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Sample records for treatment concept frakturen

  1. Bone graft substitutes for the treatment of traumatic fractures of the extremities [Knochenersatzmaterialien zur Behandlung von traumatischen Frakturen der Extremitäten

    Directory of Open Access Journals (Sweden)

    Hagen, Anja

    2012-06-01

    patient subgroup with high-grade open fractures (Gustilo-Anderson grade IIIB. Cost-effectiveness for BMP-2 versus standard care with autologous bone grafts as well as for other bone graft substitutes in fracture treatment has not been determined yet. Although there were some significant differences in favour of BMP-2, due to the overall poor quality of the studies the evidence can only be interpreted as suggestive for efficacy. In the case of CaP cements and bone marrow-based bone substitute materials, the evidence is only weakly suggestive for efficacy. From an overall economic perspective, the transferability of the results of the health economic evaluations to the current situation in Germany is limited.The current evidence is insufficient to evaluate entirely the use of different bone graft substitutes for fracture treatment. From a medical point of view, BMP-2 is a viable alternative for treatment of open fractures of the tibia, especially in cases where bone grafting is not possible. Autologous bone grafting is preferable comparing to the use of OP-1. Possible advantages of CaP cements and composites containing bone marrow over autogenous bone grafting should be taken into account in clinical decision making. The use of the hydroxyapatite material and allograft bone chips compared to autologous bone grafts cannot be recommended. From a health economic perspective, the use of BMP-2 in addition to standard care without bone grafting is recommended as cost-saving in patients with high-grade open fractures (Gustilo-Anderson grade IIIB. Based on the current evidence no further recommendations can be made regarding the use of bone graft substitutes for the treatment of fractures. To avoid legal implications, use of bone graft substitutes outside their approved indications should be avoided.[german] Bei der Behandlung von traumatischen Frakturen werden zusätzlich zur Standardtherapie und ggf. alternativ zu Knochentransplantaten zunehmend verschiedene

  2. Fractures of the atlantoaxial complex in the elderly: assessment of radiological spectrum of fractures and factors influencing imaging diagnosis; Frakturen des Atlas und Axis bei aelteren Patienten: Untersuchung des Radiologischen Spektrums der Frakturen und bedeutsamer Faktoren fuer die Bildgebende Diagnostik

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    Lomoschitz, F.M. [Universitaetsklinik fuer Radiodiagnostik, AKH Wien, Wien (Germany); Dept. of Radiology, Harborview Medical Center, Univ. of Washington, Seattle, WA (United States); Blackmore, C.C.; Linnau, K.F.; Mann, F.A. [Dept. of Radiology, Harborview Medical Center, Univ. of Washington, Seattle, WA (United States); Stadler, A. [Universitaetsklinik fuer Radiodiagnostik, AKH Wien, Wien (Germany)

    2004-02-01

    Objective: to describe patterns of atlantoaxial fractures in a population of consecutive elderly patients, including assessment of type, distribution and associated clinical and radiological findings, and to analyze any influence of the causative trauma mechanism on the individual fracture pattern. Materials and methods: the distribution and type of 123 atlantoaxial fractures in 95 subjects older than 65 years (range: 65-102; mean age: 79 years) were retrospectively assessed. For each subject, trauma mechanism and clinical and neurological status were recorded at admission. Initial imaging studies of the cervical spine were reviewed. Preexistent degenerative changes were assessed and the atlantoaxial fractures classified. Data were evaluated for the frequency of different types of fractures of C1 and C2 and for accompanying fractures of cervical vertebrae or the occipital condyles, respectively. Results: the majority of patients with injuries of the atlantoaxial complex had fractures of C2 (90 of 95, 95%). A large proportion of these patients (67 of 90, 74%) had odontoid fractures. An isolated fracture of C1 was present in only 5 (5%) patients. Associated fractures of the occipital condyles or other cervical vertebrae were rare (10 of 95, 11%). The main trauma mechanism for atlantoaxial injuries was a fall (56 of 95, 59%). Elderly patients injured in motor vehicle accidents were more likely to have isolated fractures of C2 and Type III fractures of the odontoid (p < 0.02). Conclusion: in elderly patients, fractures of the atlantoaxial complex are mainly caused by falls and almost always involve C2. The trauma mechanism influences the fracture pattern (orig.) [German] Untersuchung von Frakturen des Atlas (C1) und Axis (C2) in einer konsekutiven Population aelterer Patienten ({>=} 65 Jahre) hinsichtlich Fraktur-Typus, -Haeufigkeit, und -Kombinationen, und Analyse von assoziierter Klinik sowie Einfluss von unfall-ursaechlichen Faktoren auf Frakturen des atlanto

  3. Kyphoplastie als palliative Therapieoption bei pathologischen Frakturen der Brust- und Lendenwirbelsäule

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    Hartwig E

    2004-01-01

    Full Text Available Bedingt durch Fortschritte in der Behandlung von Tumoren hat sich die Lebenserwartung von Krebspatienten deutlich verbessert. Jedoch steigt hiermit auch die Inzidenz von Knochenmetastasen. Mit wenigen Ausnahmen, die primären Knochentumoren betreffend, ist die Art der Behandlung dieser Läsionen in der Regel palliativ. Durch operatives Intervenieren muß bei diesen Patienten ein maximaler palliativer Effekt bei minimaler Morbidität und Mortalität erzielt werden. Die vorwiegenden Ziele sind Schmerzreduktion unter Erhalt der Stabilität und Funktion. Durch die Kyphoplastie wurden Zementierungsverfahren an der Wirbelsäule auch für pathologische Frakturen auf dem Boden metastatischer Manifestationen elegibel. In einer telefonischen Evaluation von 10 Patienten konnte die Wertigkeit des Verfahrens in der palliativen Situation bei Patienten mit Wirbelsäulenmetastasen gezeigt werden.

  4. Fractures of the cervical spine. Diagnostic procedures in patients with severe cranio-cervical trauma; HWS-Frakturen. Diagnostik bei polytraumatisierten Patienten

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    Link, T.M. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany); Schuierer, G. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany); Hufendiek, A. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany); Peters, P.E. [Inst. fuer Klinische Radiologie, Univ. Muenster (Germany)

    1994-12-01

    The purpose of our study was to analyze diagnostic procedures of the cervical spine in severely traumatized patients. Findings in plain radiographs and computer radiography of 234 patients were evaluated. The image quality of the plain radiographs was examined. Casualty reports were evaluated retrospectively. Frequency, distribution and morphology of cervical spine fractures were analyzed: 44 fractures in 35 patients were diagnosed, most of the fractures were located in C2 (20/44). Twenty of the fractures diagnosed in CT were not diagnosed in plain radiography and 7 fractures were uncertain findings; 5 fractures were not detected at the casualty site. A new screening procedure in patients with severe head injury is introduced. (orig.) [Deutsch] Ziel der vorliegenden Studie war, die Diagnostik der HWS beim polytraumatisierten Patienten zu analysieren. Retrospektiv wurden Roentgenaufnahmen und Computertomogramme der HWS von 234 polytraumatisierten Patienten analysiert. Konventionelle HWS-Aufnahmen wurden in bezug auf ihre Qualitaet untersucht und der Befund der konventionellen Aufnahmen mit dem der Computertomographie verglichen. Die Befunde vom Unfalltag wurden den retrospektiv validierten Befunden gegenuebergestellt. Haeufigkeit, Verteilung und Morphologie von HWS-Frakturen bei polytraumatisierten Patienten wurden untersucht: 44 Frakturen bei 35 Patienten waren nachweisbar, am haeufigsten Frakturen von HWK 2 (21/44). 20 der Frakturen konnten konventionelle radiologisch nicht und 7 nur fraglich diagnostiziert werden. 5 Frakturen wurden am Unfalltag nicht erkannt. Ein neues Untersuchungsprotokoll mit routinemaessiger computertomographischer Untersuchung von HWK 1 und 2 bei Schaedel-Hirn-Traumata wird vorgestellt. (orig.)

  5. Concepts of radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Mackie, R.T.

    2000-01-01

    Full text: Radiotherapy treatment planning (RTP) relies heavily on medical imaging. Until recently, the most important planning tool was the treatment simulator. The kilovoltage radiographic capabilities in a treatment simulator enabled the boundaries of treatment fields to be visualized with respect to bony anatomic landmarks. Perhaps the most important advance in treatment planning in recent years is the ability to visualize the passage of the beams with respect to a more accurate geometrical representation of the tumor and other soft tissue structures. This 'virtual simulation' uses a computer-based representation of a patient to determine the extent of the disease and the location of radiation sensitive normal tissue. Computer tomographic (CT) imaging produces a high-resolution three-dimensional representation of anatomy that can be correlated with other image sets such as magnetic resonance images (MRI) of function. Positron emission tomographic (PET) imaging is beginning to be used to determine tumor proliferation and the presence of distant disease. It is likely that accurate RTP in conjunction with CT simulators will eliminate traditional treatment simulators in the future. Traditionally, patient dose calculation algorithms have been based on correcting measured dose in water phantoms to take into account beam modifiers, patient surface contours and internal tissue inhomogeneities. Recently, model-based algorithms have been computing the dose directly in the patient representation using the CT to obtain a voxel-by-voxel density map. The convolution/superposition method, which uses a Monte Carlo-derived transport kernel, is the current state-of-the-art algorithm for dose computation. Soon direct Monte Carlo simulation will be used in model-based dose computation. Model-based dose computations enable a simpler monitor unit calculation formulation. The other major breakthrough in RTP is computer-based optimization. The goals of the treatment are specified as

  6. A team approach to assisted conception treatment.

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    Muirhead, Margaret; Lawton, Janet

    1998-01-01

    A programme to improve 'continuity of care' was initiated at Bourn Hall Clinic in direct response to patient demand to see the same doctors and nurses throughout assisted conception treatment cycles. A working party comprising individuals from all disciplines involved in assisted conception care was set up to review practices and aims and to establish an action plan. As a result, in 1996, a team approach to in vitro fertilization (IVF) and frozen embryo transfer (FET) treatment cycles was introduced at the clinic. The nursing staff were divided into two teams, each with a leader, an appropriate skill mix of full- and part-time nurses, and one full-time and one relief doctor. Treatment cycles were scheduled using pituitary downregulation with gonadotrophin-releasing hormone (GnRH) agonist when appropriate, and a programme was devised in which groups of 40--45 couples started treatment during the same 5 day period. Each couple was assigned to one of the teams and starting dates for each group were separated by 2 week intervals. The objectives of the working party were successfully achieved. The team approach to treating a finite number of couples provides a better opportunity for individualized care. Couples appreciate the advantages of continuity of care and the improved rapport with team staff. Forward planning of treatment cycles provides greater flexibility for incorporating clinic visits into patients' normal routines. Staff have benefited from increased job satisfaction due to greater involvement with couples from initial contact to the completion of treatment. The new working practice provides opportunities for training and research. Staff costs have been rationalized with benefits both to couples and to the business unit.

  7. The concept and treatment of psychological trauma

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    Harold Kudler

    2014-12-01

    Full Text Available Despite a large and rapidly expanding literature on psychological trauma, many fundamental questions remain about its basic nature: Is it a psychological problem or a biological one?; Is it a past event somehow stuck in the present or is it something new which has been triggered and shaped by that event?; Does it reside only within the patient or does it live between the patient and other people (including within the therapeutic relationship? This presentation will review the history of the concept of psychological trauma and explore the theoretical bases for current evidence-based psychotherapies for PTSD, each of which will be shown to describe psychological trauma as a problem in bringing the past and the present together in memory and cognition. These theories primarily differ on the question of whether a traumatic memory becomes pathogenic, because it cannot be biologically processed or because it must be psychologically avoided. Psychoanalytic concepts of transference and countertransference will be shown to be of practical importance regardless of the type of treatment chosen. If researchers and clinicians can build on what they hold in common rather than become divided by their differences, we can improve our ability to understand and alleviate the effects of psychological trauma.

  8. [The Concept and Treatment of Kleptomania].

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    Takemura, Michio

    2016-10-01

    Research on kleptomania has lagged behind that of other mental disorders, and very few clinicians specialize in treating such patients. Futhermore, the descriptive outline of kleptomania in the DSM-5 is vague. In 2008, we started a registration system for patients suffering from habitual theft, which has recorded 1430 cases since its inauguration. In this report, we explain the concept of kleptomania and describe our clinical experience in the treatment of patients suffering from this mental disorder. The most frequent complication of kleptomania was found to be eating disorder (especially bulimia). Although many factors contribute to the close relationship between these two mental disorders, the theory of "saving money on food expenses" as the motive for thefts committed by eating disorder patients, oversimplifies a complicated matter, and is inadequate as an explanation of the mechanism of this relationship. Medical treatment for kleptomania presently comprises counseling (individual psychotherapy), cognitive behavioral therapy, family therapy, group psychotherapy, psychodrama, and self-help groups, among others. In our addiction treatment approach, we have developed and implemented a program wherein recovered (recovering) patients share their personal experiences with newcomers and beginners, as well as their family members. We strongly encourage patients with kleptomania to participate in self-help groups.

  9. Female pattern hair loss: Current treatment concepts

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    Quan Q Dinh

    2007-07-01

    Full Text Available Quan Q Dinh, Rodney SinclairDepartment of Dermatology, St Vincent’s Hospital, Fitzroy, Victoria, AustraliaAbstract: Fewer than 45% of women go through life with a full head of hair. Female pattern hair loss is the commonest cause of hair loss in women and prevalence increases with advancing age. Affected women may experience psychological distress and impaired social functioning. In most cases the diagnosis can be made clinically and the condition treated medically. While many women using oral antiandrogens and topical minoxidil will regrow some hair, early diagnosis and initiation of treatment is desirable as these treatments are more effective at arresting progression of hair loss than stimulating regrowth. Adjunctive nonpharmacological treatment modalities such as counseling, cosmetic camouflage and hair transplantation are important measures for some patients. The histology of female pattern hair loss is identical to that of male androgenetic alopecia. While the clinical pattern of the hair loss differs between men, the response to oral antiandrogens suggests that female pattern hair loss is an androgen dependant condition, at least in the majority of cases. Female pattern hair loss is a chronic progressive condition. All treatments need to be continued to maintain the effect. An initial therapeutic response often takes 12 or even 24 months. Given this delay, monitoring for treatment effect through clinical photography or standardized clinical severity scales is helpful.Keywords: female pattern hair loss, androgenetic alopecia

  10. Novel treatment concepts in Hodgkin lymphoma

    NARCIS (Netherlands)

    Glimelius, I.; Diepstra, A.

    Treatment of classical Hodgkin's lymphoma (HL) has been a success story, with cure of localized disease with radiotherapy in the 1930s, cure of advanced stages with combination chemotherapy with/without radiotherapy in the mid-1960s and continuous improvements since then. Nonetheless, at present

  11. [The Concept and Treatment of Internet Addiction].

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    Elsalhy, Muhammad; Muramatsu, Taro; Higuchi, Susumu; Mimura, Masaru

    2016-10-01

    The Internet now plays a very important role in our lives. However, for some people, Internet use can lead to a state that appears to meet the DSM definition for a mental disorder. In this review, we briefly discuss definition, symptoms, risk factors, prevalence, comorbidities, and personality traits of people who are susceptible to becoming addicts. In the second section of the article, various types of Internet addiction are discussed, focusing mainly on Internet Gaming Disorder and social networking survices (SNS) addiction. Regarding Internet Gaming Disorder, we discuss various types of the newly emerged Massive Multiplayer Online Games (MMO), as well as theories about why people become addicted to them. We do the same for the SNS Addiction for sites like Facebook and LINE; again, different types, as well as theories about why some people become addicts to such sites are discussed. Finally, preventive measures are introduced, focusing on a number of commonly used treatment methods, perticulary cognitive behavioral therapy and family therapy.

  12. Concepts and treatment modalities for hypertension by traditional ...

    African Journals Online (AJOL)

    Clinical experiences and some research findings indicate that traditional and faith healers play a role in the management of hypertension in Africa. Therefore, the purpose of the study was to assess the concepts and treatment modalities for hypertension among traditional and faith healers in the Northern Province in South ...

  13. Evaluation of a Salutogenetic Concept for Inpatient Psychosomatic Treatment

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    Loew, Thomas

    2013-01-01

    The increase of psychosomatic disorders due to cultural changes requires enhanced therapeutic models. This study investigated a salutogenetic treatment concept for inpatient psychosomatic treatment, based on data from more than 11000 patients of a psychosomatic clinic in Germany. The clinic aims at supporting patients' health improvement by fostering values such as humanity, community, and mindfulness. Most of patients found these values realized in the clinical environment. Self-assessment questionnaires addressing physical and mental health as well as symptom ratings were available for analysis of pre-post-treatment effects and long-term stability using one-year follow-up data, as well as for a comparison with other clinics. With respect to different diagnoses, symptoms improved in self-ratings with average effect sizes between 0.60 and 0.98. About 80% of positive changes could be sustained as determined in a 1-year follow-up survey. Patients with a lower concordance with the values of the clinic showed less health improvement. Compared to 14 other German psychosomatic clinics, the investigated treatment concept resulted in slightly higher decrease in symptoms (e.g., depression scale) and a higher self-rated mental and physical improvement in health. The data suggest that a successfully implemented salutogenetic clinical treatment concept not only has positive influence on treatment effects but also provides long-term stability. PMID:24159352

  14. [Current treatment concepts for olecranon and prepatellar bursitis in Austria].

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    Baumbach, S F; Michel, M; Wyen, H; Buschmann, C T; Kdolsky, R; Kanz, K-G

    2013-04-01

    The limited evidence available on the diagnosis and treatment of olecranon and prepatellar bursitis indicates nationally varying treatment approaches. Therefore the aim of this study was to survey the current treatment concepts of olecranon and prepatellar bursitis in Austria. An online questionnaire comprising of demographic data, questions regarding diagnostics and differentiation between septic bursitis (SB) and non-septic bursitis (NSB) as well as two case reports for therapy appraisal were sent to members of the Austrian Society of Orthopaedics and Orthopaedic Surgery (ÖGO) and the Austrian Society of Traumatology (ÖGU). The overall response rates were 46 % (ÖGU)/12 % (ÖGO). Differentiation between SB and NSB was predominantly based on medical history/clinical presentation (ÖGU: 100 %/ÖGO: 84 %) and blood sampling (ÖGU: 82 %/ÖGO: 77 %). 64/36 % of surveyed members of ÖGO/OGU performed a bursal aspiration. 95/55 % of Austrian ÖGU opinion leaders favoured a surgical treatment approach in cases of SB/NSB. Conversely, ÖGO members rather favoured a conservative treatment approach (28/27 %). Significant differences were found between ÖGO and ÖGU, with the latter favouring a surgical treatment approach in cases of SB and NSB. However, the international literature argues for a conservative treatment approach. Further high quality research is needed to establish an evidence-based treatment approach. Georg Thieme Verlag KG Stuttgart · New York.

  15. Current concepts in the diagnosis and treatment of shoulder impingement

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    Bijayendra Singh

    2017-01-01

    Full Text Available Subacromial impingement syndrome (SIS is a very common cause of shoulder pain in the young adults. It can cause debilitating pain, dysfunction, and affects the activities of daily living. It represents a spectrum of pathology ranging from bursitis to rotator cuff tendinopathy which can ultimately lead to degenerative tear of the rotator cuff. Various theories and concepts have been described and it is still a matter of debate. However, most published studies suggest that both extrinsic and intrinsic factors have a role in the development of SIS. The management is controversial as both nonoperative and operative treatments have shown to provide good results. This article aims to provide a comprehensive current concepts review of the pathogenesis, etiologies, clinical diagnosis, appropriate use of investigations, and discussion on the management of SIS.

  16. Current Concepts in the Diagnosis and Treatment of Shoulder Impingement.

    Science.gov (United States)

    Singh, Bijayendra; Bakti, Nik; Gulihar, Abhinav

    2017-01-01

    Subacromial impingement syndrome (SIS) is a very common cause of shoulder pain in the young adults. It can cause debilitating pain, dysfunction, and affects the activities of daily living. It represents a spectrum of pathology ranging from bursitis to rotator cuff tendinopathy which can ultimately lead to degenerative tear of the rotator cuff. Various theories and concepts have been described and it is still a matter of debate. However, most published studies suggest that both extrinsic and intrinsic factors have a role in the development of SIS. The management is controversial as both nonoperative and operative treatments have shown to provide good results. This article aims to provide a comprehensive current concepts review of the pathogenesis, etiologies, clinical diagnosis, appropriate use of investigations, and discussion on the management of SIS.

  17. Current Concepts in the Diagnosis and Treatment of Shoulder Impingement

    Science.gov (United States)

    Singh, Bijayendra; Bakti, Nik; Gulihar, Abhinav

    2017-01-01

    Subacromial impingement syndrome (SIS) is a very common cause of shoulder pain in the young adults. It can cause debilitating pain, dysfunction, and affects the activities of daily living. It represents a spectrum of pathology ranging from bursitis to rotator cuff tendinopathy which can ultimately lead to degenerative tear of the rotator cuff. Various theories and concepts have been described and it is still a matter of debate. However, most published studies suggest that both extrinsic and intrinsic factors have a role in the development of SIS. The management is controversial as both nonoperative and operative treatments have shown to provide good results. This article aims to provide a comprehensive current concepts review of the pathogenesis, etiologies, clinical diagnosis, appropriate use of investigations, and discussion on the management of SIS. PMID:28966374

  18. Cryogenic treatment of steel: from concept to metallurgical understanding

    DEFF Research Database (Denmark)

    Villa, Matteo; Somers, Marcel A. J.

    2017-01-01

    Subjecting steel to cryogenic treatment to improve its properties was conceived in the 30ies of the previous century. The proof of concept that properties, in particular wear resistance, can indeed be improved importantly, was reported in the next decades. Despite many investigations......, the metallurgical understanding of the microstructural changes involved in cryogenic treatment of steel has remained poor. It is believed that the improvement in wear resistance is promoted by an enhanced precipitation of carbides during tempering, but no explanation has been given as to how this enhanced...... precipitation can be obtained. In the last six years, the authors have applied in situ magnetometry, synchrotron X-Ray Diffraction and dilatometry to enlighten the phase transitions occurring in steels at cryogenic temperatures and to point out the connection between different treatment parameters...

  19. Concepts of nurses on supervised treatment of tuberculosis in Brazil

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    Roberta Cristina Zago Ferreira

    2015-08-01

    Full Text Available Objective: To analyze the conception of the primary care nurses about the viability of supervised treatment for tuberculosis. Methods: This was an exploratory descriptive study with 11 nurses. The interviews were recorded, transcribed and the data were organized in facilitators and hindering for supervised treatment. The Ethics Committee on Research in Human Beings, opinion No. 112.520, approved the study. Results: The nurses considered the small number of professionals, the lack of community healthcare agents, lack of in-service education and communication problems with the reference center as complicating the viability of supervised treatment and identify that the bond facilitates the adherence to treatment as well as the flexibilization in time of taking the medicine, the care incentives such as basic food, vouchers, milk donation in addition to medication availability. Conclusions: The findings of this study indicate that high demand and diversity of actions on the responsibility of the nurse, associated with reduced number of professionals, hamper the attention to supervised treatment, and suggest adjustments to increase their effectiveness, as more training and space for professionals to exchange experiences, acknowledge the effectiveness of a treatment modality for tuberculosis.

  20. Treatment decisions for localized prostate cancer: a concept mapping approach.

    Science.gov (United States)

    McFall, Stephanie L; Mullen, Patricia D; Byrd, Theresa L; Cantor, Scott B; Le, Yen-Chi; Torres-Vigil, Isabel; Pettaway, Curtis; Volk, Robert J

    2015-12-01

    Few decision aids emphasize active surveillance (AS) for localized prostate cancer. Concept mapping was used to produce a conceptual framework incorporating AS and treatment. Fifty-four statements about what men need to make a decision for localized prostate cancer were derived from focus groups with African American, Latino and white men previously screened for prostate cancer and partners (n = 80). In the second phase, 89 participants sorted and rated the importance of statements. An eight cluster map was produced for the overall sample. Clusters were labelled Doctor-patient exchange, Big picture comparisons, Weighing the options, Seeking and using information, Spirituality and inner strength, Related to active treatment, Side-effects and Family concerns. A major division was between medical and home-based clusters. Ethnic groups and genders had similar sorting, but some variation in importance. Latinos rated Big picture comparisons as less important. African Americans saw Spirituality and inner strength most important, followed by Latinos, then whites. Ethnic- and gender-specific concept maps were not analysed because of high similarity in their sorting patterns. We identified a conceptual framework for management of early-stage prostate cancer that included coverage of AS. Eliciting the conceptual framework is an important step in constructing decision aids which will address gaps related to AS. © 2014 John Wiley & Sons Ltd.

  1. The all-on-four treatment concept: Systematic review

    Science.gov (United States)

    Soto-Penaloza, David; Zaragozí-Alonso, Regino; Penarrocha-Diago, María

    2017-01-01

    Objectives To systematically review the literature on the “all-on-four” treatment concept regarding its indications, surgical procedures, prosthetic protocols and technical and biological complications after at least three years in function. Study Design The three major electronic databases were screened: MEDLINE (via PubMed), EMBASE, and the Cochrane Library of the Cochrane Collaboration (CENTRAL). In addition, electronic screening was made of the ‘grey literature’ using the System for Information on Grey Literature in Europe - Open Grey, covering the period from January 2005 up to and including April 2016. Results A total of 728 articles were obtained from the initial screening process. Of these articles, 24 fulfilled the inclusion criteria. Methodological quality assessment showed sample size calculation to be reported by only one study, and follow-up did not include a large number of participants - a fact that may introduce bias and lead to misleading interpretations of the study results. Conclusions The all-on-four treatment concept offers a predictable way to treat the atrophic jaw in patients that do not prefer regenerative procedures, which increase morbidity and the treatment fees. The results obtained indicate a survival rate for more than 24 months of 99.8%. However, current evidence is limited due the scarcity of information referred to methodological quality, a lack of adequate follow-up, and sample attrition. Biological complications (e.g., peri-implantitis) are reported in few patients after a mean follow-up of two years. Adequate definition of the success / survival criteria is thus necessary, due the high prevalence of peri-implant diseases. Key words:All-on-four, all-on-4, tilted implants, dental prostheses, immediate loading. PMID:28298995

  2. The Unstable Elbow: Current Concepts in Diagnosis and Treatment.

    Science.gov (United States)

    Tashjian, Robert Z; Wolf, Brian R; van Riet, Roger P; Steinmann, Scott P

    2016-01-01

    Elbow instability is common and may occur after a variety of injuries, including falls or direct blows. Instability can be classified as either acute or chronic. Acute instability is classified as simple (without fracture) or complex (with associated fracture). Chronic instability is classified as a chronically dislocated or recurrently unstable elbow. Recurrent instability commonly presents as isolated medial or lateral collateral ligament insufficiency. A chronically dislocated elbow is often more complex, involving both osseous and ligamentous injuries. The treatment of simple dislocations typically involves closed reduction and nonsurgical management. Chronic recurrent lateral and medial collateral ligament insufficiencies have very different clinical characteristics, but definitive treatment frequently involves ligament reconstruction. Complex instability usually requires surgery, which includes open reduction and internal fixation of coronoid and olecranon fractures, repair or replacement of radial head fractures, and lateral collateral ligament repair. Medial collateral ligament repair and/or external fixation are rarely required to restore stability. It is important for surgeons to understand current concepts in the diagnosis and management of acute and chronic elbow instability as well as the preferred surgical treatments and techniques for the management of these injuries.

  3. A new treatment concept for bronchial stump insufficiency.

    Science.gov (United States)

    Bischoff, G; Muehling, B; Orend, K; Bischoff, M; Sunder-Plassmann, L

    2010-04-01

    Bronchial stump insufficiency (BSI) remains one of the most feared complications with an incidence of 0-12% in the literature. The present retrospective study reviewed the medical records of 11 patients with BSI. Patients were divided into two groups, depending on treatment. In group A, 5 patients were treated initially unsuccessfully using other therapeutic procedures such pectoralis flap transposition, omentum majus transposition and fibrin glue applications and subsequently treated successfully with vacuum therapy (VT). In 6 patients (group B), only VT (a combination of bronchial suture, thoracoplasty, latissimus muscle transposition and VT) was performed. VT represents a closed dressing system allowing moist wound treatment in full contact with the wound surface as well as protection against contamination with nosocomial pathogens by means of continuous drainage of wound secretions. Of the 11 patients reviewed in this study, closure of the bronchial stump with VT was achieved in 8 patients. Of the 8 patients with successful closure of the bronchial stump, 4 patients were in group A and 4 in group B. Based on this preliminary experience, the combination of bronchial suture, thoracoplasty, latissimus muscle transposition and VT appears to be a promising concept for the management of bronchial stump insufficiency. Georg Thieme Verlag KG Stuttgart New York.

  4. The evolution of the female sexual response concept: Treatment implications

    Directory of Open Access Journals (Sweden)

    Damjanović Aleksandar

    2013-01-01

    Full Text Available Sexual dysfunctions have been the most prevalent group of sexual disorders and include a large number of populations of both sexes. The research of sexual behavior and treatment of women with sexual distress arises many questions related to differences in sexual response of men and women. The conceptualization of this response in modern sexology has changed over time. The objective of our paper was to present the changes and evolution of the female’s sexual response concept in a summarized and integrated way, to analyze the expanded and revised definitions of the female sexual response as well as implications and recommendations of new approaches to diagnostics and treatment according to the established changes. The lack of adequate empirical basis of the female sexual response model is a critical question in the literature dealing with this issue. Some articles report that linear models demonstrate more correctly and precisely the sexual response of women with normal sexual functions in relation to women with sexual dysfunction. Modification of this model later resulted in a circular model which more adequately presented the sexual response of women with sexual function disorder than of women with normal sexual function. The nonlinear model of female sexual response constructed by Basson incorporates the value of emotional intimacy, sexual stimulus and satisfaction with the relationship. Female functioning is significantly affected by multiple psychosocial factors such as satisfaction with the relationship, self-image, earlier negative sexual experience, etc. Newly revised, expanded definitions of female sexual dysfunction try to contribute to new knowledge about a highly contextual nature of woman’s sexuality so as to enhance clinical treatment of dysfunctions. The definitions emphasize the evaluation of the context of women’s problematic sexual experiences.

  5. The Nepalese traditional concepts of illness and treatment

    Directory of Open Access Journals (Sweden)

    Prem K. Khatry

    2011-12-01

    Full Text Available The relation between magic, religion and therapy in Nepal is analyzed here in the context of the widest process of medicalization which takes place at global level. The Nepalese indigenous system of diagnosis, treatment and healing has evolved evolved in a process of trial-and-error, empirical observation and experimental procedure. The article suggests that it is an on-going process not dissimilar to modern medicine. The concept of disease does not include the germ theory but rather the theory that the essence of the body has been captured by some external power. Task of the healer is to try to release the soul or balance the system establishing “normal” functions. The article provides the description of multiple roles related to the diagnostic process and gives ethnographic case-studies of the relation between traditional and modern medicine. Government and private agencies are described as working in the rural areas with the healers in order to use their clout to take the modern health-package to the most remote communities and to reduce the mortality rate.

  6. Treatment concept for mandibular overdentures supported by endosseous implants : A literature review

    NARCIS (Netherlands)

    Batenburg, RHK; Meijer, HJA; Raghoebar, GM; Vissink, A

    1998-01-01

    Edentulous patients with a severely resorbed mandible often experience problems with their dentures. Treatment concepts involving two to four implants for the support of an overdenture have been proposed. The aim of this study was to develop a treatment concept for mandibular overdentures supported

  7. Current concepts in the treatment of distal radial fractures.

    Science.gov (United States)

    Ruch, David S; Weiland, Andrew J; Wolfe, Scott W; Geissler, William B; Cohen, Mark S; Jupiter, Jesse B

    2004-01-01

    Surgical indications for the treatment of distal radial fractures are evolving. It is important to identify the various articular fragments and their significance to facilitate optimal surgical treatment of these fragments from the standpoint of both internal and external fixation. New techniques in the visualization and stabilization of the articular surface and the treatment of defects in the metaphysis, including the use of cement to buttress the articular surface, have been brought to the forefront. A treatment algorithm for associated injuries to the distal radioulnar joint is also helpful.

  8. Treatment-resistant panic disorder: clinical significance, concept and management.

    Science.gov (United States)

    Chen, Mu-Hong; Tsai, Shih-Jen

    2016-10-03

    Panic disorder is commonly prevalent in the population, but the treatment response for panic disorder in clinical practice is much less effective than that in our imagination. Increasing evidence suggested existence of a chronic or remitting-relapsing clinical course in panic disorder. In this systematic review, we re-examine the definition of treatment-resistant panic disorder, and present the potential risk factors related to the treatment resistance, including the characteristics of panic disorder, other psychiatric and physical comorbidities, and psychosocial stresses. Furthermore, we summarize the potential pathophysiologies, such as genetic susceptibility, altered brain functioning, brain-derived neurotrophic factor, and long-term inflammation, to explain the treatment resistance. Finally, we conclude the current therapeutic strategies for treating treatment-resistant panic disorder from pharmacological and non-pharmacological views. Copyright © 2016 Elsevier Inc. All rights reserved.

  9. [Age-, gender- and diagnosis-specific changes of body concept during stationary psychosomatic treatment].

    Science.gov (United States)

    Stumpf, Astrid; Braunheim, Michael; Heuft, Gereon; Schneider, Gudrun

    2011-01-01

    This study investigates body concept with respect to psychiatric diagnosis, age and gender of inpatients before and after treatment. We examined 153 inpatients with 131 complete datasets. The examination was done at the beginning and at the end of the treatment using the Frankfurt Body Concept Scale (FKKS, Deusinger 1998). The results were calculated by t-test for dependent samples, posthoc Scheffé-tests and univariate variance analysis. The diagnoses indicated a more positive body concept at the end of the treatment (patients with somatoform disorder had effect sizes between -0.2 and -0.4, patients with depressions between -0.4 and -0.7, and patients with eating disorders between -0.3 and -0.7). Gender and age had only little influence on the positive changes. The improvement of body concept through inpatient treatment represents a challenge especially for somatoform disorders. The duration of this improvement after inpatient treatment needs further investigation.

  10. Intraarticular fractures of calcaneus - current concepts of treatment.

    Science.gov (United States)

    Kołodziejski, Paweł; Czarnocki, Łukasz; Wojdasiewicz, Piotr; Bryłka, Krzysztof; Kuropatwa, Krzysztof; Deszczyński, Jarosław

    2014-07-14

    Fractures of calcaneus are the most common among all tarsal bone fractures. Such injuries are most often produced by large forces, while accompanying soft tissue trauma makes them complicated and difficult to treat. Due to complex structure of the foot and talocalcaneal joint all injuries to this area constitute an important orthopedic problem, as improper treatment or lack thereof leads to gait impairment, particularly with regard to moving on uneven surface. In this work we presented the problem of intraarticular calcaneal fractures with particular consideration paid to methods of its treatment. We also mentioned the problem of complications after conservative and surgical treatment as well as methods of their prevention.

  11. Current concepts in the assessment and treatment of hepatic encephalopathy.

    LENUS (Irish Health Repository)

    Cash, W J

    2012-02-01

    Hepatic encephalopathy (HE) is defined as a metabolically induced, potentially reversible, functional disturbance of the brain that may occur in acute or chronic liver disease. Standardized nomenclature has been proposed but a standardized approach to the treatment, particularly of persistent, episodic and recurrent encephalopathy associated with liver cirrhosis has not been proposed. This review focuses on the pathogenesis and treatment of HE in patients with cirrhosis. The pathogenesis and treatment of hepatic encephalopathy in fulminant hepatic failure is quite different and is reviewed elsewhere.

  12. Evolving concepts in the treatment of relapsing multiple sclerosis

    DEFF Research Database (Denmark)

    Comi, Giancarlo; Radaelli, Marta; Soelberg Sørensen, Per

    2017-01-01

    or MRI activity. The choice for therapy is increasingly complex and should be driven by an appropriate knowledge of the mechanisms of action of the different drugs and of their risk-benefit profile. Because the relapsing phase of the disease is characterised by inflammation, treatment should be started......In the past 20 years the treatment scenario of multiple sclerosis has radically changed. The increasing availability of effective disease-modifying therapies has shifted the aim of therapeutic interventions from a reduction in relapses and disability accrual, to the absence of any sign of clinical...... as early as possible and aim to re-establish the normal complex interactions in the immune system. Before starting a treatment, neurologists should carefully consider the state of the disease, its prognostic factors and comorbidities, the patient's response to previous treatments, and whether the patient...

  13. Treatment resistance and psychodynamic psychiatry: concepts psychiatry needs from psychoanalysis.

    Science.gov (United States)

    Plakun, Eric

    2012-06-01

    Over the last 30 years psychiatry and psychoanalysis have moved in substantially divergent directions. Psychiatry has become rich in methodology but conceptually limited, with a drift toward biological reductionism. Psychoanalysis has remained relatively limited in methodology, but conceptually rich. The rich methodology of psychiatry has led to major contributions in discovering gene by environment interactions, the importance of early adversity, and to recognition of the serious problem posed by treatment resistance. However, psychiatry's biologically reductionistic conceptual focus interferes with the development of a nuanced clinical perspective based on emerging knowledge that might help more treatment resistant patients become treatment responders. This article argues that recognition of the problem of treatment resistance in psychiatry creates a need for it to reconnect with the conceptual richness of psychoanalysis in order to improve patient care. Psychodynamic psychiatry is defined as the relevant intersection of psychiatry and psychoanalysis where this reconnection can occur. I will suggest selected aspects of psychoanalysis that are especially relevant to psychiatry in improving outcomes in work with treatment resistant patients.

  14. Curricular Treatment of Body Image, Self-Esteem and Self-Concept in Spain

    Science.gov (United States)

    Rodríguez, Antonio V.; Estévez, Manuel; Palomares, Juan

    2015-01-01

    Adolescence is a period of human development in which problems with the perception of body image, self-esteem and self-concept proliferate, while the child is studying for Secondary Education. This study analyses the curricular treatment given to body image, self-esteem and self-concept in different legislative elements in the region of Valencia…

  15. [Current concepts in surgical treatment of chronic ankle joint instability].

    Science.gov (United States)

    Chojecki, Łukasz; Płomiński, Janusz; Pepłoński, Artur; Pawlik, JarosŁaw; Jeśkiewicz, Mateusz

    2015-04-01

    Ankle sprain is one of the most common musculoskeletal injuries. Initial treatment of choice in acute injury is conservative and is obtained by immobilization. The goal of such treatment is to heal ruptured capsular-ligamentous complex. However, despite the conservative treatment some patients develop chronic ankle instability as a result of injury. In those cases, surgical anatomical and non-anatomical ligamentous reconstruction is advised. Aim of the study was evaluation of the results obtained with various surgical techniques in view of published data. According to most authors, in patients who experienced chronic ankle instability, surgical technique of anatomical repair is preferred. In cases when anatomical repair might not be undertaken due to technical capabilities, anatomical reconstruction using autoor allografts is advised. © 2015 MEDPRESS.

  16. Current concepts in the treatment of hereditary ataxias

    Directory of Open Access Journals (Sweden)

    Pedro Braga Neto

    2016-03-01

    Full Text Available ABSTRACT Hereditary ataxias (HA represents an extensive group of clinically and genetically heterogeneous neurodegenerative diseases, characterized by progressive ataxia combined with extra-cerebellar and multi-systemic involvements, including peripheral neuropathy, pyramidal signs, movement disorders, seizures, and cognitive dysfunction. There is no effective treatment for HA, and management remains supportive and symptomatic. In this review, we will focus on the symptomatic treatment of the main autosomal recessive ataxias, autosomal dominant ataxias, X-linked cerebellar ataxias and mitochondrial ataxias. We describe management for different clinical symptoms, mechanism-based approaches, rehabilitation therapy, disease modifying therapy, future clinical trials and perspectives, genetic counseling and preimplantation genetic diagnosis.

  17. Diagnosis and treatment of osteochondral lesions of the ankle: current concepts

    Directory of Open Access Journals (Sweden)

    Marcelo Pires Prado

    Full Text Available ABSTRACT We conducted a wide-ranging review of the literature regarding osteochondral lesions of the ankle, with the aim of presenting the current concepts, treatment options, trends and future perspectives relating to this topic.

  18. Neurofeedback for Tinnitus Treatment – Review and Current Concepts

    Science.gov (United States)

    Güntensperger, Dominik; Thüring, Christian; Meyer, Martin; Neff, Patrick; Kleinjung, Tobias

    2017-01-01

    An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB), a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically. PMID:29249959

  19. Neurofeedback for Tinnitus Treatment – Review and Current Concepts

    Directory of Open Access Journals (Sweden)

    Dominik Güntensperger

    2017-12-01

    Full Text Available An effective treatment to completely alleviate chronic tinnitus symptoms has not yet been discovered. However, recent developments suggest that neurofeedback (NFB, a method already popular in the treatment of other psychological and neurological disorders, may provide a suitable alternative. NFB is a non-invasive method generally based on electrophysiological recordings and visualizing of certain aspects of brain activity as positive or negative feedback that enables patients to voluntarily control their brain activity and thus triggers them to unlearn typical neural activity patterns related to tinnitus. The purpose of this review is to summarize and discuss previous findings of neurofeedback treatment studies in the field of chronic tinnitus. In doing so, also an overview about the underlying theories of tinnitus emergence is presented and results of resting-state EEG and MEG studies summarized and critically discussed. To date, neurofeedback as well as electrophysiological tinnitus studies lack general guidelines that are crucial to produce more comparable and consistent results. Even though neurofeedback has already shown promising results for chronic tinnitus treatment, further research is needed in order to develop more sophisticated protocols that are able to tackle the individual needs of tinnitus patients more specifically.

  20. Complement inhibition: a promising concept for cancer treatment

    Science.gov (United States)

    Pio, Ruben; Ajona, Daniel; Lambris, John D.

    2013-01-01

    For decades, complement has been recognized as an effector arm of the immune system that contributes to the destruction of tumor cells. In fact, many therapeutic strategies have been proposed that are based on the intensification of complement-mediated responses against tumors. However, recent studies have challenged this paradigm by demonstrating a tumor-promoting role for complement. Cancer cells seem to be able to establish a convenient balance between complement activation and inhibition, taking advantage of complement initiation without suffering its deleterious effects. Complement activation may support chronic inflammation, promote an immunosuppressive microenvironment, induce angiogenesis, and activate cancer-related signaling pathways. In this context, inhibition of complement activation would be a therapeutic option for treating cancer. This concept is relatively novel and deserves closer attention. In this paper, we will summarize the mechanisms of complement activation on cancer cells, the cancer-promoting effect of complement initiation, and the rationale behind the use of complement inhibition as a therapeutic strategy against cancer. PMID:23706991

  1. Concept for individualized patient allocation: ReCompare—remote comparison of particle and photon treatment plans

    International Nuclear Information System (INIS)

    Lühr, Armin; Baumann, Michael; Löck, Steffen; Roth, Klaus; Helmbrecht, Stephan; Jakobi, Annika; Petersen, Jørgen B; Just, Uwe; Krause, Mechthild; Enghardt, Wolfgang

    2014-01-01

    Identifying those patients who have a higher chance to be cured with fewer side effects by particle beam therapy than by state-of-the-art photon therapy is essential to guarantee a fair and sufficient access to specialized radiotherapy. The individualized identification requires initiatives by particle as well as non-particle radiotherapy centers to form networks, to establish procedures for the decision process, and to implement means for the remote exchange of relevant patient information. In this work, we want to contribute a practical concept that addresses these requirements. We proposed a concept for individualized patient allocation to photon or particle beam therapy at a non-particle radiotherapy institution that bases on remote treatment plan comparison. We translated this concept into the web-based software tool ReCompare (REmote COMparison of PARticlE and photon treatment plans). We substantiated the feasibility of the proposed concept by demonstrating remote exchange of treatment plans between radiotherapy institutions and the direct comparison of photon and particle treatment plans in photon treatment planning systems. ReCompare worked with several tested standard treatment planning systems, ensured patient data protection, and integrated in the clinical workflow. Our concept supports non-particle radiotherapy institutions with the patient-specific treatment decision on the optimal irradiation modality by providing expertise from a particle therapy center. The software tool ReCompare may help to improve and standardize this personalized treatment decision. It will be available from our website when proton therapy is operational at our facility

  2. The concept of treatment of scolioses employing asymmetrical aquatic exercises

    OpenAIRE

    Łubkowska, Wioletta

    2015-01-01

    According to the statistical data, there is being observed a definite increase in percentage of children affected by posture defects, particularly scolioses. The aquatic environment facilitates treatment of scolioses, since it provides relief conditions used in order to perform prophylactic, corrective and therapeutic tasks. Hydrokinetic therapy is one of the many rehabilitation methods. It seems, however, that corrective and therapeutic swimming is far too rarely used as an auxiliar...

  3. Wegener granulomatosis (granulomatosis with polyangiitis): evolving concepts in treatment.

    Science.gov (United States)

    Lynch, Joseph P; Tazelaar, Henry

    2011-06-01

    Wegener granulomatosis (WG), the most common of the pulmonary granulomatous vasculitides, typically involves the upper respiratory tract, lower respiratory tract (bronchi and lung), and kidney, with varying degrees of disseminated vasculitis. THE TERM GRANULOMATOSIS WITH POLYANGIITIS (WEGENER) WAS RECENTLY PROPOSED TO REPLACE THE OLDER TERM, WG. THE TERM GRANULOMATOSIS WITH POLYANGIITIS CAN BE ABBREVIATED TO GPA, WITH THE IDEA THAT THE EPONYM WEGENER WOULD BE OMITTED OVER TIME. Cardinal histologic features include a necrotizing vasculitis involving small vessels, extensive "geographic" necrosis, and granulomatous inflammation. Clinical manifestations of WG are protean; virtually any organ can be involved. The spectrum and severity of the disease are heterogeneous, ranging from indolent disease involving only one site to fulminant, multiorgan vasculitis. The pathogenesis of WG has not been elucidated, but both cellular and humoral components are involved. Circulating antibodies against cytoplasmic components of neutrophils [anti-neutrophil cytoplasmic antibodies (c-ANCAs)] likely play a role in the pathogenesis, and often correlate with activity of the disease. Treatment strategies are evolving. Cyclophosphamide (CYC) plus corticosteroids (CSs) is the mainstay of therapy for generalized, multisystemic WG. Historically, the combination of CYC plus CS was used for a minimum of 12 months, but concern about late toxicities associated with CYC has led to novel treatment approaches. Currently, short-course (3 to 6 months) induction treatment with CYC plus CS, followed by maintenance therapy with less toxic agents (e.g., methotrexate, azathioprine) is recommended. Further, methotrexate combined with CS may be adequate for limited, non-life-threatening WG. Recent studies suggest that rituximab may be useful for induction therapy or CYC-refractory WG. The role of other immunomodulatory agents (including trimethoprim-sulfamethoxazole) is also explored. © Thieme Medical

  4. System for supporting conception in the field of surface treatments

    International Nuclear Information System (INIS)

    Evrard, J.M.; Gras, M.

    1989-01-01

    The application of the techniques issued from artificial intelligence for assisting the development of a computer technical memory on a representative subject, which is the surface treatments and coating in tribology, is illustrated. The development of the system is composed of several steps: data acquisition and formatting representation, data validation and software. Particular attention is given to the dialogue between the user and the system. The study shows that the development of the following points are indispensable: the possibility of following the user's reasoning and coming back to previous steps or exploring several parallel ways [fr

  5. Anxiety and sleep problems: emerging concepts and theoretical treatment implications.

    Science.gov (United States)

    Uhde, Thomas W; Cortese, Bernadette M; Vedeniapin, Andrei

    2009-08-01

    The high prevalence and comorbidity of anxiety and sleep problems, especially insomnia, suggest an important underlying relationship between these disorders. In this article, we highlight two theoretical models explaining this co-occurrence, provide a brief update on the association between anxiety-insomnia and anxiety-cataplexy in general, and review more specifically sleep problems in generalized anxiety, post-traumatic stress disorder, and panic disorder. We also explore sleep paralysis as an anxiety-sleep event. Our goal with this examination of selective anxiety-sleep problems is to provide clues about diagnostic and treatment approaches and frame strategies for future research.

  6. Short dental implants: an emerging concept in implant treatment.

    Science.gov (United States)

    Al-Hashedi, Ashwaq Ali; Taiyeb Ali, Tara Bai; Yunus, Norsiah

    2014-06-01

    Short implants have been advocated as a treatment option in many clinical situations where the use of conventional implants is limited. This review outlines the effectiveness and clinical outcomes of using short implants as a valid treatment option in the rehabilitation of edentulous atrophic alveolar ridges. Initially, an electronic search was performed on the following databases: Medline, PubMed, Embase, Cochrane Database of Systematic Reviews, and DARE using key words from January 1990 until May 2012. An additional hand search was included for the relevant articles in the following journals: International Journal of Oral and Maxillofacial Implants, Clinical Oral Implants Research, Journal of Clinical Periodontology, International Journal of Periodontics, Journal of Periodontology, and Clinical Implant Dentistry and Related Research. Any relevant papers from the journals' references were hand searched. Articles were included if they provided detailed data on implant length, reported survival rates, mentioned measures for implant failure, were in the English language, involved human subjects, and researched implants inserted in healed atrophic ridges with a follow-up period of at least 1 year after implant-prosthesis loading. Short implants demonstrated a high rate of success in the replacement of missing teeth in especially atrophic alveolar ridges. The advanced technology and improvement of the implant surfaces have encouraged the success of short implants to a comparable level to that of standard implants. However, further randomized controlled clinical trials and prospective studies with longer follow-up periods are needed.

  7. Pelvic inflammatory disease: current concepts in pathogenesis, diagnosis and treatment.

    Science.gov (United States)

    Mitchell, Caroline; Prabhu, Malavika

    2013-12-01

    Pelvic inflammatory disease (PID) is characterized by infection and inflammation of the upper genital tract in women and can cause significant reproductive health sequelae for women. Although a definitive diagnosis of PID is made by laparoscopic visualization of inflamed, purulent fallopian tubes, PID is generally a clinical diagnosis and thus represents a diagnostic challenge. Therefore, diagnosis and treatment algorithms advise a high index of suspicion for PID in any woman of reproductive age with pelvic or abdominal pain. Antibiotic therapy should be started early, and given for an adequate period of time to reduce the risk of complications. Coverage for anaerobic organisms should be considered in most cases. Copyright © 2013 Elsevier Inc. All rights reserved.

  8. Common Ice Hockey Injuries and Treatment: A Current Concepts Review.

    Science.gov (United States)

    Mosenthal, William; Kim, Michael; Holzshu, Robert; Hanypsiak, Bryan; Athiviraham, Aravind

    Injuries are common in ice hockey, a contact sport where players skate at high speeds on a sheet of ice and shoot a vulcanized rubber puck in excess of one hundred miles per hour. This article reviews the diagnoses and treatment of concussions, injuries to the cervical spine, and lower and upper extremities as they pertain to hockey players. Soft tissue injury of the shoulder, acromioclavicular joint separation, glenohumeral joint dislocation, clavicle fractures, metacarpal fractures, and olecranon bursitis are discussed in the upper-extremity section of the article. Lower-extremity injuries reviewed in this article include adductor strain, athletic pubalgia, femoroacetabular impingement, sports hernia, medial collateral and anterior cruciate ligament tears, skate bite, and ankle sprains. This review is intended to aid the sports medicine physician in providing optimal sports-specific care to allow their athlete to return to their preinjury level of performance.

  9. Fractures of the distal radius. Current concepts for treatment.

    Science.gov (United States)

    Broos, P L; Fourneau, I A; Stoffelen, D V

    2001-06-01

    The authors review the treatment of fractures of the distal radius, based on their experience and from data in the literature. The choice of a treatment for any given fracture must take into account first of all the stability of the fracture. The best results are achieved in stable fractures. Only minimally displaced distal radius fractures can be treated functionally. However, a plaster cast for one week is indicated for the comfort of the patient. In displaced but stable fractures both closed reduction and percutaneous fixation are indicated. In case of closed reduction, the plaster cast should be applied for 5 to 6 weeks with an above-elbow cast for 3 weeks. Percutaneous fixation gives the best results in extraarticular fractures in younger patients. Because of its simplicity however, it should not be ignored in the elderly osteoporotic patients. In the authors' experience, both techniques were only used for extraarticular fractures. Good and excellent results were found in the closed reduction and plaster cast group in 74% of the patients; the Kapandji technique gave 75% good and excellent results. These results are in line with other findings which show that, for simple fracture types, the Kapandji technique and closed reduction seem to give similar results. External fixation is widely used for intra-articular comminuted fractures. Dynamic external fixation does not show any advantage over static devices. Additional K-wires or bone grafting may be necessary. External fixation gives superior results to plate and screw fixation. Internal fixation should be reserved for fractures with ventral comminution or severe displacement with unacceptable reduction by closed or minimally invasive techniques.

  10. Modern concepts of treatment and prevention of lightning injuries.

    Science.gov (United States)

    Edlich, Richard F; Farinholt, Heidi-Marie A; Winters, Kathryne L; Britt, L D; Long, William B

    2005-01-01

    Lightning is the second most common cause of weather-related death in the United States. Lightning is a natural atmospheric discharge that occurs between regions of net positive and net negative electric charges. There are several types of lightning, including streak lightning, sheet lightning, ribbon lightning, bead lightning, and ball lightning. Lightning causes injury through five basic mechanisms: direct strike, flash discharge (splash), contact, ground current (step voltage), and blunt trauma. While persons struck by lightning show evidence of multisystem derangement, the most dramatic effects involve the cardiovascular and central nervous systems. Cardiopulmonary arrest is the most common cause of death in lightning victims. Immediate resuscitation of people struck by lightning greatly affects the prognosis. Electrocardiographic changes observed following lightning accidents are probably from primary electric injury or burns of the myocardium without coronary artery occlusion. Lightning induces vasomotor spasm from direct sympathetic stimulation resulting in severe loss of pulses in the extremities. This vasoconstriction may be associated with transient paralysis. Damage to the central nervous system accounts for the second most debilitating group of injuries. Central nervous system injuries from lightning include amnesia and confusion, immediate loss of consciousness, weakness, intracranial injuries, and even brief aphasia. Other organ systems injured by lightning include the eye, ear, gastrointestinal system, skin, and musculoskeletal system. The best treatment of lightning injuries is prevention. The Lightning Safety Guidelines devised by the Lightning Safety Group should be instituted in the United States and other nations to prevent these devastating injuries.

  11. Current concept of the treatment of biliary atresia.

    Science.gov (United States)

    Miyano, T; Fujimoto, T; Ohya, T; Shimomura, H

    1993-01-01

    Hepatic portoenterostomy (Kasai operation) for the patient with biliary atresia (BA) can restore the bile flow in approximately 80% of children operated on before 60 days of life [1]. However, in terms of long-term survival, according to a recent nationwide survey among the major pediatric centers in Japan, only 325 of 2013 patients had more than 10 years' survival, and only 157 patients (7.8%) remained jaundice-free with normal liver function [2]. About 20% of BA cases without jaundice are generally able to survive for long periods; and most of those patients have portal hypertension or abnormal liver function [3-5]. As the results of liver transplantation have improved, controversy has arisen over the optimal care of these children [4, 6, 7]. Some investigators have claimed that transplantation is the favored primary therapy for most patients with BA [8]. We are thus at a turning point concerning the primary therapy of BA, which makes it necessary to determine the exact indications for the Kasai portoenterostomy and the timing of liver transplantation. This paper describes our strategy for the optimal treatment of BA patients based on our 117 patients who have had various form of portoenterostomy.

  12. Current concepts in travelers' diarrhea: epidemiology, antimicrobial resistance and treatment.

    Science.gov (United States)

    Okhuysen, Pablo C

    2005-12-01

    The aim of this article is to review recent advances in travelers' diarrhea, which remains one of the most common health problems afflicting individuals from developed countries visiting less affluent regions of the world. A large epidemiologic study done at the point of departure provided insights into regional risk factors for travelers' diarrhea and demonstrated that visitors rarely exercised dietary precautions aimed at disease prevention. A preventive program implemented with the close interaction between public health agencies, hotel industry and academia can result in effective reduction of cases. A polymorphism in the IL-8 gene promoter is associated with susceptibility to diarrhea due to enteroaggregative Escherichia coli. New diagnostic tools assist in better understanding the role of norovirus and emerging bacterial enteric pathogens such as enteroaggregative E. coli. Rifaximin, a non-absorbable antibiotic, is a safe and effective alternative for the prevention and treatment of travelers' diarrhea due to non-invasive organisms. Traditional public health and new antimicrobial agents can decrease the risk of travel related diarrhea.

  13. Current concepts in the treatment of sports concussions.

    Science.gov (United States)

    Putukian, Margot; Kutcher, Jeffrey

    2014-10-01

    The management of patients with sports-related concussion (SRC) is comprehensive and includes preseason planning, education, initial evaluation, postinjury assessment, disposition, return-to-play decisions, and consideration of long-term brain health. Several recent publications have addressed sports concussion management using the best available evidence, and we review them here. The diagnosis and management of sports concussion have evolved over the past several decades, and with a greater understanding of the importance of both short- and long-term sequelae, there has been a clear trend toward recognizing and treating these brain injuries more cautiously and developing a proactive approach to management and return-to-play decision making. Although each of these used different methodologies in their review of the literature, their conclusions are fairly consistent, providing basic guidelines for contemporary approaches to management of SRC. Although many questions remain unanswered, there are several areas of agreement including the importance of education, preseason assessment, the benefit and utility of a standardized multimodal assessment on the sidelines, individualized treatment and return-to-play protocols, and the benefit of a multidisciplinary team in managing complicated injuries. This paper reviews these current sports concussion guidelines and the best available evidence that guides current management of SRC.

  14. Grey water treatment concept integrating water and carbon recovery and removal of micropollutants

    NARCIS (Netherlands)

    Hernandez Leal, L.; Zeeman, G.; Buisman, C.J.N.

    2011-01-01

    A total treatment concept was developed for grey water from 32 houses in Sneek, The Netherlands. A thorough characterization of COD, nutrients, metals, micropollutants and anions was carried out. Four biological treatment systems were tested: aerobic, anaerobic, combined anaerobic¿+¿aerobic and a

  15. Burden of treatment for chronic illness: a concept analysis and review of the literature.

    Science.gov (United States)

    Sav, Adem; King, Michelle A; Whitty, Jennifer A; Kendall, Elizabeth; McMillan, Sara S; Kelly, Fiona; Hunter, Beth; Wheeler, Amanda J

    2015-06-01

    Treatment burden, the burden associated with the treatment and management of chronic illness, has not yet been well articulated. Using Rodgers' (1989, Journal of Advanced Nursing, 14, 330-335) method of concept analysis, this review describes the ways in which treatment burden has been conceptualized to define the concept and to develop a framework for understanding its attributes, antecedents and consequences. Leading databases were searched electronically between the years 2002 and 2011. To ensure the review focused on actual observations of the concept of interest, articles that did not measure treatment burden (either qualitatively or quantitatively) were excluded. An inductive approach was used to identify themes related to the concept of treatment burden. Thirty articles, identified from 1557 abstracts, were included in the review. The attributes of treatment burden include burden as a dynamic process, as a multidimensional concept, and comprising of both subjective and objective elements. Prominent predisposing factors (antecedents) include the person's age and gender, their family circumstances, possible comorbidity, high use of medications, characteristics of treatment and their relationship with their health-care provider. The most dominant consequences are poor health and well-being, non-adherence to treatment, ineffective resource use and burden on significant others. Furthermore, many of these consequences can also become antecedents, reflecting the cyclic and dynamic nature of treatment burden. The findings underscore the need for researchers and health-care professionals to engage in collaborative discussions and make cooperative efforts to help alleviate treatment burden and tailor treatment regimens to the realities of people's daily lives. © 2013 Blackwell Publishing Ltd.

  16. Neonatal posthemorrhagic hydrocephalus from prematurity: pathophysiology and current treatment concepts

    Science.gov (United States)

    Robinson, Shenandoah

    2013-01-01

    Object Preterm infants are at risk for perinatal complications, including germinal matrix–intraventricular hemorrhage (IVH) and subsequent posthemorrhagic hydrocephalus (PHH). This review summarizes the current understanding of the epidemiology, pathophysiology, management, and outcomes of IVH and PHH in preterm infants. Methods The MEDLINE database was systematically searched using terms related to IVH, PHH, and relevant neurosurgical procedures to identify publications in the English medical literature. To complement information from the systematic search, pertinent articles were selected from the references of articles identifed in the initial search. Results This review summarizes the current knowledge regarding the epidemiology and pathophysiology of IVH and PHH, primarily using evidence-based studies. Advances in obstetrics and neonatology over the past few decades have contributed to a marked improvement in the survival of preterm infants, and neurological morbidity is also starting to decrease. The incidence of IVH is declining, and the incidence of PHH will likely follow. Currently, approximately 15% of preterm infants who suffer severe IVH will require permanent CSF diversion. The clinical presentation and surgical management of symptomatic PHH with temporary ventricular reservoirs (ventricular access devices) and ventriculosubgaleal shunts and permanent ventriculoperitoneal shunts are discussed. Preterm infants who develop PHH that requires surgical treatment remain at high risk for other related neurological problems, including cerebral palsy, epilepsy, and cognitive and behavioral delay. This review highlights numerous opportunities for further study to improve the care of these children. Conclusions A better grasp of the pathophysiology of IVH is beginning to impact the incidence of IVH and PHH. Neonatologists conduct rigorous Class I and II studies to advance the outcomes of preterm infants. The need for well-designed multicenter trials is

  17. Study about the integrated treatment of chemical and radioactive effluents, introducing the zero release concept

    International Nuclear Information System (INIS)

    Mierzwa, Jose Carlos

    1996-01-01

    An Integrated System to the treatment of Chemical and Radioactive Effluents to the Centro Experimental Aramar is proposed and evaluated, introducing the Effluent Zero Release concept, where factors related to the environmental regulation in vigor in the country, as well as the availability of hydrological resources in the place where CEA have been implanted, are considered. Through a literature analysis of the main effluents treatment techniques available nowadays and after a case of study selection, take into account two industrial installations that will be implanted at CEA, it was defined an arrangement to compose the Integrated System to the Treatment of Chemicals and Radioactive Effluents, focusing the Zero Release concept consolidation. A defined arrangement uses a combination among three treatment processes, it means chemical precipitation, reverse osmosis and evaporation, that were experimentally evaluated. The proposed arrangement was evaluated using synthetic effluents, that were prepared based on data from literature and conception documents of the installation considered in this work. Three kinds of effluents were simulated, one arising from a nuclear reactor laundry, one arising from the water refrigeration system and demineralized water production to the nuclear reactor and the other one arising from a nuclear material production laboratory. Each effluent were individually submitted to the selected treatment processes, to get the best operational conditions for each treatment process. The results got during the laboratory assays show that the proposed Integrated System to the Treatment of Chemicals and Radioactive Effluents is feasible, consolidating the Effluent Zero Release concept, which is the proposition of this work. (author)

  18. Conceptions of health, illness and treatment of patients who use homeopathy in Santos, Brazil.

    Science.gov (United States)

    Patriani Justo, C M; Dé Andrea Gomes, Mara H

    2008-01-01

    To investigate the conceptions of health and illness, the reasons for seeking homeopathy and continuing treatment, compliance and the meaning of the relationship between religiosity and health for patients who adhere to homeopathy. A qualitative study of 20 adult patients in Santos (Brazil) treated by homeopaths in the public and private sector for at least 2 years. Semi-structured interviews, organized by predefined thematic categories, the content of the interviews was analyzed. The conceptions of health and illness of the interviewed patients are related to the idea of vital balance/imbalance mediated by body-mind interaction. Dissatisfaction with conventional treatment, family influence and suggestions of others were the reasons for seeking homeopathic treatment. Patients continued homeopathic treatment due to positive therapeutic results, cure without being aggressive to the organism, the holistic integrated approach, the preventive nature of the treatment and low prices of medicine. For these patients, the availability of homeopathy in the public health sector extends the possibility of access. The need for a wider dissemination of homeopathy and the difficulties in following the prescription are the main problems involved in continuing treatment. Faith is an important component. We found a correlation between the conceptions of health and illness and the principles of homeopathy, assimilated through a strong bond between patients and the homeopathic practitioners. To investigate the beliefs, values and meanings that patients attribute to homeopathy helps to understand subjective aspects that may interfere with treatment compliance.

  19. Performance of UASB septic tank for treatment of concentrated black water within DESAR concept

    NARCIS (Netherlands)

    Kujawa-Roeleveld, K.; Fernandes, T.; Wiryawan, Y.; Tafwik, A.; Visser, de M.; Zeeman, G.

    2005-01-01

    Separation of wastewater streams produced in households according to their origin, degree of pollution and affinity to a specific treatment constitutes a starting point in the DESAR concept (decentralised sanitation and reuse). Concentrated black water and kitchen waste carry the highest load of

  20. [Recognizing prevention and treatment of burn sepsis with the concept of holistic integrative medicine].

    Science.gov (United States)

    Huan, J N

    2017-04-20

    Sepsis remains a major cause of death in severe burns. The effect of sepsis management is influenced by its complicated pathophysiologic changes. In order to improve the outcome of burn sepsis, the predisposing factor of sepsis after burn analyzed by advanced technology, the early prevention, antibiotics therapy, and combined treatment in severe burns with sepsis are discussed using the concept of holistic integrative medicine.

  1. Fractures in childhood; Frakturen beim Kind

    Energy Technology Data Exchange (ETDEWEB)

    Moritz, Joerg D. [Universitaetsklinikum Schleswig-Holstein, Kiel (Germany). Klinik fuer diagnostische Radiologie, Paediatrische Radiologie und Sonografie

    2014-09-15

    Clinical diagnosis of fractures in childhood can be very difficult. Therefore imaging, not only x-rays but also ultrasound, computed tomography and magnetic resonance imaging are of special importance. There are typical pediatric types of fractures due to epiphyseal plates and high flexibility of the bone. Fractures heal faster and dislocations can be spontaneously corrected better but also growth disturbance can occur. The second part of the article describes the special types of fractures with special attention to the characteristics in childhood.

  2. Family Aided Community Treatment for the Treatment of Early Psychosis: A Proof of Concept Study.

    Science.gov (United States)

    Melton, Ryan P; Dykeman, Cass

    2016-08-01

    Major psychotic disorders are one of the leading causes of disability worldwide. If these conditions are identified early and treatment promptly implemented, the prognosis is improved. This study examined the impact of a yearlong family aided community treatment (FACT) intervention upon psychiatric symptoms. Psychiatric symptom scores improved with the FACT intervention. Improved training on early recognition for mental health clinicians, implementation of a specific treatment model in community settings and policy around treatment funding allocation are implications of this study.

  3. Self-concept and the perception of facial appearance in children and adolescents seeking orthodontic treatment.

    Science.gov (United States)

    Phillips, Ceib; Beal, Kimberly N Edwards

    2009-01-01

    To examine, in adolescents with mild to moderate malocclusion, the relationship between self-concept and demographic characteristics, a clinical assessment of malocclusion, self-perception of malocclusion, and self-perception of facial attractiveness. Fifty-nine consecutive patients ages 9 to 15 years scheduled for initial records in a graduate orthodontic clinic consented to participate. Each subject independently completed the Multidimensional Self-Concept Scale (MSCS), the Facial Image Scale, and the Index of Treatment Need-Aesthetic Component (IOTN-AC). Peer Assessment Rating (PAR) scores were obtained from the patients' diagnostic dental casts. Forward multiple-regression analysis with a backward overlook was used to analyze the effect of the demographic, clinical, and self-perception measures on each of the six self-concept (MSCS) domains. Self-perception of the dentofacial region was the only statistically significant predictor (P Academic, and Physical domains of self-concept, while age, parental marital status, and the adolescent's self-perception of the dentofacial region were statistically significant predictors (P Self-Concept. The self-perceived level of the attractiveness or "positive" feelings toward the dentofacial region is more strongly related to self-concept than the severity of the malocclusion as indicated by the PAR score or by the adolescent's perception of their malocclusion.

  4. Self-Concept and the Perception of Facial Appearance in Children and Adolescents Seeking Orthodontic Treatment

    Science.gov (United States)

    Phillips, Ceib; Beal, Kimberly N. Edwards

    2009-01-01

    Objective To examine, in adolescents with mild to moderate malocclusion, the relationship between self-concept and demographic characteristics, a clinical assessment of malocclusion, self-perception of malocclusion, and self-perception of facial attractiveness. Methods and Materials Fifty-nine consecutive patients ages 9 to 15 years scheduled for initial records in a graduate orthodontic clinic consented to participate. Each subject independently completed the Multidimensional Self-Concept Scale (MSCS), the Facial Image Scale, and the Index of Treatment Need–Aesthetic Component (IOTN-AC). Peer Assessment Rating (PAR) scores were obtained from the patients’ diagnostic dental casts. Forward multiple-regression analysis with a backward overlook was used to analyze the effect of the demographic, clinical, and self-perception measures on each of the six self-concept (MSCS) domains. Results Self-perception of the dentofacial region was the only statistically significant predictor (P < .05) for the Global, Competence, Affect, Academic, and Physical domains of self-concept, while age, parental marital status, and the adolescent's self-perception of the dentofacial region were statistically significant predictors (P < .05) of Social Self-Concept. Conclusion The self-perceived level of the attractiveness or “positive” feelings toward the dentofacial region is more strongly related to self-concept than the severity of the malocclusion as indicated by the PAR score or by the adolescent's perception of their malocclusion. PMID:19123700

  5. The greenhouse gas and energy balance of different treatment concepts for bio-waste.

    Science.gov (United States)

    Ortner, Maria E; Müller, Wolfgang; Bockreis, Anke

    2013-10-01

    The greenhouse gas (GHG) and energy performance of bio-waste treatment plants been investigated for three characteristic bio-waste treatment concepts: composting; biological drying for the production of biomass fuel fractions; and anaerobic digestion. Compared with other studies about the environmental impacts of bio-waste management, this study focused on the direct comparison of the latest process concepts and state-of-the-art emission control measures. To enable a comparison, the mass balance and products were modelled for all process concepts assuming the same bio-waste amounts and properties. In addition, the value of compost as a soil improver was included in the evaluation, using straw as a reference system. This aspect has rarely been accounted for in other studies. The study is based on data from operational facilities combined with literature data. The results show that all three concepts contribute to a reduction of GHG emissions and show a positive balance for cumulated energy demand. However, in contrast to other studies, the advantage of anaerobic digestion compared with composting is smaller as a result of accounting for the soil improving properties of compost. Still, anaerobic digestion is the environmentally superior solution. The results are intended to inform decision makers about the relevant aspects of bio-waste treatment regarding the environmental impacts of different bio-waste management strategies.

  6. How to do in persistent diarrhea of children?: concepts and treatments of chronic diarrhea.

    Science.gov (United States)

    Lee, Kun Song; Kang, Dong Soo; Yu, Jeesuk; Chang, Young Pyo; Park, Woo Sung

    2012-12-01

    Chronic diarrhea is defined as passing watery stools that lasts for more than 2 weeks. Persistent diarrhea belongs to chronic diarrhea and is a chronic episode of diarrhea of infectious etiology. The etiology of chronic diarrhea is varied. It is important to consider the child's age and clinical manifestations with alarm signals for an application of proper treatments to children with chronic diarrhea. Vicious cycle is present in chronic diarrhea and nutritional rehabilitation can break the vicious cycle of chronic diarrhea and is one of the main one thing among treatments. We should know the exact concept of chronic diarrhea and provide appropriate treatments according to etiologies of chronic diarrhea.

  7. Effective Treatment of an Apparent Meniscal Injury Using the Mulligan Concept

    Directory of Open Access Journals (Sweden)

    Alex J. Rhinehart

    2015-05-01

    Full Text Available Objective: Present a clinic case demonstrating the effectiveness of the Mulligan Concept (MC in treating an apparent meniscal injury. The utilization of the MC in the evaluation and treatment of a 20-year-old soccer player with an apparent acute meniscal injury is presented. Background: Meniscal injuries are common knee injuries. The MC is a therapeutic intervention strategy applied as both a treatment-based evaluation and therapeutic intervention. Treatment: The patient was successfully treated in four treatment sessions using the MC. The patient experienced minimal clinically-important differences on a variety of global and regional patient-rated outcomes. Uniqueness: To the author’s knowledge, there are currently no published case reports of using the MC in clinical practice to treat an apparent meniscal pathology. Conclusion: The MC can be utilized as an evaluation and treatment technique in patients suspected of having meniscal pathology in the knee.

  8. SLUDGE TREATMENT PROJECT COST COMPARISON BETWEEN HYDRAULIC LOADING AND SMALL CANISTER LOADING CONCEPTS

    Energy Technology Data Exchange (ETDEWEB)

    GEUTHER J; CONRAD EA; RHOADARMER D

    2009-08-24

    The Sludge Treatment Project (STP) is considering two different concepts for the retrieval, loading, transport and interim storage of the K Basin sludge. The two design concepts under consideration are: (1) Hydraulic Loading Concept - In the hydraulic loading concept, the sludge is retrieved from the Engineered Containers directly into the Sludge Transport and Storage Container (STSC) while located in the STS cask in the modified KW Basin Annex. The sludge is loaded via a series of transfer, settle, decant, and filtration return steps until the STSC sludge transportation limits are met. The STSC is then transported to T Plant and placed in storage arrays in the T Plant canyon cells for interim storage. (2) Small Canister Concept - In the small canister concept, the sludge is transferred from the Engineered Containers (ECs) into a settling vessel. After settling and decanting, the sludge is loaded underwater into small canisters. The small canisters are then transferred to the existing Fuel Transport System (FTS) where they are loaded underwater into the FTS Shielded Transfer Cask (STC). The STC is raised from the basin and placed into the Cask Transfer Overpack (CTO), loaded onto the trailer in the KW Basin Annex for transport to T Plant. At T Plant, the CTO is removed from the transport trailer and placed on the canyon deck. The CTO and STC are opened and the small canisters are removed using the canyon crane and placed into an STSC. The STSC is closed, and placed in storage arrays in the T Plant canyon cells for interim storage. The purpose of the cost estimate is to provide a comparison of the two concepts described.

  9. Treatment should be considered a competing risk when predicting natural conception in subfertile women.

    Science.gov (United States)

    Van Geloven, N; Broeze, K A; Bossuyt, P M M; Zwinderman, A H; Mol, B W

    2012-03-01

    Prediction of natural conception in subfertile couples can help to differentiate between couples who should have immediate treatment and couples who can aim for natural conception for some time. Natural conception rates are often estimated using standard techniques such as Kaplan-Meier or Cox proportional hazard models. These estimates can be biased by incorrect handling of data from women who start assisted reproductive technology therapy before the end of the follow-up period. This paper discusses the validity and the impact of the assumption of non-informative censoring as used in the Kaplan-Meier and Cox models. In a cohort of 5360 subfertile couples with suspected tubal pathology, the probability of natural conception and the prognostic value of additional tests for tubal pathology were estimated using traditional methods and with a competing risks analysis. The estimated probability of natural conception within 3 years was almost 2-fold higher when assuming non-informative censoring compared with the competing risks model, 41 versus 22%. The prognostic value of tests was more conservative using the competing risks model than with the traditional methods, the fecundity rate ratio for Chlamydia antibody testing was 0.72 versus 0.67, for hysterosalpingography, 0.83 versus 0.71 and for diagnostic laparoscopy, 0.89 versus 0.74. Given the improbable validity of the non-informative censoring assumption, the predictions of natural conception and of the prognostic value of tests are likely to be overestimated by the traditional analytic methods. We suggest the use of competing risks models as an alternative, more conservative, form of analysis when predicting natural conception and evaluating prognostic fertility tests.

  10. SLUDGE TREATMENT PROJECT COST COMPARISON BETWEEN HYDRAULIC LOADING AND SMALL CANISTER LOADING CONCEPTS

    International Nuclear Information System (INIS)

    Geuther, J.; Conrad, E.A.; Rhoadarmer, D.

    2009-01-01

    The Sludge Treatment Project (STP) is considering two different concepts for the retrieval, loading, transport and interim storage of the K Basin sludge. The two design concepts under consideration are: (1) Hydraulic Loading Concept - In the hydraulic loading concept, the sludge is retrieved from the Engineered Containers directly into the Sludge Transport and Storage Container (STSC) while located in the STS cask in the modified KW Basin Annex. The sludge is loaded via a series of transfer, settle, decant, and filtration return steps until the STSC sludge transportation limits are met. The STSC is then transported to T Plant and placed in storage arrays in the T Plant canyon cells for interim storage. (2) Small Canister Concept - In the small canister concept, the sludge is transferred from the Engineered Containers (ECs) into a settling vessel. After settling and decanting, the sludge is loaded underwater into small canisters. The small canisters are then transferred to the existing Fuel Transport System (FTS) where they are loaded underwater into the FTS Shielded Transfer Cask (STC). The STC is raised from the basin and placed into the Cask Transfer Overpack (CTO), loaded onto the trailer in the KW Basin Annex for transport to T Plant. At T Plant, the CTO is removed from the transport trailer and placed on the canyon deck. The CTO and STC are opened and the small canisters are removed using the canyon crane and placed into an STSC. The STSC is closed, and placed in storage arrays in the T Plant canyon cells for interim storage. The purpose of the cost estimate is to provide a comparison of the two concepts described

  11. NEW CONCEPT OF ETIOPATHOGENESIS OF INFANT'S CHRONIC CONSTIPATION AND TREATMENT PRINCIPLES

    Directory of Open Access Journals (Sweden)

    A.I. Lenyushkin

    2006-01-01

    Full Text Available Basing upon the study of conjunctive tissue frame and unstriped muscles of colon from autopsy material, as well as analysis of over 2000 clinical observations the authors set forth a new concept of etiopathogenesis of infant's chronic constipations by interpreting the functional disorders as a consequence of genetically determined status of conjunctive tissue frame. principles of conservative therapy and indications to surgery correction are considered.Key words: chronic constipation, etiology and pathogenesis, treatment, lactulose, surgical intervention, children.

  12. ALERT. Adverse late effects of cancer treatment. Vol. 1. General concepts and specific precepts

    Energy Technology Data Exchange (ETDEWEB)

    Rubin, Philip; Constine, Louis S. [Univ. Rochester Medical Center, NY (United States). Dept. of Radiation Oncology; Marks, Lawrence B. (ed.) [Univ. North Carolina and Lineberger, Comprehensive Cancer Center, Chapel Hill, NC (United States). Dept. of Radiation Oncology

    2014-09-01

    Considers in detail the general concepts and principles relevant to the adverse late effects of cancer treatment. Explains the molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Includes chapters on legal issues, economic aspects, nursing, psychological issues and quality of life. The literature on the late effects of cancer treatment is widely scattered in different journals since all major organ systems are affected and management is based on a variety of medical and surgical treatments. The aim of ALERT - Adverse Late Effects of Cancer Treatment is to offer a coherent multidisciplinary approach to the care of cancer survivors. The central paradigm is that cytotoxic multimodal therapy results in a perpetual cascade of events that affects each major organ system differently and is expressed continually over time. Essentially, radiation and chemotherapy are intense biologic modifiers that allow for cancer cure and cancer survivorship but accelerate senescence of normal tissues and increase the incidence of age-related diseases and second malignant tumors. Volume 1 of this two-volume work focuses on the general concepts and principles relevant to late effects and on the dynamic interplay of molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Chapters are also included on legal issues, economic aspects, nursing, psychological issues and quality of life.

  13. [Mentalization-Based Treatment for Adolescents with Borderline Personality Disorder - Concept and Efficacy].

    Science.gov (United States)

    Taubner, Svenja; Volkert, Jana; Gablonski, Thorsten-Christian; Rossouw, Trudie

    2017-07-01

    Mentalization-Based Treatment for Adolescents with Borderline Personality Disorder - Concept and Efficacy In recent years, the concept of mentalization has become increasingly important in practice and research. It describes the imaginative ability to understand human behavior in terms of mental states. Mentalization is a central component to understand the etiology and to treat patients with borderline personality disorder (BPD). Both adult and adolescent patients with BPD have limited mentalization abilities, which can be reliably assessed using the Reflective Functioning Scale. Mentalization-Based Treatment (MBT) was originally developed as an integrative approach for the treatment of adult patients with BPD. It is a manualized psychotherapy with psychodynamic roots with the aim to increase mentalizing abilities of patients. Since then, MBT has been further developed for other mental disorders as well as for the treatment of different age groups. One of these developments is MBT for Adolescents (MBT-A). MBT-A includes both individual as well as family sessions and the average duration of therapy is about twelve months. MBT-A can be applied in inpatient and outpatient settings and aims to improve mentalizing abilities in emotionally important relationships and the whole family system. First studies have found evidence for the efficacy of MBT-A. A randomized controlled trial (RCT) is currently being carried out to evaluate the efficacy of MBT-A for adolescents with conduct disorder. However, further evidence for efficacy and further conceptual development is needed.

  14. Concepts and treatment for diabetes among traditional and faith healers in the northern province, South Africa.

    Science.gov (United States)

    Peltzer, K; Khoza, L B; Lekhuleni, M E; Madu, S N; Cherian, V I; Cherian, L

    2001-05-01

    The purpose of the study was to assess the concepts and treatment modalities for diabetes among traditional and faith healers in the Northern Province in South Africa. The sample consisted of 50 traditional healers (13 females and 37 males) and 50 faith healers (12 females and 38 males). They were interviewed on local terminology, clinical manifestations, causes, curability, and treatment for diabetes, help-seeking behaviour of diabetes patients, and the healers' sources of information about diabetes. Results indicate that all healers were familiar with "diabetes", however, not all of them had seen patients suffering from diabetes. The perceived causes of diabetes by both traditional and faith healers could be divided into (1) diet (especially too much of sugar), (2) heredity, (3) supernatural, and (4) psychological causes. Most traditional healers (92%) and faith healers (90%) indicated that diabetes is curable. Treatments used by the healers in this study included the use of prayer, diet, and herbs. The authors conclude that the concepts and treatment modalities for diabetes among traditional and faith healers should be taken note of by health workers while developing health education programmes in the Province.

  15. ALERT. Adverse late effects of cancer treatment. Vol. 1. General concepts and specific precepts

    International Nuclear Information System (INIS)

    Rubin, Philip; Constine, Louis S.; Marks, Lawrence B.

    2014-01-01

    Considers in detail the general concepts and principles relevant to the adverse late effects of cancer treatment. Explains the molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Includes chapters on legal issues, economic aspects, nursing, psychological issues and quality of life. The literature on the late effects of cancer treatment is widely scattered in different journals since all major organ systems are affected and management is based on a variety of medical and surgical treatments. The aim of ALERT - Adverse Late Effects of Cancer Treatment is to offer a coherent multidisciplinary approach to the care of cancer survivors. The central paradigm is that cytotoxic multimodal therapy results in a perpetual cascade of events that affects each major organ system differently and is expressed continually over time. Essentially, radiation and chemotherapy are intense biologic modifiers that allow for cancer cure and cancer survivorship but accelerate senescence of normal tissues and increase the incidence of age-related diseases and second malignant tumors. Volume 1 of this two-volume work focuses on the general concepts and principles relevant to late effects and on the dynamic interplay of molecular, cytologic and histopathologic events that lead to altered physiologic and metabolic functions and their clinical manifestations. Chapters are also included on legal issues, economic aspects, nursing, psychological issues and quality of life.

  16. Designing a concept for an IT-infrastructure for an integrated research and treatment center.

    Science.gov (United States)

    Stäubert, Sebastian; Winter, Alfred; Speer, Ronald; Löffler, Markus

    2010-01-01

    Healthcare and medical research in Germany are heading to more interconnected systems. New initiatives are funded by the German government to encourage the development of Integrated Research and Treatment Centers (IFB). Within an IFB new organizational structures and infrastructures for interdisciplinary, translational and trans-sectoral working relationship between existing rigid separated sectors are intended and needed. This paper describes how an IT-infrastructure of an IFB could look like, what major challenges have to be solved and what methods can be used to plan such a complex IT-infrastructure in the field of healthcare. By means of project management, system analyses, process models, 3LGM2-models and resource plans an appropriate concept with different views is created. This concept supports the information management in its enterprise architecture planning activities and implies a first step of implementing a connected healthcare and medical research platform.

  17. An Analysis of the Concept of Partnership in the Couples Undergoing Infertility Treatment.

    Science.gov (United States)

    Ying, Liying; Loke, Alice Yuen

    2016-01-01

    The elements of a partnership in the couples undergoing infertility treatment are not well understood. This article aims to fill the gap by using Rodger's evolutionary method of concept analysis. The attributes of the concept partnership that were identified are a process of joint hardship, sharing, intracouple communication, and mutual support. The antecedents are love and attraction for each other, agreement, and interpersonal skills. The consequences are marital benefit, improvement in psychological status, and quality of life. A middle-range model for partnership in relationship to infertile couples is proposed. The understanding of the phenomenon of partnership will enable the researchers to develop interventions, identify the appropriate assessment instruments, and to determine directions for future research on effort to support infertile couples through their hardship.

  18. Compliance to treatment in patients with chronic illness: A concept exploration

    Science.gov (United States)

    Rafii, Forough; Fatemi, Naima Seyed; Danielson, Ella; Johansson, Christina Melin; Modanloo, Mahnaz

    2014-01-01

    Background: Patients’ compliance to treatment is an important indicator for evaluating the successful management in chronic illnesses. Despite the fact an applicable definition of compliance is required to suitable intervention and research, this concept is not clear and there is no consensus concerning its meaning, definition, and measurement. The aim of this study was to explore the concept of compliance and to formulate a working definition. Materials and Methods: Theoretical phase of Schwartz-Barcott and Kim's Hybrid Model of concept analysis was used to analyze the concept of compliance. Data were collected by using literature reviews. Medline, CINAHL, Ovid, Elsevier, Pro Quest and Blackwell databases were searched from 1975 to 2010 using the keywords “Compliance,” “Non-compliance,” “Adherence,” and “Concordance.” Articles published in English were selected if they included adult patients with chronic illnesses and reported attributes of compliance; 23 such relevant articles were chosen. Results: The attributes of compliance included patient obedience, ability to implement medical advice, flexibility, responsibility, collaboration, participation, and persistence in implementing the advices. Antecedents are organized into two interacting categories: Internal factors refer to the patient, disease, and treatment characteristics and external factors refer to the healthcare professionals, healthcare system, and socioeconomic factors. Compliance may lead to desirable and undesirable consequences. A working definition of compliance was formulated by comparing and contrasting the existing definitions with regard to its attributes which are useful in clinical practice and research. Conclusions: This finding will be useful in clinical practice and research. But this working definition has to be tested in a clinical context and a broad view of its applicability has to be obtained. PMID:24834085

  19. Treatment of atrophic tibia non-unions according to 'diamond concept': Results of one- and two-step treatment.

    Science.gov (United States)

    Moghaddam, Arash; Zietzschmann, Severin; Bruckner, Thomas; Schmidmaier, Gerhard

    2015-10-01

    The successful treatment of atrophic tibia non-unions and tibia non-unions with large bone defects or infections is a major challenge in orthopedic and trauma surgery. This article evaluates the use of the 'diamond concept' using a one-step or two-step procedure according to 'Masquelet technique' in the treatment of atrophic tibia non-unions. Between February 2010 and March 2014, 102 patients with atrophic non-unions were treated according to the 'diamond concept' in our center. Ninety-nine were available for follow-up. Forty-nine received a one-step treatment (Group 1, G1) and 50 patients received a two-step treatment according to the 'Masquelet technique' (Group 2, G2). Clinical and radiological parameters were measured preoperatively as well as 4, 6, and 12 weeks and 6 and 12 months postoperatively. In order to evaluate the subjective health of patients, we used the SF-12 questionnaire. Data analysis was performed one year after treatment. The rate of consolidation in G1 was 84% and 80% in G2. The time to heal in G2 was 8.6 ± 2.9 months, which is significantly longer than in G1 being 6.9 ± 3.1 months. In comparison patients in G1/G2 had an average of 3.2/6.7 previous major surgeries. In G1, 4 of 8 patients who did not heal successfully showed positive intraoperative cultures. In G2, 26 patients (52%) initially presented with positive cultures. The results of the SF-12 questionnaire improved in both groups during the postoperative follow-up, but showed no significant differences between groups. In 29 patients a gentamycin-coated nail was used for reosteosynthesis. These patients showed by trend a lower rate of complications at a higher rate of consolidation. Our study showed that the 'diamond concept' is a suitable method for safely and effectively treating non-unions with large defects or infections. The use of an antibiotic-coated nail provides a therapeutic benefit. For large bone defects of infected non-unions the two-step procedure after Masquelet is an

  20. Treatment of nonunions in fractures of the humeral shaft according to the Diamond Concept.

    Science.gov (United States)

    Miska, M; Findeisen, S; Tanner, M; Biglari, B; Studier-Fischer, S; Grützner, P A; Schmidmaier, G; Moghaddam, A

    2016-01-01

    Between 2005 and 2012, 50 patients (23 female, 27 male) with nonunion of the humeral shaft were included in this retrospective study. The mean age was 51.3 years (14 to 88). The patients had a mean of 1.5 prior operations (sd 1.2;1 to 8). All patients were assessed according to a specific risk score in order to devise an optimal and individual therapy plan consistent with the Diamond Concept. In 32 cases (64%), a change in the osteosynthesis to an angular stable locking compression plate was performed. According to the individual risk an additional bone graft and/or bone morphogenetic protein-7 (BMP-7) were applied. A successful consolidation of the nonunion was observed in 37 cases (80.4%) with a median healing time of six months (IQR 6). Younger patients showed significantly better consolidation. Four patients were lost to follow-up. Revision was necessary in a total of eight (16%) cases. In the initial treatment, intramedullary nailing was most common. The use of locking compression plates in combination with autologous cancellous bone graft has been shown to be a safe and effective treatment. In more complex cases, the use of the Masquelet technique and BMP-7 may be indicated at the first revision operation. Our results suggest the Diamond Concept is a successful treatment strategy for nonunions of the humeral shaft. ©2016 The British Editorial Society of Bone & Joint Surgery.

  1. The Initial Treatment of the Concept of Function in the Selected Secondary School Mathematics Textbooks in the US and China

    Science.gov (United States)

    Son, Ji-Won; Hu, Qintong

    2016-01-01

    In order to provide insight into cross-national differences in students' achievement, this study compares the initial treatment of the concept of function sections of Chinese and US textbooks. The number of lessons, contents, and mathematical problems were analyzed. The results show that the US curricula introduce the concept of function one year…

  2. Intended process water management concept for the mechanical biological treatment of municipal solid waste

    Directory of Open Access Journals (Sweden)

    D. Weichgrebe

    2008-03-01

    Full Text Available Accumulating operational experience in both aerobic and anaerobic mechanical biological waste treatment (MBT makes it increasingly obvious that controlled water management would substantially reduce the cost of MBT and also enhance resource recovery of the organic and inorganic fraction. The MBT plant at Gescher, Germany, is used as an example in order to determine the quantity and composition of process water and leachates from intensive and subsequent rotting, pressing water from anaerobic digestion and scrubber water from acid exhaust air treatment, and hence prepare an MBT water balance. The potential of, requirements for and limits to internal process water reuse as well as the possibilities of resource recovery from scrubber water are also examined. Finally, an assimilated process water management concept with the purpose of an extensive reduction of wastewater quantity and freshwater demand is presented.

  3. In search of patient characteristics that may guide empirically based treatment selection for personality disorder patients - a concept map approach

    NARCIS (Netherlands)

    van Manen, J.G.; Kamphuis, J.H.; Goossensen, A.; Timman, R.; Busschbach, J.J.V.; Verheul, R.

    2012-01-01

    Using the concept map method, this study aimed to summarize and describe patient characteristics pertinent to treatment selection for patients with personality disorders (PDs). Initial patient characteristics were derived from the research literature and a survey among Dutch expert clinicians.

  4. Outcomes of conception subsequent to methotrexate treatment for an unruptured ectopic pregnancy.

    Science.gov (United States)

    Svirsky, Ran; Ben-Ami, Ido; Berkovitch, Matitiahu; Halperin, Reuvit; Rozovski, Uri

    2017-11-01

    To assess the risk of adverse pregnancy outcomes in subsequent pregnancies among women treated with methotrexate for ectopic pregnancy. In a retrospective single-center study, data were assessed for women treated with methotrexate for ectopic pregnancy at Asaf Harofe Medical Center, Zerifin, Israel, between May 2004 and May 2014. Overall, 226 women were treated with methotrexate for ectopic pregnancy and subsequently conceived. The median time from treatment to conception was 10 months (range 1-120 months), and 127 women conceived within 12 months of treatment. Except for early missed abortion-which affected 23 (10.2%) pregnancies-adverse pregnancy outcomes such as fetal malformations were rare. The frequency of early abortion was lowest for women who conceived within 6 months of treatment with methotrexate (3/93, 3.2%), increased between 6 and 23 months (15/83, 18.1%), and remained high thereafter (7/50, 14.0%; P=0.006). The frequency of fetal malformation in a subsequent pregnancy was low among women treated with methotrexate for ectopic pregnancy. The frequency of early missed abortion was lowest during the first 6 months after treatment with methotrexate. © 2017 International Federation of Gynecology and Obstetrics.

  5. Photodynamic therapy in neurosurgery: a proof of concept of treatment planning system

    Science.gov (United States)

    Dupont, C.; Reyns, N.; Mordon, S.; Vermandel, M.

    2017-02-01

    Glioblastoma (GBM) is the most common primary brain tumor. PhotoDynamic Therapy (PDT) appears as an interesting research field to improve GBM treatment. Nevertheless, PDT cannot fit into the current therapeutic modalities according to several reasons: the lack of reliable and reproducible therapy schemes (devices, light delivery system), the lack of consensus on a photosensitizer and the absence of randomized and controlled multicenter clinical trial. The main objective of this study is to bring a common support for PDT planning. Here, we describe a proof of concept of Treatment Planning System (TPS) dedicated to interstitial PDT for GBM treatment. The TPS was developed with the integrated development environment C++ Builder XE8 and the environment ArtiMED, developed in our laboratory. This software enables stereotactic registration of DICOM images, light sources insertion and an accelerated CUDA GPU dosimetry modeling. Although, Monte-Carlo is more robust to describe light diffusion in biological tissue, analytical model accelerated by GPU remains relevant for dose preview or fast reverse planning processes. Finally, this preliminary work proposes a new tool to plan interstitial or intraoperative PDT treatment and might be included in the design of future clinical trials in order to deliver PDT straightforwardly and homogenously in investigator centers.

  6. Nitrous Oxide for Treatment-Resistant Major Depression: A Proof-of-Concept Trial.

    Science.gov (United States)

    Nagele, Peter; Duma, Andreas; Kopec, Michael; Gebara, Marie Anne; Parsoei, Alireza; Walker, Marie; Janski, Alvin; Panagopoulos, Vassilis N; Cristancho, Pilar; Miller, J Philip; Zorumski, Charles F; Conway, Charles R

    2015-07-01

    N-methyl-D-aspartate receptor antagonists, such as ketamine, have rapid antidepressant effects in patients with treatment-resistant depression (TRD). We hypothesized that nitrous oxide, an inhalational general anesthetic and N-methyl-D-aspartate receptor antagonist, may also be a rapidly acting treatment for TRD. In this blinded, placebo-controlled crossover trial, 20 patients with TRD were randomly assigned to 1-hour inhalation of 50% nitrous oxide/50% oxygen or 50% nitrogen/50% oxygen (placebo control). The primary endpoint was the change on the 21-item Hamilton Depression Rating Scale (HDRS-21) 24 hours after treatment. Mean duration of nitrous oxide treatment was 55.6 ± 2.5 (SD) min at a median inspiratory concentration of 44% (interquartile range, 37%-45%). In two patients, nitrous oxide treatment was briefly interrupted, and the treatment was discontinued in three patients. Depressive symptoms improved significantly at 2 hours and 24 hours after receiving nitrous oxide compared with placebo (mean HDRS-21 difference at 2 hours, -4.8 points, 95% confidence interval [CI], -1.8 to -7.8 points, p = .002; at 24 hours, -5.5 points, 95% CI, -2.5 to -8.5 points, p nitrous oxide and placebo, p nitrous oxide compared with one patient (5%) and none after placebo (odds ratio for response, 4.0, 95% CI, .45-35.79; OR for remission, 3.0, 95% CI, .31-28.8). No serious adverse events occurred; all adverse events were brief and of mild to moderate severity. This proof-of-concept trial demonstrated that nitrous oxide has rapid and marked antidepressant effects in patients with TRD. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

  7. Treatment switches during pregnancy among HIV-positive women on antiretroviral therapy at conception.

    Science.gov (United States)

    Huntington, Susie E; Bansi, Loveleen K; Thorne, Claire; Anderson, Jane; Newell, Marie-Louise; Taylor, Graham P; Pillay, Deenan; Hill, Teresa; Tookey, Pat A; Sabin, Caroline A

    2011-08-24

    To describe antiretroviral therapy (ART) use and clinical status, at start of and during pregnancy, for HIV-positive women receiving ART at conception, including the proportion conceiving on drugs (efavirenz and didanosine) not recommended for use in early pregnancy. Women with a pregnancy resulting in a live-birth after 1995 (n = 1537) were identified in an observational cohort of patients receiving HIV care at 12 clinics in the UK by matching records with national pregnancy data. Treatment and clinical data were analysed for 375 women conceiving on ART, including logistic regression to identify factors associated with changing regimen during pregnancy. Of the 375 women on ART, 39 (10%) conceived on dual therapy, 306 (82%) on triple therapy and 30 (8%) on more than three drugs. In total, 116 (31%) women conceived on a regimen containing efavirenz or didanosine (69 efavirenz, 54 didanosine, seven both). Overall, 38% (143) changed regimen during pregnancy, of whom 44% (n = 51) had a detectable viral load around that time. Detectable viral load was associated with increased risk of regimen change [adjusted odds ratio 2.97, 95% confidence interval (CI) (1.70-5.19)], while women on efavirenz at conception were three times more likely to switch than women on other drugs [3.40, (1.84-6.25)]. Regimen switching was also associated with year at conception [0.89, (0.83-0.96)]. These findings reinforce the need for careful consideration of ART use among women planning or likely to have a pregnancy in order to reduce viral load before pregnancy and avoid drugs not recommended for early antenatal use.

  8. Application of super-omni wedge concept to conformal radiotherapy treatment planning

    International Nuclear Information System (INIS)

    Dai Jianrong; Fu Weihua; Hu Yimin

    2004-01-01

    Objective: To describe a method which can optimize beam weight, wedge angle, and wedge orientation simultaneously by combining the super-omni wedge (SOW) concept with the function of beam weight optimization provided by a commercial treatment planning system. Methods: A five-step procedure including: Step 1. To set up four 60 degree nominal wedged beams for each beam direction with the wedge orientations of 'LEFT', 'IN', 'RIGHT', 'OUT', respectively; Step 2. To define an optimization request, including an optimization goal and constraints. Authors use CMS Focus treatment planning system which allows us to choose 'maximize target dose' or 'minimize critical structure dose' as the optimization goal, and to set minimum target dose, maximum target dose, and maximum average dose of critical structures as constraints. Then the optimization process was launched as step 3; Step 4. To evaluate the plan using isodose distributions and dose-volume histograms. If acceptable, go to Step 5. Otherwise, go back to Step 2 to modify optimization constraints; and Step 5. Transform the SOW beams into the beams of omni wedge so as to reduce the number of to-be-delivered beams. Results: This procedure was found being able to demonstrate successfully in two clinical cases: an esophageal carcinoma and a brain tumor. Compared with manually designed plan, the optimized plan showed better dose homogeneity in the targets and better sparing of the critical structures. Conclusions: This method described is able to optimize beam weights while working with a treatment planning system. Not only does it improve treatment plans' quality, but also shorten the treatment planning process

  9. The conception of municipal sewage treatment systems from an economical point of view

    International Nuclear Information System (INIS)

    Posch, A.

    1999-09-01

    The objective of this work is to show the fundamental decisions that are necessary for planning municipal sewage treatment systems in rural areas and to assess the consequences of the possible alternatives. The analysis shows that the specific costs depend strongly on the chosen technology, the structure of the system and the type of organization. For instance constructed wetlands used on small scales are much more favorable than complex technical sewage plants. Whether a central or decentral structured sewage treatment system is preferable depends on the local topographic conditions. The fact that private and cooperative organizations mostly cause lower costs per capita as public organizations can be explained with the principal-agent-theory of the New Institutional Economics. Further economical and important ecological criteria are discussed in the analysis, too. The conclusions drawn from analysis aim especially to improve the process of planing sewage treatment systems. Especially recommended are the implementation of a professional project management, a complete survey of the given local conditions, the use of modern planning methods, an early participation of the population, the particularly consideration of innovative technologies as well as the development of integrated concepts of water management. (author)

  10. From bladder to systemic syndrome: concept and treatment evolution of interstitial cystitis

    Directory of Open Access Journals (Sweden)

    Dinis S

    2015-07-01

    Full Text Available Sara Dinis,1,2 Joana Tavares de Oliveira,3,4 Rui Pinto,1,5 Francisco Cruz,1,5 CA Tony Buffington,6 Paulo Dinis1,5 1Faculty of Medicine, University of Porto, 2Department of Obstetrics and Gynecology, Hospital de São João, Porto, 3Faculty of Veterinary Medicine, ULHT, Lisbon, 4Institute of Molecular Pathology and Immunology (IPATIMUP, University of Porto, 5Department of Urology, Hospital de São João, Porto, Portugal; 6Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, OH, USA Abstract: Interstitial cystitis, presently known as bladder pain syndrome, has been recognized for over a century but is still far from being understood. Its etiology is unknown and the syndrome probably harbors different diseases. Autoimmune dysfunction, urothelial leakage, infection, central and peripheral nervous system dysfunction, genetic disease, childhood trauma/abuse, and subsequent stress response system dysregulation might be implicated. Management is slowly evolving from a solo act by the end-organ specialist to a team approach based on new typing and phenotyping of the disease. However, oral and invasive treatments are still largely aimed at the bladder and are based on currently proposed pathophysiologic mechanisms. Future research will better define the disease, permitting individualization of treatment. Keywords: bladder pain syndrome, concept, treatment

  11. Current concepts in the classification, diagnosis and treatment of vascular anomalies

    Energy Technology Data Exchange (ETDEWEB)

    Ernemann, Ulrike, E-mail: ulrike.ernemann@med.uni-tuebingen.d [Department of Diagnostic and Interventional Neuroradiology, Radiological Clinic, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Kramer, Ulrich; Miller, Stephan [Department of Diagnostic and Interventional Radiology, Radiological Clinic, University Hospital Tuebingen (Germany); Bisdas, Sotirios [Department of Diagnostic and Interventional Neuroradiology, Radiological Clinic, University Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076 Tuebingen (Germany); Rebmann, Hans [Department of Paediatrics, Children' s Hospital, University Hospital Tuebingen (Germany); Breuninger, Helmut [Department of Dermatology, University Hospital Tuebingen (Germany); Zwick, Christine [Department of Hand, Plastic, Reconstructive and Burns Surgery, BG Trauma Clinic Tuebingen, University Hospital Tuebingen (Germany); Hoffmann, Juergen [Department of Oral and Maxillofacial Surgery, University Hospital Tuebingen (Germany)

    2010-07-15

    Patients with extended vascular anomalies may suffer from significant aesthetic and functional impairment and represent a challenge to therapeutic planning, which is best met by an interdisciplinary concept. In agreement with the International Society for the Study of Vascular Anomalies (ISSVA), vascular lesions are classified into haemangiomas as proliferating endothelial tumours on the one hand and congenital vascular malformations on the other. According to the preponderant vascular channels and hemodynamic characteristics, malformations are subdivided into low flow (venous, lymphatic and capillary) lesions and high-flow malformations. Diagnostic imaging should be targeted at the specific structural and functional informations required for treatment planning. The imaging modality of choice to provide these informations is magnetic resonance imaging (MRI) supplemented by magnetic resonance angiography (MRA) with high spatial and temporal resolution. Treatment indications for haemangiomas depend on the proliferative behaviour of the lesion and comprise {beta}-blockers in order to induce involution as well as cryotherapy, laser and open surgery. Interventional radiological procedures have evolved as an essential element in an interdisciplinary treatment plan for vascular malformations and include percutaneous sclerotherapy with ethanol and OK-432 for venous and lymphatic malformations and transarterial embolization for high-flow lesions.

  12. Current concepts in the classification, diagnosis and treatment of vascular anomalies

    International Nuclear Information System (INIS)

    Ernemann, Ulrike; Kramer, Ulrich; Miller, Stephan; Bisdas, Sotirios; Rebmann, Hans; Breuninger, Helmut; Zwick, Christine; Hoffmann, Juergen

    2010-01-01

    Patients with extended vascular anomalies may suffer from significant aesthetic and functional impairment and represent a challenge to therapeutic planning, which is best met by an interdisciplinary concept. In agreement with the International Society for the Study of Vascular Anomalies (ISSVA), vascular lesions are classified into haemangiomas as proliferating endothelial tumours on the one hand and congenital vascular malformations on the other. According to the preponderant vascular channels and hemodynamic characteristics, malformations are subdivided into low flow (venous, lymphatic and capillary) lesions and high-flow malformations. Diagnostic imaging should be targeted at the specific structural and functional informations required for treatment planning. The imaging modality of choice to provide these informations is magnetic resonance imaging (MRI) supplemented by magnetic resonance angiography (MRA) with high spatial and temporal resolution. Treatment indications for haemangiomas depend on the proliferative behaviour of the lesion and comprise β-blockers in order to induce involution as well as cryotherapy, laser and open surgery. Interventional radiological procedures have evolved as an essential element in an interdisciplinary treatment plan for vascular malformations and include percutaneous sclerotherapy with ethanol and OK-432 for venous and lymphatic malformations and transarterial embolization for high-flow lesions.

  13. Whole Brain Irradiation With Hippocampal Sparing and Dose Escalation on Multiple Brain Metastases: A Planning Study on Treatment Concepts

    International Nuclear Information System (INIS)

    Prokic, Vesna; Wiedenmann, Nicole; Fels, Franziska; Schmucker, Marianne; Nieder, Carsten; Grosu, Anca-Ligia

    2013-01-01

    Purpose: To develop a new treatment planning strategy in patients with multiple brain metastases. The goal was to perform whole brain irradiation (WBI) with hippocampal sparing and dose escalation on multiple brain metastases. Two treatment concepts were investigated: simultaneously integrated boost (SIB) and WBI followed by stereotactic fractionated radiation therapy sequential concept (SC). Methods and Materials: Treatment plans for both concepts were calculated for 10 patients with 2-8 brain metastases using volumetric modulated arc therapy. In the SIB concept, the prescribed dose was 30 Gy in 12 fractions to the whole brain and 51 Gy in 12 fractions to individual brain metastases. In the SC concept, the prescription was 30 Gy in 12 fractions to the whole brain followed by 18 Gy in 2 fractions to brain metastases. All plans were optimized for dose coverage of whole brain and lesions, simultaneously minimizing dose to the hippocampus. The treatment plans were evaluated on target coverage, homogeneity, and minimal dose to the hippocampus and organs at risk. Results: The SIB concept enabled more successful sparing of the hippocampus; the mean dose to the hippocampus was 7.55 ± 0.62 Gy and 6.29 ± 0.62 Gy, respectively, when 5-mm and 10-mm avoidance regions around the hippocampus were used, normalized to 2-Gy fractions. In the SC concept, the mean dose to hippocampus was 9.8 ± 1.75 Gy. The mean dose to the whole brain (excluding metastases) was 33.2 ± 0.7 Gy and 32.7 ± 0.96 Gy, respectively, in the SIB concept, for 5-mm and 10-mm hippocampus avoidance regions, and 37.23 ± 1.42 Gy in SC. Conclusions: Both concepts, SIB and SC, were able to achieve adequate whole brain coverage and radiosurgery-equivalent dose distributions to individual brain metastases. The SIB technique achieved better sparing of the hippocampus, especially when a10-mm hippocampal avoidance region was used.

  14. Surgical treatment of severe osteoporosis including new concept of advanced severe osteoporosis

    Directory of Open Access Journals (Sweden)

    Jin Hwan Kim

    2017-12-01

    Full Text Available Severe osteoporosis is classified as those with a bone mineral density (BMD T-score of −2.5 or lower, and demonstrate one or more of osteoporotic, low-trauma, fragility fractures. According to the general principle of surgical approach, patients with severe osteoporosis require not only more thorough pre- and postoperative treatment plans, but improvements in surgical fixtures and techniques such as the concept of a locking plate to prevent bone deformity and maximizing the blood flow to the fracture site by using a minimally invasive plate osteosynthesis. Arthroplasty is often performed in cases of displaced femoral neck fracture. Otherwise internal fixation for the goal of bone union is the generally accepted option for intertrochanteric, subtrochanteric, and femoral shaft fractures. Most of osteoporotic spine fracture is stable compression fracture, but vertebroplasty or kyphoplasty may be performed some selective patients. If neurological paralysis, severe spinal instability, or kyphotic deformity occurs, open decompression or fusion surgery may be considered. In order to overcome shortcomings of the World Health Organization definition of osteoporosis, we proposed a concept of ‘advanced severe osteoporosis,’ which is defined by the presence of proximal femur fragility fracture or two or more fragility fractures in addition to BMD T-score of −2.5 or less. In conclusion, we need more meticulous approach for surgical treatment of severe osteoporosis who had fragility fracture. In cases of advanced severe osteoporosis, we recommend more aggressive managements using parathyroid hormone and receptor activator of nuclear factor kappa-B ligand monoclonal antibody.

  15. Concept, design and equipment of a center for the treatment of radiation accidents at the Staedtisches Krankenhaus Muenchen-Schwabing

    International Nuclear Information System (INIS)

    Bogner, L.; Muehle, P.; Czempiel, H.; Henftling, H.G.

    1987-01-01

    The concept of the treatment center for radiation accidents at the Staedtisches Krankenhaus Muenchen-Schwabing is presented by means of a flow scheme for the treatment of different possible accidents. The resulting design and equipment are discussed in detail. (orig.) [de

  16. Central nervous system abnormalities in fibromyalgia and chronic fatigue syndrome: new concepts in treatment.

    Science.gov (United States)

    Gur, Ali; Oktayoglu, Pelin

    2008-01-01

    Fibromyalgia (FM) and chronic fatigue syndrome (CFS) are poorly understood disorders that share similar demographic and clinical characteristics. The etiology and pathophysiology of these diseases remain unclear. Because of the similarities between both disorders it was suggested that they share a common pathophysiological mechanisms, namely, central nervous system (CNS) dysfunction. Current hypotheses center on atypical sensory processing in the CNS and dysfunction of skeletal muscle nociception and the hypothalamic-pituitary-adrenal (HPA) axis. Researches suggest that the (CNS) is primarily involved in both disorders in regard to the pain, fatigue and sleep disturbances. Many patients experience difficulty with concentration and memory and many others have mood disturbance, including depression and anxiety. Although fibromyalgia is common and associated with substantial morbidity and disability, there are no US Food and Drug Administration (FDA)-approved treatments except pregabalin. Recent pharmacological treatment studies about fibromyalgia have focused on selective serotonin and norepinephrine (NE) reuptake inhibitors, which enhance serotonin and NE neurotransmission in the descending pain pathways and lack many of the adverse side effects associated with tricyclic medications. CFS is a descriptive term used to define a recognisable pattern of symptoms that cannot be attributed to any alternative condition. The symptoms are currently believed to be the result of disturbed brain function. To date, no pharmacological agent has been reliably shown to be effective treatment for CFS. Management strategies are therefore primarily directed at relief of symptoms and minimising impediments to recovery. This chapter presents data demonstrating CFS, abnormal pain processing and autonomic nervous system (ANS) dysfunction in FM and CFS and concludes by reviewing the new concepts in treatments in CFS and FM.

  17. Evaluation of direct membrane filtration and direct forward osmosis as concepts for compact and energy-positive municipal wastewater treatment.

    Science.gov (United States)

    Hey, Tobias; Bajraktari, Niada; Davidsson, Åsa; Vogel, Jörg; Madsen, Henrik Tækker; Hélix-Nielsen, Claus; Jansen, Jes la Cour; Jönsson, Karin

    2018-02-01

    Municipal wastewater treatment commonly involves mechanical, biological and chemical treatment steps to protect humans and the environment from adverse effects. Membrane technology has gained increasing attention as an alternative to conventional wastewater treatment due to increased urbanization. Among the available membrane technologies, microfiltration (MF) and forward osmosis (FO) have been selected for this study due to their specific characteristics, such as compactness and efficient removal of particles. In this study, two treatment concepts were evaluated with regard to their specific electricity, energy and area demands. Both concepts would fulfil the Swedish discharge demands for small- and medium-sized wastewater treatment plants at full scale: (1) direct MF and (2) direct FO with seawater as the draw solution. The framework of this study is based on a combination of data obtained from bench- and pilot-scale experiments applying direct MF and FO, respectively. Additionally, available complementary data from a Swedish full-scale wastewater treatment plant and the literature were used to evaluate the concepts in depth. The results of this study indicate that both concepts are net positive with respect to electricity and energy, as more biogas can be produced compared to that using conventional wastewater treatment. Furthermore, the specific area demand is significantly reduced. This study demonstrates that municipal wastewater could be treated in a more energy- and area-efficient manner with techniques that are already commercially available and with future membrane technology.

  18. Evaluating two concepts for the modelling of intermediates accumulation during biological denitrification in wastewater treatment.

    Science.gov (United States)

    Pan, Yuting; Ni, Bing-Jie; Lu, Huijie; Chandran, Kartik; Richardson, David; Yuan, Zhiguo

    2015-03-15

    The accumulation of the denitrification intermediates in wastewater treatment systems is highly undesirable, since both nitrite and nitric oxide (NO) are known to be toxic to bacteria, and nitrous oxide (N2O) is a potent greenhouse gas and an ozone depleting substance. To date, two distinct concepts for the modelling of denitrification have been proposed, which are represented by the Activated Sludge Model for Nitrogen (ASMN) and the Activated Sludge Model with Indirect Coupling of Electrons (ASM-ICE), respectively. The two models are fundamentally different in describing the electron allocation among different steps of denitrification. In this study, the two models were examined and compared in their ability to predict the accumulation of denitrification intermediates reported in four different experimental datasets in literature. The N-oxide accumulation predicted by the ASM-ICE model was in good agreement with values measured in all four cases, while the ASMN model was only able to reproduce one of the four cases. The better performance of the ASM-ICE model is due to that it adopts an "indirect coupling" modelling concept through electron carriers to link the carbon oxidation and the nitrogen reduction processes, which describes the electron competition well. The ASMN model, on the other hand, is inherently limited by its structural deficiency in assuming that carbon oxidation is always able to meet the electron demand by all denitrification steps, therefore discounting electron competition among these steps. ASM-ICE therefore offers a better tool for predicting and understanding intermediates accumulation in biological denitrification. Copyright © 2014 Elsevier Ltd. All rights reserved.

  19. Outcome and prognostic factors of desmoplastic medulloblastoma treated within a multidisciplinary treatment concept

    International Nuclear Information System (INIS)

    Rieken, Stefan; Gaiser, Timo; Mohr, Angela; Welzel, Thomas; Witt, Olaf; Kulozik, Andreas E; Wick, Wolfgang; Debus, Jürgen; Combs, Stephanie E

    2010-01-01

    Desmoplasia in medulloblastoma is often diagnosed in adult patients and was repeatedly associated with improved results. Today, all medulloblastoma patients receive intensive multimodal treatment including surgery, radiotherapy and chemotherapy. This study was set up to investigate treatment outcome and prognostic factors after radiation therapy in patients with desmoplastic medulloblastomas. Twenty patients treated for desmoplastic medulloblastoma in the Department of Radiation Oncology at the University of Heidelberg between 1984 and 2007 were included. Data were collected retrospectively. Tumor resection was performed in all patients. All patients underwent postsurgical radiotherapy (RT). Two patients underwent whole brain radiotherapy (WBRT), and 18 patients received craniospinal irradiation (CSI). In all patients, an additional boost was delivered to the posterior fossa. The median dose to the whole brain and the craniospinal axis was 35.2 Gray (Gy), and 54.4 Gy to the posterior fossa. Fourteen patients received chemotherapy, including seven who were treated with combined radiochemotherapy and twelve who received adjuvant chemotherapy. Statistical analysis was performed using the log-rank test and the Kaplan-Meier method. Median follow-up was 59 months. Overall (OS), local (LPFS) and distant progression-free survival (DPFS) was 80%, 71.2%, and 83.3% at 60 months. Patients who suffered from local or distant relapses had significantly worse outcome. Five patients died from recurrent medulloblastoma. Treatment-associated toxicity was acceptable. Multimodal approaches with surgical resection followed by chemoirradiation achieved high response rates with long OS in desmoplastic medulloblastoma patients. Staging parameters expected to predict for poor prognosis did not significantly influence outcome. However, success of any first line regimen had strong impact on disease control, and remission was achieved in no patient with relapsing disease. Multimodal concepts

  20. Development of a Web-based concept for patients with ulcerative colitis and 5-aminosalicylic acid treatment

    DEFF Research Database (Denmark)

    Elkjaer, Margarita; Burisch, Johan; Avnstrøm, Søren

    2009-01-01

    of life (QoL). Lack of easy access to inflammatory bowel disease clinics and patient education, their understanding of the importance of early treatment at relapse, poor compliance and self-adherence can be partly solved by a newly developed Web-based concept. AIMS: To describe the development...... education and training through a Web-based program (www.constant-care.dk) seems to be a feasible concept for increasing patients' ability to self-initiate treatment and increase the level of disease-specific knowledge. Relevant adjustment of the concept was implemented. The final outcome of the 'Constant......BACKGROUND: Ulcerative colitis (UC) is a lifelong disease with increasing incidence. UC requires frequent outpatient clinic visits and continuous medical treatment. Web-based self-management in other chronic diseases influences disease course, and increases self-adherence, compliance and quality...

  1. Instability of the sternoclavicular joint: current concepts in classification, treatment and outcomes.

    Science.gov (United States)

    Sewell, M D; Al-Hadithy, N; Le Leu, A; Lambert, S M

    2013-06-01

    The sternoclavicular joint (SCJ) is a pivotal articulation in the linked system of the upper limb girdle, providing load-bearing in compression while resisting displacement in tension or distraction at the manubrium sterni. The SCJ and acromioclavicular joint (ACJ) both have a small surface area of contact protected by an intra-articular fibrocartilaginous disc and are supported by strong extrinsic and intrinsic capsular ligaments. The function of load-sharing in the upper limb by bulky periscapular and thoracobrachial muscles is extremely important to the longevity of both joints. Ligamentous and capsular laxity changes with age, exposing both joints to greater strain, which may explain the rising incidence of arthritis in both with age. The incidence of arthritis in the SCJ is less than that in the ACJ, suggesting that the extrinsic ligaments of the SCJ provide greater stability than the coracoclavicular ligaments of the ACJ. Instability of the SCJ is rare and can be difficult to distinguish from medial clavicular physeal or metaphyseal fracture-separation: cross-sectional imaging is often required. The distinction is important because the treatment options and outcomes of treatment are dissimilar, whereas the treatment and outcomes of ACJ separation and fracture of the lateral clavicle can be similar. Proper recognition and treatment of traumatic instability is vital as these injuries may be life-threatening. Instability of the SCJ does not always require surgical intervention. An accurate diagnosis is required before surgery can be considered, and we recommend the use of the Stanmore instability triangle. Most poor outcomes result from a failure to recognise the underlying pathology. There is a natural reluctance for orthopaedic surgeons to operate in this area owing to unfamiliarity with, and the close proximity of, the related vascular structures, but the interposed sternohyoid and sternothyroid muscles are rarely injured and provide a clear boundary to the

  2. Reported concepts for the treatment modalities and pain management of temporomandibular disorders.

    Science.gov (United States)

    Wieckiewicz, Mieszko; Boening, Klaus; Wiland, Piotr; Shiau, Yuh-Yuan; Paradowska-Stolarz, Anna

    2015-01-01

    Pain related to temporomandibular disorders (TMD) is a common problem in modern societies. The aim of the article is to present the concepts of TMD pain clinical management. A survey was performed using the PubMed, SCOPUS and CINAHL databases for documents published between 1994 and 2014. The following search keywords were selected using MeSH terms of the National Library of Medicine in combination: TMD pain, TMD, TMJ, TMJ disorders, occlusal splint, TMD physiotherapy, TMJ rheumatoid disorders and TMJ surgery. Original articles and review papers which presented the clinical relevance and practical validity regarding the possibility of application in TMD management have been included. Authors have excluded articles without outstanding practical aspect and evidence-based background. A first selection was carried out by reviewing titles and abstracts of all articles found according to the criteria. After that the full texts of potentially suitable articles were assessed. In line with these criteria, among 11467 results the writers have included 66 papers. The most commonly reported conservative treatments are massage therapy and individually fabricated occlusal splints. In addition to massage, other popular methods include manual therapy and taping, warming/cooling of aching joints, and light and laser therapy. Drugs are also commonly used. In the most severe cases of the temporomandibular joint degeneration, surgical restoration of the joint is sometimes applied. The authors concluded that conservative treatment including counselling, exercises, occlusal splint therapy, massage, manual therapy and others should be considered as a first choice therapy for TMD pain because of their low risk of side effects. In the case of severe acute pain or chronic pain resulting from serious disorders, inflammation and/or degeneration pharmacotherapy, minimally invasive and invasive procedures should be considered.

  3. [M. Linehan dialectic behavioral psychotherapy. A new concept in the treatment of borderline personality disorders].

    Science.gov (United States)

    Bohus, M; Berger, M

    1996-11-01

    M. Linehan developed "dialectical behavioral therapy" specifically to treat chronically suicidal borderline patients. It rests on a biosocial model that assumes a disorder in the regulation of emotions and in tolerance of stress. The numerous dysfunctional patterns of behavior such as self-destructive behavior, inability to govern impulses or severe dissociative phenomena are regarded as attempts at problem-solving. This concept of therapy focuses on the continuing balance between the necessity of accepting maladaptive behavior patterns in both an intrapsychic and an interactional context while still working to change them. A comprehensive manual outlines the clearly structured therapy and integrates a wide choice of therapeutic strategies. Parallel to development of the therapy itself, a method also was developed for testing therapist adherence to the manual's guidelines, thus providing a basis for empirical evaluation. An initial controlled, randomized study demonstrated the significant superiority of this method to methods of unspecific psychotherapy at various levels. In the current endeavor to develop disorder-specific approaches to the treatment of personality disorders, "dialectical behavioral therapy" is a noteworthy model.

  4. A new treatment concept for immediate loading of implants inserted in the edentulous mandible.

    Science.gov (United States)

    Eccellente, Tammaro; Piombino, Michele; Piattelli, Adriano; Perrotti, Vittoria; Iezzi, Giovanna

    2010-06-01

    Retention of mandibular complete dentures on two or four interforaminal implants is considered the most reliable procedure in implant therapy. There are different retention elements available for all implant systems. The aim of the present study was to clinically evaluate patients with a mandibular overdenture supported by the Ankylos SynCone system (Dentsply). Thirty-nine patients were treated with 156 implants. The treatment method was based on immediate loading of four interforaminal implants without the use of a bar retainer. The denture was placed on and retained by prefabricated conical crowns that were inserted into the existing denture base by direct intraoral polymerization immediately after surgery and supported by the corresponding conical primary implant abutments. The cumulative implant survival rate was 98.7% (two failures), while the prosthesis survival rate was 100%. After a total observation of 30.3 months (range 12 to 60 months), all other implants presented healthy peri-implant soft tissue conditions showing low value of clinical parameters. This method facilitates secondary splinting of the inserted complete denture. The conical crowns concept presented here resulted in stable complete denture retention, reduced the denture base, and improved oral hygiene.

  5. Current concepts in treatment of fracture-dislocations of the proximal interphalangeal joint.

    Science.gov (United States)

    Haase, Steven C; Chung, Kevin C

    2014-12-01

    Proximal interphalangeal joint fracture-dislocations are common injuries that require expedient and attentive treatment for the best outcomes. Management can range from protective splinting and early mobilization to complex surgery. In this review, the current concepts surrounding the management of these injuries are reviewed. A literature review was performed of all recent articles pertaining to proximal interphalangeal joint fracture-dislocation, with specific focus on middle phalangeal base fractures. Where appropriate, older articles or articles on closely related injury types were included for completeness. The methodology and outcomes of each study were analyzed. When small avulsion fractures are present, good results are routinely obtained with reduction and early mobilization of stable injuries. Strategies for management of the unstable dorsal fracture-dislocation have evolved over time. To provide early stability, a variety of techniques have evolved, including closed, percutaneous, external, and internal fixation methods. Although each of these techniques can be successful in skilled hands, none has been subjected to rigorous, prospective, comparative trials. Volar dislocations fare less well, with significant loss of motion in many studies. Pilon fractures represent the most complicated injuries, and return of normal motion is not expected. The best outcomes can be achieved by (1) establishing enough stability to allow early motion, (2) restoring gliding joint motion rather than noncongruent motion, and (3) restoring the articular surface congruity when possible. Although the majority of literature on this topic consists of expert opinion and retrospective case series, the consensus appears to favor less invasive techniques whenever possible.

  6. Late-onset hypogonadism: Current concepts and controversies of pathogenesis, diagnosis and treatment

    Science.gov (United States)

    Huhtaniemi, Ilpo

    2014-01-01

    - and long-term risks, is not yet available. In this review, we will summarize the current concepts and controversies in the pathogenesis, diagnosis and treatment of LOH. PMID:24407185

  7. Treatment of waste incinerator air-pollution-control residues with FeSO4: Concept and product characterization

    DEFF Research Database (Denmark)

    Lundtorp, Kasper; Jensen, Dorthe Lærke; Sørensen, Mette Abildgaard

    2002-01-01

    This paper describes a new concept for treatment of air- pollution-control (APC) residues from waste incineration and characterises the wastewater and stabilised residues generated by the process. The process involves mixing of APC-residues with a ferrous sulphate solution and subsequent oxidation...

  8. Hydrothermal Treatment (HTT) of Microalgae: Evaluation of the Process As Conversion Method in an Algae Biorefinery Concept

    NARCIS (Netherlands)

    Garcia Alba, Laura; Torri, C.; Samori, C.; van der Spek, J.J.; Fabbri, D.; Kersten, Sascha R.A.; Brilman, Derk Willem Frederik

    2012-01-01

    The hydrothermal treatment (HTT) technology is evaluated for its potential as a process to convert algae and algal debris into a liquid fuel, within a sustainable algae biorefinery concept in which, next to fuels (gaseous and liquid), high value products are coproduced, nutrients and water are

  9. Evaluation of direct membrane filtration and direct forward osmosis as concepts for compact and energy-positive municipal wastewater treatment

    DEFF Research Database (Denmark)

    Hey, Tobias; Bajraktari, Niada; Davidsson, Åsa

    2018-01-01

    . Among the available membrane technologies, microfiltration (MF) and forward osmosis (FO) have been selected for this study due to their specific characteristics, such as compactness and efficient removal of particles. In this study, two treatment concepts were evaluated with regard to their specific...

  10. Concept mapping of indicators for treatment allocation in patients with personality disorders

    NARCIS (Netherlands)

    van Manen, J.G.; Goossensen, A.; Knapen, P.; Ingenhoven, T.; de Saeger, H.; Cornelissen, K.; Kamphuis, J.H.; Timman, R.; Verheul, R.; Busschbach, J.J.V.

    2010-01-01

    In dit onderzoek werden met behulp van de ‘concept-mapping’-methode patiëntkenmerken gevonden die van belang zijn bij de indicatiestelling voor psychotherapeutische behandeling bij persoonlijkheidsstoornissen. De concept map-methode omvat zowel kenmerken van kwalitatief als kwantitatief onderzoek en

  11. Treatment concept of the edentulous mandible with prefabricated telescopic abutments and immediate functional loading.

    Science.gov (United States)

    Romanos, George E; May, Steffan; May, Dittmar

    2011-01-01

    The present paper demonstrates a new technique and long-term results of a treatment concept that uses four implants placed in the anterior mandible that are connected to prefabricated telescopic abutments and immediately loaded with removable restorations. The present retrospective study included 488 implants (Ankylos, Dentsply) placed in 122 patients (mean age: 65.2 ± 9.8 years) with clinical and radiographic evaluation for a period of at least 1 year. Eighty-four implants were placed in fresh extraction sockets and combined in the restorations with implants placed in healed ridges. All implants were placed 2 mm subcrestally (based on chart documentation, measured from the midfacial bone level). The implants were connected immediately after surgery to conical prefabricated abutments (angle of 4 to 6 degrees) using a final torque of 15 Ncm. Secondary prefabricated copings that fit the abutments were placed over the abutments after abutment connection, and the complete denture of each patient was relined chairside with methyl methacrylate resin. The prosthetic restorations were to remain in place for 10 days to ensure that the implants remained immobile. After a mean of 79 ± 29.8 months (range, 17 to 129 months) only eight implants failed (1.6%). Twenty-one implants (4.3%) showed crestal bone loss greater than 2 mm relative to the implant position at the time of implant insertion. Therefore, the failure rate was 5.94% for the entire observation period. The success rate for the evaluated implants was 94.06%. The patients were satisfied with the stability of their prostheses, and no prosthetic or peri-implant problems were observed. These telescopic implant-supported restorations with immediate loading seem to be an alternative prosthetic solution for the edentulous patient, providing long-term implant stability.

  12. Concept of patient-specific shape memory implants for the treatment of orbital floor fractures.

    Science.gov (United States)

    Grunert, Ronny; Wagner, Maximilian; Rotsch, Christian; Essig, Harald; Posern, Susanna; Pabst, Friedemann; Drossel, Welf-Guntram; Lichtenstein, Juergen

    2017-06-01

    We will aim to develop implants made of a Ni-Ti shape memory alloy which can be applied for the treatment of midface fractures, such as isolated orbital floor fractures. These can then be implanted in a compressed form and unfold automatically in the body. With the help of newly developed application instruments, the implants can be applied along transnasal and transantral approaches into the maxillary sinus. Our objective is to evaluate the operation process and the functionality of these implants, already in a pre-investigation by an experienced surgeon on a phantom. The functionality of the surgical procedure and an implant prototype were both evaluated with the help of a realistic phantom. The minimally invasive application was carried out using the transnasal and transantral approach. Instruments and implant were rated individually on a scale, from -2 (not at all) to +2 (very good) for vaious criteria, such as the implants functionality or the ergonomics of the entire procedure. For a geometric comparison between the manufactured implant and the planned target geometry, the implants were scanned by micro-computed tomography. CAD models were derived from the scans by using reverse engineering. Both the implants and the application procedure were assessed as good; thus, the implant concept is suitable for further development. Implants made of shape memory alloys could allow in the future and allow less invasive access to treat orbital floor fractures. The implant design has to be modified that the implant can be stabilized and fixed with screws or a suture to avoid dislocation or implant loosening. The complication rates and risks of conventional orbital reconstructions should be lowered by this new method.

  13. A new concept: the use of vanadium complexes in the treatment of diabetes mellitus.

    Science.gov (United States)

    Sakurai, Hiromu

    2002-01-01

    In the 21st century, patients suffering from diabetes mellitus (DM), a lifestyle-related disease, will increase more than in the 20th century. DM is threatening because of the development of many severe secondary complications, including atherosclerosis, microangiopathy, renal dysfunction and failure, cardiac abnormalities, diabetic retinopathy, and ocular disorders. Generally, DM is classified as either insulin-dependent type 1 or noninsulin-dependent type 2 DM. Type 1 DM is treated only by daily insulin injections; type 2 DM is treated by several types of synthetic therapeutic substances together with a controlled diet and physical exercise. Even with these measures, the daily necessity for several insulin injections can be painful both physically and mentally, whereas the synthetic therapeutic substances used over the long term often have side effects. For those reasons, the creation and development of a new class of pharmaceuticals for treatment of DM in the 21st century would be extremely desirable. In the last half of the 20th century, investigations of the relationships among diseases and micronutrients, such as iron, copper, zinc, and selenium, have been numerous. Research into the development of metallopharmaceuticals involving the platinum-containing anticancer drug, cisplatin, and the gold-containing rheumatoid arthritis drug, auranofin, has also been widespread. Such important findings prompted us to develop therapeutic reagents based on a new concept to replace either insulin injections or the use of synthetic drugs. After many trials, we noticed that vanadium might be very useful in the treatment of DM. Before the discovery of insulin by Banting and Best in 1921 and its clinical trial for treating DM, the findings in 1899, in which orally administered sodium vanadate (NaVO(3)) was reported to improve human DM, gave us the idea to use vanadium to treat DM. However, it has taken a long time to obtain a scientific explanation as to why the metal ion

  14. Malaria in rural Burkina Faso: local illness concepts, patterns of traditional treatment and influence on health-seeking behaviour

    Directory of Open Access Journals (Sweden)

    Kouyaté Bocar

    2007-08-01

    Full Text Available Abstract Background The literature on health care seeking behaviour in sub-Saharan Africa for children suffering from malaria is quite extensive. This literature, however, is predominately quantitative and, inevitably, fails to explore how the local concepts of illness may affect people's choices. Understanding local concepts of illness and their influence on health care-seeking behaviour can complement existing knowledge and lead to the development of more effective malaria control interventions. Methods In a rural area of Burkina Faso, four local concepts of illness resembling the biomedical picture of malaria were described according to symptoms, aetiology, and treatment. Data were collected through eight focus group discussions, 17 semi-structured interviews with key informants, and through the analysis of 100 verbal autopsy questionnaires of children under-five diagnosed with malaria. Results Sumaya, dusukun yelema, kono, and djoliban were identified as the four main local illness concepts resembling respectively uncomplicated malaria, respiratory distress syndrome, cerebral malaria, and severe anaemia. The local disease categorization was found to affect both treatment and provider choice. While sumaya is usually treated by a mix of traditional and modern methods, dusukun yelema and kono are preferably treated by traditional healers, and djoliban is preferably treated in modern health facilities. Besides the conceptualization of illness, poverty was found to be another important influencing factor of health care-seeking behaviour. Conclusion The findings complement previous evidence on health care-seeking behaviour, by showing how local concepts of illness strongly influence treatment and choice of provider. Local concepts of illness need to be considered when developing specific malaria control programmes.

  15. Treatment verification with megavoltage electronic portal imaging applied to the tomotherapy concept

    International Nuclear Information System (INIS)

    Hesse, B.-M.; Spies, L.; Groh, B.; Doll, J.; Haering, P.; Hoever, K. H.

    1997-01-01

    Purpose: A new treatment strategy called Tomotherapy, introduced by T. R. Mackie et al. in 1993, was designed to perform a dynamic conformal treatment technique in precision radiotherapy. This technique delivers sliced intensity-modulated radiation fields to achieve best tumor control while sparing neighbouring sensitive normal tissue and organs at risk. The beam continuously revolves around the patient similarly to a spiral-CT while the patient is moved through the bore of the gantry. As a first step towards the realization of such a concept with a linear accelerator (Siemens Mevatron Experimental) used in clinical routine, we focused on treatment setup and dose verification. In tomotherapy, an actual CT data set is needed for patient positioning and for the verification of the absorbed dose, also, the dose transmitted through the patient must be known. This makes possible both routine tomographic treatment setup verification and tomographic dose reconstruction of the actual delivered dose. Materials and Methods: All measurements were performed with a megavoltage electronic portal imaging device of Wellhoefer TM (BIS-710). The BIS-710 detector is based on a scintillation foil and contains a camera for 10-bit digital data output. The dimension of the detector plane is 512 x 512 pixels with a pixel size of 0.6 mm in each direction. The BIS-710 was developed especially for quantitative dose measuring, whereas most of the existing Portal Imaging Systems are used for image display only. To examine the properties of the BIS-710 concerning tomographical reconstruction with a therapeutic 6 MV X-ray beam, a tissue-equivalent Alderson head phantom was rotated stepwise across a stationary beam between the collimator and the detector plane. The influence of scattering can be estimated by comparing measurements which were taken with a homogeneous phantom which is invariant under rotation with a calculated exit dose distribution using a simple exponential law for the

  16. The Association Between Self-Concept and Self-Efficacy in Patients Under Treatment by Hemodialysis

    OpenAIRE

    Jafari; Mannani; Zarea

    2015-01-01

    Background Hemodialysis, as one of the most common methods of controlling chronic renal failure, causes the change in the ways of living as well as physical and mental health status and leads to changes in the family and social rolls of the individual. All these factors influence self-concept and self-efficacy to some extent. Objectives This study was conducted to analyze the association between self-concept and self-efficacy in t...

  17. Integrated Evaluation Concept to Assess the Efficacy of Advanced Wastewater Treatment Processes for the Elimination of Micropollutants and Pathogens.

    Science.gov (United States)

    Ternes, Thomas A; Prasse, Carsten; Eversloh, Christian Lütke; Knopp, Gregor; Cornel, Peter; Schulte-Oehlmann, Ulrike; Schwartz, Thomas; Alexander, Johannes; Seitz, Wolfram; Coors, Anja; Oehlmann, Jörg

    2017-01-03

    A multidisciplinary concept has been developed to compare advanced wastewater treatment processes for their efficacy of eliminating micropollutants and pathogens. The concept is based on (i) the removal/formation of selected indicator substances and their transformation products (TPs), (ii) the assessment of ecotoxicity via in vitro tests, and (iii) the removal of pathogens and antibiotic resistant bacteria. It includes substances passing biological wastewater treatment plants regulated or proposed to be regulated in the European Water Framework Directive, TPs formed in biological processes or during ozonation, agonistic/antagonistic endocrine activities, mutagenic/genotoxic activities, cytotoxic activities, further activities like neurotoxicity as well as antibiotics resistance genes, and taxonomic gene markers for pathogens. At a pilot plant, ozonation of conventionally treated wastewater resulted in the removal of micropollutants and pathogens and the reduction of estrogenic effects, whereas the in vitro mutagenicity increased. Subsequent post-treatment of the ozonated water by granular activated carbon (GAC) significantly reduced the mutagenic effects as well as the concentrations of remaining micropollutants, whereas this was not the case for biofiltration. The results demonstrate the suitability of the evaluation concept to assess processes of advanced wastewater treatment including ozonation and GAC by considering chemical, ecotoxicological, and microbiological parameters.

  18. Referral to treatment for hospitalized medical patients with an alcohol use disorder: A proof-of-concept brief intervention study.

    Science.gov (United States)

    Berger, Lisa; Hernandez-Meier, Jennifer; Hyatt, John; Brondino, Michael

    2017-01-01

    Substance misuse intervention in healthcare settings is becoming a US national priority, especially in the dissemination and implementation of Screening, Brief Intervention, and Referral to Treatment (SBIRT). Yet, the referral to treatment component of SBIRT is understudied. This proof-of-concept investigation tested an enhanced coordinated hospital-community two session brief intervention designed to facilitate the referral to treatment of hospitalized medical patients with an alcohol use disorder. Participants (N = 9) attended the second session of the brief intervention held in the community in most cases (56%), while one out of three (33%) received some level of post-brief intervention alcohol and/or other drug treatment. Alcohol use and alcohol-related problems also statistically improved. Based, in part, on the results plus the widespread dissemination of SBIRT, next step investigations of brief interventions to help bridge hospitalized medical patients in need to community substance abuse treatment are warranted.

  19. Conceptions and practices of an integrative treatment for substance use disorders involving Amazonian medicine: traditional healers' perspectives.

    Science.gov (United States)

    Berlowitz, Ilana; Ghasarian, Christian; Walt, Heinrich; Mendive, Fernando; Alvarado, Vanessa; Martin-Soelch, Chantal

    2017-12-18

    The harmful use of psychoactive substances represents one of today's largest public health problems. Yet, in spite of its global relevance, current treatment for substance use disorders (SUDs) is still not entirely successful. The purpose of this study was to investigate alternative treatments and conceptions from traditional Amazonian medicine adapted to SUDs. We conducted semi-structured interviews with 13 practicing experts at a well-established addiction treatment center in the Peruvian Amazon and performed qualitative content analysis on the collected data. Main categories were deductively defined and corresponding subcategories inductively developed. Our findings revealed characteristic features and consequences, causes and antecedents, and treatment methods of SUDs as the main categories. Overall, concepts of disease etiology bore resemblance with contemporary biopsychosocial models of SUDs. The Amazonian therapeutic means however differed markedly from current Western ones. The main methods involved dietary retreats, healing ceremonies, and purging rituals. The integral application of Amazonian methods, as well as their traditional implementation according to prescribed ritual protocols, were emphasized by the experts as crucial for efficacy and safety of treatment delivery. We suggest further scientific attention to these therapies, including clinical studies, for which our results provide conceptual underpinnings. Findings from this research expand the cross-cultural understanding of SUDs and, in the long run, may enhance its treatment options.

  20. An innovative treatment concept for future drinking water production : Fluidized ion exchange – ultrafiltration – nanofiltration – granular activated carbon filtration

    NARCIS (Netherlands)

    Li, S.; Heijman, S.G.J.; Verberk, J.Q.J.C.; Van Dijk, J.C.

    2009-01-01

    A new treatment concept for drinking water production from surface water has been investigated on a pilot scale. The treatment concept consists of fluidized ion exchange (FIEX), ultrafiltration (UF), nanofiltration (NF), and granular activated carbon filtration (GAC). The FIEX process removed

  1. Engaging conceptions of identity in a context of medical pluralism: explaining treatment choices for everyday illness in Niger.

    Science.gov (United States)

    Sams, Kelley

    2017-09-01

    This article uses ethnographic research to reflect upon how the treatment of 'everyday' illnesses in Niger engages concepts of social identity. Inspired by Bourdieu's concept of social distinction, as well as Appadurai's edited volume on the 'social lives' of 'things', I present an analysis of how medications are understood by their users in terms of social and ideological meaning in one rural Hausa village. Decisions about medication choice were framed by three main themes: belonging to the 'modern' world, 'traditional' Hausa culture, and religious identity. This article does not argue that these notions of identity fully explain medication use, nor necessarily predict treatment choices. The purpose of this paper is to reflect on the dynamic meanings given to treatment decisions after they have been made, attributed to the medications themselves and negotiated through their circulation in a context where multiple medical systems are drawn from to manage illness. Producers and sellers of medication also engage these meaning-centred concepts, which have theoretical and practical interest for the social sciences and public health. A virtual abstract for this paper can be viewed at: https://www.youtube.com/channel/UC_979cmCmR9rLrKuD7z0ycA. © 2017 Foundation for the Sociology of Health & Illness.

  2. Some Contributions for a Pedagogical Treatment of Alternative Conceptions in Biology: An Example from Plant Nutrition.

    Science.gov (United States)

    Vaz, Adelaine Neto; And Others

    This paper reports on a study that investigated the alternative conceptions of students in a biology and geology teacher education course regarding plant nutrition. Data were collected from first year and final year students using a questionnaire that had both multiple choice and descriptive items. Findings indicate common features related to the…

  3. The Evaluation of Relationship between Sexual Self-concept and Sexual Dysfunction in Individuals Undergoing Methadone Maintenance Treatment

    Science.gov (United States)

    Rajabizadeh, Ghodratolah; Yazdanpanah, Fatemeh; Ramezani, Mohammad Arash

    2017-01-01

    Background The present study was conducted with the aim of designing a causal model for the evaluation of sexual dysfunctions based on the variables of methadone dosage and sexual self-concept among individuals undergoing methadone maintenance treatment (MMT). Methods The study population of the present study consisted of married men of 20 to 45 years of age with sexual ýrelations and undergoing MMT for a minimum of 8 weeks referring to all MMT clinics of Kerman, Iran, in ýý2015-2016. ýThe subjects were selected through multi-stage cluster sampling (n = 250). Data were collected using the General Health Questionnaire (GHQ-28), Multi-Dimensional Sexual Self-concept Questionnaire (MSSQ), and Internal Index for Erectile Function (IIEF). Data were analyzed using path analysis method and Pearson correlation coefficient. The suggested model was evaluated using structural equation model (SEM), and indirect relationships were assessed using Bootstrap method. Findings The suggested model showed acceptable fitness with the data, and all routes, except methadone use route, to sexual function were significant. The result of the multiple ýindirect route showed that sexual function had a significant relationship with methadone use through ýsexual self-concept. In total, 60% of variance in sexual dysfunction was explained using the variables of the suggested model. Conclusion Further studies are suggested to be conducted regarding psychological factors effective on the sexual dysfunctions among individuals undergoing MMT, such as sexual self-concept. Moreover, more detailed evaluation of each subscale of positive and negative sexual self-concept is recommended to assess the psychological causes of sexual dysfunctions in these individuals and design psychological, behavioral, and cognitive-behavioral treatment interventions for them. PMID:29299211

  4. The Evaluation of Relationship between Sexual Self-concept and Sexual Dysfunction in Individuals Undergoing Methadone Maintenance Treatment.

    Science.gov (United States)

    Rajabizadeh, Ghodratolah; Yazdanpanah, Fatemeh; Ramezani, Mohammad Arash

    2017-04-01

    The present study was conducted with the aim of designing a causal model for the evaluation of sexual dysfunctions based on the variables of methadone dosage and sexual self-concept among individuals undergoing methadone maintenance treatment (MMT). The study population of the present study consisted of married men of 20 to 45 years of age with sexual ýrelations and undergoing MMT for a minimum of 8 weeks referring to all MMT clinics of Kerman, Iran, in ýý2015-2016. ýThe subjects were selected through multi-stage cluster sampling (n = 250). Data were collected using the General Health Questionnaire (GHQ-28), Multi-Dimensional Sexual Self-concept Questionnaire (MSSQ), and Internal Index for Erectile Function (IIEF). Data were analyzed using path analysis method and Pearson correlation coefficient. The suggested model was evaluated using structural equation model (SEM), and indirect relationships were assessed using Bootstrap method. The suggested model showed acceptable fitness with the data, and all routes, except methadone use route, to sexual function were significant. The result of the multiple ýindirect route showed that sexual function had a significant relationship with methadone use through ýsexual self-concept. In total, 60% of variance in sexual dysfunction was explained using the variables of the suggested model. Further studies are suggested to be conducted regarding psychological factors effective on the sexual dysfunctions among individuals undergoing MMT, such as sexual self-concept. Moreover, more detailed evaluation of each subscale of positive and negative sexual self-concept is recommended to assess the psychological causes of sexual dysfunctions in these individuals and design psychological, behavioral, and cognitive-behavioral treatment interventions for them.

  5. Hybridization of natural systems with advanced treatment processes for organic micropollutant removals: New concepts in multi-barrier treatment

    KAUST Repository

    Sudhakaran, Sairam

    2013-07-01

    In the past, emphasis has been on individual treatment processes comprising conventional treatment (coagulation, sedimentation, and filtration) followed by advanced treatment processes (adsorption, ion-exchange, oxidation, and membrane separation). With the depletion of water resources and high demand for power and chemical usage, efforts need to be made to judiciously use advanced treatment processes. There is a new interest in multiple barriers with synergies in which two coupled processes can function as a hybrid process. Within the context of this paper, the hybrid processes include a natural treatment process coupled with an advanced process. Pilot/full-scale studies have shown efficient removal of OMPs by these hybrid processes. With this hybridization, the usage of resources such as power and chemicals can be reduced. In this study, coupling/hybridization of aquifer recharge and recovery (ARR) with oxidation (O3), advanced oxidation process which involves OH radicals (AOP), nanofiltration (NF), reverse osmosis (RO) and granular activated carbon (GAC) adsorption for OMP removal was studied. O3 or AOP as a pre-treatment and GAC, NF, RO, or UV/chlorination as a post-treatment to ARR was studied. NF can be replaced by RO for removal of OMPs since studies have shown similar performance of NF to RO for removal of many OMPs, thereby reducing costs and providing a more sustainable approach. © 2013 Elsevier Ltd.

  6. Promoting a Positive Middle School Transition: A Randomized-Controlled Treatment Study Examining Self-Concept and Self-Esteem.

    Science.gov (United States)

    Coelho, Vitor Alexandre; Marchante, Marta; Jimerson, Shane R

    2017-03-01

    The middle school transition is a salient developmental experience impacting adolescents around the world. This study employed a randomized-controlled treatment design, with randomization at the school level, to investigate the impact of a school adjustment program for middle school transition and potential gender differences. Participants included 1147 students (M age  = 9.62; SD = 0.30, 45.7 % girls), who were assessed at four time points during the transition, regarding five dimensions of self-concept (academic, social, emotional, physical and family) and self-esteem. Parallel growth curves were employed to analyze the evolution of self-concept. Following the transition to middle school, students reported lower levels of self-concept (academic, emotional and physical) and self-esteem, while participation in the intervention led to increases in self-esteem and gains in social self-concept. No gender differences were found. These results provide preliminary evidence supporting such interventions in early middle school transitions.

  7. Orthodontic treatment need for adolescents in the Campania region: the malocclusion impact on self-concept.

    Science.gov (United States)

    Perillo, Letizia; Esposito, Maria; Caprioglio, Alberto; Attanasio, Stefania; Santini, Annamaria Chiara; Carotenuto, Marco

    2014-01-01

    Dental malocclusions can be considered not only as an oral health problem, because they are linked to quality of life perception. Many factors related to malocclusion have strong influences on the perception of facial esthetics (eg, anterior tooth alignment, tooth shape and position, lip thickness, symmetric gingival or tooth contour, lip profile, and overjet). Many reports have shown that the perception of facial esthetics can influence psychological development from early childhood to adulthood. The aim of this study is to investigate the effect of dental malocclusion on self-esteem in a sample of adolescents. The study population was composed of 516 orthodontically untreated subjects (256 males) mean ages 13.75±1.977 years recruited from schools in the Campania region of Italy between January 2011 and July 2011. To evaluate the self-esteem grade in our population, all subjects filled out the Multidimensional Self Concept Scale questionnaire and attended an orthodontic clinical evaluation to estimate dental occlusal aspects. Pearson's analysis shows the relationship in our sample between some occlusal characteristics (crossbite and dental crowding) and aspects of self-concept evaluation (social, competence, academic, physical, and global score) of the Multidimensional Self Concept Scale questionnaire. Moreover, logistic regression analysis shows the potential role of dental crowding (odds ratio 5.359; 95% confidence interval 3.492-8.225) and crossbite (odds ratio 6.153; 95% confidence interval 3.545-10.678) as risk factors for development of global self-concept score abnormalities. Our findings confirm the relationship between psychosocial well-being, self-esteem, and dental malocclusion among adolescents.

  8. Reported concepts for the treatment modalities and pain management of temporomandibular disorders

    OpenAIRE

    Wieckiewicz, Mieszko; Boening, Klaus; Wiland, Piotr; Shiau, Yuh-Yuan; Paradowska-Stolarz, Anna

    2015-01-01

    Background Pain related to temporomandibular disorders (TMD) is a common problem in modern societies. The aim of the article is to present the concepts of TMD pain clinical management. Methods A survey was performed using the PubMed, SCOPUS and CINAHL databases for documents published between 1994 and 2014. The following search keywords were selected using MeSH terms of the National Library of Medicine in combination: TMD pain, TMD, TMJ, TMJ disorders, occlusal splint, TMD physiotherapy, TMJ ...

  9. Alternative concepts for treatment and disposal of Hanford site high-level waste in tanks

    Energy Technology Data Exchange (ETDEWEB)

    Claghorn, R.D.; Powell, W.J.

    1994-12-01

    Some innovative approaches have recently been proposed that may have significant schedule, cost, or environmental advantages which could improve the current HLW program strategy. Three general categories of alternative concepts are now under consideration: (1) process/product alternatives, (2) facility layout options, and (3) contracting strategies. This report compares the alternate approaches to the current program baseline to illustrate their potential significance and to identify the risks associated with each approach.

  10. Reciprocal effects of exercise and nutrition treatment-induced weight loss with improved body image and physical self-concept.

    Science.gov (United States)

    Annesi, James J; Porter, Kandice J

    2015-01-01

    Improvements in self-image and mood are often reported as outcomes of obesity interventions. However, they may also concurrently influence weight loss, suggesting a reciprocal effect. Although previously reported for overweight women, such relationships were untested in morbidly obese women whose psychosocial responses to treatment may be different, and health-risks greater. Women (N = 161, Meanage = 42 years) with morbid obesity (MeanBMI = 45.1 kg/m(2)) participated in a 6-month, behaviorally based physical activity and nutrition treatment. Significant within-group improvements in weight-loss behaviors (physical activity and eating), weight, body satisfaction, physical self-concept, and depression were found. After controlling for age, mediation analyses indicated that, as a result of the treatment, weight loss was both an outcome and mediator of improvements in body-areas satisfaction and physical self-concept (reciprocal effects), but not depression. Results replicated findings from women with lower degrees of overweight, and suggested that weight-loss treatments emphasize changes in self-perception.

  11. Proof of concept trials in bipolar disorder and major depressive disorder: a translational perspective in the search for improved treatments.

    Science.gov (United States)

    Machado-Vieira, Rodrigo; Zarate, Carlos A

    2011-04-01

    A better understanding of the neurobiology of mood disorders, informed by preclinical research and bi-directionally translated to clinical research, is critical for the future development of new and effective treatments. Recently, diverse new targets/compounds have been specifically tested in preclinical models and in proof-of-concept studies, with potential relevance as treatments for mood disorders. Most of the evidence comes from case reports, case series, or controlled proof-of-concept studies, some with small sample sizes. These include (1) the opioid neuropeptide system, (2) the purinergic system, (3) the glutamatergic system, (4) the tachykinin neuropeptide system, (5) the cholinergic system (muscarinic system), and (6) intracellular signaling pathways. These targets may be of substantial interest in defining future directions in drug development, as well as in developing the next generation of therapeutic agents for the treatment of mood disorders. Overall, further study of these and similar drugs may lead to a better understanding of relevant and clinically useful drug targets in the treatment of these devastating illnesses. © 2011 Wiley-Liss, Inc.

  12. A reappraisal of the concept of suppressive versus remittive psoriasis treatments.

    Science.gov (United States)

    Feldman, Steven R; Lucas, Jennifer; Pearce, Daniel J

    2005-08-01

    Among the ways to characterize the many treatments for psoriasis is to distinguish suppressive from remittive therapies. Remittive therapies are thought to be treatments that result in a prolonged period of disease remission even after stopping the drug, while suppressive treatments are thought to work only during the treatment period. However, apparent differences in remittive and suppressive properties may be due to the remitting and relapsing nature of psoriasis and the order in which treatments are used in patients. Few clinical trials have compared the suppressive versus remittive properties of different treatments. Given the adverse events and expense associated with many psoriasis therapies, a major implication is that psoriasis patients who have cleared on therapy should probably be tested at intervals to see if they can be tapered off their medication without loss of control of their disease.

  13. Concept - or no concept

    DEFF Research Database (Denmark)

    Thorsteinsson, Uffe

    1999-01-01

    Discussion about concept in industrial companies. A method for mapping of managerial concept in specific area is shown......Discussion about concept in industrial companies. A method for mapping of managerial concept in specific area is shown...

  14. The antimicrobial treatment of subacute endometritis: a proof of concept study.

    Science.gov (United States)

    Eckert, L O; Thwin, S S; Hillier, S L; Kiviat, N B; Eschenbach, D A

    2004-02-01

    Our purpose was to evaluate the antimicrobial therapy effect on clinical and laboratory findings among women at risk for endometritis. A prospective antimicrobial treatment trial of 153 women was performed to characterize subacute endometritis and to determine the treatment effect on endometritis resolution. After antimicrobial treatment, significant reductions occurred in abnormal bleeding (60% vs 29%), mucopurulent cervicitis (20% vs 6%), uterine tenderness (20% vs 6%), and histologic endometritis (38% vs 4%), all Pcervical infection as a risk for endometritis.

  15. Current concepts and controversies in the diagnosis and treatment of attention deficit hyperactivity disorder.

    Science.gov (United States)

    Jensen, P S

    2000-04-01

    Concerns about possible over-diagnosis and over-treatment of attention deficit hyperactivity disorder (ADHD) have been prominent in media reports, as have various competing claims about the safety and efficacy of the various treatments for ADHD. Drawing upon the results of the recent National Institutes of Health Consensus Conference, this paper reviews the evidence concerning these controversial areas. Although there do appear to be pockets of over-prescribing in selected communities, the best available evidence suggests that across the United States substantial underdiagnosis continues to occur, and only 50% of all children with ADHD are being treated with stimulant medications. Among those who are treated with stimulant medications, inadequate treatment is quite common. Substantial evidence suggests that for ADHD symptoms, stimulants are more effective than behavioral therapies in head-to-head comparisons. Combined medication and behavioral treatments do not offer any meaningful advantages over medication treatments alone for ADHD symptoms. For other areas of functioning, however (social skills, academic performance, etc.), combined treatments appear to offer some modest advantages over single treatment approaches. Although research findings show that ADHD can indeed be rigorously and reliably diagnosed under optimal conditions, and that carefully delivered treatments can yield substantial benefits, such best practices do not appear to be taking place in the real world. Thus, although the above controversies are facing some resolution in principal, in practice much remains to be done.

  16. Hierarchical structure and importance of patients' reasons for treatment choices in knee and hip osteoarthritis: a concept mapping study.

    Science.gov (United States)

    Selten, Ellen M H; Geenen, Rinie; van der Laan, Willemijn H; van der Meulen-Dilling, Roelien G; Schers, Henk J; Nijhof, Marc W; van den Ende, Cornelia H M; Vriezekolk, Johanna E

    2017-02-01

    To improve patients' use of conservative treatment options of hip and knee OA, in-depth understanding of reasons underlying patients' treatment choices is required. The current study adopted a concept mapping method to thematically structure and prioritize reasons for treatment choice in knee and hip OA from a patients' perspective. Multiple reasons for treatment choices were previously identified using in-depth interviews. In consensus meetings, experts derived 51 representative reasons from the interviews. Thirty-six patients individually sorted the 51 reasons in two card-sorting tasks: one based on content similarity, and one based on importance of reasons. The individual sortings of the first card-sorting task provided input for a hierarchical cluster analysis (squared Euclidian distances, Ward's method). The importance of the reasons and clusters were examined using descriptive statistics. The hierarchical structure of reasons for treatment choices showed a core distinction between two categories of clusters: barriers [subdivided into context (e.g. the healthcare system) and disadvantages] and outcome (subdivided into treatment and personal life). At the lowest level, 15 clusters were identified of which the clusters Physical functioning, Risks and Prosthesis were considered most important when making a treatment decision for hip or knee OA. Patients' treatment choices in knee and hip OA are guided by contextual barriers, disadvantages of the treatment, outcomes of the treatment and consequences for personal life. The structured overview of reasons can be used to support shared decision-making. © The Author 2016. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  17. Differential effect of mode of conception and infertility treatment on fetal growth and prematurity.

    Science.gov (United States)

    Valenzuela-Alcaraz, Brenda; Crispi, Fátima; Manau, Dolors; Cruz-Lemini, Mónica; Borras, Aina; Balasch, Juan; Gratacós, Eduard

    2016-12-01

    Objectives To examine perinatal outcomes in pregnancies conceived by different methods: fertile women with spontaneous pregnancies, infertile women who achieved pregnancy without treatment, pregnancies achieved by ovulation induction (OI) and in vitro fertilization or intra-cytoplasmic sperm injection (IVF/ICSI). Methods Retrospective single-center cohort study including 200 fertile and 748 infertile women stratified according to infertility treatment. The outcome measurements were preterm delivery (PTD), small-for-gestational-age (SGA), gestational diabetes, placenta previa or preeclampsia. Results The overall rate of pregnancy complications was significantly increased in all infertility groups regardless of the infertility treatment (adjusted odds ratio (OR): infertile without treatment 2.3 versus OI 2.2 versus IVF/ICSI 3.4). While PTD was mainly associated to IVF/ICSI (adjusted OR: infertile without treatment 1.3 versus OI 1.6 versus IVF/ICSI 3.3), SGA was significantly associated to both OI and IVF/ICSI (adjusted OR: infertile without treatment 1.9 versus OI 2.7 versus IVF/ICSI 2.6). All these associations remained statistically significant after adjusting by maternal age and twin pregnancy. Conclusions This study confirms the higher prevalence of pregnancy complications in infertile women irrespectively of receiving infertility treatment or not, and further describes a preferential association of prematurity with IVF/ICSI, and SGA with treated infertility (OI and IVF/ICSI).

  18. A Clinical Concept for Interfractional Adaptive Radiation Therapy in the Treatment of Head and Neck Cancer

    International Nuclear Information System (INIS)

    Jensen, Alexandra D.; Nill, Simeon; Huber, Peter E.; Bendl, Rolf; Debus, Jürgen; Münter, Marc W.

    2012-01-01

    Purpose: To present an approach to fast, interfractional adaptive RT in intensity-modulated radiation therapy (IMRT) of head and neck tumors in clinical routine. Ensuring adequate patient position throughout treatment proves challenging in high-precision RT despite elaborate immobilization. Because of weight loss, treatment plans must be adapted to account for requiring supportive therapy incl. feeding tube or parenteral nutrition without treatment breaks. Methods and Materials: In-room CT position checks are used to create adapted IMRT treatment plans by stereotactic correlation to the initial setup, and volumes are adapted to the new geometry. New IMRT treatment plans are prospectively created on the basis of position control scans using the initial optimization parameters in KonRad without requiring complete reoptimization and thus facilitating quick replanning in daily routine. Patients treated for squamous cell head and neck cancer (SCCHN) in 2006–2007 were evaluated as to necessity/number of replannings, weight loss, dose, and plan parameters. Results: Seventy-two patients with SCCHN received IMRT to the primary site and lymph nodes (median dose 70.4 Gy). All patients received concomitant chemotherapy requiring supportive therapy by feeding tube or parenteral nutrition. Median weight loss was 7.8 kg, median volume loss was approximately 7%. Fifteen of 72 patients required adaptation of their treatment plans at least once. Target coverage was improved by up to 10.7% (median dose). The increase of dose to spared parotid without replanning was 11.7%. Replanning including outlining and optimization was feasible within 2 hours for each patient, and treatment could be continued without any interruptions. Conclusion: To preserve high-quality dose application, treatment plans must be adapted to anatomical changes. Replanning based on position control scans therefore presents a practical approach in clinical routine. In the absence of clinically usable online

  19. [Treatment strategies for mass casualty incidents and terrorist attacks in trauma and vascular surgery : Presentation of a treatment concept].

    Science.gov (United States)

    Friemert, B; Franke, A; Bieler, D; Achatz, A; Hinck, D; Engelhardt, M

    2017-10-01

    The treatment of patients in the context of mass casualty incidents (MCI) represents a great challenge for the participating rescue workers and clinics. Due to the increase in terrorist activities it is necessary to become familiar with this new kind of threat to civilization with respect to the medical treatment of victims of terrorist attacks. There are substantial differences between a "normal" MCI and a terrorist MCI with respect to injury patterns (blunt trauma vs. penetrating/perforating trauma), the type and form of the incident (MCI=static situation vs. terrorist attack MCI= dynamic situation) and the different security positions (rescue services vs. police services). This article is concerned with question of which changes in the surgical treatment of patients are made necessary by these new challenges. In this case it is necessary that physicians are familiar with the different injury patterns, whereby priority must be given to gunshot and explosion (blast) injuries. Furthermore, altered strategic and tactical approaches (damage control surgery vs. tactical abbreviated surgical care) are necessary to ensure survival for as many victims of terrorist attacks as possible and also to achieve the best possible functional results. It is only possible to successfully counter these new challenges by changing the mindset in the treatment of terrorist MCI compared to MCI incidents. An essential component of this mindset is the acquisition of a maximum of flexibility. This article would like to make a contribution to this problem.

  20. Tic Disorders and Tourette Syndrome: Current Concepts of Etiology and Treatment in Children and Adolescents.

    Science.gov (United States)

    Tagwerker Gloor, Friederike; Walitza, Susanne

    2016-04-01

    Tic disorders (TD), including chronic/persistent TD (CTD) and Tourette syndrome, have been described and studied for many years. Within the last two decades, intensified study efforts led to more specific assumptions about genesis and influences of both hereditary and environmental factors. TD in children and adolescents are very often accompanied by attention-deficit/hyperactivity disorders and obsessive-compulsive disorders (OCD) as comorbid disorders. Comorbidities are aggravating factors concerning prognosis and treatment opportunities. Therefore, etiological considerations and treatment strategies have to take associated psychiatric disorders into account. Treatment approaches are symptom targeted and include behavioral treatments and/or medication and show positive outcomes concerning tic symptomatology, global functioning, and associated psychopathology. This review presents an update of the research, definitions, and classification according to ICD-10 and DSM-5 and summarizes the diagnostic procedures and most effective clinical strategies. Georg Thieme Verlag KG Stuttgart · New York.

  1. Treatment concepts for the posterior maxilla and mandible: short implants versus long implants in augmented bone

    OpenAIRE

    Thoma, Daniel Stefan; Cha, Jae-Kook; Jung, Ui-Won

    2017-01-01

    The aim of this narrative review is to describe treatment options for the posterior regions of the mandible and the maxilla, comparing short implants vs. longer implants in an augmented bone. The dental literature was screened for treatment options enabling the placement of dental implants in posterior sites with a reduced vertical bone height in the maxilla and the mandible. Short dental implants have been increasingly used recently, providing a number of advantages including reduced patient...

  2. [Concept for a forward-looking communication in the palliative treatment of patients with pneumological-oncological diseases prospective].

    Science.gov (United States)

    Tessmer, G; Zaba, O; Grohé, C

    2011-08-01

    The treatment and medical care of patients with lung cancer is mostly characterised and complicated by a reduced life expectancy. The lack of time can easily be the cause for various problems concerning the handling of these patients, their relatives and medical staff. A concept for opening future perspectives through standardised steps of communication could lead to a more cautious and humane relationship between physician and patient. In the case of successful realisation of this strategy, a significant enhancement of quality of life for the patient and relatives and practicability of work for the physician can be expected. © Georg Thieme Verlag KG Stuttgart · New York.

  3. Current concepts of oral and maxillofacial rehabilitation and treatment in aviation.

    Science.gov (United States)

    Yuce, Esra; Koçer, Gulperi; Çini, Turan Atila

    2016-01-01

    Aerospace medicine is the medical discipline responsible for assessing and conserving the health, safety, and performance of individuals involved in air and space travel. With the upward trend in airline travel, flight-related oral conditions requiring treatment have become a source of concern for aircrew members. Awareness and treatment of any potential physiological problems for these aircrews have always been critical components of aviation safety. In a flight situation, oral and maxillofacial problems may in fact become life-threatening clinical conditions. The unusual nature of aerospace medicine requires practitioners to have unique expertise. Special attention to aerospace medicine will open the way for professionals to develop and apply their skills and capabilities. Both dentists and aviators should be aware of the issues involved in aviation dentistry. This article presents the principles of prevention, treatment guidelines, and dental-related flight restrictions.

  4. Development of Treatment Concepts for the Use of Botulinum Toxin A in Children with Cerebral Palsy

    Directory of Open Access Journals (Sweden)

    Julia F. Funk

    2010-08-01

    Full Text Available The treatment of children with cerebral palsy with Botulinum toxin A injections is well established, safe and effective. However, a standardized injection strategy is still missing and the used dosage has escalated over the years. In the recent past, the recommended dosages in Europe were, however, reduced due to a better understanding of the relationship between dosage, severe side effects and the kind of anesthesia used. To combine safety and efficacy, the trend tends to a lower dosage, but combined with a more specific selection of injected muscles. The treatment of these key-muscles takes into account the best support for motor development to attain each individual motor milestone.

  5. Treatment of acute periprosthetic infections with prosthesis retention: Review of current concepts.

    Science.gov (United States)

    Kuiper, Jesse Wp; Willink, Robin Tjeenk; Moojen, Dirk Jan F; van den Bekerom, Michel Pj; Colen, Sascha

    2014-11-18

    Periprosthetic joint infection (PJI) is a devastating complication after total joint arthroplasty, occurring in approximately 1%-2% of all cases. With growing populations and increasing age, PJI will have a growing effect on health care costs. Many risk factors have been identified that increase the risk of developing PJI, including obesity, immune system deficiencies, malignancy, previous surgery of the same joint and longer operating time. Acute PJI occurs either postoperatively (4 wk to 3 mo after initial arthroplasty, depending on the classification system), or via hematogenous spreading after a period in which the prosthesis had functioned properly. Diagnosis and the choice of treatment are the cornerstones to success. Although different definitions for PJI have been used in the past, most are more or less similar and include the presence of a sinus tract, blood infection values, synovial white blood cell count, signs of infection on histopathological analysis and one or more positive culture results. Debridement, antibiotics and implant retention (DAIR) is the primary treatment for acute PJI, and should be performed as soon as possible after the development of symptoms. Success rates differ, but most studies report success rates of around 60%-80%. Whether single or multiple debridement procedures are more successful remains unclear. The use of local antibiotics in addition to the administration of systemic antibiotic agents is also subject to debate, and its pro's and con's should be carefully considered. Systemic treatment, based on culture results, is of importance for all PJI treatments. Additionally, rifampin should be given in Staphylococcal PJIs, unless all foreign material is removed. The most important factors contributing to treatment failure are longer duration of symptoms, a longer time after initial arthroplasty, the need for more debridement procedures, the retention of exchangeable components, and PJI caused by Staphylococcus (aureus or

  6. Current concepts on posterior meniscal root lesion: A treatment algorithm based on the currently available evidence

    Directory of Open Access Journals (Sweden)

    Guan-Yang Song

    2014-07-01

    Full Text Available Meniscal root lesion is defined as an avulsion of the tibial insertion of the meniscus or a radial tear close to the meniscal insertion, which is commonly observed at the posterior region in the clinical practice. Although a number of biomechanical and clinical studies have shown the importance of the integrity of the posterior meniscal roots, the appropriate treatment is still controversial. The purposes of this review are to develop a current understanding of how the posterior meniscal root functions and to review the available treatment options for posterior meniscal root lesion.

  7. Concepts of illness and treatment practice in a caboclo community of the Lower Amazon.

    Science.gov (United States)

    Reeve, M E

    2000-03-01

    Comparatively little has been written recently about the health consequences of social change and economic development in Amazonia. This study focuses on patterns of morbidity, treatment practices, and illness beliefs among caboclos of the Lower Amazon. It suggests that for these people traditional medicine is a salient marker of ethnic identity. An understanding of beliefs concerning disease etiology is critical to an appreciation of individual treatment choices in a plural medical system such as that found within the Lower Amazon region, where traditional healers can play a pivotal role in developing effective linkages to clinical services.

  8. Assisted conception and South Asian communities in the UK: public perceptions of the use of donor gametes in infertility treatment.

    Science.gov (United States)

    Culley, Lorraine; Hudson, Nicky; Rapport, Frances

    2013-03-01

    This paper explores 'public' attitudes to the use of donated gametes in infertility treatment amongst members of British South Asian communities in the UK. The study included 14 single-sex focus groups with a total of 100 participants of Indian, Pakistani and Bangladeshi origins in three English cities and 20 individual semi-structured interviews with key informants. It explores five themes from the data: childlessness and stigma; using sperm and using eggs; cultural connections; choosing gametes; religion and the use of donated gametes; and disclosure and the management of information. The paper demonstrates that the socio-cultural context of fertility treatment is highly relevant and those delivering services and those consulting the public need to be aware of cultural and gender differences. Third party assisted conception represents a challenge to received ideas of identity and has implications for social reproduction and kinship which go well beyond immediate conjugal relationships.

  9. Using concept mapping to design an indicator framework for addiction treatment centers.

    NARCIS (Netherlands)

    Nabitz, U.; van den Brink, W.; Jansen, P.G.W.

    2005-01-01

    Objective. The objective of this study is to determine an indicator framework for addiction treatment centres based on the demands of stakeholders and in alignment with the European Foundation for Quality Management (EFQM) Excellence Model. Setting. The setting is the Jellinek Centre based in

  10. A new concept in the topical treatment of onychomycosis with cyanoacrylate, undecylenic acid, and hydroquinone.

    Science.gov (United States)

    Rehder, Paul; Nguyen, Tim T

    2008-04-01

    The authors report a pilot study of a new approach for the topical treatment of onychomycosis using physiologic principles of fungal growth and serial debridement. In total, 154 patients were studied for 1 year with mild, moderate, and severe nail disease. Negative mycologic cultures in these 3 groups were 100%, 65%, and 35%, respectively. All patients reported subjective improvement in the first 3 months.

  11. [Oral amyloidosis. Concept, histopathology, clinical manifestations and treatment. Presentation of a clinical case].

    Science.gov (United States)

    Bermejo Fenoll, A; Sánchez Pérez, A; Orts Feliciano, R

    1991-05-01

    The definition and current classification of amyloidosis as well as the incidence, etiopathogenesis, pathology, clinical manifestations, specific diagnosis and prognosis and treatment of the disease are reviewed. A case of amyloidosis of the oral cavity without systemic involvement is reported. A 77 year-old woman suffered from multiple tumor masses in the mouth and presented with symptoms of impaired speech and ingestion.

  12. Treatment of displaced intra-articular calcaneal fractures by ligamentotaxis: Current concepts' review

    NARCIS (Netherlands)

    T. Schepers (Tim); P. Patka (Peter)

    2009-01-01

    textabstractIntroduction: A large variety of therapeutic modalities for calcaneal fractures have been described in the literature. No single treatment modality for displaced intra-articular calcaneal fractures has proven superior over the other. This review describes and compares the different

  13. Treatment concepts for the posterior maxilla and mandible: short implants versus long implants in augmented bone.

    Science.gov (United States)

    Thoma, Daniel Stefan; Cha, Jae-Kook; Jung, Ui-Won

    2017-02-01

    The aim of this narrative review is to describe treatment options for the posterior regions of the mandible and the maxilla, comparing short implants vs. longer implants in an augmented bone. The dental literature was screened for treatment options enabling the placement of dental implants in posterior sites with a reduced vertical bone height in the maxilla and the mandible. Short dental implants have been increasingly used recently, providing a number of advantages including reduced patient morbidity, shorter treatment time, and lower costs. In the posterior maxilla, sinus elevation procedures were for long considered to be the gold standard using various bone substitute materials and rendering high implant survival rates. More recently, implants were even placed without any further use of bone substitute materials, but the long-term outcomes have yet to be documented. Vertical bone augmentation procedures in the mandible require a relatively high level of surgical skill and allow the placement of standard-length dental implants by the use of autogenous bone blocks. Both treatment options, short dental implants, and standard-length implants in combination with vertical bone augmentation procedures, appear to result in predictable outcomes in terms of implant survival rates. According to recent clinical studies comparing the therapeutic options of short implants vs. long implants in augmented bone, the use of short dental implants leads to a number of advantages for the patients and the clinician.

  14. Long-term outcome of a multidisciplinary concept of spinal dural arteriovenous fistulae treatment

    Energy Technology Data Exchange (ETDEWEB)

    Sherif, Camillo [Medical University Vienna, Department of Neurosurgery, Vienna (Austria); AKH-Wien, Universitaetsklinik fuer Neurochirurgie, Wien (Austria); Gruber, Andreas; Bavinzski, Gerhard; Standhardt, Harald; Widhalm, Georg; Knosp, Engelbert [Medical University Vienna, Department of Neurosurgery, Vienna (Austria); Gibson, Daniel [Dartmouth Medical School, Section of Neurosurgery, Lebanon, NH (United States); Richling, Bernd [Paracelsus Private Medical University, Department of Neurosurgery, Salzburg (Austria)

    2008-01-15

    The optimal treatment of spinal dural arteriovenous fistulae (SDAVF) remains controversial and long-term follow-up data, especially data from multidisciplinary treatment, are rarely available. Thus, long-term outcomes following a multidisciplinary approach to the treatment of SDAVF were investigated. The investigation included 26 patients with SDAVF treated at the authors' department over a 15-year period including a follow-up of more than 2 years. The treatment strategy when occlusion of the draining vein could be achieved was to embolize the fistula with Histoacryl, with surgery reserved for those patients unsuitable for embolization. Posttreatment angiography followed by MRI was performed in all patients. Clinical follow-up was performed using the gait and micturition Aminoff-Logue scale scores and the modified Rankin scale score. Embolization was performed in 19 patients (73.1%), and direct surgery in 7 patients (26.9%). Follow-up angiography (at a mean of 21.7 months) showed occlusion of the SDAVF in 24 patients (92.3%). Of the 19 embolized patients, 2 (10.5%) developed recurrence secondary to insufficient occlusion of the SDAVF draining vein, and one of these two patients underwent re-embolization and one re-operation. No negative effects of SDAVF recurrence on the final clinical outcome were identified in either patient. MRI after angiography (at a mean of 91.5 months) demonstrated occlusion of all SDAVFs. After a mean clinical follow-up of 103.4 months there was a statistically significant improvement in both the modified Rankin scale score and the Aminoff-Logue gait scale score (P < 0.05). The present multidisciplinary study showed for the first time that embolization leads to stable neuroradiological results and favourable clinical outcomes even for very long follow-up times of more than 100 months. Microsurgery remains the treatment of choice when safe embolization of the draining vein cannot be achieved. (orig.)

  15. A Positive Psychology Intervention for Patients with an Acute Coronary Syndrome: Treatment Development and Proof-of-Concept Trial.

    Science.gov (United States)

    Huffman, Jeff C; Millstein, Rachel A; Mastromauro, Carol A; Moore, Shannon V; Celano, Christopher M; Bedoya, C Andres; Suarez, Laura; Boehm, Julia K; Januzzi, James L

    2016-10-01

    Positive psychological constructs are associated with superior outcomes in cardiac patients, but there has been minimal study of positive psychology (PP) interventions in this population. Our objective was to describe the intervention development and pilot testing of an 8-week phone-based PP intervention for patients following an acute coronary syndrome (ACS). Initial intervention development and single-arm proof-of-concept trial, plus comparison of the PP intervention to a subsequently-recruited treatment as usual (TAU) cohort. PP development utilized existing literature, expert input, and qualitative interview data in ACS patients. In the proof-of-concept trial, the primary outcomes were feasibility and acceptability, measured by rates of exercise completion and participant ratings of exercise ease/utility. Secondary outcomes were pre-post changes in psychological outcomes and TAU comparisons, measured using effect sizes (Cohen's d ). The PP intervention and treatment manual were successfully created. In the proof-of-concept trial, 17/23 PP participants (74 %) completed at least 5 of 8 exercises. Participants rated the ease ( M = 7.4/10; SD = 2.1) and utility ( M = 8.1/10, SD = 1.6) of PP exercises highly. There were moderate pre-post improvements ( d s = .46-.69) in positive affect, anxiety, and depression, but minimal effects on dispositional optimism ( d = .08). Compared to TAU participants ( n = 22), PP participants demonstrated greater improvements in positive affect, anxiety, and depression ( d s = . 47-.71), but not optimism. A PP intervention was feasible, well-accepted, and associated with improvements in most psychological measures among cardiac patients. These results provide support for a larger trial focusing on behavioral outcomes.

  16. From bladder to systemic syndrome: concept and treatment evolution of interstitial cystitis

    Science.gov (United States)

    Dinis, Sara; de Oliveira, Joana Tavares; Pinto, Rui; Cruz, Francisco; Buffington, CA Tony; Dinis, Paulo

    2015-01-01

    Interstitial cystitis, presently known as bladder pain syndrome, has been recognized for over a century but is still far from being understood. Its etiology is unknown and the syndrome probably harbors different diseases. Autoimmune dysfunction, urothelial leakage, infection, central and peripheral nervous system dysfunction, genetic disease, childhood trauma/abuse, and subsequent stress response system dysregulation might be implicated. Management is slowly evolving from a solo act by the end-organ specialist to a team approach based on new typing and phenotyping of the disease. However, oral and invasive treatments are still largely aimed at the bladder and are based on currently proposed pathophysiologic mechanisms. Future research will better define the disease, permitting individualization of treatment. PMID:26229509

  17. Treatment of Recurrent Eczematous External Otitis with Honey Eardrops: A Proof-of-Concept Study.

    Science.gov (United States)

    Henatsch, Darius; Nabuurs, Cindy H; van de Goor, Rens M; Wolffs, Petra F; Stokroos, Robert J

    2017-10-01

    Eczematous external otitis is a chronic inflammatory disease and often difficult to treat. Our objective was to investigate the clinical effect and in vitro antibacterial potential of medical honey eardrops as treatment of eczematous external otitis. In a prospective study, 15 patients diagnosed with recurrent eczematous external otitis were treated with medical honey eardrops for 2 weeks. The following clinical outcomes were evaluated: visual analog scale of ear complaints, score of eczema, and eradication of bacterial infection. Furthermore, the antibacterial effect of honey eardrops against different bacterial strains was tested in vitro. Treatment resulted in less discomfort and itching and decreased signs of eczema, with high patient satisfaction and without adverse reactions. Honey eardrops showed a strong in vitro inhibitory activity against all tested strains but did not eradicate Staphylococcus aureus infection in vivo. The results of this preliminary study indicate a possible role of honey eardrops in eczematous ear disease.

  18. [Ogilvie syndrome or acute colonic pseudo-obstruction. Current concepts in diagnosis and treatment].

    Science.gov (United States)

    Quintero Samudio, I; Cachafeiro Vilar, M; Valdovinos Díaz, M A

    1997-01-01

    Ogilvie's syndrome or acute colonic pseudo-obstruction is a motility disorder characterized by acute and progressive colonic distension. This syndrome occurs in hospitalized patients with several medical or surgical diseases with an unclear pathophysiology. Diagnosis is established by the clinical history, physical examination and radiological findings on plain abdominal X-ray. Treatment includes: 1. general measures to reduce colonic distension, 2. drugs that improve colon motility, 3. endoscopic colonic decompression and 4. surgery. Age, associated diseases, elapsed time and diameter of cecal dilatation, presence of necrosis and perforation are the main prognostic factors. Recurrence after medical treatment is 20-50 percent; intrahospital mortality is 30 percent. A practical algorithm for the management of these patients is proposed.

  19. Current concepts on posterior meniscal root lesion: A treatment algorithm based on the currently available evidence

    OpenAIRE

    Guan-Yang Song; Jin Zhang; Xu Li; Yue Li; Hua Feng

    2014-01-01

    Meniscal root lesion is defined as an avulsion of the tibial insertion of the meniscus or a radial tear close to the meniscal insertion, which is commonly observed at the posterior region in the clinical practice. Although a number of biomechanical and clinical studies have shown the importance of the integrity of the posterior meniscal roots, the appropriate treatment is still controversial. The purposes of this review are to develop a current understanding of how the posterior meniscal root...

  20. Adjunctive minocycline treatment for major depressive disorder: A proof of concept trial.

    Science.gov (United States)

    Dean, Olivia M; Kanchanatawan, Buranee; Ashton, Melanie; Mohebbi, Mohammadreza; Ng, Chee Hong; Maes, Michael; Berk, Lesley; Sughondhabirom, Atapol; Tangwongchai, Sookjaroen; Singh, Ajeet B; McKenzie, Helen; Smith, Deidre J; Malhi, Gin S; Dowling, Nathan; Berk, Michael

    2017-08-01

    Conventional antidepressant treatments result in symptom remission in 30% of those treated for major depressive disorder, raising the need for effective adjunctive therapies. Inflammation has an established role in the pathophysiology of major depressive disorder, and minocycline has been shown to modify the immune-inflammatory processes and also reduce oxidative stress and promote neuronal growth. This double-blind, randomised, placebo-controlled trial examined adjunctive minocycline (200 mg/day, in addition to treatment as usual) for major depressive disorder. This double-blind, randomised, placebo-controlled trial investigated 200 mg/day adjunctive minocycline (in addition to treatment as usual) for major depressive disorder. A total of 71 adults with major depressive disorder ( Diagnostic and Statistical Manual of Mental Disorders-Fourth Edition) were randomised to this 12-week trial. Outcome measures included the Montgomery-Asberg Depression Rating Scale (primary outcome), Clinical Global Impression-Improvement and Clinical Global Impression-Severity, Hamilton Anxiety Rating Scale, Quality of Life Enjoyment and Satisfaction Questionnaire, Social and Occupational Functioning Scale and the Range of Impaired Functioning Tool. The study was registered on the Australian and New Zealand Clinical Trials Register: www.anzctr.org.au , #ACTRN12612000283875. Based on mixed-methods repeated measures analysis of variance at week 12, there was no significant difference in Montgomery-Asberg Depression Rating Scale scores between groups. However, there were significant differences, favouring the minocycline group at week 12 for Clinical Global Impression-Improvement score - effect size (95% confidence interval) = -0.62 [-1.8, -0.3], p = 0.02; Quality of Life Enjoyment and Satisfaction Questionnaire score - effect size (confidence interval) = -0.12 [0.0, 0.2], p depressive disorder. Further studies are warranted to confirm the potential of this accessible agent to optimise

  1. How to Do in Persistent Diarrhea of Children?: Concepts and Treatments of Chronic Diarrhea

    OpenAIRE

    Lee, Kun Song; Kang, Dong Soo; Yu, Jeesuk; Chang, Young Pyo; Park, Woo Sung

    2012-01-01

    Chronic diarrhea is defined as passing watery stools that lasts for more than 2 weeks. Persistent diarrhea belongs to chronic diarrhea and is a chronic episode of diarrhea of infectious etiology. The etiology of chronic diarrhea is varied. It is important to consider the child's age and clinical manifestations with alarm signals for an application of proper treatments to children with chronic diarrhea. Vicious cycle is present in chronic diarrhea and nutritional rehabilitation can break the v...

  2. Emerging concepts in the diagnosis and treatment of patients with undifferentiated angioedema

    Science.gov (United States)

    2012-01-01

    Angioedema is a sudden, transient swelling of well-demarcated areas of the dermis, subcutaneous tissue, mucosa, and submucosal tissues that can occur with or without urticaria. Up to 25% of people in the US will experience an episode of urticaria or angioedema during their lifetime, and many will present to the emergency department with an acute attack. Most cases of angioedema are attributable to the vasoactive mediators histamine and bradykinin. Histamine-mediated (allergic) angioedema occurs through a type I hypersensitivity reaction, whereas bradykinin-mediated (non-allergic) angioedema is iatrogenic or hereditary in origin. Although their clinical presentations bear similarities, the treatment algorithm for histamine-mediated angioedema differs significantly from that for bradykinin-mediated angioedema. Corticosteroids, and epinephrine are effective in the management of histamine-mediated angioedema but are ineffective in the management of bradykinin-mediated angioedema. Recent advancements in the understanding of angioedema have yielded pharmacologic treatment options for hereditary angioedema, a rare hereditary form of bradykinin-mediated angioedema. These novel therapies include a kallikrein inhibitor (ecallantide) and a bradykinin β2 receptor antagonist (icatibant). The physician’s ability to distinguish between these types of angioedema is critical in optimizing outcomes in the acute care setting with appropriate treatment. This article reviews the pathophysiologic mechanisms, clinical presentations, and diagnostic laboratory evaluation of angioedema, along with acute management strategies for attacks. PMID:23131076

  3. Achilles Tendinopathy: Current Concepts about the Basic Science and Clinical Treatments

    Directory of Open Access Journals (Sweden)

    Hong-Yun Li

    2016-01-01

    Full Text Available Achilles tendinopathy is one of the most frequently ankle and foot overuse injuries, which is a clinical syndrome characterized by the combination of pain, swelling, and impaired performance. The two main categories of Achilles tendinopathy are classified according to anatomical location and broadly include insertional and noninsertional tendinopathy. The etiology of Achilles tendinopathy is multifactorial including both intrinsic and extrinsic factors. Failed healing response and degenerative changes were found in the tendon. The failed healing response includes three different and continuous stages (reactive tendinopathy, tendon disrepair, and degenerative tendinopathy. The histological studies have demonstrated an increased number of tenocytes and concentration of glycosaminoglycans in the ground substance, disorganization and fragmentation of the collagen, and neovascularization. There are variable conservative and surgical treatment options for Achilles tendinopathy. However, there has not been a gold standard of these treatments because of the controversial clinical results between various studies. In the future, new level I researches will be needed to prove the effect of these treatment options.

  4. Achilles Tendinopathy: Current Concepts about the Basic Science and Clinical Treatments.

    Science.gov (United States)

    Li, Hong-Yun; Hua, Ying-Hui

    2016-01-01

    Achilles tendinopathy is one of the most frequently ankle and foot overuse injuries, which is a clinical syndrome characterized by the combination of pain, swelling, and impaired performance. The two main categories of Achilles tendinopathy are classified according to anatomical location and broadly include insertional and noninsertional tendinopathy. The etiology of Achilles tendinopathy is multifactorial including both intrinsic and extrinsic factors. Failed healing response and degenerative changes were found in the tendon. The failed healing response includes three different and continuous stages (reactive tendinopathy, tendon disrepair, and degenerative tendinopathy). The histological studies have demonstrated an increased number of tenocytes and concentration of glycosaminoglycans in the ground substance, disorganization and fragmentation of the collagen, and neovascularization. There are variable conservative and surgical treatment options for Achilles tendinopathy. However, there has not been a gold standard of these treatments because of the controversial clinical results between various studies. In the future, new level I researches will be needed to prove the effect of these treatment options.

  5. Outcomes in major depressive disorder: the evolving concept of remission and its implications for treatment.

    Science.gov (United States)

    Möller, Hans-Jürgen

    2008-01-01

    It is increasingly recognised that major depressive disorder can be a chronic condition with many patients experiencing recurrent episodes. Remission from a depressive episode implies the absence or near absence of depressive symptoms. However, for many patients the periods between depressive episodes are not symptom free. Residual symptoms are predictors of relapse or recurrence, and may be associated with residual psychosocial impairment. In clinical studies, remission is commonly defined using a cut-off score on a rating scale for depressive symptoms, such as a score of < or = 7 on the 17-item Hamilton scale. However, there is debate about which scales and cut-offs are optimal and full-length rating scales are not widely used in clinical practice. In spite of such issues, it seems clear that a therapy should aim at the most complete remission possible. Unfortunately, recent studies have highlighted that in clinical practice usually only a low rate of remission is achieved. Although long-term treatment with antidepressants can reduce the risk of relapse or recurrence only a minority of patients in clinical practice achieve this as treatment is often prematurely stopped due to long-term side effects such as sleep disturbance, sexual dysfunctioning and weight gain. Therefore, it represents an unmet need to come up with antidepressant drugs of greater efficacy and improved tolerability as such treatments could lead to more complete remission in more patients.

  6. [Innovations on technology, management and concept are indispensible for scientific research, prevention and treatment of malignant tumor in China].

    Science.gov (United States)

    Cao, G W

    2017-01-10

    Malignant tumor has become the top cause of deaths before the average life expectancy in Chinese population. From the variations in the morbidity rate and mortality rate of malignant tumor in the mainland of China between 2000 and 2011, the primary prevention targeting the risk factors/etiological agents significantly reduced the morbidity rates of gastric cancer, esophageal cancer, and primary liver cancer, therefore reduced the mortality rates of these cancers. However, the contribution of clinical treatments to the mortality reduction was not obviously improved during this period. Importantly, it is necessary to conduct research to identify precancerous lesions and early tumors which are prone to progress to aggressive diseases for the active secondary prevention to avoid over-diagnosis and over-treatment. Multi-center, prospective randomized controlled clinical trials and prognosis evaluation independently carried out by third parts are needed to evaluate the longterm effectiveness of some clinical treatment efficiency for cancers with different histological types. On the basis of a series of population-based studies in China, the prevention and clinical treatments for malignant tumor need innovations on technology, management, and even concept; the mechanisms of "forward placement of strategic pass" for the prevention and control of malignant tumor should be established and improved to reduce the increasing disease burden due to malignant tumor in China.

  7. Checkpoint inhibitors and radiation treatment in Hodgkin's lymphoma. New study concepts of the German Hodgkin Study Group

    International Nuclear Information System (INIS)

    Baues, C.; Semrau, R.; Marnitz, S.; Gaipl, U.S.; Broeckelmann, P.J.; Engert, A.; Rosenbrock, J.

    2017-01-01

    Patients with classical Hodgkin's lymphoma (cHL) have a good prognosis even in advanced stages. However, combined chemo- and radiotherapy, as the standard of care, is also associated with treatment-related toxicities such as organ damage, secondary neoplasias, infertility, or fatigue and long-term fatigue. Many patients suffer from this burden although their cHL was cured. Therefore, the efficacy of immune checkpoint inhibitors like anti-PD1/PD-L1 antibodies in the treatment of solid cancers and also in HL offers new options. A remarkable and durable response rate with a favorable toxicity profile was observed in heavily pretreated cHL patients. Planning to perform prospective randomized clinical trials in the content of radio-immune treatment in patients with Hodgkin's lymphoma (HL), we transferred the results of preliminary clinical studies and basic research in clinical relevant study concepts. Based on these promising early phase trial data, the German Hodgkin Study Group (GHSG) will investigate innovative treatment regimens in upcoming phase II trials. The therapeutic efficacy and potential synergies of anti-PD1 antibodies in combination with chemo- or radiotherapy will be investigated in various settings of HL. (orig.) [de

  8. The applicability of the concept of treatment adherence in the context of the Brazilian mental health system

    Directory of Open Access Journals (Sweden)

    Patricia Elizabeth Sanz de Alvarez

    2016-06-01

    Full Text Available Objective To present reflections on the type of research conducted on a treatment adherence among users of Public Mental Health System in Brazil and discuss the applicability of the concept of adherence to treatment in this context. Method Literature review in SciELO, LILACS, Cochrane Library and PubMed / MEDLINE using the Health Sciences Descriptors (DeCS treatment, adhesion and “mental health” and the specific vocabulary of the Medical Subject Headings (MeSH “patient compliance/psychologist” y “mental health”. They were included for review the complete texts and theses published between 2007-2012 in Portuguese, English and Spanish. Results 127 articles were recovered, 32 specifically related to mental health. Eight were excluded for duplicates and after reading the remaining 24 articles were selected for this study 10 conducted in the field of Mental Health in Brazil. No investigations have been identified with focus on adherence to psychosocial treatment offered in public mental health. Conclusions disregard of the mental health legislation and reinforce the asylum model of assistance.

  9. Proof of concept trial of tanezumab for the treatment of symptoms associated with interstitial cystitis.

    Science.gov (United States)

    Evans, R J; Moldwin, R M; Cossons, N; Darekar, A; Mills, I W; Scholfield, D

    2011-05-01

    In this randomized, double-blind, placebo controlled phase 2 study we investigated tanezumab, a humanized monoclonal antibody that specifically inhibits nerve growth factor as a treatment for interstitial cystitis pain. Patients with interstitial cystitis received a single intravenous dose of 200 μg/kg tanezumab or placebo. Patients recorded daily pain scores (on an 11-point numerical rating scale) 7 days before attending study visits and completed a urinary symptom diary for 3 of those days. Patients also completed the Interstitial Cystitis Symptom Index questionnaire and a global response assessment. The primary end point was change in average daily numerical rating scale pain score from baseline to week 6. Secondary end points included global response assessment, Interstitial Cystitis Symptom Index score, micturition and urgency episode frequency per 24 hours, and mean voided volume per micturition. The incidence of adverse events was also assessed. A total of 34 patients received tanezumab and 30 received placebo. At week 6 tanezumab produced a significant reduction from baseline in average daily pain score vs placebo (treatment difference [LS mean, 90% CI] was -1.4 [-2.2, -0.5]). A significantly higher proportion of patients on tanezumab responded as improved in the global response assessment and tanezumab also significantly reduced urgency episode frequency vs placebo. Tanezumab had no significant effect on Interstitial Cystitis Symptom Index score, micturition frequency or mean voided volume per micturition. The most common adverse events were headache (tanezumab 20.6%, placebo 16.7%) and paresthesia (tanezumab 17.6%, placebo 3.3%). Tanezumab has shown preliminary efficacy in the treatment of pain associated with interstitial cystitis. Copyright © 2011 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

  10. Photodynamic Therapy treatment of onychomycosis with Aluminium-Phthalocyanine Chloride nanoemulsions: A proof of concept clinical trial.

    Science.gov (United States)

    Morgado, Luciano Ferreira; Trávolo, Ana Regina Franchi; Muehlmann, Luís Alexandre; Narcizo, Paulo Souza; Nunes, Rodrigo Barbosa; Pereira, Pedro Alencar Gomes; Py-Daniel, Karen Rapp; Jiang, Cheng-Shi; Gu, Jinsong; Azevedo, Ricardo Bentes; Longo, João Paulo Figueiró

    2017-08-01

    The conventional treatment of onychomycosis, a common fungal infection, consists in the use of local and systemic drugs for 4-6 months. This long protocol is often ineffective due to patient compliance, and usually promotes important collateral effects such as liver and kidney failure. As the alternative, Photodynamic Therapy (PDT) has been used as a noninvasive alternative local treatment for onychomycosis due to the reduction of systemic side effects, fact indicates their use for patients undergoing other systemic treatments. In the present article, we evaluated the effectiveness, as well as the safety of PDT mediated by Aluminium-Phthalocyanine Chloride, entrapped in nanoemulsions, as a drug carrier, to treat onychomycosis in a proof of concept clinical trial. To the date, this is the first published clinical trial that uses PDT mediated by nanomedicines to treat onychomycosis. As main results, we can highlight the safety of the clinical protocol and the antifungal effectiveness similar to the conventional treatments. We observed the (1) clinical cure of 60% of treated lesions; (2) the absence of local and systemic adverse effects; (3) from these clinically healed lesions, 40% were negative for fungal infection in laboratorial exams; and (4) nails that presented negative fungal culture were kept without fungal infection for at least four weeks. The innovation of this approach is the absence of collateral effects, due to the local therapeutically treatment, and the possibility to repeat the treatment without inducing fungal resistance, a fact that indicates this approach as a possible alternative protocol for onychomycosis management. Copyright © 2017 Elsevier B.V. All rights reserved.

  11. [Therapeutic Concepts for Treatment of Patients with Non-infectious Uveitis Biologic Disease Modifying Antirheumatic Drugs].

    Science.gov (United States)

    Walscheid, Karoline; Pleyer, Uwe; Heiligenhaus, Arnd

    2018-04-12

    Biologic disease modifying antirheumatic drugs (bDMARDs) can be highly efficient in the treatment of various non-infectious uveitis entities. Currently, the TNF-α-inhibitor Adalimumab is the only in-label therapeutic option, whereas, all other bDMARDs need to be given as an off-label therapy. bDMARDs are indicated in diseases refractory to conventional synthetic DMARD therapy and/or systemic steroids, or in patients in whom treatment with those is not possible due to side effects. Therapeutic mechanisms currently employed are cytokine-specific (interferons, inhibition of TNF-α or of interleukin [IL]-1-, IL-6- or IL-17-signalling), inhibit T cell costimulation (CTLA-4 fusion protein), or act via depletion of B cells (anti-CD20). All bDMARDs need to be administered parenterally, and therapy is initiated by the treating internal specialist only after interdisciplinary coordination of all treating subspecialties and after exclusion of contraindications. Regular clinical and laboratory monitoring is mandatory for all patients while under bDMARD therapy. Georg Thieme Verlag KG Stuttgart · New York.

  12. An interdisciplinary noninvasive all-ceramic treatment concept for nonsyndromic oligodontia in adolescence.

    Science.gov (United States)

    Selz, Christian F; Jung, Britta A; Guess, Petra C

    2015-02-01

    Oligodontia has a substantial oral functional and psychosocial impact on the quality of life of children. The treatment of oligodontia in adolescence is an interdisciplinary approach which can include extraction of the primary teeth with orthodontic space closure, or prosthodontic rehabilitation. This case report describes a conservative approach for the rehabilitation of a 12-year-old patient with 19 ageneses (excluding third molars) of permanent teeth, infraocclusion of the persisting primary teeth, deep overbite, and reduced mesiodistal dimension of the maxillary incisors with a central diastema. The treatment plan to restore esthetics and function included an initial noninvasive prosthetic rehabilitation for deep bite correction with additive leucite-reinforced glass-ceramic onlays/veneers until definitive orthodontic and implant therapy are reevaluated and determined in adulthood. Esthetics, functional occlusion, and crown-to-root ratio remained stable over a follow-up period of 3 years. No signs of fractures within the all-ceramic restorations or symptoms of a temporomandibular disorder were evident.

  13. Diagnosis of occipital condyle fractures; Diagnostik von Frakturen der Okzipitalkondylen

    Energy Technology Data Exchange (ETDEWEB)

    Hefele-Roedel, B. [Radiologische Klinik Innenstadt, Univ. Muenchen (Germany); Vogl, T.J. [Radiologische Klinik Innenstadt, Univ. Muenchen (Germany); Lochbuehler, H. [Dr. v. Haunersches Kinderspital, Kinderchirurgische Klinik, Univ. Muenchen (Germany); Lissner, J. [Radiologische Klinik Innenstadt, Univ. Muenchen (Germany)

    1995-01-01

    Following the conventional X-ray diagnosis of the skull and upper cervical spine, CT proved to be the primary diagnostic method after a skull and brain injury: For all 4 cases we succeeded in detecting the occipital condyle fracture and in determing its size and location by reconstructions (coronal, sagittal, 3-D). In the case of complex occompanying injuries like soft tissue hematomas (cerebral, in the spinal cord, and the soft tissue of the neck) or for the detection of brain stem contusion, MRT had significant advantages. MRT can offer a higher image quality in soft tissue, especially in the spinal cord and the brain. (orig.) [Deutsch] Im Anschluss an die konventionelle Roentgendiagnostik des Schaedels und der Halswirbelsaeule, erwies sich die Computertomographie als primaer einzusetzendes diagnostisches Verfahren, nach erlittenem Schaedel-Hirn-Trauma. In allen Faellen gelang der exakte Frakturnachweis an den Okzipitalkondylen, die Bestimmung des Frakturausmasses und die genaue Frakturlokalisation in Rekonstruktionen (koronar, sagittal, 3-D). Bei komplexen Begleitverletzungen, wie Blutungen (zerebral, spinal und in den Halsweichteilen) oder zum Nachweis einer Hirnstammkontusion, erwies sich der Einsatz der MRT als vorteilhaft. Mit der MRT laesst sich ein deutlich hoeherer Weichteilkontrast, insbesondere spinal und zerebral, erzielen. (orig.)

  14. Conception, characterization and evaluation of new radiotracers for diagnosis and treatment of breast and prostate cancers

    International Nuclear Information System (INIS)

    Dallagi, T.

    2010-01-01

    The medicinal and organometallic chemistry group of the Charles Friedel Laboratory has been developing therapeutic approaches based on organometallic compounds for many years. It has been found that these compounds may be used as cytotoxic agents or as radiopharmaceuticals for the treatment or diagnosis of diseases. The goal of the present work is the synthesis of organometallic analogs of biological substances (such as drugs) bearing a ferrocenyl, cymantrenyl, cerhetrenyl, or cyclo-pentadienyl-tricarbonyl-technetium group. We have especially focused our research on the preparation of Tc-99m derivatives and their purification. We have found suitable methods which are easy to handle and give high yields and high specific activities. These technetium compounds have been used for the study of in vivo biodistribution in animals. (author)

  15. Current concepts and controversies in the treatment of parenchymal brain metastases: improved outcomes with aggressive management.

    Science.gov (United States)

    Bajaj, Gopal K; Kleinberg, Lawrence; Terezakis, Stephanie

    2005-01-01

    The multimodality management of brain metastases has undergone significant refinement in the last decade. Although brain metastases remain a significant source of morbidity and mortality for many cancer patients, aggresive management has led to pronounced gains in neurological functioning, disease free survival and overall survival compared to standard treatment regimens consisting of only whole brain radiation therapy. Representative studies reviewing the role of aggressive management approaches including surgical resection with or without whole brain radiation therapy or non-surgical approaches employing stereotactic radiosurgery alone or in combination with whole brain radiation therapy are highlighted. Additionally, the emerging role of systemic agents showing distinct clinical activity in patients with brain metastases are also discussed. As we continue to gain advances in systemic therapies for metastatic disease, local control of brain metastases in these patients is likely to become more critical in improving survival and quality of life, thereby calling for a more aggressive multi-modal approach to this population of patients.

  16. The abdominal aortic aneurysm and intraluminal thrombus: current concepts of development and treatment

    Directory of Open Access Journals (Sweden)

    Aleksandra ePiechota-Polańczyk

    2015-05-01

    Full Text Available The pathogenesis of the abdominal aortic aneurysm (AAA shows several hallmarks of atherosclerotic and atherothrombotic disease, but comprises an additional, predominant feature of proteolysis resulting in the degradation and destabilization of the aortic wall. This review aims to summarize the current knowledge on AAA development, involving the accumulation of neutrophils in the intraluminal thrombus and their central role in creating an oxidative and proteolytic environment. Particular focus is placed on the controversial role of heme oxygenase 1/carbon monoxide and nitric oxide synthase/peroxynitrite which may exert both protective and damaging effects in the development of the aneurysm. Treatment indications as well as surgical and pharmacological options for AAA therapy are discussed in light of recent reports.

  17. Chronic Obstructive Pulmonary Disease-Evolving Concepts in Treatment: Advances in Pulmonary Rehabilitation.

    Science.gov (United States)

    Nici, Linda; ZuWallack, Richard

    2015-08-01

    Over the past three decades, pulmonary rehabilitation has risen to the stature as a gold standard for the treatment of chronic obstructive pulmonary disease (COPD). This rise is owing to both the development of science explaining mechanisms underlying its effectiveness and the demonstration of its substantial benefits across multiple outcome areas of importance to patients. Arguably, pulmonary rehabilitation provides the greatest improvements of any therapy in the areas of dyspnea-relief, exercise performance, and functional and health status. Emerging science also indicates that it reduces subsequent health care utilization and-when administered in the perihospital period-mortality risk. These beneficial effects are realized despite the fact that pulmonary rehabilitation has virtually no direct effect on lung function in COPD. Instead, this comprehensive, patient-centered intervention reduces the negative effects from systemic morbidity (such as muscle wasting) and comorbidity (such as depression and anxiety) that frequently accompany COPD. Two major components of pulmonary rehabilitation are exercise training and behavioral interventions. An example of the latter is a collaborative action plan for the early recognition and prompt treatment of the COPD exacerbation. Innovation in pulmonary rehabilitation includes (1) expanding its applicability, such as demonstrating effectiveness in the non-COPD respiratory patient, in milder COPD, in the periexacerbation period, and its provision in the home and community settings; (2) improving its process, such as refining the self-management and behavioral interventions, and the promotion of physical activity in the home and community settings; and (3) promoting its accessibility, such as exploring its potential usefulness in nontraditional settings (the home and community) and developing technology to assist in its implementation. Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

  18. Intravenous Mistletoe Treatment in Integrative Cancer Care: A Qualitative Study Exploring the Procedures, Concepts, and Observations of Expert Doctors.

    Science.gov (United States)

    Kienle, Gunver S; Mussler, Milena; Fuchs, Dieter; Kiene, Helmut

    2016-01-01

    Background. Mistletoe therapy (MT) is widely used in patient-centered integrative cancer care. The objective of this study was to explore the concepts, procedures, and observations of expert doctors, with a focus on intravenous MT. Method. A qualitative interview study was conducted with 35 highly experienced doctors specialized in integrative and anthroposophic medicine. Structured qualitative content analysis was applied. For triangulation, the results were compared with external evidence that was systematically collected, reviewed, and presented. Results. Doctors perform individualized patient assessments that lead to multimodal treatment approaches. The underlying goal is to help patients to live with and overcome disease. Mistletoe infusions are a means of accomplishing this goal. They are applied to stabilize disease, achieve responsiveness, induce fever, improve quality of life, and improve the tolerability of conventional cancer treatments. The doctors reported long-term disease stability and improvements in patients' general condition, vitality, strength, thermal comfort, appetite, sleep, pain from bone metastases, dyspnea in pulmonary lymphangitis carcinomatosa, fatigue, and cachexia; chemotherapy was better tolerated. Also patients' emotional and mental condition was reported to have improved. Conclusion. Individualized integrative cancer treatment including MT aims to help cancer patients to live well with their disease. Further research should investigate the reported observations.

  19. Intravenous Mistletoe Treatment in Integrative Cancer Care: A Qualitative Study Exploring the Procedures, Concepts, and Observations of Expert Doctors

    Directory of Open Access Journals (Sweden)

    Gunver S. Kienle

    2016-01-01

    Full Text Available Background. Mistletoe therapy (MT is widely used in patient-centered integrative cancer care. The objective of this study was to explore the concepts, procedures, and observations of expert doctors, with a focus on intravenous MT. Method. A qualitative interview study was conducted with 35 highly experienced doctors specialized in integrative and anthroposophic medicine. Structured qualitative content analysis was applied. For triangulation, the results were compared with external evidence that was systematically collected, reviewed, and presented. Results. Doctors perform individualized patient assessments that lead to multimodal treatment approaches. The underlying goal is to help patients to live with and overcome disease. Mistletoe infusions are a means of accomplishing this goal. They are applied to stabilize disease, achieve responsiveness, induce fever, improve quality of life, and improve the tolerability of conventional cancer treatments. The doctors reported long-term disease stability and improvements in patients’ general condition, vitality, strength, thermal comfort, appetite, sleep, pain from bone metastases, dyspnea in pulmonary lymphangitis carcinomatosa, fatigue, and cachexia; chemotherapy was better tolerated. Also patients’ emotional and mental condition was reported to have improved. Conclusion. Individualized integrative cancer treatment including MT aims to help cancer patients to live well with their disease. Further research should investigate the reported observations.

  20. Treatment of Wound Healing Disorders of Radial Forearm Free Flap Donor Sites Using Cold Atmospheric Plasma: A Proof of Concept.

    Science.gov (United States)

    Hartwig, Stefan; Doll, Christian; Voss, Jan Oliver; Hertel, Moritz; Preissner, Saskia; Raguse, Jan Dirk

    2017-02-01

    The treatment of wound healing disturbances of the radial forearm free flap donor site after reconstructive surgery is typically long and burdensome and often requires additional surgery. Cold atmospheric plasma is a promising approach to overcome these impairments. The aim of this proof of concept study was to evaluate the clinical outcome of plasma irradiation in patients with wound healing disorders with exposed brachial tendons of the radial forearm. Four patients (mean age 64.2 years, range 44 to 80) who had undergone radial forearm free flap procedures and developed wound healing disturbance leading to exposed flexor tendons were included in the present prospective case series. In addition to routine wound care, all sites were irradiated with cold atmospheric plasma. The primary outcome variable was complete wound closure. In all patients, complete wound repair in terms of the absence of tendon exposure was observed within a mean treatment time of 10.1 weeks (range 4.9 to 16). No undesirable side effects were observed, and no inflammation or infection occurred. Cold atmospheric plasma could offer a reliable conservative treatment option for complicated wound healing disturbances. This was exemplarily shown in the case of radial forearm free flap donor site morbidity with exposed flexor tendons in the present study. Copyright © 2016 American Association of Oral and Maxillofacial Surgeons. Published by Elsevier Inc. All rights reserved.

  1. Molecular and cellular biology of cerebral arteriovenous malformations: a review of current concepts and future trends in treatment.

    Science.gov (United States)

    Rangel-Castilla, Leonardo; Russin, Jonathan J; Martinez-Del-Campo, Eduardo; Soriano-Baron, Hector; Spetzler, Robert F; Nakaji, Peter

    2014-09-01

    Arteriovenous malformations (AVMs) are classically described as congenital static lesions. However, in addition to rupturing, AVMs can undergo growth, remodeling, and regression. These phenomena are directly related to cellular, molecular, and physiological processes. Understanding these relationships is essential to direct future diagnostic and therapeutic strategies. The authors performed a search of the contemporary literature to review current information regarding the molecular and cellular biology of AVMs and how this biology will impact their potential future management. A PubMed search was performed using the key words "genetic," "molecular," "brain," "cerebral," "arteriovenous," "malformation," "rupture," "management," "embolization," and "radiosurgery." Only English-language papers were considered. The reference lists of all papers selected for full-text assessment were reviewed. Current concepts in genetic polymorphisms, growth factors, angiopoietins, apoptosis, endothelial cells, pathophysiology, clinical syndromes, medical treatment (including tetracycline and microRNA-18a), radiation therapy, endovascular embolization, and surgical treatment as they apply to AVMs are discussed. Understanding the complex cellular biology, physiology, hemodynamics, and flow-related phenomena of AVMs is critical for defining and predicting their behavior, developing novel drug treatments, and improving endovascular and surgical therapies.

  2. Theoretical concepts and practical applications of hypnosis in the treatment of children and adolescents with dental fear and anxiety.

    Science.gov (United States)

    Shaw, A J; Niven, N

    1996-01-06

    Dental fear and anxiety in children and adolescents is a common problem. Hypnosis has been shown to be useful in the treatment of these patients. This paper briefly reviews conventional management skills before considering the application of hypnosis. Following a definition of hypnosis, the concepts of relaxation, restricted awareness, blunting of critical faculties and the enhanced capacity to respond to suggestion are outlined. Consideration is given to the induction of hypnosis and its general application in an informal and formal manner. The application of more specific techniques, such as the use of hypnoanalgesia to reduce physical discomfort and the development of coping strategies to help children overcome their fears, are discussed. It has been widely shown that hypnosis is a useful adjunct in dentistry. However, it is unfortunate that hypnosis is not more widely used as it has the potential for making conventional dental management more acceptable and reducing the number of children requiring general anaesthesia.

  3. Bonding lithium disilicate ceramic to feather-edge tooth preparations: a minimally invasive treatment concept.

    Science.gov (United States)

    Cortellini, Davide; Canale, Angelo

    2012-02-01

    To report the short-term clinical outcome of a new minimally invasive prosthetic approach utilizing monolithic lithium-disilicate full crowns bonded to feather-edge tooth preparations. 235 teeth, 136 anterior and 99 posterior, requiring a full crown were prepared with a feather-edge finish line providing a minimum space on the vertical walls of 0.3 mm at the margin, 0.5 mm along the axial walls, and an occlusal space of 1 to 1.5 mm to ensure sufficient resistance of the restoration. The dental technician manufactured the monolithic restorations using either CAD-CAM or pressed technology. The restorations were individualized with a staining technique to obtain the necessary esthetic characterization and bonded to the natural abutments using an adhesive cementation procedure. Out of 235 treated elements, only one monolithic restoration in a molar position fractured after 3 years of service. No biological or technical complications were observed. The final esthetic result was optimal. This procedure can be considered a further option for the conservative restorative treatment of single elements where a full crown is required.

  4. Percutaneous Kirschner wire (K-wire) fixation for humerus shaft fractures in children: A treatment concept.

    Science.gov (United States)

    Sahu, Ramji Lal

    2013-09-01

    Fractures of the humeral shaft are uncommon, representing less than 10 percent of all fractures in children. Humeral shaft fractures in children can be treated by immobilisation alone. A small number of fractures are unable to be reduced adequately or maintained in adequate alignment, and these should be treated surgically. In the present study, Kirschner wires (K-wire) were used to achieve a closed intramedullary fixation of humeral shaft fractures. The objective of this study was to evaluate the efficacy of intramedullary K-wires for the treatment of humeral shaft fracture in children. This prospective study was conducted in the Department of Orthopaedic surgery in M. M. Medical College from June 2005 to June 2010. Sixty-eight children with a mean age of 7.7 years (range, 2-14 years) were recruited from Emergency and out patient department having closed fracture of humerus shaft. All patients were operated under general anaesthesia. All patients were followed for 12 months. Out of 68 patients, 64 patients underwent union in 42-70 days with a mean of 56 days. Complications found in four patients who had insignificant delayed union which were united next 3 weeks. Intramedullary K-wires were removed after an average of 5 months without any complications. The results were excellent in 94.11% and good in 5% children. This technique is simple, quick to perform, safe and reliable and avoids prolonged hospitalization with good results and is economical.

  5. Current concepts in the pathogenesis and treatment of chronic suppurative otitis media

    Science.gov (United States)

    Mittal, Rahul; Lisi, Christopher V.; Gerring, Robert; Mittal, Jeenu; Mathee, Kalai; Narasimhan, Giri; Azad, Rajeev K.; Yao, Qi; Grati, M'hamed; Yan, Denise; Eshraghi, Adrien A.; Angeli, Simon I.; Telischi, Fred F.

    2015-01-01

    Otitis media (OM) is an inflammation of the middle ear associated with infection. Despite appropriate therapy, acute OM (AOM) can progress to chronic suppurative OM (CSOM) associated with ear drum perforation and purulent discharge. The effusion prevents the middle ear ossicles from properly relaying sound vibrations from the ear drum to the oval window of the inner ear, causing conductive hearing loss. In addition, the inflammatory mediators generated during CSOM can penetrate into the inner ear through the round window. This can cause the loss of hair cells in the cochlea, leading to sensorineural hearing loss. Pseudomonas aeruginosa and Staphylococcus aureus are the most predominant pathogens that cause CSOM. Although the pathogenesis of AOM is well studied, very limited research is available in relation to CSOM. With the emergence of antibiotic resistance as well as the ototoxicity of antibiotics and the potential risks of surgery, there is an urgent need to develop effective therapeutic strategies against CSOM. This warrants understanding the role of host immunity in CSOM and how the bacteria evade these potent immune responses. Understanding the molecular mechanisms leading to CSOM will help in designing novel treatment modalities against the disease and hence preventing the hearing loss. PMID:26248613

  6. Emborrhoid: A New Concept for the Treatment of Hemorrhoids with Arterial Embolization: The First 14 Cases

    Energy Technology Data Exchange (ETDEWEB)

    Vidal, V., E-mail: vincent.vidal@ap-hm.fr [Hôpital de la Timone, Department of Radiology (France); Sapoval, M., E-mail: marc.sapoval@gmail.com [Hopital Européen Georges Pompidou, Department of Radiology (France); Sielezneff, Y., E-mail: igor.sielezneff@ap-hm.fr [Hôpital de la Timone, Department of Digestive and General Surgery (France); Parades, V. De, E-mail: v.deparades@gmail.com [Hopital Saint Joseph, Department of Proctology (France); Tradi, F., E-mail: farouk.tradi@ap-hm.fr; Louis, G., E-mail: guillaume.louis@ap-hm.fr; Bartoli, J. M., E-mail: jean-michel.bartoli@ap-hm.fr [Hôpital de la Timone, Department of Radiology (France); Pellerin, O., E-mail: olivier.pellerin@egp.aphp.fr [Hopital Européen Georges Pompidou, Department of Radiology (France)

    2015-02-15

    PurposeThe ‘emborrhoid’ technique consists of the embolization of the hemorrhoidal arteries. The endovascular arterial occlusion is performed using coils placed in the terminal branches of the superior rectal arteries. The emborrhoid technique has been modeled after elective transanal Doppler-guided hemorrhoidal artery ligation which has been shown to be effective in hemorrhoidal disease. We report the first 14 cases of our experience with emborrhoid technique.Materials and MethodsFourteen patients with disabling chronic rectal bleeding were treated using the emborrhoid technique (3 women, 11 men). The stage of the hemorrhoidal disease was II (10 patients), III (3), and IV (1). This treatment was decided by a multidisciplinary team (proctologist, visceral surgeon, and radiologist). Seven patients underwent previous proctological surgery. Ten patients had coagulation disorders (anticoagulants or cirrhosis). Superior rectal arteries were embolized with pushable microcoils (0.018).ResultsTechnical success of the embolization procedure was 100 %. Clinical success at 1 month was 72 % (10/14). Of the 4 patients who experienced rebleeding, two underwent additional embolization of the posterior rectal arteries with success. No pain or ischemic complications were observed in 13 patients. One patient experienced a temporary painful and edematous, perianal reaction.ConclusionOur case studies suggest that coil embolization of the superior rectal arteries is technically feasible, safe and well tolerated. Additional studies are needed to evaluate the efficacy of this new ‘emborrhoid’ technique in the management of hemorrhoidal disease.

  7. Heart Failure with Preserved Ejection Fraction – Concept, Pathophysiology, Diagnosis and Challenges for Treatment

    Directory of Open Access Journals (Sweden)

    Lidija Veterovska Miljkovik

    2015-07-01

    Full Text Available Heart failure (HF with preserved left ventricular (LV ejection fraction (HFpEF occurs in 40 to 60% of the patients with HF, with a prognosis which is similar to HF with reduced ejection fraction (HFrEF. HFpEF pathophysiology is different from that of HFrEF, and has been characterized with diastolic dysfunction. Diastolic dysfunction has been defined with elevated left ventricular stiffness, prolonged iso-volumetric LV relaxation, slow LV filing and elevated LV end-diastolic pressure. Arterial hypertension occurs in majority cases with HFpEF worldwide. Patients are mostly older and obese. Diabetes mellitus and atrial fibrillation appear proportionally in a high frequency of patients with HFpEF. The HFpEF diagnosis is based on existence of symptoms and signs of heart failure, normal or approximately normal ejection and diagnosing of LV diastolic dysfunction by means of heart catheterization or Doppler echocardiography and/or elevated concentration of plasma natriuretic peptide. The present recommendations for HFpEF treatment include blood pressure control, heart chamber frequency control when atrial fibrillation exists, in some situations even coronary revascularization and an attempt for sinus rhythm reestablishment. Up to now, it is considered that no medication or a group of medications improve the survival of HFpEF patients. Due to these causes and the bad prognosis of the disorder, rigorous control is recommended of the previously mentioned precipitating factors for this disorder. This paper presents a universal review of the most important parameters which determine this disorder.

  8. Virtual reality exposure therapy as treatment for pain catastrophizing in fibromyalgia patients: proof-of-concept study (Study Protocol

    Directory of Open Access Journals (Sweden)

    Spottiswoode Bruce

    2011-04-01

    Full Text Available Abstract Background Albeit exercise is currently advocated as one of the most effective management strategies for fibromyalgia syndrome (FMS; the implementation of exercise as a FMS treatment in reality is significantly hampered by patients' poor compliance. The inference that pain catastrophizing is a key predictor of poor compliance in FMS patients, justifies considering the alteration of pain catastrophizing in improving compliance towards exercises in FMS patients. The aim of this study is to provide proof-of-concept for the development and testing of a novel virtual reality exposure therapy (VRET program as treatment for exercise-related pain catastrophizing in FMS patients. Methods Two interlinked experimental studies will be conducted. Study 1 aims to objectively ascertain if neurophysiological changes occur in the functional brain areas associated with pain catastrophizing, when catastrophizing FMS subjects are exposed to visuals of exercise activities. Study 2 aims to ascertain the preliminary efficacy and feasibility of exposure to visuals of exercise activities as a treatment for exercise-related pain catastrophizing in FMS subjects. Twenty subjects will be selected from a group of FMS patients attending the Tygerberg Hospital in Cape Town, South Africa and randomly allocated to either the VRET (intervention group or waiting list (control group. Baseline neurophysiological activity for subjects will be collected in study 1 using functional magnetic resonance imaging (fMRI. In study 2, clinical improvement in pain catastrophizing will be measured using fMRI (objective and the pain catastrophizing scale (subjective. Discussion The premise is if exposing FMS patients to visuals of various exercise activities trigger the functional brain areas associated with pain catastrophizing; then as a treatment, repeated exposure to visuals of the exercise activities using a VRET program could possibly decrease exercise-related pain catastrophizing

  9. Combotherapy and current concepts as well as future strategies for the treatment of Alzheimer's disease

    Directory of Open Access Journals (Sweden)

    Fan LY

    2014-03-01

    Full Text Available Ling-Yun Fan,1,2 Ming-Jang Chiu2–4 1Department of Neurology, En Chu Kong Hospital, 2Department of Neurology, College of Medicine, Graduate Institute of Brain and Mind Sciences, 3Graduate Institute of Psychology, 4Graduate Institute of Biomedical Engineering and Bioinformatics, National Taiwan University Hospital, Taipei, Taiwan Abstract: It has been estimated that 35.6 million people globally had dementia in 2010 and the prevalence of dementia has been predicted to double every 20 years. Thus, 115.4 million people may be living with dementia in 2050. Alzheimer's disease (AD is the leading cause of dementia and is present in 60%–70% of people with dementia. Unfortunately, there are few approved drugs that can alleviate the cognitive or behavioral symptoms of AD dementia. Recent studies have revealed that pathophysiological changes related to AD occur decades before the appearance of clinical symptoms of dementia. This extended preclinical phase of AD provides a critical chance for disease-modifying agents to halt or delay the relentless process of AD. Although several trials targeting various pathological processes are ongoing, the examination of the combined use of different approaches to combat AD seems warranted. In this article, we will review current therapies, future strategies, and ongoing clinical trials for the treatment of AD with a special focus on combination therapies. Furthermore, preventive strategies for cognitively normal subjects in the presymptomatic stages of AD will also be addressed. In this review, we discuss current hypotheses of the disease process. In the decades since the approval of cholinesterase inhibitors, no new drug has ultimately demonstrated clear success in clinical trials. Given the difficulties that have been encountered in attempts to identify a single drug that can treat AD, we must pursue effective multi-target strategies, ie, combination therapies. The combination of cholinesterase inhibitors and

  10. An elastic liposomal formulation for RNAi-based topical treatment of skin disorders: Proof-of-concept in the treatment of psoriasis.

    Science.gov (United States)

    Desmet, Eline; Bracke, Stefanie; Forier, Katrien; Taevernier, Lien; Stuart, Marc C A; De Spiegeleer, Bart; Raemdonck, Koen; Van Gele, Mireille; Lambert, Jo

    2016-03-16

    RNA interference (RNAi) is a rapidly emerging approach for targeted gene silencing to alleviate disease pathology. However, lack of efficient carriers for targeted delivery delays the clinical translation of RNAi. An interesting target for local RNAi therapeutics is the skin as it allows direct access to target cells. Still, applications are limited due to the effective skin barrier which hinders penetration. Herein, a description is given of a liposomal carrier, called 'DDC642', capable of delivering RNAi molecules to the epidermis of impaired and intact human skin, without targeting the dermis or circulatory system. In a psoriasis tissue model, down-regulation of the psoriasis marker human beta-defensin 2 by DDC642-delivered siRNA was confirmed, providing proof-of-concept. These liposomes thus hold great potential as topical delivery system for RNAi therapeutics in the treatment of numerous skin diseases. Copyright © 2016 Elsevier B.V. All rights reserved.

  11. Enhanced primary treatment of concentrated black water and kitchen residues within DESAR concept using two types of anaerobic digesters.

    Science.gov (United States)

    Kujawa-Roeleveld, K; Elmitwalli, T; Zeeman, G

    2006-01-01

    Anaerobic digestion of concentrated domestic wastewater streams--black or brown water, and solid fraction of kitchen waste is considered as a core technology in a source separation based sanitation concept (DESAR--decentralised sanitation and reuse). A simple anaerobic digester can be implemented for an enhanced primary treatment or, in some situations, as a main treatment. Two reactor configurations were extensively studied; accumulation system (AC) and UASB septic tank at 15, 20 and 25 degrees C. Due to long retention times in an AC reactor, far stabilisation of treated medium can be accomplished with methanisation up to 60%. The AC systems are the most suitable to apply when the volume of waste to be treated is minimal and when a direct reuse of a treated medium in agriculture is possible. Digested effluent contains both liquid and solids. In a UASB septic tank, efficient separation of solids and liquid is accomplished. The total COD removal was above 80% at 25 degrees C. The effluent contains COD and nutrients, mainly in a soluble form. The frequency of excess sludge removal is low and sludge is well stabilised due to a long accumulation time.

  12. Opioid treatment at release from jail using extended-release naltrexone: a pilot proof-of-concept randomized effectiveness trial.

    Science.gov (United States)

    Lee, Joshua D; McDonald, Ryan; Grossman, Ellie; McNeely, Jennifer; Laska, Eugene; Rotrosen, John; Gourevitch, Marc N

    2015-06-01

    Relapse to addiction following incarceration is common. We estimated the feasibility and effectiveness of extended-release naltrexone (XR-NTX) as relapse prevention among opioid-dependent male adults leaving a large urban jail. Eight-week, proof-of-concept, open-label, non-blinded randomized effectiveness trial. New York City jails and Bellevue Hospital Center Adult Primary Care clinics, USA. From January 2010 to July 2013, 34 opioid-dependent adult males with no stated interest in agonist treatments (methadone, buprenorphine) received a counseling and referral intervention and were randomized to XR-NTX (n = 17) versus no medication (n = 17) within one week prior to jail release. XR-NTX (Vivitrol(®) ; Alkermes Inc.), a long-acting injectable mu opioid receptor antagonist. The primary intent-to-treat outcome was post-release opioid relapse at week 4, defined as ≥10 days of opioid misuse by self-report and urine toxicologies. Secondary outcomes were proportion of urine samples negative for opioids and rates of opioid abstinence, intravenous drug use (IVDU), cocaine use, community treatment participation, re-incarceration and overdose. Acceptance of XR-NTX was high; 15 of 17 initiated treatment. Rates of the primary outcome of week 4 opioid relapse were lower among XR-NTX participants: 38 versus 88% [P<0.004; odds ratio (OR) = 0.08, 95% confidence interval (CI) = 0.01-0.48]; more XR-NTX urine samples were negative for opioids, 59 versus 29% (P<0.009; OR = 3.5, 95% CI = 1.4-8.5). There were no significant differences in the remaining secondary outcomes, including rates of IVDU, cocaine use, re-incarceration and overdose. Extended-release naltrexone is associated with significantly lower rates of opioid relapse among men in the United States following release from jail when compared with a no medication treatment-as-usual condition. © 2015 Society for the Study of Addiction.

  13. Checkpoint inhibitors and radiation treatment in Hodgkin's lymphoma. New study concepts of the German Hodgkin Study Group

    Energy Technology Data Exchange (ETDEWEB)

    Baues, C.; Semrau, R.; Marnitz, S. [University of Cologne, Medical Faculty, Department of Radiooncology, Cologne (Germany); University of Cologne, German Hodgkin Study Group (GHSG), Cologne (Germany); Gaipl, U.S. [University Hospital Erlangen, Department of Radiooncology, Erlangen (Germany); Broeckelmann, P.J.; Engert, A. [University of Cologne, German Hodgkin Study Group (GHSG), Cologne (Germany); University of Cologne, Medical Faculty, Department of Internal Medicine I, Cologne (Germany); Rosenbrock, J. [University of Cologne, Medical Faculty, Department of Radiooncology, Cologne (Germany)

    2017-02-15

    Patients with classical Hodgkin's lymphoma (cHL) have a good prognosis even in advanced stages. However, combined chemo- and radiotherapy, as the standard of care, is also associated with treatment-related toxicities such as organ damage, secondary neoplasias, infertility, or fatigue and long-term fatigue. Many patients suffer from this burden although their cHL was cured. Therefore, the efficacy of immune checkpoint inhibitors like anti-PD1/PD-L1 antibodies in the treatment of solid cancers and also in HL offers new options. A remarkable and durable response rate with a favorable toxicity profile was observed in heavily pretreated cHL patients. Planning to perform prospective randomized clinical trials in the content of radio-immune treatment in patients with Hodgkin's lymphoma (HL), we transferred the results of preliminary clinical studies and basic research in clinical relevant study concepts. Based on these promising early phase trial data, the German Hodgkin Study Group (GHSG) will investigate innovative treatment regimens in upcoming phase II trials. The therapeutic efficacy and potential synergies of anti-PD1 antibodies in combination with chemo- or radiotherapy will be investigated in various settings of HL. (orig.) [German] Patienten mit einem klassischen Hodgkin-Lymphom (cHL) haben ueber alle Stadien hinweg eine gute Prognose. Allerdings treten unter der kombinierten Therapie mit Chemotherapie und Bestrahlung therapieabhaengige Toxizitaeten wie z. B. Organschaeden, Sekundaertumoren, Fatigue oder Langzeit-Fatigue auf. Viele Patienten leiden trotz einer Heilung an diesen Symptomen. Daher bietet die nachgewiesene Wirksamkeit der Anti-PD1/PD-L1-Antikoerper bei soliden Tumoren, aber auch beim HL neue Behandlungsoptionen. Bei intensiv vorbehandelten Patienten mit rezidiviertem cHL wurde bei guter Vertraeglichkeit eine hohe Ansprechrate mit z. T. langanhaltenden Remissionen beobachtet. Im Rahmen der Planung prospektiver randomisierter Studien im

  14. The applicability of the concept of treatment adherence in the context of the Brazilian mental health system.

    Science.gov (United States)

    Alvarez, Patricia Elizabeth Sanz de; Rosendo, Ernestina; Alchieri, João Carlos

    2016-06-01

    To present reflections on the type of research conducted on a treatment adherence among users of Public Mental Health System in Brazil and discuss the applicability of the concept of adherence to treatment in this context. Literature review in SciELO, LILACS, Cochrane Library and PubMed / MEDLINE using the Health Sciences Descriptors (DeCS) treatment, adhesion and "mental health" and the specific vocabulary of the Medical Subject Headings (MeSH) "patient compliance/psychologist" y "mental health". They were included for review the complete texts and theses published between 2007-2012 in Portuguese, English and Spanish. 127 articles were recovered, 32 specifically related to mental health. Eight were excluded for duplicates and after reading the remaining 24 articles were selected for this study 10 conducted in the field of Mental Health in Brazil. No investigations have been identified with focus on adherence to psychosocial treatment offered in public mental health. disregard of the mental health legislation and reinforce the asylum model of assistance. Presentar reflexiones sobre el tipo de investigaciones realizadas en Brasil sobre la adhesión al tratamiento de los usuarios del Sistema Público de Salud Mental y discutir la aplicabilidad del concepto de adhesión al tratamiento en dicho contexto. Revisión bibliográfica en las bases SciELO, LILACS, Biblioteca Cochrane y PubMed/MEDLINE utilizando los descriptores de Ciencias de la Salud (DeCS) adhesión, tratamiento y "salud mental" y el vocabulario específico de Medical Subject Headings (MeSH) "patient compliance/psychologist" y "mental health". Se incluyeron los textos completos y las tesis publicadas entre 2007-2012, en portugués, inglés y español. F1eron recuperados 127 artículos, 32 específicamente de la salud mental. Se excluyeron los 8 duplicados y de los 24 restantes fueron seleccionados para el presente trabajo los 10 realizados en Brasil. No se identificaron enfoques sobre la adhesión al

  15. Uterine Artery Embolization for Retained Products of Conception with Marked Vascularity: A Safe and Efficient First-Line Treatment

    Energy Technology Data Exchange (ETDEWEB)

    Bazeries, Paul, E-mail: paul.bazeries@chu-angers.fr; Paisant-Thouveny, Francine; Yahya, Sultan; Bouvier, Antoine; Nedelcu, Cosmina [Centre Hospitalier Universitaire d’Angers, Département d’Imagerie Diagnostique et interventionnelle (France); Boussion, Francoise; Sentilhes, Loic [Centre Hospitalier Universitaire d’Angers, Département de Gynécologie et Obstétrique (France); Willoteaux, Serge; Aubé, Christophe [Centre Hospitalier Universitaire d’Angers, Département d’Imagerie Diagnostique et interventionnelle (France)

    2017-04-15

    ObjectiveTo report our clinical practice regarding a case series of retained products of conception (RPOC) with marked vascularity (MV) managed with selective uterine artery embolization (UAE) as first-line treatment.MethodsThis was a monocentric, retrospective study of 31 consecutive cases of RPOC with MV diagnosed by Doppler ultrasound in the context of postpartum/postabortal bleeding. The primary outcome was the absence of rebleeding following embolization.ResultsRPOC with MV occurred after abortion in 27 out of 31 patients (87%). The time elapsed between delivery/abortion and UAE ranged from 1 to 210 days (mean 55.7 ± 45 days). Primary clinical success was achieved in 23 women (74.2%) following a single embolization. In total, 27 out of 31 women (87%) had been exclusively managed by UAE with conservative success. Although procedural success was achieved in this number, six women had a further procedure to evacuate RPOC despite procedural success. Large uterine arteriovenous (AV) shunts associated with RPOC were observed in five cases (16.1%), among which two were successfully treated after a single UAE and one after two UAEs, while hysterectomy was performed in the last two cases despite two and three UAE procedures respectively. RPOC was histologically proven in ten cases (32.2%) including four out of five cases of uterine AV shunt.ConclusionRPOC with MV can present with large uterine AV shunt, particularly in case of late management. Uterine artery embolization is an effective and safe first-line treatment, and should be evaluated for this indication in larger prospective trials.

  16. Stem cell-based treatments against stroke: observations from human proof-of-concept studies and considerations regarding clinical applicability

    Directory of Open Access Journals (Sweden)

    Thorsten Roland Doeppner

    2014-10-01

    Full Text Available Ischemic stroke remains a heavy burden for industrialized countries. The only causal therapy is the recanalization of occluded vessels via thrombolysis, which due to a narrow time window still can be offered only to a minority of patients. Since the majority of patients continues to exhibit neurological deficits even following successful thrombolysis, restorative therapies are urgently needed that promote brain remodeling and repair once stroke injury has occurred. Due to their unique properties of action, stem cell-based strategies gained increasing interest during recent years. Using various stroke models in both rodents and primates, the transplantation of stem cells, namely of bone marrow derived mesenchymal stem cells (MSCs or neural progenitor cells (NPCs, has been shown to promote neurological recovery most likely via indirect bystander actions. In view of promising observations, clinical proof-of-concept studies are currently under way, in which effects of stem and precursor cells are evaluated in human stroke patients. In this review we summarize already published studies, which due to the broad experience in other medical contexts mostly employed bone marrow-derived MSCs by means of intravenous transplantation. With the overall number of clinical trials limited in number, only a fraction of these studies used non-treated control groups, and only single studies were adequately blinded. Despite these limitations, first promising results justify the need for more elaborate clinical trials in order to make stem cell transplantation a success for stroke treatment in the future.

  17. Treatment of Sarcopenia with Bimagrumab: Results from a Phase II, Randomized, Controlled, Proof-of-Concept Study.

    Science.gov (United States)

    Rooks, Daniel; Praestgaard, Jens; Hariry, Sam; Laurent, Didier; Petricoul, Olivier; Perry, Robert G; Lach-Trifilieff, Estelle; Roubenoff, Ronenn

    2017-09-01

    To assess the effects of bimagrumab on skeletal muscle mass and function in older adults with sarcopenia and mobility limitations. A 24-week, randomized, double-blind, placebo-controlled, parallel-arm, proof-of-concept study. Five centers in the United States. Community-dwelling adults (N = 40) aged 65 and older with gait speed between 0.4 and 1.0 m/s over 4 m and an appendicular skeletal muscle index of 7.25 kg/m 2 or less for men and 5.67 kg/m 2 or less for women. Intravenous bimagrumab 30 mg/kg (n = 19) or placebo (n = 21). Change from baseline in thigh muscle volume (TMV), subcutaneous and intermuscular fat, appendicular and total lean body mass, grip strength, gait speed, and 6-minute walk distance (6MWD). Thirty-two (80%) participants completed the study. TMV increased by Week 2, was sustained throughout the treatment period, and remained above baseline at the end of study in bimagrumab-treated participants, whereas there was no change with placebo treatment (Week 2: 5.15 ± 2.19% vs -0.34 ± 2.59%, P < .001; Week 4: 6.12 ± 2.56% vs 0.16 ± 3.42%, P < .001; Week 8: 8.01 ± 3.70% vs 0.35 ± 3.32%, P < .001; Week 16: 7.72 ± 5.31% vs 0.42 ± 5.14%, P < .001; Week 24: 4.80 ± 5.81% vs -1.01 ± 4.43%, P = .002). Participants with slower walking speed at baseline receiving bimagrumab had clinically meaningful and statistically significantly greater improvements in gait speed (mean 0.15 m/s, P = .009) and 6MWD (mean 82 m, P = .022) than those receiving placebo at Week 16. Adverse events in the bimagrumab group included muscle-related symptoms, acne, and diarrhea, most of which were mild in severity and resolved by the end of study. Treatment with bimagrumab over 16 weeks increased muscle mass and strength in older adults with sarcopenia and improved mobility in those with slow walking speed. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

  18. Parents' anxiety and depression symptoms after successful infertility treatment and spontaneous conception: does singleton/twin pregnancy matter?

    Science.gov (United States)

    Tendais, I; Figueiredo, B

    2016-10-01

    Does mode of conception [spontaneous/after infertility treatment (IT)], type of pregnancy (singleton/twin) and parent gender have an effect on anxiety and depression levels and trajectories during pregnancy and the post-partum period? Conception after IT was associated with a transitory increase in anxiety during the perinatal period for parents of singletons, while for IT parents of twins higher levels of psychopathological symptoms tended to persist during pregnancy and the post-partum period. Most previous studies have shown that successful IT is not associated with poor psychological well-being during pregnancy and the post-partum period, but there is also some evidence for heightened pregnancy-related anxiety, lower self-esteem and lower self-efficacy. Parents of twins experience increased postnatal anxiety and depression. This prospective longitudinal study assessed 267 couples (N = 534) at each trimester of pregnancy, after childbirth and at 3 months post-partum. The sample comprised 36 couples who had conceived after IT (19 twin pairs and 17 singletons) and 231 couples who had conceived spontaneously (SC; 28 twin pairs and 203 singletons). Couples were recruited at four public hospitals in Portugal, and self-report measures of anxiety and depression symptoms were administered. IT parents reported higher anxiety after childbirth than parents who SC, regardless of pregnancy type. IT parents of twins showed higher anxiety at mid-pregnancy, as well as higher anxiety and depression at 3 months post-partum than IT parents of singletons. Among IT mothers, those who had twins exhibited higher depression after childbirth than those who had singletons. Differences according to mode of conception, pregnancy type and parents gender over time were also noted. During pregnancy, IT parents of twins showed no significant change in depression scores, while the other groups depression scores statistically significantly decreased over time. From pregnancy to the post

  19. Design of the Growth hormone deficiency and Efficacy of Treatment (GET) score and non-interventional proof of concept study.

    Science.gov (United States)

    Kann, Peter H; Bergmann, Simona; Bidlingmaier, Martin; Dimopoulou, Christina; Pedersen, Birgitte T; Stalla, Günter K; Weber, Matthias M; Meckes-Ferber, Stefanie

    2018-02-13

    The adverse effects of growth hormone (GH) deficiency (GHD) in adults (AGHD) on metabolism and health-related quality of life (HRQoL) can be improved with GH substitution. This investigation aimed to design a score summarising the features of GHD and evaluate its ability to measure the effect of GH substitution in AGHD. The Growth hormone deficiency and Efficacy of Treatment (GET) score (0-100 points) assessed (weighting): HRQoL (40%), disease-related days off work (10%), bone mineral density (20%), waist circumference (10%), low-density lipoprotein cholesterol (10%) and body fat mass (10%). A prospective, non-interventional, multicentre proof-of-concept study investigated whether the score could distinguish between untreated and GH-treated patients with AGHD. A 10-point difference in GET score during a 2-year study period was expected based on pre-existing knowledge of the effect of GH substitution in AGHD. Of 106 patients eligible for analysis, 22 were untreated GHD controls (9 females, mean ± SD age 52 ± 17 years; 13 males, 57 ± 13 years) and 84 were GH-treated (31 females, age 45 ± 13 years, GH dose 0.30 ± 0.16 mg/day; 53 males, age 49 ± 15 years, GH dose 0.25 ± 0.10 mg/day). Follow-up was 706 ± 258 days in females and 653 ± 242 days in males. The GET score differed between the untreated control and treated groups with a least squares mean difference of + 10.01 ± 4.01 (p = 0.0145). The GET score appeared to be a suitable integrative instrument to summarise the clinical features of GHD and measure the effects of GH substitution in adults. Exercise capacity and muscle strength/body muscle mass could be included in the GET score. NCT number: NCT00934063 . Date of registration: 02 July 2009.

  20. A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes

    OpenAIRE

    Jiang, Hong; Xiong, Xu; Su, Yi; Zhang, Yiming; Wu, Hongqiao; Jiang, Zhijun; Qian, Xu

    2013-01-01

    Background Evidence has suggested that periodontal disease is associated with an increased risk of various adverse pregnancy and birth outcomes. However, several large clinical randomized controlled trials failed to demonstrate periodontal therapy during pregnancy reduced the incidence of adverse pregnancy and birth outcomes. It has been suggested that the pre-conception period may be an optimal period for periodontal disease treatment rather than during pregnancy. To date, no randomized cont...

  1. An innovative treatment concept for future drinking water production: fluidized ion exchange – ultrafiltration – nanofiltration – granular activated carbon filtration

    Directory of Open Access Journals (Sweden)

    J. C. van Dijk

    2009-08-01

    Full Text Available A new treatment concept for drinking water production from surface water has been investigated on a pilot scale. The treatment concept consists of fluidized ion exchange (FIEX, ultrafiltration (UF, nanofiltration (NF, and granular activated carbon filtration (GAC. The FIEX process removed calcium and other divalent cations; the UF membrane removed particles and micro-organisms; and the NF membrane and GAC removed natural organic matter (NOM and micro-pollutants. This study focused on the prevention of fouling of the UF and scaling of the NF and investigated the overall removal of micro-pollutants by the treatment concept. The results of the experiments showed that in 14 days of continuous operation at a flux of 65 l/h m2 the UF performance was stable with the FIEX pre-treated feed water without the aid of a coagulant. The scaling of the NF was also not observed even at 97% recovery. Different micro-pollutants were spiked in the NF feed water and their concentrations in the effluent of NF and GAC were measured. The combination of NF and GAC removed most of the micro-pollutants successfully, except for the very polar substances with a molecular weight lower than 100 Daltons.

  2. Analyzing General Chemistry Texts' Treatment of Rates of Change Concepts in Reaction Kinetics Reveals Missing Conceptual Links

    Science.gov (United States)

    Seethaler, Sherry; Czworkowski, John; Wynn, Lynda

    2018-01-01

    Change over time is a crosscutting theme in the sciences that is pivotal to reaction kinetics, an anchoring concept in undergraduate chemistry, and students' struggles with rates of change are well-documented. Informed by the education scholarship in chemistry, physics, and mathematics, a research team with members from complementary disciplinary…

  3. Enhanced primary treatment of concentrated black water and kitchen residues within DESAR concept using two types of anaerobic digesters

    NARCIS (Netherlands)

    Kujawa-Roeleveld, K.; Elmitwalli, T.A.; Zeeman, G.

    2006-01-01

    Anaerobic digestion of concentrated domestic wastewater streams - black or brown water, and solid fraction of kitchen waste is considered as a core technology in a source separation based sanitation concept (DESAR - decentralised sanitation and reuse). A simple anaerobic digester can be implemented

  4. Injuries as a result of sports and vacation activities: Fractures with concomitant vascular injuries. Diagnosis and treatment concept

    International Nuclear Information System (INIS)

    Schlickewei, W.; Kuner, E.H.; Goetze, B.; Spillner, G.

    1989-01-01

    Extremity fractures with concomitant vascular injuries are surgical emergencies. Especially injuries of the upper extremities require a preoperative angiographic examination for the localization of the vascular lesion. In vascular lesions of the lower extremities a primary angiography is not necessary, if there is an opportunity for an intraoperative radiologic evaluation. In our traumatological department 104 patients were treated over the last 15 years with that combined injury. The concept of immediate stabilization of the fracture with simultaneous or postponed arterial repair has been proved to be appropriate. The fasziotomy as prophylactic procedure of a postischemic compartment syndrome is also a part of our concept during the last years. The late results in our mostly young patients depended on the degree of soft tissue damage and the time of ischemia. The often untreatable nerve lesions contributed to a loss of use of about 30% in the late courses. (orig.) [de

  5. Clinical experiences derived from implementation of an easy to use concept for treatment of wound healing by secondary intention and guidance in selection of appropriate dressings.

    Science.gov (United States)

    Braumann, Chris; Guenther, Nina; Menenakos, Charalambos; Muenzberg, Helga; Pirlich, Matthias; Lochs, Herbert; Mueller, Joachim M

    2011-06-01

    The main objective of this case-cohort-type observational study conducted at different Surgical Departments of the Charité-Universitätsmedizin in Berlin was to evaluate the sequential use concept first described by Systagenix Wound Management in 2007. Fifty-two patients with different wound healing by secondary intention were treated for 7 weeks at the Charité-Universitätsmedizin in Berlin. A multidisciplinary team worked together to reach consensus in wound assessment; in classification of infection status according to the criteria described by European Wound Management Association (EWMA); in treatment protocol and on dressings to be used to 'cover' wounds. Before dressing application, all wounds were cleaned from debris. Following the sequential use concept, wounds classified as stages 2 and 3 were dressed with SILVERCEL(®) and TIELLE(®) or TIELLE PLUS(®) to 'clean' the wounds. After 2-3 weeks, treatment was changed to PROMOGRAN PRISMA(®) and TIELLE(®) to 'close and cover' wounds, thus providing optimal wound healing. Wounds classified as non infected were dressed with PROMOGRAN PRISMA(®) and TIELLE(®) during the complete treatment period. Patients were asked to evaluate the treatment using a simplified questionnaire developed at the Charité-Universitätsmedizin in Berlin. Wounds comprised 37 surgical procedures, 8 chronic mixed ulcer, 4 pressure sores, 1 diabetic foot ulcer, 1 venous leg ulcer, and 1 mixed arterial/venous ulcer. At baseline, 12 wounds were classified as stage 3, 38 wounds as stage 2 and 2 wounds as stage 1. After 7 weeks of treatment, all patients showed a positive clinical response to the sequential use treatment. Results of wound size showed a high significant progression of wound healing expressed with a profound reduction of wound area (P in all measurements wound treatment. On the basis of the wound healing results, patients' evaluation of treatment and the clinicians' and staff experiences, this concept was implemented at

  6. Helpful Factors in the Treatment of Depression from the Patient's, Carer's and Professional's Perspective: A Concept Map Study

    NARCIS (Netherlands)

    van Grieken, R.A.; Verburg, H.F.; Koeter, M.W.; Stricker, J.; Nabitz, U.W.; Schene, A.H.

    2016-01-01

    OBJECTIVE: Depression research has resulted in knowledge about neurobiology, pharmacological strategies and short-term cost-effective treatments. However, more than two-thirds of all depressed patients experience insufficient improvement. Therefore, a better understanding of what patients, carers

  7. Helpful Factors in the Treatment of Depression from the Patient's, Carer's and Professional's Perspective: A Concept Map Study

    NARCIS (Netherlands)

    van Grieken, Rosa A.; Verburg, Hanka F.; Koeter, Maarten W. J.; Stricker, Jessica; Nabitz, Udo W.; Schene, Aart H.

    2016-01-01

    Depression research has resulted in knowledge about neurobiology, pharmacological strategies and short-term cost-effective treatments. However, more than two-thirds of all depressed patients experience insufficient improvement. Therefore, a better understanding of what patients, carers and

  8. Biologic Treatments for Sports Injuries II Think Tank-Current Concepts, Future Research, and Barriers to Advancement, Part 1: Biologics Overview, Ligament Injury, Tendinopathy.

    Science.gov (United States)

    LaPrade, Robert F; Geeslin, Andrew G; Murray, Iain R; Musahl, Volker; Zlotnicki, Jason P; Petrigliano, Frank; Mann, Barton J

    2016-12-01

    Biologic therapies, including stem cells, platelet-rich plasma, growth factors, and other biologically active adjuncts, have recently received increased attention in the basic science and clinical literature. At the 2015 AOSSM Biologics II Think Tank held in Colorado Springs, Colorado, a group of orthopaedic surgeons, basic scientists, veterinarians, and other investigators gathered to review the state of the science for biologics and barriers to implementation of biologics for the treatment of sports medicine injuries. This series of current concepts reviews reports the summary of the scientific presentations, roundtable discussions, and recommendations from this think tank. © 2016 The Author(s).

  9. Process-based approach to modeling recurrent-event data explicated on the basis of occurrences of tooth losses in two different prosthetic treatment concepts.

    Science.gov (United States)

    Diebner, Hans H; Marré, Birgit; Roeder, Ingo; Walter, Michael H

    2016-05-17

    In studies comparing different prosthetic treatment concepts the repeated loss of teeth was chosen as the primary outcome. The resulting data appear to represent a data structure of recurrent events. However, the application of an existing method for recurrent events is far from straightforward. Often only the first event or the final state is analyzed using Kaplan-Meier survival statistics, thereby giving a great deal of information away. The paper presents a strategy for the analysis of recurrent data using a previously published study on the influence of different prosthetic treatment concepts for the shortened dental arch on tooth loss. A method based on cumulative sample history functions of recurrent events was adjusted for tooth loss. The shapes of these cumulative functions suggest a time dependency of the recurrence rate. To keep the model as simple as possible, a tripartite Poisson process (which assumes piecewise time-independent rates) was fitted to the cumulative mean functions stratified by treatment. Within the middle interval of the three-phasic process, the treatment effects differ significantly, which is interpreted as a delay of tooth loss due to the use of one type of prosthesis (fixed) compared with the other (removable). An analysis based on cumulative history functions is based on process, therefore, temporally changing characteristics are better captured than in methods for survival analyses. The presented approach offers useful new insight into the temporal behavior of ongoing tooth loss after prosthetic treatment. The trial has been registered at controlled-trials.com under ISRCTN97265367 (registration date 4 April 2008).

  10. Effectiveness of Neuro-Developmental Treatment (Bobath Concept) on postural control and balance in Cerebral Palsied children.

    Science.gov (United States)

    Tekin, Fatih; Kavlak, Erdogan; Cavlak, Ugur; Altug, Filiz

    2018-01-01

    The aim of this study was to show the effects of an 8-week Neurodevelopmental Treatment based posture and balance training on postural control and balance in diparetic and hemiparetic Cerebral Palsied children (CPC). Fifteen CPC (aged 5-15 yrs) were recruited from Denizli Yağmur Çocukları Rehabilitation Centre. Gross Motor Function Classification System, Gross Motor Function Measure, 1-Min Walking Test, Modified Timed Up and Go Test, Paediatric Balance Scale, Functional Independence Measure for Children and Seated Postural Control Measure were used for assessment before and after treatment. An 8-week NDT based posture and balance training was applied to the CPC in one session (60-min) 2 days in a week. After the treatment program, all participants showed statistically significant improvements in terms of gross motor function (p< 0.05). They also showed statistically significant improvements about balance abilities and independence in terms of daily living activities (p< 0.05). Seated Postural Control Measure scores increased after the treatment program (p< 0.05). The results of this study indicate that an 8-week Neurodevelopmental Treatment based posture and balance training is an effective approach in order to improve functional motor level and functional independency by improving postural control and balance in diparetic and hemiparetic CPC.

  11. Early-stage design of municipal wastewater treatment plants – presentation and discussion of an optimisation based concept

    DEFF Research Database (Denmark)

    Bozkurt, Hande; Quaglia, Alberto; Gernaey, Krist

    2014-01-01

    decisions and previous experiences . In this contribution, we propose a new approach based on mathematical programming to manage the complexity of the problem and generate novel and optimal WWTP network designs for domestic WWT. Within this context, a superstructure concept is used to represent....... This database is embedded within the mixed integer nonlinear programming problem formulated and solved in GAMS for different objective function s (e.g . total annualized costs, etc . ) and constraint definitions (e.g. effluent discharge limits) . The developed framework is highlighted using the benchmark plant......The number of alternative WWT technologies has grown steadily to meet increasingly stringent performance demands which increased the importance and complexity of early-stage decision making in WWTP design and retrofitting problems. Currently the conceptual design task is handled bas ed on expert...

  12. Delivering patient-centred care in rural family practice: using the patient's concept of health to guide treatment.

    Science.gov (United States)

    Charlesworth, Jennifer M; McManus, Evelyn

    2017-01-09

    Through an examination of the life of an 83-year-old patient diagnosed clinically with secondary progressive multiple sclerosis (MS), general practice specialists, consultants and junior doctors will see the importance of assessing their patient's concept of health and how to use this understanding to target healthcare options within their healthcare system. This article highlights, in a resource limited context of rural family practice, the utility of a strong physician-patient relationship, recalls the definition of patient-centred care, and the role of judicious inaction in certain contexts. These lessons can be extrapolated for use in more resource rich or specialised settings such as academic hospitals throughout Europe. 2017 BMJ Publishing Group Ltd.

  13. LCA Of The “Renescience” Concept: An Alternative To Incineration For The Treatment Of Residual Municipal Solid Waste

    DEFF Research Database (Denmark)

    Tonini, Davide; Astrup, Thomas

    2010-01-01

    be separated for recycling. In this study the environmental assessment of a number of scenarios for the “REnescience” concept is presented. The scenarios assessed are co-combustion of solid and liquid fraction in coal-fired power plants (CC-CC), co-combustion of the liquid fraction and incineration......The “REnescience” system consists on a pretreatment of the waste based on heat and enzymes which liquefy the biogenic fraction of the waste (paper and organics). The outputs of the process are then liquid slurry and a remaining solid fraction from which metals, plastic and glass can eventually...... of the solid fraction (CC-INC), anaerobic digestion of the liquid fraction to produce biogas and co-combustion of the solid fraction (BG-CC) and anaerobic digestion of the liquid fraction to produce biogas and incineration of the solid fraction (BG-INC). The reference technology for the comparison...

  14. Novel industrial wastewater treatment integrated with recovery of water and salt under a zero liquid discharge concept.

    Science.gov (United States)

    Rajamani, Sengodagounder

    2016-03-01

    Conventional industrial effluent treatment systems are designed to reduce biochemical oxygen demand (BOD), chemical oxygen demand (COD) but not total dissolved solids (TDS), mainly contributed by chlorides. In addition to the removal of TDS, it is necessary to recover water for reuse to meet the challenges of shortage of quality water. To recover water, the wastewater needs to be further treated by adopting treatment systems including microfilters, low pressure membrane units such as ultrafiltration (UF), membrane bioreactors (MBR), etc., for the application of reverse osmosis (RO) systems. By adopting the RO system, 75%-80% of quality water with industrial waste for reuse has become a reality. The membrane system has been used for different applications. It has become mandatory to achieve zero liquid discharge (ZLD) in many states in India and other countries such as Spain, China, etc., and resulted in development of new treatment technologies to suit the local conditions.

  15. Underground structure pattern and multi AO reaction with step feed concept for upgrading an large wastewater treatment plant

    Science.gov (United States)

    Peng, Yi; Zhang, Jie; Li, Dong

    2018-03-01

    A large wastewater treatment plant (WWTP) could not meet the new demand of urban environment and the need of reclaimed water in China, using a US treatment technology. Thus a multi AO reaction process (Anaerobic/oxic/anoxic/oxic/anoxic/oxic) WWTP with underground structure was proposed to carry out the upgrade project. Four main new technologies were applied: (1) multi AO reaction with step feed technology; (2) deodorization; (3) new energy-saving technology such as water resource heat pump and optical fiber lighting system; (4) dependable old WWTP’s water quality support measurement during new WWTP’s construction. After construction, upgrading WWTP had saved two thirds land occupation, increased 80% treatment capacity and improved effluent standard by more than two times. Moreover, it had become a benchmark of an ecological negative capital changing to a positive capital.

  16. An integrated knowledge-based and optimization tool for the sustainable selection of wastewater treatment process concepts

    DEFF Research Database (Denmark)

    Castillo, A.; Cheali, Peam; Gómez, V.

    2016-01-01

    The increasing demand on wastewater treatment plants (WWTPs) has involved an interest in improving the alternative treatment selection process. In this study, an integrated framework including an intelligent knowledge-based system and superstructure-based optimization has been developed and applied...... to a real case study. Hence, a multi-criteria analysis together with mathematical models is applied to generate a ranked short-list of feasible treatments for three different scenarios. Finally, the uncertainty analysis performed allows for increasing the quality and robustness of the decisions considering...... variation in influent concentrations. For the case study application, the expert system identifies 5 potential process technologies and, using this input, the superstructure identifies membrane bioreactors as the optimal and robust solution under influent uncertainties and tighter effluent limits. A mutual...

  17. Current concepts in combination therapy for the treatment of hypertension: combined calcium channel blockers and RAAS inhibitors.

    Science.gov (United States)

    Rubio-Guerra, Alberto F; Castro-Serna, David; Barrera, Cesar I Elizalde; Ramos-Brizuela, Luz M

    2009-01-01

    Recent guidelines for the management of hypertension recommend target blood pressures hypertensive patients, or hypertensive patients do not reach the recommended treatment targets with monotherapy, making combination therapy necessary to achieve the therapeutic goal. Combination therapy with 2 or more agents is the most effective method for achieving strict blood pressure goals. Fixed-dose combination simplifies treatment, reduces costs, and improves adherence. There are many drug choices for combination therapy, but few data are available about the efficacy and safety of some specific combinations. Combination therapy of calcium antagonists and inhibitors of the renin-angiotensin-aldosterone system (RAAS) are efficacious and safe, and have been considered rational by both the JNC 7 and the 2007 European Society of Hypertension - European Society of Cardiology guidelines for the management of arterial hypertension. The aim of this review is to discuss some relevant issues about the use of combinations with calcium channel blockers and RAAS inhibitors in the treatment of hypertension.

  18. [A contemporary conception of insomnia syndrome and its treatments in view of International classification of sleep disorders].

    Science.gov (United States)

    Poluektov, M G; Tsenteradze, S L

    2014-01-01

    Insomnia is one of the most common and wide-spread sleep disorders. It includes difficulties of sleep initiation, sustaining and daytime impairment. A condition of cerebral hyperarousal plays the most important role in the genesis of insomnia. Cognitive, electrophysiological and metabolic parameters are correlated with hyperarousal state. According to the International classification of sleep disorders (ICSD-3), insomnia is divided into acute, chronic and unclassified. Treatment of insomnia includes specific and nonspecific approaches. Regardless of the origin of insomnia, sleep hygiene and behavioral therapy remain the methods of choice for the treatment.

  19. Short-term clinical outcomes of laser supported periodontal treatment concept using Er,Cr:YSGG (2780nm) and diode (940 nm): a pilot study

    Science.gov (United States)

    Odor, Alin A.; Violant, Deborah; Badea, Victoria; Gutknecht, Norbert

    2016-03-01

    Backgrounds: Er,Cr:YSGG (2780nm) and diode (940 nm) lasers can be used adjacent to the conventional periodontal treatment as minimally invasive non-surgical devices. Aim: To describe the short-term clinical outcomes by combining Er,Cr:YSGG (2780nm) and diode 940 nm lasers in non-surgical periodontal treatment. Materials and methods: A total of 10 patients with periodontal disease (mild, moderate, severe) - 233 teeth and 677 periodontal pockets ranging from 4 mm to 12 mm - were treated with Er,Cr:YSGG (2780nm) and diode (940 nm) lasers in adjunct to manual and piezoelectric scaling and root planning (SRP). Periodontal parameters such as mean probing depth (PD), mean clinical attachment level (CAL) and mean bleeding on probing (BOP) were evaluated at baseline and 6 months after the laser treatment using an electronic periodontal chart. Results: At baseline, the mean PD was 4.06 ± 1.06 mm, mean CAL was 4.56 ± 1.43 mm, and mean BOP was 43.8 ± 23.84 %. At 6 months after the laser supported periodontal treatments the mean PD was 2.6 ± 0.58 mm (p periodontal clinical parameters such as PD, CAL and BOP. Keywords: Laser supported periodontal treatment concept, Er,Cr:YSGG and diode 940nm lasers, Scaling and root planning, Minimally invasive non-surgical device

  20. Establishing a library of resources to help people understand key concepts in assessing treatment claims-The "Critical thinking and Appraisal Resource Library" (CARL).

    Science.gov (United States)

    Castle, John C; Chalmers, Iain; Atkinson, Patricia; Badenoch, Douglas; Oxman, Andrew D; Austvoll-Dahlgren, Astrid; Nordheim, Lena; Krause, L Kendall; Schwartz, Lisa M; Woloshin, Steven; Burls, Amanda; Mosconi, Paola; Hoffmann, Tammy; Cusack, Leila; Albarqouni, Loai; Glasziou, Paul

    2017-01-01

    People are frequently confronted with untrustworthy claims about the effects of treatments. Uncritical acceptance of these claims can lead to poor, and sometimes dangerous, treatment decisions, and wasted time and money. Resources to help people learn to think critically about treatment claims are scarce, and they are widely scattered. Furthermore, very few learning-resources have been assessed to see if they improve knowledge and behavior. Our objectives were to develop the Critical thinking and Appraisal Resource Library (CARL). This library was to be in the form of a database containing learning resources for those who are responsible for encouraging critical thinking about treatment claims, and was to be made available online. We wished to include resources for groups we identified as 'intermediaries' of knowledge, i.e. teachers of schoolchildren, undergraduates and graduates, for example those teaching evidence-based medicine, or those communicating treatment claims to the public. In selecting resources, we wished to draw particular attention to those resources that had been formally evaluated, for example, by the creators of the resource or independent research groups. CARL was populated with learning-resources identified from a variety of sources-two previously developed but unmaintained inventories; systematic reviews of learning-interventions; online and database searches; and recommendations by members of the project group and its advisors. The learning-resources in CARL were organised by 'Key Concepts' needed to judge the trustworthiness of treatment claims, and were made available online by the James Lind Initiative in Testing Treatments interactive (TTi) English (www.testingtreatments.org/category/learning-resources).TTi English also incorporated the database of Key Concepts and the Claim Evaluation Tools developed through the Informed Healthcare Choices (IHC) project (informedhealthchoices.org). We have created a database of resources called CARL

  1. Establishing a library of resources to help people understand key concepts in assessing treatment claims-The "Critical thinking and Appraisal Resource Library" (CARL.

    Directory of Open Access Journals (Sweden)

    John C Castle

    Full Text Available People are frequently confronted with untrustworthy claims about the effects of treatments. Uncritical acceptance of these claims can lead to poor, and sometimes dangerous, treatment decisions, and wasted time and money. Resources to help people learn to think critically about treatment claims are scarce, and they are widely scattered. Furthermore, very few learning-resources have been assessed to see if they improve knowledge and behavior.Our objectives were to develop the Critical thinking and Appraisal Resource Library (CARL. This library was to be in the form of a database containing learning resources for those who are responsible for encouraging critical thinking about treatment claims, and was to be made available online. We wished to include resources for groups we identified as 'intermediaries' of knowledge, i.e. teachers of schoolchildren, undergraduates and graduates, for example those teaching evidence-based medicine, or those communicating treatment claims to the public. In selecting resources, we wished to draw particular attention to those resources that had been formally evaluated, for example, by the creators of the resource or independent research groups.CARL was populated with learning-resources identified from a variety of sources-two previously developed but unmaintained inventories; systematic reviews of learning-interventions; online and database searches; and recommendations by members of the project group and its advisors. The learning-resources in CARL were organised by 'Key Concepts' needed to judge the trustworthiness of treatment claims, and were made available online by the James Lind Initiative in Testing Treatments interactive (TTi English (www.testingtreatments.org/category/learning-resources.TTi English also incorporated the database of Key Concepts and the Claim Evaluation Tools developed through the Informed Healthcare Choices (IHC project (informedhealthchoices.org.We have created a database of resources

  2. The effects of a group based stress treatment program (the Kalmia concept) targeting stress reduction and return to work. A randomized, wait-list controlled trial

    DEFF Research Database (Denmark)

    Netterstrøm, Bo; Friebel, Lene; Ladegaard, Yun Katrine

    2012-01-01

    Abstract Objective The aim of this study was to evaluate the effects of a group based multidisciplinary stress treatment program on reductions in symptom levels and the return to work (RTW) rate. Methods General practitioners referred 199 patients with persistent work related stress symptoms...... to the project. The inclusion criteria included being employed and being on sick leave. Using a randomized wait- list control design, the participants were randomized into three groups: the intervention group (IG, 70 participants) was treated using the Stress Therapy Concept of Kalmia, which consists...... of an integrative approach of group psychotherapy for 2.5 hours per week and Basic Body Awareness Therapy (BBAT) with mindfulness meditation for 1.5 hours per week, which runs in a parallel process supplemented with workplace dialogue; the treatment-as-usual control group (TAUCG, 71 participants), who received 12...

  3. A randomized controlled trial of pre-conception treatment for periodontal disease to improve periodontal status during pregnancy and birth outcomes.

    Science.gov (United States)

    Jiang, Hong; Xiong, Xu; Su, Yi; Zhang, Yiming; Wu, Hongqiao; Jiang, Zhijun; Qian, Xu

    2013-12-09

    Evidence has suggested that periodontal disease is associated with an increased risk of various adverse pregnancy and birth outcomes. However, several large clinical randomized controlled trials failed to demonstrate periodontal therapy during pregnancy reduced the incidence of adverse pregnancy and birth outcomes. It has been suggested that the pre-conception period may be an optimal period for periodontal disease treatment rather than during pregnancy. To date, no randomized controlled trial (RCT) has examined if treating periodontal disease before pregnancy reduces adverse birth outcomes. This study aims to examine if the pre-conception treatment of periodontal disease will lead to improved periodontal status during late pregnancy and subsequent birth outcomes. A sample of 470 (235 in each arm of the study) pre-conception women who plan to conceive within one year and with periodontal disease will be recruited for the study. All participants will be randomly allocated to the intervention or control group. The intervention group will receive free therapy including dental scaling and root planning (the standard therapy), supragingival prophylaxis, and oral hygiene education. The control group will only receive supragingival prophylaxis and oral hygiene education. Women will be followed throughout their pregnancy and then to childbirth. The main outcomes include periodontal disease status in late pregnancy and birth outcomes measured such as mean birth weight (grams), and mean gestational age (weeks). Periodontal disease will be diagnosed through a dental examination by measuring probing depth, clinical attachment loss and percentage of bleeding on probing (BOP) between gestational age of 32 and 36 weeks. Local and systemic inflammatory mediators are also included as main outcomes. This will be the first RCT to test whether treating periodontal disease among pre-conception women reduces periodontal disease during pregnancy and prevents adverse birth outcomes. If

  4. The power of fat and its adipose-derived stromal cells : Emerging concepts for fibrotic scar treatment

    NARCIS (Netherlands)

    Spiekman, Maroesjka; van Dongen, Joris A; Willemsen, Joep C; Hoppe, Delia L; van der Lei, Berend; Harmsen, Martin C

    2017-01-01

    Lipofilling or lipografting is a novel and promising treatment method for reduction or prevention of dermal scars after injury. Ample anecdotal evidence from case reports supports the scar-reducing properties of adipose tissue grafts. However, only a few properly controlled and designed clinical

  5. Concepts of formal concept analysis

    Science.gov (United States)

    Žáček, Martin; Homola, Dan; Miarka, Rostislav

    2017-07-01

    The aim of this article is apply of Formal Concept Analysis on concept of world. Formal concept analysis (FCA) as a methodology of data analysis, information management and knowledge representation has potential to be applied to a verity of linguistic problems. FCA is mathematical theory for concepts and concept hierarchies that reflects an understanding of concept. Formal concept analysis explicitly formalizes extension and intension of a concept, their mutual relationships. A distinguishing feature of FCA is an inherent integration of three components of conceptual processing of data and knowledge, namely, the discovery and reasoning with concepts in data, discovery and reasoning with dependencies in data, and visualization of data, concepts, and dependencies with folding/unfolding capabilities.

  6. The daily progress system: A proof of concept pilot study of a recovery support technology tool for outpatient substance abuse treatment.

    Science.gov (United States)

    Carswell, S B; Gordon, M S; Gryczynski, J; Tangires, S A

    2018-01-01

    Illicit substance use remains highly prevalent in the US, and epidemiological surveillance surveys estimate that in 2015, over 27 million individuals (10.1% of the US population) 12 years of age or older used illicit drugs in the past 30 days. 1 Outpatient treatment delivered in community-based settings is the dominant modality for addiction treatment, typically involving weekly psychosocial counseling sessions in an individual and/or group format. 2,3 Unfortunately, relapse and premature treatment discontinuation are quite common in outpatient treatment. 3-5 Objectives: This is a pilot proof of concept feasibility study involving clients presenting for outpatient SUD treatment. This study sought to examine the feasibility and acceptability of the Daily Progress System (DPS), a telephone-based software program, using interactive voice response (IVR), designed to enhance quality care and improve client outcomes. Individuals who presented at the participating treatment clinic, who met study eligibility criteria, and who provided written informed consent to participate were included in the study (N = 15; 53.3% females). Incentives were paid to participants for calls completed. Participants completed 65% of scheduled daily call-ins, representing 273 person-days of data on client cravings, mood, substance use, and involvement in recovery support activities. The average call duration was approximately 2 minutes and 42 seconds. There was a high degree of client and counselor acceptance and satisfaction using the system. Conclusions and Clinical Significance: Findings suggest that the DPS appears to be a feasible means of potentially addressing relapse and treatment engagement issues based on client and counselor engagement and satisfaction with the system.

  7. The benefits of other treatments than in vitro fertilization to aid conception in minimal and mild endometriosis.

    Science.gov (United States)

    Leung, Annie S; Dahan, Michael H

    2016-12-01

    The treatment of minimal or mild endometriosis prior to non-in-vitro fertilization (IVF) assisted reproduction to improve pregnancy outcomes is controversial. Ovulation suppression may be offered to women who do not wish to conceive to suppress advancement of the disease. There is little evidence to suggest improvements in fertility associated ovarian suppression prior to non-IVF infertility treatments. The use of intrauterine insemination without ovulation induction offers little benefit, with low pregnancy rates in most studies. Surgical ablation seems to improve outcomes when other care will not be delivered. Although controversial, surgical ablation before ovulation induction may offer benefit but further studies would be helpful. Ovulation induction seems to increase pregnancy rates and either letrozole or clomiphene citrate should be considered as first line options. If pregnancy does not occur with three months of ovulation induction, based on dropping success rates with further cycles of ovarian stimulation, IVF should be offered.

  8. Presenting a Treatment Concept for People with a Self-Reported Sexual Interest in Children in an Outpatient Setting

    OpenAIRE

    Schulz, Tina; Palmer, Simon; Stolpmann, Georg; Wernicke, Martina; Müller, Jürgen L.

    2017-01-01

    Results of several studies point to an increase in reported child sexual abuse offences in Germany and an even higher number of undetected cases are assumed. In addition, even more cases regarding the distribution of child pornography have been reported. On behalf of victims of child sexual abuse and for the general public, a preventive treatment approach for people with a sexual interest in children is of prime importance. Currently, there is no published, evaluated therapeuti...

  9. Haematopoietic stem cell transplantation as first-line treatment in myeloma: a global perspective of current concepts and future possibilities

    Directory of Open Access Journals (Sweden)

    Catriona Elizabeth Mactier

    2012-10-01

    Full Text Available Stem cell transplantation forms an integral part of the treatment for multiple myeloma. This paper reviews the current role of transplantation and the progress that has been made in order to optimize the success of this therapy. Effective induction chemotherapy is important and a combination regimen incorporating the novel agent bortezomib is now favorable. Adequate induction is a crucial adjunct to stem cell transplantation and in some cases may potentially postpone the need for transplant. Different conditioning agents prior to transplantation have been explored: high-dose melphalan is most commonly used and bortezomib is a promising additional agent. There is no well-defined superior transplantation protocol but single or tandem autologous stem cell transplantations are those most commonly used, with allogeneic transplantation only used in clinical trials. The appropriate timing of transplantation in the treatment plan is a matter of debate. Consolidation and maintenance chemotherapies, particularly thalidomide and bortezomib, aim to improve and prolong disease response to transplantation and delay recurrence. Prognostic factors for the outcome of stem cell transplant in myeloma have been highlighted. Despite good responses to chemotherapy and transplantation, the problem of disease recurrence persists. Thus, there is still much room for improvement. Treatments which harness the graft-versus-myeloma effect may offer a potential cure for this disease. Trials of novel agents are underway, including targeted therapies for specific antigens such as vaccines and monoclonal antibodies.

  10. Triangular block bridge method for surgical treatment of complex proximal humeral fractures: theoretical concept, surgical technique and clinical results.

    Science.gov (United States)

    Russo, Raffaele; D'Auria, Daniela; Ciccarelli, Michele; Della Rotonda, Giuseppe; D'Elia, Gesualdo; Siciliano, Bruno

    2017-10-01

    Criteria for classification, indication and choice of a surgical device to treat proximal humeral fractures are still controversial. We report an original technique based on a mechanical concept with a structural principle of a triangle as a rigid body applied to the humeral head fractures in association with other devices. This retrospective study aims to describe in detail the surgical technique and results at long time follow up. We analysed two series of 101 patients with proximal humeral fractures (mean age, 52.9 y; range 19-78 y) treated between 2001 and 2012 reporting the clinical and radiological results. In the first series of 23 cases (mean age 51.4 y, range 35-74 y) we used as support a bone piece taken from allograft or autologous tricortical iliac crest and shaped as a triangular pyramid during the operation; while in the second series of 78 cases (mean age 53.6 years, range 29-78 years, SD 13.5 years) a triangular titanium cage was used in 69 patients while in 9 allograft or bone substitute was used as augmentation. An analytical retrospective study was done to understand the mechanical function of medial augmentation composed by a solid body in association with different types of synthesis to stabilize properly a proximal humeral fracture. We obtained excellent and good results in 83,2% of patients, fair in 12,8% and bad in 4% in terms of active anterior elevation, external and internal rotation, pain and strength according to Constant and DASH score. A medial solid body, especially in titanium material and shaped as trapezoidal/pyramidal form used to fill the secondary bone loss in complex instable proximal humeral fracture, allows an anatomic reduction and stable fixation in association with simple and more complex tools and it provides a better biomechanical environment for union and maintenance of alignment. © 2017 Elsevier Ltd. All rights reserved.

  11. Novel Concept of CD4-Mediated Activation of Regulatory T Cells for the Treatment of Graft-Versus-Host Disease

    Directory of Open Access Journals (Sweden)

    Janine Schlöder

    2017-11-01

    Full Text Available Allogeneic hematopoietic stem cell transplantation is the only curative treatment option for several hematological malignancies and immune deficiency syndromes. Nevertheless, the development of a graft-versus-host disease (GvHD after transplantation is a high risk and a severe complication with high morbidity and mortality causing therapeutic challenges. Current pharmacological therapies of GvHD lead to generalized immunosuppression followed by severe adverse side effects including infections and relapse of leukemia. Several novel cell-based immunomodulatory strategies for treatment or prevention of GvHD have been developed. Herein, thymus-derived regulatory T cells (tTreg, essential for the maintenance of peripheral immunologic tolerance, are in the focus of investigation. However, due to the limited number of tTreg in the peripheral blood, a complex, time- and cost-intensive in vitro expansion protocol is necessary for the production of an efficient cellular therapeutic. We demonstrated that activation of tTreg using the CD4-binding human immunodeficiency virus-1 protein gp120 leads to a substantially increased suppressor activity of tTreg without the need for additional expansion. Gp120-activated tTreg prevent GvHD development in a preclinical humanized mouse model. In addition, gp120 is not only effective in prevention but also in therapy of GvHD by suppressing all clinical symptoms and improving survival of treated mice. These data indicate that tTreg activation by gp120 is a feasible and potent strategy for significant functional improvement of tTreg as cellular therapeutic for GvHD treatment without the need of complicated, time-intensive, and expensive in vitro expansion of isolated tTreg.

  12. Current concepts in combination therapy for the treatment of hypertension: combined calcium channel blockers and RAAS inhibitors

    Directory of Open Access Journals (Sweden)

    Alberto F Rubio-Guerra

    2009-11-01

    Full Text Available Alberto F Rubio-Guerra1, David Castro-Serna2, Cesar I Elizalde Barrera2, Luz M Ramos-Brizuela21Metabolic and Research Clinic, 2Internal Medicine Department, Hospital General de Ticomán SS DF, MéxicoAbstract: Recent guidelines for the management of hypertension recommend target blood pressures <140/90 mmHg in hypertensive patients, or <130/80 mmHg in subjects with diabetes, chronic kidney disease, or coronary artery disease. Despite the availability and efficacy of antihypertensive drugs, most hypertensive patients do not reach the recommended treatment targets with monotherapy, making combination therapy necessary to achieve the therapeutic goal. Combination therapy with 2 or more agents is the most effective method for achieving strict blood pressure goals. Fixed-dose combination simplifies treatment, reduces costs, and improves adherence. There are many drug choices for combination therapy, but few data are available about the efficacy and safety of some specific combinations. Combination therapy of calcium antagonists and inhibitors of the renin-angiotensin-aldosterone system (RAAS are efficacious and safe, and have been considered rational by both the JNC 7 and the 2007 European Society of Hypertension – European Society of Cardiology guidelines for the management of arterial hypertension. The aim of this review is to discuss some relevant issues about the use of combinations with calcium channel blockers and RAAS inhibitors in the treatment of hypertension.Keywords: hypertension, calcium channel blockers, renin-angiotensin-aldosterone system inhibitors, fixed-dose combination, adherence

  13. Evidence of disease control: a realistic concept beyond NEDA in the treatment of multiple sclerosis [version 1; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Ana C. Londoño

    2017-04-01

    Full Text Available Although no evidence of disease activity (NEDA permits evaluation of response to treatment in the systematic follow-up of patients with multiple sclerosis (MS, its ability to accomplish detection of surreptitious activity of disease is limited, thus being unable to prevent patients from falling into a non-reversible progressive phase of disease. A protocol of evaluation based on the use of validated biomarkers that is conducted at an early stage of disease would permit the capture of abnormal neuroimmunological phenomena and lead towards intervention with modifying therapy before tissue damage has been reached.

  14. Evidence of disease control: a realistic concept beyond NEDA in the treatment of multiple sclerosis [version 2; referees: 2 approved

    Directory of Open Access Journals (Sweden)

    Ana C. Londoño

    2017-06-01

    Full Text Available Although no evidence of disease activity (NEDA permits evaluation of response to treatment in the systematic follow-up of patients with multiple sclerosis (MS, its ability to accomplish detection of surreptitious activity of disease is limited, thus being unable to prevent patients from falling into a non-reversible progressive phase of disease. A protocol of evaluation based on the use of validated biomarkers that is conducted at an early stage of disease would permit the capture of abnormal neuroimmunological phenomena and lead towards intervention with modifying therapy before tissue damage has been reached.

  15. Early-stage design of municipal wastewater treatment plants – presentation and discussion of an optimisation based concept

    DEFF Research Database (Denmark)

    Bozkurt, Hande; Quaglia, Alberto; Gernaey, Krist

    2014-01-01

    the alternative WWT technologies described as a series of reaction and separation tasks at different treatment levels. Each process alternative is described by a generic model and the required data for bo th performance and economics of each alternative are collected and sorted in a multi-dimensional database....... This database is embedded within the mixed integer nonlinear programming problem formulated and solved in GAMS for different objective function s (e.g . total annualized costs, etc . ) and constraint definitions (e.g. effluent discharge limits) . The developed framework is highlighted using the benchmark plant...

  16. Long-Term Treatment of Eosinophilic Esophagitis With Swallowed Topical Corticosteroids: Development and Evaluation of a Therapeutic Concept.

    Science.gov (United States)

    Greuter, Thomas; Bussmann, Christian; Safroneeva, Ekaterina; Schoepfer, Alain M; Biedermann, Luc; Vavricka, Stephan R; Straumann, Alex

    2017-10-01

    Swallowed topical corticosteroids (STCs) are efficacious in inducing and presumably maintaining remission in patients with active eosinophilic esophagitis (EoE). Hitherto, it has not been evaluated whether long-lasting remission can be achieved, and whether treatment can be stopped once patients have achieved this remission. Since 2007, EoE patients included into a large database at the Swiss EoE Clinics were put on STCs as induction/maintenance therapy. Disease activity was assessed on an annual basis. In patients who achieved long-lasting (≥6 months) clinical, endoscopic, and histological (=deep) remission, treatment was stopped. Data on all patients treated using this therapeutic strategy were analyzed retrospectively. Of the 351 patients, 33 (9.4%) who were treated with STCs achieved deep remission. Median age of remitters at disease onset was 32.6 years (interquartile range (IQR) 19.1-49.3), and diagnostic delay was 5.4 years (IQR 1.2-11.4). Deep remission was achieved after 89.0 weeks (IQR 64.6-173.8). Female gender was the only independent prognostic factor for achieving deep remission (odds ratio (OR) 2.518, 95% confidence interval (CI) 1.203-5.269). Overall, STCs were stopped after 104.7 weeks (IQR 65.5-176.6). No mucosal damage was observed upon histological examination. In 27 of the 33 remitters (81.8%), a clinical relapse occurred after a median of 22.4 weeks (95% CI 5.1-39.7). Six remitters (18.2%) did not experience a clinical relapse during a follow-up of 35.1 weeks (IQR 18.3-44.9). Hence, a total of 1.7% (6/351) patients were able to discontinue STCs in the long term. Long-term EoE treatment with STCs was well tolerated, but only a minority achieved deep remission. Female gender is the only prognostic factor for attainment of such remission. After treatment cessation, the majority experienced a clinical relapse.

  17. How to avoid unintended valgus alignment in distal femoral derotational osteotomy for treatment of femoral torsional malalignment - a concept study.

    Science.gov (United States)

    Imhoff, Florian B; Scheiderer, Bastian; Zakko, Philip; Obopilwe, Elifho; Liska, Franz; Imhoff, Andreas B; Mazzocca, Augustus D; Arciero, Robert A; Beitzel, Knut

    2017-12-29

    Defining the optimal cutting plane for derotational osteotomy at the distal femur for correction of torsion in cases of patellofemoral instability is still challenging. This preliminary study investigates changes of frontal alignment by a simplified trigonometrical model and demonstrates a surgical guidance technique with the use of femur cadavers. The hypothesis was that regardless of midshaft bowing, a cutting plane perpendicular to the virtual anatomic shaft axis avoids unintended valgus malalignment due to derotation. A novel mathematical model, called the Pillar-Crane-Model, was developed to forecast changes on frontal alignment of the femur when a perpendicular cutting plane to the virtual anatomical shaft was chosen. As proof of concept, eight different torsion angles were assessed on two human cadaver femora (left and right). A single cut distal femoral osteotomy perpendicular to the virtual anatomical shaft was performed. Frontal plane alignment (mLDFA, aLDFA, AMA) was radiographically analyzed before and after rotation by 0°, 10°, 20°, and 30°. Measurements were compared to the model. The trigonometrical equation from the Pillar-Crane-Model provides mathematical proof that slight changes into varus occur, seen by an increase in AMA and mLDFA, when the cutting plane is perpendicular to the virtual anatomical shaft axis. A table with standardized values is provided. Exemplarily, the specimens showed a mean increase of AMA from 4.8° to 6.3° and mLDFA from 85.2° to 86.7 after derotation by 30°. Throughout the derotation procedure, aLDFA remained at 80.4° ± 0.4°SD. With the use of this model for surgical guidance and anatomic reference, unintended valgus changes on frontal malalignment can be avoided. When the cutting plane is considered to be perpendicular to the virtual anatomical shaft from a frontal and lateral view, a slight increase of mLDFA results when a derotational osteotomy of the distal femur is performed.

  18. Domestic Violence and Its Effects on Children: Fundamental Concepts, Safety Planning and Examples of Alternative Treatment Models

    Directory of Open Access Journals (Sweden)

    Melis Sedef Kahraman

    2016-12-01

    Full Text Available Domestic violence is defined as coercive and controlling behaviors that family members show toward each other. These behaviors are frequently seen as repetitive behavior patterns. Research indicates that many domestic violence incidents happen in the presence of children. Being exposed to domestic violence or witnessing domestic violence has similar emotional-behavioral problems in children. In this article, we emphasized different reactions of children to domestic violence within different age groups. Safety planning is a commonly used method in Western cultures for professionals either working with adult victims or child victims of domestic violence. Unfortunately, the importance of safety planning is not yet utilized in Turkey. In this article, the phases of safety planning and three different alternative treatment methods that have been proven successful for working with children who were exposed to domestic violence are explained. [Psikiyatride Guncel Yaklasimlar - Current Approaches in Psychiatry 2016; 8(4.000: 321-336

  19. Biological anoxic treatment of O{sub 2}-free VOC emissions from the petrochemical industry: A proof of concept study

    Energy Technology Data Exchange (ETDEWEB)

    Muñoz, Raúl; Souza, Theo S.O. [Department of Chemical Engineering and Environmental Technology, University of Valladolid, Dr Mergelina s/n, 47011 Valladolid (Spain); Glittmann, Lina [Ostfalia University of Applied Sciences, Department of Supply Engineering, Wolfenbüttel (Germany); Pérez, Rebeca [Department of Chemical Engineering and Environmental Technology, University of Valladolid, Dr Mergelina s/n, 47011 Valladolid (Spain); Quijano, Guillermo, E-mail: gquijano@iq.uva.es [Department of Chemical Engineering and Environmental Technology, University of Valladolid, Dr Mergelina s/n, 47011 Valladolid (Spain)

    2013-09-15

    Highlights: • The treatment of O{sub 2}-free VOC emissions can be done by means of denitrifying processes. •Toluene vapors were successfully removed under anoxic denitrifying conditions. • A high bacterial diversity was observed. • Actinobacteria and Proteobacteria were the predominant phyla. • The nature and number of metabolites accumulated varied with the toluene load -- Abstract: An innovative biofiltration technology based on anoxic biodegradation was proposed in this work for the treatment of inert VOC-laden emissions from the petrochemical industry. Anoxic biofiltration does not require conventional O{sub 2} supply to mineralize VOCs, which increases process safety and allows for the reuse of the residual gas for inertization purposes in plant. The potential of this technology was evaluated in a biotrickling filter using toluene as a model VOC at loads of 3, 5, 12 and 34 g m{sup −3} h{sup −1} (corresponding to empty bed residence times of 16, 8, 4 and 1.3 min) with a maximum elimination capacity of ∼3 g m{sup −3} h{sup −1}. However, significant differences in the nature and number of metabolites accumulated at each toluene load tested were observed, o- and p-cresol being detected only at 34 g m{sup −3} h{sup −1}, while benzyl alcohol, benzaldehyde and phenol were detected at lower loads. A complete toluene removal was maintained after increasing the inlet toluene concentration from 0.5 to 1 g m{sup −3} (which entailed a loading rate increase from 3 to 6 g m{sup −3} h{sup −1}), indicating that the system was limited by mass transfer rather than by biological activity. A high bacterial diversity was observed, the predominant phyla being Actinobacteria and Proteobacteria.

  20. Nonconvulsive Electrotherapy for Treatment Resistant Unipolar and Bipolar Major Depressive Disorder: A Proof-of-concept Trial.

    Science.gov (United States)

    Regenold, William T; Noorani, Robert J; Piez, Deborah; Patel, Palak

    2015-01-01

    Electroconvulsive therapy (ECT) is the most effective therapy for treatment resistant major depressive disorder (TRD); however, some individuals with TRD refuse ECT over concern about adverse cognitive effects. Clinical observation of two patients with TRD who had a therapeutic response to intended ECT despite having only one or no seizure suggested that nonconvulsive electrical stimulation may be effective in some patients. This study tested the hypothesis that electrical brain stimulation applied like standard ECT, but below seizure threshold, can have therapeutic effects on TRD with fewer adverse cognitive effects. Thirteen outpatients with TRD (6 unipolar, 7 bipolar) who refused ECT participated in this open label adjunctive treatment study of nonconvulsive electrotherapy (NET) at the University of Maryland Medical Center. Brief pulse bifrontal electrical stimulation was given thrice weekly with a Thymatron System IV Integrated ECT Instrument. Seizure-free data were obtained from 11 of 13 subjects. Group mean Hamilton Depression Rating Scale 17-item version scores declined significantly (P = 0.001) from 20.3 to 8.6. Response and remission rates were 73% (8) and 55% (6), respectively. Cognitive testing using the Mini-Mental State Exam and the Autobiographical Memory Inventory-Short Form did not show declines typically observed with ECT. The therapeutic effect of NET on TRD was similar to that of ECT. Serious adverse effects and adverse cognitive effects were not observed. These results challenge the widespread belief that a seizure is necessary for the antidepressant effect of ECT and merit further investigation to determine whether NET is a viable alternative to ECT in some patients with TRD. Clinical trial posted on www.clinicaltrials.gov, identifier: NCT01065597. Copyright © 2015 Elsevier Inc. All rights reserved.

  1. The Genome Health Clinic and Genome Health Nutrigenomics concepts: diagnosis and nutritional treatment of genome and epigenome damage on an individual basis.

    Science.gov (United States)

    Fenech, Michael

    2005-07-01

    The evidence of a direct link between increased genome/epigenome damage and elevated risk for adverse health outcomes during the various stages of life, such as infertility, foetal development and cancer is becoming increasingly stronger. The latter is briefly reviewed against a background of evidence indicating that genome and epigenome damage biomarkers, in the absence of overt exposure of genotoxins, are themselves sensitive indicators of deficiency in micronutrients required as cofactors or as components of DNA repair enzymes, for maintenance methylation of CpG sequences and prevention of DNA oxidation and/or uracil incorporation into DNA. The latter is illustrated with cross-sectional and dietary intervention data obtained using the micronucleus assay and other efficient biomarkers for diagnosing genome and/or epigenome instability. The concept of recommended dietary allowances for genome stability and how this could be achieved is discussed. The 'Genome Health Nutrigenomics' concept is also introduced to define and focus attention on the specialized research area of how diet impacts on genome stability and how genotype determines nutritional requirements for genome health maintenance. The review concludes with a vision for a paradigm shift in disease prevention strategy based on the diagnosis and nutritional treatment of genome/epigenome damage on an individual basis, i.e. The Genome Health Clinic.

  2. Development of in-house lattice-Boltzmann simulator of bioreactors for wastewater treatment: basic concepts and initial results.

    Science.gov (United States)

    Fortunato, V A; Caneppele, F L; Ribeiro, R; Rabi, J A

    2018-02-01

    While computational modelling has increasingly supported wastewater bioreactor engineering, novel numerical techniques have been developed such as the lattice-Boltzmann method (LBM). With vinasse treatment as case study, this work is a first step towards a comprehensive LBM simulator of a continuous-flow anaerobic packed-bed reactor. Extensions from typical models comprise one-dimensional (besides time) dependence, species transport via convection and diffusion, and imposition of either Dirichlet or Danckwerts condition at inlet. The LBM simulator proved to be operational when simulating the bioreactor at different hydraulic retention times (HRTs). Simulated profiles show that stepwise feeding concentrations are smoothed as they are transported towards the bioreactor exit while concentrations increase or decrease in response to generation or degradation kinetics. Good fitting was observed for concentrations of acetic acid (2.1 kg-COD/m 3 for HRT = 24 h) and butyric acid (1.3 kg-COD/m 3 for HRT = 16 h) at the exit whereas other concentrations were numerically simulated at proper order of magnitude.

  3. Hydrothermal treatment and enzymatic hydrolysis of Tamarix ramosissima: evaluation of the process as a conversion method in a biorefinery concept.

    Science.gov (United States)

    Xiao, Ling-Ping; Shi, Zheng-Jun; Xu, Feng; Sun, Run-Cang

    2013-05-01

    The present work investigated the effects of hydrothermal treatment (HTT) of Tamarix ramosissima by determination of sugar and inhibitor formation in the liquid fraction, and chemical and morphological changes of the pretreated solid material coupled with an evaluation of enzymatic hydrolysis. HTT was carried out in a batch reactor system at a maximal temperature (TMAX 180-240 °C) and evaluated for severities logRo ranging from 2.40 to 4.17. The liquid fractions were analyzed by HPLC, GPC, and GC-MS. The morphology and composition of the solid residues were characterized using an array of techniques, such as SEM, XRD, BET surface area, and CP/MAS (13)C NMR. Using a variety of tools, we have developed a better understanding of how HTT process affects biomass structure and cellulose properties that impact on its digestibility. These results provided new insights into the factors limiting enzymatic digestibility and mechanism of biomass deconstruction during hydrothermal process. Crown Copyright © 2012. Published by Elsevier Ltd. All rights reserved.

  4. Carbohydrate restricted diet in conjunction with metformin and liraglutide is an effective treatment in patients with deteriorated type 2 diabetes mellitus: Proof-of-concept study

    Directory of Open Access Journals (Sweden)

    Müller Jürgen E

    2011-12-01

    Full Text Available Abstract Background Type 2 diabetes mellitus is a chronic progressive disease. During the course of the disease intensive treatment is often necessary resulting in multiple interventions including administration of insulin. Although dietary intervention is highly recommended, the clinical results of the widely prescribed diets with low fat content and high carbohydrates are disappointing. In this proof-of-concept study, we tested the effect of dietary carbohydrate-restriction in conjunction with metformin and liraglutide on metabolic control in patients with type 2 diabetes. Methods Forty patients with type 2 diabetes already being treated with two oral anti-diabetic drugs or insulin treatment and who showed deterioration of their glucose metabolism (i.e. HbA1c >7.5, were treated. A carbohydrate-restricted diet and a combination of metformin and liraglutide were instituted, after stopping either insulin or oral anti-diabetic drugs (excluding metformin. After enrollment, the study patients were scheduled for follow-up visits at one, two, three and six months. Primary outcome was glycemic control, measured by HbA1c at six months. Secondary outcomes were body weight, lipid-profile and treatment satisfaction. Results Thirty-five (88% participants completed the study. Nearly all participating patients experienced a drop in HbA1c and body weight during the first three months, an effect which was maintained until the end of the study at six months. Seventy-one percent of the patients reached HbA1c values below 7.0%. The range of body weight at enrollment was extreme, reaching 165 kg as the highest initial value. The average weight loss after 6 months was 10%. Most patients were satisfied with this treatment. During the intervention no significant change of lipids was observed. Most patients who were on insulin could maintain the treatment without insulin with far better metabolic control. Conclusions Carbohydrate restriction in conjunction with

  5. Traditional Chinese medicine and new concepts of predictive, preventive and personalized medicine in diagnosis and treatment of suboptimal health.

    Science.gov (United States)

    Wang, Wei; Russell, Alyce; Yan, Yuxiang

    2014-02-13

    The premise of disease-related phenotypes is the definition of the counterpart normality in medical sciences. Contrary to clinical practices that can be carefully planned according to clinical needs, heterogeneity and uncontrollability is the essence of humans in carrying out health studies. Full characterization of consistent phenotypes that define the general population is the basis to individual difference normalization in personalized medicine. Self-claimed normal status may not represent health because asymptomatic subjects may carry chronic diseases at their early stage, such as cancer, diabetes mellitus and atherosclerosis. Currently, treatments for non-communicable chronic diseases (NCD) are implemented after disease onset, which is a very much delayed approach from the perspective of predictive, preventive and personalized medicine (PPPM). A NCD pandemic will develop and be accompanied by increased global economic burden for healthcare systems throughout both developed and developing countries. This paper examples the characterization of the suboptimal health status (SHS) which represents a new PPPM challenge in a population with ambiguous health complaints such as general weakness, unexplained medical syndrome (UMS), chronic fatigue syndrome (CFS), myalgic encephalomyelitis (ME), post-viral fatigue syndrome (PVFS) and chronic fatigue immune dysfunction syndrome (CFIDS). We applied clinical informatic approaches and developed a questionnaire-suboptimal health status questionnaire-25 (SHSQ-25) for measuring SHS. The validity and reliability of this approach were evaluated in a small pilot study and then in a cross-sectional study of 3,405 participants in China. We found a correlation between SHS and systolic blood pressure, diastolic blood pressure, plasma glucose, total cholesterol and high-density lipoprotein (HDL) cholesterol among men, and a correlation between SHS and systolic blood pressure, diastolic blood pressure, total cholesterol, triglycerides

  6. Autologous transplantation of genetically modified iris pigment epithelial cells: A promising concept for the treatment of age-related macular degeneration and other disorders of the eye

    Science.gov (United States)

    Semkova, Irina; Kreppel, Florian; Welsandt, Gerhard; Luther, Thomas; Kozlowski, Jolanta; Janicki, Hanna; Kochanek, Stefan; Schraermeyer, Ulrich

    2002-10-01

    Age-related macular degeneration (ARMD) is the leading cause for visual impairment and blindness in the elder population. Laser photocoagulation, photodynamic therapy and excision of neovascular membranes have met with limited success. Submacular transplantation of autologous iris pigment epithelial (IPE) cells has been proposed to replace the damaged retinal pigment epithelium following surgical removal of the membranes. We tested our hypothesis that the subretinal transplantation of genetically modified autologous IPE cells expressing biological therapeutics might be a promising strategy for the treatment of ARMD and other retinal disorders. Pigment epithelium-derived factor (PEDF) has strong antiangiogenic and neuroprotective activities in the eye. Subretinal transplantation of PEDF expressing IPE cells inhibited pathological choroidal neovascularization in rat models of laser-induced rupture of Bruch's membrane and of oxygen induced ischemic retinopathy. PEDF expressing IPE transplants also increased the survival and preserved rhodopsin expression of photoreceptor cells in the RCS rat, a model of retinal degeneration. These findings suggest a promising concept for the treatment of ARMD and other retinal disorders.

  7. Management concepts.

    Science.gov (United States)

    Bittner, Rhonda

    2006-01-01

    Management concepts evolve through time. Health care managers can learn new concepts by evaluating classical management strategies, as well as modern-day strategies. Focusing on quality improvement and team building can help managers align the goals of their departments with the goals of the organization, consequently improving patient care.

  8. First patients treated with a 1.5 T MRI-Linac: clinical proof of concept of a high-precision, high-field MRI guided radiotherapy treatment

    Science.gov (United States)

    Raaymakers, B. W.; Jürgenliemk-Schulz, I. M.; Bol, G. H.; Glitzner, M.; Kotte, A. N. T. J.; van Asselen, B.; de Boer, J. C. J.; Bluemink, J. J.; Hackett, S. L.; Moerland, M. A.; Woodings, S. J.; Wolthaus, J. W. H.; van Zijp, H. M.; Philippens, M. E. P.; Tijssen, R.; Kok, J. G. M.; de Groot-van Breugel, E. N.; Kiekebosch, I.; Meijers, L. T. C.; Nomden, C. N.; Sikkes, G. G.; Doornaert, P. A. H.; Eppinga, W. S. C.; Kasperts, N.; Kerkmeijer, L. G. W.; Tersteeg, J. H. A.; Brown, K. J.; Pais, B.; Woodhead, P.; Lagendijk, J. J. W.

    2017-12-01

    The integration of 1.5 T MRI functionality with a radiotherapy linear accelerator (linac) has been pursued since 1999 by the UMC Utrecht in close collaboration with Elekta and Philips. The idea behind this integrated device is to offer unrivalled, online and real-time, soft-tissue visualization of the tumour and the surroundings for more precise radiation delivery. The proof of concept of this device was given in 2009 by demonstrating simultaneous irradiation and MR imaging on phantoms, since then the device has been further developed and commercialized by Elekta. The aim of this work is to demonstrate the clinical feasibility of online, high-precision, high-field MRI guidance of radiotherapy using the first clinical prototype MRI-Linac. Four patients with lumbar spine bone metastases were treated with a 3 or 5 beam step-and-shoot IMRT plan. The IMRT plan was created while the patient was on the treatment table and based on the online 1.5 T MR images; pre-treatment CT was deformably registered to the online MRI to obtain Hounsfield values. Bone metastases were chosen as the first site as these tumors can be clearly visualized on MRI and the surrounding spine bone can be detected on the integrated portal imager. This way the portal images served as an independent verification of the MRI based guidance to quantify the geometric precision of radiation delivery. Dosimetric accuracy was assessed post-treatment from phantom measurements with an ionization chamber and film. Absolute doses were found to be highly accurate, with deviations ranging from 0.0% to 1.7% in the isocenter. The geometrical, MRI based targeting as confirmed using portal images was better than 0.5 mm, ranging from 0.2 mm to 0.4 mm. In conclusion, high precision, high-field, 1.5 T MRI guided radiotherapy is clinically feasible.

  9. Lateral Concepts

    DEFF Research Database (Denmark)

    Gad, Christopher; Bruun Jensen, casper

    2016-01-01

    This essay discusses the complex relation between the knowledges and practices of the researcher and his/her informants in terms of lateral concepts. The starting point is that it is not the prerogative of the (STS) scholar to conceptualize the world; all our “informants” do it too. This creates...... the possibility of enriching our own conceptual repertoires by letting them be inflected by the concepts of those we study. In a broad sense, the lateral means that there is a many-to-many relation between domains of knowledge and practice. However, each specific case of the lateral is necessarily immanent...... to a particular empirical setting and form of inquiry. In this sense lateral concepts are radically empirical since it locates concepts within the field. To clarify the meaning and stakes of lateral concepts, we first make a contrast between lateral anthropology and Latour’s notion of infra-reflexivity. We end...

  10. Concept theory

    DEFF Research Database (Denmark)

    Hjørland, Birger

    2009-01-01

      Concept theory is an extremely broad, interdisciplinary and complex field of research related to many deep fields with very long historical traditions without much consensus. However, information science and knowledge organization cannot avoid relating to theories of concepts. Knowledge...... organizing systems (e.g. classification systems, thesauri and ontologies) should be understood as systems basically organizing concepts and their semantic relations. The same is the case with information retrieval systems. Different theories of concepts have different implications for how to construe......, evaluate and use such systems. Based on "a post-Kuhnian view" of paradigms this paper put forward arguments that the best understanding and classification of theories of concepts is to view and classify them in accordance with epistemological theories (empiricism, rationalism, historicism and pragmatism...

  11. Treatment Concepts of Osteogenesis Imperfecta

    Directory of Open Access Journals (Sweden)

    Ramji Lal Sahu

    2012-06-01

    Full Text Available Background: To explore the Application of the intramedullary nails for correction of deformity in the lower limbs and decrease the opportunity of refractures in children with osteogenesis imperfecta.Materials and Methods: From July 2005 to July 2009, 11 patients (5 males and 6 females, were recruited from Emergency and outpatient department having deformities of osteogenesis imperfecta in lower limbs. With 3 femurs and 5 tibias with deformity in lower limps were corrected by multiosteotomy and fixed with intramedullary interlocking nails, 6 (3 femurs and 3 tibias for Rush nails; 6 (2 femurs and 4 tibias for Ender nails; and 12 (6 femurs and 6 tibias for flexible intramedullary nails. All patients were operated under general or spinal anesthesia. Results: All deformities were perfectly corrected. All patients were available at final follow up, for 9 months to 36 months, mean 18 months. 2 patients had delayed union, 2 had superficial infection in the incision or pin tract, and 1 had refractures postoperatively. The results were excellent in 72.727% and good in 27.272% patients. Conclusion: Multiosteotomy and fixed intramedullary nails can correct the deformity in the lower limbs perfectly and decrease the opportunity of refractures in children with osteogenesis imperfecta, which has been proved to be a reliable method.

  12. A randomized, double-blind, placebo-controlled, proof-of-concept trial of creatine monohydrate as adjunctive treatment for bipolar depression.

    Science.gov (United States)

    Toniolo, Ricardo Alexandre; Silva, Michelle; Fernandes, Francy de Brito Ferreira; Amaral, José Antonio de Mello Siqueira; Dias, Rodrigo da Silva; Lafer, Beny

    2018-02-01

    Depressive episodes are a major cause of morbidity and dysfunction in individuals suffering from bipolar disorder. Currently available treatments for this condition have limited efficacy and new therapeutic options are needed. Extensive research in the pathophysiology of bipolar disorder points to the existence of mitochondrial and bioenergetic dysfunction. We hypothesized that creatine monohydrate, a nutraceutical that works as a mitochondrial modulator, would be effective as an adjunctive therapy for bipolar depression. We conducted a double-blind trial in which 35 patients with bipolar disorder type I or II in a depressive episode by DSM-IV criteria and in use of regular medication for the treatment of this phase of the disease were randomly allocated into two adjunctive treatment groups for 6 weeks: creatine monohydrate 6 g daily (N = 17) or placebo (N = 18). Primary efficacy was assessed by the change in the Montgomery-Åsberg Depression Rating Scale (MADRS). We did not find a statistically significant difference in the comparison between groups for the change in score on the MADRS after 6 weeks in an intention-to-treat (ITT) analysis (p = 0.560; Cohen's d = 0.231). However, we found significant superiority of creatine add-on vs. placebo when we considered the remission criterion of a MADRS score ≤ 12 at week 6 analyzing the outcome of the 35 randomized patients on ITT (52.9% remission in the creatine group vs. 11.1% remission in the placebo group) and of the 23 completers (66.7% remission in the creatine group vs. 18.2% remission in the placebo group) (p = 0.012; OR = 9.0 and p = 0.036; OR = 9.0, respectively). Two patients who received creatine switched to hypomania/mania early in the trial. No clinically relevant physical side-effects were reported or observed. This proof-of-concept study, aiming to restore brain bioenergetics using an adjunctive mitochondrial modulator, is not conclusive on the efficacy of creatine add-on for bipolar

  13. Travelling Concepts

    DEFF Research Database (Denmark)

    Simonsen, Karen-Margrethe

    2013-01-01

    Review of "Travelling Concepts, Metaphors, and Narratives: Literary and Cultural Studies in an Age of Interdisciplinary Research" ed. by Sibylle Baumgarten, Beatrice Michaelis and Ansagar Nünning, Trier; Wissenschaftlicher Verlag Trier, 2012......Review of "Travelling Concepts, Metaphors, and Narratives: Literary and Cultural Studies in an Age of Interdisciplinary Research" ed. by Sibylle Baumgarten, Beatrice Michaelis and Ansagar Nünning, Trier; Wissenschaftlicher Verlag Trier, 2012...

  14. The QWERTY/EE concept, Quantifying Recyclability and Eco-Efficiency for End-of-Life Treatment of Consumer Electronic Products

    NARCIS (Netherlands)

    Huisman, J.

    2003-01-01

    The QWERTY/EE concept addresses recyclability and eco-efficiency of take-back and recycling of consumer electronic products, a topic currently receiving large international attention. Through the environmental part of the concept an alternative for usual weight based recycling percentages is

  15. Conservative treatment of idiopathic scoliosis according to FITS concept: presentation of the method and preliminary, short term radiological and clinical results based on SOSORT and SRS criteria

    Science.gov (United States)

    2011-01-01

    Background Conservative scoliosis therapy according to the FITS Concept is applied as a unique treatment or in combination with corrective bracing. The aim of the study was to present author's method of diagnosis and therapy for idiopathic scoliosis FITS-Functional Individual Therapy of Scoliosis and to analyze the early results of FITS therapy in a series of consecutive patients. Methods The analysis comprised separately: (1) single structural thoracic, thoracolumbar or lumbar curves and (2) double structural scoliosis-thoracic and thoracolumbar or lumbar curves. The Cobb angle and Risser sign were analyzed at the initial stage and at the 2.8-year follow-up. The percentage of patients improved (defined as decrease of Cobb angle of more than 5 degrees), stable (+/- 5 degrees), and progressed (increase of Cobb angle of more than 5 degrees) was calculated. The clinical assessment comprised: the Angle of Trunk Rotation (ATR) initial and follow-up value, the plumb line imbalance, the scapulae level and the distance from the apical spinous process of the primary curve to the plumb line. Results In the Group A: (1) in single structural scoliosis 50,0% of patients improved, 46,2% were stable and 3,8% progressed, while (2) in double scoliosis 50,0% of patients improved, 30,8% were stable and 19,2% progressed. In the Group B: (1) in single scoliosis 20,0% of patients improved, 80,0% were stable, no patient progressed, while (2) in double scoliosis 28,1% of patients improved, 46,9% were stable and 25,0% progressed. Conclusion Best results were obtained in 10-25 degrees scoliosis which is a good indication to start therapy before more structural changes within the spine establish. PMID:22122964

  16. Fasinumab (REGN475, an antinerve growth factor monoclonal antibody, for the treatment of acute sciatic pain: results of a proof-of-concept study

    Directory of Open Access Journals (Sweden)

    Tiseo PJ

    2014-08-01

    Full Text Available Paul J Tiseo,1 Haobo Ren,2 Scott Mellis3 1Pharmacovigilance Operations and Risk Management, Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA; 2Biostatitics, Regeneron Pharmaceuticals, Inc., Basking Ridge, NJ, USA; 3Translational Medicine and Predictive Medicine, Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA Objective: To evaluate the efficacy and safety of subcutaneously administered fasinumab (REGN475, a nerve growth factor-neutralizing antibody, in patients with acute sciatic pain receiving standard of care therapy. Methods: This was a double-blind, parallel-group, proof-of-concept study. Patients with unilateral, moderate-to-severe sciatic pain of 2–16 weeks' duration were randomized to a subcutaneous dose of placebo (n=51, fasinumab 0.1 mg/kg (n=53, or 0.3 mg/kg (n=53; follow-up was 12 weeks. Pain was assessed in a daily diary using a numerical rating scale (NRS (0= no pain, 10= worst pain for average and worst leg and back pain. The primary efficacy end point was the area under the curve of NRS scores for average leg pain from baseline to week 4. Key secondary end points included changes in average and worst leg and back pain from baseline to the end of week 4 and to each weekly study visit. Patient functioning (Oswestry Disability Index and concomitant analgesic use were also assessed. Safety and tolerability were evaluated by treatment-emergent adverse events (TEAEs. Results: Demographic and clinical characteristics were similar among the treatment groups; 141 (88.7% patients completed the study. For the primary end point, mean ± standard deviation area under the curve values from baseline to week 4 were not significantly different between placebo (96.8±6.0 and fasinumab 0.1 mg/kg (112.7±58.3; P=0.0610 or fasinumab 0.3 mg/kg (112.4±55.8; P=0.0923. All secondary efficacy end points of changes in pain and function demonstrated responses that were similar between placebo and fasinumab groups. Incidence of TEAEs was 45.1%, 50

  17. Basic conceptions

    International Nuclear Information System (INIS)

    Khasanov, A.Kh.

    1988-01-01

    In this part of book author presents the basic conceptions of minerals studying. The course of minerals deposits is the most important branch of geology science and studying the geology, material constitution, formation conditions and regularity of distribution in earth crust different types of mineral raw materials

  18. Simple Concepts

    Czech Academy of Sciences Publication Activity Database

    Materna, Pavel

    2013-01-01

    Roč. 28, č. 3 (2013), s. 295-319 ISSN 0353-5150 R&D Projects: GA ČR(CZ) GAP401/10/0792 Institutional support: RVO:67985955 Keywords : concept * constructions * set-theoretical paradigm Subject RIV: AA - Philosophy ; Religion

  19. The Genealogy of Epistemic Virtue Concepts | Thomas ...

    African Journals Online (AJOL)

    This paper examines the treatment of thick ethical concepts in Williams's work in order to evaluate the consistency of his treatment of ethical and epistemic concepts and to assess whether the idea of a thick concept can be extended from ethics to epistemology. A virtue epistemology is described modeled on a cognitivist ...

  20. The Amster concept

    International Nuclear Information System (INIS)

    Vergnes, J.; Garzenne, C.; Lecarpentier, D.; Mouney, H.; Ritter, G.; Valade, M.; Nuttin, A.; Heuer, D.; Meplan, O.; Loiseaux, J.M.

    2001-01-01

    AMSTER is a concept for a graphite-moderated molten salt reactor, in which the salt treatment installation has been redesigned in order to reduce waste production. Using this concept, one can define a large number of configurations according to the products loaded and recycled. This document presents a configuration which self-consumes transuranium elements and generates fissile material with a mixed thorium and uranium support. This gives a reactor, which is highly economical in uranium and thorium consumption, leaving only a few grams of transuranium elements per billion kWhe in the ultimate wastes to be disposed of. (author)

  1. Astrophysical Concepts

    CERN Document Server

    Harwit, Martin

    2006-01-01

    This classic text, aimed at senior undergraduates and beginning graduate students in physics and astronomy, presents a wide range of astrophysical concepts in sufficient depth to give the reader a quantitative understanding of the subject. Emphasizing physical concepts, the book outlines cosmic events but does not portray them in detail: it provides a series of astrophysical sketches. For this fourth edition, nearly every part of the text has been reconsidered and rewritten, new sections have been added to cover recent developments, and others have been extensively revised and brought up to date. The book begins with an outline of the scope of modern astrophysics and enumerates some of the outstanding problems faced in the field today. The basic physics needed to tackle these questions are developed in the next few chapters using specific astronomical processes as examples. The second half of the book enlarges on these topics and shows how we can obtain quantitative insight into the structure and evolution of...

  2. Reduction of the HIV-1 reservoir in resting CD4+ T-lymphocytes by high dosage intravenous immunoglobulin treatment: a proof-of-concept study

    Directory of Open Access Journals (Sweden)

    Karlsson Annika C

    2009-07-01

    Full Text Available Abstract Background The latency of HIV-1 in resting CD4+ T-lymphocytes constitutes a major obstacle for the eradication of virus in patients on antiretroviral therapy (ART. As yet, no approach to reduce this viral reservoir has proven effective. Methods Nine subjects on effective ART were included in the study and treated with high dosage intravenous immunoglobulin (IVIG for five consecutive days. Seven of those had detectable levels of replication-competent virus in the latent reservoir and were thus possible to evaluate. Highly purified resting memory CD4+ T-cells were activated and cells containing replication-competent HIV-1 were quantified. HIV-1 from plasma and activated memory CD4+ T-cells were compared with single genome sequencing (SGS of the gag region. T-lymphocyte activation markers and serum interleukins were measured. Results The latent HIV-1 pool decreased with in median 68% after IVIG was added to effective ART. The reservoir decreased in five, whereas no decrease was found in two subjects with detectable virus. Plasma HIV-1 RNA ≥ 2 copies/mL was detected in five of seven subjects at baseline, but in only one at follow-up after 8–12 weeks. The decrease of the latent HIV-1 pool and the residual plasma viremia was preceded by a transitory low-level increase in plasma HIV-1 RNA and serum interleukin 7 (IL-7 levels, and followed by an expansion of T regulatory cells. The magnitude of the viral increase in plasma correlated to the size of the latent HIV-1 pool and SGS of the gag region showed that viral clones from plasma clustered together with virus from activated memory T-cells, pointing to the latent reservoir as the source of HIV-1 RNA in plasma. Conclusion The findings from this uncontrolled proof-of-concept study suggest that the reservoir became accessible by IVIG treatment through activation of HIV-1 gene expression in latently-infected resting CD4+ T-cells. We propose that IVIG should be further evaluated as an adjuvant

  3. Targeted polyethylene glycol gold nanoparticles for the treatment of pancreatic cancer: from synthesis to proof-of-concept in vitro studies

    Directory of Open Access Journals (Sweden)

    Spadavecchia J

    2016-02-01

    Full Text Available Jolanda Spadavecchia,1,2,* Dania Movia,3,* Caroline Moore,3,4 Ciaran Manus Maguire,3,4 Hanane Moustaoui,2 Sandra Casale,1 Yuri Volkov,3,4 Adriele Prina-Mello3,4 1Laboratoire de Réactivité de Surface, Sorbonne Universités, UPMC Univ Paris VI, Paris, 2Centre National de la recherche française, UMR 7244, CSPBAT, Laboratory of Chemistry, Structures, and Properties of Biomaterials and Therapeutic Agents, Université Paris 13, Sorbonne Paris Cité, Bobigny, France; 3AMBER Centre, CRANN Institute, 4Department of Clinical Medicine, School of Medicine, Trinity College, Dublin, Ireland *These authors contributed equally to this work Abstract: The main objective of this study was to optimize and characterize a drug delivery carrier for doxorubicin, intended to be intravenously administered, capable of improving the therapeutic index of the chemotherapeutic agent itself, and aimed at the treatment of pancreatic cancer. In light of this goal, we report a robust one-step method for the synthesis of dicarboxylic acid-terminated polyethylene glycol (PEG-gold nanoparticles (AuNPs and doxorubicin-loaded PEG-AuNPs, and their further antibody targeting (anti-Kv11.1 polyclonal antibody [pAb]. In in vitro proof-of-concept studies, we evaluated the influence of the nanocarrier and of the active targeting functionality on the anti-tumor efficacy of doxorubicin, with respect to its half-maximal effective concentration (EC50 and drug-triggered changes in the cell cycle. Our results demonstrated that the therapeutic efficacy of doxorubicin was positively influenced not only by the active targeting exploited through anti-Kv11.1-pAb but also by the drug coupling with a nanometer-sized delivery system, which indeed resulted in a 30-fold decrease of doxorubicin EC50, cell cycle blockage, and drug localization in the cell nuclei. The cell internalization pathway was strongly influenced by the active targeting of the Kv11.1 subunit of the human Ether-à-go-go related gene

  4. Accident or maltreatment? Radiographic X-ray patterns in non-accidental trauma. The concept of sentinel injuries; Unfall oder Misshandlung? Radiologische Befunde beim nichtakzidentiellen Trauma. Das Konzept der ''sentinel injuries''

    Energy Technology Data Exchange (ETDEWEB)

    Hirsch, F.W.; Sorge, I.; Roth, C. [Uniklinikum Leipzig AoeR, Abteilung fuer Kinderradiologie, Leipzig (Germany); Gosemann, J.H. [Universitaetsklinikum Leipzig, Uniklinikum Leipzig AoeR, Klinik und Poliklinik fuer Kinderchirurgie, Leipzig (Germany)

    2016-05-15

    The focus of this review article is on child abuse and the radiographic pattern of X-ray findings. The radiologist should be able to recognize typical injuries resulting from child abuse. In some cases the findings are highly specific for abuse and these include metaphyseal corner fractures of the long bones in children aged up to 24 months. In other cases the fractures are not specific but highly indicative of child abuse: rib fractures, for example can be associated with child abuse in more than 50 % of the cases; however, maltreatment is difficult to diagnose without taking the entire pattern of skeletal findings into consideration so that a radiological screening of the entire skeleton is often necessary. The concept of sentinel injuries might be helpful for deciding in which cases a complete skeletal screening should be performed. In the age group up to 24 months old a complete skeletal status (with some exceptions) is recommended if one of the three sentinel injuries of rib fractures, intracranial bleeding and abdominal trauma is present. (orig.) [German] Die Kindesmisshandlung und ihre radiologischen Befundmuster sind Gegenstand dieser Uebersicht. Der Radiologe sollte in der Lage sein, typische Verletzungen als Misshandlungsfolge zu erkennen. In Einzelfaellen ist der Befund hochspezifisch fuer eine Misshandlung. Hierzu zaehlen z. B. metaphysaere Kantenabsprengungen an den langen Roehrenknochen bei bis 24 Monate alten Kindern. In anderen Faellen sind die Frakturen nicht spezifisch, aber hochsensitiv fuer das Vorliegen einer Misshandlung, z. B. bei Rippenfrakturen, die in ueber 50 % der Faelle mit einer Misshandlung assoziiert sein koennen. Die Misshandlung kann allerdings oft nur aus der Zusammenschau der unterschiedlichen Befunde, also nach Beurteilung des gesamten Skelettstatus, diagnostiziert werden. Fuer die Entscheidung, in welchen Faellen ein kompletter Skelettstatus angefertigt werden sollte, stellt sich das Konzept der ''sentinel injuries

  5. Measurement and automatic control techniques at sewage treatment plants. Concepts, experience, trends.. Manuscripts and posters; Mess- und Regelungstechnik in abwassertechnischen Anlagen. Konzepte, Erfahrungen, Trends. Manuskripte und Poster-Praesentationen

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    1997-12-31

    This conference volume on measurement and automatic control techniques at sewage treatment plants deals with the following subjects: online analytics, measurement techniques and control techniques; use of model-assisted techniques; transparency and acceptance, plant management; process control concepts; optimization of operation. (SR) [Deutsch] Themen dieses Konferenzbandes ueber Mess- und Regelungstechnik in abwassertechnischen Anlagen sind: Online-Analytik, Mess- und Stelltechnik; Einsatz modellgestuetzter Verfahren; Transparenz und Akzeptanz, Betriebsmanagement; Leittechnische Konzepte; Betriebsoptimierung. (SR)

  6. Posttraumatic stress disorder, anxiety and depression following pregnancies conceived through fertility treatments : the effects of medically assisted conception on postpartum well-being

    NARCIS (Netherlands)

    Warmelink, J Catja; Stramrood, Claire A I; Paarlberg, K Marieke; Haisma, Hinke H; Vingerhoets, A J J M; Schultz, Willibrord C M Weijmar; van Pampus, Maria G

    2012-01-01

    OBJECTIVE: To compare the postpartum prevalence of Posttraumatic Stress Disorder (PTSD), anxiety and depression in women who conceived via medically assisted conception (MAC) and women who conceived naturally. STUDY DESIGN: All women (n = 907) who delivered under supervision of four independent

  7. A concept for planning and management of on-site and centralised municipal wastewater treatment systems, a case study in Bangkok, Thailand. I: pollutant discharge indicators and pollutant removal efficiency functions.

    Science.gov (United States)

    Tsuzuki, Yoshiaki; Koottatep, Thammarat; Sinsupan, Thitiphon; Jiawkok, Supattra; Wongburana, Chira; Wattanachira, Suraphong; Sarathai, Yuttachai

    2013-01-01

    The concept of pollution load indicators for planning and management of the mixture conditions of centralised and on-site wastewater treatment systems has not been discussed in detail so far. In this paper, pollutant discharge (load) indicators and pollutant removal efficiencies were quantitatively analysed to develop a part of a strategy for planning and management of municipal wastewater treatment systems (WWTSs) under the mixture conditions in Bangkok, Thailand, as a case study. Pollutant discharge indicators of on-site WWTSs were estimated based on the relevant literature. Three kinds of pollutant removal efficiency function at centralised wastewater treatment plants (CWWTPs) were empirically developed for biological oxygen demand, chemical oxygen demand, total nitrogen, total phosphorus, total coliforms and faecal coliforms based on the existing CWWTP management data. These results will be integrated into the scenario-based analysis in the second paper in the series. The results will be base datasets, and the concept and estimation methods can be applied for wastewater treatment planning and management in other areas.

  8. Pattern of induced estrus and conception rate following Ovsynch and Ovsynch based gonadotropin-releasing hormone treatments initiated on day 6 of estrous cycle in repeat breeding crossbred cows

    Science.gov (United States)

    Ahmed, N.; Kathiresan, D.; Ahmed, F. A.; Lalrintluanga, K.; Mayengbam, P.; Gali, J. M.

    2016-01-01

    Aim: The aim was to evaluate the estrus response, incidence of accessory corpus luteum formation and fertility following different hormonal protocols in repeat breeding crossbred cows. Materials and Methods: This study was carried out on 24 repeat breeding crossbred cows allotted into four groups. Cows of Group I was not given any treatment, Group II was treated with gonadotropin-releasing hormone (GnRH) injection on day 6 post-estrus, Group III was treated with Ovsynch protocol, and Group IV was treated with Ovsynch based GnRH treatment. Estrus responses such as duration, onset, percentage, and intensity of estrus were recorded during the study. The incidence of accessory corpus luteum was recorded per rectally on day 7 after first and additional GnRH of Ovsynch treatment. The conception rate for all groups was calculated by the absence of estrus and on day 45 after artificial insemination (AI) per rectum. Serum samples were collected at AI and day 12 post-AI in Group I and II. Serum samples were also collected at GnRH, Prostaglandin F2α (PGF2α), timed AI (TAI) and day 12 post-TAI in Group III and IV. Results: Ovsynch and Ovsynch based GnRH treatments are resulted in 100.00% induction of estrus after the PGF2α injection. Onset of induced estrus after the PGF2α injection for Group III and IV was recorded as 48.750±0.713 and 51.472±1.989 h, respectively, and it was not significant. There was no significant difference in duration of estrus among the groups. The incidence of intermediate estrus intensity was found to be highest. All the cows showed the incidence of formation of accessory corpus luteum subsequent to GnRH treatment on day 6 of the estrous cycle in Group II, III, and IV. The conception rate was 0.00%, 16.67%, 50.00%, and 50.00% in Group I, II, III, and IV, respectively. Conclusion: Ovsynch and Ovsynch based GnRH treatments initiated on day 6 of estrous cycle capable of responding with a higher percentage of ovulation and formation of accessory

  9. Mathematical concepts

    CERN Document Server

    Jost, Jürgen

    2015-01-01

    The main intention of this book is to describe and develop the conceptual, structural and abstract thinking of mathematics. Specific mathematical structures are used to illustrate the conceptual approach; providing a deeper insight into mutual relationships and abstract common features. These ideas are carefully motivated, explained and illustrated by examples so that many of the more technical proofs can be omitted. The book can therefore be used: ·         simply as an overview of the panorama of mathematical structures and the relations between them, to be supplemented by more detailed texts whenever you want to acquire a working knowledge of some structure ·         by itself as a first introduction to abstract mathematics ·         together with existing textbooks, to put their results into a more general perspective ·         to gain a new and hopefully deeper perspective after having studied such textbooks Mathematical Concepts has a broader scope and is less detaile...

  10. Current Concepts

    Science.gov (United States)

    Kirsch, Jacob M.; Thomas, Jared; Bedi, Asheesh; Lawton, Jeffrey N.

    2016-01-01

    Background: Osteochondritis dissecans (OCD) of the capitellum is a painful condition, which often affects young throwing athletes. Our current understanding regarding the etiology, risks factors, diagnosis, and efficacy of the available treatment options has expanded over recent years, however remains suboptimal. Recent data on patient-reported outcomes following osteochondral autograft transplantation (OAT) for the treatment of large osteochondral lesions of the capitellum have been promising but limited. This review seeks to critically analyze and summarize the available literature on the etiology, diagnosis, and reported outcomes associated with OCD of the capitellum and the use of OAT for its treatment. Methods: A comprehensive literature search was conducted. Unique and customized search strategies were formulated in PubMed, Embase, Scopus, Web of Science, and CENTRAL. Combinations of keywords and controlled vocabulary terms were utilized in order to cast a broad net. Relevant clinical, biomechanical, anatomic and imaging studies were reviewed along with recent review articles, and case series. Results: Forty-three articles from our initial literature search were found to be relevant for this review. The majority of these articles were either review articles, clinical studies, anatomic or imaging studies or biomechanical studies. Conclusions: Current evidence suggests that OAT may lead to better and more consistent outcomes than previously described methods for treating large OCD lesions of the capitellum. PMID:28149204

  11. The science conceptions of chemical textbooks addressed to the high school, in treatment of chemical kinetics during the period from 1929 to 2004

    Directory of Open Access Journals (Sweden)

    Maria Eunice Ribeiro Marcondes

    2009-12-01

    Full Text Available This text is a part of the work that was developed based on the chemical kinetic theme and the target was how the scientific knowledge in this subject was used for high school textbooks, identifying the possible ideas about science related to these books. For that, based on the research developed by Níaz (1994 that used categories to represent the philosophical perspectives: the empirical/inductive and the rationalist, verifying which and how the concepts of science was inserted in the 20 Brazilians textbooks, edited in the period from 1929 to 2004.

  12. New concepts in treatment of gaseous emissions at solid wastes incinerators. Nuevos conceptos de depuracion de gases de incineradores de residuos solidos

    Energy Technology Data Exchange (ETDEWEB)

    Narvaez, I.; Corella, J.; Aznar, M.P.; Borque, J.A.

    1993-01-01

    New systems for treatment of gaseous emissions from solid wastes incinerators are described, with special emphasis on those developed in Spain. It consists of processes with two and three steps of exhaustive cleaning, catalytic and at high temperatures. (Author)

  13. Plastic Surgery in the Multimodal Treatment Concept of Soft Tissue Sarcoma: Influence of Radiation, Chemotherapy, and Isolated Limb Perfusion on Plastic Surgery Techniques

    OpenAIRE

    Kapalschinski, Nicolai; Goertz, Ole; Harati, Kamran; Kueckelhaus, Maximilian; Kolbenschlag, Jonas; Lehnhardt, Marcus; Hirsch, Tobias

    2015-01-01

    Surgical intervention is the mainstay treatment for soft tissue sarcomas. The significance of adjuvant and neoadjuvant therapies such as chemotherapy, radiation and isolated limb perfusion remains under controversial discussion. The goal of this review is to discuss the effects of the aforementioned treatment modalities and their timing of application on plastic surgery techniques. Furthermore, options of reconstruction in cases of complications caused by adjuvant and neoadjuvant therapies ar...

  14. A combined prosodic and linguistic treatment approach for language-communication skills in children with autism spectrum disorders: A proof-of-concept study

    Directory of Open Access Journals (Sweden)

    Silva Kuschke

    2016-07-01

    Full Text Available This study aimed to determine whether the use of prosodically varied speech within a traditional language therapy framework had any effect on the listening skills, pragmatic skills and social interaction behaviour of three children with autism spectrum disorder (ASD. A single participant multiple baseline design across behaviours was implemented. Three participants with ASD were selected for this research. The listening skills, pragmatic skills and social interaction behaviour of the participants were compared before treatment, after a 3-week period of treatment and after a 2-week withdrawal period from treatment, utilising prosodically varied speech within a traditional language therapy approach. Statistical significance was not calculated for each individual due to the limited data, but visual inspection indicated that all the participants showed positive behavioural changes in performance across all areas after 3 weeks of treatment, independent of their pre-treatment performance level. The use of prosodically varied speech within a traditional language therapy framework appears to be a viable form of treatment for children with ASD.

  15. Treatment

    Directory of Open Access Journals (Sweden)

    Safaa M. Raghab

    2013-08-01

    The main goal of this study is to utilize a natural low cost material “as an accelerator additive to enhance the chemical treatment process using Alum coagulant and the accelerator substances were Perlite and Bentonite. The performance of the chemical treatment was enhanced using the accelerator substances with 90 mg/l Alum as a constant dose. Perlite gave better performance than the Bentonite effluent. The removal ratio for conductivity, turbidity, BOD and COD for Perlite was 86.7%, 87.4%, 89.9% and 92.8% respectively, and for Bentonite was 83.5%, 85.0%, 86.5% and 85.0% respectively at the same concentration of 40 mg/l for each.

  16. Effects of sonication and ultraviolet-C treatment as a hurdle concept on quality attributes of Chokanan mango (Mangifera indica L.) juice.

    Science.gov (United States)

    Santhirasegaram, Vicknesha; Razali, Zuliana; Somasundram, Chandran

    2015-04-01

    The growing demand for fresh-like food products has encouraged the development of hurdle technology of non-thermal processing. In this study, freshly squeezed Chokanan mango juice was treated by paired combinations of sonication (for 15 and 30 min at 25 ℃, 40 kHz frequency) and UV-C treatment (for 15 and 30 min at 25 ℃). Selected physicochemical properties, antioxidant activities, microbial inactivation and other quality parameters of combined treated juice were compared to conventional thermal treatment (at 90 ℃ for 60 s). After thermal and combined treatment, no significant changes occurred in physicochemical properties. A significant increase in extractability of carotenoids (15%), polyphenols (37%), flavonoids (35%) and enhancement in antioxidant capacity was observed after combined treatment. Thermal and combined treatment exhibited significant reduction in microbial load. Results obtained support the use of sonication and UV-C in a hurdle technology to improve the quality of Chokanan mango juice along with safety standards. © The Author(s) 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  17. Advancing neurotrophic factors as treatments for age-related neurodegenerative diseases: developing and demonstrating "clinical proof-of-concept" for AAV-neurturin (CERE-120) in Parkinson's disease.

    Science.gov (United States)

    Bartus, Raymond T; Baumann, Tiffany L; Brown, Lamar; Kruegel, Brian R; Ostrove, Jeffrey M; Herzog, Christopher D

    2013-01-01

    Neurotrophic factors have long shown promise as potential therapies for age-related neurodegenerative diseases. However, 20 years of largely disappointing clinical results have underscored the difficulties involved with safely and effectively delivering these proteins to targeted sites within the central nervous system. Recent progress establishes that gene transfer can now likely overcome the delivery issues plaguing the translation of neurotrophic factors. This may be best exemplified by adeno-associated virus serotype-2-neurturin (CERE-120), a viral-vector construct designed to deliver the neurotrophic factor, neurturin to degenerating nigrostriatal neurons in Parkinson's disease. Eighty Parkinson's subjects have been dosed with CERE-120 (some 7+ years ago), with long-term, targeted neurturin expression confirmed and no serious safety issues identified. A double-blind, controlled Phase 2a trial established clinical "proof-of-concept" via 19 of the 24 prescribed efficacy end points favoring CERE-120 at the 12-month protocol-prescribed time point and all but one favoring CERE-120 at the 18-month secondary time point (p = 0.007 and 0.001, respectively). Moreover, clinically meaningful benefit was seen with CERE-120 on several specific protocol-prescribed, pairwise, blinded, motor, and quality-of-life end points at 12 months, and an even greater number of end points at 18 months. Because the trial failed to meet the primary end point (Unified Parkinson's Disease Rating Scale motor-off, measured at 12 months), a revised multicenter Phase 1/2b protocol was designed to enhance the neurotrophic effects of CERE-120, using insight gained from the Phase 2a trial. This review summarizes the development of CERE-120 from its inception through establishing "clinical proof-of-concept" and beyond. The translational obstacles and issues confronted, and the strategies applied, are reviewed. This information should be informative to investigators interested in translational

  18. Introducing the concept of a new pre-referral treatment for severely ill febrile children at community level: a sociological approach in Guinea-Bissau.

    Science.gov (United States)

    Vermeersch, Audrey; Libaud-Moal, Anaëlle; Rodrigues, Amabelia; White, Nicholas J; Olliaro, Piero; Gomes, Melba; Ashley, Elizabeth A; Millet, Pascal

    2014-02-06

    Innovative strategies are needed to tackle childhood mortality in the rural tropics. Artesunate suppositories were developed to bring emergency treatment closer to severely ill children with malaria in rural areas where injectable treatment is not possible for several hours. Adding an antibacterial rectal drug would extend this strategy to treat non-malarial febrile illness as well. The objective of these studies was to assess acceptability of such a new pre-referral strategy by healthcare providers and likely uptake by the population. Two qualitative studies were conducted between May and July 2009. Study 1 investigated the acceptability of introducing a combined antimalarial-antibacterial suppository by interviewing 27 representatives of the three administrative levels (central government, regional, local) of the health sector; Study 2 investigated treatment-seeking behaviour and acceptability of this intervention at community level by interviewing 74 mothers in 2 villages. Up to 92% of health representatives were in favour of introducing a new pre-referral strategy to tackle both malaria and non-malaria related severe illnesses in Guinea-Bissau, provided it was endorsed by international health authorities. The main obstacles to implementation were the very limited human and financial resources. In the two villages surveyed, 44% of the mothers associated severe illness with fever only, or fever plus one additional symptom. Mothers' judgement of severity and ensuing decisions were not specific for serious illness, indicating that initial training to recognize signs of severe disease and treatment availability for non-severe, fever-associated symptoms will be required to prevent overuse of a new intervention designed as a pre-referral treatment for severely ill children. Level C health centres were the first resort in both villages (50% and 87% of respondents respectively). This information is encouraging for the implementation of a pre-referral treatment.

  19. A Single-Arm, Proof-Of-Concept Trial of Lopimune (Lopinavir/Ritonavir as a Treatment for HPV-Related Pre-Invasive Cervical Disease.

    Directory of Open Access Journals (Sweden)

    Lynne Hampson

    Full Text Available Cervical cancer is the most common female malignancy in the developing nations and the third most common cancer in women globally. An effective, inexpensive and self-applied topical treatment would be an ideal solution for treatment of screen-detected, pre-invasive cervical disease in low resource settings.Between 01/03/2013 and 01/08/2013, women attending Kenyatta National Hospital's Family Planning and Gynaecology Outpatients clinics were tested for HIV, HPV (Cervista® and liquid based cervical cytology (LBC-ThinPrep®. HIV negative women diagnosed as high-risk HPV positive with high grade squamous intraepithelial lesions (HSIL were examined by colposcopy and given a 2 week course of 1 capsule of Lopimune (CIPLA twice daily, to be self-applied as a vaginal pessary. Colposcopy, HPV testing and LBC were repeated at 4 and 12 weeks post-start of treatment with a final punch biopsy at 3 months for histology. Primary outcome measures were acceptability of treatment with efficacy as a secondary consideration.A total of 23 women with HSIL were treated with Lopimune during which time no adverse reactions were reported. A maximum concentration of 10 ng/ml of lopinavir was detected in patient plasma 1 week after starting treatment. HPV was no longer detected in 12/23 (52.2%, 95%CI: 30.6-73.2%. Post-treatment cytology at 12 weeks on women with HSIL, showed 14/22 (63.6%, 95%CI: 40.6-82.8% had no dysplasia and 4/22 (18.2%, 95%CI: 9.9-65.1% were now low grade demonstrating a combined positive response in 81.8% of women of which 77.8% was confirmed by histology. These data are supported by colposcopic images, which show regression of cervical lesions.These results demonstrate the potential of Lopimune as a self-applied therapy for HPV infection and related cervical lesions. Since there were no serious adverse events or detectable post-treatment morbidity, this study indicates that further trials are clearly justified to define optimal regimes and the overall

  20. A Single-Arm, Proof-Of-Concept Trial of Lopimune (Lopinavir/Ritonavir) as a Treatment for HPV-Related Pre-Invasive Cervical Disease.

    Science.gov (United States)

    Hampson, Lynne; Maranga, Innocent O; Masinde, Millicent S; Oliver, Anthony W; Batman, Gavin; He, Xiaotong; Desai, Minaxi; Okemwa, Parmenas M; Stringfellow, Helen; Martin-Hirsch, Pierre; Mwaniki, Alex M; Gichangi, Peter; Hampson, Ian N

    2016-01-01

    Cervical cancer is the most common female malignancy in the developing nations and the third most common cancer in women globally. An effective, inexpensive and self-applied topical treatment would be an ideal solution for treatment of screen-detected, pre-invasive cervical disease in low resource settings. Between 01/03/2013 and 01/08/2013, women attending Kenyatta National Hospital's Family Planning and Gynaecology Outpatients clinics were tested for HIV, HPV (Cervista®) and liquid based cervical cytology (LBC-ThinPrep®). HIV negative women diagnosed as high-risk HPV positive with high grade squamous intraepithelial lesions (HSIL) were examined by colposcopy and given a 2 week course of 1 capsule of Lopimune (CIPLA) twice daily, to be self-applied as a vaginal pessary. Colposcopy, HPV testing and LBC were repeated at 4 and 12 weeks post-start of treatment with a final punch biopsy at 3 months for histology. Primary outcome measures were acceptability of treatment with efficacy as a secondary consideration. A total of 23 women with HSIL were treated with Lopimune during which time no adverse reactions were reported. A maximum concentration of 10 ng/ml of lopinavir was detected in patient plasma 1 week after starting treatment. HPV was no longer detected in 12/23 (52.2%, 95%CI: 30.6-73.2%). Post-treatment cytology at 12 weeks on women with HSIL, showed 14/22 (63.6%, 95%CI: 40.6-82.8%) had no dysplasia and 4/22 (18.2%, 95%CI: 9.9-65.1%) were now low grade demonstrating a combined positive response in 81.8% of women of which 77.8% was confirmed by histology. These data are supported by colposcopic images, which show regression of cervical lesions. These results demonstrate the potential of Lopimune as a self-applied therapy for HPV infection and related cervical lesions. Since there were no serious adverse events or detectable post-treatment morbidity, this study indicates that further trials are clearly justified to define optimal regimes and the overall benefit

  1. Resistance mutations and CTL epitopes in archived HIV-1 DNA of patients on antiviral treatment: toward a new concept of vaccine.

    Directory of Open Access Journals (Sweden)

    Jennifer Papuchon

    Full Text Available Eleven patients responding successfully to first-line antiretroviral therapy (ART were investigated for proviral drug resistance mutations (DRMs in RT by ultra-deep pyrosequencing (UDPS. After molecular typing of the class I alleles A and B, the CTL epitopes in the Gag, Nef and Pol regions of the provirus were sequenced and compared to the reference HXB2 HIV-1 epitopes. They were then matched with the HLA alleles with determination of theoretical affinity (TA. For 3 patients, the results could be compared with an RNA sample of the circulating virus at initiation of therapy. Five out of 11 patients exhibited DRMs by UDPS. The issue is whether a therapeutic switch is relevant in these patients by taking into account the identity of the archived resistance mutations. When the archived CTL epitopes were determined on the basis of the HLA alleles, different patterns were observed. Some epitopes were identical to those reported for the reference with the same TA, while others were mutated with a decrease in TA. In 2 cases, an epitope was observed as a combination of subpopulations at entry and was retrieved as a single population with lower TA at success. With regard to immunological stimulation and given the variability of the archived CTL epitopes, we propose a new concept of curative vaccine based on identification of HIV-1 CTL epitopes after prior sequencing of proviral DNA and matching with HLA class I alleles.

  2. Biodegradable polymer Biolimus-eluting stent (Nobori® for the treatment of coronary artery lesions: review of concept and clinical results

    Directory of Open Access Journals (Sweden)

    Schurtz G

    2014-02-01

    Full Text Available Guillaume Schurtz,1,2 Cédric Delhaye,1 Christopher Hurt,1,2 Henri Thieuleux,1,2 Gilles Lemesle1–3 1Centre Hémodynamique et Unité des Soins Intensifs de Cardiologie, Hôpital Cardiologique, Centre Hospitalier Régional et Universitaire de Lille, Lille, France; 2Faculté de Médecine de Lille, Lille, France; 3Unité INSERM UMR744, Institut Pasteur de Lille, Lille, France Abstract: First-generation drug-eluting stents have raised concerns regarding the risk of late and very late stent thrombosis compared with bare metal stents and require prolonged dual antiplatelet therapy. Despite extensive investigations, the physiopathology of these late events remains incompletely understood. Aside from patient- and lesion-related risk factors, stent polymer has been cited as one of the potential causes. In fact, the persistence of durable polymer after complete drug release has been shown to be responsible for local hypersensitivity and inflammatory reactions. Third-generation drug-eluting stents with more biocompatible or biodegradable polymers have subsequently been developed to address this problem. In this article, we evaluate and discuss the concept and clinical results (safety and efficacy of a third-generation drug-eluting stent with biodegradable polymer: the Nobori® stent. Keywords: percutaneous coronary intervention, stent thrombosis, antiplatelet therapy

  3. Altruism or obligation? The motivations and experience of women who donate oocytes to known recipients in assisted conception treatment: an interpretative phenomenological analysis study.

    Science.gov (United States)

    Acharya, Santanu; Bryant, Louise; Twiddy, Maureen

    2017-03-01

    This qualitative study was conducted to explore the motivations and experience of oocyte donors donating to women known to them. Three women who donated oocytes to a close relative were interviewed and data were analysed using an Interpretative Phenomenological Analysis approach. The two key elements noted were "motivations for donation" and "coping with the consequences of oocyte donation". The motivation for donation was influenced by the familial bond that was strengthened by the donation process in some cases. The concept of altruistic oocyte donation stemmed from the narratives of giving the gift of motherhood and gaining a positive self-image and respect from others. Coping with the consequences of oocyte donation tests the donor identity, their wishes for a positive outcome, concerns regarding disclosure of biological motherhood and detachment from the egg and potential child. Motivation is influenced by a combination of factors including the rewards of altruistic behaviour, the existence and potential strengthening of the relationship between donor and recipient, but possibly also, a sense of obligation and societal expectations. Oocyte donation can be variously viewed by donors as a unique way of reproductive empowerment or an example of acceding to subtle coercion and thus disempowerment. The study also highlights the clinical as well as ethical importance of providing support services for oocyte donors and recipients.

  4. A new concept for the non-invasive treatment of Adolescent Idiopathic Scoliosis: the Corrective Movement principle integrated in the SpineCor System.

    Science.gov (United States)

    Coillard, Christine; Circo, Alin; Rivard, Charles H

    2008-05-01

    To evaluate the change in spinal curvature and posture of Idiopathic Scoliosis patients when a curve specific 'Corrective Movement Principle' (CMP) is applied. This prospective interventional study was carried out on a group of 639 patients (92.3% females) having idiopathic scoliosis treated with the SpineCor brace. All girls were premenarchal or less than 1 year postmenarchal. Assessment of brace effectiveness followed the SRS outcome criteria for bracing. The clinical, radiological and postural evaluations assisted to define the patient classification, which guided the unique application of the CMP to each type of curvature. A total of 583 patients met the outcome criteria. Overall, 349 patients have a definitive outcome. Successful treatment was achieved in 259 (74.2%) of the 349 patients from the fitting to the weaning of the brace. Some 51 immature patients (14.6%) required surgical fusion while receiving treatment. Eight mature patients out of 298 (2.7%) required surgery within 2 years of follow-up beyond skeletal maturity. The SpineCor brace is effective for the treatment of adolescent idiopathic scoliosis. Moreover, positive outcomes are maintained after 2 years because 151 (93.2%) of 162 patients stabilized or corrected their end of bracing Cobb angle up to 2 years after bracing.

  5. Valorization of lignin and cellulose in acid-steam-exploded corn stover by a moderate alkaline ethanol post-treatment based on an integrated biorefinery concept.

    Science.gov (United States)

    Yang, Sheng; Zhang, Yue; Yue, Wen; Wang, Wei; Wang, Yun-Yan; Yuan, Tong-Qi; Sun, Run-Cang

    2016-01-01

    Due to the unsustainable consumption of fossil resources, great efforts have been made to convert lignocellulose into bioethanol and commodity organic compounds through biological methods. The conversion of cellulose is impeded by the compactness of plant cell wall matrix and crystalline structure of the native cellulose. Therefore, appropriate pretreatment and even post-treatment are indispensable to overcome this problem. Additionally, an adequate utilization of coproduct lignin will be important for improving the economic viability of modern biorefinery industries. The effectiveness of moderate alkaline ethanol post-treatment on the bioconversion efficiency of cellulose in the acid-steam-exploded corn stover was investigated in this study. Results showed that an increase of the alcoholic sodium hydroxide (NaOH) concentration from 0.05 to 4% led to a decrease in the lignin content in the post-treated samples from 32.8 to 10.7%, while the cellulose digestibility consequently increased. The cellulose conversion of the 4% alcoholic NaOH integrally treated corn stover reached up to 99.3% after 72 h, which was significantly higher than that of the acid steam exploded corn stover without post-treatment (57.3%). In addition to the decrease in lignin content, an expansion of cellulose I lattice induced by the 4% alcoholic NaOH post-treatment played a significant role in promoting the enzymatic hydrolysis of corn stover. More importantly, the lignin fraction (AL) released during the 4% alcoholic NaOH post-treatment and the lignin-rich residue (EHR) remained after the enzymatic hydrolysis of the 4% alcoholic NaOH post-treated acid-steam-exploded corn stover were employed to synthesize lignin-phenol-formaldehyde (LPF) resins. The plywoods prepared with the resins exhibit satisfactory performances. An alkaline ethanol system with an appropriate NaOH concentration could improve the removal of lignin and modification of the crystalline structure of cellulose in acid

  6. Predicting Treatment Response to Intra-arterial Therapies for Hepatocellular Carcinoma with the Use of Supervised Machine Learning-An Artificial Intelligence Concept.

    Science.gov (United States)

    Abajian, Aaron; Murali, Nikitha; Savic, Lynn Jeanette; Laage-Gaupp, Fabian Max; Nezami, Nariman; Duncan, James S; Schlachter, Todd; Lin, MingDe; Geschwind, Jean-François; Chapiro, Julius

    2018-03-14

    To use magnetic resonance (MR) imaging and clinical patient data to create an artificial intelligence (AI) framework for the prediction of therapeutic outcomes of transarterial chemoembolization by applying machine learning (ML) techniques. This study included 36 patients with hepatocellular carcinoma (HCC) treated with transarterial chemoembolization. The cohort (age 62 ± 8.9 years; 31 men; 13 white; 24 Eastern Cooperative Oncology Group performance status 0, 10 status 1, 2 status 2; 31 Child-Pugh stage A, 4 stage B, 1 stage C; 1 Barcelona Clinic Liver Cancer stage 0, 12 stage A, 10 stage B, 13 stage C; tumor size 5.2 ± 3.0 cm; number of tumors 2.6 ± 1.1; and 30 conventional transarterial chemoembolization, 6 with drug-eluting embolic agents). MR imaging was obtained before and 1 month after transarterial chemoembolization. Image-based tumor response to transarterial chemoembolization was assessed with the use of the 3D quantitative European Association for the Study of the Liver (qEASL) criterion. Clinical information, baseline imaging, and therapeutic features were used to train logistic regression (LR) and random forest (RF) models to predict patients as treatment responders or nonresponders under the qEASL response criterion. The performance of each model was validated using leave-one-out cross-validation. Both LR and RF models predicted transarterial chemoembolization treatment response with an overall accuracy of 78% (sensitivity 62.5%, specificity 82.1%, positive predictive value 50.0%, negative predictive value 88.5%). The strongest predictors of treatment response included a clinical variable (presence of cirrhosis) and an imaging variable (relative tumor signal intensity >27.0). Transarterial chemoembolization outcomes in patients with HCC may be predicted pre-procedurally by combining clinical patient data and baseline MR imaging with the use of AI and ML techniques. Copyright © 2018 SIR. Published by Elsevier Inc. All rights reserved.

  7. Plastic surgery in the multimodal treatment concept of soft tissue sarcoma: Influence of radiation, chemotherapy and isolated limb perfusion on plastic surgery techniques

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    Nicolai eKapalschinski

    2015-12-01

    Full Text Available Surgical intervention is the mainstay treatment for soft tissue sarcomas. The significance of adjuvant and neoadjuvant therapies such as chemotherapy, radiation and isolated limb perfusion remains under controversial discussion. The goal of this review is to discuss the effects of the aforementioned treatment modalities and their timing of application on plastic surgery techniques. Furthermore, options of reconstruction in cases of complications caused by adjuvant and neoadjuvant therapies are discussed. When compared with adjuvant radiation, neoadjuvant treatment can reduce negative side effects such as fibrosis and edema, because radioderma can be removed during the subsequent surgical procedure. Furthermore, there have not been any reports of negative effects of neoadjuvant radiation on microsurgical procedures. However, the dose of neoadjuvant radiation correlates with increased risks of impaired wound healing postoperatively. Thus, a patient-specific approach to decide whether radiation should be performed adjuvant or neoadjuvant is necessary. Pre-operative irradiation should be considered in cases where functional structures are exposed after tumor resection, in order to ensure the best possible functionality. Adjuvant radiation should be considered in all other cases because of its known superior wound healing. .As for chemotherapy, no negative influence of its use adjuvant or neoadjuvant to reconstructive procedures such as local or free flaps has been reported. Lastly, small sample size studies have not shown increased risks of microsurgical failure or wound complications after isolated limb perfusion. The findings of this review suggest that the chronological order of the discussed therapeutic approaches is not a decisive factor in the surgical outcome of reconstructive procedures for soft tissue sarcoma.

  8. Plastic Surgery in the Multimodal Treatment Concept of Soft Tissue Sarcoma: Influence of Radiation, Chemotherapy, and Isolated Limb Perfusion on Plastic Surgery Techniques.

    Science.gov (United States)

    Kapalschinski, Nicolai; Goertz, Ole; Harati, Kamran; Kueckelhaus, Maximilian; Kolbenschlag, Jonas; Lehnhardt, Marcus; Hirsch, Tobias

    2015-01-01

    Surgical intervention is the mainstay treatment for soft tissue sarcomas (STSs). The significance of adjuvant and neoadjuvant therapies, such as chemotherapy, radiation, and isolated limb perfusion, remains under controversial discussion. The goal of this review is to discuss the effects of the aforementioned treatment modalities and their timing of application in plastic surgery techniques. Furthermore, options of reconstruction in cases of complications caused by adjuvant and neoadjuvant therapies are discussed. When compared with adjuvant radiation, neoadjuvant treatment can reduce negative side effects such as fibrosis and edema because radioderma can be removed during the subsequent surgical procedure. Furthermore, there have not been any reports of negative effects of neoadjuvant radiation on microsurgical procedures. However, the dose of neoadjuvant radiation correlates with increased risks of impaired wound healing postoperatively. Thus, a patient-specific approach to decide whether radiation should be performed adjuvant or neoadjuvant is necessary. Preoperative irradiation should be considered in cases where functional structures are exposed after tumor resection, in order to ensure the best possible functionality. Adjuvant radiation should be considered in all other cases because of its known superior wound healing. As for chemotherapy, no negative influence of its use adjuvant or neoadjuvant to reconstructive procedures, such as local or free flaps, has been reported. Lastly, small sample size studies have not shown increased risks of microsurgical failure or wound complications after isolated limb perfusion. The findings of this review suggest that the chronological order of the discussed therapeutic approaches is not a decisive factor in the surgical outcome of reconstructive procedures for STS.

  9. Towards the development of a RNAi-based topical treatment for psoriasis: Proof-of-concept in a 3D psoriasis skin model.

    Science.gov (United States)

    Desmet, Eline; Van Gele, Mireille; Grine, Lynda; Remaut, Katrien; Lambert, Jo

    2017-08-20

    RNA interference has emerged as a powerful tool for therapeutic gene silencing, as it offers the possibility to silence virtually any known pathology-causing gene. However, in vivo delivery of RNAi molecules is hampered by their unfavourable physicochemical characteristics and susceptibility to degradation by endogenous enzymes. To overcome these limitations, we recently developed an elastic liposomal formulation, called DDC642, as topical delivery system of therapeutic RNAi molecules for skin disorders. In this study, we validated the therapeutic efficacy of DDC642-encapsulated RNAi molecules in the treatment of psoriasis using 3 different in vitro models: a standardized keratinocyte monolayer culture, psoriasis-induced keratinocytes and a psoriasis-reconstructed skin model. Four genes (IL22RA1, KRT17, DEFB4 and TSLP), known to be upregulated in psoriatic lesions, and thereby key players in psoriasis pathogenesis were selected. Moreover, the possibility of using a combined siRNA therapy in the topical treatment of psoriasis was explored. Results indicate a successful gene silencing of each different target, both at mRNA and protein levels. Additionally, siRNA-DDC642 treatment resulted in a reduced expression of specific psoriasis markers, indicating their potential in future therapeutic approach. The examined siRNA combination (ie simultaneous knockdown of KRT17, DEFB4 and TSLP) showed an enhanced reduction in TSLP expression, whereas the decrease in K17 protein expression was impaired in psoriatic keratinocytes. Although the here examined siRNA combination could still be further improved, our study proved already in vitro the clinical potential of targeting multiple genes at once, each playing a different role in a complex disease such as psoriasis. © 2017 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  10. Treating leishmaniasis in Amazonia: A review of ethnomedicinal concepts and pharmaco-chemical analysis of traditional treatments to inspire modern phytotherapies.

    Science.gov (United States)

    Odonne, Guillaume; Houël, Emeline; Bourdy, Geneviève; Stien, Didier

    2017-03-06

    Cutaneous and mucocutaneous leishmaniasis are neglected tropical diseases that occur in all intertropical regions of the world. Amazonian populations have developed an abundant knowledge of the disease and its remedies. Therefore, we undertook to review traditional antileishmanial plants in Amazonia and have developed new tools to analyze this somewhat dispersed information. A literature review of traditional remedies for cutaneous/mucocutaneous leishmaniasis in the Amazon was conducted and the data obtained was used to calculate distribution indexes designed to highlight the most relevant uses in Amazonia. The cultural distribution index represents the distribution rate of a given taxon among different cultural groups and was calculated as the ratio of the number of groups using the taxon to the total number of groups cited. The geographical distribution index allowed us to quantify spatial distribution of a taxon's uses in Amazonia and was calculated geometrically by measuring the average distance between the points where uses have been reported and the barycenter of those points. The general distribution index was defined as an arithmetic combination of the previous two and provides information on both cultural and spatial criteria. 475 use reports, concerning 291 botanical species belonging to 83 families have been gathered depicted from 29 sources. Uses concern 34 cultural groups. While the use of some taxa appears to be Pan-Amazonian, some others are clearly restricted to small geographical regions. Particular attention has been paid to the recipes and beliefs surrounding treatments. Topical application of the remedies dominated the other means of administration and this deserves particular attention as the main treatments against Neotropical leishmaniasis are painful systemic injections. The data set was analyzed using the previously defined distribution indexes and the most relevant taxa were further discussed from a phytochemical and pharmacological point

  11. Influences of melatonin treatment, melatonin receptor 1A (MTNR1A) and kisspeptin (KiSS-1) gene polymorphisms on first conception in Sarda ewe lambs.

    Science.gov (United States)

    Luridiana, S; Mura, M C; Daga, C; Cosso, G; Bodano, S; Farci, F; Zidda, F; Carcangiu, V

    2016-04-01

    In order to investigate if the melatonin receptor 1A (MTNR1A) and kisspeptin (KiSS-1) genes influence the reproductive response to melatonin treatment, 510 Sarda ewe lambs were divided into groups C (control) and M; Group M received one melatonin implant (18mg). After 35 days rams were introduced for 40 days and subsequent lambing dates and number of newborns were recorded. The MTNR1A gene Exon II and KiSS-1 gene Exon I were amplified and genotyped by restriction fragment length polymorphism (RFLP) and single-strand conformation polymorphism analysis. Two single nucleotide polymorphisms (SNPs; C606T and G612A) in MTNR1A and one (G1035A) in KiSS-1 were found. The most frequent genotypes were G/G (63%) and C/C (53%) for MTNR1A and G/G (92%) for KiSS-1. Treated animals showed a higher lambing rate (Pewe lambs and highlighted that the G/G genotype of the MTNR1A gene is able to influence the reproductive response to melatonin treatment.

  12. Conceptions of Parents, Conceptions of Self, and Conceptions of God.

    Science.gov (United States)

    Buri, John R.; Mueller, Rebecca A.

    Different theorists have suggested that an individual's view of God may be related to one's view of one's father, one's mother, or one's self. A study was conducted to examine the relationship of college students' conceptions of the wrathfulness-kindliness of God to their conceptions of their father's and mother's permissiveness, authoritarianism,…

  13. Intra-articular injection of mesenchymal stem cells for the treatment of osteoarthritis of the knee: a proof-of-concept clinical trial.

    Science.gov (United States)

    Jo, Chris Hyunchul; Lee, Young Gil; Shin, Won Hyoung; Kim, Hyang; Chai, Jee Won; Jeong, Eui Cheol; Kim, Ji Eun; Shim, Hackjoon; Shin, Ji Sun; Shin, Il Seob; Ra, Jeong Chan; Oh, Sohee; Yoon, Kang Sup

    2014-05-01

    Mesenchymal stem cells (MSCs) are known to have a potential for articular cartilage regeneration. However, most studies focused on focal cartilage defect through surgical implantation. For the treatment of generalized cartilage loss in osteoarthritis, an alternative delivery strategy would be more appropriate. The purpose of this study was to assess the safety and efficacy of intra-articular injection of autologous adipose tissue derived MSCs (AD-MSCs) for knee osteoarthritis. We enrolled 18 patients with osteoarthritis of the knee and injected AD MSCs into the knee. The phase I study consists of three dose-escalation cohorts; the low-dose (1.0 × 10(7) cells), mid-dose (5.0 × 10(7)), and high-dose (1.0 × 10(8)) group with three patients each. The phase II included nine patients receiving the high-dose. The primary outcomes were the safety and the Western Ontario and McMaster Universities Osteoarthritis index (WOMAC) at 6 months. Secondary outcomes included clinical, radiological, arthroscopic, and histological evaluations. There was no treatment-related adverse event. The WOMAC score improved at 6 months after injection in the high-dose group. The size of cartilage defect decreased while the volume of cartilage increased in the medial femoral and tibial condyles of the high-dose group. Arthroscopy showed that the size of cartilage defect decreased in the medial femoral and medial tibial condyles of the high-dose group. Histology demonstrated thick, hyaline-like cartilage regeneration. These results showed that intra-articular injection of 1.0 × 10(8) AD MSCs into the osteoarthritic knee improved function and pain of the knee joint without causing adverse events, and reduced cartilage defects by regeneration of hyaline-like articular cartilage. © 2014 AlphaMed Press.

  14. Precision Medicine in Assisted Conception: A Multicenter Observational Treatment Cohort Study of the Annexin A5 M2 Haplotype as a Biomarker for Antithrombotic Treatment to Improve Pregnancy Outcome

    Directory of Open Access Journals (Sweden)

    Simon Fishel

    2016-08-01

    Interpretation: Pragmatic ANXA5 M5 screening and treatment with LMWH in couples undergoing IVF is associated with similar outcome to couples with more favorable prognostic factors. The difference in live birth outcome for treated male only carrier couples may be consistent with an additional maternal thrombophilic factor that may adversely affect pregnancy, although other mechanisms are possible. This study suggests that LMWH treatment should be started prior to clinical pregnancy.

  15. Craving e dependência química: conceito, avaliação e tratamento Craving and chemical dependence: concept, evaluation and treatment

    Directory of Open Access Journals (Sweden)

    Renata Brasil Araujo

    2008-01-01

    Full Text Available O craving ou fissura, cuja definição mais comum é o desejo intenso por uma substância, é um conceito controverso entre os pesquisadores da área da dependência química. OBJETIVO: Realizar revisão teórica a respeito do craving nos bancos de dados PsycInfo, Medline, ProQuest e Science Direct. MÉTODO: As palavras-chave utilizadas foram craving, dependence e drug e o período pesquisado foi entre 1995 e 2007. RESULTADOS: Os resultados demonstraram que são encontrados diversos significados para o craving, alguns se restringindo a desejo, e outros, considerando-o não só como desejo, mas como antecipação do resultado positivo do uso da substância, alívio dos sintomas de abstinência ou afeto negativo e intenção de fumar, o que reflete uma visão multidimensional deste construto. A etiologia do craving pode ser explicada por intermédio dos modelos: comportamental, cognitivo ou psicossocial e neurobiológico, porquanto a opção por um destes influencia a avaliação e o manejo. CONCLUSÃO: Conclui-se quanto à multidimensionalidade do craving e quanto à necessidade de que seja utilizado um modelo biopsicossocial que integre os diversos modelos no tratamento de dependentes químicos. Destaca-se a importância da realização de mais estudos para a compreensão do craving em função deste ser um dos principais riscos de recaída.Craving is usually defined as an intense desire for a substance. This is a rather controversial concept among the researchers on the chemical dependence area. OBJECTIVE: The objective of this study was to carry out a theoretical review concerning craving at PsycInfo, Medline, ProQuest, Portal Capes and Science Direct Data Bases. METHODS: The keywords used were craving, dependence and drug, and the searching period was between 1995 and 2007. RESULTS: The results showed that many different meanings can be found for craving, some relate it only to desire, while others consider it not only as desire, but also as

  16. A novel computer system for the evaluation of nasolabial morphology, symmetry and aesthetics after cleft lip and palate treatment. Part 1: General concept and validation.

    Science.gov (United States)

    Pietruski, Piotr; Majak, Marcin; Debski, Tomasz; Antoszewski, Boguslaw

    2017-04-01

    The need for a widely accepted method suitable for a multicentre quantitative evaluation of facial aesthetics after surgical treatment of cleft lip and palate (CLP) has been emphasized for years. The aim of this study was to validate a novel computer system 'Analyse It Doc' (A.I.D.) as a tool for objective anthropometric analysis of the nasolabial region. An indirect anthropometric analysis of facial photographs was conducted with the A.I.D. system and Adobe Photoshop/ImageJ software. Intra-rater and inter-rater reliability and the time required for the analysis were estimated separately for each method and compared. Analysis with A.I.D. system was nearly 10-fold faster than that with the reference evaluation method. The A.I.D. system provided strong inter-rater and intra-rater correlations for linear, angular and area measurements of the nasolabial region, as well as a significantly higher accuracy and reproducibility of angular measurements in submental view. No statistically significant inter-method differences were found for other measurements. The hereby presented novel computer system is suitable for simple, time-efficient and reliable multicenter photogrammetric analyses of the nasolabial region in CLP patients and healthy subjects. Copyright © 2017 European Association for Cranio-Maxillo-Facial Surgery. Published by Elsevier Ltd. All rights reserved.

  17. Battlefield analgesia: a brief review of current trends and concepts in the treatment of pain in US military casualties from the conflicts in Iraq and Afghanistan.

    Science.gov (United States)

    Plunkett, Anthony; Turabi, Ali; Wilkinson, Indy

    2012-05-01

    SUMMARY Battlefield analgesia and post-injury pain management is a high priority within the military medical community. The combined military services of the USA have developed a Pain Task Force and clinical practice guidelines to ensure that adequate analgesia is provided to our wounded soldiers as far forward as the point of injury on the battlefield. As a result of this emphasis, novel analgesic techniques and equipment have led to improved pain management. Continuous peripheral nerve blocks, intranasal ketamine, battlefield acupuncture and other adjuncts have all been utilized safely and successfully. The ability to provide rapid analgesia as early in the course of injury as possible not only helps with the immediate pain of the soldier, but potentially minimizes the risk of developing chronic postinjury pain. During the long medical evacuation system the risks of both undertreatment and overtreatment of pain are very real. Future studies and observation will help to delineate best treatment regimens and pave the way for the next generation of medical providers to positively impact a soldier's recovery. This article is written from the perspective of the USA with a focus on the conflicts in Afghanistan (Operation Enduring Freedom) and Iraq (Operation Iraqi Freedom).

  18. Applying an expanded social determinant approach to the concept of adherence to treatment: the case of Colombian women living with HIV/AIDS.

    Science.gov (United States)

    Arrivillaga, Marcela; Ross, Michael; Useche, Bernardo; Springer, Andrew; Correa, Diego

    2011-01-01

    The purpose of this study was to explore and analyze social determinants that influence adherence among Colombian women living with HIV/AIDS in poverty conditions. A qualitative, descriptive-interpretative study was developed. Forty-seven women participated in five focus group discussions. Also, in-depth interviews with six women were conducted. Results showed that women with lower adherence sell their antiretroviral medication to satisfy economic needs, and prioritize the care of their HIV-positive children over their own adherence needs. In contrast, women with higher adherence were found to participate in social support groups offered by nongovernmental organizations. These findings underscore the need to understand the social determinants that facilitate and/or hinder adherence among women in poverty-associated conditions. Results indicate the need to facilitate access to treatment on a timely and continual basis; provide economic resources, including support to meet basic needs as well as subsidies for transportation to health care centers; and explore mechanism for supporting the care of their offspring. Copyright © 2011 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

  19. Experimental Treatment with Favipiravir for Ebola Virus Disease (the JIKI Trial: A Historically Controlled, Single-Arm Proof-of-Concept Trial in Guinea.

    Directory of Open Access Journals (Sweden)

    Daouda Sissoko

    2016-03-01

    Full Text Available Ebola virus disease (EVD is a highly lethal condition for which no specific treatment has proven efficacy. In September 2014, while the Ebola outbreak was at its peak, the World Health Organization released a short list of drugs suitable for EVD research. Favipiravir, an antiviral developed for the treatment of severe influenza, was one of these. In late 2014, the conditions for starting a randomized Ebola trial were not fulfilled for two reasons. One was the perception that, given the high number of patients presenting simultaneously and the very high mortality rate of the disease, it was ethically unacceptable to allocate patients from within the same family or village to receive or not receive an experimental drug, using a randomization process impossible to understand by very sick patients. The other was that, in the context of rumors and distrust of Ebola treatment centers, using a randomized design at the outset might lead even more patients to refuse to seek care. Therefore, we chose to conduct a multicenter non-randomized trial, in which all patients would receive favipiravir along with standardized care. The objectives of the trial were to test the feasibility and acceptability of an emergency trial in the context of a large Ebola outbreak, and to collect data on the safety and effectiveness of favipiravir in reducing mortality and viral load in patients with EVD. The trial was not aimed at directly informing future guidelines on Ebola treatment but at quickly gathering standardized preliminary data to optimize the design of future studies.Inclusion criteria were positive Ebola virus reverse transcription PCR (RT-PCR test, age ≥ 1 y, weight ≥ 10 kg, ability to take oral drugs, and informed consent. All participants received oral favipiravir (day 0: 6,000 mg; day 1 to day 9: 2,400 mg/d. Semi-quantitative Ebola virus RT-PCR (results expressed in "cycle threshold" [Ct] and biochemistry tests were performed at day 0, day 2, day 4, end

  20. [Endodontics in motion: new concepts, materials and techniques 2. The use of cone-beam computed tomography in endodontic diagnosis and treatment planning].

    Science.gov (United States)

    Özok, A R; Metska, M E

    2015-09-01

    Systems for cone-beam computed tomography make a high-quality 3D reconstruction of dentomaxillofacial structures possible, without exposing the patient to excessive doses of radiation. Due to its 3D nature cone-beam computed tomography is superior to conventional dental radiographic imaging methods for many aspects of endodontic diagnosis and treatment planning. There are multiple indications for the use of cone-beam computed tomography scans in endodontics, including detection of periapical lesions or root fractures and the exploration of the root canal anatomy and its deviations. Depending on conditions, a judicious decision will always have to be made with regard to the radiographic technique to be applied. Primary in that respect must be the means by which the most accurate diagnostic image can be achieved with the lowest possible dose of radiation. Making a cone-beam computed tomography scan is justified only when the required diagnostic information cannot be achieved adequately using lower dose conventional dental radiographic imaging techniques.

  1. The LDC detector concept

    Indian Academy of Sciences (India)

    and an extremely granular calorimeter. The main design force behind the LDC is the particle flow concept. Keywords. International linear collider; large detector concept. PACS No. 13.66-a. 1. Introduction. The large detector concept (LDC) detector concept group [1] was formed early in. 2004. Its goal is to design a complete ...

  2. Concepts in Change

    Science.gov (United States)

    Rusanen, Anna-Mari; Poyhonen, Samuli

    2013-01-01

    In this article we focus on the concept of concept in conceptual change. We argue that (1) theories of higher learning must often employ two different notions of concept that should not be conflated: psychological and scientific concepts. The usages for these two notions are partly distinct and thus straightforward identification between them is…

  3. Ventriculectomia parcial: um novo conceito no tratamento cirúrgico de cardiopatias em fase final Partial ventriculectomy: a new concept for surgical treatment of end stage cardiopathies

    Directory of Open Access Journals (Sweden)

    Randas J. V Batista

    1996-03-01

    cardiac problems and end stage congestive heart failure (NYHA IV with dilated cardiomyopathy underwent "Partial Ventriculectomy". The operation was based on Laplace's law (T-P.II.D and consisted of removal of a large wedge of muscle from the lateral wall of the left ventricle beginning at the apex and extending between the papillary muscles, ending proximal to the mitral annulus. The operation was performed under normothermic cardiopulmonary bypass and no cardioplegia was used. Pre-operative left ventriculography and echocardiography showed global hypocontractility of the hearts with ejection fraction lower than 20% in all patients who were considered candidates for cardiac transplantation. Males were predominant (n=73 and the age varied from 19 to 74 years. The pathologies were: viral miocarditis (n=12; post miocardioplasty (n=1; Chagas' disease (n=15; valvular disease (n=38; ischemic disease (n=16; idiopathic (n=21. Hospital mortality (30 days post operative (n=13: pulmonary embolus (n=4; renal failure (n=5; bleeding (n=4. Late deaths (after 30 days post-operative (n=10: arhythmia (n=6; "cardiac failure" (n=2; unknown (n=2; 8 patients required reoperation for bleeding. There were no infection and none required IAPB. All patients had nipride and 19 needed inotropics. Post-op ventriculographies and echocardiographies showed improvement of EF (from 100% to 300%. In conclusion, this new technique "Partial Ventriculectomy", with it's purpose of reducing the ventricular diameter, may benefit patients with end stage heart failure. And this new concept may, in our experience, give the patient improvement in his clinical status and increase life span.

  4. The Contribution of Adipose Tissue-Derived Mesenchymal Stem Cells and Platelet-Rich Plasma to the Treatment of Chronic Equine Laminitis: A Proof of Concept.

    Science.gov (United States)

    Angelone, Mario; Conti, Virna; Biacca, Cristiano; Battaglia, Beatrice; Pecorari, Laura; Piana, Francesco; Gnudi, Giacomo; Leonardi, Fabio; Ramoni, Roberto; Basini, Giuseppina; Dotti, Silvia; Renzi, Sabrina; Ferrari, Maura; Grolli, Stefano

    2017-10-11

    Laminitis, a highly debilitating disease of the foot in ungulates, is characterized by pathological changes of the complex lamellar structures that maintain the appendicular skeleton within the hoof. Laminitis is a multifactorial disease that involves perturbation of the vascular, hematological, and inflammatory homeostasis of the foot. Interestingly, the pathogenesis of the disease resembles what is observed in metabolic syndromes and sepsis-induced organ failure in humans and animals. We hypothesized that local administration of mesenchymal stem cells (MSCs) and platelet-rich plasma (PRP) might contribute to establishing an anti-inflammatory and pro-angiogenic environment, and could stimulate the injured tissue in order to restore its functional integrity. According to this assumption, an experimental protocol based on the local intravenous administration of adipose tissue-derived MSCs (aMSCs) in combination with PRP was developed for the treatment of horses affected by chronic laminitis. Nine horses with severely compromised venograms (showing grade III and IV laminitis) that had been unsuccessfully treated with conventional therapies were enrolled. aMSCs and PRP (15 × 10⁶ cells resuspended in 15 mL of PRP) were injected into the lateral or medial digital vein three times, at one-month intervals. The first administration was performed with allogeneic aMSCs, while for the following administrations, autologous aMSCs were used. There was no adverse short-term reaction to the intravenous injection of aMSCs. In the long term, venograms outlined, in all subjects, a progressive amelioration of the vascularization of the foot. An improvement in the structure and function of the hoof was also observed. No adverse events were reported during the follow-up, and the horses returned to a comfortable quality of life. Although the number of animals enrolled in the study is limited, both clinical observations and venography demonstrated an enhancement in the condition of all

  5. First-in-man / proof of concept study with molidustat - a novel selective oral HIF-prolyl hydroxylase inhibitor for the treatment of renal anaemia.

    Science.gov (United States)

    Böttcher, M; Lentini, S; Arens, E R; Kaiser, A; van der Mey, D; Thuss, U; Kubitza, D; Wensing, G

    2018-03-25

    Insufficient erythropoietin (EPO) synthesis is a relevant cause of renal anaemia in patients with chronic kidney disease. Molidustat, a selective hypoxia-inducible factor prolyl hydroxylase (HIF-PH) inhibitor, increases endogenous EPO levels dose-dependently in preclinical models. We examined the pharmacokinetics, safety, tolerability and the effect on EPO levels after single oral doses of molidustat in healthy male volunteers. This was a single centre, randomized, single-blind, placebo-controlled, group-comparison, dose-escalation study. Molidustat was administered at doses of 5, 12.5, 25, 37.5 or 50 mg as a polyethylene-glycol-based solution. In total, 45 volunteers received molidustat and 14 received placebo. Molidustat was rapidly absorbed, and mean maximum plasma concentration and area under the concentration-time curve increased dose-dependently. Mean terminal half-life was 4.64-10.4 h. A significant increase in endogenous EPO was observed following single oral doses of molidustat of 12.5 mg and above. Geometric mean peak EPO levels were 14.8 IU/L (90% confidence interval: 13.0 - 16.9) for volunteers who received placebo and 39.8 IU/L (90% confidence interval: 29.4 - 53.8) for those who received molidustat 50 mg. The time course of EPO levels resembled the normal diurnal variation in EPO. Maximum EPO levels were observed approximately 12 h post-dose and returned to baseline after approximately 24-48 h. All doses of molidustat were well tolerated and there were no significant changes in vital signs and safety laboratory parameters. Oral administration of molidustat to healthy volunteers elicited a dose-dependent increase in endogenous EPO. These results support the ongoing development of molidustat as a potential new treatment for patients with renal anaemia. This article is protected by copyright. All rights reserved.

  6. Análise do tratamento de conceitos químicos em coleções das séries iniciais. Analysis of the treatment of chemistry concepts in textbook collections of the initial grades

    Directory of Open Access Journals (Sweden)

    Theodoro, Mônica E. C.

    2014-08-01

    textbooks from 1st to 4th grades in elementary school, approved by the National Program of Textbooks - PNLD/2007. Textbook collections were analyzed with respect to conceptual sequence according to the Theory of Meaningful Learning. Deficiencies were identified in conceptual sequence and in the definition of concepts, when some of them are discussed posteriorly to their subsumers. However, several examples of adequate definition and treatment of these contents were collected. We expect to elucidate how the basic contents for the study of chemistry should be treated in the early grades. Specially when establishing the first contact of students with a scientific concept or field of knowledge, it is important to perform the evolution of concepts very carefully. The low concern given to the sequential treatment of concepts can lead to formation of (or reinforcement misconceptions that may hinder the learning of later contents, when these students join high school.

  7. The Contribution of Adipose Tissue-Derived Mesenchymal Stem Cells and Platelet-Rich Plasma to the Treatment of Chronic Equine Laminitis: A Proof of Concept

    Directory of Open Access Journals (Sweden)

    Mario Angelone

    2017-10-01

    Full Text Available Laminitis, a highly debilitating disease of the foot in ungulates, is characterized by pathological changes of the complex lamellar structures that maintain the appendicular skeleton within the hoof. Laminitis is a multifactorial disease that involves perturbation of the vascular, hematological, and inflammatory homeostasis of the foot. Interestingly, the pathogenesis of the disease resembles what is observed in metabolic syndromes and sepsis-induced organ failure in humans and animals. We hypothesized that local administration of mesenchymal stem cells (MSCs and platelet-rich plasma (PRP might contribute to establishing an anti-inflammatory and pro-angiogenic environment, and could stimulate the injured tissue in order to restore its functional integrity. According to this assumption, an experimental protocol based on the local intravenous administration of adipose tissue-derived MSCs (aMSCs in combination with PRP was developed for the treatment of horses affected by chronic laminitis. Nine horses with severely compromised venograms (showing grade III and IV laminitis that had been unsuccessfully treated with conventional therapies were enrolled. aMSCs and PRP (15 × 106 cells resuspended in 15 mL of PRP were injected into the lateral or medial digital vein three times, at one-month intervals. The first administration was performed with allogeneic aMSCs, while for the following administrations, autologous aMSCs were used. There was no adverse short-term reaction to the intravenous injection of aMSCs. In the long term, venograms outlined, in all subjects, a progressive amelioration of the vascularization of the foot. An improvement in the structure and function of the hoof was also observed. No adverse events were reported during the follow-up, and the horses returned to a comfortable quality of life. Although the number of animals enrolled in the study is limited, both clinical observations and venography demonstrated an enhancement in the

  8. A concept for planning and management of on-site and centralised municipal wastewater treatment systems, a case study in Bangkok, Thailand. II: scenario-based pollutant load analysis.

    Science.gov (United States)

    Tsuzuki, Yoshiaki; Koottatep, Thammarat; Sinsupan, Thitiphon; Jiawkok, Supattra; Wongburana, Chira; Wattanachira, Suraphong; Sarathai, Yuttachai

    2013-01-01

    Scenario-based pollutant load analysis was conducted to develop a part of a concept for planning and management of wastewater treatment systems (WWTSs) under the mixture conditions of centralised and on-site WWTSs. Pollutant discharge indicators and pollutant removal efficiency functions were applied from another paper in the series, which were developed based on the existing conditions in urban and peri-urban areas of Bangkok, Thailand. Two scenarios were developed to describe development directions of the mixture conditions. Scenario 1 involves keeping the on-site wastewater treatment plants (WWTPs) within the areas of centralised WWTSs. Scenario 2 is dividing the centralised and on-site WWTS areas. Comparison of the smallest values of total pollutant discharge per capita (PDCtotal) between Scenarios 1 and 2 showed that the smallest PDCtotal in Scenario 1 was smaller than that in Scenario 2 for biological oxygen demand, chemical oxygen demand and total phosphorus whereas the smallest PDCtotal in Scenario 2 was smaller than that in Scenario 1 for total nitrogen, total coliforms and faecal coliforms. The results suggest that the mixture conditions could be a possible reason for smaller pollutant concentrations at centralised WWTPs. Quantitative scenario-based estimation of PDCtotal is useful and a prerequisite in planning and management of WWTSs.

  9. The NobelGuide® All-on-4® Treatment Concept for Rehabilitation of Edentulous Jaws: A Retrospective Report on the 7-Years Clinical and 5-Years Radiographic Outcomes.

    Science.gov (United States)

    Lopes, Armando; Maló, Paulo; de Araújo Nobre, Miguel; Sánchez-Fernández, Elena; Gravito, Inês

    2017-04-01

    There is a necessity of studies documenting the long-term outcome of full-arch flapless rehabilitations. To evaluate the 7 years implant and prosthesis survival rate and 5-years marginal bone loss of full-arch fixed prosthetic rehabilitations supported by implants in immediate function with the All-on-4 ® treatment concept using a computer guided surgical protocol (NobelGuide ® , Nobel Biocare). This retrospective clinical study included 111 edentulous patients (n = 53 bruxers; n = 21 smokers; n = 59 systemically compromised), rehabilitated between February 2005 and November 2010 with 532 implants with the All-on-4 ® treatment concept using NobelGuide ® . Outcome measures were implant and prosthesis survival, marginal bone loss at 5-years and the incidence of mechanical and biological complications. Survival was calculated using life-table analysis. Inferential analysis was performed to compare the difference in marginal bone loss between axial and tilted implants. Sixteen patients were lost to follow-up. The implant cumulative survival rate was 94.5% at 7 years. Prosthetic survival was 97.8% (n = 3 prosthetic failures). The average (standard deviation) marginal bone loss at 5 years was 1.3 mm (1.06 mm) overall, 1.27 mm (1.02 mm) for tilted implants and 1.34 mm (1.1 mm) for axial implants (p < .001). Ninety-one patients experienced complications in the provisional prostheses (n = 47 patients who were bruxers; n = 25 patients with implant-supported rehabilitation as opposing dentition) ranging from prosthetic fracture (n = 66 patients) to abutment or prosthetic screw loosening (n = 74 patients). Thirty-three patients experienced complications in the definitive prostheses (all exclusive to patients who were bruxers or had implant-supported rehabilitations as opposing dentition) ranging from acrylic-resin prosthetic/crown fracture (n = 23 patients) to abutment or prosthetic screw loosening (n = 10 patients). Twenty

  10. Some concepts in condensed phase chemical kinetics

    International Nuclear Information System (INIS)

    Adelman, S.A.

    1986-01-01

    Some concepts in condensed phase chemical kinetics which have emerged from a recent rigorous statistical mechanical treatment of condensed phase chemical reaction dynamics (S.A. Adelman, Adv. Chem. Phys.53:61 (1983)) are discussed in simple physical terms

  11. The Extended Enterprise concept

    DEFF Research Database (Denmark)

    Larsen, Lars Bjørn; Vesterager, Johan; Gobbi, Chiara

    1999-01-01

    This paper provides an overview of the work that has been done regarding the Extended Enterprise concept in the Common Concept team of Globeman 21 including references to results deliverables concerning the development of the Extended Enterprise concept. The first section presents the basic concept...... picture from Globeman21, which illustrates the Globeman21 way of realising the Extended Enterprise concept. The second section presents the Globeman21 EE concept in a life cycle perspective, which to a large extent is based on the thoughts and ideas behind GERAM (ISO/DIS 15704)....

  12. Species concept and speciation

    Directory of Open Access Journals (Sweden)

    Amal Y. Aldhebiani

    2018-03-01

    Full Text Available Defining and recognizing a species has been a controversial issue for a long time. To determine the variation and the limitation between species, many concepts have been proposed. When a taxonomist study a particular taxa, he/she must adopted a species concept and provide a species limitation to define this taxa. In this paper some of species concepts are discussed starting from the typological species concepts to the phylogenetic concept. Positive and negative aspects of these concepts are represented in addition to their application.

  13. [Dental curriculum and team treatment concept

    NARCIS (Netherlands)

    Burgersdijk, R.C.W.; Kersten, H.

    2001-01-01

    The changing oral situation in the Netherlands, the upgrading of the dental hygienist training and the introduction of the bachelor and master degree in the Dutch higher education system asks for a new dental professional: the oral physician. To prepare the oral physician for his role as leader of a

  14. Current concepts in pediatric femur fracture treatment.

    Science.gov (United States)

    Kanlic, Enes; Cruz, Miguel

    2007-12-01

    Femoral neck fractures require urgent evacuation of intracapsular hematoma, anatomic reduction, and secure fixation with screws and cast immobilization. Extracapsular trochanteric and subtrochanteric fractures are best treated by fixed angle devices (locked plates or dynamic screw and side plate). "Length stable" low energy shaft fractures with minimal displacement or fractures are treated operatively. Transverse or short oblique shaft fractures in patients fractures. Children > 12 years have less risk of vascular disturbance to the proximal physis, and should have lateral transtrochanateric entry locked rigid nails. Fractures with severe soft tissue injuries could be temporized with external fixation. Distal physis and epiphyseal injuries require anatomical reduction and smooth wires and/or screw fixation (placed in such a way as to minimize further damage to the physis) and need to be augmented with a brace. Leg-length discrepancy is not a significant clinical problem in operatively treated patients. We recommend hardware removal after complete fracture healing, usually in 6 to 12 months. Implants left in the growing child could become buried deep inside of the bone, or cause "periprosthetic" fractures and/or eventually impede adult reconstruction. Minimal risks are reported for hardware removal in healthy patients with healed fractures (4 cortices bridged).

  15. Spondyloarthritis: from unifying concepts to improved treatment

    NARCIS (Netherlands)

    Paramarta, Jacqueline E.; Baeten, Dominique

    2014-01-01

    Spondyloarthritis (SpA) is a chronic immune-mediated inflammatory disease with diverse phenotypic manifestations including spondylitis, arthritis, enthesitis and extra-articular manifestations (psoriasis, uveitis, inflammatory bowel disease). The common genetic risk factors, the strong familial

  16. Elementary concepts of topology

    CERN Document Server

    Alexandroff, Paul

    1961-01-01

    Concise work presents topological concepts in clear, elementary fashion without sacrificing their profundity or exactness. Author proceeds from basics of set-theoretic topology, through topological theorems and questions based on concept of the algebraic complex, to the concept of Betti groups.

  17. The LDC detector concept

    Indian Academy of Sciences (India)

    2004. Its goal is to design a complete detector concept for the LDC, based on a gaseous central tracking detector, and on granular calorimetry. The concept is heavily based on the concept of particle flow for event reconstruction. LDC started from the TESLA detector, developed for the TESLA TDR [2] and published in 2001.

  18. Concepts: The Very Idea

    OpenAIRE

    Harnad, Stevan

    2009-01-01

    Machery (2009) suggests that the concept of “concept” is too heterogeneous to serve as a “natural kind” for scientific explanation, so cognitive science should do without concepts. I second the suggestion, and propose substituting, in place of concepts, inborn and acquired sensorimotor category-detectors and category-names combined into propositions that define and describe further categories.

  19. Threshold concepts in prosthetics.

    Science.gov (United States)

    Hill, Sophie

    2017-12-01

    Curriculum documents identify key concepts within learning prosthetics. Threshold concepts provide an alternative way of viewing the curriculum, focussing on the ways of thinking and practicing within prosthetics. Threshold concepts can be described as an opening to a different way of viewing a concept. This article forms part of a larger study exploring what students and staff experience as difficult in learning about prosthetics. To explore possible threshold concepts within prosthetics. Qualitative, interpretative phenomenological analysis. Data from 18 students and 8 staff at two universities with undergraduate prosthetics and orthotics programmes were generated through interviews and questionnaires. The data were analysed using an interpretative phenomenological analysis approach. Three possible threshold concepts arose from the data: 'how we walk', 'learning to talk' and 'considering the person'. Three potential threshold concepts in prosthetics are suggested with possible implications for prosthetics education. These possible threshold concepts involve changes in both conceptual and ontological knowledge, integrating into the persona of the individual. This integration occurs through the development of memories associated with procedural concepts that combine with disciplinary concepts. Considering the prosthetics curriculum through the lens of threshold concepts enables a focus on how students learn to become prosthetists. Clinical relevance This study provides new insights into how prosthetists learn. This has implications for curriculum design in prosthetics education.

  20. KALIMER design concept report

    Energy Technology Data Exchange (ETDEWEB)

    Park, Chang Kyu; Kim, Young Cheol; Kim, Young In; Kim, Young Gyun; Kim, Eui Kwang; Song, Hoon; Chung, Hyun Tai; Hwang, Woan; Nam, Cheol; Sim Yoon Sub; Kim, Yeon Sik; Wim Myung Whan; Min, Byung Tae; Yoo, Bong; Lee, Jae Han; Lee, Hyeong Yeon; Kim, Jong Bum; Koo, Gyeong Hoi; Ham, Chang Shik; Kwon, Kee Choon; Kim, Jung Taek; Park, Jae Chang; Lee, Jung Woon; Lee, Yong Hee; Kim, Chang Hwoi; Sim, Bong Shick; Hahn, Do Hee; Choi, Jong Hyeun; Kwon, Sang Woon

    1997-07-01

    KAERI is working for the development of KALIMER and work is being done for methodology development, experimental facility set up and design concept development. The development target of KALIMER has been set as to make KALIMER safer, more economic, more resistant to nuclear proliferation, and yield less impact on the environment. To achieve the target, study has been made for setting up the design concept of KALIMER including the assessment of various possible design alternatives. This report is the results of the study for the KALIMER concept study and describes the design concept of KALIMER. The developed design concept study and describes the design concept of KALIMER. The developed design concept is to be used as the starting point of the next development phase of conceptual design and the concept will be refined and modified in the conceptual design phase. The scope of the work has been set as the NSSS and essential BOP systems. For systems, NSSS and functionally related major BOP are covered. Sizing and specifying conceptual structure are covered for major equipment. Equipment and piping are arranged for the parts where the arrangement is critical in fulfilling the foresaid intention of setting up the KALIMER design concept. This report consists of 10 chapters. Chapter 2 is for the top level design requirements of KALIMER and it serves as the basis of KALIMER design concept development. Chapter 3 summarizes the KALIMER concept and describes the general design features. The remaining chapters are for specific systems. (author). 29 tabs., 37 figs.

  1. KALIMER design concept report

    International Nuclear Information System (INIS)

    Park, Chang Kyu; Kim, Young Cheol; Kim, Young In; Kim, Young Gyun; Kim, Eui Kwang; Song, Hoon; Chung, Hyun Tai; Hwang, Woan; Nam, Cheol; Sim Yoon Sub; Kim, Yeon Sik; Wim Myung Whan; Min, Byung Tae; Yoo, Bong; Lee, Jae Han; Lee, Hyeong Yeon; Kim, Jong Bum; Koo, Gyeong Hoi; Ham, Chang Shik; Kwon, Kee Choon; Kim, Jung Taek; Park, Jae Chang; Lee, Jung Woon; Lee, Yong Hee; Kim, Chang Hwoi; Sim, Bong Shick; Hahn, Do Hee; Choi, Jong Hyeun; Kwon, Sang Woon.

    1997-07-01

    KAERI is working for the development of KALIMER and work is being done for methodology development, experimental facility set up and design concept development. The development target of KALIMER has been set as to make KALIMER safer, more economic, more resistant to nuclear proliferation, and yield less impact on the environment. To achieve the target, study has been made for setting up the design concept of KALIMER including the assessment of various possible design alternatives. This report is the results of the study for the KALIMER concept study and describes the design concept of KALIMER. The developed design concept study and describes the design concept of KALIMER. The developed design concept is to be used as the starting point of the next development phase of conceptual design and the concept will be refined and modified in the conceptual design phase. The scope of the work has been set as the NSSS and essential BOP systems. For systems, NSSS and functionally related major BOP are covered. Sizing and specifying conceptual structure are covered for major equipment. Equipment and piping are arranged for the parts where the arrangement is critical in fulfilling the foresaid intention of setting up the KALIMER design concept. This report consists of 10 chapters. Chapter 2 is for the top level design requirements of KALIMER and it serves as the basis of KALIMER design concept development. Chapter 3 summarizes the KALIMER concept and describes the general design features. The remaining chapters are for specific systems. (author). 29 tabs., 37 figs

  2. Reducing the Mismatch of Geometry Concept Definitions and Concept Images Held by Pre-Service Teachers

    Science.gov (United States)

    Cunningham, Robert F.; Roberts, Allison

    2010-01-01

    Twenty-three female elementary pre-service teachers were assessed on their ability to answer questions involving geometry concepts. Despite being given the definitions of the altitude of a triangle and the diagonal of a polygon on the pretest, limited understanding of these concepts was evident. A treatment using both graphic organizer and concept…

  3. PERFORMANCE - AN EVOLVING CONCEPT

    OpenAIRE

    Assist. Mirela-Oana Pintea Ph.D Student; Lect. Monica-Violeta Achim

    2010-01-01

    The concept of performance is a problematic concept and will remain so as long as the definition of company performance varies depending on the interests of users of information. On this consideration, no consensus was reached regarding the definition, methodology and performance models used. Defining this concept is realized in accordance with its objectives of users of information, while the methodology and models used are influenced by legal regulations and management policies. The approac...

  4. The Marketing Concept

    OpenAIRE

    G. Nazan Gunay

    2001-01-01

    Since the term "Market Orientation" is recognised as the critical factor in business success there has been an overwhelming increase in research issues linking market orientation with company performance. The term market orientation has been employed by scholars to indicate the implementation of the marketing concept. In order to understand market orientation, one believes that there is a need to recall what the marketing concept is. Therefore, this study reviews the "marketing concept" as a ...

  5. Empowerment: a Concept Analysis

    OpenAIRE

    Febriana, Dara

    2011-01-01

    This paper conceptually analyzed the concept of empowerment using the strategies of Walker & Avant (2005) the objective is to clarify the meaning of the concept and to clearly identify empowerment characteristic that will provide consistent definition for practice and future research. Empowerment is defined and examined using relevant resources of literatures and selected empirical referents that described empowerment as a complex and multidimensional concept. Within nursing context empowerme...

  6. New reactor concepts

    International Nuclear Information System (INIS)

    Meskens, G.; Govaerts, P.; Baugnet, J.-M.; Delbrassine, A.

    1998-11-01

    The document gives a summary of new nuclear reactor concepts from a technological point of view. Belgium supports the development of the European Pressurized-Water Reactor, which is an evolutionary concept based on the European experience in Pressurized-Water Reactors. A reorientation of the Belgian choice for this evolutionary concept may be required in case that a decision is taken to burn plutonium, when the need for flexible nuclear power plants arises or when new reactor concepts can demonstrate proved benefits in terms of safety and cost

  7. Fundamental concepts of geometry

    CERN Document Server

    Meserve, Bruce E

    1983-01-01

    Demonstrates relationships between different types of geometry. Provides excellent overview of the foundations and historical evolution of geometrical concepts. Exercises (no solutions). Includes 98 illustrations.

  8. How Do Parenting Concepts Vary within and between the Families?

    Science.gov (United States)

    Roskam, Isabelle; Meunier, Jean Christophe

    2009-01-01

    How do parenting concepts vary within and between the families? The present study regards parenting as a complex family process by considering three concepts of parenting: styles, differential treatment and coparenting consistency. A main question was addressed: whether and how these parenting concepts vary within the families towards siblings or…

  9. Comparison of marginal bone loss and implant success between axial and tilted implants in maxillary All-on-4 treatment concept rehabilitations after 5 years of follow-up.

    Science.gov (United States)

    Hopp, Milena; de Araújo Nobre, Miguel; Maló, Paulo

    2017-10-01

    There is need for more scientific and clinical information on longer-term outcomes of tilted implants compared to implants inserted in an axial position. Comparison of marginal bone loss and implant success after a 5-year follow-up between axial and tilted implants inserted for full-arch maxillary rehabilitation. The retrospective clinical study included 891 patients with 3564 maxillary implants rehabilitated according to the All-on-4 treatment concept. The follow-up time was 5 years. Linear mixed-effect models were performed to analyze the influence of implant orientation (axial/tilted) on marginal bone loss and binary logistic regression to assess the effect of patient characteristics on occurrence of marginal bone loss >2.8 mm. Only those patients with measurements of at least one axial and one tilted implant available were analyzed. This resulted in a data set of 2379 implants (1201 axial, 1178 tilted) in 626 patients (=reduced data set). Axial and tilted implants showed comparable mean marginal bone losses of 1.14 ± 0.71 and 1.19 ± 0.82 mm, respectively. Mixed model analysis indicated that marginal bone loss levels at 5 years follow up was not significantly affected by the orientation (axial/tilted) of the implants in the maxillary bone. Smoking and female gender were associated with marginal bone loss >2.8 mm in a logistic regression analysis. Five-year implant success rates were 96%. The occurrence of implant failure showed to be statistically independent from orientation. Within the limitations of this study and considering a follow-up time of 5 years, it can be concluded that tilted implants behave similarly with regards to marginal bone loss and implant success in comparison to axial implants in full-arch rehabilitation of the maxilla. Longer-term outcomes (10 years +) are needed to verify this result. © 2017 Wiley Periodicals, Inc.

  10. Isoeffect lines using TDF and CRE concepts

    International Nuclear Information System (INIS)

    Supe, S.J.; Sasane, J.B.; Gupta, M.K.; Supe, D.S.

    1979-01-01

    In most of the radiotherapy centres the treatment planning is based on isodose lines. Isoeffect lines are also being drawn based on the concepts of TDFs and CREs. A study has been made of whether the isoeffect lines based on the concepts of TDFs, CRes and the physical isodose lines are identical in all the treatment situations. Isoeffects lines for a few treatment schedules involving treatment of carcinoma of the bladder, treatment of cancer of the uterine cervix by combined intracavitary and external beam therapies and intracavitary therapy alone have been obtained and compared. The effect of treatment mode on the isoeffect lines has also been studied. It was found that the isodose curves and the isoeffect lines using the TDF and CRE concepts were not identical in all situations. Therefore, the ultimate treatment plans based on these isoeffect lines will not be exactly the same. The dependence of the isoeffect lines with the variation of the exponents of time and number of fractions used in the empirical relationship for NSD have also been investigated. Clinical trials have been initiated in the case of cancer of the bladder and cervix uterus based on the isodose curves and isoeffect lines using CRE and TDF concepts. (author)

  11. Kierkegaard's concepts: Hypocrisy

    DEFF Research Database (Denmark)

    Fauth Hansen, Thomas Martin

    2014-01-01

    Kierkegaard’s Concepts is a comprehensive, multi-volume survey of the key concepts and categories that inform Kierkegaard’s writings. Each article is a substantial, original piece of scholarship, which discusses the etymology and lexical meaning of the relevant Danish term, traces the development...

  12. [Lilium Bosniacum_concept

    OpenAIRE

    Hasanović, Ibro

    2016-01-01

    Hasanovic_Lilium-Bosniacum-CONCEPT (2).jpg (jpeg file, 20,99x29,669 cm, 72 dpi) Schizzi e foto del progetto Hasanovic_Lilium-Bosniacum-CONCEPT (2).jpg (jpeg file, 20,99x29,669 cm, 72 dpi) Sketches and photos for the project

  13. Modeling concept drift

    DEFF Research Database (Denmark)

    Borchani, Hanen; Martinez, Ana Maria; Masegosa, Andrés R.

    2015-01-01

    An often used approach for detecting and adapting to concept drift when doing classification is to treat the data as i.i.d. and use changes in classification accuracy as an indication of concept drift. In this paper, we take a different perspective and propose a framework, based on probabilistic...

  14. Children's Conceptions of Jesus

    Science.gov (United States)

    Aylward, Karen; Freathy, Rob

    2008-01-01

    This paper presents findings from a recent study investigating young children's (aged 10-11) conceptions of Jesus in England. The overall picture revealed by the study is that whilst there was a general assent amongst pupils in our sample towards an ethical and humanistic conception of the historical Jesus, there was less of a consensus about…

  15. Tools and Concepts.

    Science.gov (United States)

    Artis, Margaret, Ed.; And Others

    This guide provides enrichment for students to develop tools and concepts used in various areas of mathematics. The first part presents arithmetic progressions, geometric progressions, and harmonic progression. In the second section, the concept of mathematic induction is developed from intuitive induction, using concrete activities, to the…

  16. Chapter 14: Clarifying concepts

    Science.gov (United States)

    M. North; P. Stine

    2012-01-01

    There are some topics that continue to be raised by managers that were not sufficiently addressed in the first and second edition of U.S. Forest Service General Technical Report GTR 220 "An Ecosystem Management Strategy for Sierran Mixed-Conifer Forests." All of them concern issues about where and when GTR 220 concepts apply and how these concepts relate to...

  17. Integral fast reactor concept

    International Nuclear Information System (INIS)

    Chang, Y.I.; Marchaterre, J.F.; Sevy, R.H.

    1984-01-01

    Key features of the IFR consist of a pool-type plant arrangement, a metal fuel-based core design, and an integral fuel cycle with colocated fuel cycle facility. Both the basic concept and the technology base have been demonstrated through actual integral cycle operation in EBR-II. This paper discusses the inherent safety characteristics of the IFR concept

  18. Integral Fast Reactor concept

    Energy Technology Data Exchange (ETDEWEB)

    Till, C.E.; Chang, Y.I.

    1986-01-01

    The Integral Fast Reactor (IFR) is an innovative LMR concept, being developed at Argonne National Laboratory, that fully exploits the inherent properties of liquid metal cooling and metallic fuel to achieve breakthroughs in economics and inherent safety. This paper describes key features and potential advantages of the IFR concept, technology development status, fuel cycle economics potential, and future development path.

  19. Integral Fast Reactor concept

    International Nuclear Information System (INIS)

    Till, C.E.; Chang, Y.I.

    1986-01-01

    The Integral Fast Reactor (IFR) is an innovative LMR concept, being developed at Argonne National Laboratory, that fully exploits the inherent properties of liquid metal cooling and metallic fuel to achieve breakthroughs in economics and inherent safety. This paper describes key features and potential advantages of the IFR concept, technology development status, fuel cycle economics potential, and future development path

  20. Efficacy and safety of a herbal mixture (Viron® tablets in the treatment of patients with chronic hepatitis C virus infection: a prospective, randomized, open-label, proof-of-concept study

    Directory of Open Access Journals (Sweden)

    Shawkat H

    2015-02-01

    formulation were reported in any of the groups, apart from mild transient nausea, bloating, giddiness, and headache in two patients in the group receiving two tablets twice daily and in three patients in the group receiving three tablets twice daily.Conclusion: We conclude that this herbal formulation is potentially safe and may offer some added clinical and quality of life benefits when used in the treatment of patients with chronic hepatitis C virus infection. Larger studies could be warranted to evaluate the effects of using this formulation as an add-on therapy to an all-oral combination of a directly acting antiviral drug protocol in the treatment of chronic hepatitis C. Keywords: chronic hepatitis C virus, proof-of-concept study, safety, efficacy

  1. The concept of cluster

    DEFF Research Database (Denmark)

    Laursen, Lea Louise Holst; Møller, Jørgen

    2013-01-01

    villages in order to secure their future. This paper will address the concept of cluster-villages as a possible approach to strengthen the conditions of contemporary Danish villages. Cluster-villages is a concept that gather a number of villages in a network-structure where the villages both work together...... important role to play in both the popular and the political debate and in relation to everyday living conditions. The debate about the future of rural Denmark is also very much a debate about the kind of welfare model we choose in self-governing, municipal Denmark. The centralised, specialised model based...... to forskellige positioner ser vi en ny mulighed for landsbyudvikling, som vi kalder Clustervillages. In order to investigate the potentials and possibilities of the cluster-village concept the paper will seek to unfold the concept strategically; looking into the benefits of such concept. Further, the paper seeks...

  2. Democracy: concept, concepts and normative justification

    Directory of Open Access Journals (Sweden)

    Ricardo Marquisio Aguirre

    2013-11-01

    Full Text Available This essay belongs to the normative theory of democracy, namely, the search for the moral grounds of democracy and the democratic institutions. Unlike the descriptive or explicative approaches, the normative theory of democracy does not point to the empirical knowing of the actual democracies, but to give an account of the moral value of democracy as an ideal and the justification of principles for designing or reforming political institutions. The aims of this article are: a To introduce some normative questions that the concept of democracy leaves open; b To present, in their basic thesis, the main contemporary conceptions; c To suggest the requirements that the proposal of an regulative ideal should meet to constitute a normative successful justification of democracy.

  3. ADVANCED SULFUR CONTROL CONCEPTS

    Energy Technology Data Exchange (ETDEWEB)

    Apostolos A. Nikolopoulos; Santosh K. Gangwal; William J. McMichael; Jeffrey W. Portzer

    2003-01-01

    Conventional sulfur removal in integrated gasification combined cycle (IGCC) power plants involves numerous steps: COS (carbonyl sulfide) hydrolysis, amine scrubbing/regeneration, Claus process, and tail-gas treatment. Advanced sulfur removal in IGCC systems involves typically the use of zinc oxide-based sorbents. The sulfides sorbent is regenerated using dilute air to produce a dilute SO{sub 2} (sulfur dioxide) tail gas. Under previous contracts the highly effective first generation Direct Sulfur Recovery Process (DSRP) for catalytic reduction of this SO{sub 2} tail gas to elemental sulfur was developed. This process is currently undergoing field-testing. In this project, advanced concepts were evaluated to reduce the number of unit operations in sulfur removal and recovery. Substantial effort was directed towards developing sorbents that could be directly regenerated to elemental sulfur in an Advanced Hot Gas Process (AHGP). Development of this process has been described in detail in Appendices A-F. RTI began the development of the Single-step Sulfur Recovery Process (SSRP) to eliminate the use of sorbents and multiple reactors in sulfur removal and recovery. This process showed promising preliminary results and thus further process development of AHGP was abandoned in favor of SSRP. The SSRP is a direct Claus process that consists of injecting SO{sub 2} directly into the quenched coal gas from a coal gasifier, and reacting the H{sub 2}S-SO{sub 2} mixture over a selective catalyst to both remove and recover sulfur in a single step. The process is conducted at gasifier pressure and 125 to 160 C. The proposed commercial embodiment of the SSRP involves a liquid phase of molten sulfur with dispersed catalyst in a slurry bubble-column reactor (SBCR).

  4. CURRENT CONCEPTS IN ACL RECONSTRUCTION

    Directory of Open Access Journals (Sweden)

    Freddie H. Fu

    2008-09-01

    Full Text Available Current Concepts in ACL Reconstruction is a complete reference text composed of the most thorough collection of topics on the ACL and its surgical reconstruction compiled, with contributions from some of the world's experts and most experienced ACL surgeons. Various procedures mentioned throughout the text are also demonstrated in an accompanying video CD-ROM. PURPOSE Composing a single, comprehensive and complete information source on ACL including basic sciences, clinical issues, latest concepts and surgical techniques, from evaluation to outcome, from history to future, editors and contributors have targeted to keep the audience pace with the latest concepts and techniques for the evaluation and the treatment of ACL injuries. FEATURES The text is composed of 27 chapters in 6 sections. The first section is mostly about basic sciences, also history of the ACL, imaging, clinical approach to adolescent and pediatric patients are subjected. In the second section, Graft Choices and Arthroscopy Portals for ACL Reconstruction are mentioned. The third section is about the technique and the outcome of the single-bundle ACL reconstruction. The fourth chapter includes the techniques and outcome of the double-bundle ACL reconstruction. In the fifth chapter revision, navigation technology, rehabilitation and the evaluation of the outcome of ACL reconstruction is subjected. The sixth/the last chapter is about the future advances to reach: What We Have Learned and the Future of ACL Reconstruction. AUDIENCE Orthopedic residents, sports traumatology and knee surgery fellows, orthopedic surgeons, also scientists in basic sciences or clinicians who are studying or planning a research on ACL forms the audience group of this book. ASSESSMENT This is the latest, the most complete and comprehensive textbook of ACL reconstruction produced by the editorial work up of two pioneer and masters "Freddie H. Fu MD and Steven B. Cohen MD" with the contribution of world

  5. The Concept of the Gentleman

    DEFF Research Database (Denmark)

    Christensen, Jørgen Riber

    2014-01-01

    analyses the ideal of the gentleman in the light of its gender aspects and its class connotations. The hypothesis of the article is that the insecure status of masculine identity in an age of post-second-generation feminism demands the seemingly parodic treatment of the concept of the gentleman......, as in this video. Yet this hypothesis is also a research question. Why is there this strong element of parody in the video? The answer to the question may depend on a consideration of contemporary male identities. It may also be based on a reading of how the music video incorporates these types. Three such types...

  6. Fundamental concepts of mathematics

    CERN Document Server

    Goodstein, R L

    Fundamental Concepts of Mathematics, 2nd Edition provides an account of some basic concepts in modern mathematics. The book is primarily intended for mathematics teachers and lay people who wants to improve their skills in mathematics. Among the concepts and problems presented in the book include the determination of which integral polynomials have integral solutions; sentence logic and informal set theory; and why four colors is enough to color a map. Unlike in the first edition, the second edition provides detailed solutions to exercises contained in the text. Mathematics teachers and people

  7. Advanced concepts for acceleration

    International Nuclear Information System (INIS)

    Keefe, D.

    1986-07-01

    Selected examples of advanced accelerator concepts are reviewed. Such plasma accelerators as plasma beat wave accelerator, plasma wake field accelerator, and plasma grating accelerator are discussed particularly as examples of concepts for accelerating relativistic electrons or positrons. Also covered are the pulsed electron-beam, pulsed laser accelerator, inverse Cherenkov accelerator, inverse free-electron laser, switched radial-line accelerators, and two-beam accelerator. Advanced concepts for ion acceleration discussed include the electron ring accelerator, excitation of waves on intense electron beams, and two-wave combinations

  8. The LDC detector concept

    Indian Academy of Sciences (India)

    ), the large detector concept (LDC) is being developed. The main points of the LDC are a large volume gaseous tracking system, combined with high precision vertex detector and an extremely granular calorimeter. The main design force ...

  9. The technological conception

    International Nuclear Information System (INIS)

    Parrochia, D.

    1998-01-01

    The 'technological conception' examines how a project can be concretized or how it is possible to 'conceive', i.e. to produce operative ideas that can be directly use. The first part of this book, called 'concepts and methods', analyzes the logics of conceiving and its philosophy in the construction of its objects and in the management of its programs or projects. The second part is devoted to some exemplary technologies: roads, tunnels, bridges, dams, nuclear power plants, aerospace constructions, and analyzes different concrete logics of technological conception. Finally, the author shows how todays conception faces the risks and complexity increase of systems and considers the possibility of an entirely automated manufacturing shop in the future. (J.S.)

  10. Designing concepts and strategies

    DEFF Research Database (Denmark)

    Kiib, Hans

    2012-01-01

    , that new developments often employ very modest research on the subject and often very little has been done in order to challenge traditional concepts and to invent new sustainable concepts for redevelopment. In order to avoid mistakes in urban redevelopment we need to learn from research and evaluation...... the combination of research and design based development can provide us with a range of conceptual models for alternative development of different valuable parts of the city. This article is focusing on the design-based methods in concept development, which can be tested with the purpose of developing new design...... of the best planning practice. But what might be just as important is to learn from concept development practice, which can give us a comprehensive understanding of our complex cities and make us develop a way of experiencing the unique qualities of the architectural typologies at the site. Finally...

  11. Concepts of radiation protection

    International Nuclear Information System (INIS)

    2013-01-01

    This seventh chapter presents the concepts and principles of safety and radiation protection, emergency situations; NORM and TENORM; radiation protection care; radiation protection plan; activities of the radiation protection service; practical rules of radiation protection and the radiation symbol

  12. Concepts in Change

    Science.gov (United States)

    Rusanen, Anna-Mari; Pöyhönen, Samuli

    2013-06-01

    In this article we focus on the concept of concept in conceptual change. We argue that (1) theories of higher learning must often employ two different notions of concept that should not be conflated: psychological and scientific concepts. The usages for these two notions are partly distinct and thus straightforward identification between them is unwarranted. Hence, the strong analogy between scientific theory change and individual learning should be approached with caution. In addition, we argue that (2) research in psychology and cognitive science provides a promising theoretical basis for developing explanatory mechanistic models of conceptual change. Moreover, we argue that (3) arguments against deeper integration between the fields of psychology and conceptual change are not convincing, and that recent theoretical developments in the cognitive sciences might prove indispensable in filling in the details in mechanisms of conceptual change.

  13. Concept medium programme

    DEFF Research Database (Denmark)

    Bjerrum, Peter

    2005-01-01

    The present essay is an attempt to determine the architectural project of the 21st century in relation to a modern conception of space as the medium of architecture, and of sociality as its program...

  14. The Concept of Alexithymia

    Directory of Open Access Journals (Sweden)

    Miray Sasioglu

    2013-08-01

    Full Text Available The concept of alexithymia, which means “no words for emotions”, emerged in order to explain the symptoms of psychosomatic patients and gained a quick recognition among psychiatrists. However, current studies indicate that alexithymia may be a personality trait seen both in different pathological groups and even in healthy population. At this point, many researches have been made in order to distinguish alexithymia from existing constructs and diagnosis, and to remove the questions on reliability and validity of the con-cept and its measurement. Ongoing discussions on alexithymia will be re-viewed in this study. The controversial concept of alexithymia will be exam-ined in terms of characteristics, theoretical background, relationship with the other disorders, measurement and the critique of the measurement and the concept.

  15. Common tester platform concept.

    Energy Technology Data Exchange (ETDEWEB)

    Hurst, Michael James

    2008-05-01

    This report summarizes the results of a case study on the doctrine of a common tester platform, a concept of a standardized platform that can be applicable across the broad spectrum of testing requirements throughout the various stages of a weapons program, as well as across the various weapons programs. The common tester concept strives to define an affordable, next-generation design that will meet testing requirements with the flexibility to grow and expand; supporting the initial development stages of a weapons program through to the final production and surveillance stages. This report discusses a concept investing key leveraging technologies and operational concepts combined with prototype tester-development experiences and practical lessons learned gleaned from past weapons programs.

  16. Innovative confinement concepts workshop

    International Nuclear Information System (INIS)

    Kirkpatrick, R.C.

    1998-01-01

    The Innovative Confinement Concepts Workshop occurred in California during the week preceding the Second Symposium on Current Trends in International Fusion Research. An informal report was made to the Second Symposium. A summary of the Workshop concluded that some very promising ideas were presented, that innovative concept development is a central element of the restructured US DOE. Fusion Energy Sciences program, and that the Workshop should promote real scientific progress in fusion

  17. Concept medium programme

    DEFF Research Database (Denmark)

    Bjerrum, Peter

    2005-01-01

    The present essay is an attempt to determine the architectural project of the 21st century in relation to a modern conception of space as the medium of architecture, and of sociality as its program......The present essay is an attempt to determine the architectural project of the 21st century in relation to a modern conception of space as the medium of architecture, and of sociality as its program...

  18. Teaching's Concept of Learning

    DEFF Research Database (Denmark)

    Qvortrup, Ane; Keiding, Tina

    This paper discusses and exemplifies how teaching’s concept of learning can be understood. The theoretical framework for the construction and discussion of teaching’s concept of learning is found insecond-order systems theory as described by the German sociologist Niklas Luhmann (Luhmann, 1995...... both produce and are products of the curricula, and for describing the taught curriculum as an emerging and contingent form in its own right (Keiding & Qvortrup, 2014)....

  19. Concepts of classical optics

    CERN Document Server

    Strong, John

    1958-01-01

    An intermediate course in optics, this volume explores both experimental and theoretical concepts, offering practical knowledge of geometrical optics that will enhance students' comprehension of any relevant applied science. Its exposition of the concepts of classical optics is presented with a minimum of mathematical detail but presumes some knowledge of calculus, vectors, and complex numbers.Subjects include light as wave motion; superposition of wave motions; electromagnetic waves; interaction of light and matter; velocities and scattering of light; polarized light and dielectric boundarie

  20. Resilience - A Concept

    Science.gov (United States)

    2016-04-05

    Image designed by Diane Fleischer Resilience —A CONCEPT Col Dennis J. Rensel, USAF (Ret.) Resilience takes on many definitions and ideas depending...upon who is speaking. Taking this one step further, consider resiliency as a concept that provides a holistic view of a system or capability, just...the assessment of the health of a network or system. The hypothesis is: resiliency is meaningful in the context of holistic assessments of

  1. Concept caring in nursing

    OpenAIRE

    Lenka Drahošová; Darja Jarošová

    2016-01-01

    Aim: The aim of this literature review was to search for qualitative studies focusing on the concept of caring in nursing, to analyse them and to synthesize knowledge that concerns the definition of the concept of caring in nursing from the point of view of nurses and patients. Design: Review. Methods: Qualitative studies were searched for systematically in the electronic databases Academic Search Complete (EBSCO), CINAHL, Medline, Science Direct, and the Wiley Library Online, according to se...

  2. Assessment of fuel concepts

    International Nuclear Information System (INIS)

    Bailey, W.J.; Barner, J.O.

    1978-01-01

    The relative merits of various LWR UO 2 fuel concepts with the potential for improved power-ramping capability were qualitatively assessed. In the evaluation, it was determined that of the various concepts being considered, those that presently possess an adequately developed experience base include annular pellets, cladding coated with graphite on the inner surface, and packed-particle fuel. Therefore, these were selected for initial evaluation as part of the Fuel Performance Improvement Program. For this program, graphite-coated cladding is being used in conjunction with annular pellet fuel as one of the concepts with the anticipation of gaining the advantage of the combined improvements. The report discusses the following: the criteria used to evaluate the candidate fuel concepts; a comparison of the concepts selected for irradiation with the criteria, including a general description of their experience bases; and a general discussion of other candidate concepts, including identifying those which may be considered for out-of-reactor evaluation as part of this program, those for which the results of other programs will be monitored, and those which have been deleted from further consideration at this time

  3. [Mindfulness: A Concept Analysis].

    Science.gov (United States)

    Chen, Tsai-Ling; Chou, Fan-Hao; Wang, Hsiu-Hung

    2016-04-01

    "Mindfulness" is an emerging concept in the field of healthcare. Ranging from stress relief to psychotherapy, mindfulness has been confirmed to be an effective tool to help individuals manage depression, anxiety, obsessive-compulsive disorder, and other health problems in clinical settings. Scholars currently use various definitions for mindfulness. While some of these definitions overlap, significant differences remain and a general scholarly consensus has yet to be reached. Several domestic and international studies have explored mindfulness-related interventions and their effectiveness. However, the majority of these studies have focused on the fields of clinical medicine, consultation, and education. Mindfulness has rarely been applied in clinical nursing practice and no related systematic concept analysis has been conducted. This paper conducts a concept analysis of mindfulness using the concept analysis method proposed by Walker and Avant (2011). We describe the defining characteristics of mindfulness, clarify the concept, and confirm the predisposing factors and effects of mindfulness using examples of typical cases, borderline cases, related cases, and contrary case. Findings may provide nursing staff with an understanding of the concept of mindfulness for use in clinical practice in order to help patients achieve a comfortable state of body and mind healing.

  4. Progressive multifocal leukoencephalopathy: new concepts

    Directory of Open Access Journals (Sweden)

    Marco A. Lima

    2013-09-01

    Full Text Available Progressive multifocal leukoencephalopathy (PML is a demyelinating disease of the CNS caused by reactivation of JC virus (JCV in a setting of cellular immunosuppression. Originally, PML was observed in patients with advanced HIV infection, lymphoproliferative disorders and transplant recipients. However, the widespread use of HIV antiretroviral drugs and the new selective immunomodulatory and immunosuppressive medications, such as Rituximab and Natalizumab, has recently modified the epidemiology, clinical presentation and prognosis of PML. Herein, we discuss the new concepts on PML, emphasizing the recent modification in the epidemiology; the impact of new immunomodulatory treatments in the disease, PML-IRIS (Immune reconstitution inflammatory síndrome, new treatment strategies and other JCV related CNS diseases.

  5. Deconstruction as concept of architectural practice

    Directory of Open Access Journals (Sweden)

    Maksimović Milan

    2013-01-01

    Full Text Available This paper inquires into the relationship between philosophical concept of deconstruction and its practical application in the interpretation of the concept of architectural creativity. Deconstruction is not only understood as a formal metaphor, but as a critical process that examines common approaches to architectural design and approach to the treatment of architectural space. Through a comparison with philosophy, this procedure highlights the architectural approach seen as a decomposition of normal and usual way of thinking about architecture and therefore associated treatment of the architectural concept in creative practice. By case study method, analyzed the formal concept of building 'Zepter Palace' in Belgrade, which is interpreted as a deconstruction of the concept of architectural practice. In this example, in comparison with the well-known interpretation of deconstruction on project of La Villette Park in Paris, derived a key contribution of the philosophical deconstruction to the concept of architectural practice - approach that establishes and promotes a method for creating and widening of architectural diversity, seen as a new space sensuality of aesthetic experience of space.

  6. [Group cohesion: a concept analysis].

    Science.gov (United States)

    Lin, Yen-Ru; Chen, Yu-Jung; Tzeng, Wen-Chii; Chou, Kuei-Ru

    2007-10-01

    Group cohesion is considered an essential condition for achieving a successful treatment team. High cohesion groups more readily reach their goals, with group members also feeling more secure about their functions and contributions. In clinical practice, nurses use group teaching and group therapy to help patient and family members gain knowledge and skills related to illness treatment and recuperation. Effective group leadership helps minimize non-productive time and manpower and enhance interpersonal interaction. A further advantage of group cohesion is that the more effective administration of nursing programs that results can raise the profession level of staffs and reduce turnover. Walker and Avant (1995) employ concept analysis to use defining attributes in order to apply the same definition and communication to the same profession. The purpose of this paper was to apply this methodology to an analysis of group cohesion. Steps used include a review of the literature on conceptual definitions of group cohesion, a determination of defining attributes, model construction, identification of borderline, contrary, and related cases, and identification of antecedents and consequences and empirical tools. It is hoped that this analysis can help nursing staff to gain a better understanding of the concept of group cohesion and to apply such to clinical practice and nursing administration.

  7. Health literacy: concept analysis.

    Science.gov (United States)

    Speros, Carolyn

    2005-06-01

    This paper reports an analysis of the concept of health literacy in order to clarify its meaning, reduce ambiguities associated with references to it, and promote consistency in using the concept in nursing dialogue and research. Health literacy is a relatively new concept in health promotion research. Only within the last decade have researchers identified the problems associated with health literacy, the role it plays in an individual's ability to comprehend health and self-care information, and its relationship to health outcomes. Clarifying the concept is essential so that nurses develop an awareness of the phenomenon and its relationship to the outcomes of their communication and health education efforts. The method used for this concept analysis was that of Walker and Avant (1995). Health literacy empowers people to act appropriately in new and changing health-related circumstances through the use of advanced cognitive and social skills. The defining attributes of health literacy are reading and numeracy skills, comprehension, the capacity to use information in health care decision-making, and successful functioning as a healthcare consumer. Antecedents of health literacy are literacy and a health-related experience. Consequences of health literacy include improved self-reported health status, lower health care costs, increased health knowledge, shorter hospitalizations, and less frequent use of health care services. Empirical referents of the concept are the Test of Functional Health Literacy in Adults and the health literacy component of the National Assessment of Adult Literacy. An analysis of the concept of health literacy enhances nurses' ability to assess more accurately their clients' levels of health literacy, thus identifying those at risk for misunderstanding health care instructions, shame associated with inadequate reading skills, and inability to adhere to health care recommendations.

  8. Tratamiento quirúrgico de las fracturas laterales de clavícula. Un nuevo concepto / Surgical treatment for lateral clavicle fractures. A new concept / Tratamento cirúgico das fraturas laterais da clavícula. Um novo conceito

    Directory of Open Access Journals (Sweden)

    Roberto Joaquín Del Gordo-D´Amato

    2014-11-01

    and treatment of these injuries every day migrates to the surgical treatment in reason that most are with large displacements. Materials and methods: Presents a prospective cohort study, in which 36 patients were operated by side fractures of clavicle in the period between April 2011 to September 2012, by open reduction and internal fixation with anatomical plate blocked with lateral clavicle extension (LCP. Of the thirty-six patients operated, were carried out follow-up complete to applying visual analog scale of pain (VAS and the Constant functional scale, to the six weeks, three months, six months and one year post-op. Results: Progressive changes in improving pain and function in each of the periods of follow-up from the sixth postoperative week with significant evidence (p<0.001 could be demonstrated and no change in the rating of pain between the sixth month and the year of follow-up (p= 0.083. Discussion: It can be concluded that open reduction and internal fixation of fractures of clavicle with side extension plates, represent an excellent alternative treatment for such injuries, with prompt and complete functional recovery and low probability of complications. [Del Gordo RJ, Acuña J, Torres E. Surgical treatment of lateral clavicle fractures. A new concept. MedUNAB 2015; 17(2:X:X] Introdução: O terço lateral da clavícula é o segundo local mais acometido por fraturas, logo após o terço médio, e o tratamento tem caminhado dia a dia para tratamento cirúrgico pois, na sua maioria, ocorrem grandes deslocamentos. Materiais e métodos: Estudo cohorte prospectivo, onde 36 pacientes foram submetidos a cirurgia corretora de fratura do terço lateral da clavícula no período de abril de 2011 a setembro de 2012, tendo sido realizada redução aberta da fratura e fixação interna com placa anatômica bloqueada com extensão lateral para clavícula(LCP. Todos os 36 pacientes foram seguidos com 6 semanas, três meses, seis meses e 1 ano de pós-operatório, e

  9. Effluent treatment for nuclear thermal propulsion ground testing

    Science.gov (United States)

    Shipers, Larry R.

    1993-01-01

    The objectives are to define treatment functions, review concept options, discuss PIPET effluent treatment system (ETS), and outline future activities. The topics covered include the following: reactor exhaust; effluent treatment functions; effluent treatment categories; effluent treatment options; concept evaluation; PIPETS ETS envelope; PIPET effluent treatment concept; and future activities.

  10. Concept Analysis: Music Therapy.

    Science.gov (United States)

    Murrock, Carolyn J; Bekhet, Abir K

    2016-01-01

    Down through the ages, music has been universally valued for its therapeutic properties based on the psychological and physiological responses in humans. However, the underlying mechanisms of the psychological and physiological responses to music have been poorly identified and defined. Without clarification, a concept can be misused, thereby diminishing its importance for application to nursing research and practice. The purpose of this article was for the clarification of the concept of music therapy based on Walker and Avant's concept analysis strategy. A review of recent nursing and health-related literature covering the years 2007-2014 was performed on the concepts of music, music therapy, preferred music, and individualized music. As a result of the search, the attributes, antecedents, and consequences of music therapy were identified, defined, and used to develop a conceptual model of music therapy. The conceptual model of music therapy provides direction for developing music interventions for nursing research and practice to be tested in various settings to improve various patient outcomes. Based on Walker and Avant's concept analysis strategy, model and contrary cases are included. Implications for future nursing research and practice to use the psychological and physiological responses to music therapy are discussed.

  11. Impure placebo is a useless concept.

    Science.gov (United States)

    Louhiala, Pekka; Hemilä, Harri; Puustinen, Raimo

    2015-08-01

    Placebos are allegedly used widely in general practice. Surveys reporting high level usage, however, have combined two categories, 'pure' and 'impure' placebos. The wide use of placebos is explained by the high level usage of impure placebos. In contrast, the prevalence of the use of pure placebos has been low. Traditional pure placebos are clinically ineffective treatments, whereas impure placebos form an ambiguous group of diverse treatments that are not always ineffective. In this paper, we focus on the impure placebo concept and demonstrate problems related to it. We also show that the common examples of impure placebos are not meaningful from the point of view of clinical practice. We conclude that the impure placebo is a scientifically misleading concept and should not be used in scientific or medical literature. The issues behind the concept, however, deserve serious attention in future research.

  12. The hue of concepts.

    Science.gov (United States)

    Albertazzi, Liliana; Canal, Luisa; Malfatti, Michela; Micciolo, Rocco

    2013-01-01

    The study shows a systematic naturally biased association between percepts and concepts. Specifically, it shows that a series of terms pertaining to an abstract semantic field (related to the frame of ethics in social behaviour) has a nonrandom, highly significant, association with colours (hues). This is the first time that consistent associations between abstract terms and colours have been reported in the general population. The main hypothesis, ie that there appear to be 'hues of concepts', was borne out by the results: the abstract terms considered were coloured with blue/green (ie cool) colours as well as their synonyms, while their antonyms were coloured with red/yellow (ie warm) colours. The association provides information about the nature of abstract concepts and their relationship with perception. It also sheds light on the interrelations among words in semantic domains that, to date, have been studied from only a computational viewpoint.

  13. Reusable platform concepts

    International Nuclear Information System (INIS)

    Gudmestad, O.T.; Sparby, B.K.; Stead, B.L.

    1993-01-01

    There is an increasing need to reduce costs of offshore production facilities in order to make development of offshore fields profitable. For small fields with short production time there is in particular a need to investigate ways to reduce costs. The idea of platform reuse is for such fields particularly attractive. This paper will review reusable platform concepts and will discuss their range of application. Particular emphasis will be placed on technical limitations. Traditional concepts as jackups and floating production facilities will be discussed by major attention will be given to newly developed ideas for reuse of steel jackets and concrete structures. It will be shown how the operator for several fields can obtain considerable savings by applying such reusable platform concepts

  14. [Family vulnerability: concept development].

    Science.gov (United States)

    Pettengill, Myriam Aparecida Mandetta; Angelo, Margareth

    2005-01-01

    This study aimed to develop the concept of family vulnerability. Data were collected through Qualitative Concept Analysis, which involves two phases. In the first, theoretical phase, data from literature were used for identification of the theoretical attributes of the concept. In the second, field phase, data were collected by means of observations and interviews with twelve families going through the experience of a child's disease and hospitalization. Symbolic Interactionism was used as a theoretical framework, which supported Grounded Theory, applied to guide data collection and analysis in the field phase. As a result of phase II, a theoretical model was built, whose central category defines family vulnerability as FEELING THREATENED IN THEIR AUTONOMY, due to the interactions between family members, illness and health team. The comparison between the two analyses allowed for a theoretical proposition of family vulnerability and advances in terms of theoretical knowledge on family nursing.

  15. Communication, concepts and grounding.

    Science.gov (United States)

    van der Velde, Frank

    2015-02-01

    This article discusses the relation between communication and conceptual grounding. In the brain, neurons, circuits and brain areas are involved in the representation of a concept, grounding it in perception and action. In terms of grounding we can distinguish between communication within the brain and communication between humans or between humans and machines. In the first form of communication, a concept is activated by sensory input. Due to grounding, the information provided by this communication is not just determined by the sensory input but also by the outgoing connection structure of the conceptual representation, which is based on previous experiences and actions. The second form of communication, that between humans or between humans and machines, is influenced by the first form. In particular, a more successful interpersonal communication might require forms of situated cognition and interaction in which the entire representations of grounded concepts are involved. Copyright © 2014 Elsevier Ltd. All rights reserved.

  16. Overcoming: a concept analysis.

    Science.gov (United States)

    Brush, Barbara L; Kirk, Keri; Gultekin, Laura; Baiardi, Janet M

    2011-01-01

    Nurses often work with individuals and populations striving to improve or maintain the quality of their lives. Many, struggling from complex health and social problems, are challenged to surmount barriers to achieve this goal. The growing number of homeless families in the United States represent one such cohort. To develop an operational definition of overcoming and explicate its meaning, attributes, and characteristics as it relates to homeless families. Using the concept analysis method described by Walker and Avant, along with an extensive literature review, and sample cases pertaining to family homelessness, we delineated the defining attributes, antecedents, consequences, and empirical referents of the concept, overcoming. The results of this concept analysis, particularly the relationship of overcoming to family homelessness, provide guidance for further conceptualization and empirical testing, as well as for clinical practice. © 2011 Wiley Periodicals, Inc.

  17. The CLIC Detector Concept

    CERN Document Server

    AUTHOR|(SzGeCERN)779659

    2016-01-01

    CLIC is a concept for a future linear collider that would provide e+e- collisions at up to 3 TeV. The physics aims require a detector system with excellent jet energy and track momentum resolution, highly efficient flavour-tagging and lepton identification capabilities, full geometrical coverage extending to low polar angles and timing information in the order of nanoseconds to reject beam-induced background. To deal with those requirements, an extensive R&D programme is in place to overcome current technological limits. The CLIC detector concept includes a low-mass all-silicon vertex and tracking detector system and fine-grained calorimeters designed for particle flow analysis techniques, surrounded by a 4 T solenoid magnet. An overview of the requirements and design optimisations for the CLIC detector concept is presented.

  18. [Concepts of therapy for children with dyslexia].

    Science.gov (United States)

    von Suchodoletz, Waldemar

    2010-09-01

    Numerous methods based on very different concepts are available to treat children with dyslexia. Basically, symptomatic and causal principles can be distinguished. Among the symptomatic methods are systematic programmes based on learning theory, in which reading and spelling or precursors of these abilities are directly trained. Causal methods promise pronounced and persistent improvement of reading and spelling abilities through elimination of the postulated reason underlying the learning disabilities. Among the causal methods are treatment programmes that train low-level functions. Such training is based on the assumption that deficits of auditory, visual or kinesthetic perception, of motor skills or of the coordination of cerebral functional areas are at the bottom of specific learning disabilities. Concepts of other causal methods act on the assumption that learning processes are blocked or that abnormal medical conditions or psychiatric disorders constitute the background of dyslexia. Reviewed in the article are treatment concepts for children with dyslexia in the German-speaking countries and the methods of treatment derived from the different concepts. Results of evaluation studies are summarized and characteristics of effective treatment methods are listed. It is stressed that efficacy is proven only for symptomatic training programmes but not for causal methods.

  19. Thoracic endometriosis syndrome: Current concept in ...

    African Journals Online (AJOL)

    Background: Thoracic endometriosis is a rare pathology. The diagnosis is often delayed or missed, however recently, there has been significant advances in the knowledge of this condition and hence, an improvement in the diagnosis and treatment. Objective: To review the current concepts in the pathophysiology and ...

  20. Key Concept Mathematics and Management Science Models

    Science.gov (United States)

    Macbeth, Thomas G.; Dery, George C.

    1973-01-01

    The presentation of topics in calculus and matrix algebra to second semester freshmen along with a treatment of exponential and power functions would permit them to cope with a significant portion of the mathematical concepts that comprise the essence of several disciplines in a business school curriculum. (Author)

  1. Putting resilience and resistance concepts into practice

    Science.gov (United States)

    Jeanne C. Chambers; Jeremy D. Maestas; Mike Pellant

    2015-01-01

    Land managers are increasingly interested in improving resilience to disturbances, such as wildfire, and resistance to invasive species, such as cheatgrass and medusahead. This factsheet is designed to assist land managers in using resilience and resistance concepts to assess risks, prioritize management activities, and select appropriate treatments.

  2. Loneliness: a concept analysis.

    Science.gov (United States)

    Bekhet, Abir K; Zauszniewski, Jaclene A; Nakhla, Wagdy E

    2008-01-01

    Loneliness is a universal human experience recognized since the dawn of time, yet it is unique for every individual. Loneliness can lead to both depression and low self-esteem. This article explicates the concept of loneliness through the examination of its conceptual definition and uses, defining attributes, related concepts, and empirical referents. Literature review using hand search and database were used as sources of information. Because loneliness is commonly encountered in nursing situations, the information provided will serve as a framework for assessment, planning, intervention, and evaluation of clients.

  3. Concepts of quantum optics

    CERN Document Server

    Knight, P L

    1983-01-01

    Concepts of Quantum Optics is a coherent and sequential coverage of some real insight into quantum physics. This book is divided into six chapters, and begins with an overview of the principles and concepts of radiation and quanta, with an emphasis on the significance of the Maxwell's electromagnetic theory of light. The next chapter describes first the properties of the radiation field in a bounded cavity, showing how each cavity field mode has the characteristics of a simple harmonic oscillator and how each can be quantized using known results for the quantum harmonic oscillator. This chapte

  4. Innatism, Concept Formation, Concept Mastery and Formal Education

    Science.gov (United States)

    Winch, Christopher

    2015-01-01

    This article will consider the claim that the possession of concepts is innate rather than learned. Innatism about concept learning is explained through consideration of the work of Fodor and Chomsky. First, an account of concept formation is developed. Second the argument against the claim that concepts are learned through the construction of a…

  5. THE EFFECT OF CONCEPT MAPPING ON CONCEPT LEARNING IN SCIENCE

    OpenAIRE

    Oka, Naoki; Imanaga, Kumiko

    2012-01-01

    An experiment was conducted to investigate the effects of concept map completion tasks on concept learning in the primary schoolchildren. The participants were to insert some of the suitable concepts (concept group) or link labeles (link label group) or both of them (concept/link label group) into the blanks to make up the map wholly. It was revealed that the results of the concept group and the concept/link label group were better than the link label group. These results were discussed in te...

  6. Thirdness and psychoanalytic concepts.

    Science.gov (United States)

    Green, André

    2004-01-01

    Many psychoanalytic concepts lend themselves to the notion of thirdness. Starting from a basis of Freudian thought, the author discusses some of the elaborative contributions of Winnicott, Lacan, and Bion, as well as the ideas of Saussure and Peirce, noting how all these incorporate an appreciation of the value and relevance of thirdness in both the theory and practice of psychoanalysis.

  7. Two Conceptions of Virtue

    Science.gov (United States)

    Hill, Thomas E., Jr.

    2013-01-01

    The general questions are: what is virtue and how can it be cultivated? The specific focus is on the conceptions of virtue in the works of Immanuel Kant and John Rawls. Kant regarded virtue as a good will that is also strong enough to resist contrary passions, impulses, and inclinations. Childhood training can prepare children for virtue, but…

  8. Liquid fuel concept benefits

    International Nuclear Information System (INIS)

    Hron, M.

    1996-01-01

    There are principle drawbacks of any kind of solid nuclear fuel listed and analyzed in the first part of the paper. One of the primary results of the analyses performed shows that the solid fuel concept, which was to certain degree advantageous in the first periods of a nuclear reactor development and operation, has guided this branch of a utilization of atomic nucleus energy to a death end. On the background of this, the liquid fuel concept and its benefits are introduced and briefly described in the first part of the paper, too. As one of the first realistic attempts to utilize the advantages of liquid fuels, the reactor/blanket system with molten fluoride salts in the role of fuel and coolant simultaneously, as incorporated in the accelerator-driven transmutation technology (ADTT) being proposed and currently having been under development in the Los Alamos National Laboratory, will be studied both theoretically and experimentally. There is a preliminary design concept of an experimental assembly LA-O briefly introduced in the paper which is under preparation in the Czech Republic for such a project. Finally, there will be another very promising concept of a small low power ADTT system introduced which is characterized by a high level of safety and economical efficiency. In the conclusion, the overall survey of principal benefits which may be expected by introducing liquid nuclear fuel in nuclear power and research reactor systems is given and critically analyzed. 7 refs, 4 figs

  9. Understanding the Agribusiness Concept.

    Science.gov (United States)

    Lee, Jasper S.

    Designed to aid in learning the main ideas of the agribusiness concept, this document answers the following questions, treating each answer in a separate explanatory section: (1) What is the meaning of the terms "agriculture" and "agribusiness"? (2) What is the relationship of agriculture and agribusiness? (3) What is involved in tracing an…

  10. The LDC detector concept

    Indian Academy of Sciences (India)

    Abstract. In preparation of the experimental program at the international linear collider (ILC), the large detector concept (LDC) is being developed. The main points of the LDC are a large volume gaseous tracking system, combined with high precision vertex detector and an extremely granular calorimeter. The main design ...

  11. Concepts and Recipes

    Czech Academy of Sciences Publication Activity Database

    Materna, Pavel

    -, č. 50 (2009), s. 69-90 ISSN 0353-5150 R&D Projects: GA ČR(CZ) GA401/07/0451 Institutional research plan: CEZ:AV0Z90090514 Keywords : effective procedure * Turing maschine * intentions * constructions * transparent intensional logic * concept Subject RIV: AA - Philosophy ; Religion

  12. Parsimonious concept modeling

    NARCIS (Netherlands)

    Meij, E.; Trieschnigg, D.; Rijke, M.de; Kraaij, W.

    2008-01-01

    In many collections, documents are annotated using concepts from a structured knowledge source such as an ontology or thesaurus. Examples include the news domain [7], where each news item is categorized according to the nature of the event that took place, and Wikipedia, with its per-article

  13. Ares I concept illustration

    Science.gov (United States)

    2008-01-01

    Shown is an illustration of the Ares I concept. The first stage will be a single, five-segment solid rocket booster derived from the space shuttle programs reusable solid rocket motor. The first stage is managed by NASA's Marshall Space Flight Center in Huntsville, Alabama for NASA's Constellation program.

  14. Learning Design: Concepts

    NARCIS (Netherlands)

    Koper, Rob; Bennett, Sue

    2006-01-01

    Koper, E. J. R., & Bennet, S. (2008). Learning Design: Concepts. In H. H. Adelsberger, Kinshuk, J. M. Pawlowski & D. Sampson, Handbook on Information Technologies for Education and Training (2th ed., pp. 135-154). Springer, Berlin Heidelberg 2008: International Handbook on Information Systems

  15. Concept medium program

    DEFF Research Database (Denmark)

    Bjerrum, Peter

    2003-01-01

    The present essays is an attempt to dertermine the architecural project of the 21st century in realation to a modern conception of space as the medium of architecture, and of society as its program. This attempt adopts the internal point of view of an architect in describing a modern architectura...

  16. Innovative transparent armour concepts

    NARCIS (Netherlands)

    Carton, E.P.; Broos, J.P.F.

    2011-01-01

    Ever since WWII transparent armour consists of a multi-layer of glass panels bonded by thin polymer bond-films using an autoclave process. TNO has worked on the development of innovative transparent armour concepts that are lighter and a have better multi-hit capacity. Two new transparent armour

  17. Advanced Concept Modeling

    Science.gov (United States)

    Chaput, Armand; Johns, Zachary; Hodges, Todd; Selfridge, Justin; Bevirt, Joeben; Ahuja, Vivek

    2015-01-01

    Advanced Concepts Modeling software validation, analysis, and design. This was a National Institute of Aerospace contract with a lot of pieces. Efforts ranged from software development and validation for structures and aerodynamics, through flight control development, and aeropropulsive analysis, to UAV piloting services.

  18. [Self esteem : concept analysis.

    Science.gov (United States)

    Doré, Christina

    2017-06-01

    Self-esteem is an inner attitude at the base of the construction of personality and psychic balance in addition to be responsible of adaptive processes over the course of life. The concept of self-esteem is commonly used in several disciplines however, it seems that the consensus on its conceptualization and its operationalization is not yet reached. In this context, the concept analysis allows to address a phenomenon and to understand its use and its evolution from a unique disciplinary perspective. The aim of this article is therefore to analyze the concept of self esteem from a nursing perspective to identify : definitions of the term and related terms, attributes, model and limit cases proposed here within the community of mental health nurses, antecedents and consequents as well as the empirical references using the Walker and Avant method. The attributes identified allowing a deeper understanding of the concept are : the self-value, the self-acceptance, the self-efficacy, attitude towards oneself and finally, self-respect.

  19. DSMS science operations concept

    Science.gov (United States)

    Connally, M. J.; Kuiper, T. B.

    2001-01-01

    The Deep Space Mission System (DSMS) Science Operations Concept describes the vision for enabling the use of the DSMS, particularly the Deep Space Network (DSN) for direct science observations in the areas of radio astronomy, planetary radar, radio science and VLBI.

  20. Communication, concepts and grounding

    NARCIS (Netherlands)

    van der Velde, Frank; van der Velde, F.

    2015-01-01

    This article discusses the relation between communication and conceptual grounding. In the brain, neurons, circuits and brain areas are involved in the representation of a concept, grounding it in perception and action. In terms of grounding we can distinguish between communication within the brain

  1. Sound Search Engine Concept

    DEFF Research Database (Denmark)

    2006-01-01

    Sound search is provided by the major search engines, however, indexing is text based, not sound based. We will establish a dedicated sound search services with based on sound feature indexing. The current demo shows the concept of the sound search engine. The first engine will be realased June...

  2. [Current concepts on gastroschisis].

    Science.gov (United States)

    Castrejón García, J M; Vivar Ferrer, I; Bautista, M L

    1979-01-01

    Present day concepts about history, etiology, embriology, and management of gastroschisis are reviewed and a case is reported; it was treated in two surgical steps. A silastic net was applied and the intestinal loops were gradually introduced until the abdominal defect closed completely. Parenteral feeding was also given.

  3. Concept of Operations: Essence

    Energy Technology Data Exchange (ETDEWEB)

    Hutton, William J.

    2014-04-01

    This concept of operations is designed to give the reader a brief overview of the National Rural Electric Cooperative Association’s Essence project and a description of the Essence device design. The data collected by the device, how the data are used, and how the data are protected are also discussed in this document.

  4. Elaborating on Threshold Concepts

    Science.gov (United States)

    Rountree, Janet; Robins, Anthony; Rountree, Nathan

    2013-01-01

    We propose an expanded definition of Threshold Concepts (TCs) that requires the successful acquisition and internalisation not only of knowledge, but also its practical elaboration in the domains of applied strategies and mental models. This richer definition allows us to clarify the relationship between TCs and Fundamental Ideas, and to account…

  5. Mengembangkan Self Concept Siswa Melalui Model Pembelajaran Concept Attainment

    OpenAIRE

    Sumartini, Tina Sri

    2015-01-01

    Dalam pembelajaran matematika, siswa masih kurang memiliki self concept yang positif. Salah satu model pembelajaran yang dapat diterapkan untuk mengembangkan self concept siswa adalah model concept attainment. Tujuan penelitian ini adalah untuk mengetahui perkembangan self concept siswa setelah mendapatkan model pembelajaran concept attainment. Penelitian ini berbentuk one shot case study. Populasi dalam penelitian ini adalah siswa di salah satu SMK di Kabupaten Garut. Pengambilan sampel d...

  6. Integrating Concepts in Biology

    Science.gov (United States)

    Luckie, Douglas B; Hoskinson, Anne-Marie; Griffin, Caleigh E; Hess, Andrea L; Price, Katrina J; Tawa, Alex; Thacker, Samantha M

    2017-01-01

    The purpose of this study was to examine the educational impact of an intervention, the inquiry-focused textbook Integrating Concepts in Biology ( ICB ), when used in a yearlong introductory biology course sequence. Student learning was evaluated using three published instruments: 1) The Biology Concept Inventory probed depth of student mastery of fundamental concepts in organismal and cellular topics when confronting misconceptions as distractors. ICB students had higher gains in all six topic categories (+43% vs. peers overall, p concepts, like experts. The frequency with which ICB students connected deep-concept pairs, or triplets, was similar to peers; but deep understanding of structure/function was much higher (for pairs: 77% vs. 25%, p < 0.01). 3) A content-focused Medical College Admission Test (MCAT) posttest compared ICB student content knowledge with that of peers from 15 prior years. Historically, MCAT performance for each semester ranged from 53% to 64%; the ICB cohort scored 62%, in the top quintile. Longitudinal tracking in five upper-level science courses the following year found ICB students outperformed peers in physiology (85% vs. 80%, p < 0.01). © 2017 D. B. Luckie et al. CBE—Life Sciences Education © 2017 The American Society for Cell Biology. This article is distributed by The American Society for Cell Biology under license from the author(s). It is available to the public under an Attribution–Noncommercial–Share Alike 3.0 Unported Creative Commons License (http://creativecommons.org/licenses/by-nc-sa/3.0).

  7. Age differences in concept formation.

    Science.gov (United States)

    Hartman, Marilyn; Stratton-Salib, Brea C

    2007-02-01

    In order to identify the source of age-related deficits in concept formation, older and younger adults completed a new Concept Matching Test, tests of selective attention, and the Sorting Test, a standardized test of concept formation (Delis, Kaplan, & Kramer, 2001). Older adults showed intact concept identification, the ability to generate abstract concepts from stimulus features, but age differences were observed when irrelevant features were present. In addition, selective attention, but not concept identification ability, predicted age-related declines on the Sorting Test. Thus, reduced concept formation in older adults may stem from declines in abilities other than the capacity for abstraction.

  8. The Bobath concept in contemporary clinical practice.

    Science.gov (United States)

    Graham, Julie Vaughan; Eustace, Catherine; Brock, Kim; Swain, Elizabeth; Irwin-Carruthers, Sheena

    2009-01-01

    Future development in neurorehabilitation depends upon bringing together the endeavors of basic science and clinical practice. The Bobath concept is widely utilized in rehabilitation following stroke and other neurological conditions. This concept was first developed in the 1950s, based on the neuroscience knowledge of those times. The theoretical basis of the Bobath concept is redefined based on contemporary neuroscience and rehabilitation science. The framework utilized in the Bobath concept for the analysis of movement and movement dysfunction is described. This framework focuses on postural control for task performance, the ability to move selectively, the ability to produce coordinated sequences of movement and vary movement patterns to fit a task, and the role of sensory input in motor behaviour and learning. The article describes aspects of clinical practice that differentiate this approach from other models of practice. Contemporary practice in the Bobath concept utilizes a problem-solving approach to the individual's clinical presentation and personal goals. Treatment is focused toward remediation, where possible, and guiding the individual towards efficient movement strategies for task performance. The aim of this article is to provide a theoretical framework on which future research into the Bobath concept can be based.

  9. Semantic search via concept annealing

    Science.gov (United States)

    Dunkelberger, Kirk A.

    2007-04-01

    Annealing, in metallurgy and materials science, is a heat treatment wherein the microstructure of a material is altered, causing changes in its properties such as strength and hardness. We define concept annealing as a lexical, syntactic, and semantic expansion capability (the removal of defects and the internal stresses that cause term- and phrase-based search failure) coupled with a directed contraction capability (semantically-related terms, queries, and concepts nucleate and grow to replace those originally deformed by internal stresses). These two capabilities are tied together in a control loop mediated by the information retrieval precision and recall metrics coupled with intuition provided by the operator. The specific representations developed have been targeted at facilitating highly efficient and effective semantic indexing and searching. This new generation of Find capability enables additional processing (i.e. all-source tracking, relationship extraction, and total system resource management) at rates, precisions, and accuracies previously considered infeasible. In a recent experiment, an order magnitude reduction in time to actionable intelligence and nearly three orderss magnitude reduction in false alarm rate was achieved.

  10. The concept of sexual narcissism

    Directory of Open Access Journals (Sweden)

    Silvana Gasar

    2001-12-01

    Full Text Available David Farley Hurlbert, a marriage and sex therapist in Belton, Texas, and Carol Apt, a therapist in private practice in Lexington, Kentucky, developed the concept of sexual narcissism after they studied the characteristics of nonalcoholic abusive males. Men and women who claim to be sex addicts or sexually compulsive are actually sexual narcissists, according to the abovementioned authors. Sexual narcissists lack the ability to experience intimacy. They are fixated on the sex act, but they cannot be intimate. He or she compensates for low self-esteem through high sexual esteem, and tries to build a positive self-image with one sexual encounter after another. They believe that sexual narcissism is more common in men. Treatment can be very difficult, because they never face the problem. It is important that the sexual narcissist is never identified as a patient - their fragile egos cannot handle being considered inadequate in any way. Group therapy does not work with them. A more constructive treatment plan includes gradual confrontation. Only long-term treatment will tell if such subjects can learn to become intimate.

  11. The "child size medicines" concept

    DEFF Research Database (Denmark)

    Nsabagasani, Xavier; Okeng, Jasper Ogwal; Mbonye, Anthony

    2015-01-01

    Background In 2007, the World Health Organization (WHO) launched the ‘make medicines child size’ (MMCS) campaign by urging countries to prioritize procurement of medicines with appropriate strengths for children’s age and weight and, in child-friendly formulations of rectal and flexible oral solid...... of policy provisions for the MMCS recommendations. Results For most medicines for the selected diseases, appropriate strength for children’s age and weight was addressed especially in the EMHSLU 2012. However, policy documents neither referred to ‘child size medicines’ concept nor provided for flexible oral...... health policy documents reflected limited adherence to the MMCS recommendations. This and failure to use evidence based medicines may result into treatment failure and or death. A revision of the current policies and guidelines to better reflect ‘child size’, child appropriate and evidence based...

  12. Accelerated treatment.

    Science.gov (United States)

    Barkley, H T

    1985-05-01

    In the first third of this century, the prevailing concept was that malignant cells had a brief period of sensitivity and radiation treatments were ideally given in overall times of 2 weeks or less. Following the Second World War, routine treatment times were extended to 5 to 8 weeks to avoid severe acute normal tissue reactions and achieve higher tumor doses. In reaction to these prolonged overall times, a series of large-fraction, shortened-overall-time clinical experiments were attempted, with disastrous normal tissue effects and poor tumor control. More recently, attempts to accelerate treatment have been accomplished by utilizing multiple fractions per day or semicontinuous irradiation. Unfortunately, the majority of these attempts have been forced by the occurrence of unacceptable normal tissue reactions to significantly reduce total dose or introduce lengthy splits in treatment. These results suggest that in our current state of knowledge accelerated schedules be reserved for use in the treatment of rapidly proliferating neoplasms or for palliation.

  13. Proof of Concept

    DEFF Research Database (Denmark)

    Margheritini, Lucia; Parmeggiani, Stefano; Kofoed, Jens Peter

    The Wave Energized Baltic Aeration Pump (WEBAP) is a concept that proposes to find a solution to the low level of oxygenation of the Baltic Sea by bringing the surface sea water to the depth where the oxygen is needed. It proposes to do so by using the rich in oxygen overtopping water collected...... in a reservoir floating on the sea. The stored water, after overtopping the ramp leading to the reservoir, will be at a higher level than mean water level and therefore will have a potential energy. This potential energy is indeed used to pump down to the sea bed the oxygenated water right there where...... it is needed. In the following paragraphs, the desk study on the WEBAP concept is presented in terms of overtopping flow rates for different configurations. Investigations on different drafts, slope angles and crest levels have been completed. Calculations on the pipe discharge have been made in order...

  14. TQM: the essential concepts.

    Science.gov (United States)

    Chambers, D W

    1998-01-01

    This is an introduction to the major concepts in total quality management, a loose collection of management approaches that focus on continuous improvement of processes, guided by routine data collection and adjustment of the processes. Customer focus and involvement of all members of an organization are also characteristics commonly found in TQM. The seventy-five-year history of the movement is sketched from its beginning in statistical work on quality assurance through the many improvements and redefinitions added by American and Japanese thinkers. Essential concepts covered include: control cycles, focus on the process rather than the defects, the GEAR model, importance of the customer, upstream quality, just-in-time, kaizen, and service quality.

  15. Concepts in Thermal Physics

    CERN Document Server

    Blundell, Stephen J

    2006-01-01

    This modern introduction to thermal physics contains a step-by-step presentation of the key concepts. The text is copiously illustrated and each chapter contains several worked examples. - ;An understanding of thermal physics is crucial to much of modern physics, chemistry and engineering. This book provides a modern introduction to the main principles that are foundational to thermal physics, thermodynamics, and statistical mechanics. The key concepts are carefully presented in a clear way, and new ideas are illustrated with copious worked examples as well as a description of the historical background to their discovery. Applications are presented to subjects as. diverse as stellar astrophysics, information and communication theory, condensed matter physics, and climate change. Each chapter concludes with detailed exercises. -

  16. Dual coolant blanket concept

    International Nuclear Information System (INIS)

    Malang, S.; Schleisiek, K.

    1994-11-01

    A self-cooled liquid metal breeder blanket with helium-cooled first wall ('Dual Coolant Blanket Concept') for a fusion DEMO reactor is described. This is one of the four blanket concepts under development in the frame of the European fusion technology program with the aim to select in 1995 the two most promising ones for further development. Described are the design of the blankets including the ancillary loop system and the results of the theoretical and experimental work in the fields of neutronics, magnetohydrodynamics, thermohydraulics, mechanical stresses, compatibility and purification of lead-lithium, tritium control, safety, reliability, and electrically insulating coatings. The remaining open questions and the required R and D programme are identified. (orig.) [de

  17. Lynx Mission concept status

    Science.gov (United States)

    Gaskin, Jessica A.; Allured, Ryan; Bandler, Simon R.; Basso, Stefano; Bautz, Marshall W.; Baysinger, Michael F.; Biskach, Michael P.; Boswell, Tyrone M.; Capizzo, Peter D.; Chan, Kai-Wing; Civitani, Marta M.; Cohen, Lester M.; Cotroneo, Vincenzo; Davis, Jacqueline M.; DeRoo, Casey T.; DiPirro, Michael J.; Dominguez, Alexandra; Fabisinski, Leo L.; Falcone, Abraham D.; Figueroa-Feliciano, Enectali; Garcia, Jay C.; Gelmis, Karen E.; Heilmann, Ralf K.; Hopkins, Randall C.; Jackson, Thomas; Kilaru, Kiranmayee; Kraft, Ralph P.; Liu, Tianning; McClelland, Ryan S.; McEntaffer, Randy L.; McCarley, Kevin S.; Mulqueen, John A.; Özel, Feryal; Pareschi, Giovanni; Reid, Paul B.; Riveros, Raul E.; Rodriguez, Mitchell A.; Rowe, Justin W.; Saha, Timo T.; Schattenburg, Mark L.; Schnell, Andrew R.; Schwartz, Daniel A.; Solly, Peter M.; Suggs, Robert M.; Sutherlin, Steven G.; Swartz, Douglas A.; Trolier-McKinstry, Susan; Tutt, James H.; Vikhlinin, Alexey; Walker, Julian; Yoon, Wonsik; Zhang, William W.

    2017-09-01

    Lynx is a concept under study for prioritization in the 2020 Astrophysics Decadal Survey. Providing orders of magnitude increase in sensitivity over Chandra, Lynx will examine the first black holes and their galaxies, map the large-scale structure and galactic halos, and shed new light on the environments of young stars and their planetary systems. In order to meet the Lynx science goals, the telescope consists of a high-angular resolution optical assembly complemented by an instrument suite that may include a High Definition X-ray Imager, X-ray Microcalorimeter and an X-ray Grating Spectrometer. The telescope is integrated onto the spacecraft to form a comprehensive observatory concept. Progress on the formulation of the Lynx telescope and observatory configuration is reported in this paper.

  18. Fundamental concepts on energy

    International Nuclear Information System (INIS)

    Rodriguez, M.H.

    1998-01-01

    The fundamental concepts on energy and the different forms in which it is manifested are presented. Since it is possible to transform energy in a way to other, the laws that govern these transformations are discussed. The energy transformation processes are an essential compound in the capacity humanizes to survive and be developed. The energy use brings important economic aspects, technical and political. Because this, any decision to administer energy system will be key for our future life

  19. Upcoming Ideas and Concepts

    OpenAIRE

    Odenthal, Christian

    2017-01-01

    This module gives an overview of upcoming ideas and concepts for thermal energy storage. After attending the module, the listener will be able to understand which shortcomings of current thermal energy storage technologies are there and what possible improvements are currently under research. The topic is divided into three main sections according to the underlying technologies. The first technology is sensible heat storage, which is based on storing heat by changing the temperature o...

  20. Basic concepts in oceanography

    International Nuclear Information System (INIS)

    Small, L.F.

    1997-01-01

    Basic concepts in oceanography include major wind patterns that drive ocean currents, and the effects that the earth's rotation, positions of land masses, and temperature and salinity have on oceanic circulation and hence global distribution of radioactivity. Special attention is given to coastal and near-coastal processes such as upwelling, tidal effects, and small-scale processes, as radionuclide distributions are currently most associated with coastal regions. (author)

  1. CONCEPT ANALYSIS: AGGRESSION

    OpenAIRE

    Liu, Jianghong

    2004-01-01

    The concept of aggression is important to nursing because further knowledge of aggression can help generate a better theoretical model to drive more effective intervention and prevention approaches. This paper outlines a conceptual analysis of aggression. First, the different forms of aggression are reviewed, including the clinical classification and the stimulus-based classification. Then the manifestations and measurement of aggression are described. Finally, the causes and consequences of ...

  2. ARES 1 ARTIST CONCEPTION

    Science.gov (United States)

    2008-01-01

    A CONCEPT IMAGE SHOWS THE ARES I CREW LAUNCH VEHICLE DURING ASCENT. ARES I IS AN IN-LINE, TWO-STAGE ROCKET CONFIGURATION TOPED BY THE ORION CREW EXPLORATION VEHICLE AND LAUNCH ABORT SYSTEM. THE ARES I FIRST STAGE IS A SINGLE, FIVE-SEGMENT REUSABLE SOLID ROCKET BOOSTER, DERIVED FROM THE SPACE SHUTTLE. ITS UPPER STAGE IS POWERED BY A J-2X ENGINE. ARES I WILL CARRY THE ORION WITH ITS CRW OF UP TO SIX ASTRONAUTS TO EARTH ORBIT.

  3. Some core contested concepts.

    Science.gov (United States)

    Chomsky, Noam

    2015-02-01

    Core concepts of language are highly contested. In some cases this is legitimate: real empirical and conceptual issues arise. In other cases, it seems that controversies are based on misunderstanding. A number of crucial cases are reviewed, and an approach to language is outlined that appears to have strong conceptual and empirical motivation, and to lead to conclusions about a number of significant issues that differ from some conventional beliefs.

  4. BN-1200 Safety Concept

    International Nuclear Information System (INIS)

    Ashurko, Y.

    2013-01-01

    Safety concept of the BN-1200 design: • Takes into account experience gained from the BR-5/10, BOR-60, BN-350, BN-600, BN-800 and requirements imposed to the 4th generation advanced reactors; • Provides maximal application of inherent safety features and passive safety systems. Such approach permits: • To excel in safety existing designs, in particular BN-800; • And to meet requirements of the 4th generation

  5. Hegel's conceptions of mediation

    OpenAIRE

    O'Connor, Brian

    1999-01-01

    Given its centrality to the intellectual thought processes through which the great structures of logic, nature, and spirit are unfolded it is clear that mediation is vital to the very possibility of Hegel's encyclopaedic philosophy. Yet Hegel gives little specific explanation of the concept of mediation. Surprisingly, it has been the subject of even less attention by scholars of Hegel. Nevertheless it is casually used in discussions of Hegel and post-Hegelian philosophy as though its meaning ...

  6. Molten salt reactor concept

    International Nuclear Information System (INIS)

    Sood, D.D.

    1980-01-01

    Molten salt reactor is an advanced breeder concept which is suited for the utilization of thorium for nuclear power production. This reactor is based on the use of solutions of uranium or plutonium fluorides in LiF-BeF 2 -ThF 4 as fuel. Unlike the conventional reactors, no external coolant is used in the reactor core and the fuel salt itself is circulated through heat exchangers to transfer the fission produced heat to a secondary salt (NaF-NaBF 4 ) for steam generation. A part of the fuel stream is continuously processed to isolate 233 Pa, so that it can decay to fissile 233 U without getting converted to 234 Pa, and for the removal of neutron absorbing fission products. This on-line processing scheme makes this reactor concept to achieve a breeding ratio of 1.07 which is the highest for any thermal breeder reactor. Experimental studies at the Bhabha Atomic Research Centre, Bombay, have established the use of plutonium as fuel for this reactor. This molten salt reactor concept is described and the work conducted at the Bhabha Atomic Research Centre is summarised. (auth.)

  7. Indicatoren voor de zorgtoewijzing bij persoonlijkheidsstoornissen: resultaten van een concept map analyse

    NARCIS (Netherlands)

    J.G. van Manen (Janine); M.A. Goossensen (Anne); P.M.F.J.J. Knapen; T. Ingenhoven (Theo); H. de Saeger (Hilde); C. Cornelissen (Kees); J.H. Kamphuis (Jan Henk); R. Timman (Reinier); R. Verheul (Roel); J.J. van Busschbach (Jan)

    2010-01-01

    textabstractUsing the concept map method, this study revealed patient characteristics that are important for treatment selection decisions in patients with personality disorders. Concept mapping is a specific type of structured conceptualization process and describes the underlying structure of

  8. The concept of shalom as a constructive bereavement healing ...

    African Journals Online (AJOL)

    existence of African traditional healing and biomedical treatment, that is, plurality of health seeking practices. The approach ... The Hebrew concept of shalom, though distinctly salvific, is inclusive of holistic and personalistic healing aspects.

  9. Proprioceptive derivation concept-Implications in dentistry

    Directory of Open Access Journals (Sweden)

    Ajay Bhambhal

    2013-01-01

    Full Text Available Dentists and dental students often assume awkward physical positions while providing treatment to (a get a better view of the intraoral cavity; (b provide a more comfortable position for the patient; and/or (c operate equipment and reach for instruments and supplies. Posture isn′t the only concern. New technologies and changes aims to give the dentist new concepts to give greater comfort and better health. This review emphasizes on a new technology: proprioceptive derivation concept.Proprioceptive derivation concept helps dentists to discover new ways of positioning themselves, and working comfortably and effectively, which makes it possible for dentists to adopt a more neutral, less awkward working posture.

  10. Self-Concept Is a Concept Worth Considering

    Science.gov (United States)

    Shields, Nora

    2009-01-01

    There is a growing recognition of the importance of self-concept in the pediatric rehabilitation research literature. There also is confusion and inconsistency in the definitions of and the terminology used to describe self-concept. What is agreed is that self-concept is multidimensional, comprising a child's perception of their personal…

  11. Actuator concepts and mechatronics

    Science.gov (United States)

    Gilbert, Michael G.; Horner, Garnett C.

    1998-06-01

    Mechatronic design implies the consideration of integrated mechanical, electrical, and local control characteristics in electromechanical device design. In this paper, mechatronic development of actuation device concepts for active aircraft aerodynamic flow control are presented and discussed. The devices are intended to be embedded in aircraft aerodynamic surfaces to provide zero-net-momentum jets or additional flow-vorticity to control boundary layers and flow- separation. Two synthetic jet device prototypes and one vorticity-on-demand prototype currently in development are described in the paper. The aspects of actuation materials, design approaches to generating jets and vorticity, and the integration of miniaturized electronics are stressed.

  12. On the gestalt concept.

    Science.gov (United States)

    Breidbach, Olaf; Jost, Jürgen

    2006-08-01

    We define a gestalt as the invariants of a collection of patterns that can mutually be transformed into each other through a class of transformations encoded by, or conversely, determining that gestalt. The class of these transformations needs to satisfy structural regularities like the ones of the mathematical structure of a group. This makes an analysis of a gestalt possible in terms of relations between its representing patterns. While the gestalt concept has its origins in cognitive psychology, it has also important implications for morphology.

  13. Existing Sustainable Renovation Concepts

    DEFF Research Database (Denmark)

    Tommerup, Henrik M.; Vanhoutteghem, Lies; Gustavsson, Leif

    The Nordic single-family house renovation market is dominated by a craftsman based approach with individual solutions, traditional warehouses ”do-it-yourself-shops” and some actors marketing single products. To speed up the implementation of sustainable renovation of single-family houses...... there is a great need for full-service packages including consulting, contract work, follow-up, financing and operation and maintenance. There are few Nordic examples of such service models for renovation of single-family houses which entered the market recently. The success of these concepts is yet...

  14. Concepts of modern mathematics

    CERN Document Server

    Stewart, Ian

    1995-01-01

    Some years ago, ""new math"" took the country's classrooms by storm. Based on the abstract, general style of mathematical exposition favored by research mathematicians, its goal was to teach students not just to manipulate numbers and formulas, but to grasp the underlying mathematical concepts. The result, at least at first, was a great deal of confusion among teachers, students, and parents. Since then, the negative aspects of ""new math"" have been eliminated and its positive elements assimilated into classroom instruction.In this charming volume, a noted English mathematician uses humor an

  15. Advanced divertor concepts

    International Nuclear Information System (INIS)

    Ohyabu, N.; Komori, A.; Sagara, A.; Suzuki, H.; Morisaki, T.; Masuzaki, S.; Watanabe, T.; Noda, N.; Motojima, O.

    1996-01-01

    LHD divertor development program has generated various innovative divertor concepts and technologies which will help to improve the plasma performance in both helical and tokamak devices. They are two divertor operational scenarios (confinement improvement by generating high temperature divertor plasma and simultaneous achievement of radiative cooling and H-mode-like confinement improvement). Local island divertor geometry has also been proposed. This new divertor has been successfully tested in the CHS device and is planned to be installed in the LHD device. In addition, technological development of new efficient hydrogen pumping schemes (carbon sheet pump and membrane pump) are being pursued for enhancement of the divertor control capability. 17 refs., 8 figs

  16. Pediatric obesity: Current concepts.

    Science.gov (United States)

    Greydanus, Donald E; Agana, Marisha; Kamboj, Manmohan K; Shebrain, Saad; Soares, Neelkamal; Eke, Ransome; Patel, Dilip R

    2018-04-01

    This discussion reflects on concepts of obesity in children and adolescents in the early 21st century. It includes reflections on its history, definition, epidemiology, diagnostic perspectives, psychosocial considerations, musculoskeletal complications, endocrine complications and principles of management. In addition to emphasis on diet and exercise, research and clinical applications in the second decade of the 21 st century emphasize the increasing use of pharmacotherapy and bariatric surgery for adolescent and adult populations with critical problems of overweight and obesity. We conclude with a discussion of future directions in pediatric obesity management. Copyright © 2018 Mosby, Inc. All rights reserved.

  17. Concepts of combinatorial optimization

    CERN Document Server

    Paschos, Vangelis Th

    2014-01-01

    Combinatorial optimization is a multidisciplinary scientific area, lying in the interface of three major scientific domains: mathematics, theoretical computer science and management.  The three volumes of the Combinatorial Optimization series aim to cover a wide range  of topics in this area. These topics also deal with fundamental notions and approaches as with several classical applications of combinatorial optimization.Concepts of Combinatorial Optimization, is divided into three parts:- On the complexity of combinatorial optimization problems, presenting basics about worst-case and randomi

  18. Anaxagoras concept of Nous

    OpenAIRE

    Gorgijev, Slađana

    2015-01-01

    When Ambrose, Anaxagoras have a theory of origin of the world, on whose head is immortal and eternal law Nous. Nous or cosmic mind, according to Anaxagoras is not the creator of the world but someone who plan governing the world, someone who runs the original seed and shapes. According to Anaxagoras original particles would be an amorphous material that was not Nous who has put in motion and thus introduced in order. The concept of Nous some philosophers understood as a mechanical principle a...

  19. On the Probabilty Concept

    Directory of Open Access Journals (Sweden)

    Bruno De Finetti

    2016-09-01

    Full Text Available As it has been already done for the Corrado Gini's works, STATISTICA has accepted the invitation of some researchers who asked to republish the English translation of some fundamental De Finetti's papers. These works were translated into English and published in the volume: Bruno De Finetti, Induction and Probability, Biblioteca di Statistica, eds. P. Monari, D. Cocchi, Clueb, Bologna, 1993. On the Probability Concept is one of the first fundamental philosophical papers in which we can find the essential basis of De Finetti's subjective approach to the Theory of probability.

  20. CONCEPT computer code

    International Nuclear Information System (INIS)

    Delene, J.

    1984-01-01

    CONCEPT is a computer code that will provide conceptual capital investment cost estimates for nuclear and coal-fired power plants. The code can develop an estimate for construction at any point in time. Any unit size within the range of about 400 to 1300 MW electric may be selected. Any of 23 reference site locations across the United States and Canada may be selected. PWR, BWR, and coal-fired plants burning high-sulfur and low-sulfur coal can be estimated. Multiple-unit plants can be estimated. Costs due to escalation/inflation and interest during construction are calculated

  1. [Is family physician concept possible to resume?].

    Science.gov (United States)

    Jovanović, Aleksandar; Gluhak, Ines; Stevanović, Ranko; Pristas, Ivan; Jurković, Ljiljanka; Nekić, Venija Cerovecki; Bezovan, Blazenka; Ostrić, Gordana Mrazovac; Vuk, Zeljko; Bilić, Jolanda

    2007-02-01

    An anonymous survey was performed in a sample of 454 adult patients from the catchment population of eight family medicine teams at Dugave-Travno Clinic in Zagreb to assess their attitudes towards the family physician concept, its advantages and shortcomings. These family medicine teams providing care for 16,077 insures also the number of families with all their members receiving care from these teams. The method of descriptive statistics was used. Data were obtained on the number of families where only some members received care at the same physician's office and on the proportion of individual family members receiving care at family medicine offices. The sample indicated that more than half of patients received care from the same family physician, and that only one tenth of patients were without their family medical file. Study subjects considered that the family doctor institution contributed to improved care and were aware of the advantages of the family doctor concept. The concept of comprehensive family treatment could currently be implemented in half of the patients. However, the other half are broken up, receiving medical care at offices of different teams. The family physician concept could be implemented in two ways: exchange of the insures among the teams at a particular clinic providing care for defined populations, and in administrative way. The family physician concept would require two strategic decisions: establishment and development of group practice, and virtual linkage of the family member medical data through an integrated primary health care information system.

  2. Mulligan Concept manual therapy: standardizing annotation.

    Science.gov (United States)

    McDowell, Jillian Marie; Johnson, Gillian Margaret; Hetherington, Barbara Helen

    2014-10-01

    Quality technique documentation is integral to the practice of manual therapy, ensuring uniform application and reproducibility of treatment. Manual therapy techniques are described by annotations utilizing a range of acronyms, abbreviations and universal terminology based on biomechanical and anatomical concepts. The various combinations of therapist and patient generated forces utilized in a variety of weight-bearing positions, which are synonymous with Mulligan Concept, challenge practitioners existing annotational skills. An annotation framework with recording rules adapted to the Mulligan Concept is proposed in which the abbreviations incorporate established manual therapy tenets and are detailed in the following sequence of; starting position, side, joint/s, method of application, glide/s, Mulligan technique, movement (or function), whether an assistant is used, overpressure (and by whom) and numbers of repetitions or time and sets. Therapist or patient application of overpressure and utilization of treatment belts or manual techniques must be recorded to capture the complete description. The adoption of the Mulligan Concept annotation framework in this way for documentation purposes will provide uniformity and clarity of information transfer for the future purposes of teaching, clinical practice and audit for its practitioners. Copyright © 2014 Elsevier Ltd. All rights reserved.

  3. Separations innovative concepts: Project summary

    Energy Technology Data Exchange (ETDEWEB)

    Lee, V.E. (ed.)

    1988-05-01

    This project summary includes the results of 10 innovations that were funded under the US Department's Innovative Concept Programs. The concepts address innovations that can substantially reduce the energy used in industrial separations. Each paper describes the proposed concept, and discusses the concept's potential energy savings, market applications, technical feasibility, prior work and state of the art, and future development needs.

  4. Concepts in surface physics

    CERN Document Server

    Desjonquères, M -C

    1993-01-01

    This textbook is intended as an introduction to surface science for graduate students. It began as a course of lectures that we gave at the University of Paris (Orsay). Its main objectives are twofold: to provide the reader with a compre­ hensive presentation of the basic principles and concepts of surface physics and to show the usefulness of these concepts in the real world by referring to experiments. It starts at a rather elementary level since it only requires a knowledge of solid state physics, quantum mechanics, thermodynamics and statistical physics which does not exceed the background usually taught to students early in their university courses. However, since it finally reaches an advanced level, we have tried to render it as self-contained as possible so that it remains accessible even to an unexperienced reader. Furthermore, the emphasis has been put on a pedagogical level rather than on a technical level. In this spirit, whenever possible, models which are simplified, but which contain the featu...

  5. Concept of 'bad death'

    Directory of Open Access Journals (Sweden)

    Marija Vučković

    2016-02-01

    Full Text Available Following previous research on the linguistic concept of а 'bad death' which lexical expression is the word family of the verb ginuti, I focus my attention in this paper on the relationship between language conceptualization of а 'bad death' and the representation of а 'bad death' in traditional and contemporary culture. Diachronically based language corpus makes possible to trace the changes of referential frame and use of verb ginuti and its derivatives. In the traditional culture а 'bad death' is marked in action code by irregular way of burial and beliefs in demons stemming from the 'impure dead'. In the paper I explore the degree of synonymy of the symbols of all three codes: verbal code, action code and code of beliefs. In the contemporary culture the lack of individual control and choice is considered to be the key element of the concept of a 'bad death'. This change of conceptual content manifests itself in the use of its lexical expressions.

  6. Diet quality concept.

    Science.gov (United States)

    Alkerwi, Ala'a

    2014-06-01

    The term diet quality has recently gained considerable attention in nutritional research. Despite widespread use, it is often poorly defined and remains difficult to measure. Confusion surrounds the term, as there is no consensus on how to define quality of the diet or to pin down a framework for producing a standard indicator. The composite and cut-off selection of most diet quality indices depend on investigator choices in line with research objectives. In addition to the frequently used dietary compliance-based approach, innovative approaches have emerged to construct diet quality indices based on antioxidant and anti-inflammatory profiles of diet. Different viewpoints and overlapping interests may yield different interpretations. Most of the unresolved issues are related directly or indirectly to the multidimensional and open-textured nature of the concept. This review aims to elucidate several debated key points to understand the reasons behind this confusion and address the complexity of how to define and quantify this concept. A standardized and well-defined framework of diet quality is of great importance for both consumers and scientists from different disciplines. Copyright © 2014 Elsevier Inc. All rights reserved.

  7. Teachers' Conceptions of Tangent Line

    Science.gov (United States)

    Paez Murillo, Rosa Elvira; Vivier, Laurent

    2013-01-01

    In order to study the conceptions, and their evolutions, of the tangent line to a curve an updating workshop which took place in Mexico was designed for upper secondary school teachers. This workshop was planned using the methodology of cooperative learning, scientific debate and auto reflection (ACODESA) and the conception-knowing-concept model…

  8. Concepts of Chinese Folk Happiness

    Science.gov (United States)

    Ip, Po Keung

    2011-01-01

    Discourses on Chinese folk happiness are often based on anecdotal narratives or qualitative analysis. Two traditional concepts of happiness popular in Chinese culture are introduced. The paper constructs a concept of Chinese folk happiness on basis of the findings of a scientific survey on the Taiwanese people regarding their concepts of…

  9. The Concept of Philosophical Education

    Science.gov (United States)

    Boyum, Steinar

    2010-01-01

    Strangely, the concept of philosophical education is not much in use, at least not as a "philosophical" concept. In this essay, Steinar Boyum attempts to outline such a philosophical concept of philosophical education. Boyum uses Plato's Allegory of the Cave, Rene Descartes's life of doubt, and Immanuel Kant's criticism of metaphysics as paradigms…

  10. Monte Carlo Calculation of Radioimmunotherapy with 90Y-, 177Lu-, 131I-, 124I-, and 188Re-Nanoobjects: Choice of the Best Radionuclide for Solid Tumour Treatment by Using TCP and NTCP Concepts

    Directory of Open Access Journals (Sweden)

    S. Lucas

    2015-01-01

    Full Text Available Radioimmunotherapy has shown that the use of monoclonal antibodies combined with a radioisotope like 131I or 90Y still remains ineffective for solid and radioresistant tumour treatment. Previous simulations have revealed that an increase in the number of 90Y labelled to each antibody or nanoobject could be a solution to improve treatment output. It now seems important to assess the treatment output and toxicity when radionuclides such as 90Y, 177Lu, 131I, 124I, and 188Re are used. Tumour control probability (TCP and normal tissue complication probability (NTCP curves versus the number of radionuclides per nanoobject were computed with MCNPX to evaluate treatment efficacy for solid tumours and to predict the incidence of surrounding side effects. Analyses were carried out for two solid tumour sizes of 0.5 and 1.0 cm radius and for nanoobject (i.e., a radiolabelled antibody distributed uniformly or nonuniformly throughout a solid tumour (e.g., Non-small-cell-lung cancer (NSCLC. 90Y and 188Re are the best candidates for solid tumour treatment when only one radionuclide is coupled to one carrier. Furthermore, regardless of the radionuclide properties, high values of TCP can be reached without toxicity if the number of radionuclides per nanoobject increases.

  11. The problem of automatic identification of concepts

    International Nuclear Information System (INIS)

    Andreewsky, Alexandre

    1975-11-01

    This paper deals with the problem of the automatic recognition of concepts and describes an important language tool, the ''linguistic filter'', which facilitates the construction of statistical algorithms. Certain special filters, of prepositions, conjunctions, negatives, logical implication, compound words, are presented. This is followed by a detailed description of a statistical algorithm allowing recognition of pronoun referents, and finally the problem of the automatic treatment of negatives in French is discussed [fr

  12. Enhancing clinical concept extraction with distributional semantics

    Science.gov (United States)

    Cohen, Trevor; Wu, Stephen; Gonzalez, Graciela

    2011-01-01

    Extracting concepts (such as drugs, symptoms, and diagnoses) from clinical narratives constitutes a basic enabling technology to unlock the knowledge within and support more advanced reasoning applications such as diagnosis explanation, disease progression modeling, and intelligent analysis of the effectiveness of treatment. The recent release of annotated training sets of de-identified clinical narratives has contributed to the development and refinement of concept extraction methods. However, as the annotation process is labor-intensive, training data are necessarily limited in the concepts and concept patterns covered, which impacts the performance of supervised machine learning applications trained with these data. This paper proposes an approach to minimize this limitation by combining supervised machine learning with empirical learning of semantic relatedness from the distribution of the relevant words in additional unannotated text. The approach uses a sequential discriminative classifier (Conditional Random Fields) to extract the mentions of medical problems, treatments and tests from clinical narratives. It takes advantage of all Medline abstracts indexed as being of the publication type “clinical trials” to estimate the relatedness between words in the i2b2/VA training and testing corpora. In addition to the traditional features such as dictionary matching, pattern matching and part-of-speech tags, we also used as a feature words that appear in similar contexts to the word in question (that is, words that have a similar vector representation measured with the commonly used cosine metric, where vector representations are derived using methods of distributional semantics). To the best of our knowledge, this is the first effort exploring the use of distributional semantics, the semantics derived empirically from unannotated text often using vector space models, for a sequence classification task such as concept extraction. Therefore, we first

  13. The effectiveness of the Bobath concept in stroke rehabilitation: what is the evidence?

    NARCIS (Netherlands)

    Kollen, B.J.; Lennon, S.; Lyons, B.; Wheatley-Smith, L.; Scheper, M.; Buurke, J.H.; Halfens, J.; Geurts, A.C.; Kwakkel, G.

    2009-01-01

    BACKGROUND AND PURPOSE: In the Western world, the Bobath Concept or neurodevelopmental treatment is the most popular treatment approach used in stroke rehabilitation, yet the superiority of the Bobath Concept as the optimal type of treatment has not been established. This systematic review of

  14. Semantic Representatives of the Concept

    Directory of Open Access Journals (Sweden)

    Elena N. Tsay

    2013-01-01

    Full Text Available In the article concept as one of the principle notions of cognitive linguistics is investigated. Considering concept as culture phenomenon, having language realization and ethnocultural peculiarities, the description of the concept “happiness” is presented. Lexical and semantic paradigm of the concept of happiness correlates with a great number of lexical and semantic variants. In the work semantic representatives of the concept of happiness, covering supreme spiritual values are revealed and semantic interpretation of their functioning in the Biblical discourse is given.

  15. Affect, Emotion and Similar Concepts

    Directory of Open Access Journals (Sweden)

    J.L. Pio Abreu

    2013-12-01

    Full Text Available The author begins by commenting on the difficulty of the semantic delimitation between concepts of affect, emotion, sentiment, feeling, mood, and passion. This difficulty becomes greater when the terms are translated into different languages. He then foccuses on the concept of emotion, which has benefited from recent research, and its distinction from mood, a concept which is at the base of the psychopathology of bipolar disorders. Much more complex is the Portuguese concept of affect (different from the English concept, which has an interpersonal dimension and can be developed from recent discoveries of “mirror neurons” and “theory of mind”.

  16. [Treatment of parent-adolescent conflicts with the therapy program for adolescents with disturbances of self-esteem, performance and relationships (SELBST) – concept and results of a pilot study].

    Science.gov (United States)

    Rademacher, Christiane; Hautmann, Christopher; Döpfner, Manfred

    2017-07-01

    Parent-adolescent conflicts often comprise the reasons for the referral of adolescents in treatment facilities. However, studies on the effects of behavioral interventions with this indication are rarely published, even in the international literature. In an explorative study, we assessed the efficacy and the acceptance of systemic-behavioral treatment modules of the treatment program for adolescents with disturbances of self-esteem, performance and relationships (SELBST). Ten adolescents aged 12 to 18 years (mean age 14,7 years) and their parents with severe parent-adolescents conflicts according to clinical judgment and with increased parent and adolescent ratings of conflicts on the Conflict-Behavior-Questionnaire-Cologne were included in the study. Analyses of pre to post changes showed a reduction in conflicts and/or an increase in conflict-solving skills as rated by the parents on various outcome measures. However, parents had problems attending the family sessions regularly and to implement therapeutic tasks in the daily family routine which may have limited the effects of the intervention. There is preliminary evidence that SELBST is a useful program for the treatment of parent-adolescent conflicts. To further increase the effectiveness of the program, knowledge from this trial has been considered in the development of the manual.

  17. The Point Mass Concept

    Directory of Open Access Journals (Sweden)

    Lehnert B.

    2011-04-01

    Full Text Available A point-mass concept has been elaborated from the equations of the gravitational field. One application of these deductions results in a black hole configuration of the Schwarzschild type, having no electric charge and no angular momentum. The critical mass of a gravitational collapse with respect to the nuclear binding energy is found to be in the range of 0.4 to 90 solar masses. A second application is connected with the spec- ulation about an extended symmetric law of gravitation, based on the options of positive and negative mass for a particle at given positive energy. This would make masses of equal polarity attract each other, while masses of opposite polarity repel each other. Matter and antimatter are further proposed to be associated with the states of positive and negative mass. Under fully symmetric conditions this could provide a mechanism for the separation of antimatter from matter at an early stage of the universe.

  18. [The concept of masochism].

    Science.gov (United States)

    Matot, J P

    1989-01-01

    The terms masochism and masochistic behaviour are clinically used for acceptations extending well beyond the relatively well-defined limits of sexual perversion. If it is indeed rather unusual to see a masochist pervert identified as such among psychiatric hospital or ambulatory patients, yet you very often find in a medical record the term masochist applied to a patient without there being any question of his sexual habits. This enlargement of the concept masochism has its roots in the works of Freud who introduces, next to the masochist perversion, notions of feminine and moral masochism. The aim of this paper is to re-situate in the light of psycho-analytic theory, the specificity of the various masochistic formulas in order to render them their semiologistic value, more particularly in connection with the therapeutic indications involved.

  19. New Concept of Photosynthesis

    Directory of Open Access Journals (Sweden)

    Komissarov Gennadiy Germanovich

    2014-12-01

    Full Text Available The history of the formation of a new concept of photosynthesis proposed by the author is considered for the period since 1966 to 2013. Its essence consists in the following facts: the photosynthetic oxygen (hydrogen source is not water, but exo- and endogenous hydrogen peroxide; thermal energy is a necessary part of the photosynthetic process; along with the carbon dioxide the air (oxygen, inert gases is included in the photosynthetic equation. The mechanism of the photovoltaic (Becquerel effect in films of chlorophyll and its synthetic analogue - phthalocyanine are briefly touched upon in the article. The article presents the works on artificial photosynthesis performed in the laboratory of Photobionics of N.N. Semenov Institute of Chemical Physics, RAS.

  20. Students' conceptions about force

    International Nuclear Information System (INIS)

    Soeguet, Oe.

    2005-01-01

    Students from a young age have developed in their own minds differing concepts of things such as all creatures having a soul. Also children see the environment and interpret what they see according to their own understanding and explanation. In particular, with regards to physics, things like light, heat, motion, structure of matter and energy are understood at the level of a child s comprehension. Most often the child s understanding varies quite differently from the actual true meaning. As a result the child is reluctant to accept any other explanation. In such situations the necessary difficulties must be tackled with care and caution pertinent to the individual. Studies at K.S.U University related to force and motion of various departments in the Faculty of Science and Letters have been investigated. After evaluations of all the findings a number of suggestions have been made to change student views and ideas

  1. Avicenna's concept of pain

    Directory of Open Access Journals (Sweden)

    Osama A. Tashani

    2010-09-01

    Full Text Available Ibn Sina (Latin name – Avicenna, 980–1037 is a famous Muslim physician who wrote The Canon of Medicine. Pain-related writings within The Canon were identified and analysed and compared to Galen and Modern Pain Theory. We found evidence in The Canon that Avicenna challenged Galen's concept of pain. Galen insisted that injuries (breach of continuity were the only cause of pain. In contrast, Avicenna suggested that the true cause of pain was a change of the physical condition (temperament change of the organ whether there was an injury present or not. Avicenna extended Galen's descriptions of 4 to 15 types of pain and used a terminology that is remarkably similar to that used in the McGill Pain Questionnaire.

  2. Repository design concepts

    International Nuclear Information System (INIS)

    Mogg, C.S.

    1994-01-01

    This paper describes the development of a deep hard rock repository design from an initial generic approach through to a Sellafield site-specific preferred concept. As in the development of any engineering project, certain key requirements have been defined. For the repository these are that the design shall be robust in terms of safety, both during the construction and operational periods, providing maximum protection for the workforce and general public. It shall satisfy the requirements for long-term radiological safety laid down by the Department of the Environment and, as far as possible, incorporate technology and equipment which is already in use elsewhere. This will minimize the risks associated with new developments and provide opportunity to draw on expertise acquired by existing users. The repository project will inevitably involve engineering challenges not encountered in the design of other types of nuclear facility. (Author)

  3. Landfilling: Concepts and Challenges

    DEFF Research Database (Denmark)

    Christensen, Thomas Højlund; Scharff, H.; Hjelmar, O.

    2011-01-01

    new approaches and technological advancement the landfill still is a long lasting accumulation of waste in the environment. Much of current landfill design and technology has been introduced as a reaction to problems encountered at actual landfills. The solution was in many cases sought in isolation......Landfilling of waste historically has been the main management route for waste, and in many parts of the world it still is. Landfills have developed from open polluting dumps to modern highly engineered facilities with sophisticated control measures and monitoring routines. However, in spite of all...... to understand the concepts, the processes and the long-term aspects of landfilling. This chapter describes the main conceptual aspects of landfilling. The historical development is presented and key issues of time frames, mass balances and technical approaches are discussed. The environmental issues...

  4. Introducing the CTA concept

    Science.gov (United States)

    Acharya, B. S.; Actis, M.; Aghajani, T.; Agnetta, G.; Aguilar, J.; Aharonian, F.; Ajello, M.; Akhperjanian, A.; Alcubierre, M.; Aleksić, J.; Alfaro, R.; Aliu, E.; Allafort, A. J.; Allan, D.; Allekotte, I.; Amato, E.; Anderson, J.; Angüner, E. O.; Antonelli, L. A.; Antoranz, P.; Aravantinos, A.; Arlen, T.; Armstrong, T.; Arnaldi, H.; Arrabito, L.; Asano, K.; Ashton, T.; Asorey, H. G.; Awane, Y.; Baba, H.; Babic, A.; Baby, N.; Bähr, J.; Bais, A.; Baixeras, C.; Bajtlik, S.; Balbo, M.; Balis, D.; Balkowski, C.; Bamba, A.; Bandiera, R.; Barber, A.; Barbier, C.; Barceló, M.; Barnacka, A.; Barnstedt, J.; Barres de Almeida, U.; Barrio, J. A.; Basili, A.; Basso, S.; Bastieri, D.; Bauer, C.; Baushev, A.; Becerra, J.; Becherini, Y.; Bechtol, K. C.; Becker Tjus, J.; Beckmann, V.; Bednarek, W.; Behera, B.; Belluso, M.; Benbow, W.; Berdugo, J.; Berger, K.; Bernard, F.; Bernardino, T.; Bernlöhr, K.; Bhat, N.; Bhattacharyya, S.; Bigongiari, C.; Biland, A.; Billotta, S.; Bird, T.; Birsin, E.; Bissaldi, E.; Biteau, J.; Bitossi, M.; Blake, S.; Blanch Bigas, O.; Blasi, P.; Bobkov, A.; Boccone, V.; Boettcher, M.; Bogacz, L.; Bogart, J.; Bogdan, M.; Boisson, C.; Boix Gargallo, J.; Bolmont, J.; Bonanno, G.; Bonardi, A.; Bonev, T.; Bonifacio, P.; Bonnoli, G.; Bordas, P.; Borgland, A.; Borkowski, J.; Bose, R.; Botner, O.; Bottani, A.; Bouchet, L.; Bourgeat, M.; Boutonnet, C.; Bouvier, A.; Brau-Nogué, S.; Braun, I.; Bretz, T.; Briggs, M.; Bringmann, T.; Brook, P.; Brun, P.; Brunetti, L.; Buanes, T.; Buckley, J.; Buehler, R.; Bugaev, V.; Bulgarelli, A.; Bulik, T.; Busetto, G.; Buson, S.; Byrum, K.; Cailles, M.; Cameron, R.; Camprecios, J.; Canestrari, R.; Cantu, S.; Capalbi, M.; Caraveo, P.; Carmona, E.; Carosi, A.; Carr, J.; Carton, P.-H.; Casanova, S.; Casiraghi, M.; Catalano, O.; Cavazzani, S.; Cazaux, S.; Cerruti, M.; Chabanne, E.; Chadwick, P.; Champion, C.; Chen, A.; Chiang, J.; Chiappetti, L.; Chikawa, M.; Chitnis, V. R.; Chollet, F.; Chudoba, J.; Cieślar, M.; Cillis, A.; Cohen-Tanugi, J.; Colafrancesco, S.; Colin, P.; Colome, J.; Colonges, S.; Compin, M.; Conconi, P.; Conforti, V.; Connaughton, V.; Conrad, J.; Contreras, J. L.; Coppi, P.; Corona, P.; Corti, D.; Cortina, J.; Cossio, L.; Costantini, H.; Cotter, G.; Courty, B.; Couturier, S.; Covino, S.; Crimi, G.; Criswell, S. J.; Croston, J.; Cusumano, G.; Dafonseca, M.; Dale, O.; Daniel, M.; Darling, J.; Davids, I.; Dazzi, F.; De Angelis, A.; De Caprio, V.; De Frondat, F.; de Gouveia Dal Pino, E. M.; de la Calle, I.; De La Vega, G. A.; de los Reyes Lopez, R.; De Lotto, B.; De Luca, A.; de Mello Neto, J. R. T.; de Naurois, M.; de Oliveira, Y.; de Oña Wilhelmi, E.; de Souza, V.; Decerprit, G.; Decock, G.; Deil, C.; Delagnes, E.; Deleglise, G.; Delgado, C.; Della Volpe, D.; Demange, P.; Depaola, G.; Dettlaff, A.; Di Paola, A.; Di Pierro, F.; Díaz, C.; Dick, J.; Dickherber, R.; Dickinson, H.; Diez-Blanco, V.; Digel, S.; Dimitrov, D.; Disset, G.; Djannati-Ataï, A.; Doert, M.; Dohmke, M.; Domainko, W.; Dominis Prester, D.; Donat, A.; Dorner, D.; Doro, M.; Dournaux, J.-L.; Drake, G.; Dravins, D.; Drury, L.; Dubois, F.; Dubois, R.; Dubus, G.; Dufour, C.; Dumas, D.; Dumm, J.; Durand, D.; Dyks, J.; Dyrda, M.; Ebr, J.; Edy, E.; Egberts, K.; Eger, P.; Einecke, S.; Eleftheriadis, C.; Elles, S.; Emmanoulopoulos, D.; Engelhaupt, D.; Enomoto, R.; Ernenwein, J.-P.; Errando, M.; Etchegoyen, A.; Evans, P.; Falcone, A.; Fantinel, D.; Farakos, K.; Farnier, C.; Fasola, G.; Favill, B.; Fede, E.; Federici, S.; Fegan, S.; Feinstein, F.; Ferenc, D.; Ferrando, P.; Fesquet, M.; Fiasson, A.; Fillin-Martino, E.; Fink, D.; Finley, C.; Finley, J. P.; Fiorini, M.; Firpo Curcoll, R.; Flores, H.; Florin, D.; Focke, W.; Föhr, C.; Fokitis, E.; Font, L.; Fontaine, G.; Fornasa, M.; Förster, A.; Fortson, L.; Fouque, N.; Franckowiak, A.; Fransson, C.; Fraser, G.; Frei, R.; Albuquerque, I. F. M.; Fresnillo, L.; Fruck, C.; Fujita, Y.; Fukazawa, Y.; Fukui, Y.; Funk, S.; Gäbele, W.; Gabici, S.; Gabriele, R.; Gadola, A.; Galante, N.; Gall, D.; Gallant, Y.; Gámez-García, J.; García, B.; Garcia López, R.; Gardiol, D.; Garrido, D.; Garrido, L.; Gascon, D.; Gaug, M.; Gaweda, J.; Gebremedhin, L.; Geffroy, N.; Gerard, L.; Ghedina, A.; Ghigo, M.; Giannakaki, E.; Gianotti, F.; Giarrusso, S.; Giavitto, G.; Giebels, B.; Gika, V.; Giommi, P.; Girard, N.; Giro, E.; Giuliani, A.; Glanzman, T.; Glicenstein, J.-F.; Godinovic, N.; Golev, V.; Gomez Berisso, M.; Gómez-Ortega, J.; Gonzalez, M. M.; González, A.; González, F.; González Muñoz, A.; Gothe, K. S.; Gougerot, M.; Graciani, R.; Grandi, P.; Grañena, F.; Granot, J.; Grasseau, G.; Gredig, R.; Green, A.; Greenshaw, T.; Grégoire, T.; Grimm, O.; Grube, J.; Grudzinska, M.; Gruev, V.; Grünewald, S.; Grygorczuk, J.; Guarino, V.; Gunji, S.; Gyuk, G.; Hadasch, D.; Hagiwara, R.; Hahn, J.; Hakansson, N.; Hallgren, A.; Hamer Heras, N.; Hara, S.; Hardcastle, M. J.; Harris, J.; Hassan, T.; Hatanaka, K.; Haubold, T.; Haupt, A.; Hayakawa, T.; Hayashida, M.; Heller, R.; Henault, F.; Henri, G.; Hermann, G.; Hermel, R.; Herrero, A.; Hidaka, N.; Hinton, J.; Hoffmann, D.; Hofmann, W.; Hofverberg, P.; Holder, J.; Horns, D.; Horville, D.; Houles, J.; Hrabovsky, M.; Hrupec, D.; Huan, H.; Huber, B.; Huet, J.-M.; Hughes, G.; Humensky, T. B.; Huovelin, J.; Ibarra, A.; Illa, J. M.; Impiombato, D.; Incorvaia, S.; Inoue, S.; Inoue, Y.; Ioka, K.; Ismailova, E.; Jablonski, C.; Jacholkowska, A.; Jamrozy, M.; Janiak, M.; Jean, P.; Jeanney, C.; Jimenez, J. J.; Jogler, T.; Johnson, T.; Journet, L.; Juffroy, C.; Jung, I.; Kaaret, P.; Kabuki, S.; Kagaya, M.; Kakuwa, J.; Kalkuhl, C.; Kankanyan, R.; Karastergiou, A.; Kärcher, K.; Karczewski, M.; Karkar, S.; Kasperek, J.; Kastana, D.; Katagiri, H.; Kataoka, J.; Katarzyński, K.; Katz, U.; Kawanaka, N.; Kellner-Leidel, B.; Kelly, H.; Kendziorra, E.; Khélifi, B.; Kieda, D. B.; Kifune, T.; Kihm, T.; Kishimoto, T.; Kitamoto, K.; Kluźniak, W.; Knapic, C.; Knapp, J.; Knödlseder, J.; Köck, F.; Kocot, J.; Kodani, K.; Köhne, J.-H.; Kohri, K.; Kokkotas, K.; Kolitzus, D.; Komin, N.; Kominis, I.; Konno, Y.; Köppel, H.; Korohoda, P.; Kosack, K.; Koss, G.; Kossakowski, R.; Kostka, P.; Koul, R.; Kowal, G.; Koyama, S.; Kozioł, J.; Krähenbühl, T.; Krause, J.; Krawzcynski, H.; Krennrich, F.; Krepps, A.; Kretzschmann, A.; Krobot, R.; Krueger, P.; Kubo, H.; Kudryavtsev, V. A.; Kushida, J.; Kuznetsov, A.; La Barbera, A.; La Palombara, N.; La Parola, V.; La Rosa, G.; Lacombe, K.; Lamanna, G.; Lande, J.; Languignon, D.; Lapington, J.; Laporte, P.; Lavalley, C.; Le Flour, T.; Le Padellec, A.; Lee, S.-H.; Lee, W. H.; Leigui de Oliveira, M. A.; Lelas, D.; Lenain, J.-P.; Leopold, D. J.; Lerch, T.; Lessio, L.; Lieunard, B.; Lindfors, E.; Liolios, A.; Lipniacka, A.; Lockart, H.; Lohse, T.; Lombardi, S.; Lopatin, A.; Lopez, M.; López-Coto, R.; López-Oramas, A.; Lorca, A.; Lorenz, E.; Lubinski, P.; Lucarelli, F.; Lüdecke, H.; Ludwin, J.; Luque-Escamilla, P. L.; Lustermann, W.; Luz, O.; Lyard, E.; Maccarone, M. C.; Maccarone, T. J.; Madejski, G. M.; Madhavan, A.; Mahabir, M.; Maier, G.; Majumdar, P.; Malaguti, G.; Maltezos, S.; Manalaysay, A.; Mancilla, A.; Mandat, D.; Maneva, G.; Mangano, A.; Manigot, P.; Mannheim, K.; Manthos, I.; Maragos, N.; Marcowith, A.; Mariotti, M.; Marisaldi, M.; Markoff, S.; Marszałek, A.; Martens, C.; Martí, J.; Martin, J.-M.; Martin, P.; Martínez, G.; Martínez, F.; Martínez, M.; Masserot, A.; Mastichiadis, A.; Mathieu, A.; Matsumoto, H.; Mattana, F.; Mattiazzo, S.; Maurin, G.; Maxfield, S.; Maya, J.; Mazin, D.; Mc Comb, L.; McCubbin, N.; McHardy, I.; McKay, R.; Medina, C.; Melioli, C.; Melkumyan, D.; Mereghetti, S.; Mertsch, P.; Meucci, M.; Michałowski, J.; Micolon, P.; Mihailidis, A.; Mineo, T.; Minuti, M.; Mirabal, N.; Mirabel, F.; Miranda, J. M.; Mirzoyan, R.; Mizuno, T.; Moal, B.; Moderski, R.; Mognet, I.; Molinari, E.; Molinaro, M.; Montaruli, T.; Monteiro, I.; Moore, P.; Moralejo Olaizola, A.; Mordalska, M.; Morello, C.; Mori, K.; Mottez, F.; Moudden, Y.; Moulin, E.; Mrusek, I.; Mukherjee, R.; Munar-Adrover, P.; Muraishi, H.; Murase, K.; Murphy, A.; Nagataki, S.; Naito, T.; Nakajima, D.; Nakamori, T.; Nakayama, K.; Naumann, C.; Naumann, D.; Naumann-Godo, M.; Nayman, P.; Nedbal, D.; Neise, D.; Nellen, L.; Neustroev, V.; Neyroud, N.; Nicastro, L.; Nicolau-Kukliński, J.; Niedźwiecki, A.; Niemiec, J.; Nieto, D.; Nikolaidis, A.; Nishijima, K.; Nolan, S.; Northrop, R.; Nosek, D.; Nowak, N.; Nozato, A.; O'Brien, P.; Ohira, Y.; Ohishi, M.; Ohm, S.; Ohoka, H.; Okuda, T.; Okumura, A.; Olive, J.-F.; Ong, R. A.; Orito, R.; Orr, M.; Osborne, J.; Ostrowski, M.; Otero, L. A.; Otte, N.; Ovcharov, E.; Oya, I.; Ozieblo, A.; Padilla, L.; Paiano, S.; Paillot, D.; Paizis, A.; Palanque, S.; Palatka, M.; Pallota, J.; Panagiotidis, K.; Panazol, J.-L.; Paneque, D.; Panter, M.; Paoletti, R.; Papayannis, A.; Papyan, G.; Paredes, J. M.; Pareschi, G.; Parks, G.; Parraud, J.-M.; Parsons, D.; Paz Arribas, M.; Pech, M.; Pedaletti, G.; Pelassa, V.; Pelat, D.; Perez, M. d. C.; Persic, M.; Petrucci, P.-O.; Peyaud, B.; Pichel, A.; Pita, S.; Pizzolato, F.; Platos, Ł.; Platzer, R.; Pogosyan, L.; Pohl, M.; Pojmanski, G.; Ponz, J. D.; Potter, W.; Poutanen, J.; Prandini, E.; Prast, J.; Preece, R.; Profeti, F.; Prokoph, H.; Prouza, M.; Proyetti, M.; Puerto-Gimenez, I.; Pühlhofer, G.; Puljak, I.; Punch, M.; Pyzioł, R.; Quel, E. J.; Quinn, J.; Quirrenbach, A.; Racero, E.; Rajda, P. J.; Ramon, P.; Rando, R.; Rannot, R. C.; Rataj, M.; Raue, M.; Reardon, P.; Reimann, O.; Reimer, A.; Reimer, O.; Reitberger, K.; Renaud, M.; Renner, S.; Reville, B.; Rhode, W.; Ribó, M.; Ribordy, M.; Richer, M. G.; Rico, J.; Ridky, J.; Rieger, F.; Ringegni, P.; Ripken, J.; Ristori, P. R.; Riviére, A.; Rivoire, S.; Rob, L.; Roeser, U.; Rohlfs, R.; Rojas, G.; Romano, P.; Romaszkan, W.; Romero, G. E.; Rosen, S.; Rosier Lees, S.; Ross, D.; Rouaix, G.; Rousselle, J.; Rousselle, S.; Rovero, A. C.; Roy, F.; Royer, S.; Rudak, B.; Rulten, C.; Rupiński, M.; Russo, F.; Ryde, F.; Sacco, B.; Saemann, E. O.; Saggion, A.; Sahakian, V.; Saito, K.; Saito, T.; Saito, Y.; Sakaki, N.; Sakonaka, R.; Salini, A.; Sanchez, F.; Sanchez-Conde, M.; Sandoval, A.; Sandaker, H.; Sant'Ambrogio, E.; Santangelo, A.; Santos, E. M.; Sanuy, A.; Sapozhnikov, L.; Sarkar, S.; Sartore, N.; Sasaki, H.; Satalecka, K.; Sawada, M.; Scalzotto, V.; Scapin, V.; Scarcioffolo, M.; Schafer, J.; Schanz, T.; Schlenstedt, S.; Schlickeiser, R.; Schmidt, T.; Schmoll, J.; Schovanek, P.; Schroedter, M.; Schultz, C.; Schultze, J.; Schulz, A.; Schure, K.; Schwab, T.; Schwanke, U.; Schwarz, J.; Schwarzburg, S.; Schweizer, T.; Schwemmer, S.; Segreto, A.; Seiradakis, J.-H.; Sembroski, G. H.; Seweryn, K.; Sharma, M.; Shayduk, M.; Shellard, R. C.; Shi, J.; Shibata, T.; Shibuya, A.; Shum, E.; Sidoli, L.; Sidz, M.; Sieiro, J.; Sikora, M.; Silk, J.; Sillanpää, A.; Singh, B. B.; Sitarek, J.; Skole, C.; Smareglia, R.; Smith, A.; Smith, D.; Smith, J.; Smith, N.; Sobczyńska, D.; Sol, H.; Sottile, G.; Sowiński, M.; Spanier, F.; Spiga, D.; Spyrou, S.; Stamatescu, V.; Stamerra, A.; Starling, R.; Stawarz, Ł.; Steenkamp, R.; Stegmann, C.; Steiner, S.; Stergioulas, N.; Sternberger, R.; Sterzel, M.; Stinzing, F.; Stodulski, M.; Straumann, U.; Strazzeri, E.; Stringhetti, L.; Suarez, A.; Suchenek, M.; Sugawara, R.; Sulanke, K.-H.; Sun, S.; Supanitsky, A. D.; Suric, T.; Sutcliffe, P.; Sykes, J.; Szanecki, M.; Szepieniec, T.; Szostek, A.; Tagliaferri, G.; Tajima, H.; Takahashi, H.; Takahashi, K.; Takalo, L.; Takami, H.; Talbot, G.; Tammi, J.; Tanaka, M.; Tanaka, S.; Tasan, J.; Tavani, M.; Tavernet, J.-P.; Tejedor, L. A.; Telezhinsky, I.; Temnikov, P.; Tenzer, C.; Terada, Y.; Terrier, R.; Teshima, M.; Testa, V.; Tezier, D.; Thuermann, D.; Tibaldo, L.; Tibolla, O.; Tiengo, A.; Tluczykont, M.; Todero Peixoto, C. J.; Tokanai, F.; Tokarz, M.; Toma, K.; Torii, K.; Tornikoski, M.; Torres, D. F.; Torres, M.; Tosti, G.; Totani, T.; Toussenel, F.; Tovmassian, G.; Travnicek, P.; Trifoglio, M.; Troyano, I.; Tsinganos, K.; Ueno, H.; Umehara, K.; Upadhya, S. S.; Usher, T.; Uslenghi, M.; Valdes-Galicia, J. F.; Vallania, P.; Vallejo, G.; van Driel, W.; van Eldik, C.; Vandenbrouke, J.; Vanderwalt, J.; Vankov, H.; Vasileiadis, G.; Vassiliev, V.; Veberic, D.; Vegas, I.; Vercellone, S.; Vergani, S.; Veyssiére, C.; Vialle, J. P.; Viana, A.; Videla, M.; Vincent, P.; Vincent, S.; Vink, J.; Vlahakis, N.; Vlahos, L.; Vogler, P.; Vollhardt, A.; von Gunten, H.-P.; Vorobiov, S.; Vuerli, C.; Waegebaert, V.; Wagner, R.; Wagner, R. G.; Wagner, S.; Wakely, S. P.; Walter, R.; Walther, T.; Warda, K.; Warwick, R.; Wawer, P.; Wawrzaszek, R.; Webb, N.; Wegner, P.; Weinstein, A.; Weitzel, Q.; Welsing, R.; Werner, M.; Wetteskind, H.; White, R.; Wierzcholska, A.; Wiesand, S.; Wilkinson, M.; Williams, D. A.; Willingale, R.; Winiarski, K.; Wischnewski, R.; Wiśniewski, Ł.; Wood, M.; Wörnlein, A.; Xiong, Q.; Yadav, K. K.; Yamamoto, H.; Yamamoto, T.; Yamazaki, R.; Yanagita, S.; Yebras, J. M.; Yelos, D.; Yoshida, A.; Yoshida, T.; Yoshikoshi, T.; Zabalza, V.; Zacharias, M.; Zajczyk, A.; Zanin, R.; Zdziarski, A.; Zech, A.; Zhao, A.; Zhou, X.; Ziętara, K.; Ziolkowski, J.; Ziółkowski, P.; Zitelli, V.; Zurbach, C.; Żychowski, P.; CTA Consortium

    2013-03-01

    The Cherenkov Telescope Array (CTA) is a new observatory for very high-energy (VHE) gamma rays. CTA has ambitions science goals, for which it is necessary to achieve full-sky coverage, to improve the sensitivity by about an order of magnitude, to span about four decades of energy, from a few tens of GeV to above 100 TeV with enhanced angular and energy resolutions over existing VHE gamma-ray observatories. An international collaboration has formed with more than 1000 members from 27 countries in Europe, Asia, Africa and North and South America. In 2010 the CTA Consortium completed a Design Study and started a three-year Preparatory Phase which leads to production readiness of CTA in 2014. In this paper we introduce the science goals and the concept of CTA, and provide an overview of the project.

  5. Development concept plan

    International Nuclear Information System (INIS)

    1992-06-01

    The following management objectives for New River Gorge National River relate to the Kaymoor site to: Preserve coal mining, railroad, and other historic resources that best illustrate park significance; Develop a system of land- and water-based recreation opportunities that allow visitors to experience the park's resources to the extent that natural, cultural, and scenic values are not imparied; and Work with the community to the extent possible to help it maximize economic benefits related to park development without impairing key resources. The Development Concept Plant outlining a plan of development for Kaymoor is a part of a larger emphasis by the National Park Service to identify and develop significant coal-related historic and cultural resources in southern West Virginia in cooperation with the West Virginia State Historic Preservation Office

  6. Longing: a concept analysis.

    Science.gov (United States)

    Pehler, Shelley-Rae; Sjostrom, Stephanie; Markwardt, Michelle

    2014-10-01

    This paper uses Rodgers' evolutionary view of concept analysis to define the human response of longing. The purpose is to develop a definition of longing as the first step in diagnosis development. A literature review was conducted by searching the Cumulative Index to Nursing and Allied Health Literature, American Theological Library Association Religion, JSTOR Philosophy, JSTOR Religion, PsycINFO, and PubMed databases to yield an across-discipline sample of articles. Three researchers identified the attributes, antecedents, consequences, situational context, and surrogate terms of longing. An operational definition was developed. Longing is clearly a human response to loss, crossing illness and situations in which nurses encounter patients in multiple settings. This supports the need to further develop longing into a nursing diagnosis. © 2014 NANDA International.

  7. The Seismographic Design Concept

    DEFF Research Database (Denmark)

    Salamon, Karen Lisa; Engholm, Ida

    2015-01-01

    This article gives an overview of the theoretical development of the design concept through two centuries in Europe and North America. Drawing on the academic disciplines of design history and anthropology, the authors present seminal moments in the theorization of “design”. Historically formative...... or seismograph, teetering back and forth between Romanticist and Scientist ideological positions. The gradual marginalization of certain understandings of design, and the inclusion of other understandings formerly external to the design concept’s application range are also addressed. The article conclusively...... argues for a more historically reflective glance on theory’s influence on the moulding of practice from ideology also in the context of design, and presents itself as a step in this self reflective direction....

  8. Concepts in quantum mechanics

    CERN Document Server

    Mathur, Vishnu S

    2008-01-01

    NEED FOR QUANTUM MECHANICS AND ITS PHYSICAL BASIS Inadequacy of Classical Description for Small Systems Basis of Quantum Mechanics Representation of States Dual Vectors: Bra and Ket Vectors Linear Operators Adjoint of a Linear Operator Eigenvalues and Eigenvectors of a Linear Operator Physical Interpretation Observables and Completeness Criterion Commutativity and Compatibility of Observables Position and Momentum Commutation Relations Commutation Relation and the Uncertainty ProductAppendix: Basic Concepts in Classical MechanicsREPRESENTATION THEORY Meaning of Representation How to Set up a Representation Representatives of a Linear Operator Change of Representation Coordinate Representation Replacement of Momentum Observable p by -ih d/dqIntegral Representation of Dirac Bracket A2|F|A1> The Momentum Representation Dirac Delta FunctionRelation between the Coordinate and Momentum RepresentationsEQUATIONS OF MOTIONSchrödinger Equation of Motion Schrödinger Equation in the Coordinate Representation Equation o...

  9. Concept Overview & Preliminary Analysis

    Energy Technology Data Exchange (ETDEWEB)

    Ruth, Mark

    2017-07-12

    'H2@Scale' is an opportunity for wide-scale use of hydrogen as an intermediate that carries energy from various production options to multiple uses. It is based on identifying and developing opportunities for low-cost hydrogen production and investigating opportunities for using that hydrogen across the electricity, industrial, and transportation sectors. One of the key production opportunities is use of low-cost electricity that may be generated under high penetrations of variable renewable generators such as wind and solar photovoltaics. The technical potential demand for hydrogen across the sectors is 60 million metric tons per year. The U.S. has sufficient domestic renewable resources so that each could meet that demand and could readily meet the demand using a portfolio of generation options. This presentation provides an overview of the concept and the technical potential demand and resources. It also motivates analysis and research on H2@Scale.

  10. The Point Mass Concept

    Directory of Open Access Journals (Sweden)

    Lehnert B.

    2011-04-01

    Full Text Available A point-mass concept has been elaborated from the equations of the gravitational field. One application of these deductions results in a black hole configuration of the Schwarzschild type, having no electric charge and no angular momentum. The critical mass of a gravitational collapse with respect to the nuclear binding energy is found to be in the range of 0.4 to 90 solar masses. A second application is connected with the speculation about an extended symmetric law of gravitation, based on the options of positive and negative mass for a particle at given positive energy. This would make masses of equal polarity attract each other, while masses of opposite polarity repel each other. Matter and antimatter are further proposed to be associated with the states of positive and negative mass. Under fully symmetric conditions this could provide a mechanism for the separation of antimatter from matter at an early stage of the universe.

  11. Determination of concept technology - the ontology of the concept as a component of the knowledge development in caring science.

    Science.gov (United States)

    Korhonen, Eila-Sisko; Nordman, Tina; Eriksson, Katie

    2014-12-01

    The purpose of this study is to determine the ontology of the concept of technology from the perspective of caring science. The aim is to increase knowledge of the concept in caring science and to answer the research question concerning what the concept of technology is in caring science. In literature, the concept of technology is used diversely referring it to caring technology, nursing technology, wellbeing technology, information technology, telenursing and technology in care named by a specific device or an area of nursing or medicine. The definition of the concept of technology and its ontology has not been determined from the viewpoint of caring science. Eriksson's model of concept determination provides a method to explore the ontology of the concept. This includes an etymological and semantic analysis as well as a determination of essence and basic category of the concept. The results showed that the concept of technology is multidimensional. It has evolved and altered over the centuries. The origin of the concept formulated from the Greek word 'techne', which has wider ontological dimensions. It is universal, it can be taught and it depends on the substance. Subsequently, the concept was introduced an ethical dimension, and it also developed more to the direction of engineering, mechanics and technical know-how. The semantic analysis revealed synonyms of the concept: art, equipment and knowledge. These introduced concepts such as craft, skill, treatment, engineering, science, study method and way. The nuances of the concept framed its nature. On the one hand, it stands out as practical and advanced, but on the other hand, it is difficult and conventional. The knowledge gained in this study will help to understand the phenomenon of technology in caring science. © 2014 Nordic College of Caring Science.

  12. The Moon Village Concept

    Science.gov (United States)

    Messina, Piero; Foing, Bernard H.; Hufenbach, Bernhard; Haignere, Claudie; Schrogl, Kai-Uwe

    2016-07-01

    The "Moon Village" concept Space exploration is anchored in the International Space Station and in the current and future automatic and planetary automatic and robotic missions that pave the way for future long-term exploration objectives. The Moon represents a prime choice for scientific, operational and programmatic reasons and could be the enterprise that federates all interested Nations. On these considerations ESA is currently elaborating the concept of a Moon Village as an ensemble where multiple users can carry out multiple activities. The Moon Village has the ambition to serve a number of objectives that have proven to be of interest (including astronomy, fundamental research, resources management, moon science, etc. ) to the space community and should be the catalyst of new alliances between public and private entities including non-space industries. Additionally the Moon Village should provide a strong inspirational and education tool for the younger generations . The Moon Village will rely both on automatic, robotic and human-tendered structures to achieve sustainable moon surface operations serving multiple purposes on an open-architecture basis. This Europe-inspired initiative should rally all communities (across scientific disciplines, nations, industries) and make it to the top of the political agendas as a the scientific and technological undertaking but also political and inspirational endeavour of the XXI century. The current reflections are of course based on the current activities and plans on board the ISS and the discussion held in international fora such as the ISECG. The paper will present the status of these reflections, also in view of the ESA Council at Ministerial Level 2016, and will give an overview of the on-going activities being carried out to enable the vision of a Moon Village.

  13. An Alternative Health Care Facility: Concept of Operations for the Off-site Triage, Treatment, and Transportation Center (OST3C). Mass Casualty Care Strategy for a Chemical Terrorism Incident

    Science.gov (United States)

    2001-03-01

    TRANSPORTATION CENTER (OST3C) Mass Casualty Care Strategy for a Chemical Terrorism Incident Prepared by: Health & Safety...the Off-site Triage, Treatment, and Transportation Center (OST3C),Mass Casualty Care Strategy for a Chemical Terrorism Incident, Revision 1, Dec 2003...1.4.1 The citizens of the United States are subject to an act of chemical terrorism . 1.4.2 A well-planned chemical agent release is likely to produce a

  14. Mirroring everyday clinical practice in clinical trial design: a new concept to improve the external validity of randomized double-blind placebo-controlled trials in the pharmacological treatment of major depression

    Directory of Open Access Journals (Sweden)

    Severus Emanuel

    2012-07-01

    Full Text Available Abstract Background Randomized, double-blind, placebo-controlled trials constitute the gold standard in clinical research when testing the efficacy of new psychopharmacological interventions in the treatment of major depression. However, the blinded use of placebo has been found to influence clinical trial outcomes and may bias patient selection. Discussion To improve clinical trial design in major depression so as to reflect clinical practice more closely we propose to present patients with a balanced view of the benefits of study participation irrespective of their assignment to placebo or active treatment. In addition every participant should be given the option to finally receive the active medication. A research agenda is outlined to evaluate the impact of the proposed changes on the efficacy of the drug to be evaluated and on the demographic and clinical characteristics of the enrollment fraction with regard to its representativeness of the eligible population. Summary We propose a list of measures to be taken to improve the external validity of double-blind, placebo-controlled trials in major depression. The recommended changes to clinical trial design may also be relevant for other psychiatric as well as medical disorders in which expectations regarding treatment outcome may affect the outcome itself.

  15. A concept analysis of befriending.

    Science.gov (United States)

    Balaam, Marie-Clare

    2015-01-01

    To report an analysis of the concept of befriending. Befriending is an intervention used in a range of nursing, health and social care settings to provide support for individuals who are socially isolated or lack social support. However, in many cases befriending and its impact remains poorly understood and under researched. Concept analysis provides clarification of the concept and basis for further research and development. Concept analysis. AMED, Psyc Articles, Psych Info, Medline, MedlinePlus, Social Science Index and CINHAL databases were searched for literature published between 1993-2013 using the search term Befriending. Walker and Avant's method of concept analysis was chosen. This combined with insights from Risjord's work produced a theoretical concept analysis which focused on the concept in peer reviewed academic literature. There are currently several ways the mechanisms of befriending and its effects on individuals and communities are understood. It is possible however to identify key attributes which define the concept and differentiate it from related concepts, such as peer support and mentoring. Key attributes are that it is an organised intervention, involving the creation of an emotionally connected friend-like relationship, where there is a negotiation of power. This concept analysis has clarified current understandings and uses of befriending. It provides the basis for widening the focus of research into the effectiveness and impact of befriending on those who are befriended, those who befriend and the communities where befriending takes place. © 2014 John Wiley & Sons Ltd.

  16. Alien Sunset (Artist Concept)

    Science.gov (United States)

    2007-01-01

    Our solitary sunsets here on Earth might not be all that common in the grand scheme of things. New observations from NASA's Spitzer Space Telescope have revealed that mature planetary systems -- dusty disks of asteroids, comets and possibly planets -- are more frequent around close-knit twin, or binary, stars than single stars like our sun. That means sunsets like the one portrayed in this artist's photo concept, and more famously in the movie 'Star Wars,' might be quite commonplace in the universe. Binary and multiple-star systems are about twice as abundant as single-star systems in our galaxy, and, in theory, other galaxies. In a typical binary system, two stars of roughly similar masses twirl around each other like pair-figure skaters. In some systems, the two stars are very far apart and barely interact with each other. In other cases, the stellar twins are intricately linked, whipping around each other quickly due to the force of gravity. Astronomers have discovered dozens of planets that orbit around a single member of a very wide stellar duo. Sunsets from these worlds would look like our own, and the second sun would just look like a bright star in the night sky. But do planets exist in the tighter systems, where two suns would dip below a planet's horizon one by one? Unveiling planets in these systems is tricky, so astronomers used Spitzer to look for disks of swirling planetary debris instead. These disks are made of asteroids, comets and possibly planets. The rocky material in them bangs together and kicks up dust that Spitzer's infrared eyes can see. Our own solar system is swaddled in a similar type of disk. Surprisingly, Spitzer found more debris disks around the tightest binaries it studied (about 20 stars) than in a comparable sample of single stars. About 60 percent of the tight binaries had disks, while the single stars only had about 20 percent. These snug binary systems are as close or closer than just three times the distance between Earth and

  17. TFTR tritium handling concepts

    International Nuclear Information System (INIS)

    Garber, H.J.

    1976-01-01

    The Tokamak Fusion Test Reactor, to be located on the Princeton Forrestal Campus, is expected to operate with 1 to 2.5 MA tritium--deuterium plasmas, with the pulses involving injection of 50 to 150 Ci (5 to 16 mg) of tritium. Attainment of fusion conditions is based on generation of an approximately 1 keV tritium plasma by ohmic heating and conversion to a moderately hot tritium--deuterium ion plasma by injection of a ''preheating'' deuterium neutral beam (40 to 80 keV), followed by injection of a ''reacting'' beam of high energy neutral deuterium (120 to 150 keV). Additionally, compressions accompany the beam injections. Environmental, safety and cost considerations led to the decision to limit the amount of tritium gas on-site to that required for an experiment, maintaining all other tritium in ''solidified'' form. The form of the tritium supply is as uranium tritide, while the spent tritium and other hydrogen isotopes are getter-trapped by zirconium--aluminum alloy. The issues treated include: (1) design concepts for the tritium generator and its purification, dispensing, replenishment, containment, and containment--cleanup systems; (2) features of the spent plasma trapping system, particularly the regenerable absorption cartridges, their integration into the vacuum system, and the handling of non-getterables; (3) tritium permeation through the equipment and the anticipated releases to the environment; (4) overview of the tritium related ventilation systems; and (5) design bases for the facility's tritium clean-up systems

  18. RF Measurement Concepts

    CERN Document Server

    Caspers, F

    2014-01-01

    For the characterization of components, systems and signals in the radiofrequency (RF) and microwave ranges, several dedicated instruments are in use. In this article the fundamentals of the RF signal techniques are discussed. The key element in these front ends is the Schottky diode which can be used either as a RF mixer or as a single sampler. The spectrum analyser has become an absolutely indispensable tool for RF signal analysis. Here the front end is the RF mixer as the RF section of modern spectrum analyses has a ra ther complex architecture. The reasons for this complexity and certain working principles as well as limitations are discussed. In addition, an overview of the development of scalar and vector signal analysers is given. For the determination of the noise temperature of a one-port and the noise figure of a two-port, basic concepts and relations are shown as well as a brief discussion of commonly used noise-measurement techniques. In a further part of this article the operating principles of n...

  19. The PRISM concept

    International Nuclear Information System (INIS)

    Circeo, L.J. Jr.; Camacho, S.L.; Tixier, J.S.

    1994-01-01

    Contaminated soils and buried wastes represent one of the most widespread and costly remediation problems in the United States and other developed countries around the world. This concept of in situ remediation using a plasma arc torch should be directly applicable to many of the contaminated soil remediation needs described the DOE, EPA, and DoD. Plasma Remediation of In Situ Materials (PRISM) could provide a highly efficient, cost-effective, reliable and controllable technique to selectively melt and vitrify any contaminated/buried volume of soils, materials, or objects at any depth underground. If necessary, it could pinpoint underground objects such as buried drums for selective remediation. Plasma arc technology was developed over 30 years ago by NASA for the US space program to simulate reentry temperatures on heat shields. Only recently has this technology begun to emerge as a commercial tool in several industries such as steelmaking, metallurgy, precious metal recovery, and waste disposal. Conceptually, a plasma torch could be used on the ground surface or lowered to the bottom of a small diameter, cased borehole. By raising and operating the torch at progressively higher levels a column of contaminated material would be vitrified and converted into an environmentally safe, glassy residue, highly resistant to leaching. With proper borehole spacing the vitrified columns could be coalesced together to form a contiguous, homogeneous mass of vitrified material which is environmentally safe and highly resistant to leaching

  20. A centrality detector concept

    Energy Technology Data Exchange (ETDEWEB)

    Tarafdar, Sourav; Citron, Zvi; Milov, Alexander, E-mail: alexander.milov@weizmann.ac.il

    2014-12-21

    The nucleus–nucleus impact parameter and collision geometry of a heavy ion collision are typically characterized by assigning a collision “centrality”. In all present heavy ion experiments centrality is measured indirectly, by detecting the number of particles or the energy of the particles produced in the interactions, typically at high rapidity. Centrality parameters are associated to the measured detector response using the Glauber model. This approach suffers from systematic uncertainties related to the assumptions about the particle production mechanism and limitations of the Glauber model. In the collider based experiments there is a unique possibility to measure centrality parameters by registering spectator fragments remaining from the collision. This approach does not require model assumptions and relies on the fact that spectators and participants are related via the total number of nucleons in the colliding species. This paper describes the concept of a centrality detector for heavy ion experiment, which measures the total mass number of all fragments by measuring their deflection in the magnetic field of the collider elements.

  1. Intuition: A Concept Analysis.

    Science.gov (United States)

    Chilcote, Deborah R

    2017-01-01

    The purpose of this article is to conceptually examine intuition; identify the importance of intuition in nursing education, clinical practice, and patient care; encourage acceptance of the use of intuition; and add to the body of nursing knowledge. Nurses often report using intuition when making clinical decisions. Intuition is a rapid, unconscious process based in global knowledge that views the patient holistically while synthesizing information to improve patient outcomes. However, with the advent of evidence-based practice (EBP), the use of intuition has become undervalued in nursing. Walker and Avant's framework was used to analyze intuition. A literature search from 1987 to 2014 was conducted using the following keywords: intuition, intuition and nursing, clinical decision making, clinical decision making and intuition, patient outcomes, EBP, and analytical thinking. The use of intuition is reported by nurses, but is not legitimized within the nursing profession. Defining attributes of intuition are an unconscious, holistic knowledge gathered without using an analytical process and knowledge derived through synthesis, not analysis. Consequences include verification of intuition through an analytical process and translating that knowledge into a course of action. This article supports the use of intuition in nursing by offering clarity to the concept, adds to the nursing knowledge base, encourages a holistic view of the patient during clinical decision making, and encourages nurse educators to promote the use of intuition. © 2016 Wiley Periodicals, Inc.

  2. Phonological Concept Learning.

    Science.gov (United States)

    Moreton, Elliott; Pater, Joe; Pertsova, Katya

    2017-01-01

    Linguistic and non-linguistic pattern learning have been studied separately, but we argue for a comparative approach. Analogous inductive problems arise in phonological and visual pattern learning. Evidence from three experiments shows that human learners can solve them in analogous ways, and that human performance in both cases can be captured by the same models. We test GMECCS (Gradual Maximum Entropy with a Conjunctive Constraint Schema), an implementation of the Configural Cue Model (Gluck & Bower, ) in a Maximum Entropy phonotactic-learning framework (Goldwater & Johnson, ; Hayes & Wilson, ) with a single free parameter, against the alternative hypothesis that learners seek featurally simple algebraic rules ("rule-seeking"). We study the full typology of patterns introduced by Shepard, Hovland, and Jenkins () ("SHJ"), instantiated as both phonotactic patterns and visual analogs, using unsupervised training. Unlike SHJ, Experiments 1 and 2 found that both phonotactic and visual patterns that depended on fewer features could be more difficult than those that depended on more features, as predicted by GMECCS but not by rule-seeking. GMECCS also correctly predicted performance differences between stimulus subclasses within each pattern. A third experiment tried supervised training (which can facilitate rule-seeking in visual learning) to elicit simple rule-seeking phonotactic learning, but cue-based behavior persisted. We conclude that similar cue-based cognitive processes are available for phonological and visual concept learning, and hence that studying either kind of learning can lead to significant insights about the other. Copyright © 2015 Cognitive Science Society, Inc.

  3. Formation Flying Concept Issues

    Directory of Open Access Journals (Sweden)

    M. V. Palkin

    2015-01-01

    Full Text Available The term “formation flying” implies coordinated movement of at least two satellites on coplanar and non-coplanar orbits with a maximum distance between them being much less than the length of the orbit. Peculiarities of formation flying concept also include:- automatic coordination of satellites;- sub-group specialization of formation flying satellites;- equipment and data exchange technology unification in each specialized group or subgroup.Formation flying satellites can be classified according to the configuration stability level (order (array, cluster («swarm», intergroup specialization rules («central satellite», «leader», «slave», manoeuvrability («active» and «passive» satellites.Tasks of formation flying include:- experiments with payload, distributed in formation flying satellites;- various near-earth space and earth-surface research;- super-sized aperture antenna development;- land-based telescope calibration;- «space advertisement» (earth-surface observable satellite compositions of a logotype, word, etc.;- orbital satellite maintenance, etc.Main issues of formation flying satellite system design are:- development of an autonomous satellite group manoeuvring technology;- providing a sufficient characteristic velocity of formation flying satellites;- ballistic and navigation maintenance for satellite formation flying;- technical and economic assessment of formation flying orbital delivery and deployment;- standardization, unification, miniaturization and integration of equipment;- intergroup and intersatellite function redistribution.

  4. An innovative design to establish proof of concept of the antidepressant effects of the NR2B subunit selective N-methyl-D-aspartate antagonist, CP-101,606, in patients with treatment-refractory major depressive disorder.

    Science.gov (United States)

    Preskorn, Sheldon H; Baker, Bryan; Kolluri, Sheela; Menniti, Frank S; Krams, Michael; Landen, Jaren W

    2008-12-01

    This randomized, placebo-controlled, double-blind study was the first to evaluate the antidepressant efficacy, safety, and tolerability of an NR2B subunit-selective N-methyl-D-aspartate receptor antagonist, CP-101,606. Subjects had major depression, according to Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition criteria and a history of treatment refractoriness to least 1 adequate trial of a selective serotonin reuptake inhibitor. The study had 2 treatment periods. In period 1, subjects first received a 6-week open-label trial of paroxetine and a single-blind, intravenous placebo infusion. Period 1 nonresponders (n = 30) then received a randomized double-blind single infusion of CP-101,606 or placebo plus continued treatment with paroxetine for up to an additional 4 weeks (period 2). Depression severity was assessed using the Montgomery-Asberg Depression Rating Scale and 17-item Hamilton Depression Rating Scale. On the prespecified main outcome measure (change from baseline in the Montgomery-Asberg Depression Rating Scale total score at day 5 of period 2), CP-101,606 produced a greater decrease than did placebo (mean difference, 8.6; 80% confidence interval, -12.3 to -4.5) (P Depression Rating Scale response rate was 60% for CP-101,606 versus 20% for placebo. Seventy-eight percent of CP-101,606-treated responders maintained response status for at least 1 week after the infusion. CP-101,606 was safe, generally well tolerated, and capable of producing an antidepressant response without also producing a dissociative reaction. Antagonism of the NR2B subtype of the N-methyl-D-aspartate receptor may be a fruitful target for the development of a new antidepressant with more robust effects and a faster onset compared with those currently available and capable of working when existing antidepressants do not.

  5. Innovation Concepts in Healthcare

    CERN Multimedia

    CERN. Geneva

    2010-01-01

    AbstractDemographic change and advances in medical science pose increased challenges to healthcare systems globally: The economic basis is aging and thus health is becoming more and more a productivity factor. At the same time, with today’s new communication possibilities the demand and expectations of effective medical treatment have been increased. This presentation will illustrate the need for the “industrialization” of healthcare in order to achieve highest results at limited budgets. Thereby, industrialization is not meaning the medical treatment based on the assembly line approach. Rather it is to recognize the cost of medical care as an investment with respective expectations on the return of the investment. Innovations in imaging and pharmaceutical products as well as in processes - that lead to similar medical results, but with lower efforts - are keys in such scenarios.BiographyProf. Dr. Hermann Requardt, 54, is a member of the Managing Board of Siemens AG and Chief Executive Officer of the He...

  6. Enhancing Elementary Pre-Service Teachers' Plant Processes Conceptions

    Science.gov (United States)

    Thompson, Stephen L.; Lotter, Christine; Fann, Xumei; Taylor, Laurie

    2016-01-01

    Researchers examined how an inquiry-based instructional treatment emphasizing interrelated plant processes influenced 210 elementary pre-service teachers' (PTs) conceptions of three plant processes, photosynthesis, cellular respiration, and transpiration, and the interrelated nature of these processes. The instructional treatment required PTs to…

  7. [Concepts of inhibition in psychiatry].

    Science.gov (United States)

    Auroux, Y; Bourrat, M M; Brun, J P

    1978-01-01

    Following a historical approach, the authors first describe the original development of the concept of inhibition in neurophysiology and then analyze the subsequent adaptations made in psychiatry around such concept including those of: -- Pavlov, Hull, Watson and the behaviorists, -- Freud and the Freudian School, -- clinicians and psychopharmacologists. The concept of inhibition has thus various meanings in psychiatry. Although some unity is achieved on the semiological level, this aspect cannot explain the extent of the process.

  8. Progress in advanced accelerator concepts

    International Nuclear Information System (INIS)

    Sessler, A.M.

    1994-08-01

    A review is given of recent progress in this field, drawing heavily upon material presented at the Workshop on Advanced Accelerator Concepts, The Abbey, June 12--18, 1994. Attention is addressed to (1) plasma based concepts, (2) photo-cathodes, (3) radio frequency sources and Two-Beam Accelerators, (4) near and far-field schemes (including collective accelerators), (5) beam handling and conditioning, and (6) exotic collider concepts (such as photon colliders and muon colliders)

  9. ITER concept definition. V.2

    International Nuclear Information System (INIS)

    1989-01-01

    Volume II of the two volumes describing the concept definition of the International Thermonuclear Experimental Reactor deals with the ITER concept in technical depth, and covers all areas of design of the ITER tokamak. Included are an assessment of the current database for design, scoping studies, rationale for concepts selection, performance flexibility, the ITER concept, the operations and experimental/testing program, ITER parameters and design phase schedule, and research and development specific to ITER. This latter includes a definition of specific research and development tasks, a division of tasks among members, specific milestones, required results, and schedules. Figs and tabs

  10. Flourishing: An Evolutionary Concept Analysis.

    Science.gov (United States)

    Agenor, Christine; Conner, Norma; Aroian, Karen

    2017-11-01

    Mental health is an important measure of public health (WHO, 2004); however, nursing practice and research continues to prioritize mental illness, rather than well-being (Wand, 2011). Flourishing is a recent concept in the field of well-being. The term has been used sparingly in nursing practice and research, and conceptual clarification is needed to promote comprehensive understanding of the phenomenon. The purpose of this study is to critically analyze flourishing, assess the maturity of the concept, and provide recommendations for future research, education, and practice. The concept of flourishing was analyzed using the evolutionary approach to concept analysis (Rodgers, 2000). A search for articles on flourishing within the context of well-being was conducted through CINAHL, MEDLINE, and PsycINFO. A sample of 32 articles and 1 book was reviewed. Data were reviewed for concept attributes, antecedents, consequences, surrogate terms and related concepts. Four models of flourishing were identified with six overlapping attributes: meaning, positive relationships, engagement, competence, positive emotion, and self-esteem. Limited longitudinal and predictive studies have been conducted, but there is evidence for several antecedents and outcomes of flourishing. Research is ongoing primarily in psychology and sociology and is lacking in other disciplines. The concept of flourishing is immature; however, evidence is building for related concepts. A lack of consistent terminology regarding flourishing prevents knowledge development of flourishing as a distinct concept. Further multidisciplinary research is needed to establish standard operational and conceptual definitions and develop effective interventions.

  11. Preservice Teachers' Alternative Conceptions in Elementary Science Concepts

    Science.gov (United States)

    Koc, Isil; Yager, Robert E.

    2016-01-01

    This study was conducted to investigate the extent to which preservice teachers held alternative conceptions in elementary science concepts. Eighty-six preservice elementary teachers participated in this study. Twelve preservice elementary teachers participated in follow-up interviews. Data were collected through the use of Alternative Conceptions…

  12. Concepts in radiation protection

    International Nuclear Information System (INIS)

    Oncescu, M.

    1996-01-01

    This monograph provides basic notions and principles in dosimetry and radiation protection in compliance with two fundamental works: IAEA Safety Series No.115 - International Basic Safety Standards for Protection against Ionizing Radiation and for the Safety of Radiation Sources - and Publication no. 60 of International Commission on Radiological Protection. After the review of quantities and units necessary in radiation protection, the book presents the new values of dose limits as well as the values of 'radiation weighting factor', 'tissue weighting factor' and 'conversion factor intake-dose' (committed effective dose per unit intake) by ingestion and inhalation for 30 most important radionuclides. The new values of dose limits, lower than the old values, are a challenge for the radiation protection, especially of the 'public' where the dose limit diminished by a factor of five relative to the earlier edition. The new value of dose limit for public, 1 mSv per year (obviously over the natural exposure of 2.4 mSv per year), imposes new action ways and levels in radiation protection, especially in some cases of exacerbated natural radioactivity. The book provides the calculus of external exposure with the Gamma constant expressed in adequate units, to make the calculation easier. In the calculus of protection shield for gamma sources one uses a method, which while approximate helps save time. The calculus of internal exposure is made using the conversion factor intake-dose. Finally, the 'dosimetric watch' of the natural and artificial radioactivity of the atmosphere, hydrosphere and biosphere is intended to comply with the International Basic Safety Standards. Each chapter ends with a set of illustrative problems which enhances the reader's understanding of underlying concepts and current methods used in the field

  13. Conceptions of Church Slavonic

    Directory of Open Access Journals (Sweden)

    Helmut Keipert

    2017-08-01

    Full Text Available In our time Church Slavonic is a “language without native speakers,” but it is not in all respects a “dead” one. It is for this reason that the Slavs have given it a great variety of names, the different use of which in philological publications heavily depends on the respective linguists’ connotative purposes (e.g., national and ideological interests and so forth. As a rule, the description of the language is based on the analysis of written or printed texts. Only recently have a few additional corpora been introduced in addition to the well-known group of “classical” Old Church Slavonic manuscripts, which, for all their merits in the history of Slavistics, can give only a vague idea of the rich language tradition of Church Slavonic as a whole, since, as a means of actual (oral communication, it can nowadays be observed only in the liturgy. The article discusses the main linguistic conceptions applied to Church Slavonic in the past and present (root language, i.e., proto-language, common language, literary language [Schriftsprache], Ausbau language, etc.; singles out binaristic approaches in opposition to vernaculars; gives an overview of the numerous varieties to be differentiated within the language (connected to regions, chronology, functions, individuals, and groups; recalls the role of reconstruction in modern textbooks and the widely neglected construction devices used in early grammars and dictionaries; and, at the end, refers to the possibility of including Church Slavonic as a model for comparative judgments on degrees of diversity in the structural development of Slavonic languages.

  14. Sociological concept of morale

    Directory of Open Access Journals (Sweden)

    Marjanović Miloš

    2012-01-01

    Full Text Available The author first discusses the overall unity of the total normative regulation, from which it is separated in the late Roman empire the right, but only in the new century and the morale. There are analyzed the relationship between the moral and ethical reflection and Weber's distinction between pure ethics will (Gesinnungsethik and ethics of responsibility (Verantwortungsethik. The morale is determined by the good as the highest value, as a specific form of social norms but also as a kind of human behavior. These three definitions can be combined in an integrative approach. There are examined the dimensions of moral statements, subjective and objective side of morality, as well as the difference between morale and morality. A general notion of morale can not be defined in substantive but only in formal way . The formal definition is a constituent of general as well as of sociological concept of morale and it is related to morality as a social phenomenon. Its essence is to define the morale by specific norms, the characteristics of the internal and external mandatory (with the pricks of conscience as the most distinctive moral sanction and control exercised by the formal not institutionalized or diffuse society , and in consideration of morality as a social process (actions of people associated moral norms . The basic types of social moral process - being, education, functioning and changing of morale are described. There are briefly analyzed the influence of society to the morale and social function of morale, with special emphasis on the relationship between law and morale.

  15. Neurodermatitis--a concept.

    Science.gov (United States)

    Nickel, W R

    1978-05-01

    The skin is an obvious "shock organ" for emotional stresses, as well as the other organ systems. Lividity, blushing, blanching, "goose flesh" are common observations. Personal emotional stress is carried in the mind of the patient, but often, after a period of time, this stress becomes manifest as skin disease. This delay interval is usually two to four weeks, if the histories are accurate. The patient can often be benefited by accepting the relationship of emotional stress and skin disease, along with appropriate treatment.

  16. Molecular Similarity Concepts for Informatics Applications.

    Science.gov (United States)

    Bajorath, Jürgen

    2017-01-01

    The assessment of small molecule similarity is a central task in chemoinformatics and medicinal chemistry. A variety of molecular representations and metrics are applied to computationally evaluate and quantify molecular similarity. A critically important aspect of molecular similarity analysis in chemoinformatics and pharmaceutical research is that one is typically not interested in quantifying the degree of structural or chemical similarity between compounds per se, but rather in extrapolating from molecular similarity to property similarity. In other words, one assumes that there is a correlation between calculated similarity and specific properties of small molecules including, first and foremost, biological activities. Although similarity is a priori a subjective concept, and difficult to quantify, it must computationally be assessed in a formally consistent manner. Otherwise, there is little utility of similarity calculations. Consistent treatment requires approximations to be made and the consideration of alternative computational similarity concepts, as discussed herein.

  17. Diabetic foot infections: current concept review

    Directory of Open Access Journals (Sweden)

    Kimberlee B. Hobizal

    2012-05-01

    Full Text Available The purpose of this manuscript is to provide a current concept review on the diagnosis and management of diabetic foot infections which are among the most serious and frequent complications encountered in patients with diabetes mellitus. A literature review on diabetic foot infections with emphasis on pathophysiology, identifiable risk factors, evaluation including physical examination, laboratory values, treatment strategies and assessing the severity of infection has been performed in detail. Diabetic foot infections are associated with high morbidity and risk factors for failure of treatment and classification systems are also described. Most diabetic foot infections begin with a wound and once an infection occurs, the risk of hospitalization and amputation increases dramatically. Early identification of infection and prompt treatment may optimize the patient's outcome and provide limb salvage.

  18. Recent developments and current concepts in medulloblastoma.

    Science.gov (United States)

    Gerber, N U; Mynarek, M; von Hoff, K; Friedrich, C; Resch, A; Rutkowski, S

    2014-04-01

    Medulloblastoma is the most common malignant brain tumor of childhood. While prognosis has significantly improved in the last decades with multimodal therapy including surgery, radiotherapy, and chemotherapy, one third of patients still succumb to their disease. Further research is needed to find more efficient treatment strategies for prognostically unfavorable patient groups and to minimize long-term sequelae of tumor treatment. This review gives a summary of the current state of treatment concepts including an outlook on the near future. We describe recent advances in the understanding of molecular mechanisms, their potential impact on risk stratification in upcoming clinical trials, and perspectives for the clinical implementation of targeted therapies. Copyright © 2013 Elsevier Ltd. All rights reserved.

  19. Developing an Action Concept Inventory

    Science.gov (United States)

    McGinness, Lachlan P.; Savage, C. M.

    2016-01-01

    We report on progress towards the development of an Action Concept Inventory (ACI), a test that measures student understanding of action principles in introductory mechanics and optics. The ACI also covers key concepts of many-paths quantum mechanics, from which classical action physics arises. We used a multistage iterative development cycle for…

  20. Concepts are a functional kind.

    Science.gov (United States)

    Lalumera, Elisabetta

    2010-06-01

    This commentary focuses on Machery's eliminativist claim, that "concept" ought to be eliminated from the theoretical vocabulary of psychology because it fails to denote a natural kind. I argue for the more traditional view that concepts are a functional kind, which provides the simplest account of the empirical evidence discussed by Machery.