against invading viruses. Small RNAs determine the specificity of the RNAi through precise recognition of their targets. These small RNAs in insects comprise small interfering RNAs (siRNAs), micro RNAs (miRNAs) and Piwi interacting RNAs (piRNAs) of various lengths. In this review, we have explored different forms of the RNAi inducers that are presently in use, and their applications for an effective and efficient fundamental and practical RNAi research with insects. Further, we reviewed trends in next generation sequencing (NGS) technologies and their importance for insect RNAi, including the identification of novel insect targets as well as insect viruses. Here we also describe a rapidly emerging trend of using plant viruses to deliver the RNAi inducer molecules into insects for an efficient RNAi response.

  1. Laser surface treatment of grey cast iron for automotive applications

    NARCIS (Netherlands)

    Ocelik, V.; Tang, P.N.; de Boer, M.C.; de Oliveira, U.; de Hosson, J.T.M.; DeHosson, JTM; Brebbia, CA; Nishida, SI

    2005-01-01

    The surface of pearlitic grey cast iron was treated using a 2 kW Nd:YAG laser beam with the final aim to improve its surface properties, mainly for automotive applications. Two kinds of laser surface treatments were experimentally applied. In the laser surface hardening approach the surface of cast

  2. Assiut Experience in the Application of Holmium Laser in Treatment ...

    African Journals Online (AJOL)

    Assiut Experience in the Application of Holmium Laser in Treatment of Ureteral Calculi in Adults. A.M. Abdel Lateef, A.E. Abdel Moniem, M.I. Taha, M.A. Shalaby. Abstract. Internal Optical Urethrotomy at the National Medical Center of Sanou Souro in Bobo-Dioulasso: Feasibility, Safety and Short-Term Results Objective To ...

  3. Strategies to improve adherence to treatment in adolescents and young adults with cancer: a systematic review

    Directory of Open Access Journals (Sweden)

    Robertson EG

    2015-07-01

    Full Text Available Eden G Robertson,1,2 Claire E Wakefield,1,2 Kate H Marshall,2 Ursula M Sansom-Daly1–3 1Discipline of Paediatrics, School of Women's and Children's Health, UNSW Medicine, University of New South Wales, University of New South Wales, Kensington, NSW, Australia; 2Behavioural Sciences Unit, Kids Cancer Centre, Sydney Children's Hospital, 3Sydney Youth Cancer Service, Prince of Wales/Sydney Children's Hospital, Randwick, NSW, Australia Purpose: Adolescents and young adults (AYAs with cancer have higher rates of nonadherence to treatment relative to younger and older cancer patients. Efforts to improve adherence in this population are therefore increasing. This review aimed: 1 to synthesize recommendations and strategies used to improve treatment adherence in AYAs with cancer, and 2 to summarize the available evidence supporting the efficacy of adherence-promoting strategies for AYAs with cancer.Methods: We conducted a systematic review with two stages: 1 a narrative stage, to analyze expert recommendations, and 2 an evaluative stage, to summarize quantitative evidence for interventions. Four electronic databases were searched for studies involving AYAs, aged 10–39 years, with cancer, published from 2005 to 2015. Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA guidelines were used to ensure quality of the review. The Delphi list was used to assess study quality.Results: Nine articles were identified in the narrative stage of the review. For the evaluative stage, out of 113 screened abstracts, only one eligible intervention was identified. Common themes of adherence-promoting strategies were grouped into five domains: developmental, communication, educational, psychological well-being, and logistical/management strategies. Strategies to address developmental stage and to improve communication were the most highly recommended to improve adherence. Few strategies focused on the role of the patient in adherence. One

  4. CryoSat-2 SIRAL Calibration: Strategy, Application and Results

    Science.gov (United States)

    Parrinello, T.; Fornari, M.; Bouzinac, C.; Scagliola, M.; Tagliani, N.

    2012-04-01

    The main payload of CryoSat-2 is a Ku band pulsewidth limited radar altimeter, called SIRAL (Synthetic interferometric radar altimeter), that transmits pulses at a high pulse repetition frequency thus making the received echoes phase coherent and suitable for azimuth processing. This allows to reach an along track resolution of about 250 meters which is an important improvement over traditional pulse-width limited altimeters. Due to the fact that SIRAL is a phase coherent pulse-width limited radar altimeter, a proper calibration approach has been developed. In fact, not only the corrections for transfer function amplitude with respect to frequency, gain and instrument path delay have to be computed but it is also needed to provide corrections for transfer function phase with respect to frequency and AGC setting as well as the phase variation across bursts of pulses. As a consequence, SIRAL performs regularly four types of calibrations: (1) CAL1 in order to calibrate the internal path delay and peak power variation, (2) CAL2 in order to compensate the instrument transfer function, (3) CAL4 to calibrate the interferometer and (4) AutoCal, a specific sequence in order to calibrate the gain and phase difference for each AGC setting. Commissioning phase results (April-December 2010) revealed high stability of the instrument, which made possible to reduce the calibration frequency during Operations. Internal calibration data are processed on ground by the CryoSat-2 Instrument Processing Facility (IPF1) and then applied to the science data. In this poster we will describe as first the calibration strategy and then how the four different types of calibration are applied to science data. Moreover the calibration results over almost 2 years of mission will be presented, analyzing their temporal evolution in order to highlight the stability of the instrument over its life.

  5. Neuroinspired control strategies with applications to flapping flight

    Science.gov (United States)

    Dorothy, Michael Ray

    This dissertation is centered on a theoretical, simulation, and experimental study of control strategies which are inspired by biological systems. Biological systems, along with sufficiently complicated engineered systems, often have many interacting degrees of freedom and need to excite large-displacement oscillations in order to locomote. Combining these factors can make high-level control design difficult. This thesis revolves around three different levels of abstraction, providing tools for analysis and design. First, we consider central pattern generators (CPGs) to control flapping-flight dynamics. The key idea here is dimensional reduction - we want to convert complicated interactions of many degrees of freedom into a handful of parameters which have intuitive connections to the overall system behavior, leaving the control designer unconcerned with the details of particular motions. A rigorous mathematical and control theoretic framework to design complex three-dimensional wing motions is presented based on phase synchronization of nonlinear oscillators. In particular, we show that flapping-flying dynamics without a tail or traditional aerodynamic control surfaces can be effectively controlled by a reduced set of central pattern generator parameters that generate phase-synchronized or symmetry-breaking oscillatory motions of two main wings. Furthermore, by using a Hopf bifurcation, we show that tailless aircraft (inspired by bats) alternating between flapping and gliding can be effectively stabilized by smooth wing motions driven by the central pattern generator network. Results of numerical simulation with a full six-degree-of-freedom flight dynamic model validate the effectiveness of the proposed neurobiologically inspired control approach. Further, we present experimental micro aerial vehicle (MAV) research with low-frequency flapping and articulated wing gliding. The importance of phase difference control via an abstract mathematical model of central

  6. Comparison of various online IGRT strategies: The benefits of online treatment plan re-optimization

    International Nuclear Information System (INIS)

    Schulze, Derek; Liang, Jian; Yan, Di; Zhang Tiezhi

    2009-01-01

    Purpose: To compare the dosimetric differences of various online IGRT strategies and to predict potential benefits of online re-optimization techniques in prostate cancer radiation treatments. Materials and methods: Nine prostate patients were recruited in this study. Each patient has one treatment planning CT images and 10-treatment day CT images. Five different online IGRT strategies were evaluated which include 3D conformal with bone alignment, 3D conformal re-planning via aperture changes, intensity modulated radiation treatment (IMRT) with bone alignment, IMRT with target alignment and IMRT daily re-optimization. Treatment planning and virtual treatment delivery were performed. The delivered doses were obtained using in-house deformable dose mapping software. The results were analyzed using equivalent uniform dose (EUD). Results: With the same margin, rectum and bladder doses in IMRT plans were about 10% and 5% less than those in CRT plans, respectively. Rectum and bladder doses were reduced as much as 20% if motion margin is reduced by 1 cm. IMRT is more sensitive to organ motion. Large discrepancies of bladder and rectum doses were observed compared to the actual delivered dose with treatment plan predication. The therapeutic ratio can be improved by 14% and 25% for rectum and bladder, respectively, if IMRT online re-planning is employed compared to the IMRT bone alignment approach. The improvement of target alignment approach is similar with 11% and 21% dose reduction to rectum and bladder, respectively. However, underdosing in seminal vesicles was observed on certain patients. Conclusions: Online treatment plan re-optimization may significantly improve therapeutic ratio in prostate cancer treatments mostly due to the reduction of PTV margin. However, for low risk patient with only prostate involved, online target alignment IMRT treatment would achieve similar results as online re-planning. For all IGRT approaches, the delivered organ-at-risk doses may be

  7. Treatment decision-making strategies and influences in patients with localized prostate carcinoma.

    Science.gov (United States)

    Gwede, Clement K; Pow-Sang, Julio; Seigne, John; Heysek, Randy; Helal, Mohamed; Shade, Kristin; Cantor, Alan; Jacobsen, Paul B

    2005-10-01

    Patients diagnosed with localized prostate carcinoma need to interpret complicated medical information to make an informed treatment selection from among treatments that have comparable efficacy but differing side effects. The authors reported initial results for treatment decision-making strategies among men receiving definitive treatment for localized prostate carcinoma. One hundred nineteen men treated with radical prostatectomy (44%) or brachytherapy (56%) consented to participate. Guided by a cognitive-affective theoretic framework, the authors assessed differences in decision-making strategies, and treatment and disease-relevant beliefs and affects, in addition to demographic and clinical variables. Approximately half of patients reported difficulty (49%) and distress (45%) while making treatment decisions, but no regrets (74%) regarding the treatment choice they made. Patients who underwent prostatectomy were younger, were more likely to be employed, had worse tumor grade, and had a shorter time since diagnosis (P Decision-making aids or other interventions to reduce decisional difficulty and emotional distress during decision making were indicated.

  8. Dosimetric evaluation of three adaptive strategies for prostate cancer treatment including pelvic lymph nodes irradiation.

    Science.gov (United States)

    Cantin, Audrey; Gingras, Luc; Lachance, Bernard; Foster, William; Goudreault, Julie; Archambault, Louis

    2015-12-01

    The movements of the prostate relative to the pelvic lymph nodes during intensity-modulated radiation therapy treatment can limit margin reduction and affect the protection of the organs at risk (OAR). In this study, the authors performed an analysis of three adaptive treatment strategies that combine information from both bony and gold marker registrations. The robustness of those treatments against the interfraction prostate movements was evaluated. A retrospective study was conducted on five prostate cancer patients with 7-13 daily cone-beam CTs (CBCTs). The clinical target volumes (CTVs) consisting of pelvic lymph nodes, prostate, and seminal vesicles as well as the OARs were delineated on each CBCT and the initial CT. Three adaptive strategies were analyzed. Two of these methods relied on a two-step patient positioning at each fraction. First step: a bony registration was used to deliver the nodal CTV prescription. Second step: a gold marker registration was then used either to (1) complete the dose delivered to the prostate (complement); (2) or give almost the entire prescription to the prostate with a weak dose gradient between the targets to compensate for possible motions (gradient). The third method (COR) used a pool of precalculated plans based on images acquired at previous treatment fractions. At each new fraction, a plan is selected from that pool based on the daily position of prostate center-of-mass. The dosimetric comparison was conducted and results are presented with and without the systematic shift in the prostate position on the CT planning. The adaptive strategies were compared to the current clinical standard where all fractions are treated with the initial nonadaptive plan. The minimum daily prostate D95% is improved by 2%, 9%, and 6% for the complement, the gradient, and the COR approaches, respectively, compared to the nonadaptive method. The average nodal CTV D95% remains constant across the strategies, except for the gradient approach

  9. Dosimetric evaluation of three adaptive strategies for prostate cancer treatment including pelvic lymph nodes irradiation

    International Nuclear Information System (INIS)

    Cantin, Audrey; Gingras, Luc; Archambault, Louis; Lachance, Bernard; Foster, William; Goudreault, Julie

    2015-01-01

    Purpose: The movements of the prostate relative to the pelvic lymph nodes during intensity-modulated radiation therapy treatment can limit margin reduction and affect the protection of the organs at risk (OAR). In this study, the authors performed an analysis of three adaptive treatment strategies that combine information from both bony and gold marker registrations. The robustness of those treatments against the interfraction prostate movements was evaluated. Methods: A retrospective study was conducted on five prostate cancer patients with 7–13 daily cone-beam CTs (CBCTs). The clinical target volumes (CTVs) consisting of pelvic lymph nodes, prostate, and seminal vesicles as well as the OARs were delineated on each CBCT and the initial CT. Three adaptive strategies were analyzed. Two of these methods relied on a two-step patient positioning at each fraction. First step: a bony registration was used to deliver the nodal CTV prescription. Second step: a gold marker registration was then used either to (1) complete the dose delivered to the prostate (complement); (2) or give almost the entire prescription to the prostate with a weak dose gradient between the targets to compensate for possible motions (gradient). The third method (COR) used a pool of precalculated plans based on images acquired at previous treatment fractions. At each new fraction, a plan is selected from that pool based on the daily position of prostate center-of-mass. The dosimetric comparison was conducted and results are presented with and without the systematic shift in the prostate position on the CT planning. The adaptive strategies were compared to the current clinical standard where all fractions are treated with the initial nonadaptive plan. Results: The minimum daily prostate D 95% is improved by 2%, 9%, and 6% for the complement, the gradient, and the COR approaches, respectively, compared to the nonadaptive method. The average nodal CTV D 95% remains constant across the strategies

  10. A cost-controlling treatment strategy of adding liraglutide to insulin in type 2 diabetes.

    Science.gov (United States)

    de Wit, H M; Vervoort, G M M; de Galan, B E; Tack, C J

    2017-09-01

    Addition of the GLP-1 receptor agonist liraglutide to insulin can reverse insulin-associated weight gain, improve HbA1c and decrease the need for insulin, but is expensive. From a cost perspective, such treatment should be discontinued when it is clear that treatment targets will not be achieved. Our aim was to find the best cost-controlling treatment strategy: the shortest possible trial period needed to discriminate successfully treated patients from those failing to achieve predefined targets of treatment success. We used data from the 'Effect of Liraglutide on insulin-associated wEight GAiN in patients with Type 2 diabetes' (ELEGANT) trial, comparing additional liraglutide (n = 47) and standard insulin therapy (n = 24) during 26 weeks, to calculate the costs associated with different trial periods. Treatment success after 26 weeks was defined by having achieved ≥ 2 of the following: ≥ 4% weight loss, HbA1c ≤ 53 mmol/mol (7%), and/or discontinuation of insulin. The additional direct costs of adding liraglutide for 26 weeks were € 699 per patient, or € 137 per 1 kg weight loss, compared with standard therapy. The best cost-controlling treatment strategy (identifying 21 of 23 responders, treating four non-responders) was to continue treatment in patients showing ≥ 3% weight loss or ≥ 60% decrease in insulin dose at 8 weeks, with a total cost of € 246 for this t rial period, saving € 453 in case of early discontinuation. An 8-week trial period of adding liraglutide to insulin in patients with insulin-associated weight gain is an effective cost-controlling treatment strategy if the liraglutide is discontinued in patients not showing an early response regarding weight loss or insulin reduction.

  11. Dasatinib and Doxorubicin Treatment of Sarcoma Initiating Cells: A Possible New Treatment Strategy

    Directory of Open Access Journals (Sweden)

    Ninna Aggerholm-Pedersen

    2016-01-01

    Full Text Available Background. One of the major challenges affecting sarcoma treatment outcome, particularly that of metastatic disease, is resistance to chemotherapy. Cancer-initiating cells are considered a major contributor to this resistance. Methods. An immortalised nontransformed human stromal (mesenchymal stem cell line hMSC-TERT4 and a transformed cell line hMSC-TERT20-CE8, known to form sarcoma-like tumours when implanted in immune-deficient mice, were used as models. Receptor tyrosine kinase (RTK activation was analysed by RTK arrays and cellular viability after tyrosine kinases inhibitor (TKI treatment with or without doxorubicin was assessed by MTS assay. Results. Initial results showed that the hMSC-TERT4 was more doxorubicin-sensitive while hMSC-TERT20-CE8 was less doxorubicin-sensitive evidenced by monitoring cell viability in the presence of doxorubicin at different doses. The epidermal growth factor receptor (EGFR was activated in both cell lines. However hMSC-TERT20-CE8 exhibited significantly higher expression of the EGFR ligands. EGFR inhibitors such as erlotinib and afatinib alone or in combination with doxorubicin failed to further decrease cell viability of hMSC-TERT20-CE8. However, inhibition with the TKI dasatinib in combination with doxorubicin decreased cell viability of the hMSC-TERT20-CE8 cell line. Conclusion. Our results demonstrate that dasatinib, but not EGFR-directed treatment, can decrease cell viability of stromal cancer stem cells less sensitive to doxorubicin.

  12. Dasatinib and Doxorubicin Treatment of Sarcoma Initiating Cells: A Possible New Treatment Strategy.

    Science.gov (United States)

    Aggerholm-Pedersen, Ninna; Demuth, Christina; Safwat, Akmal; Meldgaard, Peter; Kassem, Moustapha; Sandahl Sorensen, Boe

    2016-01-01

    Background. One of the major challenges affecting sarcoma treatment outcome, particularly that of metastatic disease, is resistance to chemotherapy. Cancer-initiating cells are considered a major contributor to this resistance. Methods. An immortalised nontransformed human stromal (mesenchymal) stem cell line hMSC-TERT4 and a transformed cell line hMSC-TERT20-CE8, known to form sarcoma-like tumours when implanted in immune-deficient mice, were used as models. Receptor tyrosine kinase (RTK) activation was analysed by RTK arrays and cellular viability after tyrosine kinases inhibitor (TKI) treatment with or without doxorubicin was assessed by MTS assay. Results. Initial results showed that the hMSC-TERT4 was more doxorubicin-sensitive while hMSC-TERT20-CE8 was less doxorubicin-sensitive evidenced by monitoring cell viability in the presence of doxorubicin at different doses. The epidermal growth factor receptor (EGFR) was activated in both cell lines. However hMSC-TERT20-CE8 exhibited significantly higher expression of the EGFR ligands. EGFR inhibitors such as erlotinib and afatinib alone or in combination with doxorubicin failed to further decrease cell viability of hMSC-TERT20-CE8. However, inhibition with the TKI dasatinib in combination with doxorubicin decreased cell viability of the hMSC-TERT20-CE8 cell line. Conclusion. Our results demonstrate that dasatinib, but not EGFR-directed treatment, can decrease cell viability of stromal cancer stem cells less sensitive to doxorubicin.

  13. Dasatinib and Doxorubicin Treatment of Sarcoma Initiating Cells: A Possible New Treatment Strategy

    DEFF Research Database (Denmark)

    Aggerholm-Pedersen, Ninna; Demouth, Christina; Safwat, Akmal

    2016-01-01

    Background. One of the major challenges affecting sarcoma treatment outcome, particularly that of metastatic disease, is resistance to chemotherapy. Cancer-initiating cells are considered a major contributor to this resistance. Methods. An immortalised nontransformed human stromal (mesenchymal......) stem cell line hMSC-TERT4 and a transformed cell line hMSC-TERT20-CE8, known to form sarcoma-like tumours when implanted in immune-deficient mice, were used as models. Receptor tyrosine kinase (RTK) activation was analysed by RTK arrays and cellular viability after tyrosine kinases inhibitor (TKI...

  14. Delisting strategy for the Hanford Site 242-A Evaporator PUREX Plant Condensate Treatment Facility

    International Nuclear Information System (INIS)

    1992-04-01

    This document describes the strategy that the US Department of Energy, Richland Field Office intends to use in preparing the delisting petition for the 242-A Evaporator/PUREX Plant Condensate Treatment Facility. Because the 242-A Evaporator/PUREX Plant Condensate Treatment Facility will not be operational until 1994, the delisting petition will be structured as an up-front petition based on the ''multiple waste treatment facility'' approach outline in the 1985 US Environmental Protection Agency's Petitions to Delist Hazardous Waste. The 242-A evaporator/PUREX Plant Condensate Treatment Facility effluent characterization data will not be available to support the delisting petition, because the delisting petition will be submitted to the US Environmental Protection Agency before start-up of the 242-A Evaporator/PUREX Plant Condensate Treatment Facility. Therefore, the delisting petition will be based on data collected during the pilot plant testing for the 242-A Evaporator/PUREX Plant Condensate Treatment Facility. This pilot plant testing will be conducted on synthetic waste. The composition of the synthetic waste will be based on: (1) constituents of regulatory concern, and (2) on process knowledge. The pilot plant testing will be performed to determine the removal efficiencies of the process equipment at concentrations greater than reasonably could be expected in the actual waste. This strategy document also describes the logic used to develop the synthetic waste, to develop the pilot plant testing program, and to prepare the delisting petition. This strategy document also described how full-scale operating data will be collected during initial operation of the 242-A Evaporator/PUREX Plant Condensate Treatment Facility to verify information presented in the delisting petition

  15. Design strategies and applications of nacre-based biomaterials.

    Science.gov (United States)

    Gerhard, Ethan Michael; Wang, Wei; Li, Caiyan; Guo, Jinshan; Ozbolat, Ibrahim Tarik; Rahn, Kevin Michael; Armstrong, April Dawn; Xia, Jingfen; Qian, Guoying; Yang, Jian

    2017-05-01

    The field of tissue engineering and regenerative medicine relies heavily on materials capable of implantation without significant foreign body reactions and with the ability to promote tissue differentiation and regeneration. The field of bone tissue engineering in particular requires materials capable of providing enhanced mechanical properties and promoting osteogenic cell lineage commitment. While bone repair has long relied almost exclusively on inorganic, calcium phosphate ceramics such as hydroxyapatite and their composites or on non-degradable metals, the organically derived shell and pearl nacre generated by mollusks has emerged as a promising alternative. Nacre is a naturally occurring composite material composed of inorganic, calcium carbonate plates connected by a framework of organic molecules. Similar to mammalian bone, the highly organized microstructure of nacre endows the composite with superior mechanical properties while the organic phase contributes to significant bioactivity. Studies, both in vitro and in vivo, have demonstrated nacre's biocompatibility, biodegradability, and osteogenic potential, which are superior to pure inorganic minerals such as hydroxyapatite or non-degradable metals. Nacre can be used directly as a bulk implant or as part of a composite material when combined with polymers or other ceramics. While nacre has demonstrated its effectiveness in multiple cell culture and animal models, it remains a relatively underexplored biomaterial. This review introduces the formation, structure, and characteristics of nacre, and discusses the present and future uses of this biologically-derived material as a novel biomaterial for orthopedic and other tissue engineering applications. Mussel derived nacre, a biological composite composed of mineralized calcium carbonate platelets and interplatelet protein components, has recently gained interest as a potential alternative ceramic material in orthopedic biomaterials, combining the

  16. Advanced-stage III/IV follicular lymphoma. Treatment strategies for individual patients

    Energy Technology Data Exchange (ETDEWEB)

    Heinzelmann, Frank; Bamberg, Michael; Weinmann, Martin [Dept. of Radiation Oncology, Univ. of Tuebingen (Germany); Ottinger, Hellmut [Dept. of Bone Marrow Transplantation, Univ. of Essen (Germany); Engelhard, Marianne [Dept. of Radiation Oncology, Univ. of Essen (Germany); Soekler, Martin [Dept. of Internal Medicine II, Univ. of Tuebingen (Germany)

    2010-05-15

    Background: in patients with advanced-stage III/IV follicular lymphoma (FL), there are many treatment options available. The current challenge is to choose the optimal strategy for the individual patient. Methods: the literature was reviewed with respect to treatment strategies in patients with advanced FL by screening the PubMed databank. Results: in advanced-stage III/IV FL, median survival may approach 8-10 years. Treatment strategies include a watch-and-wait strategy, chemoimmunotherapy, monotherapy with rituximab, and - as an experimental approach so far - radioimmunotherapy. The use of autologous hematopoietic stem cell transplantation (HSCT) for patients in first remission or chemosensitive relapse prolongs progression-free survival while the effect on overall survival remains unclear compared to standard chemotherapy. However, long-term results are flawed by high relapse rates and risk of secondary malignancies. In patients with relapsed/chemoresistant disease, allogeneic HSCT constitutes the only curative approach but is associated with high treatment-related mortality. In the palliative setting, low-dose involved-field irradiation constitutes an effective treatment option in order to control local symptoms with potential long-lasting response. Conclusion: in case of advanced-disease FL, asymptomatic patients can be managed expectantly. In symptomatic patients, chemoimmunotherapy is regarded as standard therapy. In symptomatic elderly patients with relevant comorbidities, rituximab {+-} single-agent chemotherapy, or low-dose involved-field radiotherapy might be appropriate. For younger patients with chemoresistant/relapsed disease, allogeneic HSCT might be considered, since advances in supportive care and better patient selection have resulted in improved outcomes. (orig.)

  17. PRE-FEASIBILITY STUDY FOR TREATMENT WETLAND APPLICATION FOR WASTEWATER TREATMENT IN DISPERSED DEVELOPMENT

    Directory of Open Access Journals (Sweden)

    Magdalena Gajewska

    2016-07-01

    Full Text Available The aim of the paper is to present the conducted analyses of pre-feasibility study of different approaches for wastewater management in a settlement of 180 persons. In the assessment both technical and economic aspects were analyzed. The costs were calculated for three different and, at the same time, most popular as well as possible technical solutions like: (i construction of local wastewater treatment plant with gravitational and pressurized networks, (ii construction of single family wastewater treatment plants, (iii construction of sealed septic tanks. Carried out analyses of investment and maintenance costs revealed that at the stage of construction the most expensive is local sewer network with treatment plant, while the construction of a single family treatment plant has similar cost regardless of the technology used. When the long term operation and investment cost are accounted the most economical reasonable solution is the application of wetland treatment for household wastewater treatment.

  18. Inorganic Membranes: Preparation and Application for Water Treatment and Desalination

    Science.gov (United States)

    McKay, Gordon; Buekenhoudt, Anita; Motmans, Filip; Khraisheh, Marwan; Atieh, Muataz

    2018-01-01

    Inorganic membrane science and technology is an attractive field of membrane separation technology, which has been dominated by polymer membranes. Recently, the inorganic membrane has been undergoing rapid development and innovation. Inorganic membranes have the advantage of resisting harsh chemical cleaning, high temperature and wear resistance, high chemical stability, long lifetime, and autoclavable. All of these outstanding properties made inorganic membranes good candidates to be used for water treatment and desalination applications. This paper is a state of the art review on the synthesis, development, and application of different inorganic membranes for water and wastewater treatment. The inorganic membranes reviewed in this paper include liquid membranes, dynamic membranes, various ceramic membranes, carbon based membranes, silica membranes, and zeolite membranes. A brief description of the different synthesis routes for the development of inorganic membranes for application in water industry is given and each synthesis rout is critically reviewed and compared. Thereafter, the recent studies on different application of inorganic membrane and their properties for water treatment and desalination in literature are critically summarized. It was reported that inorganic membranes despite their high synthesis cost, showed very promising results with high flux, full salt rejection, and very low or no fouling. PMID:29304024

  19. Inorganic Membranes: Preparation and Application for Water Treatment and Desalination

    Directory of Open Access Journals (Sweden)

    Ahmad Kayvani Fard

    2018-01-01

    Full Text Available Inorganic membrane science and technology is an attractive field of membrane separation technology, which has been dominated by polymer membranes. Recently, the inorganic membrane has been undergoing rapid development and innovation. Inorganic membranes have the advantage of resisting harsh chemical cleaning, high temperature and wear resistance, high chemical stability, long lifetime, and autoclavable. All of these outstanding properties made inorganic membranes good candidates to be used for water treatment and desalination applications. This paper is a state of the art review on the synthesis, development, and application of different inorganic membranes for water and wastewater treatment. The inorganic membranes reviewed in this paper include liquid membranes, dynamic membranes, various ceramic membranes, carbon based membranes, silica membranes, and zeolite membranes. A brief description of the different synthesis routes for the development of inorganic membranes for application in water industry is given and each synthesis rout is critically reviewed and compared. Thereafter, the recent studies on different application of inorganic membrane and their properties for water treatment and desalination in literature are critically summarized. It was reported that inorganic membranes despite their high synthesis cost, showed very promising results with high flux, full salt rejection, and very low or no fouling.

  20. Application of Apium Graveolens in treatment of hypertension

    Directory of Open Access Journals (Sweden)

    Sarkarati AR

    2000-08-01

    Full Text Available Apium graveolence has an small brown olyptical seed with pharmacological activity. To evaluate it's application in treatment of hypertension, 37 hypertensive patients (20 female, 17 male with the age range of 45-65 were given 6 grams of powder of Apium graveolence seed and then the blood pressures before and after the remedy were compared. Before treatment, the mean systolic blood pressure was 171.35 mlHg and the mean diastolic blood pressure was 94 mlHg. After they became 154.3 mlHg and 89.6 mlHg respectively. The difference of blood pressure before and after treatment was statistically significant (P<0.05, so we concluded that Apium graveolence seed can be used as is a safe and effective treatment for high blood pressure. Further controlled studies should be done to compare it with available anti-hypertensive drugs.

  1. Application of laser therapy for the treatment of dentinal hyperesthesia

    International Nuclear Information System (INIS)

    Fumero Sanchez, Yanisley; Rodriguez Jorrin, Daimy; Castanneda Marin, Raul

    2009-01-01

    An experimental study was carried out, to evaluate the effectiveness of the low - power laser combined with fluoride varnish to 2% (Profilac) in the treatment of the Dentinal Hyperesthesia in patients attended to in the Stomatology Clinic of Ciro Redondo in the period from October 2007 to January 2008. The universe of study was constituted by 75 patients diagnosed with dentinal hyperesthesia in the period of time indicated above, being conformed the sample by those 25 who fulfilled the pre-established criteria for the study. With the application of the laser combined with Lacquer Fluorine (Profilac), a remission of the pain was observed that increased gradually with the treatment sessions, having been obtained to almost eliminate in the totality of the cases the group of symptoms when finalizing it, evaluating the treatment of effective in 100% of the cases. We only found a recidivism after a year of treatment

  2. Frontiers in biomaterials the design, synthetic strategies and biocompatibility of polymer scaffolds for biomedical application

    CERN Document Server

    Cao, Shunsheng

    2014-01-01

    Frontiers in Biomaterials: The Design, Synthetic Strategies and Biocompatibility of Polymer Scaffolds for Biomedical Application, Volume 1" highlights the importance of biomaterials and their interaction with biological system. The need for the development of biomaterials as scaffold for tissue regeneration is driven by the increasing demands for materials that mimic functions of extracellular matrices of body tissues.This ebook covers the latest challenges on the biocompatibility of scaffold overtime after implantation and discusses the requirement of innovative technologies and strategies f

  3. The Application of Long Term Asset Management (LTAM) Strategy of KHNP

    International Nuclear Information System (INIS)

    Boo, Myung Hwan; Park, Young Sheop

    2007-01-01

    In KHNP, 20 units of Nuclear Power Plants (NPP) are operating and 6 units are under construction. As increase of the number of power plants and operating year, it is needed to develop the integrated cost-effective asset management. Long Term Asset Management (LTAM) strategy is the process by which the nuclear power plants integrate operations, maintenance, engineering, regulatory, and economic planning activities. This paper introduces the application of LTAM strategy of nuclear power plants

  4. The Application of Dividend Yield Based Investment Strategy in Indonesian Stock Exchange

    OpenAIRE

    Ekaputra, Adriansyah; Sukarno, Subiakto

    2012-01-01

    Stock market development in Indonesia is growing rapidly, coupled with the increase of Indonesia's investment rating by investment research and rating companies such as Moody's and S&P, it makes Indonesian stock market look sexy in the eyes of investors from various countries. The investment strategy that simple and applicable is often sought by investors to maximize the investors' portfolio. One investment strategy is evolving but still not widely used in Indonesia is an investment strat...

  5. Application of discrete choice experiments to enhance stakeholder engagement as a strategy for advancing implementation: a systematic review.

    Science.gov (United States)

    Salloum, Ramzi G; Shenkman, Elizabeth A; Louviere, Jordan J; Chambers, David A

    2017-11-23

    One of the key strategies to successful implementation of effective health-related interventions is targeting improvements in stakeholder engagement. The discrete choice experiment (DCE) is a stated preference technique for eliciting individual preferences over hypothetical alternative scenarios that is increasingly being used in health-related applications. DCEs are a dynamic approach to systematically measure health preferences which can be applied in enhancing stakeholder engagement. However, a knowledge gap exists in characterizing the extent to which DCEs are used in implementation science. We conducted a systematic literature search (up to December 2016) of the English literature to identify and describe the use of DCEs in engaging stakeholders as an implementation strategy. We searched the following electronic databases: MEDLINE, Econlit, PsychINFO, and the CINAHL using mesh terms. Studies were categorized according to application type, stakeholder(s), healthcare setting, and implementation outcome. Seventy-five publications were selected for analysis in this systematic review. Studies were categorized by application type: (1) characterizing demand for therapies and treatment technologies (n = 32), (2) comparing implementation strategies (n = 22), (3) incentivizing workforce participation (n = 11), and (4) prioritizing interventions (n = 10). Stakeholders included providers (n = 27), patients (n = 25), caregivers (n = 5), and administrators (n = 2). The remaining studies (n = 16) engaged multiple stakeholders (i.e., combination of patients, caregivers, providers, and/or administrators). The following implementation outcomes were discussed: acceptability (n = 75), appropriateness (n = 34), adoption (n = 19), feasibility (n = 16), and fidelity (n = 3). The number of DCE studies engaging stakeholders as an implementation strategy has been increasing over the past decade. As DCEs are more widely used as a

  6. Heterogeneous Photocatalysis: Fundamentals and Application for Treatment of Polluted Air

    Directory of Open Access Journals (Sweden)

    Tomašić, V.

    2011-07-01

    the photocatalytic degradation of organic compounds is generally more efficient in the gas phase than in the liquid phase, and the fact that the treatment cost may be significantly lower than that of the water phase photocatalytic treatment, the scientific interest has shifted towards the application of photocatalysis for air treatment. This paper describes the basics of heterogeneous photocatalysis, mainly on TiO2 and the application of photocatalytic processes for air treatment purposes. Review of more interesting practical application of heterogeneous photocatalysis for the treatment of polluted air is presented. Special efforts are made to describe the technical aspects of the photocatalytic processes and to characterize different photocatalytic reactors in use for air treatment.

  7. Evolution of transoral approaches, endoscopic endonasal approaches, and reduction strategies for treatment of craniovertebral junction pathology: a treatment algorithm update.

    Science.gov (United States)

    Dlouhy, Brian J; Dahdaleh, Nader S; Menezes, Arnold H

    2015-04-01

    The craniovertebral junction (CVJ), or the craniocervical junction (CCJ) as it is otherwise known, houses the crossroads of the CNS and is composed of the occipital bone that surrounds the foramen magnum, the atlas vertebrae, the axis vertebrae, and their associated ligaments and musculature. The musculoskeletal organization of the CVJ is unique and complex, resulting in a wide range of congenital, developmental, and acquired pathology. The refinements of the transoral approach to the CVJ by the senior author (A.H.M.) in the late 1970s revolutionized the treatment of CVJ pathology. At the same time, a physiological approach to CVJ management was adopted at the University of Iowa Hospitals and Clinics in 1977 based on the stability and motion dynamics of the CVJ and the site of encroachment, incorporating the transoral approach for irreducible ventral CVJ pathology. Since then, approaches and techniques to treat ventral CVJ lesions have evolved. In the last 40 years at University of Iowa Hospitals and Clinics, multiple approaches to the CVJ have evolved and a better understanding of CVJ pathology has been established. In addition, new reduction strategies that have diminished the need to perform ventral decompressive approaches have been developed and implemented. In this era of surgical subspecialization, to properly treat complex CVJ pathology, the CVJ specialist must be trained in skull base transoral and endoscopic endonasal approaches, pediatric and adult CVJ spine surgery, and must understand and be able to treat the complex CSF dynamics present in CVJ pathology to provide the appropriate, optimal, and tailored treatment strategy for each individual patient, both child and adult. This is a comprehensive review of the history and evolution of the transoral approaches, extended transoral approaches, endoscopie assisted transoral approaches, endoscopie endonasal approaches, and CVJ reduction strategies. Incorporating these advancements, the authors update the

  8. Application of hydrodynamic cavitation in ballast water treatment.

    Science.gov (United States)

    Cvetković, Martina; Kompare, Boris; Klemenčič, Aleksandra Krivograd

    2015-05-01

    Ballast water is, together with hull fouling and aquaculture, considered the most important factor of the worldwide transfer of invasive non-indigenous organisms in aquatic ecosystems and the most important factor in European Union. With the aim of preventing and halting the spread of the transfer of invasive organisms in aquatic ecosystems and also in accordance with IMO's International Convention for the Control and Management of Ships Ballast Water and Sediments, the systems for ballast water treatment, whose work includes, e.g. chemical treatment, ozonation and filtration, are used. Although hydrodynamic cavitation (HC) is used in many different areas, such as science and engineering, implied acoustics, biomedicine, botany, chemistry and hydraulics, the application of HC in ballast water treatment area remains insufficiently researched. This paper presents the first literature review that studies lab- and large-scale setups for ballast water treatment together with the type-approved systems currently available on the market that use HC as a step in their operation. This paper deals with the possible advantages and disadvantages of such systems, as well as their influence on the crew and marine environment. It also analyses perspectives on the further development and application of HC in ballast water treatment.

  9. Application of ozone in the treatment of periodontal disease

    Science.gov (United States)

    Srikanth, Adusumilli; Sathish, Manthena; Sri Harsha, Anumolu Venkatanaga

    2013-01-01

    Gingivitis and periodontitis are most common inflammatory diseases of supporting tissues of teeth. Role of microbial etiology and host response in progression of gingival and periodontal diseases has been well established. Because of the beneficial biological effects of ozone, due to its antimicrobial and immunostimulating effect, it is well indicated in the treatment of gingival and periodontal diseases. The objective of this article is to provide a general review about clinical applications of ozone in treatment of periodontal diseases and to summarize the available in vitro and in vivo studies in Periodontics in which ozone has been used. PMID:23946585

  10. Strategies used by breast cancer survivors to address work-related limitations during and after treatment.

    Science.gov (United States)

    Sandberg, Joanne C; Strom, Carla; Arcury, Thomas A

    2014-01-01

    The primary objective of this exploratory study was to delineate the broad range of adjustments women breast cancer survivors draw upon to minimize cancer-related limitations at the workplace. The study also analyzed whether survivors used strategies to address work-related limitations in isolation or in combination with other strategies, and whether they used formal or informal strategies. Semi-structured, in-depth interviews were conducted with 14 women who were employed at the time of diagnosis of breast cancer and who continued to work during treatment or returned to work. Interviews were conducted 3 to 24 months after diagnosis. An iterative process was used to systematically analyze the data (the transcripts) using qualitative methods. Participants who worked during or after treatment adjusted their work schedule, performed fewer or other tasks, modified or changed their work environment, reduced non-work activities at the workplace, used cognitive prompts, and acted preemptively to make work tasks manageable after their return to work. Survivors used multiple adjustments and drew upon both formal and informal tactics to minimize or prevent cancer- or treatment-related effects from negatively affecting job performance. Knowledge about the broad range of both formal and informal strategies identified in this study may enable health care and social services providers, as well as cancer survivors and employers, to identify a wide range of specific strategies that may reduce the negative effects of work-related limitations in specific work settings. Insights gained from this analysis should inform future research on work and cancer survivorship. Copyright © 2014 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  11. Spinal cord stimulation: Current applications for treatment of chronic pain.

    Science.gov (United States)

    Vannemreddy, Prasad; Slavin, Konstantin V

    2011-01-01

    Spinal cord stimulation (SCS) is thought to relieve chronic intractable pain by stimulating nerve fibers in the spinal cord. The resulting impulses in the fibers may inhibit the conduction of pain signals to the brain, according to the pain gate theory proposed by Melzack and Wall in 1965 and the sensation of pain is thus blocked. Although SCS may reduce pain, it will not eliminate it. After a period of concern about safety and efficacy, SCS is now regaining popularity among pain specialists for the treatment of chronic pain. The sympatholytic effect of SCS is one of its most interesting therapeutic properties. This effect is considered responsible for the effectiveness of SCS in peripheral ischemia, and at least some cases of complex regional pain syndrome. The sympatholytic effect has also been considered part of the management of other chronic pain states such as failed back surgery syndrome, phantom pain, diabetic neuropathy, and postherpetic neuralgia. In general, SCS is part of an overall treatment strategy and is used only after the more conservative treatments have failed. The concept of SCS has evolved rapidly following the technological advances that have produced leads with multiple contact electrodes and battery systems. The current prevalence of patients with chronic pain requiring treatment other than conventional medical management has significantly increased and so has been the need for SCS. With the cost benefit analysis showing significant support for SCS, it may be appropriate to offer this as an effective alternative treatment for these patients.

  12. Application of Liposomes in Treatment of Rheumatoid Arthritis: Quo Vadis

    Directory of Open Access Journals (Sweden)

    Bhupinder Kapoor

    2014-01-01

    Full Text Available The most common treatments for rheumatoid arthritis include nonsteroidal anti-inflammatory drugs (NSAIDs, corticosteroids, disease modifying antirheumatic drugs (DMARDs, and some biological agents. However, none of the treatments available is able to achieve the ultimate goal of treatment, that is, drug-free remission. This limitation has shifted the focus of treatment to delivery strategies with an ability to deliver the drugs into the synovial cavity in the proper dosage while mitigating side effects to other tissues. A number of approaches like microemulsions, microspheres, liposomes, microballoons, cocrystals, nanoemulsions, dendrimers, microsponges, and so forth, have been used for intrasynovial delivery of these drugs. Amongst these, liposomes have proven to be very effective for retaining the drug in the synovial cavity by virtue of their size and chemical composition. The fast clearance of intra-synovially administered drugs can be overcome by use of liposomes leading to increased uptake of drugs by the target synovial cells, which in turn reduces the exposure of nontarget sites and eliminates most of the undesirable effects associated with therapy. This review focuses on the use of liposomes in treatment of rheumatoid arthritis and summarizes data relating to the liposome formulations of various drugs. It also discusses emerging trends of this promising technology.

  13. Preliminary analysis of treatment strategies for transuranic wastes from reprocessing plants

    International Nuclear Information System (INIS)

    Ross, W.A.; Schneider, K.J.; Swanson, J.L.; Yasutake, K.M.; Allen, R.P.

    1985-07-01

    This document provides a comparison of six treatment options for transuranic wastes (TRUW) resulting from the reprocessing of commercial spent fuel. Projected transuranic waste streams from the Barnwell Nuclear Fuel Plant (BNFP), the reference fuel reprocessing plant in this report, were grouped into the five categories of hulls and hardware, failed equipment, filters, fluorinator solids, and general process trash (GPT) and sample and analytical cell (SAC) wastes. Six potential treatment options were selected for the five categories of waste. These options represent six basic treatment objectives: (1) no treatment, (2) minimum treatment (compaction), (3) minimum number of processes and products (cementing or grouting), (4) maximum volume reduction without decontamination (melting, incinerating, hot pressing), (5) maximum volume reduction with decontamination (decontamination, treatment of residues), and (6) noncombustible waste forms (melting, incinerating, cementing). Schemes for treatment of each waste type were selected and developed for each treatment option and each type of waste. From these schemes, transuranic waste volumes were found to vary from 1 m 3 /MTU for no treatment to as low as 0.02 m 3 /MTU. Based on conceptual design requirements, life-cycle costs were estimated for treatment plus on-site storage, transportation, and disposal of both high-level and transuranic wastes (and incremental low-level wastes) from 70,000 MTU. The study concludes that extensive treatment is warranted from both cost and waste form characteristics considerations, and that the characteristics of most of the processing systems used are acceptable. The study recommends that additional combinations of treatment methods or strategies be evaluated and that in the interim, melting, incineration, and cementing be further developed for commercial TRUW. 45 refs., 9 figs., 32 tabs

  14. Preliminary analysis of treatment strategies for transuranic wastes from reprocessing plants

    Energy Technology Data Exchange (ETDEWEB)

    Ross, W.A.; Schneider, K.J.; Swanson, J.L.; Yasutake, K.M.; Allen, R.P.

    1985-07-01

    This document provides a comparison of six treatment options for transuranic wastes (TRUW) resulting from the reprocessing of commercial spent fuel. Projected transuranic waste streams from the Barnwell Nuclear Fuel Plant (BNFP), the reference fuel reprocessing plant in this report, were grouped into the five categories of hulls and hardware, failed equipment, filters, fluorinator solids, and general process trash (GPT) and sample and analytical cell (SAC) wastes. Six potential treatment options were selected for the five categories of waste. These options represent six basic treatment objectives: (1) no treatment, (2) minimum treatment (compaction), (3) minimum number of processes and products (cementing or grouting), (4) maximum volume reduction without decontamination (melting, incinerating, hot pressing), (5) maximum volume reduction with decontamination (decontamination, treatment of residues), and (6) noncombustible waste forms (melting, incinerating, cementing). Schemes for treatment of each waste type were selected and developed for each treatment option and each type of waste. From these schemes, transuranic waste volumes were found to vary from 1 m/sup 3//MTU for no treatment to as low as 0.02 m/sup 3//MTU. Based on conceptual design requirements, life-cycle costs were estimated for treatment plus on-site storage, transportation, and disposal of both high-level and transuranic wastes (and incremental low-level wastes) from 70,000 MTU. The study concludes that extensive treatment is warranted from both cost and waste form characteristics considerations, and that the characteristics of most of the processing systems used are acceptable. The study recommends that additional combinations of treatment methods or strategies be evaluated and that in the interim, melting, incineration, and cementing be further developed for commercial TRUW. 45 refs., 9 figs., 32 tabs.

  15. Social capital strategies to enhance hepatitis C treatment awareness and uptake among men in prison.

    Science.gov (United States)

    Lafferty, L; Treloar, C; Guthrie, J; Chambers, G M; Butler, T

    2017-02-01

    Prisoner populations are characterized by high rates of hepatitis C (HCV), up to thirty times that of the general population in Australia. Within Australian prisons, less than 1% of eligible inmates access treatment. Public health strategies informed by social capital could be important in addressing this inequality in access to HCV treatment. Twenty-eight male inmates participated in qualitative interviews across three correctional centres in New South Wales, Australia. All participants had recently tested as HCV RNA positive or were receiving HCV treatment. Analysis was conducted with participants including men with experiences of HCV treatment (n=10) (including those currently accessing treatment and those with a history of treatment) and those who were treatment naïve (n=18). Social capital was a resourceful commodity for inmates considering and undergoing treatment while in custody. Inmates were a valuable resource for information regarding HCV treatment, including personal accounts and reassurance (bonding social capital), while nurses a resource for the provision of information and care (linking social capital). Although linking social capital between inmates and nurses appeared influential in HCV treatment access, there remained opportunities for increasing linking social capital within the prison setting (such as nurse-led engagement within the prisons). Bonding and linking social capital can be valuable resources in promoting HCV treatment awareness, uptake and adherence. Peer-based programmes are likely to be influential in promoting HCV outcomes in the prison setting. Engagement in prisons, outside of the clinics, would enhance opportunities for linking social capital to influence HCV treatment outcomes. © 2016 John Wiley & Sons Ltd.

  16. A proposed strategy for upgrade of the ORNL Process Wastewater Treatment Plant

    International Nuclear Information System (INIS)

    Kent, T.E.; Robinson, S.M.; Scott, C.B.

    1990-01-01

    An approach to the upgrade of the radiological Process Wastewater Treatment Plant (PWTP) at Oak Ridge National Laboratory (ORNL) has been developed that, if adopted, will result in significant cost reductions and improved water quality. The strategy described in this report satisfies the short-term upgrade needs of the PWTP and ultimately results in replacement of existing PWTP softening/ion- exchange technology with a zeolite molecular sieve treatment system for removal of radioactive contaminants from process wastewater. Use of zeolites will improve wastewater quality while reducing operating and disposal costs. The zeolite system would be constructed adjacent to the site now occupied by the Non-Radiological Process Wastewater Treatment Plant (NRWTP), thereby consolidating all process wastewater treatment systems at one location. 4 refs., 4 figs

  17. A proposed strategy for upgrade of the ORNL process wastewater treatment plant

    International Nuclear Information System (INIS)

    Kent, T.E.; Robinson, S.M.; Scott, C.B.

    1990-01-01

    This paper reports on an approach to the upgrade of the radiological Process Wastewater Treatment Plant (PWTP) at Oak Ridge National Laboratory (ORNL), which has been developed and that, if adopted, will result in significant cost reductions and improved water quality. The strategy described in this report satisfies the short-term upgrade needs of the PWTP and ultimately results in replacement of existing PWTP softening/ion-exchange technology with a zeolite molecular sieve treatment system for removal of radioactive contaminants from process wastewater. Use of zeolites will improve wastewater quality while reducing operating and disposal costs. The zeolite system would be constructed adjacent to the site now occupied by the Non-Radiological Process Wastewater Treatment Plant (NRWTP), thereby consolidating all process wastewater treatment systems at one location

  18. Study on emission characteristics and reduction strategy of nitrous oxide during wastewater treatment by different processes.

    Science.gov (United States)

    Sun, Shichang; Bao, Zhiyuan; Sun, Dezhi

    2015-03-01

    Given the inexorable increase in global wastewater treatment, increasing amounts of nitrous oxide are expected to be emitted from wastewater treatment plants and released to the atmosphere. It has become imperative to study the emission and control of nitrous oxide in the various wastewater treatment processes currently in use. In the present investigation, the emission characteristics and the factors affecting the release of nitrous oxide were studied via full- and pilot-scale experiments in anoxic-oxic, sequencing batch reactor and oxidation ditch processes. We propose an optimal treatment process and relative strategy for nitrous oxide reduction. Our results show that both the bio-nitrifying and bio-denitrifying treatment units in wastewater treatment plants are the predominant sites for nitrous oxide production in each process, while the aerated treatment units are the critical sources for nitrous oxide emission. Compared with the emission of nitrous oxide from the anoxic-oxic (1.37% of N-influent) and sequencing batch reactor (2.69% of N-influent) processes, much less nitrous oxide (0.25% of N-influent) is emitted from the oxidation ditch process, which we determined as the optimal wastewater treatment process for nitrous oxide reduction, given the current technologies. Nitrous oxide emissions differed with various operating parameters. Controlling the dissolved oxygen concentration at a proper level during nitrification and denitrification and enhancing the utilization rate of organic carbon in the influent for denitrification are the two critical methods for nitrous oxide reduction in the various processes considered.

  19. Bone marrow mesenchymal stem cell therapy in ischemic stroke: mechanisms of action and treatment optimization strategies

    Directory of Open Access Journals (Sweden)

    Guihong Li

    2016-01-01

    Full Text Available Animal and clinical studies have confirmed the therapeutic effect of bone marrow mesenchymal stem cells on cerebral ischemia, but their mechanisms of action remain poorly understood. Here, we summarize the transplantation approaches, directional migration, differentiation, replacement, neural circuit reconstruction, angiogenesis, neurotrophic factor secretion, apoptosis, immunomodulation, multiple mechanisms of action, and optimization strategies for bone marrow mesenchymal stem cells in the treatment of ischemic stroke. We also explore the safety of bone marrow mesenchymal stem cell transplantation and conclude that bone marrow mesenchymal stem cell transplantation is an important direction for future treatment of cerebral ischemia. Determining the optimal timing and dose for the transplantation are important directions for future research.

  20. Contemporary Directions in Theories and Psychotherapeutic Strategies in Treatment of Personality Disorders

    DEFF Research Database (Denmark)

    Simonsen, Sebastian; Simonsen, Erik

    2014-01-01

    and improved adaptation. Based on this finding, we argue that the Level of Personality Functioning could be a useful assessment method for improving treatment selection. Finally, we raise questions and offer considerations regarding the understanding of empathy, low motivation and autobiographical memory......In this commentary on treatment strategies for personality disorders, we analyze each of the cases and the problem of low motivation in terms of how they fit with the Level of Personality Functioning scale. We then show how patients vary in terms of both level and breadth of pathology. Three...

  1. Behavioral side effects of pediatric acute lymphoblastic leukemia treatment: the role of parenting strategies.

    Science.gov (United States)

    Williams, Lauren K; Lamb, Karen E; McCarthy, Maria C

    2014-11-01

    Behavioral and emotional difficulties are a recognised side effect of childhood acute lymphoblastic leukemia (ALL) treatment. Modifiable factors, such as parenting strategies, may be an appropriate target for interventions to assist families with managing their child's behavior, potentially leading to improved psychosocial and clinical outcomes. This study examined whether parenting strategies are associated with child behavioral and emotional problems in a pediatric oncology context, with the aim of establishing whether parenting is a potential modifiable target for psychosocial intervention. Participants included 73 parents of children aged 2-6 years who were either (i) in the maintenance phase of treatment for ALL at the Royal Children's Hospital Children's Cancer Centre, Melbourne (N = 43), or (ii) had no major medical history (healthy control group) (N = 30). Participants completed psychometrically validated questionnaires that assessed parenting strategies and child emotional and behavioral problems. Results revealed that the ALL group parents reported higher lax parenting and more spoiling and bribing of their child than the healthy control group. Results from regression models indicated that, after controlling for the significant contribution of illness status and child age on child emotional and behavioral difficulties, parental laxness and parental overprotection were significantly associated with child emotional and behavioral difficulties. Supporting parents to minimise sub-optimal parenting strategies, particularly lax parenting, may offer a fruitful avenue for future research directed toward modifiable factors associated with managing child emotional and behavioral problems in a pediatric oncology context. © 2014 Wiley Periodicals, Inc.

  2. Marketing skills as determinants that underpin the competitiveness of the rice industry in Yaguachi canton. Application of SVN numbers to the prioritization of strategies

    Directory of Open Access Journals (Sweden)

    Pablo José Menéndez Vera

    2016-12-01

    Full Text Available In Ecuador, specifically in the Yaguachi Canton, there is an enormous potential in the rice production, which unfortunately is not being well used and driven by marketing strategies. In this work, marketing strategies were developed that help to sustain the commercial activity of rice in Yaguachi Canton and its surroundings. The proposed strategies were analyzed and prioritized using SVN and Euclidean distance for the treatment of neutralities. The paper ends with conclusion and future work proposal for the application of neutrosophy to new areas of marketing.

  3. Gaps in clinical prevention and treatment for alcohol use disorders: costs, consequences, and strategies.

    Science.gov (United States)

    Willenbring, Mark L

    2013-01-01

    Heavy drinking causes significant morbidity, premature mortality, and other social and economic burdens on society, prompting numerous prevention and treatment efforts to avoid or ameliorate the prevalence of heavy drinking and its consequences. However, the impact on public health of current selective (i.e., clinical) prevention and treatment strategies is unclear. Screening and brief counseling for at-risk drinkers in ambulatory primary care has the strongest evidence for efficacy, and some evidence indicates this approach is cost-effective and reduces excess morbidity and dysfunction. Widespread implementation of screening and brief counseling of nondependent heavy drinkers outside of the medical context has the potential to have a large public health impact. For people with functional dependence, no appropriate treatment and prevention approaches currently exist, although such strategies might be able to prevent or reduce the morbidity and other harmful consequences associated with the condition before its eventual natural resolution. For people with alcohol use disorders, particularly severe and recurrent dependence, treatment studies have shown improvement in the short term. However, there is no compelling evidence that treatment of alcohol use disorders has resulted in reductions in overall disease burden. More research is needed on ways to address functional alcohol dependence as well as severe and recurrent alcohol dependence.

  4. An analysis of vascular surgery in elderly patients to determine whether age affects treatment strategy.

    LENUS (Irish Health Repository)

    O'Brien, G

    2012-03-01

    The incidence of arterial disease increases with age. Increasing life expectancy in the western world will intensify demands on vascular surgeons with regard to increasing caseload, expanding patient selection criteria, and more complex and minimally-invasive treatment options. We analysed our arterial cases over the past 31 years (n = 6,144) and compared our methods of intervention and complication rates in the elderly population (>75) with the younger cohort, in order to determine whether age should influence our management strategies.

  5. Sialendoscopy-Assisted Treatment for Chronic Obstructive Parotitis—Our Treatment Strategy with 31 Patients.

    Science.gov (United States)

    Wu, Chuan-Bin; Xue, Lei; Zhang, Bin; Sun, Ning-Ning; Zhou, Qing

    2015-08-01

    Chronic obstructive parotitis (COP) is the most common non-neoplastic salivary disorder. The aim of this study was to describe the authors' experience using sialendoscopy for diagnosing and treating COP. Thirty-one patients with COP who were treated with sialendoscopy from January 2013 through June 2014 at the Department of Oral and Maxillofacial Surgery, School of Stomatology, China Medical University (Shenyang, China) were retrospectively reviewed. The cohort underwent ultrasonography and salivary gland scintigraphy examinations before sialendoscopy. Patients without stones underwent sialography before surgery. All patients were asked to report visual analog scale (VAS) scores before and 6 months after surgery to evaluate their condition. A paired t test was conducted and differences with a P value less than .05 were considered statistically significant. Thirty patients (44 parotid glands) successfully underwent interventional sialendoscopy under local anesthesia; 1 patient (1 parotid gland) received general anesthesia. The mean preoperative VAS score was 6, and the mean VAS score 6 months after sialendoscopy was 4.9. The postoperative VAS score was significantly lower than the preoperative VAS score (P < .05). Interventional sialendoscopy plays an important role in the treatment of COP. Copyright © 2015 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  6. Group vs. Individual Treatment for Acute Insomnia: A Pilot Study Evaluating a “One-Shot” Treatment Strategy

    Directory of Open Access Journals (Sweden)

    Pam Boullin

    2016-12-01

    Full Text Available Background: Despite undeniable evidence for the efficacy and effectiveness of Cognitive Behaviour Therapy for Insomnia (CBT-I, the potential for its widespread dissemination and implementation has yet to be realised. A suggested reason for this is that traditional CBT-I is considered too burdensome for deployment, in its current form, within the context of where it would be most beneficial—Primary Care. One strategy, aimed to address this, has been to develop briefer versions of CBT-I, whilst another has been to deliver CBT-I in a group format. An alternative has been to attempt to address insomnia during its acute phase with a view to circumventing its progression to chronic insomnia. The aim of the present study was to compare a brief version of CBT-I (one-shot when delivered individually or in groups to those with acute insomnia. Method: Twenty-eight individuals with acute insomnia (i.e., meeting full DSM-5 criteria for insomnia disorder for less than three months self-assigned to either a group or individual treatment arm. Treatment consisted of a single one-hour session accompanied by a self-help pamphlet. Subjects completed measures of insomnia severity, anxiety and depression pre-treatment and at one-month post-treatment. Additionally, daily sleep diaries were compared between pre-treatment and at the one-month follow up. Results: There were no significant between group differences in treatment outcome on any sleep or mood measures although those in the group treatment arm were less adherent than those who received individual treatment. Furthermore, the combined (group and individual treatment arms pre-post test effect size on insomnia symptoms, using the Insomnia Severity Index, was large (d = 2.27. Discussion: It appears that group treatment is as efficacious as individual treatment within the context of a “one shot” intervention for individuals with acute insomnia. The results are discussed with a view to integrating one-shot CBT

  7. Recycling cellulase towards industrial application of enzyme treatment on hardwood kraft-based dissolving pulp.

    Science.gov (United States)

    Wang, Qiang; Liu, Shanshan; Yang, Guihua; Chen, Jiachuan; Ji, Xingxiang; Ni, Yonghao

    2016-07-01

    Cost-effectiveness is vital for enzymatic treatment of dissolving pulp towards industrial application. The strategy of cellulase recycling with fresh cellulase addition was demonstrated in this work to activate the dissolving pulp, i.e. decreasing viscosity and increasing Fock reactivity. Results showed that 48.8-35.1% of cellulase activity can be recovered from the filtered liquor in five recycle rounds, which can be reused for enzymatic treatment of dissolving pulp. As a result, the recycling cellulase with addition fresh cellulase of 1mg/g led to the pulp of viscosity 470mL/g and Fock reactivity 80%, which is comparable with cellulase charge of 2mg/g. Other pulp properties such as alpha-cellulose, alkaline solubility and molecular weight distribution were also determined. Additionally, a zero-release of recycling cellulase treatment was proposed to integrate into the dissolving pulp production process. Copyright © 2016 Elsevier Ltd. All rights reserved.

  8. Data-Centric Knowledge Discovery Strategy for a Safety-Critical Sensor Application

    Directory of Open Access Journals (Sweden)

    Nilamadhab Mishra

    2014-01-01

    Full Text Available In an indoor safety-critical application, sensors and actuators are clustered together to accomplish critical actions within a limited time constraint. The cluster may be controlled by a dedicated programmed autonomous microcontroller device powered with electricity to perform in-network time critical functions, such as data collection, data processing, and knowledge production. In a data-centric sensor network, approximately 3–60% of the sensor data are faulty, and the data collected from the sensor environment are highly unstructured and ambiguous. Therefore, for safety-critical sensor applications, actuators must function intelligently within a hard time frame and have proper knowledge to perform their logical actions. This paper proposes a knowledge discovery strategy and an exploration algorithm for indoor safety-critical industrial applications. The application evidence and discussion validate that the proposed strategy and algorithm can be implemented for knowledge discovery within the operational framework.

  9. Validation and implementation of model based control strategies at an industrial wastewater treatment plant.

    Science.gov (United States)

    Demey, D; Vanderhaegen, B; Vanhooren, H; Liessens, J; Van Eyck, L; Hopkins, L; Vanrolleghem, P A

    2001-01-01

    In this paper, the practical implementation and validation of advanced control strategies, designed using model based techniques, at an industrial wastewater treatment plant is demonstrated. The plant under study is treating the wastewater of a large pharmaceutical production facility. The process characteristics of the wastewater treatment were quantified by means of tracer tests, intensive measurement campaigns and the use of on-line sensors. In parallel, a dynamical model of the complete wastewater plant was developed according to the specific kinetic characteristics of the sludge and the highly varying composition of the industrial wastewater. Based on real-time data and dynamic models, control strategies for the equalisation system, the polymer dosing and phosphorus addition were established. The control strategies are being integrated in the existing SCADA system combining traditional PLC technology with robust PC based control calculations. The use of intelligent control in wastewater treatment offers a wide spectrum of possibilities to upgrade existing plants, to increase the capacity of the plant and to eliminate peaks. This can result in a more stable and secure overall performance and, finally, in cost savings. The use of on-line sensors has a potential not only for monitoring concentrations, but also for manipulating flows and concentrations. This way the performance of the plant can be secured.

  10. Determining a sustainable and economically optimal wastewater treatment and discharge strategy.

    Science.gov (United States)

    Hardisty, Paul E; Sivapalan, Mayuran; Humphries, Robert

    2013-01-15

    Options for treatment and discharge of wastewater in regional Western Australia (WA) are examined from the perspective of overall sustainability and social net benefit. Current practice in the state has typically involved a basic standard of treatment deemed to be protective of human health, followed by discharge to surface water bodies. Community and regulatory pressure to move to higher standards of treatment is based on the presumption that a higher standard of treatment is more protective of the environment and society, and thus is more sustainable. This analysis tests that hypothesis for Western Australian conditions. The merits of various wastewater treatment and discharge strategies are examined by quantifying financial costs (capital and operations), and by monetising the wider environmental and social costs and benefits of each option over an expanded planning horizon (30 years). Six technical treatment-disposal options were assessed at a test site, all of which met the fundamental criterion of protecting human health. From a financial perspective, the current business-as-usual option is preferred - it is the least cost solution. However, valuing externalities such as water, greenhouse gases, ecological impacts and community amenity, the status quo is revealed as sub-optimal. Advanced secondary treatment with stream disposal improves water quality and provides overall net benefit to society. All of the other options were net present value (NPV) negative. Sensitivity analysis shows that the favoured option outperforms all of the others under a wide range of financial and externality values and assumptions. Expanding the findings across the state reveals that moving from the identified socially optimal level of treatment to higher (tertiary) levels of treatment would result in a net loss to society equivalent to several hundred million dollars. In other words, everyone benefits from improving treatment to the optimum point. But society, the environment, and

  11. A proposed maintenance strategy for generator sets utilised in biogas applications

    OpenAIRE

    2012-01-01

    M. Ing. The overall purpose of this research project was to develop a proposed maintenance strategy for generator sets utilised in biogas applications. One specific biogas application, involving the use of landfill gas (LFG) to generate electrical energy, was the focal point of the research project. This is due to the fact that the author’s organisation is extensively involved with landfills and power generation through the use of LFG.

  12. RFID Application Strategy in Agri-Food Supply Chain Based on Safety and Benefit Analysis

    Science.gov (United States)

    Zhang, Min; Li, Peichong

    Agri-food supply chain management (SCM), a management method to optimize internal costs and productivities, has evolved as an application of e-business technologies. These days, RFID has been widely used in many fields. In this paper, we analyze the characteristics of agri-food supply chain. Then the disadvantages of RFID are discussed. After that, we study the application strategies of RFID based on benefit and safety degree.

  13. Early change in coping strategies in responsive treatments for borderline personality disorder: A mediation analysis.

    Science.gov (United States)

    Kramer, Ueli; Keller, Sabine; Caspar, Franz; de Roten, Yves; Despland, Jean-Nicolas; Kolly, Stéphane

    2017-05-01

    Difficulty in emotion regulation is a hallmark feature of patients with borderline personality disorder (BPD). Therefore, change in the frequency of certain patients' coping strategies-aiming at emotion regulation-are among the most promising mechanisms of change in treatments for BPD. In parallel, it was highlighted that therapist responsiveness significantly contributed to outcome across treatment approaches (Stiles, 2009). Based on a randomized controlled trial (Kramer et al., 2014), the present process-outcome mediation analysis aims at examining the patient's early change in frequency of coping strategies-in particular the decrease in behavioral forms of coping-as potential mechanism of change in responsive treatments for BPD. A total of 57 patients with BPD were included in the present analysis, out of whom 27 were randomly assigned to a 10-session psychiatric treatment and 30 to a 10-session psychiatric treatment augmented with the responsive intervention of the motive-oriented therapeutic relationship (Caspar, 2007). The 1st, 5th, and 9th session of each therapy were transcribed and analyzed using the Coping Action Pattern Rating Scale (Perry et al., 2005; 171 sessions analyzed in total), a validated observer-rated method for assessing coping strategies in the therapy process. Psychological distress was assessed using the OQ-45 at intake, after Session 5, and after Session 10. The results confirmed a responsiveness effect associated with the motive-oriented therapeutic relationship and showed a significant decrease in frequency of behavioral forms of coping, F(1, 54) = 3.09, p = .05, d = .56, which was not different between the 2 conditions. In addition, we demonstrated that the early decrease in behavioral forms of coping between Sessions 1 and 5 partially mediated the link between the group assignment and the change in psychological distress between Sessions 5 and 10. These results shed light on the centrality of therapist responsiveness in treatments for

  14. Review of biotechnology applications to nuclear waste treatment

    International Nuclear Information System (INIS)

    Ashley, N.V.; Roach, D.J.W.

    1990-01-01

    This paper gives an overview of the feasibility of the application of biotechnology to nuclear waste treatment. Many living and dead organisms accumulate heavy metals and radionuclides. The controlled use of this phenomenon forms the basis for the application of biotechnology to the removal of radionuclides from nuclear waste streams. An overview of biotechnology areas, namely the use of biopolymers and biosorption using biomass applicable to the removal of radionuclides from industrial nuclear effluents is given. The potential of biomagnetic separation technology, genetic engineering and monoclonal antibody technology is also to be examined. The most appropriate technologies to develop for radionuclide removal in the short term appear to be those based on biosorption of radionuclides by biomass and the use of modified and unmodified biopolymers in the medium term. (author)

  15. Cost-effectiveness of treatment strategies for BRAF-mutated metastatic melanoma.

    Directory of Open Access Journals (Sweden)

    Patti Curl

    Full Text Available Genetically-targeted therapies are both promising and costly advances in the field of oncology. Several treatments for metastatic melanoma with a mutation in the BRAF gene have been approved. They extend life but are more expensive than the previous standard of care (dacarbazine. Vemurafenib, the first drug in this class, costs $13,000 per month ($207,000 for a patient with median survival. Patients failing vemurafenib are often given ipilimumab, an immunomodulator, at $150,000 per course. Assessment of cost-effectiveness is a valuable tool to help navigate the transition toward targeted cancer therapy.We performed a cost-utility analysis to compare three strategies for patients with BRAF+ metastatic melanoma using a deterministic expected-value decision tree model to calculate the present value of lifetime costs and quality-adjusted life years (QALYs for each strategy. We performed sensitivity analyses on all variables.In the base case, the incremental cost-effectiveness ratio (ICER for vemurafenib compared with dacarbazine was $353,993 per QALY gained (0.42 QALYs added, $156,831 added. The ICER for vemurafenib followed by ipilimumab compared with vemurafenib alone was $158,139. In sensitivity analysis, treatment cost had the largest influence on results: the ICER for vemurafenib versus dacarbazine dropped to $100,000 per QALY gained with a treatment cost of $3600 per month.The cost per QALY gained for treatment of BRAF+ metastatic melanoma with vemurafenib alone or in combination exceeds widely-cited thresholds for cost-effectiveness. These strategies may become cost-effective with lower drug prices or confirmation of a durable response without continued treatment.

  16. Applications of nanotechnology in water and wastewater treatment.

    Science.gov (United States)

    Qu, Xiaolei; Alvarez, Pedro J J; Li, Qilin

    2013-08-01

    Providing clean and affordable water to meet human needs is a grand challenge of the 21st century. Worldwide, water supply struggles to keep up with the fast growing demand, which is exacerbated by population growth, global climate change, and water quality deterioration. The need for technological innovation to enable integrated water management cannot be overstated. Nanotechnology holds great potential in advancing water and wastewater treatment to improve treatment efficiency as well as to augment water supply through safe use of unconventional water sources. Here we review recent development in nanotechnology for water and wastewater treatment. The discussion covers candidate nanomaterials, properties and mechanisms that enable the applications, advantages and limitations as compared to existing processes, and barriers and research needs for commercialization. By tracing these technological advances to the physicochemical properties of nanomaterials, the present review outlines the opportunities and limitations to further capitalize on these unique properties for sustainable water management. Copyright © 2013 Elsevier Ltd. All rights reserved.

  17. Integrated ground-water monitoring strategy for NRC-licensed facilities and sites: Case study applications

    Science.gov (United States)

    Price, V.; Temples, T.; Hodges, R.; Dai, Z.; Watkins, D.; Imrich, J.

    2007-01-01

    This document discusses results of applying the Integrated Ground-Water Monitoring Strategy (the Strategy) to actual waste sites using existing field characterization and monitoring data. The Strategy is a systematic approach to dealing with complex sites. Application of such a systematic approach will reduce uncertainty associated with site analysis, and therefore uncertainty associated with management decisions about a site. The Strategy can be used to guide the development of a ground-water monitoring program or to review an existing one. The sites selected for study fall within a wide range of geologic and climatic settings, waste compositions, and site design characteristics and represent realistic cases that might be encountered by the NRC. No one case study illustrates a comprehensive application of the Strategy using all available site data. Rather, within each case study we focus on certain aspects of the Strategy, to illustrate concepts that can be applied generically to all sites. The test sites selected include:Charleston, South Carolina, Naval Weapons Station,Brookhaven National Laboratory on Long Island, New York,The USGS Amargosa Desert Research Site in Nevada,Rocky Flats in Colorado,C-Area at the Savannah River Site in South Carolina, andThe Hanford 300 Area.A Data Analysis section provides examples of detailed data analysis of monitoring data.

  18. The association between implementation strategy use and the uptake of hepatitis C treatment in a national sample.

    Science.gov (United States)

    Rogal, Shari S; Yakovchenko, Vera; Waltz, Thomas J; Powell, Byron J; Kirchner, JoAnn E; Proctor, Enola K; Gonzalez, Rachel; Park, Angela; Ross, David; Morgan, Timothy R; Chartier, Maggie; Chinman, Matthew J

    2017-05-11

    Hepatitis C virus (HCV) is a common and highly morbid illness. New medications that have much higher cure rates have become the new evidence-based practice in the field. Understanding the implementation of these new medications nationally provides an opportunity to advance the understanding of the role of implementation strategies in clinical outcomes on a large scale. The Expert Recommendations for Implementing Change (ERIC) study defined discrete implementation strategies and clustered these strategies into groups. The present evaluation assessed the use of these strategies and clusters in the context of HCV treatment across the US Department of Veterans Affairs (VA), Veterans Health Administration, the largest provider of HCV care nationally. A 73-item survey was developed and sent to all VA sites treating HCV via electronic survey, to assess whether or not a site used each ERIC-defined implementation strategy related to employing the new HCV medication in 2014. VA national data regarding the number of Veterans starting on the new HCV medications at each site were collected. The associations between treatment starts and number and type of implementation strategies were assessed. A total of 80 (62%) sites responded. Respondents endorsed an average of 25 ± 14 strategies. The number of treatment starts was positively correlated with the total number of strategies endorsed (r = 0.43, p strategies endorsed (p strategies, compared to 15 strategies in the lowest quartile. There were significant differences in the types of strategies endorsed by sites in the highest and lowest quartiles of treatment starts. Four of the 10 top strategies for sites in the top quartile had significant correlations with treatment starts compared to only 1 of the 10 top strategies in the bottom quartile sites. Overall, only 3 of the top 15 most frequently used strategies were associated with treatment. These results suggest that sites that used a greater number of implementation

  19. Access to hepatitis C virus treatment: Lessons from implementation of strategies for increasing access to antiretroviral treatment.

    Science.gov (United States)

    Assefa, Yibeltal; Hill, Peter S; Williams, Owain D

    2018-05-01

    At September's 2017 United Nations General Assembly, a state-of-the-art HIV medicine was announced to be made available at just $75 per person per year. There have been a number of strategies that the global AIDS community and countries have utilized to reduce prices and make antiretrovirals (ARVs) accessible for people living with HIV/AIDS. There appears to be an opportunity for the treatment of hepatitis C virus infection using direct-acting antivirals (DAAs) to benefit from the often painful and laboured history of driving down the prices of ARVs. In general, the success of lowering prices for ARVs has stemmed from the politics needed to initially support generic entry into the on-patent market. The use of flexibilities present in the World Trade Organization's Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS) have been used to overcome patent barriers, with the use of compulsory licenses and/or the threat of their use as instruments for strengthening the bargaining power in price negotiations. These strategies have been combined with new financing mechanisms that have promoted more effective procurement and price negotiations. Partnership among the different stakeholders has also been critical in this regard. Countries have also invested in their health systems and implemented several strategies to reduce stigma and discrimination to increase access to and improve utilization of ARVs. This article suggests that any future international initiatives to increase access to DAAs can learn from these lessons surrounding price reduction, improved financing, advocacy, as well as health systems strengthening and stigma reduction. Adopting and reconfiguring these strategies will also incur substantial savings in time, money and lives. Crown Copyright © 2018. Published by Elsevier Ltd. All rights reserved.

  20. Access to hepatitis C virus treatment: Lessons from implementation of strategies for increasing access to antiretroviral treatment

    Directory of Open Access Journals (Sweden)

    Yibeltal Assefa

    2018-05-01

    Full Text Available At September’s 2017 United Nations General Assembly, a state-of-the-art HIV medicine was announced to be made available at just $75 per person per year. There have been a number of strategies that the global AIDS community and countries have utilized to reduce prices and make antiretrovirals (ARVs accessible for people living with HIV/AIDS. There appears to be an opportunity for the treatment of hepatitis C virus infection using direct-acting antivirals (DAAs to benefit from the often painful and laboured history of driving down the prices of ARVs. In general, the success of lowering prices for ARVs has stemmed from the politics needed to initially support generic entry into the on-patent market. The use of flexibilities present in the World Trade Organization’s Agreement on Trade-Related Aspects of Intellectual Property Rights (TRIPS have been used to overcome patent barriers, with the use of compulsory licenses and/or the threat of their use as instruments for strengthening the bargaining power in price negotiations.These strategies have been combined with new financing mechanisms that have promoted more effective procurement and price negotiations. Partnership among the different stakeholders has also been critical in this regard. Countries have also invested in their health systems and implemented several strategies to reduce stigma and discrimination to increase access to and improve utilization of ARVs. This article suggests that any future international initiatives to increase access to DAAs can learn from these lessons surrounding price reduction, improved financing, advocacy, as well as health systems strengthening and stigma reduction. Adopting and reconfiguring these strategies will also incur substantial savings in time, money and lives. Keywords: Acces to medicines, Hepatitis C virus, HIV, Antiretrovirals, Direct-acting antivirals

  1. Hydrothermal treatment of grape marc for solid fuel applications

    International Nuclear Information System (INIS)

    Mäkelä, Mikko; Kwong, Chi Wai; Broström, Markus; Yoshikawa, Kunio

    2017-01-01

    Highlights: • The effects of treatment temperature and liquid pH on char and liquid properties. • Liquid pH had a statistically significant effect only on liquid carbon yield. • Higher treatment temperature increased char volatiles that can enhance ignitability. • Char showed promising fuel properties if elevated ash phosphorus can be tolerated. - Abstract: The treatment and disposal of grape marc, a residue from grape processing, represents a significant economic and environmental challenge for the winemaking industry. Hydrothermal treatment of grape marc could be an efficient way for producing solid fuels on-site at the wineries. In this work the effects of treatment temperature and liquid pH on grape marc char and liquid properties were determined based on laboratory experiments and the combustion characteristics of char were assessed through thermogravimetric analysis and fuel ash classification. The results showed that hydrothermal treatment increased the energy and carbon contents and decreased the ash content of grape marc. The effect of liquid pH was statistically significant (p < 0.05) only for the determined carbon yield of liquid samples. The energy yield from grape marc was maximized at lower treatment temperatures, which also decreased the content of less thermally stable compounds in the attained char. Higher treatment temperatures decreased grape marc solid, carbon and energy yields and led to an increase in thermally labile compounds compared to lower temperatures likely due to the condensation of liquid compounds or volatiles trapped in the pores of char particles. The alkali metal contents of char ash were reduced coupled with an increase in respective phosphorus. Overall the results support the use of hydrothermally treated grape marc in solid fuel applications, if elevated levels of ash phosphorus can be tolerated.

  2. Costs and cost-effectiveness of different DOT strategies for the treatment of tuberculosis in Pakistan. Directly Observed Treatment.

    Science.gov (United States)

    Khan, M A; Walley, J D; Witter, S N; Imran, A; Safdar, N

    2002-06-01

    An economic study was conducted alongside a clinical trial at three sites in Pakistan to establish the costs and effectiveness of different strategies for implementing directly observed treatment (DOT) for tuberculosis. Patients were randomly allocated to one of three arms: DOTS with direct observation by health workers (at health centres or by community health workers); DOTS with direct observation by family members; and DOTS without direct observation. The clinical trial found no statistically significant difference in cure rate for the different arms. The economic study collected data on the full range of health service costs and patient costs of the different treatment arms. Data were also disaggregated by gender, rural and urban patients, by treatment site and by economic categories, to investigate the costs of the different strategies, their cost-effectiveness and the impact that they might have on patient compliance with treatment. The study found that direct observation by health centre-based health workers was the least cost-effective of the strategies tested (US dollars 310 per case cured). This is an interesting result, as this is the model recommended by the World Health Organization and International Union against Tuberculosis and Lung Disease. Attending health centres daily during the first 2 months generated high patient costs (direct and in terms of time lost), yet cure rates for this group fell below those of the non-observed group (58%, compared with 62%). One factor suggested by this study is that the high costs of attending may be deterring patients, and in particular, economically active patients who have most to lose from the time taken by direct observation. Without stronger evidence of benefits, it is hard to justify the costs to health services and patients that this type of direct observation imposes. The self-administered group came out as most cost-effective (164 dollars per case cured). The community health worker sub-group achieved the

  3. The impact of tumor biology on cancer treatment and multidisciplinary strategies

    International Nuclear Information System (INIS)

    Molls, Michael; Vaupel, Peter; Nieder, Carsten; Anscher, Mitchell S.

    2009-01-01

    This book provides an overview of the fundamentals of tumor biology and the influence of various biologic factors, including inhomogeneity of cancer cells, microenvironment, and host factors, on the design of therapeutic strategies and the outcome of established and emerging treatments. Particular attention is devoted to multidisciplinary combined modality therapy. The topics reviewed include tumorigenesis, cell proliferation, angiogenesis, physiology of malignant tissues, adhesion and invasion, development of metastases, and the role of the immune system in cancer development. Subsequent chapters focus on cancer prevention, detection, and treatment. The principles of chemotherapy, radiotherapy, and molecularly targeted therapy are discussed, treatment resistance is explained, and strategies for rational combinations are provided, including the design of translational studies. Furthermore, the principles and clinical implications of new diagnostic and therapeutic approaches, such as gene expression profiling, gene transfer and silencing, proteomics, and molecular imaging, are presented. The chapters in this book have been written by an outstanding group of basic scientists, clinical researchers, and cancer professionals with long experience in the field. Their aim is to educate and inspire all those who devote most of their work to research into cancer and its treatment. (orig.)

  4. Primary care: constipation and encopresis treatment strategies and reasons to refer.

    Science.gov (United States)

    Philichi, Lisa; Yuwono, Melawati

    2010-01-01

    The purpose of the study was to assess constipation and encopresis treatment strategies of primary care providers and determine reasons to refer to a pediatric gastroenterology specialist. A closed-ended questionnaire was mailed to a convenience sampling of 237 pediatric primary care providers. Ninety-one questionnaires were returned with a 38% response rate: 74 (81%) pediatricians and 17 (19%) nurse practitioners. The majority of responders recommended pharmacologic treatment and diet changes. Many providers (73%) estimated a 75%-100% success rate when managing constipation, whereas 19% providers estimated a greater than 80% success rate with encopresis patients. The number one reason to refer was unresponsiveness to treatment (71%), followed by parents want a second opinion (15%), rule out organic cause (9%), and management is too time-consuming (5%). Both primary care providers and pediatric gastroenterologists use medication strategies, but diet recommendations are not the same. Unresponsiveness to treatment is the main reason for referral. If better management can occur in the primary care setting, costly specialty services may be avoided and possibly reduce healthcare costs.

  5. Influence of application strategy of coconut soap on the development of sooty blotch on apple

    OpenAIRE

    Fuchs, J. G.; Haseli, A.; Tamm, L.

    2002-01-01

    Sooty blotch causes heavy losses in Swiss organic apple production. In 2000 and 2001 a late season application strategy with coconut soap (Biofa Cocana RF) was evaluated. Coconut soap reduced disease occurrence in ali experiments. However, the efficacy was much higher in 2000 than in 2001, probably due to a much higher disease pressure in 2001.

  6. Coupling Cover Crops with Alternative Swine Manure Application Strategies: Manure-15N Tracer Studies

    Science.gov (United States)

    Integration of rye cover crops with alternative liquid swine (Sus scrofa L.) manure application strategies may enhance retention of manure N in corn (Zea mays L.) - soybean [Glycine max (L.) Merr] cropping systems. The objective of this study was to quantify uptake of manure derived-N by a rye (Seca...

  7. Multimedia Instructional Tools' Impact on Student Motivation and Learning Strategies in Computer Applications Courses

    Science.gov (United States)

    Chapman, Debra; Wang, Shuyan

    2015-01-01

    Multimedia instructional tools (MMIT) have been identified as a way effectively and economically present instructional material. MMITs are commonly used in introductory computer applications courses as MMITs should be effective in increasing student knowledge and positively impact motivation and learning strategies, without increasing costs. This…

  8. Small-scale fuel cell cogen: application potentials and market strategies

    International Nuclear Information System (INIS)

    Vogel, Bernd

    2000-01-01

    Small (less than 5 kW) fuel-cell cogeneration systems are now being developed for use in residential buildings. The devices are expected to be on the market in five years. The article discusses the potential for their large-scale introduction, the impact of this new technology on the natural gas business, potential applications and marketing strategies

  9. Lanthanide-Based Metal Organic Frameworks: Synthetic Strategies and Catalytic Applications

    NARCIS (Netherlands)

    Pagis, C.; Ferbinteanu, M.; Rothenberg, G.; Grecea, S.

    2016-01-01

    This short critical review outlines the main synthetic strategies used in the designed synthesis of lanthanide-based metal organic frameworks (Ln-MOFs). It explains the impact of the choice of organic linker on the final network topology, and it highlights the applications of Ln-MOFs in the

  10. HPV Positive Head and Neck Cancers: Molecular Pathogenesis and Evolving Treatment Strategies

    Directory of Open Access Journals (Sweden)

    Rüveyda Dok

    2016-03-01

    Full Text Available Head and neck squamous cell carcinoma (HNSCC is a highly heterogeneous disease that is the result of tobacco and/or alcohol abuse or infection with high-risk Human papillomaviruses. Despite the fact that HPV positive HNSCC cancers form a distinct clinical entity with better treatment outcome, all HNSCC are currently treated uniformly with the same treatment modality. At present, biologic basis of these different outcomes and their therapeutic influence are areas of intense investigation. In this review, we will summarize the molecular basis for this different outcome, novel treatment opportunities and possible biomarkers for HPV positive HNSCC. In particular, the focus will be on several molecular targeted strategies that can improve the chemoradiation response by influencing DNA repair mechanisms.

  11. Biosolids management strategies: an evaluation of energy production as an alternative to land application.

    Science.gov (United States)

    Egan, Maureen

    2013-07-01

    Currently, more than half of the biosolids produced within the USA are land applied. Land application of biosolids introduces organic contaminants into the environment. There are potential ecological and human health risks associated with land application of biosolids. Biosolids may be used as a renewable energy source. Nutrients may be recovered from biosolids used for energy generation for use as fertilizer. The by-products of biosolids energy generation may be used beneficially in construction materials. It is recommended that energy generation replace land application as the leading biosolids management strategy.

  12. Variation in treatment strategies of Swiss general practitioners for subclinical hypothyroidism in older adults.

    Science.gov (United States)

    Baumgartner, Christine; den Elzen, Wendy P J; Blum, Manuel R; Coslovsky, Michael; Streit, Sven; Frey, Peter; Herzig, Lilli; Haller, Dagmar M; Mooijaart, Simon P; Bischoff, Thomas; Rosemann, Thomas; Gussekloo, Jacobijn; Rodondi, Nicolas

    2015-01-01

    As the best management of subclinical hypothyroidism is controversial, we aimed to assess variations in treatment strategies depending on different Swiss regions, physician and patient characteristics. We performed a case-based survey among general practitioners (GPs) in different Swiss regions, which consisted of eight hypothetical cases presenting a female patient with subclinical hypothyroidism and nonspecific complaints differing by age, vitality status and thyroid-stimulating hormone (TSH) concentration. A total of 262 GPs participated in the survey. There was considerable variation in the levothyroxine starting dose chosen by GPs, ranging from 25 µg to 100 µg. Across the Swiss regions, GPs in the Bern region were significantly more inclined to treat, with a higher probability of initiating treatment (60%, p = 0.01) and higher mean starting doses (45 µg, p treatment rate and other physician characteristics. GPs were more reluctant to initiate treatment in 85-year-old than in 70-year-old women (odds ratio [OR] 0.77, 95% confidence interval [CI] 0.63-0.94), and more likely to treat women with a TSH of 15 mU/l than those with a TSH of 6mU/l (OR 8.71, 95% CI 6.21-12.20). There are strong variations in treatment strategies for elderly patients with subclinical hypothyroidism across different Swiss regions, including use of higher starting doses than the recommended 25 µg in the Swiss guidelines, which recommend a starting dose of 25 µg. These variations likely reflect the current uncertainty about the benefits of treatment, which arise from the current lack of evidence from adequately powered clinical trials.

  13. Influence of post-treatment strategies on the properties of activated chars from broiler manure.

    Science.gov (United States)

    Lima, Isabel M; Boykin, Debbie L; Thomas Klasson, K; Uchimiya, Minori

    2014-01-01

    There are a myriad of carbonaceous precursors that can be used advantageously to produce activated carbons or chars, due to their low cost, availability and intrinsic properties. Because of the nature of the raw material, production of granular activated chars from broiler manure results in a significant ash fraction. This study was conducted to determine the influence of several pre- and post-treatment strategies in various physicochemical and adsorptive properties of the resulting activated chars. Pelletized samples of broiler litter and cake were pyrolyzed at 700 °C for 1h followed by a 45 min steam activation at 800 °C at different water flow rates from 1 to 5 mL min(-1). For each activation strategy, samples were either water-rinsed or acid-washed and rinsed or used as is (no acid wash/rinse). Activated char's physicochemical and adsorptive properties towards copper ions were selectively affected by both pre- and post-treatments. Percent ash reduction after either rinsing or acid washing ranged from 1.1 to 15.1% but washed activated chars were still alkaline with pH ranging from 8.4 to 9.1. Acid washing or water rinsing had no significant effect in the ability of the activated char to adsorb copper ions, however it significantly affected surface area, pH, ash content and carbon content. Instead, manure type (litter versus cake) and the activation water flow rate were determining factors in copper ion adsorption which ranged from 38 mg g(-1) to 104 mg g(-1) of activated char. Moreover, strong positive correlations were found between copper uptake and concentration of certain elements in the activated char such as phosphorous, sulfur, calcium and sodium. Rinsing could suffice as a post treatment strategy for ash reduction since no significant differences in the carbon properties were observed between rinsed and acid wash treatments. Published by Elsevier Ltd.

  14. Commissioning and first clinical application of mARC treatment

    International Nuclear Information System (INIS)

    Dzierma, Yvonne; Nuesken, Frank G.; Kremp, Stephanie; Palm, Jan; Licht, Norbert P.; Ruebe, Christian

    2014-01-01

    The modulated arc (mARC) technique has recently been introduced for Siemens ARTISTE linear accelerators. We present the first experiences with the commissioning of the system and first patient treatments. Treatment planning and delivery are presented for the Prowess Panther treatment planning system or, alternatively, an in-house code. Dosimetric verification is performed both by point dose measurements and in 3D dose distribution. Depending on the target volume, one or two arcs can be used to create highly conformal plans. Dosimetric verification of the converted mARC plans with step-and-shoot plans shows deviations below 1 % in absolute point dose; in the 3D dose distribution, over 95 % of the points pass the 3D gamma criteria (3 % deviation in local dose and 3 mm distance to agreement for doses > 20 % of the maximum). Patient specific verification of the mARC dose distribution with the calculations has a similar pass rate. Treatment times range between 2 and 5 min for a single arc. To our knowledge, this is the first report of clinical application of the mARC technique. The mARC offers the possibility to save significant amounts of time, with single-arc treatments of only a few minutes achieving comparable dose distribution to IMRT plans taking up to twice as long. (orig.) [de

  15. Application of Ozone MBBR Process in Refinery Wastewater Treatment

    Science.gov (United States)

    Lin, Wang

    2018-01-01

    Moving Bed Biofilm Reactor (MBBR) is a kind of sewage treatment technology based on fluidized bed. At the same time, it can also be regarded as an efficient new reactor between active sludge method and the biological membrane method. The application of ozone MBBR process in refinery wastewater treatment is mainly studied. The key point is to design the ozone +MBBR combined process based on MBBR process. The ozone +MBBR process is used to analyze the treatment of concentrated water COD discharged from the refinery wastewater treatment plant. The experimental results show that the average removal rate of COD is 46.0%~67.3% in the treatment of reverse osmosis concentrated water by ozone MBBR process, and the effluent can meet the relevant standard requirements. Compared with the traditional process, the ozone MBBR process is more flexible. The investment of this process is mainly ozone generator, blower and so on. The prices of these items are relatively inexpensive, and these costs can be offset by the excess investment in traditional activated sludge processes. At the same time, ozone MBBR process has obvious advantages in water quality, stability and other aspects.

  16. PRACTICAL APPLICATION OF EXCLUSIVE AND INCLUSIVE TALENT MANAGEMENT STRATEGY IN COMPANIES

    Directory of Open Access Journals (Sweden)

    Asta Savanevičienė

    2017-12-01

    Full Text Available The article deals with the practical application of exclusive and inclusive talent management strategies in order to form and maintain a competitive human resource potential of the company. The features of both exclusive and inclusive talent management strategies were defined and their practical appication in companies of various Lithuaniam industries was studied. The input from the respondents suggests that major companies prefer the inclusive talent management strategy, rather than exclusive. Summing up all the research results, the following conclusions were formulated: the features characteristic to inclusive talent management strategy dominate in the companies of manufacturing, banking, catering, consulting, trade, energy, transport, and agribusiness industries. In the company of technology industry, features of a mixed (having both exclusive and inclusive talent management strategy are apparent. The company in the construction-engineering industry has the dominating features of exclusive talent management strategy. Inclusive talent management strategy responds to the principles of human potential development-oriented expression and is an important message for the formulation of further insight into talent management, based on the use of internal potential.

  17. Treatment strategy for primary lung cancer in patients over 80 years old

    International Nuclear Information System (INIS)

    Kobashi, Yoshihiro; Yagi, Shinichi; Yoshida, Kouichirou; Miyashita, Naoyuki; Niki, Yoshihito; Matsushima, Toshiharu; Okimoto, Niro

    2003-01-01

    In order to establish the treatment strategies for primary lung cancer patients over 80 years old, we retrospectively analyzed the treatment methods and outcome of 174 patients admitted to our hospital from April 1987 to March 2002. A total of 174 patients were classified into stage I (n=25), stage II (n=7), stage III (n=64) and stage IV (n=78). Although the general condition and nutritional condition of patients over 80 years were comparatively poorer than all patients with primary lung cancer, there was no significant difference. In total, 73 patients were treated with surgical resection (13 patients), radiation (35 patients), chemotherapy (15 patients), and chemo-radiation (10 patients). Although the surgical treatment group predominantly included patients at stage I, there were no significant differences in general or nutritional condition, pulmonary function or arterial blood gas among the four treatment groups. The outcome of surgically treated patients was significantly better (p<0.05), whereas there were no significant differences among the other three groups or between the treated group and untreated groups. Only surgical treatment was evaluated to improve the prognosis of primary lung cancer patients over 80 years when respiratory function was adequate for surgical treatment. (author)

  18. Exploring Diversification as A Management Strategy in Substance Use Disorder Treatment Organizations.

    Science.gov (United States)

    Fields, Dail; Riesenmy, Kelly; Roman, Paul M

    2015-10-01

    Implementation of the Affordable Care Act (ACA) creates both environmental uncertainties and opportunities for substance use disorder (SUD) treatment providers. One managerial response to uncertainties and emergent opportunities is strategic diversification of various dimensions of organizational activity. This paper explored organizational outcomes related to diversification of funding sources, services offered, and referral sources in a national sample of 590 SUD treatment organizations. Funding diversification was related to higher average levels of census, organization size, and recent expansion of operations. Service diversification was related to higher average levels of use of medication-assisted treatment (MAT), organization size, and expansion. Referral source diversification was related only to greater average use of MAT. Overall, strategic diversification in the three areas explored was related to positive organizational outcomes. Considering alternative strategies of diversification may help position SUD treatment centers to deliver more innovative treatments such as MAT as well as enhance capacity to satisfy current unmet treatment needs of individuals with behavioral health coverage provided under the ACA. Copyright © 2015 Elsevier Inc. All rights reserved.

  19. SU-F-T-212: A Comparison of Treatment Strategies for Intracranial Stereotactic Radiosurgery

    International Nuclear Information System (INIS)

    Lamberton, T; Slater, J; Wroe, A

    2016-01-01

    Purpose: Stereotactic radiosurgery is an effective and noninvasive treatment for intracranial lesions that uses highly focused radiation beams in a single treatment fraction. The purpose of this study is to investigate the dosimetric differences between the treatment brain metastasis with a proton beam vs. intensity modulated radiation therapy (IMRT). Methods: Ten separate brain metastasis targets where chosen and treatment plans were created for each, using three different strategies: custom proton beam shaping devices, standardized proton beam shaping devices, and IMRT. Each plan was required to satisfy set parameters for providing adequate coverage and minimizing risk to adjacent tissues. The effectiveness of each plan was calculated by comparing the homogeneity index, conformity index, and V12 for each target using a paired one tailed T-test (α=0.05). Specific comparison of the conformity indices was also made using a subcategory containing targets with volume>1cc. Results: There was no significant difference between the homogeneity indices of the three plans (p>0.05), showing that each plan has the capability of adequately covering the targets. There was a statistically significant difference (p 1cc) there was no statistical difference between the proton plans and the IMRT treatment for the conformity index. Conclusion: A custom proton plan is the recommended treatment explored in this study as it is the most reliable way of effectively treating the target while sparing the maximum amount of normal tissue.

  20. The impact of real life treatment strategies for Candida peritonitis-A retrospective analysis.

    Science.gov (United States)

    Dubler, S; Laun, M; Koch, C; Hecker, A; Weiterer, S; Siegler, B H; Röhrig, R; Weigand, M A; Lichtenstern, C

    2017-07-01

    Candida species are commonly detected isolates from abdominal foci. The question remains as to who would benefit from early empiric treatment in cases of Candida peritonitis. This study collected real-life data on critically ill patients with Candida peritonitis to estimate the relevance of the chosen treatment strategy on the outcome of these patients. One hundred and thirty-seven surgical intensive care unit (ICU) patients with intra-abdominal invasive Candidiasis were included in the study. Fifty-six patients did not get any antifungal agent. Twenty-nine patients were empirically treated, and 52 patients were specifically treated. In the group without, with empiric and with specific antifungal treatment, the 30-day mortality rate was 33.9, 48.3 and 44.2 respectively. Candida albicans was the most frequently found species. Seven patients in the specific treatment group and one patient in the empiric treatment group emerged with candidaemia. Age, leucocyte count, APACHE II Score and acute liver failure were independent predictors of 30-day mortality in patients with Candida peritonitis. Not all patients with Candida peritonitis received antifungal treatment in real clinical practice. Patients with higher morbidity more often got antifungals. Early empirical therapy has not been associated with a better 30-day mortality. © 2017 Blackwell Verlag GmbH.

  1. Therapeutic strategy for the treatment of isolated spontaneous dissection of superior mesenteric arteries

    International Nuclear Information System (INIS)

    Xu Yongle; Xiong Jiang; Guo Wei; Liu Xiaoping; Liu Meng

    2010-01-01

    Objective: To summarize the treatment strategies of isolated superior mesenteric artery (SMA) dissection and to discuss the selection of therapeutic methods. Methods: The clinical data of ten patients, who were encountered during the period from Jan. 2007 to Feb. 2010 in General Hospital of Chinese PLA and diagnosed as isolated SMA dissection,were retrospectively analyzed. According to the presence or absence of intestinal ischemic necrosis and SMA rupture, the patients were divided into simple group (n = 9) and complicated group(n = 1). The treatments for different type of SMA dissection were discussed and the results and prognosis were analyzed. Results: Nine patients were divided into simple group and received conservative treatment, of which anticoagulation was not employed in 5. One patient was divided into complicated group and had to receive an iliomesenteric bypass surgery after the patient had failed to respond to conservative treatment. After the treatment the abdominal pain was relieved in all ten patients. Conclusion: With the wide use of computer tomography angiography and digital subtraction angiography, more and more isolated SMA dissections have been confirmed. For most patients with SMA dissection, especially for simple ones (i.e. without bowel ischemia or SMA rupture), excellent short-term results can be achieved by pure conservative treatment, even no anticoagulation needed. However, for the complicated isolated SMA dissections, vascular reconstruction procedure with various techniques, including open surgery, is necessary in order to obtain satisfactory short-term results. (authors)

  2. Neurotransmitter-based strategies for the treatment of cognitive dysfunction in Down syndrome.

    Science.gov (United States)

    Das, Devsmita; Phillips, Cristy; Hsieh, Wayne; Sumanth, Krithika; Dang, Van; Salehi, Ahmad

    2014-10-03

    Down syndrome (DS) is a multisystem disorder affecting the cardiovascular, respiratory, gastrointestinal, neurological, hematopoietic, and musculoskeletal systems and is characterized by significant cognitive disability and a possible common pathogenic mechanism with Alzheimer's disease. During the last decade, numerous studies have supported the notion that the triplication of specific genes on human chromosome 21 plays a significant role in cognitive dysfunction in DS. Here we reviewed studies in trisomic mouse models and humans, including children and adults with DS. In order to identify groups of genes that contribute to cognitive disability in DS, multiple mouse models of DS with segmental trisomy have been generated. Over-expression of these particular genes in DS can lead to dysfunction of several neurotransmitter systems. Therapeutic strategies for DS have either focused on normalizing the expression of triplicated genes with important roles in DS or restoring the function of these systems. Indeed, our extensive review of studies on the pathogenesis of DS suggests that one plausible strategy for the treatment of cognitive dysfunction is to target the cholinergic, serotonergic, GABA-ergic, glutamatergic, and norepinephrinergic system. However, a fundamental strategy for treatment of cognitive dysfunction in DS would include reducing to normal levels the expression of specific triplicated genes in affected systems before the onset of neurodegeneration. Published by Elsevier Inc.

  3. Biological prevention and/or treatment strategies for radiation myelopathy. Discussion of a new perspective

    International Nuclear Information System (INIS)

    Nieder, C.; Ataman, F.; Price, R.E.; Kian Ang, K.

    1999-01-01

    Background: Radiosensitivity of the spinal cord makes both curative first-line treatment of numerous malignancies and re-irradiation of recurrent or second tumors more difficult. This review discusses recent advances in basic research that alter the view on the pathogenesis of radiation myelopathy, possibly offering strategies for prevention and/or therapy. Results: Available data of developmental neurobiology and preclinical studies of demyelinating diseases revealed interesting insights into oligodendrocyte development, intercellular signaling pathways, and myelination processes. Current findings suggest that administration of cytokines could increase proliferation of oligodendrocyte progenitor cells, enhance their differentiation, upregulate synthesis of myelin constituents, and promote myelin regeneration in the adult central nervous system. Other compounds might also be able to modulate progression of pathogenic processes that eventually lead to radiation myelopathy. This offers several possible biological prevention and/or treatment strategies, which currently are being investigated in animal studies. Conclusions: Technical options as well as optimization of fractionation parameters should be given priority in the attempt to reduce iatrogenic neurotoxicity. However, rational biological strategies could offer a new perspective for many patients. (orig.) [de

  4. The Charles F. Prentice Award Lecture 2010: A Case for Peripheral Optical Treatment Strategies for Myopia

    Science.gov (United States)

    Smith, Earl L.

    2011-01-01

    It is well established that refractive development is regulated by visual feedback. However, most optical treatment strategies designed to reduce myopia progression have not produced the desired results, primarily because some of our assumptions concerning the operating characteristics of the vision-dependent mechanisms that regulate refractive development have been incorrect. In particular, because of the prominence of central vision in primates, it has generally been assumed that signals from the fovea determine the effects of vision on refractive development. However, experiments in laboratory animals demonstrate that ocular growth and emmetropization are mediated by local retinal mechanisms and that foveal vision is not essential for many vision-dependent aspects of refractive development. On the other hand, the peripheral retina, in isolation, can effectively regulate emmetropization and mediate many of the effects of vision on the eye’s refractive status. Moreover, when there are conflicting visual signals between the fovea and the periphery, peripheral vision can dominate refractive development. The overall pattern of results suggests that optical treatment strategies for myopia that take into account the effects of peripheral vision are likely to be more successful than strategies that effectively manipulate only central vision. PMID:21747306

  5. Adaptive Treatment Strategies in Youth Mental Health: A Commentary on Advantages, Challenges, and Potential Directions.

    Science.gov (United States)

    Sherrill, Joel T

    2016-01-01

    This commentary underscores the importance and potential of the research approaches and intervention strategies described in the JCCAP special issue on the Science of Adaptive Treatment Strategies in Child and Adolescent Mental Health for addressing the widely observed heterogeneity in response to even our most promising research-informed interventions. First, the commentary briefly summarizes the advantages of these approaches and highlights how these programs of research are responsive to widely agreed-upon calls for more personalized, prescriptive interventions. Next, the commentary briefly discusses key common challenges and gaps in our knowledge that might be addressed to advance the development, testing, and implementation of adaptive intervention strategies. For example, research to identify robust moderators that might serve as potential tailoring variables for initial assignment and sequencing of interventions, efforts to operationalize surrogate endpoints for early identification of individuals who are unlikely to respond to first-line interventions, and research that helps define what constitutes an adequate exposure (i.e., dose) or response threshold (e.g., response that suggests the need to intensify, switch, or augment interventions) would inform decision rules for adaptive algorithms. The commentary concludes with a discussion of potential strategies and current initiatives that might ultimately help facilitate research on more targeted, prescriptive approaches to intervening, including efforts to encourage investigators to use common data elements, to share and integrate data across trials, and to employ a more mechanism-based approach to intervention development and testing.

  6. Developing strategies for thermal treatment technology R and D in MIREC

    International Nuclear Information System (INIS)

    Muhd Noor Muhd Yunus

    2004-01-01

    The degree of the solid waste management problem in Malaysia is very crucial, needing immediate solutions. The estimated amount of MSW generated is 16,000 ton/day with the initial cost of the entire activity is estimated to worth RM35 billions. However, Malaysia is still negotiating for the best strategies to manage her MSW in the best manner - politically, economically and environmentally. A National Solid Waste Strategic Plan has been established, advocating and adopting the Integrated Solid Waste Management System (IWMS). However, choosing the right mix of the waste management hierarchy is not simple. The 3-R concept with an effective and consistent role by the society at large is still not well taken up despite of various efforts taken by the government. The role of biological treatment such as composting and bio-gasification (AD), is slowly gaining momentum, however, needed much more effort and understanding when applied to local waste and market conditions. The vigor to introduce the-state-of-the-art thermal treatment process has been done as early as in 2000, but the project has faced a severe set back with regard to public acceptance, lingering around the dioxin issues, and the resulting political consequences caused delays in implementation. Finally, there seems to be a more practical and sensible solution nationally to build more Sanitary Landfills (SLF) in various states and municipalities due to economic reasons as well as for final disposal of waste. It is therefore seen that the Mechanical / 3 -R and Biological Treatment (MBT) methods play a better role as a pretreatment process prior to landfills, environmentally speaking. In case the economics does not permit the above practice, direct land filling of the MSW should entails with the Land Fill Gas (LFG) extraction and utilization. Despite of the general trends to import foreign technologies to circumvent the unavailability of local solutions, the needs for local input cannot be denied. Hence, the R

  7. Application of Traditional Chinese Medicine in Treatment of Atrial Fibrillation

    Directory of Open Access Journals (Sweden)

    Yan Dong

    2017-01-01

    Full Text Available Atrial fibrillation (AF is the most common cardiac arrhythmia, which is related to many cardiac and cerebral vascular diseases, especially stroke. It can therefore increase cardiovascular mortality and all-cause death. The current treatments of AF remain to be western drugs and radiofrequency ablation which are limited by the tolerance of patients, adverse side effects, and high recurrence rate, especially for the elderly. On the contrary, traditional Chinese medicine (TCM with long history of use involves various treatment methods, including Chinese herbal medicines (CHMs or bioactive ingredients, Chinese patent medicines, acupuncture, Qigong, and Tai Chi Chuan. With more and more researches reported, the active roles of TCM in AF management have been discovered. Then it is likely that TCM would be effective preventive means and valuable additional remedy for AF. The potential mechanisms further found by numerous experimental studies showed the distinct characteristics of TCM. Some CHMs or bioactive ingredients are atrial-selective, while others are multichannel and multifunctional. Therefore, in this review we summarized the treatment strategies reported in TCM, with the purpose of providing novel ideas and directions for AF management.

  8. Application of microorganisms in concrete: a promising sustainable strategy to improve concrete durability.

    Science.gov (United States)

    Wang, Jianyun; Ersan, Yusuf Cagatay; Boon, Nico; De Belie, Nele

    2016-04-01

    The beneficial effect of microbially induced carbonate precipitation on building materials has been gradually disclosed in the last decade. After the first applications of on historical stones, promising results were obtained with the respect of improved durability. An extensive study then followed on the application of this environmentally friendly and compatible material on a currently widely used construction material, concrete. This review is focused on the discussion of the impact of the two main applications, bacterial surface treatment and bacteria based crack repair, on concrete durability. Special attention was paid to the choice of suitable bacteria and the metabolic pathway aiming at their functionality in concrete environment. Interactions between bacterial cells and cementitious matrix were also elaborated. Furthermore, recommendations to improve the effectiveness of bacterial treatment are provided. Limitations of current studies, updated applications and future application perspectives are shortly outlined.

  9. The strategy of the treatment for arteriovenous malformations by gamma knife radiosurgery

    International Nuclear Information System (INIS)

    Fukuoka, Seiji; Seo, Yoshinobu; Hyougo, Toshio; Sasaki, Takehiko; Toshima, Masahiko; Takeda, Rihei; Nakamura, Junichi; Suematu, Katsumi.

    1992-01-01

    Successful gamma knife radiosurgery depends on the volume of nidus of cerebral arteriovenous malformations (AVMs). Because of lower possibility of obliteration of large AVMs treated by gamma knife radiosurgery, embolization therapies were carried out in 10 cases out of 50 AVMs to reduce the volume of nidus before gamma knife radiosurgery. The strategy is as follows: 1) when the volume of nidus is less than 5 ml, gamma knife radiosurgery is selected as the first treatment; 2) when the procedure seems to be safely performed; 3) when the volume of nidus is over 10 ml, embolization should be tried in all cases. In this strategy, it is essential to evaluate the accurate volume of nidus before gamma knife radiosurgery to decide whether embolization should be carried out or not. Angiography with painless fixation of Leksell frame was thought to be best procedure to measure the accurate volume of nidus before gamma knife radiosurgery. (author)

  10. Control and decision strategies in wastewater treatment plants for operation improvement

    CERN Document Server

    Santín, Ignacio; Vilanova, Ramón

    2017-01-01

    This book examines the operation of biological wastewater treatment plants (WWTPs), with a focus on maintaining effluent water quality while keeping operational costs within constrained limits. It includes control operation and decision schemes and is based on the use of benchmarking scenarios that yield easily reproducible results that readers can implement for their own solutions. The final criterion is the effect of the applied control strategy on plant performance – specifically, improving effluent quality, reducing costs and avoiding violations of established effluent limits. The evaluation of the different control strategies is achieved with the help of two Benchmark Simulation Models (BSM1, BSM2). Given the complexity of the biological and biochemical processes involved and the major fluctuations in the influent flow rate, controlling WWTPs poses a serious challenge. Further, the importance of control goal formulation and control structure design in relation to WWTP process control is widely recogniz...

  11. The cardiometabolic effect of current management of polycystic ovary syndrome: strategies of prevention and treatment.

    Science.gov (United States)

    Baldani, Dinka Pavicic; Skrgatic, Lana; Ougouag, Roya; Kasum, Miro

    2018-02-01

    Polycystic ovary syndrome (PCOS) is the commonest endocrine disorder amongst women of reproductive age, which is characterized by reproductive and cardiometabolic disturbances with long-term health repercussions. Insulin resistance (IR), impaired glucose tolerance, type 2 diabetes mellitus (DM2), obesity and dyslipidemia occur more in women with PCOS than in age-comparable women without PCOS. Long term data regarding risks or benefits of medical intervention for metabolic dysfunction of PCOS are lacking. Therapies, such as oral contraceptives (OCPs) and anti-androgenic medications used to manage the reproductive manifestations of PCOS, may themselves be the cause of cardiometabolic perturbations. Hence, strategies regarding the management of reproductive issues in PCOS encompass a patient-specific tailored approach. Factors that influence the cardiometabolic side effects arising during treatment of the reproductive manifestations of PCOS (hirsutism/anovulation) are also discussed in this paper in order to build future strategies to minimize the overall cardiometabolic risk.

  12. Pharmacologic strategies in the prevention and treatment of corneal transplant rejection.

    Science.gov (United States)

    Tabbara, Khalid F

    2008-06-01

    Corneal transplantation remains one of the most successful organ transplantation procedures in humans. The unique structure of the cornea, with its absence of blood vessels and corneal lymphatic, allows the survival of corneal allograft. Recent advances in sutures, storage media, microsurgical instrumentation, and new pharmacological strategies have greatly improved the success of corneal transplantation and the prevention of corneal allograft rejection. Our strategies in the management and prevention of corneal graft rejection can modify and improve the survival of corneal allografts. Preoperative evaluation, understanding the risk factors, and management of ocular surface disorders may greatly improve the survival of the corneal transplant. Early recognition of corneal allograft rejection and aggressive treatment may improve the survival of the corneal graft. Furthermore, patients who undergo corneal transplantation should be maintained under close ophthalmic surveillance and patients should be informed to report immediately whenever symptoms of corneal graft rejection occur. The mainstay of therapy is topical corticosteroids. In severe cases, periocular, intravenous, and oral corticosteroids therapy can be rendered. New therapeutic modalities such as cyclosporine, tacrolimus, daclizumab, mycophenolate mofetil, leflunomide, rapamycin, and others may prove to be of help in the prevention and treatment of corneal graft rejection. Early recognition of corneal graft rejection and prompt treatment are mandatory for the successful survival of the corneal allograft.

  13. A comprehensive review on pre-treatment strategy for lignocellulosic food industry waste: Challenges and opportunities.

    Science.gov (United States)

    Ravindran, Rajeev; Jaiswal, Amit Kumar

    2016-01-01

    Lignocellulose is a generic term used to describe plant biomass. It is the most abundant renewable carbon resource in the world and is mainly composed of lignin, cellulose and hemicelluloses. Most of the food and food processing industry waste are lignocellulosic in nature with a global estimate of up to 1.3 billion tons/year. Lignocellulose, on hydrolysis, releases reducing sugars which is used for the production of bioethanol, biogas, organic acids, enzymes and biosorbents. However, structural conformation, high lignin content and crystalline cellulose hinder its use for value addition. Pre-treatment strategies facilitate the exposure of more cellulose and hemicelluloses for enzymatic hydrolysis. The present article confers about the structure of lignocellulose and how it influences enzymatic degradation emphasising the need for pre-treatments along with a comprehensive analysis and categorisation of the same. Finally, this article concludes with a detailed discussion on microbial/enzymatic inhibitors that arise post pre-treatment and strategies to eliminate them. Copyright © 2015 Elsevier Ltd. All rights reserved.

  14. Management of acute basilar artery occlusion: should any treatment strategy prevail?

    Science.gov (United States)

    Dornak, Tomas; Herzig, Roman; Sanak, Daniel; Skoloudik, David

    2014-12-01

    Acute basilar artery occlusion (BAO) is relatively infrequent form of acute ischemic stroke associated with severe and persisting neurological deficit and high mortality rate (to 86%). Early recanalization is essential for good clinical outcome but the most effective treatment approach remains unestablished. Several treatment strategies are currently available but their safety and efficacy have only been tested in retrospective/prospective case series. Randomized controlled trials (RCTs) are lacking. We searched the PubMed database for assessments of recanalization rate and clinical outcome in BAO patients treated with various treatment methods. The results show that antithrombotics are least effective while specific reperfusion therapies including intravenous thrombolysis (IVT) and various types of intra-arterial therapy (IAT) are more so. Less than half of BAO patients reach independent outcome following IVT with a recanalization rate 52-78%. Even though IAT recanalizes BAO more frequently (in up to 100%), the higher recanalization rate is not necessarily associated with better outcome. Good clinical outcome is strongly dependent on recanalization time. Thus, the concept of bridging therapy, combining widely available IVT with IAT, was introduced and is usually considered a rescue strategy in non-responders to IV alteplase. A trend to better outcome in patients treated with bridging therapy in some studies, has to be confirmed by large RCTs.

  15. Final report on LDRD project : coupling strategies for multi-physics applications.

    Energy Technology Data Exchange (ETDEWEB)

    Hopkins, Matthew Morgan; Moffat, Harry K.; Carnes, Brian; Hooper, Russell Warren; Pawlowski, Roger P.

    2007-11-01

    Many current and future modeling applications at Sandia including ASC milestones will critically depend on the simultaneous solution of vastly different physical phenomena. Issues due to code coupling are often not addressed, understood, or even recognized. The objectives of the LDRD has been both in theory and in code development. We will show that we have provided a fundamental analysis of coupling, i.e., when strong coupling vs. a successive substitution strategy is needed. We have enabled the implementation of tighter coupling strategies through additions to the NOX and Sierra code suites to make coupling strategies available now. We have leveraged existing functionality to do this. Specifically, we have built into NOX the capability to handle fully coupled simulations from multiple codes, and we have also built into NOX the capability to handle Jacobi Free Newton Krylov simulations that link multiple applications. We show how this capability may be accessed from within the Sierra Framework as well as from outside of Sierra. The critical impact from this LDRD is that we have shown how and have delivered strategies for enabling strong Newton-based coupling while respecting the modularity of existing codes. This will facilitate the use of these codes in a coupled manner to solve multi-physic applications.

  16. Nanomedicine for Infectious Disease Applications: Innovation towards Broad-Spectrum Treatment of Viral Infections.

    Science.gov (United States)

    Jackman, Joshua A; Lee, Jaywon; Cho, Nam-Joon

    2016-03-02

    Nanomedicine enables unique diagnostic and therapeutic capabilities to tackle problems in clinical medicine. As multifunctional agents with programmable properties, nanomedicines are poised to revolutionize treatment strategies. This promise is especially evident for infectious disease applications, for which the continual emergence, re-emergence, and evolution of pathogens has proven difficult to counter by conventional approaches. Herein, a conceptual framework is presented that envisions possible routes for the development of nanomedicines as superior broad-spectrum antiviral agents against enveloped viruses. With lipid membranes playing a critical role in the life cycle of medically important enveloped viruses including HIV, influenza, and Ebola, cellular and viral membrane interfaces are ideal elements to incorporate into broad-spectrum antiviral strategies. Examples are presented that demonstrate how nanomedicine strategies inspired by lipid membranes enable a wide range of targeting opportunities to gain control of critical stages in the virus life cycle through either direct or indirect approaches involving membrane interfaces. The capabilities can be realized by enabling new inhibitory functions or improving the function of existing drugs through nanotechnology-enabled solutions. With these exciting opportunities, due attention is also given to the clinical translation of nanomedicines for infectious disease applications, especially as pharmaceutical drug-discovery pipelines demand new routes of innovation. © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  17. Cost-Effectiveness of Competing Treatment Strategies for Clostridium difficile Infection: A Systematic Review.

    Science.gov (United States)

    Le, Phuc; Nghiem, Van T; Mullen, Patricia Dolan; Deshpande, Abhishek

    2018-04-01

    BACKGROUND Clostridium difficile infection (CDI) presents a substantial economic burden and is associated with significant morbidity. While multiple treatment strategies have been evaluated, a cost-effective management strategy remains unclear. OBJECTIVE We conducted a systematic review to assess cost-effectiveness analyses of CDI treatment and to summarize key issues for clinicians and policy makers to consider. METHODS We searched PubMed and 5 other databases from inception to August 2016. These searches were not limited by study design or language of publication. Two reviewers independently screened the literature, abstracted data, and assessed methodological quality using the Drummond and Jefferson checklist. We extracted data on study characteristics, type of CDI, treatment characteristics, and model structure and inputs. RESULTS We included 14 studies, and 13 of these were from high-income countries. More than 90% of these studies were deemed moderate-to-high or high quality. Overall, 6 studies used a decision-tree model and 7 studies used a Markov model. Cost of therapy, time horizon, treatment cure rates, and recurrence rates were common influential factors in the study results. For initial CDI, fidaxomicin was a more cost-effective therapy than metronidazole or vancomycin in 2 of 3 studies. For severe initial CDI, 2 of 3 studies found fidaxomicin to be the most cost-effective therapy. For recurrent CDI, fidaxomicin was cost-effective in 3 of 5 studies, while fecal microbiota transplantation (FMT) by colonoscopy was consistently cost-effective in 4 of 4 studies. CONCLUSIONS The cost-effectiveness of fidaxomicin compared with other pharmacologic therapies was not definitive for either initial or recurrent CDI. Despite its high cost, FMT by colonoscopy may be a cost-effective therapy for recurrent CDI. A consensus on model design and assumptions are necessary for future comparison of CDI treatment. Infect Control Hosp Epidemiol 2018;39:412-424.

  18. Decentralized approaches to wastewater treatment and management: applicability in developing countries.

    Science.gov (United States)

    Massoud, May A; Tarhini, Akram; Nasr, Joumana A

    2009-01-01

    Providing reliable and affordable wastewater treatment in rural areas is a challenge in many parts of the world, particularly in developing countries. The problems and limitations of the centralized approaches for wastewater treatment are progressively surfacing. Centralized wastewater collection and treatment systems are costly to build and operate, especially in areas with low population densities and dispersed households. Developing countries lack both the funding to construct centralized facilities and the technical expertise to manage and operate them. Alternatively, the decentralized approach for wastewater treatment which employs a combination of onsite and/or cluster systems is gaining more attention. Such an approach allows for flexibility in management, and simple as well as complex technologies are available. The decentralized system is not only a long-term solution for small communities but is more reliable and cost effective. This paper presents a review of the various decentralized approaches to wastewater treatment and management. A discussion as to their applicability in developing countries, primarily in rural areas, and challenges faced is emphasized all through the paper. While there are many impediments and challenges towards wastewater management in developing countries, these can be overcome by suitable planning and policy implementation. Understanding the receiving environment is crucial for technology selection and should be accomplished by conducting a comprehensive site evaluation process. Centralized management of the decentralized wastewater treatment systems is essential to ensure they are inspected and maintained regularly. Management strategies should be site specific accounting for social, cultural, environmental and economic conditions in the target area.

  19. Applicability and trends of anaerobic granular sludge treatment processes

    International Nuclear Information System (INIS)

    Lim, Seung Joo; Kim, Tak-Hyun

    2014-01-01

    Anaerobic granular sludge treatment processes have been continuously developed, although the anaerobic sludge granulation process was not clearly understood. In this review, an upflow anaerobic sludge blanket (UASB), an expanded granule sludge blanket (EGSB), and a static granular bed reactor (SGBR) were introduced as components of a representative anaerobic granular sludge treatment processes. The characteristics and application trends of each reactor were presented. The UASB reactor was developed in the late 1970s and its use has been rapidly widespread due to the excellent performance. With the active granules, this reactor is able to treat various high-strength wastewaters as well as municipal wastewater. Most soluble industrial wastewaters can be efficiently applied using a UASB. The EGSB reactor was developed owing to give more chance to contact between wastewater and the granules. Dispersed sludge is separated from mature granules using the rapid upward velocity in this reactor. The EGSB reactor shows the excellent performance in treating low-strength and/or high-strength wastewater, especially under low temperatures. The SGBR, developed at Iowa State University, is one of anaerobic granular sludge treatment processes. Although the configuration of the SGBR is very simple, the performance of this system is similar to that of the UASB or EGSB reactor. The anaerobic sludge granulation processes showed excellent performance for various wastewaters at a broad range of organic loading rate in lab-, pilot-scale tests. This leads to erect thousands of full-scale granular processes, which has been widely operated around the world. -- Highlights: • Anaerobic sludge granulation is a key parameter for maintaining granular processes. • Anaerobic granular digestion processes are applicable for various wastewaters. • The UASB is an economic high-rate anaerobic granular process. • The EGSB can treat high-strength wastewater using expanding granules. • The SGBR is

  20. Advancements and applications of plasma arc centrifugal treatment

    International Nuclear Information System (INIS)

    Eschenbach, R.C.; Leland, L.B.; Chen, W.M.

    1997-01-01

    A process using a transferred arc plasma to heat material charged into a spinning tube inside a sealed, water-cooled container has been applied to radioactive and hazardous waste treatment in several countries. Inorganic material in the feed is melted into a leach-resistant slag, while organic material is vaporized and reacted to form carbon dioxide and water vapor. Any acid gases formed plus particulates are removed in a gas cleanup system. Design features and their relations to design objectives are described. Current and near-future applications are reported for treating nuclear power plant wastes and for remediating contamination from past nuclear weapons activities

  1. Application of nanotechnology in cancers prevention, early detection and treatment.

    Science.gov (United States)

    Patel, Shraddha P; Patel, Parshottambhai B; Parekh, Bhavesh B

    2014-01-01

    Use of nanotechnology in medical science is a rapidly developing area. New opportunities of diagnosis, imaging and therapy have developed due to recent rapid advancement by nanotechnology. The most common areas to be affected are diagnostic, imaging and targeted drug delivery in gastroenterology, oncology, cardiovascular medicine, obstetrics and gynecology. Mass screening with inexpensive imaging might be possible in the near future with the help of nanotechnology. This review paper provides an overview of causes of cancer and the application of nanotechnology in cancer prevention, detection and treatment.

  2. Damage control strategy for the treatment of perforated diverticulitis with generalized peritonitis.

    Science.gov (United States)

    Sohn, M; Agha, A; Heitland, W; Gundling, F; Steiner, P; Iesalnieks, I

    2016-08-01

    The best surgical strategy for the management of perforated diverticulitis with generalized peritonitis of the sigmoid colon is not clearly defined. The aim of this retrospective cohort study was to evaluate the value of a damage control strategy. All patients who underwent emergency laparotomy for perforated diverticular disease of the sigmoid colon with generalized peritonitis between 2010 and 2015 were included. The damage control strategy (study group), included a two- stage procedure: limited resection of the diseased colonic segment, closure of proximal colon and distal stump, and application of an abdominal vacuum at the initial surgery followed by second-look laparotomy 24-48 h later At this point a choice was made between anastomosis and Hartmann's procedure. The control group consisted of patients receiving definitive reconstruction (anastomosis or Hartmann's procedure) at the initial operation. Thirty-seven patients were included in the study. Damage control strategy was applied in 19 patients and the control group consisted of 18 patients. Both groups were comparable in terms of demographics, severity of peritonitis, and comorbidities. The overall postoperative mortality was 11 % (n = 4). There were no statistically significant differences between both groups regarding postoperative morbidity and mortality; however, a significantly higher proportion of patients in the control group had a stoma after the initial hospital stay (83 vs. 47 %, p = 0.038). This difference was still significant after adjustment for sex, age, Mannheim Peritonitis Index, American Society of Anesthesiologists class and presence of septic shock at presentation. At the end of the follow-up period, 15 of 17 survivors in the study group and 13 of 16 survivors in the control group had their intestinal continuity restored (p = 0.66). Damage control strategy in patients with generalized peritonitis due to perforated diverticulitis leads to a significantly reduced stoma rate

  3. Antibiotic susceptibility, heteroresistance, and updated treatment strategies in Helicobacter pylori infection.

    Science.gov (United States)

    Mascellino, Maria Teresa; Porowska, Barbara; De Angelis, Massimiliano; Oliva, Alessandra

    2017-01-01

    In this review, we discuss the problem of antibiotic resistance, heteroresistance, the utility of cultures and antibiotic susceptibility tests in Helicobacter pylori ( Hp ) eradication, as well as the updated treatment strategies for this infection. The prevalence of antibiotic resistance is increasing all over the world, especially for metronidazole and clarithromycin, because of their heavy use in some geographical areas. Heteroresistance (simultaneous presence of both susceptible and resistant strains in different sites of a single stomach) is another important issue, as an isolate could be mistakenly considered susceptible if a single biopsy is used for antimicrobial tests. We also examined literature data regarding eradication success rates of culture-guided and empiric therapies. The empiric therapy and the one based on susceptibility testing, in Hp eradication, may depend on several factors such as concomitant diseases, the number of previous antibiotic treatments, differences in bacterial virulence in individuals with positive or negative cultures, together with local antibiotic resistance patterns in real-world settings. Updated treatment strategies in Hp infection presented in the guidelines of the Toronto Consensus Group (2016) are reported. These suggest to prolong eradication therapy up to 14 days, replacing the old triple therapy with a quadruple therapy based on proton pump inhibitor (PPI), bismuth, metronidazole, and tetracycline for most of the patients, or as an alternative quadruple therapy without bismuth, based on the use of PPI, amoxicillin, metronidazole, and clarithromycin. The new drug vonoprazan, a first-in-class potassium-competitive acid blocker recently approved in Japan, is also considered to be a promising solution for Hp eradication, even for clarithromycin-resistant strains. Furthermore, there is growing interest in finding new therapeutic strategies, such as the development of vaccines or the use of natural resources, including

  4. Regenerative medicine provides alternative strategies for the treatment of anal incontinence.

    Science.gov (United States)

    Gräs, Søren; Tolstrup, Cæcilie Krogsgaard; Lose, Gunnar

    2017-03-01

    Anal incontinence is a common disorder but current treatment modalities are not ideal and the development of new treatments is needed. The aim of this review was to identify the existing knowledge of regenerative medicine strategies in the form of cellular therapies or bioengineering as a treatment for anal incontinence caused by anal sphincter defects. PubMed was searched for preclinical and clinical studies in English published from January 2005 to January 2016. Animal studies have demonstrated that cellular therapy in the form of local injections of culture-expanded skeletal myogenic cells stimulates repair of both acute and 2 - 4-week-old anal sphincter injuries. The results from a small clinical trial with ten patients and a case report support the preclinical findings. Animal studies have also demonstrated that local injections of mesenchymal stem cells stimulate repair of sphincter injuries, and a complex bioengineering strategy for creation and implantation of an intrinsically innervated internal anal sphincter construct has been successfully developed in a series of animal studies. Cellular therapies with myogenic cells and mesenchymal stem cells and the use of bioengineering technology to create an anal sphincter are new potential strategies to treat anal incontinence caused by anal sphincter defects, but the clinical evidence is extremely limited. The use of culture-expanded autologous skeletal myogenic cells has been most intensively investigated and several clinical trials were ongoing at the time of this report. The cost-effectiveness of such a therapy is an issue and muscle fragmentation is suggested as a simple alternative.

  5. Intracranial aneurysms: optimized diagnostic tools call for thorough interdisciplinary treatment strategies.

    Science.gov (United States)

    Mueller, Oliver M; Schlamann, Marc; Mueller, Daniela; Sandalcioglu, I Erol; Forsting, Michael; Sure, Ulrich

    2011-09-01

    Intracranial aneurysms (IAs) require deliberately selected treatment strategies as they are incrementally found prior to rupture and deleterious subarachnoid haemorrhage (SAH). Multiple and recurrent aneurysms necessitate both neurointerventionalists and neurosurgeons to optimize aneurysmal occlusion in an interdisciplinary effort. The present study was conducted to condense essential strategies from a single neurovascular centre with regard to the lessons learned. Medical charts of 321 consecutive patients treated for IAs at our centre from September 2008 until December 2010 were retrospectively analysed for clinical presentation of the aneurysms, multiplicity and treatment pathways. In addition, a selective Medline search was performed. A total of 321 patients with 492 aneurysms underwent occlusion of their symptomatic aneurysm: 132 (41.1%) individuals were treated surgically, 189 (58.2%) interventionally; 138 patients presented with a SAH, of these 44.2% were clipped and 55.8% were coiled. Aneurysms of the middle cerebral artery were primarily occluded surgically (88), whereas most of the aneurysms of the internal carotid artery and anterior communicating artery (114) were treated endovascularly. Multiple aneurysms (range 2-5 aneurysms/individual) were diagnosed in 98 patients (30.2%). During the study period 12 patients with recurrent aneurysms were allocated to another treatment modality (previously clip to coil and vice versa). Our data show that successful interdisciplinary occlusion of IAs is based on both neurosurgical and neurointerventional therapy. In particular, multiple and recurrent aneurysms require tailored individual approaches to aneurysmal occlusion. This is achieved by a consequent interdisciplinary pondering of the optimal strategy to occlude IAs in order to prevent SAH.

  6. [Treatment Strategy and Results of Carotid Endarterectomy in Chronic Renal Failure Patients].

    Science.gov (United States)

    Murahashi, Takeo; Kamiyama, Kenji; Osato, Toshiaki; Watanabe, Toshiichi; Ogino, Tatsuya; Sugio, Hironori; Endo, Hideki; Takahira, Kazuki; Shindo, Koichiro; Takahashi, Shuhei; Nakamura, Hirohiko

    2017-02-01

    The number of patients receiving chronic dialysis treatment in Japan currently exceeds 300,000 people. Few reports have described carotid endarterectomy(CEA)for chronic renal failure patients because of the unacceptable rate of perioperative stroke and other morbidities. A strategy for and treatment results of CEA for chronic renal failure patients in our hospital are described herein. The present study included 6 patients who underwent CEA while receiving dialysis treatment between April 2011 and November 2014. Dialysis treatment was initiated due to diabetes in 4 patients and renal sclerosis in 2 patients. All the patients were men, with a mean age of 74.0 years. Two patients were symptomatic, and four were asymptomatic. In all the patients, heart vascular lesions and arteriosclerosis risk factors were present. Postoperatively, pneumonia transient cranial neuropathy, heart failure, and pneumonia in 1 case required extensive treatment. However, by the time of discharge from hospital, no cases had deteriorated compared with their pre-CEA state. The modified Rankin scale score on discharge was 0-2 for all the patients. CEA can be performed safely in patients receiving dialysis, but further operative procedures and careful postoperative management are likely to be needed for patients with CEA who are receiving dialysis.

  7. Vesicants and nerve agents in chemical warfare. Decontamination and treatment strategies for a changed world.

    Science.gov (United States)

    Devereaux, Asha; Amundson, Dennis E; Parrish, J S; Lazarus, Angeline A

    2002-10-01

    Vesicants and nerve agents have been used in chemical warfare for ages. They remain a threat in today's altered political climate because they are relatively simple to produce, transport, and deploy. Vesicants, such as mustard and lewisite, can affect the skin, eyes, respiratory system, and gastrointestinal system. They leave affected persons at risk for long-term effects. Nerve agents, such as tabun, sarin, soman, and VX, hyperstimulate the muscarinic and nicotinic receptors of the nervous system. Physicians need to familiarize themselves with the clinical findings of such exposures and the decontamination and treatment strategies necessary to minimize injuries and deaths.

  8. The Application of Microencapsulation Techniques in the Treatment of Endodontic and Periodontal Diseases

    Directory of Open Access Journals (Sweden)

    José Blanco Méndez

    2011-08-01

    Full Text Available In the treatment of intracanal and periodontal infections, the local application of antibiotics and other therapeutic agents in the root canal or in periodontal pockets may be a promising approach to achieve sustained drug release, high antimicrobial activity and low systemic side effects. Microparticles made from biodegradable polymers have been reported to be an effective means of delivering antibacterial drugs in endodontic and periodontal therapy. The aim of this review article is to assess recent therapeutic strategies in which biocompatible microparticles are used for effective management of periodontal and endodontic diseases. In vitro and in vivo studies that have investigated the biocompatibility or efficacy of certain microparticle formulations and devices are presented. Future directions in the application of microencapsulation techniques in endodontic and periodontal therapies are discussed.

  9. Modeling economic implications of alternative treatment strategies for acute bacterial skin and skin structure infections.

    Science.gov (United States)

    Revankar, Nikhil; Ward, Alexandra J; Pelligra, Christopher G; Kongnakorn, Thitima; Fan, Weihong; LaPensee, Kenneth T

    2014-10-01

    The economic implications from the US Medicare perspective of adopting alternative treatment strategies for acute bacterial skin and skin structure infections (ABSSSIs) are substantial. The objective of this study is to describe a modeling framework that explores the impact of decisions related to both the location of care and switching to different antibiotics at discharge. A discrete event simulation (DES) was developed to model the treatment pathway of each patient through various locations (emergency department [ED], inpatient, and outpatient) and the treatments prescribed (empiric antibiotic, switching to a different antibiotic at discharge, or a second antibiotic). Costs are reported in 2012 USD. The mean number of days on antibiotic in a cohort assigned to a full course of vancomycin was 11.2 days, with 64% of the treatment course being administered in the outpatient setting. Mean total costs per patient were $8671, with inpatient care accounting for 58% of the costs accrued. The majority of outpatient costs were associated with parenteral administration rather than drug acquisition or monitoring. Scenarios modifying the treatment pathway to increase the proportion of patients receiving the first dose in the ED, and then managing them in the outpatient setting or prescribing an oral antibiotic at discharge to avoid the cost associated with administering parenteral therapy, therefore have a major impact and lower the typical cost per patient by 11-20%. Since vancomycin is commonly used as empiric therapy in clinical practice, based on these analyses, a shift in treatment practice could result in substantial savings from the Medicare perspective. The choice of antibiotic and location of care influence the costs and resource use associated with the management of ABSSSIs. The DES framework presented here can provide insight into the potential economic implications of decisions that modify the treatment pathway.

  10. Kleptomania after head trauma: two case reports and combination treatment strategies.

    Science.gov (United States)

    Aizer, Anat; Lowengrub, Katherine; Dannon, Pinhas N

    2004-01-01

    The purpose of this paper is to add to the growing number of reports about kleptomania occurring in relation to brain injury as well as to present the authors' findings regarding treatment strategies. The authors present two case reports of patients who developed the new onset of kleptomania after closed head trauma. Both patients had comorbid psychiatric symptoms associated with the kleptomania. Antidepressant monotherapy was not beneficial in reducing kleptomania in either patient. Kleptomanic behavior was successfully treated in both patients, however, through combination treatment using an antidepressant agent together with adjunctive cognitive behavioral therapy or adjunctive naltrexone. In one patient, single photon emission tomography showed a perfusion deficit in the left temporal lobe. Various hypotheses regarding this finding and the etiopathology of kleptomania are discussed. Review of current work in the field suggests that kleptomania is a heterogeneous disorder that shares features of both impulse and addiction disorders as well as affective spectrum disorders.

  11. New strategies for the treatment of undifferentiated thyroid cancer and poorly differentiated thyroid cancer

    International Nuclear Information System (INIS)

    Juvenal, Guillermo J.

    2006-01-01

    Undifferentiated thyroid cancer, which accounts for about 5-10% of thyroid cancer cases, is a very aggressive tumor with no effective treatment, since it lacks iodine uptake and does not respond to radio or chemotherapy. The prognosis of these patients is bad, due to the rapid growth of the tumor and the early development of metastasis. Oncogenes and tumor suppressor genes are involved in the genetic changes that underlie thyroid cancer, as all kinds of tumors. The characterization of these proteins is being exploited to delineate new therapeutic strategies for the treatment of this cancer. This work is focused on those compounds or therapeutic approaches that are being used in clinical essays or in animal models. (author) [es

  12. [Selection of access and positioning for operative treatment of pelvic injuries. Decision-making strategies].

    Science.gov (United States)

    Ossendorf, C; Hofmann, A; Rommens, P M

    2013-03-01

    Surgical treatment of pelvic ring injuries requires in-depth knowledge of the topographic anatomy of the pelvic bones, joints and soft tissue structures. A wide range of stabilizing techniques is available including bridging plate osteosynthesis, iliosacral compression screw osteosynthesis and transpubic positioning screws. In this article the different treatment strategies with the respective surgical approaches and patient positioning for pelvic ring fractures and combined lesions of the pelvic ring and acetabulum are presented. Pelvic ring lesions with rotational instability are approached from the anterior and occasionally from both the anterior and posterior based on the amount and localization of the instability. In vertically unstable lesions the most unstable part must be addressed first by reduction and fixation of the dislocated part to the axial skeleton. In combined fractures of the pelvis and acetabulum dorsal stabilization is carried out first.

  13. A Current Review of the Diagnostic and Treatment Strategies of Hepatic Encephalopathy

    Directory of Open Access Journals (Sweden)

    Z. Poh

    2012-01-01

    Full Text Available Hepatic encephalopathy (HE is a serious and potentially fatal complication in patients with cirrhotic liver disease. It is a spectrum ranging from minimal hepatic encephalopathy (MHE without recognizable clinical symptoms or signs, to overt HE with risk of cerebral edema and death. HE results in diminished quality of life and survival. The broad range of neuropsychiatric manifestations reflects the range of pathophysiological mechanisms and impairment in neurotransmission that are purported to cause HE including hyperammonemia, astrocyte swelling, intra-astrocytic glutamine, upregulation of 18-kDa translocator protein (TSPO (formerly known as peripheral benzodiazepine receptor or PBTR, and manganese. There is a myriad of diagnostic tools including simple bedside clinical assessment, and more complex neuropsychological batteries and neurophysiological tests available today. Current treatment strategies are directed at reducing ammonia, with newer agents showing some early promise. This paper describes the pathophysiology of the disease and summarises current diagnostic and treatment therapies available.

  14. Novel Strategies in the Prevention and Treatment of Urinary Tract Infections

    Science.gov (United States)

    Lüthje, Petra; Brauner, Annelie

    2016-01-01

    Urinary tract infections are one of the most common bacterial infections, especially in women and children, frequently treated with antibiotics. The alarming increase in antibiotic resistance is a global threat to future treatment of infections. Therefore, alternative strategies are urgently needed. The innate immune system plays a fundamental role in protecting the urinary tract from infections. Antimicrobial peptides form an important part of the innate immunity. They are produced by epithelial cells and neutrophils and defend the urinary tract against invading bacteria. Since efficient resistance mechanisms have not evolved among bacterial pathogens, much effort has been put into exploring the role of antimicrobial peptides and possibilities to utilize them in clinical practice. Here, we describe the impact of antimicrobial peptides in the urinary tract and ways to enhance the production by hormones like vitamin D and estrogen. We also discuss the potential of medicinal herbs to be used in the prophylaxis and the treatment of urinary tract infections. PMID:26828523

  15. Epigenetics application in the diagnosis and treatment of bladder cancer.

    Science.gov (United States)

    Harb-de la Rosa, Alfredo; Acker, Matthew; Kumar, Raj A; Manoharan, Murugesan

    2015-10-01

    Bladder cancer is the sixth most common cancer in the Western world. Patients with bladder cancer require close monitoring, which may include frequent cystoscopy and urine cytology. Such monitoring results in significant health care cost. The application of epigenetics may allow for a risk adapted approach and more cost-effective method of monitoring. A number of epigenetic changes have been described for many cancer sites, including the urinary bladder. In this review, we discuss the use of epigenetics in bladder cancer and the potential diagnostic and therapeutic applications. A comprehensive search of the English medical literature was conducted in PubMed using the terms microRNA regulation, DNA methylation, histone modification and bladder cancer. The most important epigenetic changes include DNA methylation, histone modification and microRNA regulation. Both DNA hypomethylation and hypermethylation have been associated with higher rate of cancer. The association of epigenetic changes with bladder cancer has led to the research of its diagnostic and prognostic implications as well as to the development of novel drugs to target these changes with the aim of achieving a survival benefit. Recently, epigenetics has been shown to play a much greater role than previously anticipated in the initiation and propagation of many tumors. The use of epigenetics for the diagnosis and treatment of bladder cancer is an evolving and promising field. The possibility of reversing epigenetic changes may facilitate additional cancer treatment options in the future.

  16. Implant strategies for endocervical and interstitial ultrasound hyperthermia adjunct to HDR brachytherapy for the treatment of cervical cancer

    Science.gov (United States)

    Wootton, Jeffery H.; Prakash, Punit; Hsu, I.-Chow Joe; Diederich, Chris J.

    2011-07-01

    Catheter-based ultrasound devices provide a method to deliver 3D conformable heating integrated with HDR brachytherapy delivery. Theoretical characterization of heating patterns was performed to identify implant strategies for these devices which can best be used to apply hyperthermia to cervical cancer. A constrained optimization-based hyperthermia treatment planning platform was used for the analysis. The proportion of tissue >=41 °C in a hyperthermia treatment volume was maximized with constraints Tmax 200 cm3) is possible using multiple sectored interstitial and endocervical ultrasound devices. The endocervical device can heat >41 °C to 4.6 cm diameter compared to 3.6 cm for the interstitial. Sectored applicators afford tight control of heating that is robust to perfusion changes in most regularly spaced configurations. T90 in example patient cases was 40.5-42.7 °C (1.9-39.6 EM43 °C) at 1 kg m-3 s-1 with 10/14 patients >=41 °C. Guidelines are presented for positioning of implant catheters during the initial surgery, selection of ultrasound applicator configurations, and tailored power schemes for achieving T90 >= 41 °C in clinically practical implant configurations. Catheter-based ultrasound devices, when adhering to the guidelines, show potential to generate conformal therapeutic heating ranging from a single endocervical device targeting small volumes local to the cervix (directional interstitial applicators in the lateral periphery to target much larger volumes (6 cm radial), while preferentially limiting heating of the bladder and rectum.

  17. Application of poultry processing industry waste: a strategy for vegetation growth in degraded soil.

    Science.gov (United States)

    do Nascimento, Carla Danielle Vasconcelos; Pontes Filho, Roberto Albuquerque; Artur, Adriana Guirado; Costa, Mirian Cristina Gomes

    2015-02-01

    The disposal of poultry processing industry waste into the environment without proper care, can cause contamination. Agricultural monitored application is an alternative for disposal, considering its high amount of organic matter and its potential as a soil fertilizer. This study aimed to evaluate the potential of poultry processing industry waste to improve the conditions of a degraded soil from a desertification hotspot, contributing to leguminous tree seedlings growth. The study was carried out under greenhouse conditions in a randomized blocks design and a 4 × 2 factorial scheme with five replicates. The treatments featured four amounts of poultry processing industry waste (D1 = control 0 kg ha(-1); D2 = 1020.41 kg ha(-1); D3 = 2040.82 kg ha(-1); D4 = 4081.63 kg ha(-1)) and two leguminous tree species (Mimosa caesalpiniaefolia Benth and Leucaena leucocephala (Lam.) de Wit). The poultry processing industry waste was composed of poultry blood, grease, excrements and substances from the digestive system. Plant height, biomass production, plant nutrient accumulation and soil organic carbon were measured forty days after waste application. Leguminous tree seedlings growth was increased by waste amounts, especially M. caesalpiniaefolia Benth, with height increment of 29.5 cm for the waste amount of 1625 kg ha(-1), and L. leucocephala (Lam.) de Wit, with maximum height increment of 20 cm for the waste amount of 3814.3 kg ha(-1). M. caesalpiniaefolia Benth had greater initial growth, as well as greater biomass and nutrient accumulation compared with L. leucocephala (Lam.) de Wit. However, belowground biomass was similar between the evaluated species, resulting in higher root/shoot ratio for L. leucocephala (Lam.) de Wit. Soil organic carbon did not show significant response to waste amounts, but it did to leguminous tree seedlings growth, especially L. leucocephala (Lam.) de Wit. Poultry processing industry waste contributes to leguminous tree seedlings growth

  18. THE APPLICATION OF FORESIGHT PROJECTS IN FORMATION OF TECHNOLOGICAL COMPANIES’ INNOVATION DEVELOPMENT STRATEGY

    Directory of Open Access Journals (Sweden)

    M. E. Zolotareva

    2016-01-01

    Full Text Available In the article is considered the possibility of application of methodology of foresight to the formation of strategy of innovative development of technological companies. The application of existing approaches to defining targets and goals of innovation development does not meet the requirements of the nonlinearity of the modern processes of technological companies’ innovation development.The goals and objectives. The purpose of this article is to study the possibilities of application of methods of foresight in forming of technological companies’ innovation development strategy. To achieve the goal, the author has solved the following problems: considered the interrelationship and interdependence between corporate strategy and technological companies’ innovation development strategy; defined the main problems of formation technological companies’ innovation development strategies; revealed the concept of "foresight" and diff erence in methodology of foresight and traditional forecasting techniques; defined the basic principles of foresight; presents the main stages of the foresight project implementation in technological companies.Research methods. The theoretical basis of the study are the publications of Russian and foreign scientists in the field of formation and development of innovation strategies through the application of foresight methods at the level of national innovation system and at company level. As a methodological basis of the study used methods of analysis, synthesis, induction method, deduction method, the comparison, was applied certain aspects of the synergetic analysis.Summary. The results of Russian and foreign researchers systematized by author confirm the possibility and necessity foresight projects implementation in formation and adjustment of technological companies’ innovation development strategies and in the national innovation system development. The principles of engagement of various social forces

  19. DEA-BASED INVESTMENT STRATEGY AND ITS APPLICATION IN THE CROATIAN STOCK MARKET

    Directory of Open Access Journals (Sweden)

    Margareta Gardijan

    2012-12-01

    Full Text Available This paper describes the DEA-based investment strategy for constructing of a stock portfolio in the Croatian stock market. The relative efficiency of the DMUs, which are in this case the selected stocks from Zagreb Stock Exchange, is obtained from the output oriented CCR and BCC models. The set of inputs consists of risk measures, namely return variance, Value at Risk (VaR and beta coefficient $(\\beta$, while monthly return represents an output. Following the „efficiency scores“, obtained from the models, we construct a portfolio of DEA-efficient stocks (DEA-portfolio. This portfolio can be modified over time according to changes of the DMU's efficiency scores. By comparing the returns of the EA-portfolio and the market return during the given time period, the applicability of the investment strategy based on a DEA methodology, as a strategy for achieving superior returns, is estimated.

  20. Fate of dispersed marine fuel oil in sediment under pre-spill application strategy

    International Nuclear Information System (INIS)

    Jian Hua

    2004-01-01

    A comparison of the movement of dispersed oil in marine sediment under two dispersant application scenarios, applied prior to and after oil being spilled overboard, was examined. The pre-spill application scenario caused much less oil to be retained in the top sediment than post-spill scenario. The difference in oil retention in the top sediment between pre- and post-spill application scenario increased with increase in fuel oil temperature. For fuel oil above 40 o C, the difference in the effect of pre-spill application strategy under various water temperatures was negligible. When soap water was used as replacement for chemical dispersant, almost one-half as much oil was retained in the top sediment as that when using chemical dispersant. The adsorption of dispersed oil to the top sediment was almost proportionally decreased with doubling of soap dosage. (Author)

  1. The '333' integrated strategy for effective pollution control and its application to the heavily polluted Jialu River in north China.

    Science.gov (United States)

    Huang, Yu; Sun, Jie; Li, Aimin; Xie, Xianchuan

    2018-05-01

    In this study, an integrated approach named the '333' strategy was applied to pollution control in the Jialu River, in northern China, which is heavily burdened with anthropogenic pollution. Due to a deficiency of the natural ecological inflow, the Jialu River receives predominantly industrial and municipal effluent. The '333' strategy is composed of three steps of pollution control including industrial point-source pollution control, advanced treatment of municipal wastewater, and ecological restoration; three increased stringency emission standards; and three stages of reclamation. Phase 1 of the '333' strategy focuses on industrial point-source pollution control; phase 2 aims to harness municipal wastewater and minimize sewage effluents using novel techniques for advanced water purification; phase 3 of the '333' strategy focuses on the further purification of effluents flowing into Jialu River with the employment of an engineering-based ecological restoration project. The application of the '333' strategy resulted in the development of novel techniques for water purification including modified magnetic resins (NDMP resin), a two-stage internal circulation anaerobic reactor (IC reactor) and an ecological restoration system. The results indicate that water quality in the river was significantly improved, with increased concentrations of dissolved oxygen (DO), as well as reduction of COD by 42.8% and NH 3 -N by 61.4%. In addition, it was observed that the total population of phytoplankton in treated river water notably increased from only one prior to restoration to 8 following restoration. This system also provides a tool for pollution control of other similar industrial and anthropogenic source polluted rivers.

  2. Antipsychotic treatment, psychoeducation & regular follow up as a public health strategy for schizophrenia: Results from a prospective study

    Directory of Open Access Journals (Sweden)

    Channaveerachari Naveen Kumar

    2017-01-01

    Interpretation & conclusions: Treatment with antipsychotics and psychoeducation can favourably influence the course of schizophrenia and reduce disability in a substantial proportion of patients. Structured psychosocial interventions may be indicated in the significant minority who show suboptimal outcome with this strategy.

  3. Biomarker-based strategy for early discontinuation of empirical antifungal treatment in critically ill patients: a randomized controlled trial.

    Science.gov (United States)

    Rouzé, Anahita; Loridant, Séverine; Poissy, Julien; Dervaux, Benoit; Sendid, Boualem; Cornu, Marjorie; Nseir, Saad

    2017-11-01

    The aim of this study was to determine the impact of a biomarker-based strategy on early discontinuation of empirical antifungal treatment. Prospective randomized controlled single-center unblinded study, performed in a mixed ICU. A total of 110 patients were randomly assigned to a strategy in which empirical antifungal treatment duration was determined by (1,3)-β-D-glucan, mannan, and anti-mannan serum assays, performed on day 0 and day 4; or to a routine care strategy, based on international guidelines, which recommend 14 days of treatment. In the biomarker group, early stop recommendation was determined using an algorithm based on the results of biomarkers. The primary outcome was the percentage of survivors discontinuing empirical antifungal treatment early, defined as a discontinuation strictly before day 7. A total of 109 patients were analyzed (one patient withdraw consent). Empirical antifungal treatment was discontinued early in 29 out of 54 patients in the biomarker strategy group, compared with one patient out of 55 in the routine strategy group [54% vs 2%, p strategy compared with routine strategy [median (IQR) 6 (4-13) vs 13 (12-14) days, p strategy increased the percentage of early discontinuation of empirical antifungal treatment among critically ill patients with suspected invasive Candida infection. These results confirm previous findings suggesting that early discontinuation of empirical antifungal treatment had no negative impact on outcome. However, further studies are needed to confirm the safety of this strategy. This trial was registered at ClinicalTrials.gov, NCT02154178.

  4. Statistical analysis with measurement error or misclassification strategy, method and application

    CERN Document Server

    Yi, Grace Y

    2017-01-01

    This monograph on measurement error and misclassification covers a broad range of problems and emphasizes unique features in modeling and analyzing problems arising from medical research and epidemiological studies. Many measurement error and misclassification problems have been addressed in various fields over the years as well as with a wide spectrum of data, including event history data (such as survival data and recurrent event data), correlated data (such as longitudinal data and clustered data), multi-state event data, and data arising from case-control studies. Statistical Analysis with Measurement Error or Misclassification: Strategy, Method and Application brings together assorted methods in a single text and provides an update of recent developments for a variety of settings. Measurement error effects and strategies of handling mismeasurement for different models are closely examined in combination with applications to specific problems. Readers with diverse backgrounds and objectives can utilize th...

  5. Encapsulation Strategies of Bacteriophage (Felix O1) for Oral Therapeutic Application.

    Science.gov (United States)

    Islam, Golam S; Wang, Qi; Sabour, Parviz M

    2018-01-01

    Due to emerging antibiotic-resistant strains among the pathogens, a variety of strategies, including therapeutic application of bacteriophages, have been suggested as a possible alternative to antibiotics in food animal production. As pathogen-specific biocontrol agents, bacteriophages are being studied intensively. Primarily their applications in the food industry and animal production have been recognized in the USA and Europe, for pathogens including Salmonella, Campylobacter, Escherichia coli, and Listeria. However, the viability of orally administered phage may rapidly reduce under the harsh acidic conditions of the stomach, presence of enzymes and bile. It is evident that bacteriophages, intended for phage therapy by oral administration, require efficient protection from the acidic environment of the stomach and should remain active in the animal's gastrointestinal tract where pathogen colonizes. Encapsulation of phages by spray drying or extrusion methods can protect phages from the simulated hostile gut conditions and help controlled release of phages to the digestive system when appropriate formulation strategy is implemented.

  6. Recent progress on magnetic iron oxide nanoparticles: synthesis, surface functional strategies and biomedical applications

    Science.gov (United States)

    Wu, Wei; Wu, Zhaohui; Yu, Taekyung; Jiang, Changzhong; Kim, Woo-Sik

    2015-01-01

    This review focuses on the recent development and various strategies in the preparation, microstructure, and magnetic properties of bare and surface functionalized iron oxide nanoparticles (IONPs); their corresponding biological application was also discussed. In order to implement the practical in vivo or in vitro applications, the IONPs must have combined properties of high magnetic saturation, stability, biocompatibility, and interactive functions at the surface. Moreover, the surface of IONPs could be modified by organic materials or inorganic materials, such as polymers, biomolecules, silica, metals, etc. The new functionalized strategies, problems and major challenges, along with the current directions for the synthesis, surface functionalization and bioapplication of IONPs, are considered. Finally, some future trends and the prospects in these research areas are also discussed. PMID:27877761

  7. TU-G-210-00: Treatment Planning Strategies, Modeling, Control

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2015-06-15

    Modeling can play a vital role in predicting, optimizing and analyzing the results of therapeutic ultrasound treatments. Simulating the propagating acoustic beam in various targeted regions of the body allows for the prediction of the resulting power deposition and temperature profiles. In this session we will apply various modeling approaches to breast, abdominal organ and brain treatments. Of particular interest is the effectiveness of procedures for correcting for phase aberrations caused by intervening irregular tissues, such as the skull in transcranial applications or inhomogeneous breast tissues. Also described are methods to compensate for motion in targeted abdominal organs such as the liver or kidney. Douglas Christensen – Modeling for Breast and Brain HIFU Treatment Planning Tobias Preusser – TRANS-FUSIMO – An Integrative Approach to Model-Based Treatment Planning of Liver FUS Tobias Preusser – TRANS-FUSIMO – An Integrative Approach to Model-Based Treatment Planning of Liver FUS Learning Objectives: Understand the role of acoustic beam modeling for predicting the effectiveness of therapeutic ultrasound treatments. Apply acoustic modeling to specific breast, liver, kidney and transcranial anatomies. Determine how to obtain appropriate acoustic modeling parameters from clinical images. Understand the separate role of absorption and scattering in energy delivery to tissues. See how organ motion can be compensated for in ultrasound therapies. Compare simulated data with clinical temperature measurements in transcranial applications. Supported by NIH R01 HL172787 and R01 EB013433 (DC); EU Seventh Framework Programme (FP7/2007-2013) under 270186 (FUSIMO) and 611889 (TRANS-FUSIMO)(TP); and P01 CA159992, GE, FUSF and InSightec (UV)

  8. TU-G-210-00: Treatment Planning Strategies, Modeling, Control

    International Nuclear Information System (INIS)

    2015-01-01

    Modeling can play a vital role in predicting, optimizing and analyzing the results of therapeutic ultrasound treatments. Simulating the propagating acoustic beam in various targeted regions of the body allows for the prediction of the resulting power deposition and temperature profiles. In this session we will apply various modeling approaches to breast, abdominal organ and brain treatments. Of particular interest is the effectiveness of procedures for correcting for phase aberrations caused by intervening irregular tissues, such as the skull in transcranial applications or inhomogeneous breast tissues. Also described are methods to compensate for motion in targeted abdominal organs such as the liver or kidney. Douglas Christensen – Modeling for Breast and Brain HIFU Treatment Planning Tobias Preusser – TRANS-FUSIMO – An Integrative Approach to Model-Based Treatment Planning of Liver FUS Tobias Preusser – TRANS-FUSIMO – An Integrative Approach to Model-Based Treatment Planning of Liver FUS Learning Objectives: Understand the role of acoustic beam modeling for predicting the effectiveness of therapeutic ultrasound treatments. Apply acoustic modeling to specific breast, liver, kidney and transcranial anatomies. Determine how to obtain appropriate acoustic modeling parameters from clinical images. Understand the separate role of absorption and scattering in energy delivery to tissues. See how organ motion can be compensated for in ultrasound therapies. Compare simulated data with clinical temperature measurements in transcranial applications. Supported by NIH R01 HL172787 and R01 EB013433 (DC); EU Seventh Framework Programme (FP7/2007-2013) under 270186 (FUSIMO) and 611889 (TRANS-FUSIMO)(TP); and P01 CA159992, GE, FUSF and InSightec (UV)

  9. A strategy for the application of steam explosion codes to reactor analysis

    International Nuclear Information System (INIS)

    Moriyama, Kiyofumi; Nakamura, Hideo

    2006-01-01

    A technical view on the strategy for the application of steam explosion codes for plant scale analysis is described. It includes assumption of triggering at the time of peak premixed melt mass, tuning of the explosion model on typical alumina steam explosion data, consideration of void and solidification effects as primary mechanism to limit the premixed mass and explosion energetics, choice of simple heat partition models affecting evaporation. The view was developed through experiences in development, verification and application of a steam explosion simulation code, JASMINE, at Japan Atomic Energy Agency (JAEA), as well as participation in OECD SERENA Phase-1 program. (author)

  10. Strategies of bringing drug product marketing applications to meet current regulatory standards.

    Science.gov (United States)

    Wu, Yan; Freed, Anita; Lavrich, David; Raghavachari, Ramesh; Huynh-Ba, Kim; Shah, Ketan; Alasandro, Mark

    2015-08-01

    In the past decade, many guidance documents have been issued through collaboration of global organizations and regulatory authorities. Most of these are applicable to new products, but there is a risk that currently marketed products will not meet the new compliance standards during audits and inspections while companies continue to make changes through the product life cycle for continuous improvement or market demands. This discussion presents different strategies to bringing drug product marketing applications to meet current and emerging standards. It also discusses stability and method designs to meet process validation and global development efforts.

  11. Targeting Bruton Tyrosine Kinase: A novel strategy in the treatment of B-cell lymphomas

    Directory of Open Access Journals (Sweden)

    Sklavenitis-Pistofidis R.

    2017-06-01

    Full Text Available In normal B-cells, Bruton tyrosine kinase (Btk, a non-receptor tyrosine kinase involved in B-cell receptor (BCR signalling, is essential for cell survival and maturation. Not surprisingly, Btk is also implicated in the pathogenesis of B-cell lymphomas, like Chronic Lymphocytic Leukaemia/Small Lymphocytic Lymphoma (CLL/SLL, Mantle Cell Lymphoma (MCL and Waldenström’s Macroglobulinemia (WM, which are driven by aberrant BCR signalling. Thus, targeting Btk represents a promising therapeutic strategy in the treatment of B-cell lymphoma patients. Ibrutinib, a selective Btk inhibitor, has already been approved as second-line treatment of CLL/SLL, MCL and WM patients, while more clinical studies of ibrutinib and novel Btk inhibitors are currently under way. In light of results of the RESONATE-2 trial, the approval of ibrutinib as a first-line treatment of CLL/SLL may well be approaching. Herein, we review Btk’s role in normal and malignant BCR signalling, as well as ibrutinib’s performance in B-cell lymphoma treatment and prognosis.

  12. Idiopathic Intracranial Hypertension After Surgical Treatment of Cushing Disease: Case Report and Review of Management Strategies.

    Science.gov (United States)

    Wagner, Jeffrey; Fleseriu, Cara M; Ibrahim, Aly; Cetas, Justin S

    2016-12-01

    Idiopathic intracranial hypertension (IIH) in patients with Cushing disease (CD), after treatment, is rarely described, in adults. The cause is believed to be multifactorial, potentially related to a relative decrease in cortisol after surgical resection or medical treatment of a corticotroph pituitary adenoma. We investigate our center's CD database (140 surgically and 60 medically [primary or adjunct] treated patients) for cases of IIH, describe our center's experience with symptomatic IIH, and review treatment strategies in adults with CD after transsphenoidal resection. We present the case of a 22-year-old woman who presented with worsening headache, nausea, vomiting, blurry vision, diplopia, visual loss, and facial numbness 14 weeks after surgical resection of adrenocorticotropic hormone-positive pituitary adenoma. Her CD had been in remission since surgery, with subsequent adrenal insufficiency (AI), which was initially treated with supraphysiologic glucocorticoid replacement, tapered down to physiologic doses at the time the IIH symptoms developed. Symptomatic IIH is rare in adult patients but can be severe and result in permanent vision loss. A high index of suspicion should be maintained and a fundus examination is necessary to exclude papilledema, whenever there are suggestive symptoms that initially may overlap with AI. It is possible that some cases of mild IIH are misdiagnosed as GC withdrawal or AI; however, further studies are needed. Treatment consists of reinitiation of higher steroid doses together with acetazolamide with or without cerebrospinal fluid diversion and the priority is to preserve vision and reverse any visual loss. Published by Elsevier Inc.

  13. New strategy for treatment of carcinoma of the hilar bile duct

    International Nuclear Information System (INIS)

    Koyama, K.; Tanaka, J.; Kato, S.; Asanuma, Y.

    1989-01-01

    Surgical treatment for carcinoma of the hilar bile duct has been a challenging problem, because the five year survival rate is less than 5 per cent and the mean survival period is 17 to 24 months even in curatively resected instances. The prognostic factors of carcinoma of the hilar bile duct are remnant carcinoma at the bile duct stump and cancerous invasion into the lymphatics, veins, perineural spaces around the intrahepatic bile duct and caudate lobe of the liver. Based on these data, a new strategy for treatment of carcinoma of the hilar bile duct has been developed and applied clinically. The strategy consists of three procedures. The first is resection of the hilar bile duct with portajejunostomy; the second, specific anticancer therapy with mitomycin C (4 milligrams) adsorbed to the activated charcoal (MMC-CH) focused on the invasion of carcinoma to the periductal lymphatics, and third, intracavitary irradiation (32 to 40 gray) by 60Co using the remote after loading system through the bile duct focused on the periductal infiltration of the carcinoma and through the inferior vena cava focused on the caudate lobe of the liver. In this article, the operative procedures and theoretic background of the specific chemotherapy and irradiation are described. Seven patients have been treated using this regimen. Follow-up study ranged from seven to 38 months. All patients are alive, and five of seven are disease-free

  14. Old treatments for new insights and strategies: proposed management in adults and children with alkaptonuria.

    Science.gov (United States)

    Arnoux, Jean-Baptiste; Le Quan Sang, Kim-Hanh; Brassier, Anais; Grisel, Coraline; Servais, Aude; Wippf, Julien; Dubois, Sandrine; Sireau, Nicolas; Job-Deslandre, Chantal; Ranganath, Lakshminarayan; de Lonlay, Pascale

    2015-09-01

    Alkaptonuria (AKU) is caused by deficiency of the enzyme homogentisate 1,2 dioxygenase. It results in an accumulation of homogentisate which oxidizes spontaneously to benzoquinone acetate, a highly oxidant compound, which polymerises to a melanin-like structure, in a process called ochronosis. Asymptomatic during childhood, this accumulation will lead from the second decade of life to a progressive and severe spondylo-arthopathy, associated with multisystem involvement: osteoporosis/fractures, stones (renal, prostatic, gall bladder, salivary glands), ruptures of tendons/muscle/ligaments, renal failure and aortic valve disease. The pathophysiological mechanisms of AKU remain poorly understood, but recent advances lead us to reconsider the treatment strategy in AKU patients. Besides the supporting therapies (pain killers, anti-inflammatory drugs, physiotherapy, joints replacements and others), specific therapies have been considered (anti-oxidant, low protein diet, nitisinone), but clinical studies have failed to prove efficiency on the rheumatological lesions of the disease. Here we propose a treatment strategy for children and adults with AKU, based on a review of the latest findings on AKU and lessons from other aminoacipathies, especially tyrosinemias.

  15. Using pilot data to size a two-arm randomized trial to find a nearly optimal personalized treatment strategy.

    Science.gov (United States)

    Laber, Eric B; Zhao, Ying-Qi; Regh, Todd; Davidian, Marie; Tsiatis, Anastasios; Stanford, Joseph B; Zeng, Donglin; Song, Rui; Kosorok, Michael R

    2016-04-15

    A personalized treatment strategy formalizes evidence-based treatment selection by mapping patient information to a recommended treatment. Personalized treatment strategies can produce better patient outcomes while reducing cost and treatment burden. Thus, among clinical and intervention scientists, there is a growing interest in conducting randomized clinical trials when one of the primary aims is estimation of a personalized treatment strategy. However, at present, there are no appropriate sample size formulae to assist in the design of such a trial. Furthermore, because the sampling distribution of the estimated outcome under an estimated optimal treatment strategy can be highly sensitive to small perturbations in the underlying generative model, sample size calculations based on standard (uncorrected) asymptotic approximations or computer simulations may not be reliable. We offer a simple and robust method for powering a single stage, two-armed randomized clinical trial when the primary aim is estimating the optimal single stage personalized treatment strategy. The proposed method is based on inverting a plugin projection confidence interval and is thereby regular and robust to small perturbations of the underlying generative model. The proposed method requires elicitation of two clinically meaningful parameters from clinical scientists and uses data from a small pilot study to estimate nuisance parameters, which are not easily elicited. The method performs well in simulated experiments and is illustrated using data from a pilot study of time to conception and fertility awareness. Copyright © 2015 John Wiley & Sons, Ltd.

  16. Evaluation of the implementation of the directly observed treatment strategy for tuberculosis in a large city.

    Science.gov (United States)

    Lavôr, Débora Cristina Brasil da Silva; Pinheiro, Jair Dos Santos; Gonçalves, Maria Jacirema Ferreira

    2016-04-01

    To assess the degree of implementation of the Directly Observed Treatment, Short-course - DOTS for tuberculosis (TB) in a large city. Assessment of the implementation of the logic model, whose new cases of infectious pulmonary TB were recruited from specialized clinics and followed-up in basic health units. The judgment matrix covering the five components of the DOTS strategy were used. The result of the logic model indicates DOTS was partially implemented. In external, organizational and implementation contexts, the DOTS strategy was partially implemented; and, the effectiveness was not implemented. The partial implementation of the DOTS strategy in the city of Manaus did not reflect in TB control compliance, leading to low effectiveness of the program. Avaliar o grau de implantação da estratégia de tratamento diretamente observado (Directly Observed Treatment, Short-course - DOTS) para tuberculose (TB) em um município de grande porte. Avaliação de implantação por meio de modelo lógico, cujos casos novos de TB pulmonar bacilífera foram recrutados em ambulatórios especializados e acompanhados nas unidades básicas de saúde. Utilizou-se matriz de julgamento que abrange os cinco componentes da estratégia DOTS. O resultado do modelo lógico indica DOTS implantada parcialmente. Nos contextos externo, organizacional e de implantação, a estratégia DOTS está implantada parcialmente; e, na efetividade não está implantada. A implantação parcial da estratégia DOTS, na cidade de Manaus, reflete na não conformidade do controle da TB, levando à baixa efetividade do programa.

  17. Rabies Control and Treatment: From Prophylaxis to Strategies with Curative Potential

    Science.gov (United States)

    Zhu, Shimao; Guo, Caiping

    2016-01-01

    Rabies is an acute, fatal, neurological disease that affects almost all kinds of mammals. Vaccination (using an inactivated rabies vaccine), combined with administration of rabies immune globulin, is the only approved, effective method for post-exposure prophylaxis against rabies in humans. In the search for novel rabies control and treatment strategies, live-attenuated viruses have recently emerged as a practical and promising approach for immunizing and controlling rabies. Unlike the conventional, inactivated rabies vaccine, live-attenuated viruses are genetically modified viruses that are able to replicate in an inoculated recipient without causing adverse effects, while still eliciting robust and effective immune responses against rabies virus infection. A number of viruses with an intrinsic capacity that could be used as putative candidates for live-attenuated rabies vaccine have been intensively evaluated for therapeutic purposes. Additional novel strategies, such as a monoclonal antibody-based approach, nucleic acid-based vaccines, or small interfering RNAs (siRNAs) interfering with virus replication, could further add to the arena of strategies to combat rabies. In this review, we highlight current advances in rabies therapy and discuss the role that they might have in the future of rabies treatment. Given the pronounced and complex impact of rabies on a patient, a combination of these novel modalities has the potential to achieve maximal anti-rabies efficacy, or may even have promising curative effects in the future. However, several hurdles regarding clinical safety considerations and public awareness should be overcome before these approaches can ultimately become clinically relevant therapies. PMID:27801824

  18. Facilitating Transfer of Skills and Strategies in Occupational Therapy Practice: Practical Application of Transfer Principles.

    Science.gov (United States)

    Babulal, Ganesh M; Foster, Erin R; Wolf, Timothy J

    2016-01-01

    In Occupational Therapy (OT) practice, practitioners assume that the skills and strategies taught to clients during rehabilitation will transfer to performance and participation in everyday life. Despite transfer serving as a practice foundation, outcome studies conclude that this assumption of transfer is not occurring and it often results in decreased efficacy of rehabilitation. This paper investigated key aspects of transfer and found concepts in the psychology literature that can support transfer of skills and strategies in OT. Six key principles proposed from educational psychology can serve as a guide for practitioners to better train for transfer. In this paper, we discuss the six principles and apply concepts from psychology. Each principle is supported with examples of how they may be incorporated OT practice. If occupational therapists understand these principles and implement them in treatment, the efficacy of treatment may improve for many populations.

  19. Fabrication strategies, sensing modes and analytical applications of ratiometric electrochemical biosensors.

    Science.gov (United States)

    Jin, Hui; Gui, Rijun; Yu, Jianbo; Lv, Wei; Wang, Zonghua

    2017-05-15

    Previously developed electrochemical biosensors with single-electric signal output are probably affected by intrinsic and extrinsic factors. In contrast, the ratiometric electrochemical biosensors (RECBSs) with dual-electric signal outputs have an intrinsic built-in correction to the effects from system or background electric signals, and therefore exhibit a significant potential to improve the accuracy and sensitivity in electrochemical sensing applications. In this review, we systematically summarize the fabrication strategies, sensing modes and analytical applications of RECBSs. First, the different fabrication strategies of RECBSs were introduced, referring to the analytes-induced single- and dual-dependent electrochemical signal strategies for RECBSs. Second, the different sensing modes of RECBSs were illustrated, such as differential pulse voltammetry, square wave voltammetry, cyclic voltammetry, alternating current voltammetry, electrochemiluminescence, and so forth. Third, the analytical applications of RECBSs were discussed based on the types of target analytes. Finally, the forthcoming development and future prospects in the research field of RECBSs were also highlighted. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. An Economic Evaluation of Tofacitinib Treatment in Rheumatoid Arthritis: Modeling the Cost of Treatment Strategies in the United States.

    Science.gov (United States)

    Claxton, Lindsay; Jenks, Michelle; Taylor, Matthew; Wallenstein, Gene; Mendelsohn, Alan M; Bourret, Jeffrey A; Singh, Amitabh; Moynagh, Dermot; Gerber, Robert A

    2016-09-01

    Tofacitinib is an oral Janus kinase inhibitor for the treatment of rheumatoid arthritis (RA). Tofacitinib is approved in the United States for use in adults with moderately to severely active RA and an inadequate response or intolerance to methotrexate. To (a) evaluate, using an economic model, the treatment costs of an RA strategy including tofacitinib, compared with adalimumab, etanercept, certolizumab and tocilizumab biologic RA treatment strategies, which are commonly prescribed in the United States, and (b) assess the economic impact of monotherapy and combination therapy in patients who had an inadequate response to methotrexate therapy (MTX-IR analysis) and to combination therapy in patients who had an inadequate response to a tumor necrosis factor inhibitor (TNF-IR analysis). A transparent, Excel-based economic model with a decision-tree approach was developed to evaluate costs over a 1- and 2-year time horizon. The model compared tofacitinib 5 mg twice a day (BID) either as monotherapy or in combination with MTX with similarly labeled biologic therapies. Response to treatment was modeled as American College of Rheumatology (ACR) 20/50/70 response. ACR20 represented clinical response and determined whether patients continued therapy. ACR response rates at 6-month intervals were sourced from prescribing information and safety event rates from a published meta-analysis. Following an adverse event or a lack of response to treatment, it was assumed that 75% of patients switched to the next line of treatment (first to abatacept and then to rituximab). The perspective was that of a U.S. payer. Costs were reported in 2015 U.S. dollars and included drug wholesale acquisition costs, monitoring, drug administration, and treatment for minor and serious adverse events. The patient population eligible for treatment was based on the total number of members (i.e., RA and non-RA) in a payer organization; members with RA treated with biologic therapies were estimated using

  1. Potential applications of plasma science techniques for water treatment systems

    International Nuclear Information System (INIS)

    Pavlik, D.

    1994-01-01

    The historical evolution of water treatment techniques and their impact on man and his environment are presented. Ancient man recognized the relationship between good water and good health. However, it was not until the late 1800's that man's own contribution to the pollution of water via biological and chemical contamination of the water stream was recognized as having adverse affects on water quality. Since that time virtually every nation has adopted laws and regulations to ensure that safe sources of unpolluted water are available to its citizens. In the United States, water quality is governed by the Clean Water Act of 1972 administered at the federal level by the Environmental Protection Agency (EPA). Further, each state has established its equivalent agency which administers its own laws and regulations. Different biological and chemical biohazards present in the water system are discussed. Biological contaminants include various types of viruses, bacteria, fungii, molds, yeasts, algae, amoebas, and parasites. Chemical contaminates include elemental heavy metals and other organic and inorganic compounds which interfere with normal biological functions. Conventional water treatments for both consumption and sewage effluent commonly employ four different principals: mechanical filtration, quiescent gravity settling, biological oxidation, and chemical treatment. Although these techniques have greatly reduced the incidence of water-borne disease recent studies suggest that more effective means of eliminating biohazards are needed. Regulatory requirements for more aggressive treatment and elimination of residual contaminants present a significant opportunity for the application of various forms of electromagnetic radiation techniques. A comparison between conventional techniques and more advanced methods using various forms of electromagnetic radiation is discussed

  2. Implant strategies for endocervical and interstitial ultrasound hyperthermia adjunct to HDR brachytherapy for the treatment of cervical cancer

    International Nuclear Information System (INIS)

    Wootton, Jeffery H; Prakash, Punit; Hsu, I-Chow Joe; Diederich, Chris J

    2011-01-01

    Catheter-based ultrasound devices provide a method to deliver 3D conformable heating integrated with HDR brachytherapy delivery. Theoretical characterization of heating patterns was performed to identify implant strategies for these devices which can best be used to apply hyperthermia to cervical cancer. A constrained optimization-based hyperthermia treatment planning platform was used for the analysis. The proportion of tissue ≥41 deg. C in a hyperthermia treatment volume was maximized with constraints T max ≤ 47 deg. C, T rectum ≤ 41.5 deg. C, and T bladder ≤ 42.5 deg. C. Hyperthermia treatment was modeled for generalized implant configurations and complex configurations from a database of patients (n = 14) treated with HDR brachytherapy. Various combinations of endocervical (360 0 or 2 x 180 0 output; 6 mm OD) and interstitial (180 0 , 270 0 , or 360 0 output; 2.4 mm OD) applicators within catheter locations from brachytherapy implants were modeled, with perfusion constant (1 or 3 kg m -3 s -1 ) or varying with location or temperature. Device positioning, sectoring, active length and aiming were empirically optimized to maximize thermal coverage. Conformable heating of appreciable volumes (>200 cm 3 ) is possible using multiple sectored interstitial and endocervical ultrasound devices. The endocervical device can heat >41 deg. C to 4.6 cm diameter compared to 3.6 cm for the interstitial. Sectored applicators afford tight control of heating that is robust to perfusion changes in most regularly spaced configurations. T 90 in example patient cases was 40.5-42.7 deg. C (1.9-39.6 EM 43deg.C ) at 1 kg m -3 s -1 with 10/14 patients ≥41 deg. C. Guidelines are presented for positioning of implant catheters during the initial surgery, selection of ultrasound applicator configurations, and tailored power schemes for achieving T 90 ≥ 41 deg. C in clinically practical implant configurations. Catheter-based ultrasound devices, when adhering to the guidelines, show

  3. Surgical management of U-shaped sacral fractures: a systematic review of current treatment strategies.

    Science.gov (United States)

    König, M A; Jehan, S; Boszczyk, A A; Boszczyk, B M

    2012-05-01

    U-shaped sacral fractures usually result from axial loading of the spine with simultaneous sacral pivoting due to a horizontal fracture which leads to a highly unstable spino-pelvic dissociation. Due to the rarity of these fractures, there is lack of an agreed treatment strategy. A thorough literature search was carried out to identify current treatment concepts. The studies were analysed for mechanism of injury, diagnostic imaging, associated injuries, type of surgery, follow-up times, complications, neurological, clinical and radiological outcome. Sixty-three cases were found in 12 articles. No Class I, II or III evidence was found in the literature. The most common mechanism of injury was a fall or jump from height. Pre-operative neurological deficit was noted in 50 (94.3%) out of 53 cases (not available in 10 patients). The most used surgical options were spino-pelvic fixation with or without decompression and ilio-sacral screws. Post-operative complications occurred in 24 (38.1%) patients. Average follow-up time was 18.6 months (range 2-34 months). Full neurological recovery was noted in 20 cases, partial recovery in 14 and 9 patients had no neurological recovery (5 patients were lost in follow-up). Fracture healing was mentioned in 7 articles with only 1 case of fracture reduction loss. From the current available data, an evidence based treatment strategy regarding outcome, neurological recovery or fracture healing could not be identified. Limited access and minimal-invasive surgery focussing on sacral reduction and restoration seems to offer comparable results to large spino-pelvic constructs with fewer complications and should be considered as the method of choice. If the fracture is highly unstable and displaced, spino-pelvic fixation might offer better stability.

  4. A treatment strategy for waste waters resulting from uranium mine decommissioning in Romania

    International Nuclear Information System (INIS)

    Georgescu, D.P.; Vacariu, V.T.; Popa, N.

    2000-01-01

    The exploitation activities in two important uranium mining areas in Romania are foreseen to be closed down in correlation with the national energy policy and nuclear strategy. This close down activity involves a number of technical decisions for environmental restoration. Reducing the contamination due to radioactive water of these areas, during the operation period and after the close down period, is one of the main components of the environment rehabilitation strategy. In this paper, the current situation and the program foreseen for ground and surface water treatment at an uranium mining unit situated in the S-W of Romania are presented. This program was established on the base of the results of our research carried out in order to decrease the content of radioactive elements. After closing down the mining facility, naturally flooding waters should be evacuated at the surface by a pump system and properly treated. A station for water decontamination is under construction. The underground water decontamination is based on two methods: ion exchange for uranium and adsorption on active coal for Ra-226. The technological flow chart of the treatment installation is realized on the basis of laboratory and industrial research and it will output treated water with less than 60 mg solid/l, 0.021 mg U/l and 0.088 Bq Ra-226/l. The installation is able to treat contaminated water flow rates between 10 and 30 l/s at a cost of about 0.1 USD/m 3 . The total investment cost is estimated to be 9.7 - 12.6 billions RO Lei (USD 500.000 - 650.000), depending of the treatment capacity. (authors)

  5. Application of discrete choice experiments to enhance stakeholder engagement as a strategy for advancing implementation: a systematic review

    Directory of Open Access Journals (Sweden)

    Ramzi G. Salloum

    2017-11-01

    Full Text Available Abstract Background One of the key strategies to successful implementation of effective health-related interventions is targeting improvements in stakeholder engagement. The discrete choice experiment (DCE is a stated preference technique for eliciting individual preferences over hypothetical alternative scenarios that is increasingly being used in health-related applications. DCEs are a dynamic approach to systematically measure health preferences which can be applied in enhancing stakeholder engagement. However, a knowledge gap exists in characterizing the extent to which DCEs are used in implementation science. Methods We conducted a systematic literature search (up to December 2016 of the English literature to identify and describe the use of DCEs in engaging stakeholders as an implementation strategy. We searched the following electronic databases: MEDLINE, Econlit, PsychINFO, and the CINAHL using mesh terms. Studies were categorized according to application type, stakeholder(s, healthcare setting, and implementation outcome. Results Seventy-five publications were selected for analysis in this systematic review. Studies were categorized by application type: (1 characterizing demand for therapies and treatment technologies (n = 32, (2 comparing implementation strategies (n = 22, (3 incentivizing workforce participation (n = 11, and (4 prioritizing interventions (n = 10. Stakeholders included providers (n = 27, patients (n = 25, caregivers (n = 5, and administrators (n = 2. The remaining studies (n = 16 engaged multiple stakeholders (i.e., combination of patients, caregivers, providers, and/or administrators. The following implementation outcomes were discussed: acceptability (n = 75, appropriateness (n = 34, adoption (n = 19, feasibility (n = 16, and fidelity (n = 3. Conclusions The number of DCE studies engaging stakeholders as an implementation strategy has been increasing over the

  6. Development and application of efficient strategies for parallel magnetic resonance imaging

    Energy Technology Data Exchange (ETDEWEB)

    Breuer, F.

    2006-07-01

    Virtually all existing MRI applications require both a high spatial and high temporal resolution for optimum detection and classification of the state of disease. The main strategy to meet the increasing demands of advanced diagnostic imaging applications has been the steady improvement of gradient systems, which provide increased gradient strengths and faster switching times. Rapid imaging techniques and the advances in gradient performance have significantly reduced acquisition times from about an hour to several minutes or seconds. In order to further increase imaging speed, much higher gradient strengths and much faster switching times are required which are technically challenging to provide. In addition to significant hardware costs, peripheral neuro-stimulations and the surpassing of admissable acoustic noise levels may occur. Today's whole body gradient systems already operate just below the allowed safety levels. For these reasons, alternative strategies are needed to bypass these limitations. The greatest progress in further increasing imaging speed has been the development of multi-coil arrays and the advent of partially parallel acquisition (PPA) techniques in the late 1990's. Within the last years, parallel imaging methods have become commercially available,and are therefore ready for broad clinical use. The basic feature of parallel imaging is a scan time reduction, applicable to nearly any available MRI method, while maintaining the contrast behavior without requiring higher gradient system performance. PPA operates by allowing an array of receiver surface coils, positioned around the object under investigation, to partially replace time-consuming spatial encoding which normally is performed by switching magnetic field gradients. Using this strategy, spatial resolution can be improved given a specific imaging time, or scan times can be reduced at a given spatial resolution. Furthermore, in some cases, PPA can even be used to reduce image

  7. Development and application of efficient strategies for parallel magnetic resonance imaging

    International Nuclear Information System (INIS)

    Breuer, F.

    2006-01-01

    Virtually all existing MRI applications require both a high spatial and high temporal resolution for optimum detection and classification of the state of disease. The main strategy to meet the increasing demands of advanced diagnostic imaging applications has been the steady improvement of gradient systems, which provide increased gradient strengths and faster switching times. Rapid imaging techniques and the advances in gradient performance have significantly reduced acquisition times from about an hour to several minutes or seconds. In order to further increase imaging speed, much higher gradient strengths and much faster switching times are required which are technically challenging to provide. In addition to significant hardware costs, peripheral neuro-stimulations and the surpassing of admissable acoustic noise levels may occur. Today's whole body gradient systems already operate just below the allowed safety levels. For these reasons, alternative strategies are needed to bypass these limitations. The greatest progress in further increasing imaging speed has been the development of multi-coil arrays and the advent of partially parallel acquisition (PPA) techniques in the late 1990's. Within the last years, parallel imaging methods have become commercially available,and are therefore ready for broad clinical use. The basic feature of parallel imaging is a scan time reduction, applicable to nearly any available MRI method, while maintaining the contrast behavior without requiring higher gradient system performance. PPA operates by allowing an array of receiver surface coils, positioned around the object under investigation, to partially replace time-consuming spatial encoding which normally is performed by switching magnetic field gradients. Using this strategy, spatial resolution can be improved given a specific imaging time, or scan times can be reduced at a given spatial resolution. Furthermore, in some cases, PPA can even be used to reduce image artifacts

  8. The development of PubMed search strategies for patient preferences for treatment outcomes

    Directory of Open Access Journals (Sweden)

    Ralph van Hoorn

    2016-07-01

    Full Text Available Abstract Background The importance of respecting patients’ preferences when making treatment decisions is increasingly recognized. Efficiently retrieving papers from the scientific literature reporting on the presence and nature of such preferences can help to achieve this goal. The objective of this study was to create a search filter for PubMed to help retrieve evidence on patient preferences for treatment outcomes. Methods A total of 27 journals were hand-searched for articles on patient preferences for treatment outcomes published in 2011. Selected articles served as a reference set. To develop optimal search strategies to retrieve this set, all articles in the reference set were randomly split into a development and a validation set. MeSH-terms and keywords retrieved using PubReMiner were tested individually and as combinations in PubMed and evaluated for retrieval performance (e.g. sensitivity (Se and specificity (Sp. Results Of 8238 articles, 22 were considered to report empirical evidence on patient preferences for specific treatment outcomes. The best search filters reached Se of 100 % [95 % CI 100-100] with Sp of 95 % [94–95 %] and Sp of 97 % [97–98 %] with 75 % Se [74–76 %]. In the validation set these queries reached values of Se of 90 % [89–91 %] with Sp 94 % [93–95 %] and Se of 80 % [79–81 %] with Sp of 97 % [96–96 %], respectively. Conclusions Narrow and broad search queries were developed which can help in retrieving literature on patient preferences for treatment outcomes. Identifying such evidence may in turn enhance the incorporation of patient preferences in clinical decision making and health technology assessment.

  9. The development of PubMed search strategies for patient preferences for treatment outcomes.

    Science.gov (United States)

    van Hoorn, Ralph; Kievit, Wietske; Booth, Andrew; Mozygemba, Kati; Lysdahl, Kristin Bakke; Refolo, Pietro; Sacchini, Dario; Gerhardus, Ansgar; van der Wilt, Gert Jan; Tummers, Marcia

    2016-07-29

    The importance of respecting patients' preferences when making treatment decisions is increasingly recognized. Efficiently retrieving papers from the scientific literature reporting on the presence and nature of such preferences can help to achieve this goal. The objective of this study was to create a search filter for PubMed to help retrieve evidence on patient preferences for treatment outcomes. A total of 27 journals were hand-searched for articles on patient preferences for treatment outcomes published in 2011. Selected articles served as a reference set. To develop optimal search strategies to retrieve this set, all articles in the reference set were randomly split into a development and a validation set. MeSH-terms and keywords retrieved using PubReMiner were tested individually and as combinations in PubMed and evaluated for retrieval performance (e.g. sensitivity (Se) and specificity (Sp)). Of 8238 articles, 22 were considered to report empirical evidence on patient preferences for specific treatment outcomes. The best search filters reached Se of 100 % [95 % CI 100-100] with Sp of 95 % [94-95 %] and Sp of 97 % [97-98 %] with 75 % Se [74-76 %]. In the validation set these queries reached values of Se of 90 % [89-91 %] with Sp 94 % [93-95 %] and Se of 80 % [79-81 %] with Sp of 97 % [96-96 %], respectively. Narrow and broad search queries were developed which can help in retrieving literature on patient preferences for treatment outcomes. Identifying such evidence may in turn enhance the incorporation of patient preferences in clinical decision making and health technology assessment.

  10. A global epidemiological survey and strategy of treatment of military ocular injury

    Directory of Open Access Journals (Sweden)

    Mao-nian ZHANG

    2011-10-01

    Full Text Available Objective To investigate the current global status of military ocular injury for the purpose of improving the level of domestic epidemiological investigation,in order to improve treatment strategies,and to prevent and reduce the incidence of military ocular injury in Chinese PLA.Methods The epidemiological literature concerning military ocular injury occurring in our country and abroad in recent five years was retrieved by information research;the problems and experiences in the aspects of epidemiological survey,registry,data collection,systematic treatment and prevention of military ocular injury existed in PLA were also summarized and analyzed.Results There were currently no systematic epidemiological data about ocular injury in PLA.A few articles about epidemiological study on ocular injury showed that servicemen were the high risk population of ocular injury.Both in peacetime or wartime the ocular injury was the primary cause leading to monocular blindness of soldiers.As to the ocular injury,in 51.55% of the patients,it occurred in the military operations and work,and 30.31% in military training.The incidence of ocular injury was different in various services,for example,the incidence in the internal security forces of armed police could be as high as 78.85% due to training of martial arts and boxing and wrestling.The deficiency of microsurgery equipments and untimely evacuation were the main causes affecting prognosis during treatment course in primary military hospitals.Conclusions Military affairs,physical training,military maneuver and defense constructions are the main causes of ocular injury in servicemen,and young male soldiers are the main group for prevention and treatment for military ocular injury.More attention should be paid to the epidemiological survey of military ocular injury to find out the causes leading to ocular injury,to improve treatment strategies,to formulate feasible protective measures and then military ocular

  11. APPLICATION STRATEGIES AND DESIGN CRITERIA FOR IN SITU BIOREMEDIATION OF SOIL AND GROUNDWATER IMPACTED BY PAHS

    Science.gov (United States)

    Biotreatability studies conducted in our laboratory used soils from two former wood-treatment facilities to evaluate the use of in situ bioventing and biosparging applications for their potential ability to remediate soil and groundwater containing creosote. The combination of ph...

  12. Strategies for the design of bright upconversion nanoparticles for bioanalytical applications

    Science.gov (United States)

    Wiesholler, Lisa M.; Hirsch, Thomas

    2018-06-01

    In recent years upconversion nanoparticles (UCNPs) received great attention because of their outstanding optical properties. Especially in bioanalytical applications this class of materials can overcome limitations of common probes like high background fluorescence or blinking. Nevertheless, the requirements for UCNPs to be applicable in biological samples, e.g. small size, water-dispersibility, excitation at low power density are in contradiction with the demand of high brightness. Therefore, a lot of attention is payed to the enhancement of the upconversion luminescence. This review discuss the recent trends and strategies to boost the brightness of UCNPs, classified in three main directions: a) improving the efficiency of energy absorption by the sensitizer via coupling to plasmonic or photonic structures or via attachment of ligands for light harvesting; b) minimizing non-radiative deactivation by variations in the architecture of UCNPs; and c) changing the excitation wavelength to get bright particles at low excitation power density for applications in aqueous systems. These strategies are critically reviewed including current limitations as well as future perspectives for the design of efficient UCNPs especially for sensing application in biological samples or cells.

  13. Personalized versus standardized dosing strategies for the treatment of childhood amblyopia: study protocol for a randomized controlled trial.

    Science.gov (United States)

    Moseley, Merrick J; Wallace, Michael P; Stephens, David A; Fielder, Alistair R; Smith, Laura C; Stewart, Catherine E

    2015-04-25

    Amblyopia is the commonest visual disorder of childhood in Western societies, affecting, predominantly, spatial visual function. Treatment typically requires a period of refractive correction ('optical treatment') followed by occlusion: covering the nonamblyopic eye with a fabric patch for varying daily durations. Recent studies have provided insight into the optimal amount of patching ('dose'), leading to the adoption of standardized dosing strategies, which, though an advance on previous ad-hoc regimens, take little account of individual patient characteristics. This trial compares the effectiveness of a standardized dosing strategy (that is, a fixed daily occlusion dose based on disease severity) with a personalized dosing strategy (derived from known treatment dose-response functions), in which an initially prescribed occlusion dose is modulated, in a systematic manner, dependent on treatment compliance. A total of 120 children aged between 3 and 8 years of age diagnosed with amblyopia in association with either anisometropia or strabismus, or both, will be randomized to receive either a standardized or a personalized occlusion dose regimen. To avoid confounding by the known benefits of refractive correction, participants will not be randomized until they have completed an optical treatment phase. The primary study objective is to determine whether, at trial endpoint, participants receiving a personalized dosing strategy require fewer hours of occlusion than those in receipt of a standardized dosing strategy. Secondary objectives are to quantify the relationship between observed changes in visual acuity (logMAR, logarithm of the Minimum Angle of Resolution) with age, amblyopia type, and severity of amblyopic visual acuity deficit. This is the first randomized controlled trial of occlusion therapy for amblyopia to compare a treatment arm representative of current best practice with an arm representative of an entirely novel treatment regimen based on statistical

  14. Treatment of waters before use. Processes and applications

    International Nuclear Information System (INIS)

    Mouchet, P.

    2006-01-01

    Some industrial processes require a water without any particulate in suspension and stable with respect to various aspects: no post-precipitations, no interference with storage and distribution equipments (corrosion or fouling), no development of bacterial, algal or other type of fauna (no chemical nutrients) etc. The water preparation process used will be different depending on the origin of the water (surface or underground). This article describes, first, the different type of treatments depending on the origin of the water and on the quality requested (clear and stable water, drinkable water, specific complementary processes, different processing files). Then, in a second part, the application of these processes to some industries are given (beverage, food, textile, paper, steel-making, aerospace and automotive, petroleum, power plants, ultra-pure waters) and in particular the preparation of demineralized water for nuclear power plants is described. (J.S.)

  15. Application of Fenton oxidation to cosmetic wastewaters treatment.

    Science.gov (United States)

    Bautista, P; Mohedano, A F; Gilarranz, M A; Casas, J A; Rodriguez, J J

    2007-05-08

    The removal of organic matter (TOC and COD) from a cosmetic wastewater by Fenton oxidation treatment has been evaluated. The operating conditions (temperature as well as ferrous ion and hydrogen peroxide dosage) have been optimized. Working at an initial pH equal to 3.0, a Fe(2+) concentration of 200 mg/L and a H(2)O(2) concentration to COD initial weight ratio corresponding to the theoretical stoichiometric value (2.12), a TOC conversion higher than 45% at 25 degrees C and 60% at 50 degrees C was achieved. Application of the Fenton oxidation process allows to reach the COD regional limit for industrial wastewaters discharges to the municipal sewer system. A simple kinetic analysis based on TOC was carried out. A second-order equation describes well the overall kinetics of the process within a wide TOC conversion range covering up to the 80-90% of the maximum achievable conversion.

  16. Treatment of emulsified oils by electrocoagulation: pulsed voltage applications.

    Science.gov (United States)

    Genc, Ayten; Bakirci, Busra

    2015-01-01

    The effect of pulsed voltage application on energy consumption during electrocoagulation was investigated. Three voltage profiles having the same arithmetic average with respect to time were applied to the electrodes. The specific energy consumption for these profiles were evaluated and analyzed together with oil removal efficiencies. The effects of applied voltages, electrode materials, electrode configurations, and pH on oil removal efficiency were determined. Electrocoagulation experiments were performed by using synthetic and real wastewater samples. The pulsed voltages saved energy during the electrocoagulation process. In continuous operation, energy saving was as high as 48%. Aluminum electrodes used for the treatment of emulsified oils resulted in higher oil removal efficiencies in comparison with stainless steel and iron electrodes. When the electrodes gap was less than 1 cm, higher oil removal efficiencies were obtained. The highest oil removal efficiencies were 95% and 35% for the batch and continuous operating modes, respectively.

  17. Surface treatments for biological, chemical and physical applications

    CERN Document Server

    Karaman, Mustafa

    2017-01-01

    A step-by-step guide to the topic with a mix of theory and practice in the fields of biology, chemistry and physics. Straightforward and well-structured, the first chapter introduces fundamental aspects of surface treatments, after which examples from nature are given. Subsequent chapters discuss various methods to surface modification, including chemical and physical approaches, followed by the characterization of the functionalized surfaces. Applications discussed include the lotus effect, diffusion barriers, enzyme immobilization and catalysis. Finally, the book concludes with a look at future technology advances. Throughout the text, tutorials and case studies are used for training purposes to grant a deeper understanding of the topic, resulting in an essential reference for students as well as for experienced engineers in R&D.

  18. Application of nanofiltration to the treatment of uranium mill effluents

    International Nuclear Information System (INIS)

    Macnaughton, S.J.; McCulloch, J.K.; Marshall, K.; Ring, R.J.

    2002-01-01

    Nanofiltration is widely used in water treatment due to the lower energy requirements and higher yields than reverse osmosis. Separation characteristics are dependent on both the molecular size and charge of the dissolved species in the feed solution as well as membrane properties. In this investigation the potential of nanofiltration to remove dissolved species from uranium mill effluent has been studied. The background behind the application is discussed and the results of the first testwork programme are presented. An initial screening of seventeen commercially available membranes was completed and it was found that uranium rejections of greater than 75% were consistently achieved. Selected membranes also showed potential for the separation of radium, sulfate and manganese. (author)

  19. The Mammotome biopsy system is an effective treatment strategy for breast abscess.

    Science.gov (United States)

    Wang, Keren; Ye, Yuqin; Sun, Guang; Xu, Zheli

    2013-01-01

    Although most breast abscesses can be treated with the current first-line treatment of antibiotics by needle aspiration, the therapeutic duration is lengthy and recurrences often occur. Therefore, we aimed to investigate the clinical efficacy of the Mammotome biopsy system (Johnson & Johnson Corp., New Brunswick, NJ) in a cohort of patients with breast abscesses. Forty lactating and 30 nonlactating breast abscess patients with unfavorable outcomes with antibiotic treatment and/or needle aspiration failure were recruited and treated with the Mammotome biopsy system. Skin inflammation of all patients disappeared within 6 days with no recurrence. The clinical outcomes in patients with an abscess size ≤ 3.5 cm was significantly better than those with an abscess size >3.5 cm (P = .025). The Mammotome biopsy system, an effective treatment strategy that is minimally invasive and less damaging, in combination with appropriate antibiotic therapy can be used safely as the first-line approach to breast abscess management. Copyright © 2013 Elsevier Inc. All rights reserved.

  20. Traditional Chinese Medicine for Refractory Nephrotic Syndrome: Strategies and Promising Treatments

    Science.gov (United States)

    Tu, Yuan-Chao

    2018-01-01

    Refractory nephrotic syndrome (RNS) is an immune-related kidney disease with poor clinical outcomes. Standard treatments include corticosteroids as the initial therapy and other immunosuppressants as second-line options. A substantial proportion of patients with RNS are resistant to or dependent on immunosuppressive drugs and often experience unremitting edema and proteinuria, cycles of remission and relapse, and/or serious adverse events due to long-term immunosuppression. Traditional Chinese medicine has a long history of treating complicated kidney diseases and holds great potential for providing effective treatments for RNS. This review describes the Chinese medical theories relating to the pathogenesis of RNS and discusses the strategies and treatment options using Chinese herbal medicine. Available preclinical and clinical evidence strongly supports the integration of traditional Chinese medicine and Western medicine for improving the outcome of RNS. Herbal medicine such as Astragalus membranaceus, Stephania tetrandra S. Moore, and Tripterygium wilfordii Hook F can serve as the alternative therapy when patients fail to respond to immunosuppression or as the complementary therapy to improve therapeutic efficacy and reduce side effects of immunosuppressive agents. Wuzhi capsules (Schisandra sphenanthera extract) with tacrolimus and tetrandrine with corticosteroids are two herb-drug combinations that have shown great promise and warrant further studies. PMID:29507594

  1. Management of high-risk Myeloma: an evidence-based review of treatment strategies.

    Science.gov (United States)

    Lehners, Nicola; Hayden, Patrick J; Goldschmidt, Hartmut; Raab, Marc-Steffen

    2016-08-01

    Despite the progress made in the treatment of patients with multiple myeloma over recent decades, a significant cohort with high-risk disease as defined by specific clinical and genetic criteria continue to respond poorly to standard treatment. These patients represent a particular challenge to the treating physician and require early identification as well as personalized treatment strategies. In this review, we discuss the prognostic impact of adverse clinical, radiological and genetic factors, evaluate available scoring systems and highlight key aspects of the therapeutic management of high-risk myeloma. MEDLINE and recent scientific meetings' databases were searched for the keywords 'high-risk' and 'multiple myeloma' and relevant studies relating to both diagnostic and therapeutic approaches were identified. Expert commentary: A case is made for intensive induction using combinations of novel agents, early high-dose therapy supported by autologous stem cell transplantation and the widespread use of maintenance therapies. Novel therapeutic options, especially in the field of immunotherapy, are currently explored in clinical trials and have the potential to further improve outcomes for patients with high-risk multiple myeloma.

  2. A review of treatment strategies for hydrofluoric acid burns: current status and future prospects.

    Science.gov (United States)

    Wang, Xingang; Zhang, Yuanhai; Ni, Liangfang; You, Chuangang; Ye, Chunjiang; Jiang, Ruiming; Liu, Liping; Liu, Jia; Han, Chunmao

    2014-12-01

    Hydrofluoric acid (HF), a dangerous inorganic acid, can cause severe corrosive effects and systemic toxicity. HF enters the human body via where it contacts, such as skin and mucosa, alimentary and respiratory tracts, and ocular surfaces. In the recent years, the incidence of HF burn has tended to increase over time. The injury mechanism of HF is associated primarily with the massive absorption of HF and the release of hydrogen ions. Correct diagnosis and timely treatment are especially important for HF burns. The critical procedure to treat HF burn is to prevent on-going HF absorption, and block the progressive destruction caused by fluoride ions. Due to the distinct characteristics of HF burns, the topical treatment, as well as systemic support, has been emphasised. Whereas, management of patients with HF burns remains a great challenge in some situations. To date, there has been no widely accepted protocol for the rescue of HF burns, partly due to the diversity of HF burns. This paper overviews the current status and problems of treatment strategies for HF burns, for the purpose of promoting the future researches and improvement. Copyright © 2014 Elsevier Ltd and ISBI. All rights reserved.

  3. High Risk Aortic Valve Replacement - The Challenges of Multiple Treatment Strategies with an Evolving Technology.

    Science.gov (United States)

    Booth, K; Beattie, R; McBride, M; Manoharan, G; Spence, M; Jones, J M

    2016-01-01

    Deciding on the optimal treatment strategy for high risk aortic valve replacement is challenging. Transcatheter Aortic Valve implantation (TAVI) has been available in our centre as an alternative treatment modality for patients since 2008. We present our early experience of TAVI and SAVR (surgical Aortic Valve Replacement) in high risk patients who required SAVR because TAVI could not be performed. The database for Surgical aortic valve and Transcatheter aortic valve replacement referrals was interrogated to identify relevant patients. Survival to hospital discharge was 95.5% in the forty five patients who had SAVR when TAVI was deemed technically unsuitable. One year survival was 86%. Defining who is appropriate for TAVI or high risk SAVR is challenging and multidisciplinary team discussion has never been more prudent in this field of evolving technology with ever decreasing risks of surgery. The introduction of TAVI at our institution has seen a rise in our surgical caseload by approximately by 25%. Overall, the option of aortic valve intervention is being offered to more patients in general which is a substantial benefit in the treatment of aortic valve disease.

  4. Current therapeutic strategies of anti-HER2 treatment in advanced breast cancer patients

    Directory of Open Access Journals (Sweden)

    Joanna Huszno

    2016-03-01

    Full Text Available The HER2/neu ( ERBB2 oncogene is amplified and/or overexpressed in approximately 20% of breast cancers, and is a strong prognostic factor for relapse and poor overall survival, particularly in node-positive patients. It is also an important predictor for response to trastuzumab, which has established efficacy against breast cancer with overexpression or amplification of the HER2 oncogene. Treatment with the anti-HER2 humanized monoclonal antibody – trastuzumab significantly improves progression-free and overall survival among patients with HER2-positive breast cancer. However, in most patients with HER2-positive metastatic breast cancer, the disease progresses occurred, what cause the need for new targeted therapies for advanced disease. In clinical trials, there are tested new drugs to improve the results of treatment for this group of patients. This paper presents new drugs introduced into clinical practice for treatment of advanced breast cancer, whose molecular target are receptors of the HER2 family. In addition, new therapeutic strategies and drugs that are currently in clinical researches are discussed.

  5. Cellulose degradation: a therapeutic strategy in the improved treatment of Acanthamoeba infections.

    Science.gov (United States)

    Lakhundi, Sahreena; Siddiqui, Ruqaiyyah; Khan, Naveed Ahmed

    2015-01-14

    Acanthamoeba is an opportunistic free-living amoeba that can cause blinding keratitis and fatal brain infection. Early diagnosis, followed by aggressive treatment is a pre-requisite in the successful treatment but even then the prognosis remains poor. A major drawback during the course of treatment is the ability of the amoeba to enclose itself within a shell (a process known as encystment), making it resistant to chemotherapeutic agents. As the cyst wall is partly made of cellulose, thus cellulose degradation offers a potential therapeutic strategy in the effective targeting of trophozoite encased within the cyst walls. Here, we present a comprehensive report on the structure of cellulose and cellulases, as well as known cellulose degradation mechanisms with an eye to target the Acanthamoeba cyst wall. The disruption of the cyst wall will make amoeba (concealed within) susceptible to chemotherapeutic agents, and at the very least inhibition of the excystment process will impede infection recurrence, as we bring these promising drug targets into focus so that they can be explored to their fullest.

  6. Strategic plan, 1991: A strategy for leadership in space through excellence in space science and applications

    Science.gov (United States)

    1991-01-01

    In 1988, the Office of Space Science and Applications (OSSA) developed and published a Strategic Plan for the United States' space science and applications program during the next 5 to 10 years. The Plan presented the proposed OSSA program for the next fiscal year and defined a flexible process that provides the basis for near-term decisions on the allocation of resources and the planning of future efforts. Based on the strategies that have been developed by the advisory committees both of the National Academy of Sciences and of NASA, the Plan balances major, moderate, and small mission initiatives, the utilization of Space Station Freedom, and the requirements for a vital research base. The Plan can be adjusted to accommodate varying budget levels, both those levels that provide opportunities for an expanded science and applications program, and those that constrain growth. SSA's strategic planning is constructed around five actions: establish a set of programmatic themes; establish a set of decision rules; establish a set of priorities for missions and programs within each theme; demonstrate that the strategy can yield a viable program; and check the strategy for consistency with resource constraints. The outcome of this process is a clear, coherent strategy that meets both NASA's and OSSA's goals, that assures realism in long-range planning and advanced technology development, and that provides sufficient resiliency to respond and adapt to both known and unexpected internal and external realities. The OSSA Strategic Plan is revised annually to reflect the approval of new programs, improved understanding of requirements and issues, and any major changes in the circumstances, both within NASA and external to NASA, in which OSSA initiatives are considered.

  7. Antibiotic susceptibility, heteroresistance, and updated treatment strategies in Helicobacter pylori infection

    Directory of Open Access Journals (Sweden)

    Mascellino MT

    2017-07-01

    Full Text Available Maria Teresa Mascellino,1 Barbara Porowska,2 Massimiliano De Angelis,1 Alessandra Oliva1 1Department of Public Health and Infectious Diseases, 2Department of Cardio-Thoracic, Vascular, General Surgery and of Organ Transplants, Policlinico Umberto I, Rome, Italy Abstract: In this review, we discuss the problem of antibiotic resistance, heteroresistance, the utility of cultures and antibiotic susceptibility tests in Helicobacter pylori (Hp eradication, as well as the updated treatment strategies for this infection. The prevalence of antibiotic resistance is increasing all over the world, especially for metronidazole and clarithromycin, because of their heavy use in some geographical areas. Heteroresistance (simultaneous presence of both susceptible and resistant strains in different sites of a single stomach is another important issue, as an isolate could be mistakenly considered susceptible if a single biopsy is used for antimicrobial tests. We also examined literature data regarding eradication success rates of culture-guided and empiric therapies. The empiric therapy and the one based on susceptibility testing, in Hp eradication, may depend on several factors such as concomitant diseases, the number of previous antibiotic treatments, differences in bacterial virulence in individuals with positive or negative cultures, together with local antibiotic resistance patterns in real-world settings. Updated treatment strategies in Hp infection presented in the guidelines of the Toronto Consensus Group (2016 are reported. These suggest to prolong eradication therapy up to 14 days, replacing the old triple therapy with a quadruple therapy based on proton pump inhibitor (PPI, bismuth, metronidazole, and tetracycline for most of the patients, or as an alternative quadruple therapy without bismuth, based on the use of PPI, amoxicillin, metronidazole, and clarithromycin. The new drug vonoprazan, a first-in-class potassium-competitive acid blocker recently

  8. Application of fast track surgery strategy in perioperative period of primary suture of laparoscopic choledocholithotomy

    Directory of Open Access Journals (Sweden)

    LIU Jinheng

    2016-11-01

    Full Text Available ObjectiveTo investigate the clinical application value of fast track surgery strategy (EARS in the perioperative period of primary suture of laparoscopy in the treatment of common bile duct stones. MethodsA total of 64 patients with gallstones complicated by common bile duct stones who were hospitalized in Department of Hepatobiliary Surgery in The Second People′s Hospital of Chengdu from October 2015 to February 2016 were enrolled, and according to the treatment in the perioperative period, the patients were divided into EARS group (32 patients and control group (32 patients. Clinical indices and complications were compared between the two groups. The t-test was used for comparison of continuous data between groups, and the chi-square test was used for comparison of categorical data between groups. ResultsCompared with the control group, the ERAS group had significantly shortened time of extraction of drainage tube (1.6±0.9 d vs 2.7±1.0 d, t=-5.675, P<0.01 and length of hospital stay (5.1±1.0 d vs 6.8±1.1 d, t=-5.910, P<0.01, significantly shorter time to first ambulation (1.0±0.3 d vs 1.6±0.7 d, t=-4.313, P<0.01 and time to intestinal functional recovery (1.1±0.4 d vs 1.8±0.6 d, t=-4.842, P<0.01, a significantly shortened time to stopping infusion after surgery (3.8±1.0 d vs 4.9±1.2 d, t=-3.923, P<0.01, significantly reduced total hospital costs (17 433.5±1411.3 ten thousand yuan vs 26 651.6±2945.8 ten thousand yuan, t=-15.942, P<0.001, a significantly lower proportion of patients who experienced pain after surgery [4 (12.5% vs 13 (40.6%, χ2=6.490, P=0.011], and significantly lower levels of alanine aminotransferase (105.25±35.34 U/L vs 179.00±48.64 U/L, t=-5.973, P<0.05 and total bilirubin (50.78±12.60 μmol/L vs 79.70±18.56 μmol/L, t=-7.090, P<0.05 after surgery. ConclusionEARS is highly practical in the perioperative period of laparoscopic surgery and can promote patients′ rapid recovery. Therefore

  9. Multi-criteria evaluation of wastewater treatment plant control strategies under uncertainty.

    Science.gov (United States)

    Flores-Alsina, Xavier; Rodríguez-Roda, Ignasi; Sin, Gürkan; Gernaey, Krist V

    2008-11-01

    The evaluation of activated sludge control strategies in wastewater treatment plants (WWTP) via mathematical modelling is a complex activity because several objectives; e.g. economic, environmental, technical and legal; must be taken into account at the same time, i.e. the evaluation of the alternatives is a multi-criteria problem. Activated sludge models are not well characterized and some of the parameters can present uncertainty, e.g. the influent fractions arriving to the facility and the effect of either temperature or toxic compounds on the kinetic parameters, having a strong influence in the model predictions used during the evaluation of the alternatives and affecting the resulting rank of preferences. Using a simplified version of the IWA Benchmark Simulation Model No. 2 as a case study, this article shows the variations in the decision making when the uncertainty in activated sludge model (ASM) parameters is either included or not during the evaluation of WWTP control strategies. This paper comprises two main sections. Firstly, there is the evaluation of six WWTP control strategies using multi-criteria decision analysis setting the ASM parameters at their default value. In the following section, the uncertainty is introduced, i.e. input uncertainty, which is characterized by probability distribution functions based on the available process knowledge. Next, Monte Carlo simulations are run to propagate input through the model and affect the different outcomes. Thus (i) the variation in the overall degree of satisfaction of the control objectives for the generated WWTP control strategies is quantified, (ii) the contributions of environmental, legal, technical and economic objectives to the existing variance are identified and finally (iii) the influence of the relative importance of the control objectives during the selection of alternatives is analyzed. The results show that the control strategies with an external carbon source reduce the output uncertainty

  10. Ultrasound applications and ionizing radiations in water treatment

    International Nuclear Information System (INIS)

    Al-Oraby, M.N.A.

    2013-01-01

    Application of ultrasound irradiation is one of the innovative techniques that was used for improvement of water treatment process and lowering levels of contaminants in waste water. The main mechanism of sonication is based on the cavitation phenomenon which includes the whole procedure of creation, expansion and collapsing of micro bubbles throughout liquid phase when negative pressure is applied to the medium during sonication. Consequently, hydroxyl and hydrogen radicals would be formed by thermal dissociation of water and hydrogen. These radicals penetrate into water and oxidize dissolved organic compounds. Hydrogen peroxide is formed as a consequence of hydroxyl and water radical recombination. During the free radical attack, the cell membranes of microorganisms are ruptured physically. The application of ionizing radiation for the removal of odorific substances and organic pollutants from water is an advanced oxidation process based on fast reactions with hydroxyl radicals formed as a result of radiolysis of water. GEO and MIB are the main responsible organic composites for the taste and odor in water. These compounds and other organic pollutants such as herbicide 2,4-DCP can be removed by different doses of gamma rays depending on magnitude, rate of radiation dose, chemical condition of the process and other factors. (author)

  11. Commissioning and first clinical application of mARC treatment

    Energy Technology Data Exchange (ETDEWEB)

    Dzierma, Yvonne; Nuesken, Frank G.; Kremp, Stephanie; Palm, Jan; Licht, Norbert P.; Ruebe, Christian [Universitaetsklinikum des Saarlandes, Klinik fuer Strahlentherapie und Radioonkologie, Homburg, Saarland (Germany)

    2014-11-15

    The modulated arc (mARC) technique has recently been introduced for Siemens ARTISTE linear accelerators. We present the first experiences with the commissioning of the system and first patient treatments. Treatment planning and delivery are presented for the Prowess Panther treatment planning system or, alternatively, an in-house code. Dosimetric verification is performed both by point dose measurements and in 3D dose distribution. Depending on the target volume, one or two arcs can be used to create highly conformal plans. Dosimetric verification of the converted mARC plans with step-and-shoot plans shows deviations below 1 % in absolute point dose; in the 3D dose distribution, over 95 % of the points pass the 3D gamma criteria (3 % deviation in local dose and 3 mm distance to agreement for doses > 20 % of the maximum). Patient specific verification of the mARC dose distribution with the calculations has a similar pass rate. Treatment times range between 2 and 5 min for a single arc. To our knowledge, this is the first report of clinical application of the mARC technique. The mARC offers the possibility to save significant amounts of time, with single-arc treatments of only a few minutes achieving comparable dose distribution to IMRT plans taking up to twice as long. (orig.) [German] Die mARC (modulated arc) Technik wurde vor kurzen fuer Siemens ARTISTE Linearbeschleuniger eingefuehrt. Wir zeigen die ersten Erfahrungen mit der Kommissionierung des Systems sowie die ersten Patientenbestrahlungen. Bestrahlungsplanung und Behandlung werden fuer das Prowess Panther Bestrahlungsplanungssystem oder alternativ in einer in-house-Loesung praesentiert. Die dosimetrische Verifikation wurde sowohl mit Punktmessungen als auch fuer die 3D-Dosisverteilung durchgefuehrt. Je nach Zielvolumen koennen mit einem oder zwei Boegen hochkonformale Plaene erzeugt werden. Die dosimetrische Verifikation konvertierter mARC-Plaene gegen step-and-shoot-Plaene weicht in absoluter Dosis um

  12. Single-Participant Assessment of Treatment Mediators: Strategy Description and Examples from a Behavioral Activation Intervention for Depressed Adolescents

    Science.gov (United States)

    Gaynor, Scott T.; Harris, Amanda

    2008-01-01

    Determining the means by which effective psychotherapy works is critical. A generally recommended strategy for identifying the potential causal variables is to conduct group-level statistical tests of treatment mediators. Herein the case is made for also assessing mediators of treatment outcome at the level of the individual participant.…

  13. Evaluation and Treatment of Coal Fly Ash for Adsorption Application

    Directory of Open Access Journals (Sweden)

    Samson Oluwaseyi BADA

    Full Text Available Many researchers had investigated fly ash as an adsorbent for the uptake of organic compounds from petrochemical waste effluents. The availability, inexpensive and its adsorption characteristic had made it an alternative media for the removal of organic compounds from aqueous solution. The physical property of South African Coal Fly Ash (SACFA was investigated to determine its adsorption capability and how it can be improved. Chemical treatment using 1M HCl solution in the ratio of (1 g fly ash to (2 ml of acid was used and compared with untreated heat-treated samples. The chemically treated fly ash has a higher specific surface area of 5.4116 m2/g than the heat-treated fly ash with 2.9969 m2/g. More attention had to be given to the utilization of SACFA for the treatment of wastewaters containing organic compounds through the application of Liquid phase adsorption process that was considered as an inexpensive and environmentally friendly technology.

  14. Application of bee venom and its main constituent melittin for cancer treatment.

    Science.gov (United States)

    Liu, Cui-Cui; Hao, Ding-Jun; Zhang, Qian; An, Jing; Zhao, Jing-Jing; Chen, Bo; Zhang, Ling-Ling; Yang, Hao

    2016-12-01

    Bee venom and its main constituent melittin (MEL) have been extensively studied in the treatment of tumors. However, the non-specific cytotoxicity and hemolytic activity have hampered the clinical application. Currently, a number of research groups have reported a series of optimization strategies, including gene therapy, recombinant immunotoxin incorporating MEL or MEL nanoparticles, targeting tumor cells to attenuate the cytotoxicity and improve its antitumor efficiency and therapeutic capabilities, which have shown very promising in overcoming some of these obstacles. In this review, we summarize the current knowledge regarding anticancer effects of bee venom and its main compound MEL on different kinds of tumor cells as well as elucidate their possible anticancer mechanisms. It could be concluded that MEL exerts multiple effects on cellular functions of cancerous cells such as proliferation, apoptosis, metastasis, angiogenesis as well as cell cycle, and the anticancer processes involve diverse signal molecules and regulatory pathways. We also highlight the recent research progress for efficient delivery of MEL peptide, thus providing new ideas and hopeful strategies for the in vivo application of MEL.

  15. Surface treatments of metal supports for photocatalysis applications

    Energy Technology Data Exchange (ETDEWEB)

    Montecchio, Francesco, E-mail: fmon@kth.se [KTH, Royal Institute of Technology, Dept. of Chemical Engineering and Technology, 100 44 Stockholm (Sweden); Chinungi, Don [KTH, Royal Institute of Technology, Dept. of Chemical Engineering and Technology, 100 44 Stockholm (Sweden); Lanza, Roberto [Verdant Chemical Technologies AB, 114 28 Stockholm (Sweden); Engvall, Klas [KTH, Royal Institute of Technology, Dept. of Chemical Engineering and Technology, 100 44 Stockholm (Sweden)

    2017-04-15

    Highlights: • Treated metals can be used as photocatalyst support in full-scale applications. • Various electrochemical treatments were performed, checking the surface corrugation. • Stainless steel etched in DC and aqua regia shows the highest surface modification. • P25 coated on the DC etched sample has a high stability, with constant activity. • The support modification increases the UV irradiated area and the activity of P25. - Abstract: One of the most important challenges, for scaling up a photocatalytic system for VOCs abatement to full-scale, is the design of a suitable photocatalyst support. The support has to firmly immobilize the photocatalyst, without using an organic adhesive, and should also withstand relatively high mechanical stresses. Metals may be effectively implemented as a support material, after a corrugation of the surface with electrochemical treatments. In the present work, we treated stainless steel and aluminum supports, evaluating the surface modifications due to the electrochemical treatments, with scanning electron microscopy (SEM) and confocal microscopy. Five samples showing the highest degree of restructuring were selected and spray coated with P25, a TiO{sub 2} photocatalyst, evaluating the mechanical stability of the coating with a standard tape test method. One particular stainless steel sample presented a superior surface restructuring and coating stability. The photocatalytic activity of this sample, evaluated measuring the complete oxidation of acetaldehyde, was tested for 15 h, and compared with sample of TiO{sub 2}-P25 on a ceramic support. The stainless steel exhibited a constant performance after an initial stabilization period. The stainless steel sample showed a slightly higher activity, due to the surface restructuring, increasing the irradiated area available for the coated photocatalyst.

  16. Advanced biomaterials and their potential applications in the treatment of periodontal disease.

    Science.gov (United States)

    Chen, Xi; Wu, Guofeng; Feng, Zhihong; Dong, Yan; Zhou, Wei; Li, Bei; Bai, Shizhu; Zhao, Yimin

    2016-08-01

    Periodontal disease is considered as a widespread infectious disease and the most common cause of tooth loss in adults. Attempts for developing periodontal disease treatment strategies, including drug delivery and regeneration approaches, provide a useful experimental model for the evaluation of future periodontal therapies. Recently, emerging advanced biomaterials including hydrogels, films, micro/nanofibers and particles, hold great potential to be utilized as cell/drug carriers for local drug delivery and biomimetic scaffolds for future regeneration therapies. In this review, first, we describe the pathogenesis of periodontal disease, including plaque formation, immune response and inflammatory reactions caused by bacteria. Second, periodontal therapy and an overview of current biomaterials in periodontal regenerative medicine have been discussed. Third, the roles of state-of-the-art biomaterials, including hydrogels, films, micro/nanofibers and micro/nanoparticles, developed for periodontal disease treatment and periodontal tissue regeneration, and their fabrication methods, have been presented. Finally, biological properties, including biocompatibility, biodegradability and immunogenicity of the biomaterials, together with their current applications strategies are given. Conclusive remarks and future perspectives for such advanced biomaterials are discussed.

  17. Thermal treatments of solid wastes. Different strategies for related pollutant management

    Energy Technology Data Exchange (ETDEWEB)

    Nicolella, C; Convertti, A; Rovatti, M [Genoa Univ. (Italy); Boschi, R; Cozzani, V; Tognotti, L [Pisa Univ. (Italy). Dept. of Chemistry Engineering

    1996-12-31

    Thermal treatment of solid wastes present different advantages/disadvantages as far as recovery and emissions concerns. They provide a captive energy source; reduce the quantity of waste to be landfilled; there are limited by-product and pollutant generating problems. Combined treatment of solid wastes (incineration, pyrolysis, gasification) have been considered to evaluate the energy recovery as well as the quality and the amount of pollutants potentially generated by the combined processes. Direct incineration of MSW, RDF or specific industrial wastes represents a viable, definitive, low environmental impact solution for most refuses. Treatment of emissions can be efficiently achieved by dry or wet processes. Nowadays abatement technologies are able to provide emissions within the guidelines of EEC countries. Problems arise when wastes contain large amount of chlorinated compounds (for example PVC) and/or heavy rentals: incineration may be not best way to be pursued. The general aim of the research program carried out by ISTIC (Genova), and Department of Chemical Engineering (Pisa) is to gain fundamental information on pyrolysis of refuse materials and to study the possible industrial application of these processes. Possible solutions have been studied in terms of material and energy balances, in order to verify the feasibility of combined treatments. Here, preliminary results are given on a two-stage process (low temperature pyrolysis (LTP) followed by incineration or gasification/pyrolysis) for treating specific wastes. (author)

  18. Thermal treatments of solid wastes. Different strategies for related pollutant management

    Energy Technology Data Exchange (ETDEWEB)

    Nicolella, C.; Convertti, A.; Rovatti, M. [Genoa Univ. (Italy); Boschi, R.; Cozzani, V.; Tognotti, L. [Pisa Univ. (Italy). Dept. of Chemistry Engineering

    1995-12-31

    Thermal treatment of solid wastes present different advantages/disadvantages as far as recovery and emissions concerns. They provide a captive energy source; reduce the quantity of waste to be landfilled; there are limited by-product and pollutant generating problems. Combined treatment of solid wastes (incineration, pyrolysis, gasification) have been considered to evaluate the energy recovery as well as the quality and the amount of pollutants potentially generated by the combined processes. Direct incineration of MSW, RDF or specific industrial wastes represents a viable, definitive, low environmental impact solution for most refuses. Treatment of emissions can be efficiently achieved by dry or wet processes. Nowadays abatement technologies are able to provide emissions within the guidelines of EEC countries. Problems arise when wastes contain large amount of chlorinated compounds (for example PVC) and/or heavy rentals: incineration may be not best way to be pursued. The general aim of the research program carried out by ISTIC (Genova), and Department of Chemical Engineering (Pisa) is to gain fundamental information on pyrolysis of refuse materials and to study the possible industrial application of these processes. Possible solutions have been studied in terms of material and energy balances, in order to verify the feasibility of combined treatments. Here, preliminary results are given on a two-stage process (low temperature pyrolysis (LTP) followed by incineration or gasification/pyrolysis) for treating specific wastes. (author)

  19. Antipsychotic-associated weight gain: management strategies and impact on treatment adherence

    Directory of Open Access Journals (Sweden)

    Dayabandara M

    2017-08-01

    Full Text Available Madhubhashinee Dayabandara, Raveen Hanwella, Suhashini Ratnatunga, Sudarshi Seneviratne, Chathurie Suraweera, Varuni A de Silva Department of Psychiatry, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka Abstract: Antipsychotic-induced weight gain is a major management problem for clinicians. It has been shown that weight gain and obesity lead to increased cardiovascular and cerebrovascular morbidity and mortality, reduced quality of life and poor drug compliance. This narrative review discusses the propensity of various antipsychotics to cause weight gain, the pharmacologic and nonpharmacologic interventions available to counteract this effect and its impact on adherence. Most antipsychotics cause weight gain. The risk appears to be highest with olanzapine and clozapine. Weight increases rapidly in the initial period after starting antipsychotics. Patients continue to gain weight in the long term. Children appear to be particularly vulnerable to antipsychotic-induced weight gain. Tailoring antipsychotics according to the needs of the individual and close monitoring of weight and other metabolic parameters are the best preventive strategies at the outset. Switching to an agent with lesser tendency to cause weight gain is an option, but carries the risk of relapse of the illness. Nonpharmacologic interventions of dietary counseling, exercise programs and cognitive and behavioral strategies appear to be equally effective in individual and group therapy formats. Both nonpharmacologic prevention and intervention strategies have shown modest effects on weight. Multiple compounds have been investigated as add-on medications to cause weight loss. Metformin has the best evidence in this respect. Burden of side effects needs to be considered when prescribing weight loss medications. There is no strong evidence to recommend routine prescription of add-on medication for weight reduction. Heterogeneity of study methodologies and other

  20. A strategy for multimodal deformable image registration to integrate PET/MR into radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Leibfarth, Sara; Moennich, David; Thorwarth, Daniela; Welz, Stefan; Siegel, Christine; Zips, Daniel; Schwenzer, Nina; Holger Schmidt, Holger

    2013-01-01

    Background: Combined positron emission tomography (PET)/magnetic resonance imaging (MRI) is highly promising for biologically individualized radiotherapy (RT). Hence, the purpose of this work was to develop an accurate and robust registration strategy to integrate combined PET/MR data into RT treatment planning. Material and methods: Eight patient datasets consisting of an FDG PET/computed tomography (CT) and a subsequently acquired PET/MR of the head and neck (HN) region were available. Registration strategies were developed based on CT and MR data only, whereas the PET components were fused with the resulting deformation field. Following a rigid registration, deformable registration was performed with a transform parametrized by B-splines. Three different optimization metrics were investigated: global mutual information (GMI), GMI combined with a bending energy penalty (BEP) for regularization (GMI + BEP) and localized mutual information with BEP (LMI + BEP). Different quantitative registration quality measures were developed, including volumetric overlap and mean distance measures for structures segmented on CT and MR as well as anatomical landmark distances. Moreover, the local registration quality in the tumor region was assessed by the normalized cross correlation (NCC) of the two PET datasets. Results: LMI + BEP yielded the most robust and accurate registration results. For GMI, GMI + BEP and LMI + BEP, mean landmark distances (standard deviations) were 23.9 mm (15.5 mm), 4.8 mm (4.0 mm) and 3.0 mm (1.0 mm), and mean NCC values (standard deviations) were 0.29 (0.29), 0.84 (0.14) and 0.88 (0.06), respectively. Conclusion: Accurate and robust multimodal deformable image registration of CT and MR in the HN region can be performed using a B-spline parametrized transform and LMI + BEP as optimization metric. With this strategy, biologically individualized RT based on combined PET/MRI in terms of dose painting is possible

  1. Emerging Strategies for Developing Next-Generation Protein Therapeutics for Cancer Treatment.

    Science.gov (United States)

    Kintzing, James R; Filsinger Interrante, Maria V; Cochran, Jennifer R

    2016-12-01

    Protein-based therapeutics have been revolutionizing the oncology space since they first appeared in the clinic two decades ago. Unlike traditional small-molecule chemotherapeutics, protein biologics promote active targeting of cancer cells by binding to cell-surface receptors and other markers specifically associated with or overexpressed on tumors versus healthy tissue. While the first approved cancer biologics were monoclonal antibodies, the burgeoning field of protein engineering is spawning research on an expanded range of protein formats and modifications that allow tuning of properties such as target-binding affinity, serum half-life, stability, and immunogenicity. In this review we highlight some of these strategies and provide examples of modified and engineered proteins under development as preclinical and clinical-stage drug candidates for the treatment of cancer. Copyright © 2016 Elsevier Ltd. All rights reserved.

  2. Primary ovary choriocarcinoma: individual DNA polymorphic analysis as a strategy to confirm diagnosis and treatment

    Directory of Open Access Journals (Sweden)

    Fernando Nalesso

    2013-04-01

    Full Text Available Primary choriocarcinoma of the ovary is rare. Furthermore, this tumor can arise from gestational tissue or pure germ cells of the ovary, with the latter resulting in non-gestational choriocarcinoma. While the clinical characteristics and histology of both tumor types are identical, differentiation of these tumors is necessary for effective treatment. One strategy for the differentiation of these tumors types is to assay for the presence of paternal DNA. Accordingly, in the present case, a patient with primary choriocarcinoma of the ovary with a non-gestational origin was confirmed by DNA analysis. The patient subsequently exhibited an excellent response to chemotherapy, and following surgery, achieved complete remission. A pathological analysis of surgical specimens further confirmed the absence of tumor.

  3. Interventional and surgical therapeutic strategies for pulmonary arterial hypertension: Beyond palliative treatments.

    Science.gov (United States)

    Sandoval, Julio; Gomez-Arroyo, Jose; Gaspar, Jorge; Pulido-Zamudio, Tomas

    2015-10-01

    Despite significant advances in pharmacological treatments, pulmonary arterial hypertension remains an incurable disease with an unreasonably high morbidity and mortality. Although specific pharmacotherapies have shifted the survival curves of patients and improved exercise endurance as well as quality of life, it is also true that these pharmacological interventions are not always accessible (particularly in developing countries) and, perhaps most importantly, not all patients respond similarly to these drugs. Furthermore, many patients will continue to deteriorate and will eventually require an additional, non-pharmacological, intervention. In this review we analyze the role of atrial septostomy and Potts anastomosis in the management of patients with pulmonary arterial hypertension, we summarize the current worldwide clinical experience (case reports and case series), and discuss why these interventional/surgical strategies might have a therapeutic role beyond that of a "bridge" to transplantation. Copyright © 2015 Japanese College of Cardiology. Published by Elsevier Ltd. All rights reserved.

  4. Oncolytic Adenovirus: Strategies and Insights for Vector Design and Immuno-Oncolytic Applications

    Directory of Open Access Journals (Sweden)

    Hanni Uusi-Kerttula

    2015-11-01

    Full Text Available Adenoviruses (Ad are commonly used both experimentally and clinically, including oncolytic virotherapy applications. In the clinical area, efficacy is frequently hampered by the high rates of neutralizing immunity, estimated as high as 90% in some populations that promote vector clearance and limit bioavailability for tumor targeting following systemic delivery. Active tumor targeting is also hampered by the ubiquitous nature of the Ad5 receptor, hCAR, as well as the lack of highly tumor-selective targeting ligands and suitable targeting strategies. Furthermore, significant off-target interactions between the viral vector and cellular and proteinaceous components of the bloodstream have been documented that promote uptake into non-target cells and determine dose-limiting toxicities. Novel strategies are therefore needed to overcome the obstacles that prevent efficacious Ad deployment for wider clinical applications. The use of less seroprevalent Ad serotypes, non-human serotypes, capsid pseudotyping, chemical shielding and genetic masking by heterologous peptide incorporation are all potential strategies to achieve efficient vector escape from humoral immune recognition. Conversely, selective vector arming with immunostimulatory agents can be utilized to enhance their oncolytic potential by activation of cancer-specific immune responses against the malignant tissues. This review presents recent advantages and pitfalls occurring in the field of adenoviral oncolytic therapies.

  5. BRAF-mutant melanoma: treatment approaches, resistance mechanisms, and diagnostic strategies

    Directory of Open Access Journals (Sweden)

    Spagnolo F

    2015-01-01

    available today for patients affected by BRAF V600-mutated metastatic melanoma, as well as to summarize the mechanisms of resistance to BRAF inhibitors and discuss the possible strategies to overcome them. Moreover, since the molecular analysis of tumor specimens is now a pivotal and decisional factor in the treatment strategy of metastatic melanoma patients, the advances in the molecular detection techniques for the BRAF V600 mutation will be reported. Keywords: melanoma, BRAF, vemurafenib, dabrafenib, resistance, BRAF inhibitor

  6. Novel treatment strategies for chronic kidney disease: insights from the animal kingdom.

    Science.gov (United States)

    Stenvinkel, Peter; Painer, Johanna; Kuro-O, Makoto; Lanaspa, Miguel; Arnold, Walter; Ruf, Thomas; Shiels, Paul G; Johnson, Richard J

    2018-04-01

    Many of the >2 million animal species that inhabit Earth have developed survival mechanisms that aid in the prevention of obesity, kidney disease, starvation, dehydration and vascular ageing; however, some animals remain susceptible to these complications. Domestic and captive wild felids, for example, show susceptibility to chronic kidney disease (CKD), potentially linked to the high protein intake of these animals. By contrast, naked mole rats are a model of longevity and are protected from extreme environmental conditions through mechanisms that provide resistance to oxidative stress. Biomimetic studies suggest that the transcription factor nuclear factor erythroid 2-related factor 2 (NRF2) offers protection in extreme environmental conditions and promotes longevity in the animal kingdom. Similarly, during months of fasting, immobilization and anuria, hibernating bears are protected from muscle wasting, azotaemia, thrombotic complications, organ damage and osteoporosis - features that are often associated with CKD. Improved understanding of the susceptibility and protective mechanisms of these animals and others could provide insights into novel strategies to prevent and treat several human diseases, such as CKD and ageing-associated complications. An integrated collaboration between nephrologists and experts from other fields, such as veterinarians, zoologists, biologists, anthropologists and ecologists, could introduce a novel approach for improving human health and help nephrologists to find novel treatment strategies for CKD.

  7. Treatment strategies in the left main coronary artery disease associated with acute coronary syndromes

    Directory of Open Access Journals (Sweden)

    Ahmet Karabulut

    2015-10-01

    Full Text Available Significant left main coronary artery (LMCA stenosis is not rare and reported 3 to 10% of patients undergoing coronary angiography. Unprotected LMCA intervention is a still clinical challenge and surgery is still going to be a traditional management method in many cardiac centers. With a presentation of drug eluting stent (DES, extensive use of IVUS and skilled operators, number of such interventions increased rapidly which lead to change in recommendation in the guidelines regarding LMCA procedures in the stable angina (Class 2a recommendation for ostial and shaft lesion and class 2b recommendation for distal bifurcation lesion. However, there was not clear consensus about the management of unprotected LMCA lesion associated with acute myocardial infarction (MI with a LMCA culprit lesion itself or distinct culprit lesion of other major coronary arteries. Surgery could be preferred as an obligatory management strategy even in the high risk patients. With this review, we aimed to demonstrate treatment strategies of LMCA disease associated with acute coronary syndrome, particularly acute myocardial infarction (MI. In addition, we presented a short case series with LMCA lesion and ST elevated acute MI in which culprit lesion placed either in the left anterior descending artery or circumflex artery. We reviewed the current medical literature and propose simple algorithm for management.

  8. Optimisation of treatment, storage and disposal strategies for (unconditioned and conditioned) radioactive waste

    International Nuclear Information System (INIS)

    Bealby, J.

    1989-03-01

    This study examines the trade-offs involved between unconditioned and conditioned waste storage, by investigating the effects of different cost and environmental minimisation strategies on radioactive waste treatment and disposal strategies. The costs and environmental impacts from storage (unconditioned and conditioned), conditioning, transport and disposal are examined. A single generic mixed Magnox/AGR site is investigated, assuming a moderate nuclear power growth scenario over the period 1986 to 2030. Assessments have been performed for four weighting sets which cover the range of views perceived to exist about the relative importance of cost and environmental impact reduction. The base case conditioning option considers the availability of a LLW low force compaction plant in 1986 and two ILW conditioning plants (cement encapsulation and dissolution) in 1990. A base case set of disposal options considers the options of disposal to shallow land and burial facility and deep cavity facilities. The study investigates the effect of deferring the opening dates of the conditioning plants. A set of sensitivity studies show that the assessments are robust to the assumptions and impact parameters used. (author)

  9. Bioaugmentation: An Emerging Strategy of Industrial Wastewater Treatment for Reuse and Discharge

    Directory of Open Access Journals (Sweden)

    Alexis Nzila

    2016-08-01

    Full Text Available A promising long-term and sustainable solution to the growing scarcity of water worldwide is to recycle and reuse wastewater. In wastewater treatment plants, the biodegradation of contaminants or pollutants by harnessing microorganisms present in activated sludge is one of the most important strategies to remove organic contaminants from wastewater. However, this approach has limitations because many pollutants are not efficiently eliminated. To counterbalance the limitations, bioaugmentation has been developed and consists of adding specific and efficient pollutant-biodegrading microorganisms into a microbial community in an effort to enhance the ability of this microbial community to biodegrade contaminants. This approach has been tested for wastewater cleaning with encouraging results, but failure has also been reported, especially during scale-up. In this review, work on the bioaugmentation in the context of removal of important pollutants from industrial wastewater is summarized, with an emphasis on recalcitrant compounds, and strategies that can be used to improve the efficiency of bioaugmentation are also discussed. This review also initiates a discussion regarding new research areas, such as nanotechnology and quorum sensing, that should be investigated to improve the efficiency of wastewater bioaugmentation.

  10. Interaction between behavioral and pharmacological treatment strategies to decrease cocaine choice in rhesus monkeys.

    Science.gov (United States)

    Banks, Matthew L; Blough, Bruce E; Negus, S Stevens

    2013-02-01

    Behavioral and pharmacotherapeutic approaches constitute two prominent strategies for treating cocaine dependence. This study investigated interactions between behavioral and pharmacological strategies in a preclinical model of cocaine vs food choice. Six rhesus monkeys, implanted with a chronic indwelling double-lumen venous catheter, initially responded under a concurrent schedule of food delivery (1-g pellets, fixed-ratio (FR) 100 schedule) and cocaine injections (0-0.1 mg/kg/injection, FR 10 schedule) during continuous 7-day treatment periods with saline or the agonist medication phenmetrazine (0.032-0.1 mg/kg/h). Subsequently, the FR response requirement for cocaine or food was varied (food, FR 100; cocaine, FR 1-100; cocaine, FR 10; food, FR 10-300), and effects of phenmetrazine on cocaine vs food choice were redetermined. Decreases in the cocaine FR or increases in the food FR resulted in leftward shifts in the cocaine choice dose-effect curve, whereas increases in the cocaine FR or decreases in the food FR resulted in rightward shifts in the cocaine choice dose-effect curve. The efficacy of phenmetrazine to decrease cocaine choice varied systematically as a function of the prevailing response requirements, such that phenmetrazine efficacy was greatest when cocaine choice was maintained by relatively low unit cocaine doses. These results suggest that efficacy of pharmacotherapies to modulate cocaine use can be influenced by behavioral contingencies of cocaine availability. Agonist medications may be most effective under contingencies that engender choice of relatively low cocaine doses.

  11. Factors associated with contingency management adoption among opioid treatment providers receiving a comprehensive implementation strategy.

    Science.gov (United States)

    Becker, Sara J; Kelly, Lourah M; Kang, Augustine W; Escobar, Katherine I; Squires, Daniel D

    2018-03-29

    Contingency management (CM) is an evidence-based behavioral intervention for opioid use disorders (OUDs); however, CM adoption in OUD treatment centers remains low due to barriers at patient, provider, and organizational levels. In a recent trial, OUD treatment providers who received the Science to Service Laboratory (SSL), a multilevel implementation strategy developed by a federally funded addiction training center, had significantly greater odds of CM adoption than providers who received training as usual. This study examined whether CM adoption frequency varied as a function of provider sociodemographic characteristics (i.e., age, race/ethnicity, licensure) and perceived barriers to adoption (i.e., patient-, provider-, organization-level) among providers receiving the SSL in an opioid treatment program. Thirty-nine providers (67% female, 77% non-Hispanic white, 72% with specialty licensure, M age = 42 [SD = 11.46]) received the SSL, which consisted of didactic training, performance feedback, specialized training of internal change champions, and external coaching. Providers completed a comprehensive baseline assessment and reported on their adoption of CM biweekly for 52 weeks. Providers reported using CM an average of nine 2-week intervals (SD = 6.35). Hierarchical multiple regression found that providers identifying as younger, non-Hispanic white, and