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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. Hepatic fibrosis: Concept to treatment.

    Science.gov (United States)

    Trautwein, Christian; Friedman, Scott L; Schuppan, Detlef; Pinzani, Massimo

    2015-04-01

    Understanding the molecular mechanisms underlying liver fibrogenesis is fundamentally relevant to developing new treatments that are independent of the underlying etiology. The increasing success of antiviral treatments in blocking or reversing the fibrogenic progression of chronic liver disease has unearthed vital information about the natural history of fibrosis regression, and has established important principles and targets for antifibrotic drugs. Although antifibrotic activity has been demonstrated for many compounds in vitro and in animal models, none has been thoroughly validated in the clinic or commercialized as a therapy for fibrosis. In addition, it is likely that combination therapies that affect two or more key pathogenic targets and/or pathways will be needed. To accelerate the preclinical development of these combination therapies, reliable single target validation is necessary, followed by the rational selection and systematic testing of combination approaches. Improved noninvasive tools for the assessment of fibrosis content, fibrogenesis and fibrolysis must accompany in vivo validation in experimental fibrosis models, and especially in clinical trials. The rapidly changing landscape of clinical trial design for liver disease is recognized by regulatory agencies in the United States (FDA) and Western Europe (EMA), who are working together with the broad range of stakeholders to standardize approaches to testing antifibrotic drugs in cohorts of patients with chronic liver diseases. Copyright © 2015. Published by Elsevier B.V.

  6. Pediatric Ankle Fractures: Concepts and Treatment Principles

    Science.gov (United States)

    Su, Alvin W.; Larson, A. Noelle

    2016-01-01

    Synopsis Current clinical concepts are reviewed regarding the epidemiology, anatomy, evaluation and treatment of pediatric ankle fractures. Correct diagnosis and management relies on appropriate exam, imaging, and knowledge of fracture patterns specific to children. Treatment is guided by patient history, physical examination, plain film radiographs and, in some instances, CT. Treatment goals are to restore acceptable limb alignment, physeal anatomy, and joint congruency. For high risk physeal fractures, patients should be monitored for growth disturbance as needed until skeletal maturity. PMID:26589088

  7. [The Concept and Treatment of Kleptomania].

    Science.gov (United States)

    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.

  8. Female pattern hair loss: Current treatment concepts

    Directory of Open Access Journals (Sweden)

    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

  9. 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

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

    Science.gov (United States)

    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.

  11. 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 ...

  12. [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.

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

    DEFF Research Database (Denmark)

    Villa, Matteo; Somers, Marcel A. J.

    2017-01-01

    , 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......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...... 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...

  14. Endoradiotherapy in cancer treatment--basic concepts and future trends.

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    Zoller, Frederic; Eisenhut, Michael; Haberkorn, Uwe; Mier, Walter

    2009-12-25

    Endoradiotherapy represents an alternative therapeutic method in cancer treatment with advantageous features compared to chemotherapy and radiation therapy. Intelligent dose delivery concepts using small drugs, peptides or antibodies as radionuclide carriers enable the verification of a selective accumulation in the tumour lesion and to reduce radiation toxicity for the peripheral organs. The development of endoradiotherapeutic agents, especially chelator-conjugated biomolecules, for example ibritumomab tiuxetan or DOTATOC, gains importance due to the stable complexation of versatile radiometals, such as (90)Y or (177)Lu. The rational design of novel target binding sides and their grafting into a drug scaffold is a highly promising strategy, which may promote further implication in endoradiotherapy. This review highlights the basic concepts of endoradiotherapy and discusses the potential of targeted therapy and the properties of energy-rich particles emitted by radionuclides for tumour therapy.

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

    Directory of Open Access Journals (Sweden)

    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. [ERRORS IN DIAGNOSIS AND TREATMENT OF IMMUNODEPENDENT PATHOLOGY (ORIGINAL CONCEPT)].

    Science.gov (United States)

    Kazmirchuk, V E; Tsaryk, V V; Maltsev, D V; Dyseeva, V V; Voytyuk, T V; Sidorenko, E I; Solon'ko, I I; Pyankova, A V

    2015-01-01

    Based on many years of experience in 2009, we developed the original concept of a mixed approach to the treatment of infectious diseases in patients. During 2.5 years(from 2013 to June 2015) to have applied for consultative-diagnostic help of 3965 patients who had not verified the primary diagnosis. The basic principle of verification of the pathology of the removal of various causes immunosuppression. Based on our extensive, research and observation was often found in patients ascaridosis (55%) and giardiasis (65%), as a possible cause of immunosuppression. In 13% of patients was found the mucosal candidiasis. Among frequently and chronically ill persons we identified the active forms of Epstein-Barr virus (quantitative polymerase chain reaction in saliva) in 40%. The criterion for assessing performance immunogram was a decrease of two sigmal deviation from the lower age limit. In the study of neutrophil myeloperoxidase content observed decline (Immunological study of patients should be redynamics after eliminating the causes immunosuppression and sanitation foci of infection. Only multi-level examination of the patient will determine the final diagnosis and adequate treatment.

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

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    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.

  18. The Nepalese traditional concepts of illness and treatment

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    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.

  19. Amelogenesis imperfecta: review of diagnostic findings and treatment concepts.

    Science.gov (United States)

    Sabandal, Martin M I; Schäfer, Edgar

    2016-09-01

    Mineralization defects like amelogenesis imperfecta are often of hereditary origin. This article reviews the diagnostic findings and summarizes the suggested treatment approaches. Currently, there are no defined therapy recommendations available for patients suffering from amelogenesis imperfecta. The mentioned therapies are more or less equal but no comprehensive therapy recommendation is evident. When treating patients suffering from amelogenesis imperfecta, a comprehensive therapy of almost every dental discipline has to be considered. The earlier the diagnosis of amelogenesis imperfecta is confirmed, the better the outcome is. Optimal treatment approaches consist of early diagnosis and treatment approach and frequent dental recall appointments to prevent progressive occlusal wear or early destruction by caries. Full-mouth prosthetic treatment seems to be the best treatment option.

  20. 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.

  1. Evolving concepts in the treatment of relapsing multiple sclerosis

    DEFF Research Database (Denmark)

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

    2017-01-01

    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...... 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...... 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...

  2. Neurofeedback for Tinnitus Treatment – Review and Current Concepts

    OpenAIRE

    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 ...

  3. 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.

  4. Concepts in local treatment of extensive paediatric burns

    Science.gov (United States)

    Ungureanu, M

    2014-01-01

    Abstract There is a wide variety of local therapeutical methods for extensive burns. This article aims to be a general overview of the most common methods used in the local treatment for extensive burns, both in our clinic and globally. Clinical examples are shown from our clinic; cases of the last 8 years. None of the less there is no such thing as the "perfect method of treatment" but a thin balance between the clinical experience of plastic surgeons, every case particularities and specified characteristics, meaning advantages, disadvantages and limited indications of local topics or methods of skin covering. PMID:25408723

  5. 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.

  6. 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…

  7. 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.

  8. 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.

  9. 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

  10. Treatment of giant cell tumor of bone: Current concepts.

    Science.gov (United States)

    Puri, Ajay; Agarwal, Manish

    2007-04-01

    Giant cell tumor (GCT) of bone though one of the commonest bone tumors encountered by an orthopedic surgeon continues to intrigue treating surgeons. Usually benign, they are locally aggressive and may occasionally undergo malignant transformation. The surgeon needs to strike a balance during treatment between reducing the incidence of local recurrence while preserving maximal function.Differing opinions pertaining to the use of adjuvants for extension of curettage, the relative role of bone graft or cement to pack the defect and the management of recurrent lesions are some of the issues that offer topics for eternal debate.Current literature suggests that intralesional curettage strikes the best balance between controlling disease and preserving optimum function in the majority of the cases though there may be occasions where the extent of the disease mandates resection to ensure adequate disease clearance.An accompanying treatment algorithm helps outline the management strategy in GCT.

  11. Treatment of giant cell tumor of bone: Current concepts

    Directory of Open Access Journals (Sweden)

    Puri Ajay

    2007-01-01

    Full Text Available Giant cell tumor (GCT of bone though one of the commonest bone tumors encountered by an orthopedic surgeon continues to intrigue treating surgeons. Usually benign, they are locally aggressive and may occasionally undergo malignant transformation. The surgeon needs to strike a balance during treatment between reducing the incidence of local recurrence while preserving maximal function. Differing opinions pertaining to the use of adjuvants for extension of curettage, the relative role of bone graft or cement to pack the defect and the management of recurrent lesions are some of the issues that offer topics for eternal debate. Current literature suggests that intralesional curettage strikes the best balance between controlling disease and preserving optimum function in the majority of the cases though there may be occasions where the extent of the disease mandates resection to ensure adequate disease clearance. An accompanying treatment algorithm helps outline the management strategy in GCT.

  12. Treatment of giant cell tumor of bone: Current concepts

    OpenAIRE

    Puri Ajay; Agarwal Manish

    2007-01-01

    Giant cell tumor (GCT) of bone though one of the commonest bone tumors encountered by an orthopedic surgeon continues to intrigue treating surgeons. Usually benign, they are locally aggressive and may occasionally undergo malignant transformation. The surgeon needs to strike a balance during treatment between reducing the incidence of local recurrence while preserving maximal function. Differing opinions pertaining to the use of adjuvants for extension of curettage, the relative role of bone ...

  13. Current concepts of etiology and treatment of chondromalacia patellae.

    Science.gov (United States)

    Bentley, G; Dowd, G

    1984-10-01

    Chondromalacia patellae is a distinct clinical entity characterized by retropatellar pain that is associated with recognizable changes in the articular cartilage of the posterior surface of the patella. Several factors may be involved in the etiology, such as severe patella alta, trauma, and, in rare cases, abnormal patellar tracking. Clinical symptoms and signs are reliable in only 50% of cases, but measurable quadriceps wasting, palpable patellofemoral crepitus, and effusion are strongly suggestive. Diagnosis must be confirmed by arthroscopy or direct examination of the posterior surface of the patella. Radiologic measurements of patellofemoral relations are of limited value in diagnosis. The initial pathologic finding is usually surface cartilage breakdown. Radioisotope studies show cartilage cell replication which suggests a healing capacity in early cases following treatment that alters the load through the affected cartilage. There is no evidence of progression to patellofemoral osteoarthritis, which is probably a different entity. The treatment should be conservative where possible with isometric quadriceps exercises and simple anti-inflammatory drugs such as aspirin. Operative treatment is indicated for patients with persistent pain and macroscopic involvement of more than half a centimeter of the articular cartilage surface. The simplest effective procedure that avoids quadriceps dysfunction and fibrosis is a distal patellar tendon medial realignment with lateral release and medial reefing of the quadriceps expansion. Patellectomy is indicated in more extensive involvement of the patella of 2 or more centimeters in diameter, but this must be performed only when the patient has excellent quadriceps function before surgery and is motivated to exercise after surgery.

  14. [New concepts on the physiopathology, diagnosis, and treatment of achalasia].

    Science.gov (United States)

    Carmona-Sánchez, R; Valdovinos-Díaz, M A

    1998-01-01

    To review the most relevant publications on the pathophysiology, clinical manifestations, diagnosis and treatment of esophageal achalasia, and the clinical experience achieved at our institution in order to propose a practical strategy to facilitate the management of these patients. Manual and MEDLINE search of key articles published between January 1986 and July 1997 in addition to publications of our institute of thirty years. All kinds of publications with substantial clinical experience, new information or research protocols. Achalasia is an uncommon disorder of the myenteric plexus of the esophagus. Main symptoms are dysphagia, regurgitations and chest pain. The diagnosis is established by manometric criteria. Esophagogram, endoscopy and radionuclide esophageal emptying test help to differentiate other conditions and evaluate the response to treatment. Pharmacotherapy may provide relief to patients with mild symptoms and is useful for patients with high risk of complications. Dilations and myotomy are safe, effective and long lasting procedures. Botulinum toxin may be effective in selected cases. Predictive factors of response have been described for each therapy. A systematic approach to the management of patients with achalasia is necessary. Introduction of new therapies as botulinum toxin and minimal invasion surgery are changing the therapeutic decisions in this field. Drugs and BoTox are considered the first line of treatment for high risk patients and dilation and surgery for patients with no risk.

  15. Concepts for treatment of micrometastases developed in murine systems

    International Nuclear Information System (INIS)

    Schabel, F.M. Jr.

    1976-01-01

    Current knowledge of tumor cell population growth kinetics indicates that the growth fraction (viable tumor cells undergoing active cell replication) is inversely related to population size. Tumor cells in micrometastases should, therefore, be more sensitive to anticancer drugs active against anabolizing cells than are tumor cells in the larger, grossly apparent primary tumor from which they were derived. This indicates the probability that micrometastases will be effectively responsive to more drugs than is the primary and clinically apparent tumor from which they came. Studies with at least four metastatic and uniformly fatal murine solid tumors (lung, breast, colon, and melanoma) have demonstrated significantly improved cure rates with drug treatment following surgical removal of the grossly apparent primary tumor than can be obtained with either surgery or drug treatment when used alone. Further, both disease staging and drug dosage have been shown to influence cure rates of combined-modality treatment. With several mouse tumors, a significantly smaller number of viable tumor cells can establish lethal tumors in the presence of radiation-inactivated tumor cells than in their absence. This suggests that small numbers of residual viable tumor cells in radiation-treated tumor sites may be a greater threat to clinical cure than smaller tumor cell populations remaining in situ after surgery

  16. 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

  17. Esophageal Motility Disorders: Current Concepts of Pathogenesis and Treatment

    Directory of Open Access Journals (Sweden)

    Peter J Kahrilas

    2000-01-01

    Full Text Available Current concepts of esophageal motility disorders are summarized. Primary data sources were located via MEDLINE or cross-citation. No attempt was made to be comprehensive or inclusive of the literature because fewer than 10% of citations are discussed. Instead, emphasis was placed on new developments in diagnosis, therapeutics, and practice patterns. Controlled therapeutic trials and pathophysiological observations are emphasized. Achalasia is a rare disease of failed lower sphincter relaxation and aperistalsis. Diffuse esophageal spasm (DES, an equally rare disease, is defined by non-propagated esophageal contractions. Nonspecific motility disorders, including nutcracker esophagus and hypertensive lower esophageal sphincter, are identified only by manometry and are ten times as prevalent. Neuromuscular pathology is evident only with achalasia (myenteric plexus neurons destruction. Pharmacological therapies have limited efficacy with achalasia; more limited with DES; and none with the nonspecific motility disorders. More efficacious therapies for the nonspecific disorders are directed at associated reflux disease or psychiatric disorders. Pneumatic dilation is effective therapy for achalasia 72% of instances, but frequently requires repeat dilation and is complicated by a 3% perforation rate. Surgical myotomy is effective in 88% of achalasics; morbidity from thoracotomy has been the major limitation but this has been sharply reduced with a laparoscopic approach. In conclusion, although it has been suggested that esophageal motility disorders are distinct clinical entities, critical review of the literature supports this only in the case of achalasia, a disease of well defined pathophysiology, functional disturbance, and therapies. This clarity diminishes progressively for DES and non-specific esophageal motility disorders.

  18. 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

  19. 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.

  20. 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.

  1. Current concepts regarding pharmacologic treatment of rheumatoid and osteoarthritis.

    Science.gov (United States)

    Wildy, K S; Wasko, M C

    2001-05-01

    Treating patients with osteoarthritis (OA) and rheumatoid arthritis (RA) remains challenging; however, new agents offer the chance for an improved quality of life. As an alternative to traditional nonsteroidal anti-inflammatories, cyclooxygenase-2 inhibitors provide pain relief for OA and RA patients with possible fewer side effects. Otherwise, OA patients may opt for topical agents, injections, or supplements. Rheumatoid arthritis research has led to an improved understanding of the inflammatory cascade and an appreciation of the early tissue destruction. A new treatment philosophy has thus emerged along with the development of new biologic agents; the latter, along with combination therapy and a new disease modifying antirheumatic drug, leflunomide, have greatly expanded the chances for disease control in RA patients.

  2. Radiation treatment of brain tumors: Concepts and strategies

    International Nuclear Information System (INIS)

    Marks, J.E.

    1989-01-01

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

  3. 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.

  4. 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

  5. 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

  6. 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)

  7. 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.

  8. 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

  9. [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.

  10. Changes in Perception of Selected Concepts That Accompany Differing Leadership Treatments.

    Science.gov (United States)

    Callan, Laurence Brian

    A study was made of effects of two different leadership treatments on perception of nonverbal stimuli relating to concepts of leaders, authority, and cohesion as measured by changes in the Semantic Differential Scale. Subjects (28 Yaqui Indian and Mexican-American members of the Neighborhood Youth Corps) were randomly assigned to an autocratic…

  11. 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

  12. 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.

  13. The Male Aesthetic Patient: Facial Anatomy, Concepts of Attractiveness, and Treatment Patterns.

    Science.gov (United States)

    Keaney, Terrence C; Anolik, Robert; Braz, André; Eidelman, Michael; Eviatar, Joseph A; Green, Jeremy B; Jones, Derek H; Narurkar, Vic A; Rossi, Anthony M; Gallagher, Conor J

    2018-01-01

    BACKGROUND: The number of nonsurgical aesthetic procedures performed in men is growing rapidly. However, there are limited data on treatment principles and goals for the male aesthetic patient. OBJECTIVE: To review the objective data available on male aging and aesthetics and to synthesize with expert opinion on treatment considerations specific to male patients. METHODS: Expert advisors met to discuss anatomical differences in male versus female facial anatomy related to aging, facial treatment preferences in aesthetically oriented men, and current dosing data for facial injectable treatments in male versus female patients. RESULTS: Symmetry, averageness, sexual dimorphism, and youthfulness are generally accepted as factors that contribute to the perception of attractiveness. There are differences between men and women in facial anatomy, concepts of attractiveness in the context of masculinity and femininity, and treatment objectives. A communication gap exists for men, as evidenced by the lack of information available online or by word of mouth about injectable treatments. CONCLUSIONS: Approaches to aesthetic consultation and treatment should differ between men and women based on the fundamental dissimilarities between the sexes. Educating men about available aesthetic treatments and about the safety and side effects associated with each treatment, as well as addressing concerns about their treatment results looking natural, are key considerations. J Drugs Dermatol. 2018;17(1):19-28..

  14. 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.

  15. 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

  16. 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 self-perception of the dentofacial region were statistically significant predictors (P < .05) of Social 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.

  17. [Alcoholism: definition, diagnosis, illness concept, follow-up, results and costs of treatment].

    Science.gov (United States)

    Feuerlein, W

    1991-02-01

    The article starts with a review on the definition of alcoholism stressing the useful differentiation between alcohol abuse and alcohol dependence. On the basis of this definition the principles of the diagnosis of alcoholism are demonstrated. The disease concept of alcoholism is discussed in detail. Then the aims, the structure and the results of the therapy for alcoholics are briefly described. The article concludes with a short cost-benefit analysis of the alcoholism treatment.

  18. An innovative concept for handling and operation of the wastewater treatment plant of Cottbus

    International Nuclear Information System (INIS)

    Spiller, K.; Schmitt, J.

    1994-01-01

    A new concept for handling and operating the wastewater treatment plant of Cottbus, with computerized modelling and an expert system as integral parts of process analysis and decision-making, is developed. Optimized plant operation and process stability is to be achieved by conrolling process-dependent dosage of wastewater coming from sludge treatment and from faecal wastewater. With the treatment plant still being built, a thorough analysis of the influent and the resulting process conditions is done, using the computerized model. Results and consequences for process optimization are presented in this article. Special attention has to be given to load smoothing and optimization of denitrification, influencing process stability and quality. Thereby not only the legal requirements can be fulfilled but improvement of effluent quality also could be achieved, reducing total nitrogen in the effluent by as much as 50%, lowering wastewater treatment costs by allowing lower control levels and fees to be payed. (orig.) [de

  19. The concept of treatment-free remission in chronic myeloid leukemia

    Science.gov (United States)

    Saußele, S; Richter, J; Hochhaus, A; Mahon, F-X

    2016-01-01

    The advent of tyrosine kinase inhibitors (TKI) into the management of patients with chronic myeloid leukemia (CML) has profoundly improved prognosis. Survival of responders is approaching that of the general population but lifelong treatment is still recommended. In several trials, TKI treatment has been stopped successfully in approximately half of the patients with deep molecular response. This has prompted the development of a new concept in the evaluation of CML patients known as ‘treatment-free remission'. The future in CML treatment will be to define criteria for the safe and most promising discontinuation of TKI on one hand, and, on the other, to increase the number of patients available for such an attempt. Until safe criteria have been defined, discontinuation of therapy is still experimental and should be restricted to clinical trials or registries. This review will provide an overview of current knowledge as well as an outlook on future challenges. PMID:27133824

  20. 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.

  1. [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.

  2. 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.

  3. 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.

  4. 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.

  5. Essential role of radiation therapy for the treatment of pancreatic cancer. Novel study concepts and established treatment recommendations

    International Nuclear Information System (INIS)

    Dobiasch, Sophie; Goerig, Nicole L.; Fietkau, Rainer; Combs, Stephanie E.

    2018-01-01

    Pancreatic cancer is one of the most aggressive human tumors and the incidence has increased over the last 6 years. In the majority of cases the disease is already in an advanced stage at the time of diagnosis where surgery, the only curative treatment, is no longer an option and explains the still abysmal overall survival. The role of radiation therapy as treatment option for patients with pancreatic cancer is controversially discussed although radiation oncology has emerged as a central pillar in the combined oncological treatment. The present manuscript gives an overview of advanced radiotherapeutic strategies in the context of chemotherapy and surgery according to the current American Society of Clinical Oncology (ASCO) guidelines in comparison with the German guidelines and to elucidate the role of radiation therapy for the treatment of pancreatic cancer. Advanced modern radiotherapeutic techniques in combination with individualized high-precision radiation concepts are new therapeutic approaches for pancreatic cancer in a multimodal setting with tolerable side effects. Several clinical studies together with experimental approaches are in process, to deliver further evidence and ultimately allow true personalized medicine. (orig.) [de

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

    Institute of Scientific and Technical Information of China (English)

    D. Weichgrebe; S. Maerker; T. Boning; H. Stegemann

    2008-01-01

    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.

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

    Science.gov (United States)

    Kujawa-Roeleveld, K; Fernandes, T; Wiryawan, Y; Tawfik, A; Visser, 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 organic matter and nutrients from all waste(water)streams generated from different human activities. Anaerobic digestion of concentrated black water is a core technology in the DESAR concept. The applicability of the UASB septic tank for treatment of concentrated black water was investigated under two different temperatures, 15 and 25 degrees C. The removal of total COD was dependent on the operational temperature and attained 61 and 74% respectively. A high removal of the suspended COD of 88 and 94% respectively was measured. Effluent nutrients were mainly in the soluble form. Precipitation of phosphate was observed. Effective sludge/water separation, long HRT and higher operational temperature contributed to a reduction of E. coli. Based on standards there is little risk of contamination with heavy metals when treated effluent is to be applied in agriculture as fertiliser.

  8. 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.

  9. 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.

  10. Essential role of radiation therapy for the treatment of pancreatic cancer. Novel study concepts and established treatment recommendations

    Energy Technology Data Exchange (ETDEWEB)

    Dobiasch, Sophie [Technical University of Munich (TUM), Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Goerig, Nicole L.; Fietkau, Rainer [Friedrich-Alexander-Universitaet Erlangen-Nuernberg, Department of Radiation Oncology, Universitaetsklinikum Erlangen, Erlangen (Germany); Combs, Stephanie E. [Technical University of Munich (TUM), Department of Radiation Oncology, Klinikum rechts der Isar, Munich (Germany); Helmholtz Zentrum Muenchen, Institute of Innovative Radiotherapy (iRT), Department of Radiation Sciences (DRS), Neuherberg (Germany)

    2018-03-15

    Pancreatic cancer is one of the most aggressive human tumors and the incidence has increased over the last 6 years. In the majority of cases the disease is already in an advanced stage at the time of diagnosis where surgery, the only curative treatment, is no longer an option and explains the still abysmal overall survival. The role of radiation therapy as treatment option for patients with pancreatic cancer is controversially discussed although radiation oncology has emerged as a central pillar in the combined oncological treatment. The present manuscript gives an overview of advanced radiotherapeutic strategies in the context of chemotherapy and surgery according to the current American Society of Clinical Oncology (ASCO) guidelines in comparison with the German guidelines and to elucidate the role of radiation therapy for the treatment of pancreatic cancer. Advanced modern radiotherapeutic techniques in combination with individualized high-precision radiation concepts are new therapeutic approaches for pancreatic cancer in a multimodal setting with tolerable side effects. Several clinical studies together with experimental approaches are in process, to deliver further evidence and ultimately allow true personalized medicine. (orig.) [German] Das Pankreaskarzinom gehoert zu den aggressivsten menschlichen Tumoren und verzeichnete in den letzten 6 Jahren eine steigende Inzidenz. Die Diagnose wird meist erst im fortgeschrittenen Stadium gestellt; dies schliesst haeufig eine primaer kurative Intervention mithilfe der chirurgischen Resektion aus und bedingt die hohe Mortalitaet. Obwohl die Strahlentherapie im multimodalen Therapieansatz des Pankreaskarzinoms eine zentrale Saeule darstellt, wird die Rolle der Strahlentherapie in der Literatur kontrovers diskutiert. Der vorliegende Beitrag bietet eine Uebersicht moderner Bestrahlungsstrategien im interdisziplinaeren Konzept gemaess der Leitlinien der American Society of Clinical Oncology (ASCO) im Vergleich zu den

  11. Surgery and Multimodal treatments in pancreatic cancer. A review on the basis of future multimodal treatment concepts

    International Nuclear Information System (INIS)

    Link, K.H.; Leder, G; Formentini, A.; Fortnagel, G.; Kornmann, M.; Schatz, M.; Beger, H.G.

    1999-01-01

    The literature on the indications and results of adjuvant/neoadjuvant therapies in pancreatic cancer was reviewed to provide a solid base for current recommendations and future developments. A special view was concentrated on the biology of the disease in the spontaneous course, after surgery and during/after various palliative and adjuvant/neoadjuvant treatment modalities, to characterize the disease for an optimally targeted treatment in conjunction with surgical removal of the tumor. The results of systemic and regional chemotherapy and radiotherapy either alone or in combination, before, during, and after surgery, were critically analyzed with respect to the oncological possibilities and pitfalls of each treatment method. In two randomized trials, one testing postoperative radio chemotherapy (GITSG), and one postoperative chemotherapy (Bakkevold), the adjuvant treatment, achieved a significant prolongation of the median survival time. The 5- and 10-year survival rates were improved in the GITSG study. The EORTC-GITCCG trial could not confirm the benefit of adjuvant radiochemotherapy. This study had a different design than the GITSG trial. Several historical control studies supported the beneficial effect of postoperative radio chemotherapy. In three historical control trials using regional chemotherapy, one with intraoperative radiotherapy, the survival times were improved vs. surgery alone. Intraoperative or postoperative radiotherapy as single modalities might reduce local relapses, but a survival advantage is still debated. Preoperative neoadjuvant radio chemotherapy has several advantages, and does not seem to increase the postoperative morbidity. Several trials have confirmed the feasibility of this concept, but no survival advantage has yet been proven. Systemic and regional chemotherapy is able to down stage primarily nonresectable pancreatic cancers. (K.H.). 111 refs

  12. 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

  13. 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.

  14. 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)

  15. 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.

  16. Gamma knife radiosurgery for benign cavernous sinus tumors. Treatment concept and outcomes in 120 cases

    International Nuclear Information System (INIS)

    Hayashi, Motohiro; Chernov, Mikhail; Tamura, Noriko

    2012-01-01

    Availability of modern computer-aided robotized devices, such as the Automatic Positioning System (APS TM ; Elekta Instruments AB, Stockholm, Sweden) and Perfexion TM (Elekta Instruments AB), allowed us to develop the original concept of robotic gamma knife microradiosurgery, which is based on the very precise irradiation of the lesion with regard to conformity and selectivity; intentional avoidance of the excessive irradiation of functionally-important anatomical structures, particularly cranial nerves, located both within and in the vicinity of the target; and delivery of sufficient irradiation energy to the tumor with the intention to attain lesion shrinkage, while keeping the marginal dose sufficiently low for prevention of possible complications. The results of such treatment strategy were evaluated retrospectively in 120 patients with benign cavernous sinus neoplasms (pituitary adenomas, meningiomas, schwannomas, and hemangiomas), who were followed up from 24 to 78 months (mean 47 months) after radiosurgery. Tumor growth control and shrinkage rates were 98% and 68%, respectively. More than 50% volume reduction was noted in 25% of lesions. The most prominent volumetric tumor response was observed in hemangiomas, followed by schwannomas, pituitary adenomas, and meningiomas. Treatment-related complications were marked in 7% of cases, and were mainly related to transient isolated cranial neuropathy appearing within several months after radiosurgery. Major morbidity was limited to one patient (0.8%). Application of microradiosurgical treatment principles provides effective and safe management of benign cavernous sinus tumors and is associated with high probability of lesion shrinkage and minimal risk of complications. (author)

  17. 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.

  18. 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

  19. 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.

  20. Effects of depression pharmacotherapy in fertility treatment on conception, birth, and neonatal health: A systematic review.

    Science.gov (United States)

    Akioyamen, Leo E; Minhas, Hersimren; Holloway, Alison C; Taylor, Valerie H; Akioyamen, Noel O; Sherifali, Diana

    2016-05-01

    While antidepressant medications are currently used during conception, gestation and post-partum, considerable uncertainty exists regarding the benefits and harms conferred to mothers and their offspring. A significant body of evidence has focused on antidepressant use during pregnancy and post-partum. However, it is difficult to know if this translates to specific populations. Women receiving treatment for infertility are especially vulnerable to symptoms of depression and adverse perinatal outcomes. This systematic review aimed to determine the effects of antidepressants taken during the perinatal period by women receiving fertility treatment on conception, birth, and long-term maternal and child health outcomes. We searched MEDLINE, EMBASE, CINAHL, the Cochrane Library, PsycINFO, ProQuest Dissertation & Theses, and Pubmed databases from January 1950 to November 2015. Articles were screened for inclusion independently by two reviewers. Studies were included if they enrolled women of reproductive age exposed to pharmacotherapy for depression and infertility at any point during the perinatal period. A total of 8587 unique citations, and 83 full-text articles were reviewed. Of these, two randomized controlled trials and two retrospective chart reviews were included in the narrative synthesis. While most studies reported on assisted reproduction processes and birth outcomes, none examined long-term impacts on maternal-child health. The few included studies did not find that antidepressant use by women receiving fertility therapy impacted gamete quality or pregnancy success. Currently, no studies address whether pharmacotherapy for the treatment of depression in women undergoing assisted reproduction affects their health or that of their offspring long-term. It appears that much like antidepressant use in fertile women, there are risks associated with both antidepressant use and untreated depression. Decisions regarding the treatment of depression should be made

  1. 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.

  2. Psilocybin-assisted treatment for alcohol dependence: a proof-of-concept study.

    Science.gov (United States)

    Bogenschutz, Michael P; Forcehimes, Alyssa A; Pommy, Jessica A; Wilcox, Claire E; Barbosa, P C R; Strassman, Rick J

    2015-03-01

    Several lines of evidence suggest that classic (5HT2A agonist) hallucinogens have clinically relevant effects in alcohol and drug addiction. Although recent studies have investigated the effects of psilocybin in various populations, there have been no studies on the efficacy of psilocybin for alcohol dependence. We conducted a single-group proof-of-concept study to quantify acute effects of psilocybin in alcohol-dependent participants and to provide preliminary outcome and safety data. Ten volunteers with DSM-IV alcohol dependence received orally administered psilocybin in one or two supervised sessions in addition to Motivational Enhancement Therapy and therapy sessions devoted to preparation for and debriefing from the psilocybin sessions. Participants' responses to psilocybin were qualitatively similar to those described in other populations. Abstinence did not increase significantly in the first 4 weeks of treatment (when participants had not yet received psilocybin), but increased significantly following psilocybin administration (p psilocybin session (at week 4) strongly predicted change in drinking during weeks 5-8 (r = 0.76 to r = 0.89) and also predicted decreases in craving and increases in abstinence self-efficacy during week 5. There were no significant treatment-related adverse events. These preliminary findings provide a strong rationale for controlled trials with larger samples to investigate efficacy and mechanisms. NCT02061293. © The Author(s) 2015.

  3. [Opiate addiction in gravidity - consequences for the newborn. Results of an interdisciplinary treatment concept].

    Science.gov (United States)

    Rohrmeister, K; Bernert, G; Langer, M; Fischer, G; Weninger, M; Pollak, A

    2001-01-01

    To evaluate the outcome of infants of drug dependent mothers (IDM) after establishing an interdisciplinary attention concept at the University Hospital in Vienna. To compare the influence of different maintenance agents on neonatal morbidity. All newborns of opiate dependent mothers were prospectively included from III 1995 to IX 1999. The following data were collected: maintenance agent (methadone, slow release morphine, buprenorphine), infectious status, demographic data, congenital malformations, perinatal complications, as well as incidence and duration of the neonatal abstinence syndrome (NAS). Medical treatment with phenobarbital (1995 - 96) or morphine hydrochloride (MoHCl) (1997 - 99), respectively, was indicated when Finnegan score exceeded 10. 88 neonates (38 females/50 males) with a median gestational age of 39 weeks were included, 18 (20.5 %) were born prematurely. The median birthweight was 2905 g, 24 (27.3 %) infants were small for date (methadone group 76 %, in the morphine group 93 %, but in the buprenorphine group 19 % only (p methadone and morphine exposure (8.3 d versus 15 d and 16.5 d respectively). In neonates treated with phenobarbital duration of NAS was 17.6 d, whereas NAS in infants with MoHCl therapy lasted 12.8 d (p methadone and morphine exposure. Withdrawal time under morphin-hydrochloride therapy was reduced by one third compared to treatment with phenobarbital.

  4. Late-onset hypogonadism: current concepts and controversies of pathogenesis, diagnosis and treatment.

    Science.gov (United States)

    Huhtaniemi, Ilpo

    2014-01-01

    Although suppressed serum testosterone (T) is common in ageing men, only a small proportion of them develop the genuine syndrome of low T associated with diffuse sexual (e.g., erectile dysfunction), physical (e.g. loss of vigor and frailty) and psychological (e.g., depression) symptoms. This syndrome carries many names, including male menopause or climacterium, andropause and partial androgen deficiency of the ageing male (PADAM). Late-onset hypogonadism (LOH) describes it best and is therefore generally preferred. The decrease of T in LOH is often marginal, and hypogonadism can be either due to primary testicular failure (low T, high luteinizing hormone (LH)) or secondary to a hypothalamic-pituitary failure (low T, low or inappropriately normal LH). The latter form is more common and it is usually associated with overweight/obesity or chronic diseases (e.g., type 2 diabetes mellitus, the metabolic syndrome, cardiovascular and chronic obstructive pulmonary disease, and frailty). A problem with the diagnosis of LOH is that often the symptoms (in 20%-40% of unselected men) and low circulating T (in 20% of men >70 years of age) do not coincide in the same individual. The European Male Ageing Study (EMAS) has recently defined the strict diagnostic criteria for LOH to include the simultaneous presence of reproducibly low serum T (total T treatment of comorbid diseases. T replacement is widely used for the treatment, but evidence-based information about its real benefi ts and short- 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.

  5. Dextromethorphan/quinidine pharmacotherapy in patients with treatment resistant depression: A proof of concept clinical trial.

    Science.gov (United States)

    Murrough, James W; Wade, Elizabeth; Sayed, Sehrish; Ahle, Gabriella; Kiraly, Drew D; Welch, Alison; Collins, Katherine A; Soleimani, Laili; Iosifescu, Dan V; Charney, Dennis S

    2017-08-15

    At least one-third of patients with major depressive disorder (MDD) have treatment-resistant depression (TRD), defined as lack of response to two or more adequate antidepressant trials. For these patients, novel antidepressant treatments are urgently needed. The current study is a phase IIa open label clinical trial examining the efficacy and tolerability of a combination of dextromethorphan (DM) and the CYP2D6 enzyme inhibitor quinidine (Q) in patients with TRD. Dextromethorphan acts as an antagonist at the glutamate N-methyl-d-aspartate (NMDA) receptor, in addition to other pharmacodynamics properties that include activity at sigma-1 receptors. Twenty patients with unipolar TRD who completed informed consent and met all eligibility criteria we enrolled in an open-label study of DM/Q up to 45/10mg by mouth administered every 12h over the course of a 10-week period, and constitute the intention to treat (ITT) sample. Six patients discontinued prior to study completion. There was no treatment-emergent suicidal ideation, psychotomimetic or dissociative symptoms. Montgomery-Asberg Depression Rating Scale (MADRS) score was reduced from baseline to the 10-week primary outcome (mean change: -13.0±11.5, t 19 =5.0, p<0.001), as was QIDS-SR score (mean change: -5.9±6.6, t 19 =4.0, p<0.001). The response and remission rates in the ITT sample were 45% and 35%, respectively. Open-label, proof-of-concept design. Herein we report acceptable tolerability and preliminary efficacy of DM/Q up to 45/10mg administered every 12h in patients with TRD. Future larger placebo controlled randomized trials in this population are warranted. Copyright © 2017 Elsevier B.V. All rights reserved.

  6. 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

  7. 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.

  8. [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.

  9. Tissue perfusion as a key underlying concept of pressure ulcer development and treatment.

    Science.gov (United States)

    Wywialowski, E F

    1999-03-01

    The purpose of this article is to refine and advance the theory that tissue perfusion is the key concept in the development and delayed healing of pressure ulcers. The person likely to have (be at risk for) pressure ulcers is at greater risk for inadequate tissue perfusion generally and specifically at pressure points. Accordingly, the tissue perfusion theory of pressure ulcer development states that the factors that contribute to inadequate tissue perfusion should be used to predict (identify risk factors for) pressure ulcer development and delayed healing. Factors influencing a person's adequacy of tissue perfusion need to be assessed to identify risk for pressure ulcers. In addition, adequate tissue perfusion needs to be maintained to provide for healing of such wounds. Current beliefs about the causes and prevention of pressure ulcers are described. Physiologic components of the tissue perfusion theory are discussed: cellular exchange of nutrients and wastes, autoregulation of blood flow at the cellular level, and regulatory mechanisms that affect tissue perfusion when it is significantly compromised. The North American Nursing Diagnosis Association (NANDA) framework is used to classify or group examples of common pathophysiologic, treatment-related, situational, and maturational factors. Implications for research, practice, and education also are discussed.

  10. Disease concepts and treatment by tribal healers of an Amazonian forest culture.

    Science.gov (United States)

    Herndon, Christopher N; Uiterloo, Melvin; Uremaru, Amasina; Plotkin, Mark J; Emanuels-Smith, Gwendolyn; Jitan, Jeetendra

    2009-10-12

    The extensive medicinal plant knowledge of Amazonian tribal peoples is widely recognized in the scientific literature and celebrated in popular lore. Despite this broad interest, the ethnomedical systems and knowledge of disease which guide indigenous utilization of botanical diversity for healing remain poorly characterized and understood. No study, to our knowledge, has attempted to directly examine patterns of actual disease recognition and treatment by healers of an Amazonian indigenous culture. The establishment of traditional medicine clinics, operated and directed by elder tribal shamans in two remote Trio villages of the Suriname rainforest, presented a unique investigational opportunity. Quantitative analysis of clinic records from both villages permitted examination of diseases treated over a continuous period of four years. Cross-cultural comparative translations were articulated of recorded disease conditions through ethnographic interviews of elder Trio shamans and a comprehensive atlas of indigenous anatomical nomenclature was developed. 20,337 patient visits within the period 2000 to 2004 were analyzed. 75 disease conditions and 127 anatomical terms are presented. Trio concepts of disease and medical practices are broadly examined within the present and historical state of their culture. The findings of this investigation support the presence of a comprehensive and highly formalized ethnomedical institution within Trio culture with attendant health policy and conservation implications.

  11. The Future of Bronchopulmonary Dysplasia: Emerging Pathophysiological Concepts and Potential New Avenues of Treatment

    Directory of Open Access Journals (Sweden)

    Jennifer J. P. Collins

    2017-05-01

    Full Text Available Yearly more than 15 million babies are born premature (<37 weeks gestational age, accounting for more than 1 in 10 births worldwide. Lung injury caused by maternal chorioamnionitis or preeclampsia, postnatal ventilation, hyperoxia, or inflammation can lead to the development of bronchopulmonary dysplasia (BPD, one of the most common adverse outcomes in these preterm neonates. BPD patients have an arrest in alveolar and microvascular development and more frequently develop asthma and early-onset emphysema as they age. Understanding how the alveoli develop, and repair, and regenerate after injury is critical for the development of therapies, as unfortunately there is still no cure for BPD. In this review, we aim to provide an overview of emerging new concepts in the understanding of perinatal lung development and injury from a molecular and cellular point of view and how this is paving the way for new therapeutic options to prevent or treat BPD, as well as a reflection on current treatment procedures.

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

    Directory of Open Access Journals (Sweden)

    Ilpo Huhtaniemi

    2014-04-01

    short- 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.

  13. 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

  14. 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

  15. 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...

  16. Concept and treatment of hydrocephalus in the Greco-Roman and early Arabic medicine.

    Science.gov (United States)

    Grunert, P; Charalampaki, P; Ayyad, A

    2007-10-01

    In the ancient medical literature hydrocephalus was not often described although its existence and symptomatology were well known. Most detailed descriptions of hydrocephalus including the surgical treatment are extant in the encyclopaedic works on medicine of the physicians Oreibasios and Aetios from Amida from the 4th and 6th centuries AD, respectively. Because of their broad scientific interests, this type of physicians, typical for the late Roman empire, were known as philosophy-physicians (iota alpha tau rho o sigma o phi iota sigma tau alpha iota). They defined hydrocephalus in contrast to our present understanding as a fluid collection excluding abscesses visible as a bulging tumour localised either outside or inside the skull of an infant. They classified the hydrocephalus similar as stated first by Galen in the 2nd century AD in four types corresponding to the assumed anatomic localisation of the fluid collection: 1st Type between the skin and the pericranium corresponding to the subgaleal haematoma or caput succedaneum of the newborn in our terminology, 2nd Type between the pericranium and the skull corresponding to the cephal haematoma after delivery, 3rd Type between skull and the meninges with increased head circumference, bone sutures being increasingly driven apart corresponding most likely to the hydrocephalus in our understanding, and 4th Type between the menings and the brain characterised by severe neurological deficit with lethal prognosis corresponding probably to all pathologies which were accompanied by an excessive increase of the intracranial pressure with a bulging fontanel. Due to the lack of autopsies in ancient times, the hydrocephalus was never linked to the pathology of the ventricles. All forms of hydrocephalus were believed to be caused by improper handling of the head by the midwife during delivery. Only the extracranial fluid collections, but not hydrocephalus in our sense, were considered to be suitable for surgical treatment

  17. 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

  18. 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.

  19. 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.

  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. Recovery concept in a Norwegian setting to be examined by the assertive community treatment model and mixed methods.

    Science.gov (United States)

    Lofthus, Ann-Mari; Westerlund, Heidi; Bjørgen, Dagfinn; Lindstrøm, Jonas Christoffer; Lauveng, Arnhild; Rose, Diana; Ruud, Torleif; Heiervang, Kristin

    2018-02-01

    Recovery is a crucial concept in the mental health field. The research of recovery is split into the categories of personal, social and clinical recovery. The purpose of this study was to explore the fragmented concept of recovery in light of assertive community treatment (ACT) in Norway. The study has a mixed methods design with a pragmatic approach. The Questionnaire about the Process of Recovery and open-ended questions posed to 70 participants from 12 ACT teams in Norway, gathered by the "Users interview users" method, are combined with interviews or focus groups with eight of these participants. Surprisingly those under a community treatment order (CTO) report the highest degree of personal recovery. The qualitative material shows that the service users interpreted the concept of recovery differently than researchers and professionals. The ACT service users highlighted three important elements: flexible treatment, medication and access to a car. They emphasized the necessity for basic needs to be met in order to experience a meaningful recovery process, and these basic needs may be of even greater importance to those under CTOs. Their experiences should imply a greater emphasis on securing basic needs such as secure housing, sounder finances and access to the normal benefits offered by society. © 2016 Australian College of Mental Health Nurses Inc.

  2. 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......-treatment after the educational training (ET). A significant increase in knowledge from 36 to 69% (group A) and 28 to 75% (group B) was obtained. A majority of the patients were satisfied with the ET. Patients' QoL, anxiety, depression and general well-being showed no difference after the ET. CONCLUSION: Patient...

  3. 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

    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...... 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...

  4. 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…

  5. Replication, randomization, and treatment design concepts for on-farm research

    Science.gov (United States)

    For most agronomists, randomization and replication are fundamental concepts that have a nearly sacred or spiritual status. They are an integral part of nearly all of our field-based activities. Some on-farm research falls into this category, simply because it is driven and designed by researchers w...

  6. The prediction of failure situations using the CTOD concept based on the engineering treatment model (ETM)

    International Nuclear Information System (INIS)

    Schwalbe, K.H.

    1985-01-01

    Under the assumption of plane stress conditions, the CTOD concept is extended such that a full R-curve methodology arises consisting of an experimental procedure for the determination of the R-curve and of the driving force prediction. Predictions of initiation and maximum loads are in reasonable agreement with experimental results. (orig./HP)

  7. 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

  8. 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.

  9. 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.

  10. How to Create Evidence for the Integration of Local and Locoregional Treatments in Future Oncological Treatment Concepts?

    OpenAIRE

    Lordick, Florian; Ricke, Jens; Mohnike, Konrad; Hacker, Ulrich

    2014-01-01

    Summary Background While local treatment using more innovative technologies is increasingly applied in contemporary treatment of advanced cancer, its impact on outcomes is not well understood. Methods We reviewed the literature using PubMed and major oncology congress websites, and report here about the understanding of oligometastatic disease, about the role of primary tumor resection in metastatic disease, and about the value of cytoreduction and tumor ablation. Results The Achilless' heel ...

  11. 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.

  12. 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.

  13. 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.

  14. 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 ...

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

    International Nuclear Information System (INIS)

    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

  16. 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.

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

    Science.gov (United States)

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

    2012-08-01

    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. Concept mapping is a formalized conceptualization procedure that describes the underlying cognitive structures people use in complex tasks, such as treatment allocation. Based on expert opinions of 29 Dutch clinicians, a concept map was generated that yielded eight domains of patient characteristics, i.e., Severity of symptoms, Severity of personality pathology, Ego-adaptive capacities, Motivation and working alliance, Social context, Social demographic characteristics, Trauma, and Treatment history and medical condition. These domains can be ordered along two bipolar axes, running from internal to external concepts and from vulnerability to strength concepts, respectively. Our findings may serve as input for the delineation of algorithms for patient-treatment matching research in PD.

  18. Treatment of thyroid disorders before conception and in early pregnancy: a systematic review

    NARCIS (Netherlands)

    Vissenberg, R.; van den Boogaard, E.; van Wely, M.; van der Post, J. A.; Fliers, E.; Bisschop, P. H.; Goddijn, M.

    2012-01-01

    Thyroid disorders are associated with pregnancy complications. Universal screening is currently not recommended because of a lack of evidence on the effectiveness of treatment. Women with hyperthyroidism and hypothyroidism evidently require treatment but this is less clear for women with subclinical

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

    KAUST Repository

    Sudhakaran, Sairam; Maeng, Sungkyu; Amy, Gary L.

    2013-01-01

    ). 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

  20. [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.

  1. 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...

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

    Energy Technology Data Exchange (ETDEWEB)

    Jensen, Alexandra D., E-mail: Alexandra.Jensen@med.uni-heidelberg.de [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany); Nill, Simeon [Department of Medical Physics, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Huber, Peter E. [Clinical Co-Operation Unit Radiation Oncology, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Bendl, Rolf [Department of Medical Physics, German Cancer Research Centre (DKFZ), Heidelberg (Germany); Debus, Juergen; Muenter, Marc W. [Department of Radiation Oncology, University of Heidelberg, Heidelberg (Germany)

    2012-02-01

    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

  3. 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

  4. A clinical concept for interfractional adaptive radiation therapy in the treatment of head and neck cancer.

    Science.gov (United States)

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

    2012-02-01

    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. 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. 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. 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 correction methods, this approach allows significant

  5. 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.

  6. [Acute inpatient conservative multimodal treatment of complex and multifactorial orthopedic diseases in the ANOA concept].

    Science.gov (United States)

    Psczolla, M

    2013-10-01

    In Germany there is a clear deficit in the non-operative treatment of chronic and complex diseases and pain disorders in acute care hospitals. Only about 20 % of the treatments are carried out in orthopedic hospitals. Hospitals specialized in manual medicine have therefore formed a working group on non-operative orthopedic manual medicine acute care clinics (ANOA). The ANOA has developed a multimodal assessment procedure called the OPS 8-977 which describes the structure and process quality of multimodal and interdisciplinary diagnosis and treatment of the musculoskeletal system. Patients are treated according to clinical pathways oriented on the clinical findings. The increased duration of treatment in the German diagnosis-related groups (DRG) system is compensated for with a supplemental remuneration. Thus, complex and multifactorial orthopedic diseases and pain disorders are conservatively and appropriately treated as inpatient departments of acute care hospitals.

  7. Legal frameworks and key concepts regulating diversion and treatment of mentally disordered offenders in European Union member states.

    Science.gov (United States)

    Dressing, Harald; Salize, Hans Joachim; Gordon, Harvey

    2007-10-01

    There is only limited research on the various legal regulations governing assessment, placement and treatment of mentally ill offenders in European Union member states (EU-member states). To provide a structured description and cross-boundary comparison of legal frameworks regulating diversion and treatment of mentally disordered offenders in EU-member states before the extension in May 2004. A special focus is on the concept of criminal responsibility. Information on legislation and practice concerning the assessment, placement and treatment of mentally ill offenders was gathered by means of a detailed, structured questionnaire which was filled in by national experts. The legal regulations relevant for forensic psychiatry in EU-member states are outlined. Definitions of mental disorders given within these acts are introduced and compared with ICD-10 diagnoses. Finally the application of the concept of criminal responsibility by the law and in routine practice is presented. Legal frameworks for the processing and placement of mentally disordered offenders varied markedly across EU-member states. Since May 2004 the European Union has expanded to 25 member states and in January 2007 it will reach 27. With increasing mobility across Europe, the need for increasing trans-national co-operation is becoming apparent in which great variation in legal tradition pertains.

  8. Alternate day treatment and late effects: The concept of an effective dose per fraction

    International Nuclear Information System (INIS)

    Courdi, A.; Hery, M.; Gabillat, J.M.

    1990-01-01

    Although most institutions treat all fields each day, some radiotherapists continue to adopt an alternate day schedule. The resulting daily variations of the dose per fraction in laterally located targets have been analyzed using the linear-quadratic model. Patients with breast carcinoma treated with definitive radiotherapy in 1974-1975 with one field a day were studied. An effective dose per fraction was derived, with a value higher than the average dose per fraction received by the reference point. The greater the fluctuations between the doses per fraction on successive days, the higher the effective dose per fraction. The corresponding cell survival due to alternate treatment as compared to survival with daily treatment depends on the alpha/beta ratio. For a late effect with low alpha/beta ratio, an alternate treatment may lead to almost 10-fold increase in cell kill in these lateral targets such as those responsible for subcutaneous sclerosis as compared to daily treatment of all fields with the same total dose. Taking the average effective dose per fraction in our series, the increase in cell kill was 4-fold. Acute effects would suffer less damage due to alternate treatment because of a high alpha/beta ratio. Treatment on an alternate schedule should be restricted to palliative radiotherapy

  9. Targeting Endothelial Adhesion Molecule Transcription for Treatment of Inflammatory Disease: A Proof-of-Concept Study

    Directory of Open Access Journals (Sweden)

    Liam M. Ashander

    2016-01-01

    Full Text Available Targeting the endothelial adhesion molecules that control leukocyte trafficking into a tissue has been explored as a biological therapy for inflammatory diseases. However, these molecules also participate in leukocyte migration for immune surveillance, and inhibiting the physiological level of an adhesion molecule might promote infection or malignancy. We explored the concept of targeting endothelial adhesion molecule transcription during inflammation in a human system. Intercellular adhesion molecule 1 (ICAM-1 mediates leukocyte migration across the retinal endothelium in noninfectious posterior uveitis. We observed an increase in the transcription factor, nuclear factor of kappa light polypeptide gene enhancer in B-cells 1 (NF-κB1, in parallel with ICAM-1, in human retinal endothelial cells treated with tumor necrosis factor-alpha (TNF-α, and identified putative binding sites for NF-κB1 within the ICAM-1 regulatory region. We targeted induced NF-κB1 expression in endothelial cells with small interfering (siRNA. Knockdown of NF-κB1 significantly decreased cell surface expression of ICAM-1 protein induced by TNF-α but did not reduce constitutive ICAM-1 expression. Consistently, NF-κB1 knockdown significantly reduced leukocyte binding to cell monolayers in the presence of TNF-α but did not impact baseline binding. Findings of this proof-of-concept study indicate that induced transcription of endothelial adhesion molecules might be targeted therapeutically for inflammatory disease in humans.

  10. Treatment of thyroid disorders before conception and in early pregnancy: a systematic review.

    Science.gov (United States)

    Vissenberg, R; van den Boogaard, E; van Wely, M; van der Post, J A; Fliers, E; Bisschop, P H; Goddijn, M

    2012-07-01

    Thyroid disorders are associated with pregnancy complications. Universal screening is currently not recommended because of a lack of evidence on the effectiveness of treatment. Women with hyperthyroidism and hypothyroidism evidently require treatment but this is less clear for women with subclinical hypothyroidism and thyroid autoimmunity. Therefore, we conducted a systematic review to provide a comprehensive overview on the available treatment interventions. Relevant studies were identified by searching Medline, EMBASE and Cochrane Controlled Trials Register, published until December 2011. From a total of 7334 primary selected titles, 22 articles were included for the systematic review and 11 were appropriate for meta-analyses. Eight studies reported on hyperthyroidism. Propylthiouracil (PTU) and methimazole reduce the risk for preterm delivery [risk ratio (RR): 0.23, confidence interval (CI): 0.1-0.52], pre-eclampsia (RR: 0.23, CI: 0.06-0.89) and low birthweight (RR: 0.38, CI: 0.22-0.66). The nine studies that reported on clinical hypothyroidism showed that levothyroxine is effective in reducing the risk for miscarriage (RR: 0.19, CI: 0.08-0.39) and preterm delivery (RR: 0.41, CI: 0.24-0.68). For treatment of subclinical hypothyroidism, current evidence is insufficient. The five studies available on thyroid autoimmunity showed a not significant reduction in miscarriage (RR: 0.58, CI: 0.32-1.06), but significant reduction in preterm birth by treatment with levothyoxine (RR: 0.31, CI: 0.11-0.90). For hyperthyroidism, methimazole and PTU are effective in preventing pregnancy complications. For clinical hypothyroidism, treatment with levothyroxine is recommended. For subclinical hypothyroidism and thyroid autoimmunity, evidence is insufficient to recommend treatment with levothyroxine. The overall lack of evidence precludes a recommendation for universal screening and is only justified in a research setting.

  11. Adolescence and polycystic ovary syndrome: current concepts on diagnosis and treatment.

    Science.gov (United States)

    Spritzer, P M; Motta, A B

    2015-11-01

    Adolescence is a time characterised by changes in reproductive hormones and menstrual patterns, which makes it difficult to diagnose polycystic ovary syndrome (PCOS) in this population. The diagnosis of PCOS has a great physical and psychosocial impact on the young person. Despite the importance of a diagnosis of PCOS at adolescence, data available are limited. This review focuses on analysing markers of PCOS diagnosis and possible treatments in adolescence. Although, during adolescence, diagnosis criteria of PCOS overlap with physiological changes including clinical manifestations of hyperandrogenism (acne and hirsutism), oligo/amenorrhoea, anovulation and ovarian microcysts, there is agreement that irregular menses and hyperandrogenaemia should be used to diagnose PCOS in this population. Moreover, considering that PCOS phenotype could change through the reproductive age and that adolescents display heterogeneous ovarian morphology, it has been proposed that diagnosis of PCOS should be confirmed after the age of 18. The first-line treatment for menstrual irregularity and hirsutism are oral contraceptive pills (OCPs) and for obesity and metabolic abnormalities are lifestyle changes. Insulin-sensitizer drugs, such as metformin, may be added to the treatment in the presence of metabolic alterations. Antiandrogen drugs may also be associated for treating moderate to severe hirsutism. During adolescence, physiological changes overlap with signs and symptoms of PCOS; thus the diagnosis criteria should be carefully considered. Regarding the treatment of adolescents with PCOS, non-pharmacological interventions include lifestyle changes. Pharmacological treatments comprise OCPs, antiandrogens and metformin, used isolated or combined. During adolescence, physiological changes overlap with signs and symptoms of PCOS; thus the diagnosis criteria should be carefully considered. Regarding the treatment of adolescents with PCOS, non-pharmacological interventions include

  12. Pancreatic Cysts: Current Concepts of Pathogenesis, Diagnosis and Diagnostic and Treatment Approach

    Directory of Open Access Journals (Sweden)

    V.М. Ratchik

    2014-09-01

    Full Text Available The relevance of pancreatic cyst treatment is determined by the increase in the incidence of pancreatitis, a considerable number of complications and high mortality rate. In recent decades, there has been steady growth of destructive forms of pancreatitis, respectively the number of pancreatic cysts increases. Pancreatic cysts in 18–68 % of cases cause various complications (suppuration, perforation, bleeding, internal and external fistulas, malignant transformation that define high mortality — 9.2–53 %. The nature and extent of surgery depend on the etiology, the presence or absence of the cyst connection with ductal system, the presence of complications. Surgical treatment for pancreatic cysts remains the method of choice. Minimally invasive surgical procedures became widely used. High prevalence of cystic lesions of the pancreas, the difficulty of choosing the optimal method of treatment require the creation of a rational, convenient for clinical practice diagnostic and therapeutic algorithm. Dissatisfaction with the results of treatment and a large number of complications lead to the search for a new, so called gold standard for treatment of patients and determine the real place of minimally invasive and open surgical techniques.

  13. 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.

  14. Palliative radiotherapy. Ranking within an interdisciplinary treatment concept in case of advanced tumor disease

    International Nuclear Information System (INIS)

    Seegenschmiedt, M.H.

    1998-01-01

    Many tumor-induced symptoms can be alleviated by suitable irradiation in a direct, effective and sparing manner. The clinical response amounts to 80% and is independent of tumor histology. Careful diagnosis and accurate localisation of the causes of symptoms as well as exact therapy planning and execution are required. Based on individual dose planning harmonising single dosis and total dosis, pin-pointed definition of target areas, and application of modern planning and irradiation techniques, palliative radiotherapy is able to achieve long-term improvement with neglectible side-effects, sometimes within only a few days or weeks. It is a valuable part of a consistant therapy concept that is tailored to the individual needs of a patient, by cooperative action of experts from a variety of medical disciplines, intended to optimize the quality of life of patients, and sometimes may exclude conventional radiotherapy. (orig./CB) [de

  15. 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.

  16. Using Concept Mapping to Identify Action Steps for Physical Activity Promotion in Cancer Treatment

    Science.gov (United States)

    Fitzpatrick, Sean Joseph; Zizzi, Sam J.

    2014-01-01

    Background: The benefits of exercise during and after cancer treatment represent research areas that have received increased attention throughout the past 2 decades. Numerous benefits have been observed for cancer survivors who are physically active, yet oncologists have been slow to incorporate exercise counseling into practice. Purpose: The…

  17. 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

  18. Treatment of displaced intra-articular calcaneal fractures by ligamentotaxis: current concepts' review

    NARCIS (Netherlands)

    Schepers, T.; Patka, P.

    2009-01-01

    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 percutaneous distractional

  19. 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.

  20. 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

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

    International Nuclear Information System (INIS)

    Sherif, Camillo; Gruber, Andreas; Bavinzski, Gerhard; Standhardt, Harald; Widhalm, Georg; Knosp, Engelbert; Gibson, Daniel; Richling, Bernd

    2008-01-01

    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.)

  2. Treatment of tension-type headache: from old myths to modern concepts.

    Science.gov (United States)

    Barbanti, P; Egeo, G; Aurilia, C; Fofi, L

    2014-05-01

    Tension-type headache (TTH) is the second most common human disease, accounting for intense disability, high costs and numerous workdays lost. Tension-type headache is less simple and easy-to-treat than commonly thought. Antidepressants, despite their poor tolerability, are still the first-choice drugs for preventing TTH. The most widely studied non-pharmacological approach to TTH, cognitive-behavioral techniques, effectively relieve pain only in selected patients. The most frequently used and recommended treatments for acute TTH, NSAIDs and paracetamol have scarce efficacy as documented by their low therapeutic gain over placebo in the 2-h pain-free response. Their effectiveness may be increased by a more proper use and by the adjunction of caffeine, antiemetics, myorelaxants or tranquillizers but the risk of medication-overuse headache must be considered. Hence, the need for more effective and tailored treatments in TTH remains.

  3. 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.

  4. Studies, Transport and Treatment Concept for Boilers from Berkeley NPP, England - 13599

    International Nuclear Information System (INIS)

    Wirendal, Bo; Saul, David; Robinson, Joe; Davidson, Gavin

    2013-01-01

    In November 2011 Studsvik was awarded a contract to transport five decommissioned boilers from the Berkeley Nuclear Licensed Site in the UK to the Studsvik Nuclear Site in Sweden for metal treatment and recycling. A key objective of the project was to remove the boilers from the site by 31 March 2012 and this was successfully achieved with all boilers off site by 22 March and delivered to Studsvik on 6 April. Four boilers have been processed and the fifth is planned for completion by end of December 2012.The project had many challenges including a very tight timescale and has been successfully delivered to cost and ahead of the baseline programme. This paper describes the project and the experience gained from treatment of the first four boilers. It is the first UK project to send large components overseas for recycling and provides new insight into the processing of Magnox gas-circuit components. (authors)

  5. 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...

  6. 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 minocycline may be a useful adjunct to improve global experience, functioning and quality of life in people with

  7. [Modern concepts of etiology, pathogenesis and treatment approaches to endo-perio lesions].

    Science.gov (United States)

    Grudianov, A I; Makeeva, M K; Piatgorskaia, N V

    2013-01-01

    A combination ofperiodontitis and pulp or periapical tissues inflammation in one tooth is known as endo-periodontal lesions. Such kind of lesion is serious problem of modern dentistry. It was found that pathogenic microflora of periodontal pocket and root canal of tooth with eno-perio lesion is almost the equal and consist of anaerobic microorganisms. Pathogenic effects have not only microorganisms but also their life products. Apical foramen, lateral and additional canals are physiological ways for pathogens migration. Inflammatory processes in these structures complicate each other. Lack of information among dentists about treatment possibilities of endo-perio lesions is a main reasons of extraction such kind of teeth. Simultaneous elimination of pathogens both from periodontal pocket and root canal is a key factor for effective treatment. Periodontal status is main factor for prognosis of tooth with endo-perio lesion, because of it treatment of endo-perio lesions should consist of two stages: infection elimination and regeneration of tooth-supported structures.

  8. Research concepts use in the diagnosis and treatment of urinary incontinence

    Directory of Open Access Journals (Sweden)

    Gabriela Bidzińska

    2017-12-01

    Full Text Available Urinary incontinence is a significant social problem that affects both women and men regardless of age, ethnic or cultural differences. It is estimated that in Poland about 5 million people suffer from this disorder and it affects twice as many women than men. In addition, it has been shown that the frequency of disease and the severity of symptoms increases with age. Recent reports indicate that over 50% of all cases are stress urinary incontinence (WNM, which using appropriate diagnostic and therapeutic methods, is reversible and can be cured. The cause of stress urinary incontinence is the reduction of muscle tone of the crotch, pelvic floor, fascia and relaxation of connective tissue. Diagnosis of the lower urinary tract should be based on the interview, analysis of the micturition diary, physical and urodynamic examination. In recent years, imaging diagnostics, mainly including ultrasound, have also begun to be used. The cheapest and safest method for the patient is conservative treatment and the patient should be qualified for this form of therapy at the very beginning. Surgical treatment should be used when conservative treatment does not bring positive effects.

  9. Application of heat treatment and dispersive strengthening concept in interlayer deposition to enhance diamond film adherence

    Energy Technology Data Exchange (ETDEWEB)

    Lin Chiiruey [Tatung Inst. of Technol., Taipei (Taiwan, Province of China). Dept. of Mech. Eng.; Kuo Chengtzu; Chang Rueyming [Institute of Materials Science and Engineering, National Chiao Tung University, 1001 Ta-Hsueh Road, Hsinchu 30050 (Taiwan, Province of China)

    1997-10-31

    Two different deposition processes were carried out to enhance adherence of diamond films on WC+3-5%Co substrate with Ti-Si as the interlayer. One process can be called two-step diamond deposition process. Another process can be called interlayer heat treatment process. Diamond films were deposited by a microwave plasma chemical vapor deposition system. Ti and Si interlayer are deposited by DC sputter and an E-gun, respectively. Film morphologies, interface structure and film quality were examined by SEM, XRD, Auger electron spectroscopy and Raman spectroscopy. The residual stresses and adhesion strengths of the films were determined by Raman spectroscopy and indentation adhesion testing, respectively. Comparing the regular one-step diamond deposition process with the present two different new processes, the average dP/dX values, which are a measure of the adherence of the film, are 354 kgf/mm, 494 kgf/mm and 787 kgf/mm, respectively. In other words, the interlayer heat treatment process gives the best film adherence on average. For the two-step diamond deposition process, the interlayer thickness and the percent diamond surface coverage of the first diamond deposition step are the main parameters, and there exists an optimum Ti thickness and percent diamond coverage for the best film adherence. The main contribution to better film adherence is not a large difference in residual stress, but is due to the following reasons. The interlayer heat treatment can transform amorphous Si to polycrystalline Si, and may form strong TiC and SiC bonding. The polycrystalline Si and the diamond particles from the first diamond deposition step can be an effective seeds to enhance diamond nucleation. (orig.) 11 refs.

  10. [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.

  11. 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.)

  12. 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)

  13. [Lysozyme in the treatment of juvenile laryngeal papillomatosis. A new concept in its etiopathogenesis].

    Science.gov (United States)

    Altamar-Ríos, J

    1990-01-01

    The A. inform about the results achieved with lysozyme chlorhydrate in the treatment of 15 patients with juvenile laryngeal papillomatosis. The lysozyme is an electropositive enzyme which synthesis is related to the degree of proteins and vitamin B complex ingestion. Lysozyme is a component of the immunitary inespecific system, serving to prevent against HPV-DNA at the level of the secretory film of the mucociliary apparatus of the respiratory mucous membrane. Furthermore, lysozyme hydrolyzes the mucopolysaccharide of the connective tissue and inhibits the virus-DNA replication. 100-300 mgr daily during 30-60 days simultaneously with hyperproteic diet and vitamin B complex (after correction of the nutrimental deficiencies) brought about the evanishment of papillomatosis. The A. suggest that the predisposition to infection by virus DNA is primarily of immunitary origin, because of lysozyme deficiency, and secondary due to a low intake of proteins and vitamin B complex.

  14. [Multistep surgery for spondylosyndesis. Treatment concept of destructive spondylodiscitis in patients with reduced general condition].

    Science.gov (United States)

    Isenberg, J; Jubel, A; Hahn, U; Seifert, H; Prokop, A

    2005-02-01

    Retrospective assessment of multistage surgery in the treatment of progressive spondylodiscitis in patients with critical physical status. A total of 34 patients (mean age 58.6 years) with 37 progressive spondylodiscitis foci and destruction of one to three vertebral segments (1.9 mean) were recorded within an 8-year period. Time between first complaints and operative treatment was 3 months (mean). Preoperative health status was critically reduced in 11 patients (ASA IV) and poor general condition (ASA III) was seen in 23 patients when vital indication was seen preoperatively. Considerable systemic disease (n=31), further infection focus (n=18), and nosocomial trauma (n=5) were causally related. Spondylodiscitis was seen more frequently in the lumbar (n=20) and thoracolumbar than in the thoracic (n=10) and cervical spine (n=1). Staphylococcus aureus was detectable from operative specimens and hemoculture in 15 cases, MRSA in 6 of these. In cases of monosegmentary involvement (n=7) ventral debridement, biopsy, and application of antibiotic chains were followed by autologous interbody bone grafting in a second stage operation. In 29 cases with destruction of two (n=27) and three (n=3) segments, posterior instrumentation including laminectomy in 4 patients was completed by anterior debridement and application of antibiotic chains during a first surgical intervention. After stabilization of physical condition and having reached a macroscopically indisputable implant bed, the ventral fusion with autologous interbody bone grafting or cage in combination with a plate or internal fixation system was performed as the last of several surgical steps. No case of perioperative mortality was observed. Intensive care continued 9.1 days and hospitalization 49.5 days (mean). During a 37.6-month follow-up two late recurrences were observed. A multistep surgical procedure under protection of dorsal instrumentation can limit perioperative mortality in patients in critical general

  15. 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.

  16. 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.

  17. 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.

  18. 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.

  19. [New aspects of complex chronic tinnitus. I: Assessment of a multi-modality behavioral medicine treatment concept].

    Science.gov (United States)

    Goebel, G; Keeser, W; Fichter, M; Rief, W

    1991-01-01

    "Complex tinnitus" is a diagnostic term denoting a disturbance pattern where the patient hears highly annoying and painful noises or sounds that do not originate from a recognisable external source and can be described only by the patient himself. It seems that the suffering mainly depends upon the extent to which the tinnitus is experienced as a phenomenon that is beyond control. Part I reports on an examination of the treatment success achieved with 28 consecutive patients who had been treated according to an integrative multimodal behavioural medicine concept. This resulted--despite continual loudness--in a decrease in the degree of unpleasantness of the tinnitus, by 17% (p less than 0.01) with corresponding normalisation of decisive symptom factors in Hopkins Symptom-Check-List (SCL-90-R) and Freiburg Personality-Inventary (FPI-R). On the whole, 19 out of the total of 28 patients showed essential to marked improvement of the disturbance pattern. Part II presents a multidimensional tinnitus model and the essential psychotherapeutic focal points of a multimodal psychotherapy concept in complex chronic tinnitus, as well as the parallel phenomena in the chronic pain syndrome.

  20. 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.

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

    International Nuclear Information System (INIS)

    Vidal, V.; Sapoval, M.; Sielezneff, Y.; Parades, V. De; Tradi, F.; Louis, G.; Bartoli, J. M.; Pellerin, O.

    2015-01-01

    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

  2. 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

  3. [Feeding disorders in infancy: feeding interaction concept in diagnosis and treatment].

    Science.gov (United States)

    Keren, M; Tyano, S

    1998-09-01

    In infancy clinical manifestations of psychological distress are mainly somatic. Feeding disorders are one of the most common and nonspecific manifestations of different kinds of disturbed parent-child relationships. These disturbances may have their origins in the baby's constitution and physical status, in the parent's personality structure, or both, as has been conceptualized in the transactional model of normal and abnormal development. Among the daily interactions a baby has with parents, feeding has special inherent impact on the early parent-child relationship because of its psychological meanings. Therefore, feeding disorders, with or without failure to thrive, often reflect various disorders of infancy, still not well recognized in the medical community, such as regulatory disorders, attachment disorders, depression of infancy, disorders of separation-individuation, and post-traumatic eating disorder. 3 clinical cases are brought to increase awareness of psychological distress in the infant, and of feeding disorders as 1 of its manifestations. Each illustrates a different kind of feeding disorder in terms of etiology and pathogenesis. Through these cases we emphasize the need for a multi-disciplinary, integrative approach in diagnosis and treatment. Our conceptual background is based both on the transactional model of development (infant and parental factors impact on each other) in a very dynamic paradigm, and on psychodynamic premises. Intrapsychic conflicts and past representations impact heavily on the parenting characteristics. We emphasize the psychological significance of disturbed feeding interactions, with or without failure to thrive.

  4. 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.

  5. Drug-Induced Sleep Endoscopy Changes the Treatment Concept in Patients with Obstructive Sleep Apnoea

    Directory of Open Access Journals (Sweden)

    Jaroslava Hybášková

    2016-01-01

    Full Text Available The present study evaluated whether drug-induced sleep endoscopy (DISE helps identify the site of obstruction in patients with obstructive sleep apnoea (OSA. A total of 51 consecutive patients with polysomnography-confirmed OSA were enrolled in this prospective study. The presumed site of obstruction was determined according to history, otorhinolaryngologic examination, and polysomnography and a therapeutic plan designed before DISE. In 11 patients with severe OSA and/or previously failed continuous positive airway pressure (CPAP treatment, DISE with simultaneous CPAP was performed. Multilevel collapse was noted in 49 patients (96.1%. The most frequent multilevel collapse was palatal, oropharyngeal, and tongue base collapse (n=17, 33.3%, followed by palatal and oropharyngeal collapse (n=12, 23.5%. Pathology of the larynx (epiglottis was observed in 16 patients (31.4%. The laryngeal obstruction as a reason for intolerance of CPAP was observed in 3/11 (27.3% patients. After DISE, the surgical plan was changed in 31 patients (60.8%. The results indicate that DISE helps identify the site of obstruction in the upper airways in patients with OSA more accurately and that the larynx plays an important role in OSA.

  6. Treatment Concept for a Patient with a High Smile Line and Gingival Pigmentation: A Case Report.

    Science.gov (United States)

    Zarone, Fernando; Leone, Renato; Ferrari, Marco; Sorrentino, Roberto

    Today, innovative restorative materials and techniques allow for minimally invasive prosthetic procedures, which are paramount to the preservation of hard and soft dental tissues. An integrated approach combining dental and esthetic medical therapies could be useful to improve the quality of life of patients, improving function, esthetics, and self-confidence. Oral esthetics depends on several variables, including tooth visibility and proportions as well as healthy gingival tissues. Proper integration between teeth and periodontal tissues plays an important role in esthetic success, which is mainly represented by an appealing smile. The present case report was aimed at describing the multidisciplinary treatment of a woman who was unsatisfied with the shape of her central incisors and the dark gingival pigmentation displayed by a high smile line. The patient was treated with minimally invasive combined periodontal, prosthetic, and esthetic medical techniques. The described multidisciplinary approach based on surgical gingival depigmentation, adhesive ceramic veneers, and selective botulinum toxin injection was effective in solving the undesired high smile line and achieving patient satisfaction.

  7. Tumour biology of obesity-related cancers: understanding the molecular concept for better diagnosis and treatment.

    Science.gov (United States)

    Teoh, Seong Lin; Das, Srijit

    2016-11-01

    Obesity continues to be a major global problem. Various cancers are related to obesity and proper understanding of their aetiology, especially their molecular tumour biology is important for early diagnosis and better treatment. Genes play an important role in the development of obesity. Few genes such as leptin, leptin receptor encoded by the db (diabetes), pro-opiomelanocortin, AgRP and NPY and melanocortin-4 receptors and insulin-induced gene 2 were linked to obesity. MicroRNAs control gene expression via mRNA degradation and protein translation inhibition and influence cell differentiation, cell growth and cell death. Overexpression of miR-143 inhibits tumour growth by suppressing B cell lymphoma 2, extracellular signal-regulated kinase-5 activities and KRAS oncogene. Cancers of the breast, uterus, renal, thyroid and liver are also related to obesity. Any disturbance in the production of sex hormones and insulin, leads to distortion in the balance between cell proliferation, differentiation and apoptosis. The possible mechanism linking obesity to cancer involves alteration in the level of adipokines and sex hormones. These mediators act as biomarkers for cancer progression and act as targets for cancer therapy and prevention. Interestingly, many anti-cancerous drugs are also beneficial in treating obesity and vice versa. We also reviewed the possible link in the mechanism of few drugs which act both on cancer and obesity. The present review may be important for molecular biologists, oncologists and clinicians treating cancers and also pave the way for better therapeutic options.

  8. La morfologia i els seus conceptes en l'ensenyament secundari: tractaments habituals | Morphology and its Concepts in Secondary Education: Common Treatments

    Directory of Open Access Journals (Sweden)

    Abelard Saragossà

    2015-05-01

    Full Text Available Resum Este article descriu les anomalies metodològiques més freqüents que apareixen en l’ensenyament secundari quan tracta els conceptes de la morfologia (o flexió, o accidents gramaticals. En la concepció històrica, es reduïx a sis nocions: gènere, nombre i cas (nom; temps i concordança (verb; comparació i concordança (adjectiu. Després d’exposar què tenen en comú les dos maneres d’expressar-los ({pensaré contra I will think}, {longer contra més llarg}, el treball mostra que els manuals actuals contenen dos idees de la morfologia, diferents i incompatibles entre elles: la tradicional i aquella en què el morfema (unitat significativa implica tota la lingüística excepte el fonema (unitat no significativa. Este article es complementa amb el de Sara Martínez Fraile, que oferix una alternativa. Abstract This article describes methodological anomalies that appear frequently in secondary school when the concepts of morphology (or inflection, or grammatical accidents are treated. Morphological concepts are six concepts in historical conception: gender, number and case (name; time and agreement (verb; comparison and agreement (adjective. After exposing what the two ways of expressing them have in common ({pensaré against I will think}, {longer against més llarg}, the present study shows that manuals contain two conceptions of morphology, which are different and incompatible: the traditional one and the one in which the morpheme (meaningful unit involves all language except the phoneme (unit without meaning. This article is complemented by Sara Martinez Fraile, which offers an alternative.

  9. 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.

  10. 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.

  11. Gender identity disorders in childhood and adolescence: currently debated concepts and treatment strategies.

    Science.gov (United States)

    Korte, Alexander; Lehmkuhl, Ulrike; Goecker, David; Beier, Klaus Michael; Krude, Heiko; Grüters-Kieslich, Annette

    2008-11-01

    Gender identity disorders (GID) can appear even in early infancy with a variable degree of severity. Their prevalence in childhood and adolescence is below 1%. GID are often associated with emotional and behavioral problems as well as a high rate of psychiatric comorbidity. Their clinical course is highly variable. There is controversy at present over theoretical explanations of the causes of GID and over treatment approaches, particularly with respect to early hormonal intervention strategies. This review is based on a selective Medline literature search, existing national and international guidelines, and the results of a discussion among experts from multiple relevant disciplines. As there have been no large studies to date on the course of GID, and, in particular, no studies focusing on causal factors for GID, the evidence level for the various etiological models that have been proposed is generally low. Most models of these disorders assume that they result from a complex biopsychosocial interaction. Only 2.5% to 20% of all cases of GID in childhood and adolescence are the initial manifestation of irreversible transsexualism. The current state of research on this subject does not allow any valid diagnostic parameters to be identified with which one could reliably predict whether the manifestations of GID will persist, i.e., whether transsexualism will develop with certainty or, at least, a high degree of probability. The types of modulating influences that are known from the fields of developmental psychology and family dynamics have therapeutic implications for GID. As children with GID only rarely go on to have permanent transsexualism, irreversible physical interventions are clearly not indicated until after the individual's psychosexual development ist complete. The identity-creating experiences of this phase of development should not be restricted by the use of LHRH analogues that prevent puberty.

  12. Technical progress, the concept of individualized cancer treatment and the innovation of computer-assisted radiotherapy planning

    International Nuclear Information System (INIS)

    Merkle, K.; Tanneberger, S.; Matschke, S.

    1985-01-01

    After a first step of cancerogenesis, the further development of the tumor is an individual process. At the end of this process the tumor is formed as an individual in the individual. The individuality of cancer exists on the level of organs, tissues and cells and includes an individual tumor-host relationship. Today, optimized cancer treatment requires a most precise biological characterization possible of the tumor and of the tumor-host relationship, which will provide objective information about the individual character of every tumor. Routine analysis and strict therapeutic consideration of the clinical and biological individuality of human cancer can offer real chances for the improvement of cancer treatment. A routine acquisition of individual tumor characteristics will be possible only if methods and equipment are available for the registration of suitable parameters. In this context technical innovations have an essential influence on the realization of the concept of individualized cancer treatment. With the method of flow cytophotometry and other techniques examples are given in how far the ideas of individual cancer management can be realized by introduction of new technical solutions into medical research and clinical practice. Unfortunately there is still a lack of methodology in individualizing cancer treatment. The individualization of radiotherapy is connected to an extremely high degree of technical innovations. Particularly this refers to the topometrical description of the target volume in relation to the adjacent anatomical structures and the body contour as well as the fitting of isodoses to the shape and size of the target volume. As an example of innovation of a technical solution for individual radiotherapy planning the computer-assisted radiotherapy planning system DOPSY is described. (author)

  13. 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.

  14. 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

  15. 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

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

    International Nuclear Information System (INIS)

    Bazeries, Paul; Paisant-Thouveny, Francine; Yahya, Sultan; Bouvier, Antoine; Nedelcu, Cosmina; Boussion, Francoise; Sentilhes, Loic; Willoteaux, Serge; Aubé, Christophe

    2017-01-01

    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.

  17. 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.

  18. 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.

  19. 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.

  20. Volumetric MR-Guided High-Intensity Focused Ultrasound with Direct Skin Cooling for the Treatment of Symptomatic Uterine Fibroids : Proof-of-Concept Study

    NARCIS (Netherlands)

    Ikink, Marlijne E; van Breugel, Johanna M M; Schubert, Gerald; Nijenhuis, Robbert J; Bartels, LW; Moonen, Chrit T W; van den Bosch, Maurice A A J

    2015-01-01

    Objective. To prospectively assess the safety and technical feasibility of volumetric magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU) ablation with direct skin cooling (DISC) during treatment of uterine fibroids. Methods. In this proof-of-concept study, eight patients were

  1. 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

  2. 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.

  3. 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...

  4. 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.

  5. 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

  6. 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…

  7. Introductory concepts

    International Nuclear Information System (INIS)

    Barnes, W.E.

    1983-01-01

    Physical theories are commonly classified as being either ''classical'' or ''modern''. The reasons for this distinction are both historical and substantive. Limited in the sophistication of their measuring instruments, early scientists proposed theories appropriate for the description of the simplest and most accessible physical phenomena, e.g., the trajectories of the planets. Because of the class of phenomena observed, certain beliefs came to underlie all classical theories with regard to the nature of time, space, matter, etc. For example, the idea was undisputed that an object has at all times both a definite position and velocity. Not until the interior of the atom and the nature of electromagnetic radiation were explored was it discovered that the concepts of classical physics are inadequate to deal with many phenomena. A reassessment of fundamental postulates led to the formulation of modern physics which, it is believed, successfully treats the behavior of all physical systems. To gain an understanding of the rudiments of modern physics, one proceeds as the early scientists did by first mastering the classical concepts that emerge from their intuitive picture of the world. Modifications of these concepts are subsequently introduced which allow a more accurate treatment of physical phenomena, particularly atomic and nuclear systems

  8. 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

  9. 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...... benefit and synergy is achieved when both tools are integrated because expert knowledge and expertise are considered together with mathematical models to select the most appropriate treatment alternative...

  10. 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).

  11. Glocal assessment of integrated wastewater treatment and recovery concepts using partial nitritation/Anammox and microalgae for environmental impacts.

    Science.gov (United States)

    Khiewwijit, Rungnapha; Rijnaarts, Huub; Temmink, Hardy; Keesman, Karel J

    2018-07-01

    This study explored the feasibility and estimated the environmental impacts of two novel wastewater treatment configurations. Both include combined bioflocculation and anaerobic digestion but apply different nutrient removal technologies, i.e. partial nitritation/Anammox or microalgae treatment. The feasibility of such configurations was investigated for 16 locations worldwide with respect to environmental impacts, such as net energy yield, nutrient recovery and effluent quality, CO 2 emission, and area requirements. The results quantitatively support the applicability of partial nitritation/Anammox in tropical regions and some locations in temperate regions, whereas microalgae treatment is only applicable the whole year round in tropical regions that are close to the equator line. Microalgae treatment has an advantage over the configuration with partial nitritation/Anammox with respect to aeration energy and nutrient recovery, but not with area requirements. Differential sensitivity analysis points out the dominant influence of microalgal biomass yield and wastewater nutrient concentrations on area requirements and effluent quality. This study provides initial selection criteria for worldwide feasibility and corresponding environmental impacts of these novel municipal wastewater treatment plant configurations. Copyright © 2018. Published by Elsevier B.V.

  12. 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.

  13. Contemporary conceptions of etiology, pathogenesis, management and treatment of primary diffuse large b-cell central nervous system lymphoma

    Directory of Open Access Journals (Sweden)

    S. V. Voloshin

    2013-01-01

    Full Text Available In this article we present the most up-to-date information about etiology, pathogenesis, diagnostic and treatment principles of primary central nervous system diffuse large B-cell lymphoma. We propose algorithm of diagnosis and treatment based on literature review and own experience. The main methods for diagnosis verification are magneto-resonance tomography and stereotactic biopsy of mass with subsequent histological examination including immune staining. The common first-line therapy regimen is high-dose methotrexate therapy. However long-term prognosis still remains poor. Adverse prognostic factors for therapy response are age > 60 years, multifocal lesions, neurologic symptoms,previous treated disease. Considerable part of patient have contraindications or high-risk of adverse events for high-dose chemotherapy treatment. Anti-CD20 monoclonal antibody has no neurological toxicity with intravenous and intrathecal administrations. Combination therapy with reduced dose methotrexate and monoclonal antibody can be a reasonable treatment alternative for old and disable persons. The further survival improvement would be achieved by patient stratification and using of risk-adapted treatment algorithm. 

  14. Contemporary conceptions of etiology, pathogenesis, management and treatment of primary diffuse large b-cell central nervous system lymphoma

    Directory of Open Access Journals (Sweden)

    S. V. Voloshin

    2014-07-01

    Full Text Available In this article we present the most up-to-date information about etiology, pathogenesis, diagnostic and treatment principles of primary central nervous system diffuse large B-cell lymphoma. We propose algorithm of diagnosis and treatment based on literature review and own experience. The main methods for diagnosis verification are magneto-resonance tomography and stereotactic biopsy of mass with subsequent histological examination including immune staining. The common first-line therapy regimen is high-dose methotrexate therapy. However long-term prognosis still remains poor. Adverse prognostic factors for therapy response are age > 60 years, multifocal lesions, neurologic symptoms,previous treated disease. Considerable part of patient have contraindications or high-risk of adverse events for high-dose chemotherapy treatment. Anti-CD20 monoclonal antibody has no neurological toxicity with intravenous and intrathecal administrations. Combination therapy with reduced dose methotrexate and monoclonal antibody can be a reasonable treatment alternative for old and disable persons. The further survival improvement would be achieved by patient stratification and using of risk-adapted treatment algorithm. 

  15. The Würzburg MIH concept: the MIH treatment need index (MIH TNI) : A new index to assess and plan treatment in patients with molar incisior hypomineralisation (MIH).

    Science.gov (United States)

    Steffen, R; Krämer, N; Bekes, K

    2017-10-01

    This was to create a new easy-to-use index for the treatment of MIH. An international MIH working group developed a new MIH index as an epidemiological screening procedure for assessing MIH treatment needs (MIH-TNI), and also for the screening and monitoring of individuals by dental practitioners. The MIH TNI assesses in particular the extent of the destruction of tooth structure in combination with any hypersensitivity occurring in MIH. The MIH-TNI is suggested as a basis for individual dental examinations covering all MIH typical problems or treatment planning. In addition, this index shall be the basis for decision-making in any MIH therapy studies already planned. After the validation of the MIH TNI it may be possible to create a standardised approach for dental treatment for MIH.

  16. 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.

  17. Fate of pharmaceuticals and personal care products in wastewater treatment plants - Conception of a database and first results

    International Nuclear Information System (INIS)

    Miege, C.; Choubert, J.M.; Ribeiro, L.; Eusebe, M.; Coquery, M.

    2009-01-01

    We created a database in order to quantitatively assess the occurrence and removal efficiency of pharmaceuticals and personal care products (PPCPs) in wastewater treatment plants (WWTPs). From 117 scientific publications, we compiled 6641 data covering 184 PPCPs. Data included the concentrations of PPCPs in WWTP influents and effluents, their removal efficiency and their loads to the aquatic environment. The first outputs of our database allowed to identify the most investigated PPCPs in WWTPs and the most persistent ones, and to obtain reliable and quantitative values on their concentrations, frequency of detection and removal efficiency in WWTPs. We were also able to compare various processes and pointed out activated sludge with nitrogen treatment and membrane bioreactor as the most efficient ones. - By means of a database including information from 117 international scientific papers, we present quantitative conclusions on the concentrations, frequencies of detection and removals of pharmaceutical products in wastewater treatment plants.

  18. 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

    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...... 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...... are mainly connected to metals recovery (around -12 mPE/tonne of ww). The results for the toxicity categories show that the “REnescience” options are more environmentally friendly with respect to ETwc because of the higher recycling but contribute with environmental loads on HTs and HTw because of potential...

  19. 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...

  20. [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.

  1. 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 laser wavelengths in adjunct to SRP offers significant improvements of 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

  2. 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

  3. THE SYSTEM OF TREATMENT OF HIP DYSPLASIA IN CHILDREN (CONCEPTION OF SRICO N.A. H.I. TURNER

    Directory of Open Access Journals (Sweden)

    Mikhail Mikhailovich Kamosko

    2013-03-01

    Full Text Available The system of treatment of hip dysplasia that is developed, applied and perfected at FSBI "Scientific and Research Institute for Children's Orthopedics n.a. H. Turner" involves the early entirely functional treatment (Lorenz method, other methods are similar in gist, providing immobilization with a cast or other devices, are not applied. The operative therapy is performed in primary patients with intrauterine or teratogenic dislocations of the hip. Technology of operative treatment is extremely gentle, sparing. Operations on deepening of socket, iatrogenic affection on cartilage cover, capsular arthroplasty are excluded from the arsenal of surgeons. Anatomy of a children’s dysplastic of hip joints (not subjected to inappropriate conservative or surgical treatment has several fairly standard options. For each option, there is a combination of classical operational techniques (tenomyotomy of lumbar-iliac muscle, capsulotomy, detorsion, varization, shortening, medialization, changes in the spatial orientation of the arch or of the whole acetabulum, which have proven on the vast clinical material to be very effective with the right technical performance.

  4. 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

  5. Vaginismus: review of current concepts and treatment using botox injections, bupivacaine injections, and progressive dilation with the patient under anesthesia.

    Science.gov (United States)

    Pacik, Peter T

    2011-12-01

    Vaginismus is a poorly understood condition affecting approximately 1-7% of females worldwide. This article aims to bring attention to this disorder and to review the use of Botox injections to treat these patients. Vaginismus, also known as vaginal penetration disorder, is an aversion to any form of vaginal penetration as a result of painful attempts and a fear of anticipated pain. It is involuntary and uncontrolled and functions much the same as any reflex to avoid injury. It is the most common reason for unconsummated marriages. The etiology is thought to be unknown. Numerous papers note a history of religious or strict sexual upbringing or aversion to penetration because of perceived pain and bleeding with first-time intercourse. Sexual molestation may be more prevalent in this group of patients. The Lamont classification is very helpful in stratifying these patients for treatment. Lamont grade 5 vaginismus is introduced. Vaginal Botox injections for the treatment of vaginismus has received increasing attention since the technique was first described in a 1997 case report. Plastic surgeons worldwide with their experience using Botox are well positioned to learn more about this relatively unknown entity and render treatment.

  6. 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.

  7. Point-of-care genetic testing for personalisation of antiplatelet treatment (RAPID GENE): a prospective, randomised, proof-of-concept trial.

    Science.gov (United States)

    Roberts, Jason D; Wells, George A; Le May, Michel R; Labinaz, Marino; Glover, Chris; Froeschl, Michael; Dick, Alexander; Marquis, Jean-Francois; O'Brien, Edward; Goncalves, Sandro; Druce, Irena; Stewart, Alexandre; Gollob, Michael H; So, Derek Y F

    2012-05-05

    Prospective assessment of pharmacogenetic strategies has been limited by an inability to undertake bedside genetic testing. The CYP2C19*2 allele is a common genetic variant associated with increased rates of major adverse events in individuals given clopidogrel after percutaneous coronary intervention (PCI). We used a novel point-of-care genetic test to identify carriers of the CYP2C19*2 allele and aimed to assess a pharmacogenetic approach to dual antiplatelet treatment after PCI. Between Aug 26, 2010, and July 7, 2011, 200 patients were enrolled into our prospective, randomised, proof-of-concept study. Patients undergoing PCI for acute coronary syndrome or stable angina were randomly assigned to rapid point-of-care genotyping or to standard treatment. Individuals in the rapid genotyping group were screened for the CYP2C19*2 allele. Carriers were given 10 mg prasugrel daily, and non-carriers and patients in the standard treatment group were given 75 mg clopidogrel daily. The primary endpoint was the proportion of CYP2C19*2 carriers with high on-treatment platelet reactivity (P2Y12 reactivity unit [PRU] value of more than 234) after 1 week of dual antiplatelet treatment, which is a marker associated with increased adverse cardiovascular events. Interventional cardiologists and data analysts were masked to genetic status and treatment. Patients were not masked to treatment allocation. All analyses were by intention to treat. This study is registered with ClinicalTrials.gov, NCT01184300. After randomisation, 187 patients completed follow-up (91 rapid genotyping group, 96 standard treatment). 23 individuals in each group carried at least one CYP2C19*2 allele. None of the 23 carriers in the rapid genotyping group had a PRU value of more than 234 at day 7, compared with seven (30%) given standard treatment (p=0·0092). The point-of-care genetic test had a sensitivity of 100% (95% CI 92·3-100) and a specificity of 99·3% (96·3-100). Point-of-care genetic testing after

  8. Volumetric MR-Guided High-Intensity Focused Ultrasound with Direct Skin Cooling for the Treatment of Symptomatic Uterine Fibroids: Proof-of-Concept Study

    Directory of Open Access Journals (Sweden)

    Marlijne E. Ikink

    2015-01-01

    Full Text Available Objective. To prospectively assess the safety and technical feasibility of volumetric magnetic resonance-guided high-intensity focused ultrasound (MR-HIFU ablation with direct skin cooling (DISC during treatment of uterine fibroids. Methods. In this proof-of-concept study, eight patients were consecutively selected for clinical MR-HIFU ablation of uterine fibroids with the use of an additional DISC device to maintain a constant temperature (T≈20°C at the interface between the HIFU table top and the skin. Technical feasibility was verified by successful completion of MR-HIFU ablation. Contrast-enhanced T1-weighted MRI was used to measure the treatment effect (nonperfused volume (NPV ratio. Safety was evaluated by recording of adverse events (AEs within 30 days’ follow-up. Results. All MR-HIFU treatments were successfully completed in an outpatient setting. The median NPV ratio was 0.56 (IQR [0.27–0.72]. Immediately after treatment, two patients experienced coldness related discomfort which resolved at the same day. No serious (device-related AEs were reported. Specifically, no skin burns, cold injuries, or subcutaneous edema were observed. Conclusion. This study showed that it is safe and technically feasible to complete a volumetric MR-HIFU ablation with DISC. This technique may reduce the risk of thermal injury to the abdominal wall during MR-HIFU ablation of uterine fibroids. This trial is registered with NTR4189.

  9. 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.

  10. 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.

  11. 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

  12. 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.

  13. Biological anoxic treatment of O2-free VOC emissions from the petrochemical industry: A proof of concept study

    International Nuclear Information System (INIS)

    Muñoz, Raúl; Souza, Theo S.O.; Glittmann, Lina; Pérez, Rebeca; Quijano, Guillermo

    2013-01-01

    Highlights: • The treatment of O 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 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 −3 h −1 (corresponding to empty bed residence times of 16, 8, 4 and 1.3 min) with a maximum elimination capacity of ∼3 g m −3 h −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 −3 h −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 −3 (which entailed a loading rate increase from 3 to 6 g m −3 h −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

  14. 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 [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.

  15. Ultrasound and MRI of nerves for monitoring disease activity and treatment effects in chronic dysimmune neuropathies - Current concepts and future directions.

    Science.gov (United States)

    Décard, Bernhard F; Pham, Mirko; Grimm, Alexander

    2018-01-01

    New imaging modalities like high-resolution-ultrasound (HRUS) and MR-Neurography (MRN) are increasingly used for the evaluation of the peripheral nervous system. The increasing knowledge on morphological changes observed in different neuropathies has led to a better understanding of underlying pathophysiological processes. The diagnosis of acquired chronic dysimmune neuropathies (CDN) like chronic inflammatory demyelinating polyneuropathy (CIDP), Lewis-Sumner Syndrome (LSS) or multifocal motor neuropathy (MMN) can be challenging. The current diagnostic criteria and outcome parameters are mainly based on clinical and electrophysiological parameters. Especially in CDN cases with atypical presentation or during early disease stages, the diagnostic accuracy is low and standardized protocols for the evaluation of disease activity and treatment response are lacking. The establishment of combined diagnostic criteria for CDN including imaging modalities could help to improve the diagnostic accuracy, allow a better differentiation of subtypes and facilitate the follow-up of disease course. The appropriate selection of eligible patients and sensitive monitoring of treatment response is mandatory future in treatment trials. In this article, we briefly summarize the clinical presentations and pathophysiological concepts of different CDN like CIDP, LSS and MMN. Furthermore, this review focuses on the diagnostic value of HRUS/MRN and its potential role for the monitoring of disease activity. Copyright © 2017 International Federation of Clinical Neurophysiology. Published by Elsevier B.V. All rights reserved.

  16. New concepts of microbial treatment processes for the nitrogen removal: effect of protein and amino acids degradation.

    Science.gov (United States)

    González-Martínez, Alejandro; Calderón, Kadiya; González-López, Jesús

    2016-05-01

    High concentrations of proteins and amino acids can be found in wastewater and wastewater stream produced in anaerobic digesters, having shown that amino acids could persist over different managements for nitrogen removal affecting the nitrogen removal processes. Nitrogen removal is completely necessary because of their implications and the significant adverse environmental impact of ammonium such as eutrophication and toxicity to aquatic life on the receiving bodies. In the last decade, the treatment of effluents with high ammonium concentration through anammox-based bioprocesses has been enhanced because these biotechnologies are cheaper and more environmentally friendly than conventional technologies. However, it has been shown that the presence of important amounts of proteins and amino acids in the effluents seriously affects the microbial autotrophic consortia leading to important losses in terms of ammonium oxidation efficiency. Particularly the presence of sulfur amino acids such as methionine and cysteine has been reported to drastically decrease the autotrophic denitrification processes as well as affect the microbial community structure promoting the decline of ammonium oxidizing bacteria in favor of other phylotypes. In this context we discuss that new biotechnological processes that improve the degradation of protein and amino acids must be considered as a priority to increase the performance of the autotrophic denitrification biotechnologies.

  17. Cell therapy in the treatment of bipolar mania in an animal model: a proof of concept study

    Directory of Open Access Journals (Sweden)

    Bruna M. Ascoli

    2017-05-01

    Full Text Available Abstract Introduction The rationale of mesenchymal stem cells (MSCs as a novel therapeutic approach in certain neurodegenerative diseases is based on their ability to promote neurogenesis. Hippocampal atrophy has been related to bipolar disorder (BD in preclinical, imaging and postmortem studies. Therefore, the development of new strategies to stimulate the neurogenesis process in BD is crucial. Objectives To investigate the behavioral and neurochemical changes induced by transplantation of MSCs in a model of mania-like behavior induced by lisdexamfetamine dimesylate (LDX. Methods Wistar rats (n=65 received one oral daily dose of LDX (10 mg/kg or saline for 14 days. On the 8th day of treatment, the animals additionally received intrahippocampal saline or MSC (1 µL containing 25,000 cells or lithium (47.5 mg/kg as an internal experimental control. Two hours after the last administration, behavioral and neurochemical analyses were performed. Results LDX-treated rats had increased locomotor activity compared to saline-saline rats (p=0.004, and lithium reversed LDX-related hyperactive behavior (p0.05 in the hippocampus of rats. Conclusion Even though these results suggest that a single intrahippocampal injection of MSCs was not helpful to treat hyperactivity induced by LDX and neither influenced BDNF secretion, we cannot rule out the possible therapeutic effects of MSCs. Further research is required to determine direct effects of LDX on brain structures as well as in other pathophysiological targets related to BD.

  18. 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.

  19. Evolving Concepts in Posterior Subthalamic Area Deep Brain Stimulation for Treatment of Tremor: Surgical Neuroanatomy and Practical Considerations.

    Science.gov (United States)

    Ramirez-Zamora, Adolfo; Smith, Heather; Kumar, Vignessh; Prusik, Julia; Phookan, Sujoy; Pilitsis, Julie G

    2016-01-01

    Although thalamic deep brain stimulation (DBS) has been established as an effective therapy for refractory tremor in Parkinson's disease and essential tremor, reports investigating the efficacy of posterior subthalamic area (PSA) DBS for severe, debilitating tremors continue to emerge. However, questions regarding the optimal anatomical target, surgical approach, programming paradigms and effectiveness compared to other targets remain. In this report, we aimed to review the current literature to assess different stereotactic techniques, anatomical considerations, adverse effects and stimulation settings in PSA DBS. A comprehensive literature review was performed searching for articles discussing tremors and PSA stimulation. We performed a quantitative analysis comparing different DBS tremor targets. Tremor improvement is consistently documented in most reports with an average reduction in tremor of 79% depending on the specific tremor syndrome. Tremor benefit in patients with multiple sclerosis (MS) tremor was significantly higher than for other stimulation targets. Transient paresthesias, imbalance, dizziness and dysarthria are the most common side effects with PSA DBS. PSA DBS is an effective and safe treatment for tremor control and should be considered in patients with refractory tremors with associated cerebellar or dystonic features, proximal tremors and MS tremor. © 2016 S. Karger AG, Basel.

  20. 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

  1. 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)

    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

    Background 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. Objectives 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. Methods 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). Results We have

  2. Role of membrane technology to achieve ALARA concept in reprocessing plant: utilization of low pressure reverse osmosis for treatment of delay tank solutions

    International Nuclear Information System (INIS)

    Pabby, Anil K.; Sonawane, J.V.; Rathore, N.S.; Gupta, S.K.; Roy, S.C.; Venugopalan, A.K.; Chagrani, R.D.; Dey, P.K.; Prabhakar, S.; Tiwari, P.K.

    2004-01-01

    Reverse osmosis is a well-developed technology. The systems have been used in industrial settings for many years with applications to separation, concentration of product streams and waste water treatment. The technology has been used for removal of the radionuclides from low-level liquid wastes, such as waste streams at nuclear power plants. Because reverse osmosis rejects nearly all contaminants from a solution the high purity product water may be recycled within the power plant, or is usually of such low activity that it is suitable for discharge to the environment. This technology will help in achieving ALARA concept which will be beneficial for the environment. In the present study, the removal of alpha and beta activities from delay tank solution is planned

  3. 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...... to the WLCG . Further, the prevalence of depression declined significantly in the IG and the TAUCG compared to the WLCG. Regarding the RTW rate, 66% of the participants in the IG had returned to full time work after three months. This rate was significantly greater than the percentage in the TAUCG (36...

  4. In situ iron activated persulfate oxidative fluid sparging treatment of TCE contamination--a proof of concept study.

    Science.gov (United States)

    Liang, Chenju; Lee, I-Ling

    2008-09-10

    In situ chemical oxidation (ISCO) is considered a reliable technology to treat groundwater contaminated with high concentrations of organic contaminants. An ISCO oxidant, persulfate anion (S(2)O(8)(2-)) can be activated by ferrous ion (Fe(2+)) to generate sulfate radicals (E(o)=2.6 V), which are capable of destroying trichloroethylene (TCE). The property of polarity inhibits S(2)O(8)(2-) or sulfate radical (SO(4)(-)) from effectively oxidizing separate phase TCE, a dense non-aqueous phase liquid (DNAPL). Thus the oxidation primarily takes place in the aqueous phase where TCE is dissolved. A bench column study was conducted to demonstrate a conceptual remediation method by flushing either S(2)O(8)(2-) or Fe(2+) through a soil column, where the TCE DNAPL was present, and passing the dissolved mixture through either a Fe(2+) or S(2)O(8)(2-) fluid sparging curtain. Also, the effect of a solubility enhancing chemical, hydroxypropyl-beta-cyclodextrin (HPCD), was tested to evaluate its ability to increase the aqueous TCE concentration. Both flushing arrangements may result in similar TCE degradation efficiencies of 35% to 42% estimated by the ratio of TCE degraded/(TCE degraded+TCE remained in effluent) and degradation byproduct chloride generation rates of 4.9 to 7.6 mg Cl(-) per soil column pore volume. The addition of HPCD did greatly increase the aqueous TCE concentration. However, the TCE degradation efficiency decreased because the TCE degradation was a lower percentage of the relatively greater amount of dissolved TCE by HPCD. This conceptual treatment may serve as a reference for potential on-site application.

  5. Concepts and challenges in the use of mesenchymal stem cells as a treatment for cartilage damage in the horse.

    Science.gov (United States)

    Zayed, Mohammed; Adair, Steve; Ursini, Tena; Schumacher, James; Misk, Nabil; Dhar, Madhu

    2018-03-20

    Osteoarthritis (OA), the most common form of joint disease affecting humans and horses, is characterized by the advance and decline of cartilage and loss of function of the affected joint. The progression of OA is steadily accompanied with biochemical events, which interfere with the cytokines and proteolytic enzymes responsible for progress of the disease. Recently, regenerative therapies have been used with an assumption that mesenchymal stem cells (MSCs) possess the potential to prevent the advancement of cartilage damage and potentially regenerate the injured tissue with an ultimate goal of preventing OA. We believe that despite various challenges, the use of allogenic versus autologous MSCs in cartilage regeneration, is a major issue which can directly or indirectly affect the other factors including, the timing of implantation, dose or cell numbers for implantation, and the source of MSCs. Current knowledge reporting some of these challenges that the clinicians might face in the treatment of cartilage damage in horses are presented. In this regard we conducted two independent studies. In the first study we compared donor matched bone marrow and synovial fluid - derived equine MSCs in vitro, and showed that the SFMSCs were similar to the BMMSCs in their proliferation, expression of CD29, CD44 and CD90, but, exhibited a significantly different chondrogenesis. Additionally, 3.2-21% of all SFMSCs were positive for MHC II, whereas, BMMSCs were negative. In the second study we observed that injection of both the autologous and allogenic SFMSCs into the tarsocrural joint resulted in elevated levels of total protein and total nucleated cell counts. Further experiments to evaluate the in vivo acute or chronic response to allogenic or autologous MSCs are imperative. Copyright © 2018 Elsevier Ltd. All rights reserved.

  6. 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

  7. 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.

  8. A clinical trial to evaluate the effects of flumethrin or ivermectin treatment on hemoparasites, gastrointestinal parasites, conception and daily weight gain in a dairy farm in Japan.

    Science.gov (United States)

    Yamane, I; Arai, S; Nakamura, Y; Hisashi, M; Fukazawa, Y; Onuki, T

    2000-02-01

    A clinical trial was performed to compare the effects of flumethrin and ivermectin treatments of grazing heifers at one farm in central Japan. 64 heifers were randomly allocated into two groups. Flumethrin (1 mg/kg pour on) was applied approximately once every 3 weeks to heifers in one group and heifers in the second group were injected approximately once every month with ivermectin (200 microg/kg; id). Between groups, no significant differences were detected in the proportions of animals that showed parasitemia of Theileria sergenti and conception risks. Significantly lower average log-transformed nematode-egg counts and higher average daily weight gain were observed in the ivermectin-treated group. Animals with higher body weight at the start of grazing and lower log-transformed total nematode-egg and coccidia-oocyst counts had higher odds of conceiving. Animals with ivermectin treatment, lower body weight at the start of grazing and lower log-transformed coccidia-oocyst count had higher daily weight gain. Ivermectin may be more useful in this farm because of the higher productivity for cattle and lower cost for its usage.

  9. 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.

  10. COMET concept

    International Nuclear Information System (INIS)

    Alsmeyer, H.; Tromm, W.

    1995-01-01

    Studies of the COMET core catcher concept developed for a future PWR have been continued. The concept is based on the spreading of a core melt on a sacrificial layer and its erosion, until a subsequent addition of water from below causes a fragmentation of the melt. A porous solidification of the melt would then admit a complete flooding within a short period. (orig.)

  11. Concept Mapping

    Science.gov (United States)

    Technology & Learning, 2005

    2005-01-01

    Concept maps are graphical ways of working with ideas and presenting information. They reveal patterns and relationships and help students to clarify their thinking, and to process, organize and prioritize. Displaying information visually--in concept maps, word webs, or diagrams--stimulates creativity. Being able to think logically teaches…

  12. 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.

  13. 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.

  14. 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...

  15. 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...

  16. 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

  17. 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...

  18. 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

  19. 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

  20. 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

    Directory of Open Access Journals (Sweden)

    Białek Marianna

    2011-11-01

    Full Text Available Abstract 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.

  1. Concept on coupled spectrum B/T (burning and/or transmutation) reactor for treatment of minor actinides by thermal and fast neutrons

    International Nuclear Information System (INIS)

    Aziz, Ferhat; Kitamoto, Asashi

    1996-01-01

    A conceptual design of B/T (burning and/or transmutation) reactor based on a modified conventional 1150 MWe-PWR system, with core consisted of two concentric regions for thermal and fast neutrons, was proposed herein for B/T treatment of MA (minor actinides). The B/T fuel considered was supposed such that MA discharged from 1 GWe-LWR was blended homogeneously with the composition of LWR fuel. In the outer region 23- Np, 241 Am and 243 Am were loaded and burned by thermal neutron, while in the inner region 244 Cm was loaded and burned mainly by fast neutron. The geometry of B/T fuel and the fuel assembly in the outer region was left in the same condition to those of standard PWR while in the inner region the B/T fuel was arranged in the hexagonal geometry, allowed high fuel to coolant volume ratio (V m /V f ), to keep the harder neutron spectrum. Two cases of the Coupled Spectrum B/T Reactor (CSR) with different (V m 1 f ) ratio in the inner region were studied, and the results for the tight lattice with (V m /V f ) = 0.5 showed that those isotopes approached the equilibrium composition after about 5 recycle period, when the CSR was operated under the reactivity swing of 2.8 % dk/k. The evaluations on the void coefficient of reactivity, the Doppler effect and the reactivity swing showed that the CSR concept has the inherent safety and can burn and/or transmute all kind of MA in a single reactor. This CSR can burn about 808 kg of MA in one recycle period of 3 years, which is equivalent to the discharged fuel from about 12 units of LWR in a year. (author)

  2. Low-Level Tragus Stimulation for the Treatment of Ischemia and Reperfusion Injury in Patients With ST-Segment Elevation Myocardial Infarction: A Proof-of-Concept Study.

    Science.gov (United States)

    Yu, Lilei; Huang, Bing; Po, Sunny S; Tan, Tuantuan; Wang, Menglong; Zhou, Liping; Meng, Guannan; Yuan, Shenxu; Zhou, Xiaoya; Li, Xuefei; Wang, Zhuo; Wang, Songyun; Jiang, Hong

    2017-08-14

    The aim of this study was to investigate whether low-level tragus stimulation (LL-TS) treatment could reduce myocardial ischemia-reperfusion injury in patients with ST-segment elevation myocardial infarction (STEMI). The authors' previous studies suggested that LL-TS could reduce the size of myocardial injury induced by ischemia. Patients who presented with STEMI within 12 h of symptom onset, treated with primary percutaneous coronary intervention, were randomized to the LL-TS group (n = 47) or the control group (with sham stimulation [n = 48]). LL-TS, 50% lower than the electric current that slowed the sinus rate, was delivered to the right tragus once the patients arrived in the catheterization room and lasted for 2 h after balloon dilatation (reperfusion). All patients were followed for 7 days. The occurrence of reperfusion-related arrhythmia, blood levels of creatine kinase-MB, myoglobin, N-terminal pro-B-type natriuretic peptide and inflammatory markers, and echocardiographic characteristics were evaluated. The incidence of reperfusion-related ventricular arrhythmia during the first 24 h was significantly attenuated by LL-TS. In addition, the area under the curve for creatine kinase-MB and myoglobin over 72 h was smaller in the LL-TS group than the control group. Furthermore, blood levels of inflammatory markers were decreased by LL-TS. Cardiac function, as demonstrated by the level of N-terminal pro-B-type natriuretic peptide, the left ventricular ejection fraction, and the wall motion index, was markedly improved by LL-TS. LL-TS reduces myocardial ischemia-reperfusion injury in patients with STEMI. This proof-of-concept study raises the possibility that this noninvasive strategy may be used to treat patients with STEMI undergoing primary percutaneous coronary intervention. Copyright © 2017. Published by Elsevier Inc.

  3. 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

  4. Basic concepts

    International Nuclear Information System (INIS)

    Dorner, B.

    1999-01-01

    The basic concepts of neutron scattering as a tool for studying the structure and the dynamics of condensed matter. Theoretical aspects are outlined, the two different cases of coherent and incoherent scattering are presented. The issue of resolution, coherence volume and the role of monochromators are also discussed. (K.A.)

  5. 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

  6. Isoeffect lines using TDF and CRE concepts

    International Nuclear Information System (INIS)

    Supe, S.J.; Sasane, J.B.; Supe, D.S.

    1980-01-01

    Isoeffect lines based on Ellis' Nominal Standard Dose concept, Orton's Time Dose and Fractionation Factor (TDF) concept, and Kirk et al's Cumulative Radiation Effect (CRE) concept give differing results of treatment planning. Experience with isoeffect lines based on the above concepts in planning in case of radiotherapy for carcinoma of bladder and carcinoma of uterine cervix is narrated. (M.G.B.)

  7. 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 ...

  8. 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...

  9. 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

  10. 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

  11. 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)

  12. 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

  13. The effect of intrauterine cephapirin treatment after insemination on conception rate in repeat breeder dairy cows subjected to the progesterone-based Ovsynch protocol

    OpenAIRE

    GÜMEN, Ahmet; MECİTOĞLU, Gülnaz YILMAZBAŞ; KESKİN, Abdulkadir; KARAKAYA, Ebru; ALKAN, Ali; TAŞDEMİR, Umut; OKUT, Hayrettin

    2012-01-01

    Subclinical endometritis contributes to repeat breeder syndrome in dairy cows. This study evaluated the effect of intrauterine cephapirin benzathine administration after timed artificial insemination (TAI) on the conception rate (CR) in repeat breeder dairy cows. To determine the antibiotic effects, all cows (n = 335) that had more than 3 services with no clinical abnormalities of the reproductive tract received the same combined synchronisation protocol: an ear implant containing progestagen...

  14. Medullary aplasia secondary to an irradiation accident: Treatment options and evolution of the concepts; L'aplasie medullaire secondaire a un accident d'irradiation : options therapeutiques et evolution des concepts

    Energy Technology Data Exchange (ETDEWEB)

    De Revel, T. [Service d' Hematologie, HIA Percy, et Service de Neurovirologie, Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France); Fagot, T.; Souleau, B. [Service d' Hematologie, HIA Percy, Clamart (France); Dormont, D. [Service de Neurovirologie, Commissariat a l' Energie Atomique, Fontenay-aux-Roses (France); Nedellec, G. [Service d' Hematologie, HIA Percy, Clamart (France)

    2002-07-01

    Bone marrow grafting following accidental irradiation exposure should be viewed in the perspective of a severe myeloablative syndrome linked to high medullary damage for a dose range higher than 6-8 Gy, resulting in very late or no recovery. Prognosis will depend on the presence or absence of radio-combined injuries, the toxicity of the transplant procedure, and the risk of rejection induced by insufficient percritical immunosuppression. It is in this context that new cell therapy modalities, which combine enhanced peripheral hematopoietic cell engraftment and high immunosuppressive conditioning regimen with low extrahematological toxicity, inducing early and stable mixed lymphomyeloid chimerism with minimal morbidity, can be considered. Such an approach is being evaluated in the treatment of patients with hematological malignancies at high risk of transplant-related mortality using conventional bone marrow methods. (author)

  15. 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...

  16. 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.

  17. 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.

  18. 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.

  19. 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.

  20. 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.

  1. 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

  2. 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

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

    OpenAIRE

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

    2016-01-01

    Background 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 ...

  4. 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.

  5. Cardiac surgery fast-track treatment in a postanesthetic care unit: six-month results of the Leipzig fast-track concept.

    Science.gov (United States)

    Ender, Joerg; Borger, Michael Andrew; Scholz, Markus; Funkat, Anne-Kathrin; Anwar, Nadeem; Sommer, Marcus; Mohr, Friedrich Wilhelm; Fassl, Jens

    2008-07-01

    The authors compared the safety and efficacy of a newly developed fast-track concept at their center, including implementation of a direct admission postanesthetic care unit, to standard perioperative management. All fast-track patients treated within the first 6 months of implementation of our direct admission postanesthetic care unit were matched via propensity scores and compared with a historical control group of patients who underwent cardiac surgery prior to fast-track implementation. A total of 421 fast-track patients were matched successfully to 421 control patients. The two groups of patients had a similar age (64 +/- 13 vs. 64 +/- 12 yr for fast-track vs. control, P = 0.45) and European System for Cardiac Operative Risk Evaluation-predicted risk of mortality (4.8 +/- 6.1% vs. 4.6 +/- 5.1%, P = 0.97). Fast-track patients had significantly shorter times to extubation (75 min [45-110] vs. 900 min [600-1140]), as well as shorter lengths of stay in the postanesthetic or intensive care unit (4 h [3.0-5] vs. 20 h [16-25]), intermediate care unit (21 h [17-39] vs. 26 h [19-49]), and hospital (10 days [8-12] vs. 11 days [9-14]) (expressed as median and interquartile range, all P operations.

  6. Palliative radiotherapy. Ranking within an interdisciplinary treatment concept in case of advanced tumor disease; Palliative Strahlentherapie. Rolle im interdisziplinaeren Behandlungskonzept bei fortgeschrittenem Tumorleiden

    Energy Technology Data Exchange (ETDEWEB)

    Seegenschmiedt, M.H. [Krupp Krankenanstalten Gemeinnuetzige GmbH, Essen (Germany). Klinik fuer Strahlentherapie und Nuklearmedizin

    1998-10-23

    Many tumor-induced symptoms can be alleviated by suitable irradiation in a direct, effective and sparing manner. The clinical response amounts to 80% and is independent of tumor histology. Careful diagnosis and accurate localisation of the causes of symptoms as well as exact therapy planning and execution are required. Based on individual dose planning harmonising single dosis and total dosis, pin-pointed definition of target areas, and application of modern planning and irradiation techniques, palliative radiotherapy is able to achieve long-term improvement with neglectible side-effects, sometimes within only a few days or weeks. It is a valuable part of a consistant therapy concept that is tailored to the individual needs of a patient, by cooperative action of experts from a variety of medical disciplines, intended to optimize the qulity of life of patients, and sometimes may exclude conventional radiotherapy. (orig./CB) [Deutsch] Viele tumorbedingten Symptome koennen mit Strahlentherapie kausal wirksam, effektiv und schonend behandelt werden. Das klinische Ansprechen betraegt 80% und ist unabhaengig von der Histologie des Tumors. Eine sorgfaeltige Indikationsstellung und genaue Lokalisation der Symptomursache sowie exakte Planung und Durchfuehrung der Strahlentherapie sind Bedingung. Mit einer individuellen Anpassung der Einzel- und Gesamtdosis, des Zielvolumens und dem Einsatz moderner Planungs- und Bestrahlungstechniken gelingt es, oft innerhalb weniger Tage bis Wochen eine langanhaltende Symptombesserung ohne wesentliche Nebenwirkungen zu erzielen. Die palliative Strahlentherapie ist dabei Teil eines Gesamtbehandlungskonzeptes, das interdisziplinaer abgestimmt ist und eine optimale Lebensqualitaet fuer den Tumorpatienten anstrebt, manchmal auch unter Verzicht auf eine Therapie. (orig.)

  7. 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

  8. 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

    2018-06-01

    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 before procedures 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.

  9. 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

  10. Early and mid-term results with the Growth Stent--a possible concept for transcatheter treatment of aortic coarctation from infancy to adulthood by stent implantation?

    Science.gov (United States)

    Ewert, Peter; Peters, Bjoern; Nagdyman, Nicole; Miera, Oliver; Kühne, Titus; Berger, Felix

    2008-01-01

    Evaluation of the Growth Stent-a stent consisting of two stent halves connected by reabsorbable sutures-for the treatment of aortic coarctation in infants. Surveillance study of 13 Growth Stents implanted in 12 patients aged 1-15 months (median 5 months). Body weight ranged from 3.4-12.8 kg (median 5.4 kg). Eight patients suffered from aortic (re-)coarctation, four of them from stenosis of the aortic anastomosis after a Norwood I procedure. The follow-up period was 24 months (11-51 months). Pressure gradients immediately after stent implantation decreased from 30 mm Hg (range 20-50 mm Hg) to 8 mm Hg (range 0-15 mm Hg). Five patients had one (3 pts) or two (2 pts) balloon dilations 3-28 months (median 12 months) after Growth Stent implantation. The median pressure gradient decreased from 25 mm Hg (range 15-30 mm Hg) to 15 mm Hg (range 5-25 mm Hg). Six patients received a large stent after 19-34 months. Median body weight was 11.8 kg (9.4-15 kg). The Growth Stent is suitable for the acute treatment of aortic coarctation in infants and can be overstented later on--if necessary--with a larger stent without causing restriction. Copyright 2008 Wiley-Liss, Inc.

  11. 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.

  12. Proof of Concept Study for the Design, Manufacturing, and Testing of a Patient-Specific Shape Memory Device for Treatment of Unicoronal Craniosynostosis.

    Science.gov (United States)

    Borghi, Alessandro; Rodgers, Will; Schievano, Silvia; Ponniah, Allan; Jeelani, Owase; Dunaway, David

    2018-01-01

    Treatment of unicoronal craniosynostosis is a surgically challenging problem, due to the involvement of coronal suture and cranial base, with complex asymmetries of the calvarium and orbit. Several techniques for correction have been described, including surgical bony remodeling, early strip craniotomy with orthotic helmet remodeling and distraction. Current distraction devices provide unidirectional forces and have had very limited success. Nitinol is a shape memory alloy that can be programmed to the shape of a patient-specific anatomy by means of thermal treatment.In this work, a methodology to produce a nitinol patient-specific distractor is presented: computer tomography images of a 16-month-old patient with unicoronal craniosynostosis were processed to create a 3-dimensional model of his skull and define the ideal shape postsurgery. A mesh was produced from a nitinol sheet, formed to the ideal skull shape and heat treated to be malleable at room temperature. The mesh was afterward deformed to be attached to a rapid prototyped plastic skull, replica of the patient initial anatomy. The mesh/skull construct was placed in hot water to activate the mesh shape memory property: the deformed plastic skull was computed tomography scanned for comparison of its shape with the initial anatomy and with the desired shape, showing that the nitinol mesh had been able to distract the plastic skull to a shape close to the desired one.The shape-memory properties of nitinol allow for the design and production of patient-specific devices able to deliver complex, preprogrammable shape changes.

  13. Proof-of-concept, randomized, controlled clinical trial of Bacillus-Calmette-Guerin for treatment of long-term type 1 diabetes.

    Directory of Open Access Journals (Sweden)

    Denise L Faustman

    Full Text Available No targeted immunotherapies reverse type 1 diabetes in humans. However, in a rodent model of type 1 diabetes, Bacillus Calmette-Guerin (BCG reverses disease by restoring insulin secretion. Specifically, it stimulates innate immunity by inducing the host to produce tumor necrosis factor (TNF, which, in turn, kills disease-causing autoimmune cells and restores pancreatic beta-cell function through regeneration.Translating these findings to humans, we administered BCG, a generic vaccine, in a proof-of-principle, double-blind, placebo-controlled trial of adults with long-term type 1 diabetes (mean: 15.3 years at one clinical center in North America. Six subjects were randomly assigned to BCG or placebo and compared to self, healthy paired controls (n = 6 or reference subjects with (n = 57 or without (n = 16 type 1 diabetes, depending upon the outcome measure. We monitored weekly blood samples for 20 weeks for insulin-autoreactive T cells, regulatory T cells (Tregs, glutamic acid decarboxylase (GAD and other autoantibodies, and C-peptide, a marker of insulin secretion. BCG-treated patients and one placebo-treated patient who, after enrollment, unexpectedly developed acute Epstein-Barr virus infection, a known TNF inducer, exclusively showed increases in dead insulin-autoreactive T cells and induction of Tregs. C-peptide levels (pmol/L significantly rose transiently in two BCG-treated subjects (means: 3.49 pmol/L [95% CI 2.95-3.8], 2.57 [95% CI 1.65-3.49] and the EBV-infected subject (3.16 [95% CI 2.54-3.69] vs.1.65 [95% CI 1.55-3.2] in reference diabetic subjects. BCG-treated subjects each had more than 50% of their C-peptide values above the 95(th percentile of the reference subjects. The EBV-infected subject had 18% of C-peptide values above this level.We conclude that BCG treatment or EBV infection transiently modified the autoimmunity that underlies type 1 diabetes by stimulating the host innate immune response. This suggests that BCG or other

  14. Analysis of nocturia with 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration: concept for effective treatment modality.

    Science.gov (United States)

    Udo, Yukihiro; Nakao, Masahiro; Honjo, Hisashi; Ukimura, Osamu; Kawauchi, Akihiro; Kitakoji, Hiroshi; Miki, Tsuneharu

    2011-03-01

    with nocturnal polyuria and both long sleep duration and nocturnal polyuria. • Because nocturia is a multifactorial disorder and closely related to four factors (i.e. 24-h urine volume, nocturnal urine volume, nocturnal bladder capacity and length of sleep duration), the evaluation of all these factors appears to be clinically useful for determining the main contributing factor in patients with nocturia as well as the suitable treatment modality on an individual basis. • Physicians should take all these factors into consideration in the evaluation and treatment of nocturia. © 2010 THE AUTHORS. JOURNAL COMPILATION © 2010 BJU INTERNATIONAL.

  15. 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,…

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

    Science.gov (United States)

    Sissoko, Daouda; Laouenan, Cedric; Folkesson, Elin; M’Lebing, Abdoul-Bing; Beavogui, Abdoul-Habib; Baize, Sylvain; Camara, Alseny-Modet; Maes, Piet; Shepherd, Susan; Danel, Christine; Carazo, Sara; Conde, Mamoudou N.; Gala, Jean-Luc; Colin, Géraldine; Savini, Hélène; Bore, Joseph Akoi; Le Marcis, Frederic; Koundouno, Fara Raymond; Petitjean, Frédéric; Lamah, Marie-Claire; Diederich, Sandra; Tounkara, Alexis; Poelart, Geertrui; Berbain, Emmanuel; Dindart, Jean-Michel; Duraffour, Sophie; Lefevre, Annabelle; Leno, Tamba; Peyrouset, Olivier; Irenge, Léonid; Bangoura, N’Famara; Palich, Romain; Hinzmann, Julia; Kraus, Annette; Barry, Thierno Sadou; Berette, Sakoba; Bongono, André; Camara, Mohamed Seto; Chanfreau Munoz, Valérie; Doumbouya, Lanciné; Souley Harouna; Kighoma, Patient Mumbere; Koundouno, Fara Roger; Réné Lolamou; Loua, Cécé Moriba; Massala, Vincent; Moumouni, Kinda; Provost, Célia; Samake, Nenefing; Sekou, Conde; Soumah, Abdoulaye; Arnould, Isabelle; Komano, Michel Saa; Gustin, Lina; Berutto, Carlotta; Camara, Diarra; Camara, Fodé Saydou; Colpaert, Joliene; Delamou, Léontine; Jansson, Lena; Kourouma, Etienne; Loua, Maurice; Malme, Kristian; Manfrin, Emma; Maomou, André; Milinouno, Adele; Ombelet, Sien; Sidiboun, Aboubacar Youla; Verreckt, Isabelle; Yombouno, Pauline; Bocquin, Anne; Carbonnelle, Caroline; Carmoi, Thierry; Frange, Pierre; Mely, Stéphane; Nguyen, Vinh-Kim; Pannetier, Delphine; Taburet, Anne-Marie; Treluyer, Jean-Marc; Kolie, Jacques; Moh, Raoul; Gonzalez, Minerva Cervantes; Kuisma, Eeva; Liedigk, Britta; Ngabo, Didier; Rudolf, Martin; Thom, Ruth; Kerber, Romy; Gabriel, Martin; Di Caro, Antonino; Wölfel, Roman; Badir, Jamal; Bentahir, Mostafa; Deccache, Yann; Dumont, Catherine; Durant, Jean-François; El Bakkouri, Karim; Gasasira Uwamahoro, Marie; Smits, Benjamin; Toufik, Nora; Van Cauwenberghe, Stéphane; Ezzedine, Khaled; Dortenzio, Eric; Pizarro, Louis; Etienne, Aurélie; Guedj, Jérémie; Fizet, Alexandra; Barte de Sainte Fare, Eric; Murgue, Bernadette; Tran-Minh, Tuan; Rapp, Christophe; Piguet, Pascal; Poncin, Marc; Draguez, Bertrand; Allaford Duverger, Thierry; Barbe, Solenne; Baret, Guillaume; Defourny, Isabelle; Carroll, Miles; Raoul, Hervé; Augier, Augustin; Eholie, Serge P.; Yazdanpanah, Yazdan; Levy-Marchal, Claire; Antierrens, Annick; Van Herp, Michel; Günther, Stephan; de Lamballerie, Xavier; Keïta, Sakoba; Mentre, France

    2016-01-01

    Background 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. Methods and Findings 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

  17. Formulation and development of ophthalmic in situ gel for the treatment ocular inflammation and infection using application of quality by design concept.

    Science.gov (United States)

    Patel, Nirav; Thakkar, Vaishali; Metalia, Viral; Baldaniya, Lalji; Gandhi, Tejal; Gohel, Mukesh

    2016-09-01

    The conventional liquid ophthalmic delivery systems exhibit short pre-corneal residence time and the relative impermeability to the cornea which leads to poor ocular bioavailability. The aim of this study was to apply quality by design (QbD) for development of dexamethasone sodium phosphate (DSP) and tobramycin sulfate (TS)-loaded thermoresponsive ophthalmic in situ gel containing Poloxamer 407 and hydroxyl propyl methyl cellulose (HPMC) K4M for prolonging the pre-corneal residence time, ocular bioavability and decreases the frequency of administration of dosage form. The material attributes and the critical quality attributes (CQA) of the in situ gel were identified. Central composite design (CCD) was adopted to optimize the formulation. The ophthalmic in situ forming gels were prepared by cold method. Materials attributes were the amount of Poloxamer 407 and HPMC and CQA identified were Gel strength, mucoadhesive index, gelation temperature and % of drug release of both drug. Optimized batch (F*) containing 16.75% poloxamer 407 and 0.54% HPMC K4M were exhibited all results in acceptable limits. Compared with the marketed formulation, optimized in situ gel showed delayed Tmax, improved Cmax and AUC in rabbit aqueous humor, suggesting the sustained drug release and better corneal penetration and absorption. According to the study, it could be concluded that DSP and TS would be successfully formulated as in situ gelling mucoadhesive system for the treatment of steroid responsive eye infections with the properties of sustained drug release, prolonged ocular retention and improved corneal penetration.

  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. 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.

  20. 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

  1. Successful ovulation induction, conception, and normal delivery after chronic therapy with etanercept: a recombinant fusion anti-cytokine treatment for rheumatoid arthritis.

    Science.gov (United States)

    Sills, E S; Perloe, M; Tucker, M J; Kaplan, C R; Palermo, G D

    2001-11-01

    Etanercept (Enbrel; Wyeth-Ayerst/Immunex Inc, Seattle, WA, USA) is a subcutaneously administered novel fusion protein consisting of the extracellular ligand-binding domain of the 75 kD receptor for tumor necrosis factor-alpha (anti-TNFalpha) and the Fc portion of human IgG1. The agent is synthesized by plasmid transfection of a Chinese hamster ovary cell line, utilizing recombinant DNA technology. Etanercept was approved by the US FDA for treatment of multi-drug resistant rheumatoid arthritis in 1998, but no human data exist regarding the impact of anti-TNFalpha therapy on human reproductive function or its use before ovulation induction. As TNFalpha potentiates collagenolysis via matrix metalloproteinase gene expression (thereby facilitating ovulation), there exists a theoretical risk that TNFalpha-inhibition could exert an undesirable effect on ovulation and pregnancy. In this report, we describe the first case of ovulation induction, intrauterine insemination, normal pregnancy and singleton delivery of a healthy infant following chronic ( > 1 year) pre-ovulatory TNFalpha-inhibitor therapy for rheumatoid arthritis. Reproductive endocrinologists and obstetrician-gynecologists should be familiar with etanercept therapy in the context of severe rheumatic disease, and offer appropriate reassurance regarding its safe use for infertility patients planning ovulation induction.

  2. Progestogen treatments for cycle management in a sheep model of assisted conception affect the growth patterns, the expression of luteinizing hormone receptors, and the progesterone secretion of induced corpora lutea.

    Science.gov (United States)

    Letelier, Claudia; García-Fernández, Rosa Ana; Contreras-Solis, Ignacio; Sanchez, María Angeles; Garcia-Palencia, Pilar; Sanchez, Belen; Gonzalez-Bulnes, Antonio; Flores, Juana María

    2010-03-01

    To determine, in a sheep model, the effect of a short-term progestative treatment on growth dynamics and functionality of induced corpora lutea. Observational, model study. Public university. Sixty adult female sheep. Synchronization and induction of ovulation with progestogens and prostaglandin analogues; ovarian ultrasonography, blood sampling, and ovariectomy. Determination of pituitary function and morphologic characteristics, expression of luteinizing hormone (LH) receptors, and progesterone secretion of corpora lutea. The use of progestative pretreatments for assisted conception affect the growth patterns, the expression of LH receptors, and the progesterone secretion of induced corpora lutea. The current study indicates, in a sheep model, the existence of deleterious effects from progestogens on functionality of induced corpora lutea. Copyright 2010 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.

  3. 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

    2018-07-01

    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 effect on EPO levels of 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 absorbed rapidly, and the mean maximum plasma concentration and area under the concentration-time curve increased dose dependently. The mean terminal half-life was 4.64-10.40 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 -1 (90% confidence interval 13.0, 16.9) for volunteers who received placebo and 39.8 IU l -1 (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 postdose 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 or laboratory safety 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. © 2018 The British Pharmacological Society.

  4. 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.

  5. 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.

  6. 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. Keywords: Species concept, Species limitation, Species, Taxonomy, Classification

  7. 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

  8. Self-Concept Change in Behavior Modification

    Science.gov (United States)

    Ryan, Victor L.; And Others

    1976-01-01

    Changes in self-concept as a function of behavioral treatment for test anxiety are investigated. Test-anxious subjects (N=72) were randomly assigned to systematic desensitization, relaxation-training only, or no-treatment control conditions. Results indicate that the desensitization and relaxation treatments were both effective in reducing test…

  9. 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

  10. 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)....

  11. [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

  12. Quantitative Concept Analysis

    NARCIS (Netherlands)

    Pavlovic, Dusko; Domenach, Florent; Ignatov, Dmitry I.; Poelmans, Jonas

    2012-01-01

    Formal Concept Analysis (FCA) begins from a context, given as a binary relation between some objects and some attributes, and derives a lattice of concepts, where each concept is given as a set of objects and a set of attributes, such that the first set consists of all objects that satisfy all

  13. Planner concepts in IMRT planning

    International Nuclear Information System (INIS)

    Sahoo, Suvendu Kr.; Rath, A.K.; Patnaik, S.; Mishra, S.K.

    2008-01-01

    IMRT is the most sophisticated, innovative, three- dimensional conformal radiation treatment that delivers highly focused radiation with minimal impact to surrounding normal tissue. As it is a computer control technique, the planar should have adequate knowledge to execute the plan in proper way other wise it is very difficult to get the optimal plan. In this article we want to high light, planner should have the basic concepts before starting the IMRT planning

  14. Deep remission: a new concept?

    Science.gov (United States)

    Colombel, Jean-Frédéric; Louis, Edouard; Peyrin-Biroulet, Laurent; Sandborn, William J; Panaccione, Remo

    2012-01-01

    Crohn's disease (CD) is a chronic inflammatory disorder characterized by periods of clinical remission alternating with periods of relapse defined by recurrent clinical symptoms. Persistent inflammation is believed to lead to progressive bowel damage over time, which manifests with the development of strictures, fistulae and abscesses. These disease complications frequently lead to a need for surgical resection, which in turn leads to disability. So CD can be characterized as a chronic, progressive, destructive and disabling disease. In rheumatoid arthritis, treatment paradigms have evolved beyond partial symptom control alone toward the induction and maintenance of sustained biological remission, also known as a 'treat to target' strategy, with the goal of improving long-term disease outcomes. In CD, there is currently no accepted, well-defined, comprehensive treatment goal that entails the treatment of both clinical symptoms and biologic inflammation. It is important that such a treatment concept begins to evolve for CD. A treatment strategy that delays or halts the progression of CD to increasing damage and disability is a priority. As a starting point, a working definition of sustained deep remission (that includes long-term biological remission and symptom control) with defined patient outcomes (including no disease progression) has been proposed. The concept of sustained deep remission represents a goal for CD management that may still evolve. It is not clear if the concept also applies to ulcerative colitis. Clinical trials are needed to evaluate whether treatment algorithms that tailor therapy to achieve deep remission in patients with CD can prevent disease progression and disability. Copyright © 2012 S. Karger AG, Basel.

  15. Design of a Bayesian adaptive phase 2 proof-of-concept trial for BAN2401, a putative disease-modifying monoclonal antibody for the treatment of Alzheimer's disease.

    Science.gov (United States)

    Satlin, Andrew; Wang, Jinping; Logovinsky, Veronika; Berry, Scott; Swanson, Chad; Dhadda, Shobha; Berry, Donald A

    2016-01-01

    Recent failures in phase 3 clinical trials in Alzheimer's disease (AD) suggest that novel approaches to drug development are urgently needed. Phase 3 risk can be mitigated by ensuring that clinical efficacy is established before initiating confirmatory trials, but traditional phase 2 trials in AD can be lengthy and costly. We designed a Bayesian adaptive phase 2, proof-of-concept trial with a clinical endpoint to evaluate BAN2401, a monoclonal antibody targeting amyloid protofibrils. The study design used dose response and longitudinal modeling. Simulations were used to refine study design features to achieve optimal operating characteristics. The study design includes five active treatment arms plus placebo, a clinical outcome, 12-month primary endpoint, and a maximum sample size of 800. The average overall probability of success is ≥80% when at least one dose shows a treatment effect that would be considered clinically meaningful. Using frequent interim analyses, the randomization ratios are adapted based on the clinical endpoint, and the trial can be stopped for success or futility before full enrollment. Bayesian statistics can enhance the efficiency of analyzing the study data. The adaptive randomization generates more data on doses that appear to be more efficacious, which can improve dose selection for phase 3. The interim analyses permit stopping as soon as a predefined signal is detected, which can accelerate decision making. Both features can reduce the size and duration of the trial. This study design can mitigate some of the risks associated with advancing to phase 3 in the absence of data demonstrating clinical efficacy. Limitations to the approach are discussed.

  16. 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...... 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...

  17. 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; Sub, Sim Yoon; Kim, Yeon Sik; Whan, Wim Myung; 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.

  18. 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

  19. 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...

  20. 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 ...

  1. 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...

  2. The efficacy and tolerability of 5-aminolevulinic acid 5% thermosetting gel photodynamic therapy (PDT) in the treatment of mild-to-moderate acne vulgaris. A two-center, prospective assessor-blinded, proof-of-concept study.

    Science.gov (United States)

    Serini, Stefano Maria; Cannizzaro, Maria Vittoria; Dattola, Annunziata; Garofalo, Virginia; Del Duca, Esther; Ventura, Alessandra; Milani, Massimo; Campione, Elena; Bianchi, Luca

    2018-05-22

    Acne vulgaris is a chronic inflammatory skin disease, commonly treated with topical or systemic drugs, according to the severity of the condition. Retinoids and antibiotic compounds are considered cornerstone approaches in this condition. However, low adherence to the therapy and the issue of bacterial resistance undermine the efficacy in the long term. Photodynamic therapy (PDT) with 20% aminolevulinic acid (ALA) has shown to be effective in the treatment of inflammatory acne. Skin tolerability, however, could be a limiting factor for a widespread use of this approach. A new formulation of 5% ALA in thermosetting gel has been recently available. This formulation allows a more convenient application procedure without occlusion and better and more efficient release of the active compound in comparison with traditional ALA formulations like creams or ointments. To evaluate in a two-center, assessor-blinded, prospective, proof-of-concept study, the efficacy, and tolerability of red-light (630 nm) PDT with a new 5-ALA "low-dose" topical gel formulation (5%) in the treatment of inflammatory mild-to-moderate acne vulgaris (AV). A total of 35 subjects with moderate AV of the face (mean age: 24 ± 8 years, 13 men and 22 women) were enrolled, after their written informed consent. The primary outcome was the evolution of GAG (Global Acne Grade System) score at baseline and after an average of three, 630-nm, 15-minute, PDT sessions, performed every 2 weeks. GAG score was also calculated in a follow-up visit 6 months after the last PDT session. Skin tolerability was assessed during PDT sessions with a patient-reported discomfort level evaluation score from 0 (no discomfort at all) to 3 (severe discomfort). At baseline, the GAG score was 21 ± 6. After the last PDT session, the GAG score evaluated in a blinded fashion (digital photographs) was significantly reduced to 6.5 ± 5.7, representing a 70% reduction (P = .0001, Wilcoxon test; mean difference 14.9; 95% CI of

  3. 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

  4. Evolving Ethical Concepts

    Science.gov (United States)

    Potter, Van Rensselaer

    1977-01-01

    Discusses the role of the scientist in changing ethical concepts from simple interpersonal and theological imperatives towards "survival imperatives that must form the core of environmental bioethics." (CS)

  5. 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...... of the concept over the course of the authorship, and explains how it functions in the wider context of Kierkegaard’s thought. Concepts have been selected on the basis of their importance for Kierkegaard’s contributions to philosophy, theology, the social sciences, literature and aesthetics, thereby making...... this volume an ideal reference work for students and scholars in a wide range of disciplines....

  6. 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.

  7. 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.

  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. 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)

  10. 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

  11. 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.

  12. Concepts of scale

    NARCIS (Netherlands)

    Padt, F.J.G.; Arts, B.J.M.

    2014-01-01

    This chapter provides some clarity to the scale debate. It bridges a variety of approaches, definitions and jargons used in various disciplines in order to provide common ground for a concept of scale as a basis for scale-sensitive governance of the environment. The chapter introduces the concept of

  13. 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…

  14. Concepts of particle physics

    International Nuclear Information System (INIS)

    Gottfried, K.; Weisskopf, V.F.

    1984-01-01

    This volume elucidates basic and well-established concepts of particle physics for the autodidact who is curious about recent developments in fundamental physics. Elementary quantum mechanics is a background must. Contents, abridged: The evolution of the particle concept before the advent of quantum mechanics. Nonrelativistic quantum mechanics and atomic physics. Relativistic quantum theory. Nuclear phenomena. Subnuclear phenomena. Index

  15. 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 ...... data set from a Spanish bank....

  16. 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

  17. Badminton--Teaching Concepts.

    Science.gov (United States)

    Gibbs, Marilyn J.

    1988-01-01

    Teaching four basic badminton concepts along with the usual basic skill shots allows players to develop game strategy awareness as well as mechanical skills. These four basic concepts are: (1) ready position, (2) flight trajectory, (3) early shuttle contact, and (4) camouflage. (IAH)

  18. 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).

  19. Students’ conceptions analysis on several electricity concepts

    Science.gov (United States)

    Saputro, D. E.; Sarwanto, S.; Sukarmin, S.; Ratnasari, D.

    2018-05-01

    This research is aimed to analyse students’ conceptions on several electricity concept. This is a descriptive research with the subjects of new students of Sebelas Maret University. The numbers of the subject were 279 students that consisted of several departments such as science education, physics education, chemistry education, biology education and mathematics education in the academic year of 2017/2018. The instrument used in this research was the multiple-choice test with arguments. Based on the result of the research and analysis, it can be concluded that most of the students still find misconceptions and do not understand electricity concept on sub-topics such as electric current characteristic in the series and parallel arrangement, the value of capacitor capacitance, the influence of the capacitor charge and discharge towards the loads, and the amount of capacitor series arrangement. For the future research, it is suggested to improve students’ conceptual understanding with appropriate learning method and assessment instrument because electricity is one of physics material that closely related with students’ daily life.

  20. 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

  1. Clinical reasoning: concept analysis.

    Science.gov (United States)

    Simmons, Barbara

    2010-05-01

    This paper is a report of a concept analysis of clinical reasoning in nursing. Clinical reasoning is an ambiguous term that is often used synonymously with decision-making and clinical judgment. Clinical reasoning has not been clearly defined in the literature. Healthcare settings are increasingly filled with uncertainty, risk and complexity due to increased patient acuity, multiple comorbidities, and enhanced use of technology, all of which require clinical reasoning. Data sources. Literature for this concept analysis was retrieved from several databases, including CINAHL, PubMed, PsycINFO, ERIC and OvidMEDLINE, for the years 1980 to 2008. Rodgers's evolutionary method of concept analysis was used because of its applicability to concepts that are still evolving. Multiple terms have been used synonymously to describe the thinking skills that nurses use. Research in the past 20 years has elucidated differences among these terms and identified the cognitive processes that precede judgment and decision-making. Our concept analysis defines one of these terms, 'clinical reasoning,' as a complex process that uses cognition, metacognition, and discipline-specific knowledge to gather and analyse patient information, evaluate its significance, and weigh alternative actions. This concept analysis provides a middle-range descriptive theory of clinical reasoning in nursing that helps clarify meaning and gives direction for future research. Appropriate instruments to operationalize the concept need to be developed. Research is needed to identify additional variables that have an impact on clinical reasoning and what are the consequences of clinical reasoning in specific situations.

  2. 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

  3. 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

  4. German emergency management concept

    International Nuclear Information System (INIS)

    Burkart, K.

    1993-01-01

    The advantages and disadvantages of the margin and start-up value concepts (according to ICRP 40 and EU-ordinances) are explained, and it is demonstrated that the two concepts are combinable. The combined concept has the advantage of immediately providing, if required, intervention levels for the various measures to be taken, and of obliging those persons concerned with emergency protection to study and quantify, already at the planning stage, the influence of a range of accident conditions on the decision on measures. In this context, the use of computerized decision support systems which are currently being developed is indispensable. (orig./DG) [de

  5. Advanced fusion concepts program

    International Nuclear Information System (INIS)

    Dove, W.F.

    1978-01-01

    While the prospects for the eventual development of a tokamak-based fusion reactor appear promising at the present time, the Department of Energy maintains a vigorous program in alternate magnetic fusion concepts. Several of the concepts presently supported include the toroidal reversed field pinch, Tormac, Elmo Bumpy Torus, and various linear options. Recent technical accomplishments and program evaluations indicate that the possibility now exists for undertaking the next development stage, a proof-of-principle experiment, for a few of the most promising alternate concepts

  6. Radiation promotive concept

    International Nuclear Information System (INIS)

    Shebaita, M.K.

    1975-01-01

    The concept of radiation promotion was proposed in this study. The proposal of this concept was dependent upon stimulation in growth weight of survived chicks when fertile eggs were exposed to 60 Co gamma radiation. It was found that female chick (Promotive Sex) responded to this proposal concept rather than the male. Moreover, the dose level of 640 rads was found to be the Promotive Dose. It is important before applying ionizing radiation as a growth promotive to take into consideration whether you want increasing egg or meat production, as meat promotion in layers breed is bound to decrease egg production. (orig.) [de

  7. 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.)

  8. Stormwater Management Concept Information

    Data.gov (United States)

    Montgomery County of Maryland — A stormwater management concept is a statement or drawing, or both, describing the manner in which stormwater runoff from a proposed development will be controlled...

  9. 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.

  10. 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

  11. 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...

  12. 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 architectural...... project within the framework: concept - program, these notions being concieved as spatial representations primarily and immediately "given" to architecture....

  13. 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

  14. Alternative fusion concepts

    International Nuclear Information System (INIS)

    Rostagni, G.

    1981-01-01

    The paper reports the discussions and statements made by the participants on the actual state and future of five different approaches on the fusion concept; they are the following: bumpy torus, reversed-field pinch, open-ended configurations, compact toroids and stellarators. Tables show for each concept parameters that represent the achieved results; data expected for future devices and extrapolations on reactor requirements are included

  15. Data governance implementation concept

    OpenAIRE

    Ullrichová, Jana

    2016-01-01

    This master´s thesis discusses concept of implementation for data governance. The theoretical part of this thesis is about data governance. It explains why data are important for company, describes definitoons of data governance, its history, its components, its principles and processes and fitting in company. Theoretical part is amended with examples of data governance failures and banking specifics. The main goal of this thesis is to create a concept for implementing data governance and its...

  16. 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

  17. Concept of contracting authority

    OpenAIRE

    Kasiliauskaitė, Vitalija

    2016-01-01

    Concept of Contracting Authority Law on Public Procurement the procurement concept implies the conclusion that public procurement be declared only such purchases are carried out by the contracting authority. The contracting authorities can be a subject of state and municipal management institutes, whose assignment authority is determined by a functional approach. Also, contracting authorities may be public and legal entities, but that the public interest and operates non-commercial activities...

  18. 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.

  19. 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

  20. 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.

  1. Teamwork: a concept analysis.

    Science.gov (United States)

    Xyrichis, Andreas; Ream, Emma

    2008-01-01

    This paper is a report of an analysis of the concept of teamwork. Teamwork is seen as an important facilitator in delivering quality healthcare services internationally. However, research studies of teamwork in health care are criticized for lacking a basic conceptual understanding of what this concept represents. A universal definition for healthcare settings and professionals is missing from published literature. Walker and Avant's approach was used to guide this concept analysis. Literature searches used bibliographic databases (Medline, CINAHL, Web of Science, Proquest CSA), internet search engines (GoogleScholar), and hand searches. Literature published between 1976 and 2006 was reviewed but only material in English was included. Based on the analysis undertaken, teamwork is proposed as a dynamic process involving two or more healthcare professionals with complementary backgrounds and skills, sharing common health goals and exercising concerted physical and mental effort in assessing, planning, or evaluating patient care. This is accomplished through interdependent collaboration, open communication and shared decision-making, and generates value-added patient, organizational and staff outcomes. Praising the value of teamwork without a common understanding of what this concept represents endangers both research into this way of working and its effective utilization in practice. The proposed definition helps reconcile discrepancies between how this concept is understood by nurses and doctors, as well as allied health professionals. A common understanding can facilitate communication in educational, research and clinical settings and is imperative for improving clarity and validity of future research.

  2. 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.

  3. Development of numerical concepts

    Directory of Open Access Journals (Sweden)

    Sabine Peucker

    2013-06-01

    Full Text Available The development of numerical concepts is described from infancy to preschool age. Infants a few days old exhibit an early sensitivity for numerosities. In the course of development, nonverbal mental models allow for the exact representation of small quantities as well as changes in these quantities. Subitising, as the accurate recognition of small numerosities (without counting, plays an important role. It can be assumed that numerical concepts and procedures start with insights about small numerosities. Protoquantitative schemata comprise fundamental knowledge about quantities. One-to-one-correspondence connects elements and numbers, and, for this reason, both quantitative and numerical knowledge. If children understand that they can determine the numerosity of a collection of elements by enumerating the elements, they have acquired the concept of cardinality. Protoquantitative knowledge becomes quantitative if it can be applied to numerosities and sequential numbers. The concepts of cardinality and part-part-whole are key to numerical development. Developmentally appropriate learning and teaching should focus on cardinality and part-part-whole concepts.

  4. Faith: a concept analysis.

    Science.gov (United States)

    Dyess, Susan Macleod

    2011-12-01

    This paper reports a concept analysis of faith. There are numerous scholars who consider spirituality and religiosity as they relate to health and nursing. Faith is often implied as linked to these concepts but deserves distinct exploration. In addition, as nursing practice conducted within communities of faith continues to emerge, concept clarification of faith is warranted. Qualitative analysis deliberately considered the concept of faith within the lens of Margaret Newman's health as expanding consciousness. Data sources used included a secondary analysis of stories collected within a study conducted in 2008, two specific reconstructed stories, the identification of attributes noted within these various stories and selected philosophical literature from 1950 to 2009.  A definition was identified from the analysis; faith is an evolving pattern of believing, that grounds and guides authentic living and gives meaning in the present moment of inter-relating. Four key attributes of faith were also identified as focusing on beliefs, foundational meaning for life, living authentically in accordance with beliefs, and interrelating with self, others and/or Divine. Although a seemingly universal concept, faith was defined individually. Faith appeared to be broader than spiritual practices and religious ritual and became the very foundation that enabled human beings to make sense of their world and circumstances. More work is needed to understand how faith community nursing can expand the traditional understanding of denominationally defined faith community practices and how nurses can support faith for individuals with whom they encounter within all nursing practice. © 2011 Blackwell Publishing Ltd.

  5. 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

  6. Outsourcing. The Concept

    Directory of Open Access Journals (Sweden)

    Victor-Adrian TROACĂ

    2012-06-01

    Full Text Available In the last two decades, an economic phenomenon took place, phenomenon characterized by the transfer of manufacturing activity from the developed countries to those in developing process. This practice can be considered as the response found by the large companies to the problem of production costs that were in a continuous rising, concomitant with the rising of living standards and remuneration.This paper aims to analyze the concept of outsourcing in terms of its evolution, but also in terms of incentives, ups and downs associated with the concept. On the other hand, this paper seeks to capture the fundamentals of this concept veracity and whether it could be implemented in the public service.

  7. 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.

  8. 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...... 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...... and strategies are briefly described in the article, and the adaption by city planners and developers has been critical reviewed....

  9. 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.

  10. Concepts in catalysis

    International Nuclear Information System (INIS)

    Boudart, M.

    1992-01-01

    This paper reports on concept in catalysis which are very important in heterogeneous catalysis, even today, when in spite of surface science, the complexity of events at a real catalytic surface is still evading the understanding necessary for design. In this paper the authors will attempt to give an update on evolving concepts in heterogeneous catalysis. The topics include: counting active centers on metal surfaces; the notion of turnover frequency for a catalytic cycle; the concept of structure (in) sensitive reactions; the ensemble (geometric) vs. The ligand (electronic) effect following Sachtler's school; the idea of a rate determining step and of a most abundant reactive intermediate; the effect of surface non-uniformity on catalytic kinetics; what makes catalytic cycles turnover

  11. Systemizing the Pedagogic Concepts

    Directory of Open Access Journals (Sweden)

    G. N. Serikov

    2013-01-01

    Full Text Available The paper emphasizes the necessity of systemizing the pedagogic concepts to complement the pluralism principle dominating in pedagogy over the recent years. The author recommends the person oriented systematic synergetic methodology combining various research data into a holistic scientific approach. The paper regards education as the core pedagogic concept - including training, upbringing, self-education, their respective subcomponents, and generated personal resource. The elements of personal resource combine the acquired knowledge, skills and values, developed subjective attitudes and individual health data. The key pedagogic terms describing the educational process are represented by a three-level system; the first level involves the educational form concepts, the second – generated personal resource, the third – summarized notion system combining the previous levels and reflecting their binary relations. The given construct systemizes the pedagogic conceptual apparatus and clarifies the theoretical notion of personal education. 

  12. 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 ...

  13. 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)

  14. Introduction: Bridging Concepts.

    Science.gov (United States)

    Davids, Karel

    2015-12-01

    How can those in the history of science, history of technology, and economics communicate more with each other than they are accustomed? How can they become more globally oriented? While these three disciplines today have more convergent interests than in the past, there is still a large potential for further exchange and involvement to explore and exploit. The contributors to this Focus section discuss a number of concepts that may serve as tools to bring these three disciplines more closely together and ease their evolution in a less Eurocentric direction. These concepts include trading zones, interaction and formalization, production, and machines and self-organization.

  15. CONCEPT-5 user's manual

    International Nuclear Information System (INIS)

    Hudson, C.R. II.

    1979-01-01

    The CONCEPT computer code package was developed to provide conceptual capital cost estimates for nuclear-fueled and fossil-fired power plants. Cost estimates can be made as a function of plant type, size, location, and date of initial operation. The output includes a detailed breakdown of the estimate into direct and indirect costs similar to the accounting system described in document NUS--531. Cost models are currently provided in CONCEPT 5 for single- and multiunit pressurized-water reactors, boiling-water reactors, and cost-fired plants with and without flue gas desulfurization equipment

  16. 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

  17. 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.

  18. Stress: a concept analysis.

    Science.gov (United States)

    Goodnite, Patricia M

    2014-01-01

    To analyze the concept of stress and provide an operational definition of stress. Literature review revealed that stress is a commonly used, but often ambiguous, term. Findings supported a definition of stress entailing an individual's perception of a stimulus as overwhelming, which in turn elicits a measurable response resulting in a transformed state. This analysis adopts a dynamic definition of stress that may serve to encourage communication, promote reflection, and enhance concept understanding. This definition may provide direction for future work, as well as enhance efforts to serve patients affected by stress. © 2013 Wiley Periodicals, Inc.

  19. Tokamak concept innovations

    International Nuclear Information System (INIS)

    1986-04-01

    This document contains the results of the IAEA Specialists' Meeting on Tokamak Concept Innovations held 13-17 January 1986 in Vienna. Although it is the most advanced fusion reactor concept the tokamak is not without its problems. Most of these problems should be solved within the ongoing R and D studies for the next generation of tokamaks. Emphasis for this meeting was placed on innovations that would lead to substantial improvements in a tokamak reactor, even if they involved a radical departure from present thinking

  20. 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…

  1. THE EFFECT OF CONCEPT MAPPING ON CONCEPT LEARNING IN SCIENCE

    OpenAIRE

    岡, 直樹; 今永, 久美子

    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...

  2. New detector concepts

    International Nuclear Information System (INIS)

    Kemmer, J.; Lutz, G.

    1986-07-01

    On the basis of the semiconductor drift chamber many new detectors are proposed, which enable the determination of energy, energy loss, position and penetration depth of radiation. A novel integrated transistor-detector configuration allows non destructive repeated readout and amplification of the signal. The concept may be used for the construction of one or two-dimensional PIXEL arrays. (orig.)

  3. 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

  4. CONCEPT OF MOBILE LEARNING

    Directory of Open Access Journals (Sweden)

    Г О Дуйсеева

    2016-12-01

    Full Text Available This article deals with the definition and the description of mobile learning. Ten years’ experience of the latest mobile technologies use and devices in educational process abroad is analyzed. Prospects and the possibilities of application of these technologies are considered. The basic concepts and development of mobile learning which proposed by scientists for the last years have been given.

  5. [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.

  6. 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

  7. 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.

  8. 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…

  9. 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…

  10. Some Core Contested Concepts

    Science.gov (United States)

    Chomsky, Noam

    2015-01-01

    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…

  11. 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...

  12. 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 ...

  13. 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

  14. 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...

  15. 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.

  16. 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.

  17. 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...

  18. Role of radiotherapy in the treatment of multiple myeloma; Wertigkeit der Radiotherapie in der Behandlung des multiplen Myeloms

    Energy Technology Data Exchange (ETDEWEB)

    Mose, S.; Pfitzner, D.; Rahn, A.; Nierhoff, C.; Schiemann, M.; Boettcher, H.D. [Frankfurt Univ. (Germany). Klinik fuer Strahlentherapie und Nuklearmedizin

    2000-11-01

    suppose that in multiple myeloma the local response to radiation is supported by a favorable performance status and simultaneous chemotherapy. Irradiation treatment does not change prognosis regarding overall survival. (orig.) [German] Die Radiotherapie nimmt im Rahmen der Schmerztherapie, die Behandlung von (drohenden) Frakturen und von Myelonkompressionen eine wichtige Rolle im palliativen Konzept ein. Ziel der vorliegenden retrospektiven Arbeit ist es, anhand dieser Indikationen den Effekt der Strahlentherapie auf Analgesie, Rekalzifizierung und neurologische Symptomatik am eigenen Patientenkollektiv aufzuzeigen und moegliche Einflussfaktoren auf den Therapieeffekt zu evaluieren. Patienten und Methoden: Vom 1.1.1988 bis 31.12.1998 wurden 42 Patienten (19 Frauen, 23 Maenner) im Alter von 46 bis 85 Jahren (Median: 64,9 Jahre) in 71 Zielvolumina aufgrund einer bestehenden Symptomatik (67/71: Ossaere Schmerzen, 45/71: Fraktur/-gefahr, 13/71: Rueckenmarkkompression) radiotherapiert (Median 36 Gy, 2 bis 3 Gy 2-mal/Woche). Die Zeit zwischen Diagnose und erster Bestrahlung betrug im Median 11,9 Monate (0,3 bis 90 Monate). Zum Zeitpunkt der ersten Radiotherapie befanden sich fuenf Patienten im Stadium II, 37 im Stadium III nach Salmon/Durie; der Karnofsky-Index lag im Median bei 70% (40 bis 90%). Ergebnisse: Im Verlauf der mindestens sechsmonatigen Nachbeobachtungszeit zeigte sich bei 85% der Zielvolumina eine komplette bzw. partielle Analgesie; es wurden 8,8% Schmerzrezidive gesehen. Eine roentgenologisch verifizierte Rekalzifizierung wurde in 26/56 (46,4%) auswertbaren Laesionen beobachtet; 17,9% waren progredient. In 22,3% der initial frakturgefaehrdeten Laesionen (4/18) kam es posttherapeutsich zu Frakturen. Eine simultane Chemotherapie sowie ein Karnofsky-Index{>=}70 wirkten sich signifikant positiv auf das Therapieansprechen aus. Eine Symptomreduktion nach Rueckenmarkkompression (nach Findley 1987) wurde bei 7/13 (53,8%) der Patienten erreicht. Das mediane Ueberleben

  19. Two Concepts of Rationality

    Directory of Open Access Journals (Sweden)

    Danny Frederick

    2010-02-01

    Full Text Available The dominant tradition in Western philosophy sees rationality as dictating. Thus rationality may require that we believe the best explanation and simple conceptual truths and that we infer in accordance with evident rules of inference. I argue that, given what we know about the growth of knowledge, this authoritarian concept of rationality leads to absurdities and should be abandoned. I then outline a libertarian concept of rationality, derived from Popper, which eschews the dictates and which sees a rational agent as one who questions, criticises, conjectures and experiments. I argue that, while the libertarian approach escapes the absurdities of the authoritarian, it requires two significant developments and an important clarification to be made fully consistent with itself.

  20. 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. -

  1. Hybrid system concepts

    International Nuclear Information System (INIS)

    Landeyro, P.A.

    1995-01-01

    Hybrid systems studied for fissile material production, were reconsidered for minor actinide and long-lived fission product destruction as alternative to the traditional final disposal of nuclear waste. Now there are attempts to extend the use of the concepts developed for minor actinide incineration to plutonium burning. The most promising hybrid system concept considers fuel and target both as liquids. From the results obtained, the possibility to adopt composite targets seems the most promising solution, but still there remains the problem of Pu production, not acceptable in a burning system. This kind of targets can be mainly used for fissile material production, while for accelerator driven burners it is most convenient to use a liquid lead target. The most suitable solvent is heavy water for minor actinide annihilation in the blanket of a hybrid system. Due to the criticality conditions and the necessity of electric energy production, the blanket using plutonium dissolved in molten salts is the most convenient one. (author)

  2. Three concepts of history

    Directory of Open Access Journals (Sweden)

    Antonio Campillo

    2016-05-01

    Full Text Available The aim of this article is twofold. On the one hand, I will outline the diverse usages that the concept of history has taken on throughout Western history. These different usages may be grouped together in three semantic fields (history as a way of knowing, as a way of being and as a way of doing, which correspond to three ways of understanding the Philosophy of History: as Epistemology of History, as Ontology of historicity and as ethical-political Critique of the present. On the other hand, I will show that these three concepts of history (and, accordingly, the three ways of understanding the Philosophy of History refer mutually to each other and, thus, are inseparable from each other.

  3. Concepts of intrinsic safety

    International Nuclear Information System (INIS)

    Anon.

    1985-01-01

    A newly introduced Japanese reactor concept, ISER (Intrinsically Safe and Economical Reactor), is intended to be a reference intrinsically safe light water reactor. ISER is designed similarly to PIUS but with greater economy in mind such that any utility in any country can choose it for its power system. Social assimilation and acceptability in the Asia Pacific Region including the United States are the keys to the ISER with the hope of dramatic reductions of social costs due to safeguards, reliability, financiability, and infrastructure building, particularly in the third world, as well as reactor safety itself. In this respect and others, the ISER proposal is different from other vendor-proposed reactor concepts and is unique

  4. 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.

  5. 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

  6. Conception of Brownian coil

    OpenAIRE

    Zhang, Jiayuan

    2018-01-01

    This article proposes a conception of Brownian coil. Brownian coil is a tiny coil with the same size of pollen. Once immersed into designed magnetic field and liquid, the coil will be moved and deformed macroscopically, due to the microscopic thermodynamic molecular collisions. Such deformation and movement will change the magnetic flux through the coil, by which an ElectroMotive Force (EMF) is produced. In this work, Brownian heat exchanger and Brownian generator are further designed to tran...

  7. 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.

  8. 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 formativ...... 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....

  9. 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 ...

  10. 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)

  11. 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

  12. Resilience - A Concept

    Science.gov (United States)

    2016-04-05

    the assessment of the health of a network or system. The hypothesis is: resiliency is meaningful in the context of holistic assessments of... health , holistic , Resiliency Tier, Resiliency Tier Matrix, State of Resiliency 295Defense ARJ, July 2015, Vol. 22 No. 3 : 294–324 296 Defense ARJ, July...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

  13. 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.)

  14. Four concepts of Africa

    Directory of Open Access Journals (Sweden)

    Willem Fourie

    2015-05-01

    Full Text Available What makes the words ‘Africa’ and ‘African’ possible and useful? In this article it is argued that at least four internally coherent concepts of Africa exist, and that none of these concepts are ethically neutral. The article is presented as a contribution to attempts at using the term ‘Africa’ in self-critical, reflexive and constructive ways. It could therefore be of interest to all researchers, particularly those in the humanities and theology, who locate their research within the context of ‘Africa’. It is argued that Africa can be conceived of as a place, a commodity, a condition and an ideal. By drawing on mostly primary sources it is shown that the term ‘Africa’ only relatively recently came to refer to a continent, that Africa as a place and Africa as a condition in need of betterment formed the foundation for its commodification, and that Africa only very recently became a self-description of the people who live on the continent of Africa. Each of these concepts of Africa is shown to be based on a particular logic with both strengths and weaknesses.

  15. SCWR Concept in Korea

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2014-08-15

    One of the major difficulties in the design of an SCWR is the additional neutron moderation in order to compensate the low coolant density in the later stage of coolant heat-up. The water rod concept was introduced as a simple method to provide additional moderation, however it may result in an inevitable complexity in the design of the reactor upper part. A solid moderator concept was introduced in the Korean SCWR to avoid this difficulty. A conceptual design of a 1400 MWe SCWR core with a cruciform type of U/ZrH{sub 2} solid moderator has been studied. The design features include a solid moderator design, an axial zoning of the burnable poison and fuel rod, a flow rate control by adjusting the orifice design, and a control rod design for an excess reactivity control. The maximum power peaking is 2.48 and the maximum coolant temperature is 577°C. Reactivity coefficients such as the moderator temperature coefficient and fuel temperature coefficient are negative for the whole burn-up period. At a cold zero power condition, the minimum shutdown margin is 1.16%Δρ at the beginning of a cycle, which satisfies the required shutdown margin limit. The concept described here should not be considered as a complete one, but a preliminary idea. It is solely based on information frozen at the time, and is subject to further improvement.

  16. 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.

  17. Indian mental concepts on children and adolescents.

    Science.gov (United States)

    Sitholey, Prabhat; Agarwal, Vivek; Vrat, Satya

    2013-01-01

    Ancient Indian mental concepts of children and adolescents are very similar to the contemporary modern concepts. The ancient concepts were based on a very positive regard for the children's development, education and future independence, adult role and contribution to society. Children were wanted and considered precious. The children were categorized in to 4 different varnas based on their intelligence, abilities, merit and aptitude and educated accordingly, away from their home, at Gurukuls. They had universal right to education. Girls received attention equal to boys. The boys were expected to earn their livelihood, while the girls were expected to be homemakers. Graduation of the young person at the end of education and return to home marked the emancipation from adolescence. Children's physical and mental health and its disorders were given due attention. Aetiology and treatment of physical and mental disorders was in accordance with the overall scientific development of those times.

  18. Novel concepts for CO2 capture

    International Nuclear Information System (INIS)

    Dijkstra, J.W.; Jansen, D.

    2004-01-01

    This paper describes the possibilities for power generation with CO 2 capture using envisaged key technologies: gas turbines, membranes and solid oxide fuel cells (SOFCs). First, the underlying programs in the Netherlands and at ECN are introduced. Then the key technologies are introduced, and concepts using these technologies are discussed. A literature overview of systems for power generation with fuel cells in combination with CO 2 capture is presented. Then a novel concept is introduced. This concept uses a water gas shift membrane reactor to convert the CO and H 2 in the SOFC anode off-gas to gain a CO 2 rich stream, which can be used for sequestration without elaborate treatment. Several implementation schemes of the technique are discussed such as atmospheric systems and hybrid SOFC-GT systems

  19. Space Mission Concept Development Using Concept Maturity Levels

    Science.gov (United States)

    Wessen, Randii R.; Borden, Chester; Ziemer, John; Kwok, Johnny

    2013-01-01

    Over the past five years, pre-project formulation experts at the Jet Propulsion Laboratory (JPL) has developed and implemented a method for measuring and communicating the maturity of space mission concepts. Mission concept development teams use this method, and associated tools, prior to concepts entering their Formulation Phases (Phase A/B). The organizing structure is Concept Maturity Level (CML), which is a classification system for characterizing the various levels of a concept's maturity. The key strength of CMLs is the ability to evolve mission concepts guided by an incremental set of assessment needs. The CML definitions have been expanded into a matrix form to identify the breadth and depth of analysis needed for a concept to reach a specific level of maturity. This matrix enables improved assessment and communication by addressing the fundamental dimensions (e.g., science objectives, mission design, technical risk, project organization, cost, export compliance, etc.) associated with mission concept evolution. JPL's collaborative engineering, dedicated concept development, and proposal teams all use these and other CML-appropriate design tools to advance their mission concept designs. This paper focuses on mission concept's early Pre-Phase A represented by CMLs 1- 4. The scope was limited due to the fact that CMLs 5 and 6 are already well defined based on the requirements documented in specific Announcement of Opportunities (AO) and Concept Study Report (CSR) guidelines, respectively, for competitive missions; and by NASA's Procedural Requirements NPR 7120.5E document for Projects in their Formulation Phase.

  20. 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…

  1. Concept caring in nursing

    Directory of Open Access Journals (Sweden)

    Lenka Drahošová

    2016-05-01

    Full Text Available 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 set criteria and defined key words for the period 1970-2015. Seven selected articles were analysed after selection of documents with the aid of a sorting chart. Results: Nurses understand caring in nursing as a relationship with patients which is characterised on the nurses' part by an individual and empathetic approach, attentiveness, experience and sensitivity. Through caring, active communication takes place, providing information which reduces anxiety and leads to the breaking down of barriers. This relationship helps protect patients' autonomy, dignity and comfort. It requires experience on the part of nurses, and it is influenced by the environment. The nurses' personal qualities (what professional knowledge, attitudes and skills they have and their availability, reliability, and emotional and physical support are important to patients. Conclusion: The concept of caring is a content specific interpersonal process which is characterized by the professional knowledge, skills, personal maturity, and interpersonal sensitivity of nurses, which result in the protection, emotional support, and the meeting of bio-psycho-social needs of patients. The results of the overview study could contribute to an explanation and understanding of the nature of caring as a fundamental feature of the discipline of nursing.

  2. SCWR Concepts in Japan

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2014-08-15

    Two SCWR concepts are being developed in Japan, one corresponding to the thermal spectrum reactor and the other to the fast spectrum reactor. Yamada et al. described the thermal-spectrum reactor concept referred to as the Japan SCWR (or JSCWR). This concept was developed under the financial support of the Ministry of Economy, Trade and Industry (METI). The basic philosophy of the JSCWR development is to utilize proven light water reactor and supercritical fossil-fired power plant technologies as much as possible to minimize the R&D cost, time and risks. Therefore, the JSCWR is designed as a thermal neutron spectrum reactor using light water as moderator and reactor coolant. The JSCWR plant consists of a pressure-vessel type, once-through reactor and a direct Rankine cycle system. Reactor coolant fed through inlet nozzles is heated up in the core and flows through outlet nozzles with no recirculation in the vessel. Other options to the JSCWR core design are being investigated at the University of Tokyo. The electric output of the JSCWR is assumed to range from 600 MWe to 1700 MWe class to fulfill user’s requirements as much as possible. In this section, the reference value is selected to 1725 MWe, which corresponds to a reactor thermal output of 4039 MWth. Nakatsuka et al. described the core design for the fast-spectrum reactor, which is based on a similar plant system compared to that of the thermal-spectrum reactor. The fast-spectrum reactor, however, would produce higher power rating than the thermal-spectrum one of the same reactor pressure-vessel size. Since the fast-spectrum reactor does not require the moderator, its unit capital cost would be lower than the thermal-spectrum reactor.

  3. 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

  4. 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

  5. The concept of probability

    International Nuclear Information System (INIS)

    Bitsakis, E.I.; Nicolaides, C.A.

    1989-01-01

    The concept of probability is now, and always has been, central to the debate on the interpretation of quantum mechanics. Furthermore, probability permeates all of science, as well as our every day life. The papers included in this volume, written by leading proponents of the ideas expressed, embrace a broad spectrum of thought and results: mathematical, physical epistemological, and experimental, both specific and general. The contributions are arranged in parts under the following headings: Following Schroedinger's thoughts; Probability and quantum mechanics; Aspects of the arguments on nonlocality; Bell's theorem and EPR correlations; Real or Gedanken experiments and their interpretation; Questions about irreversibility and stochasticity; and Epistemology, interpretation and culture. (author). refs.; figs.; tabs

  6. Simulation - Concepts and Applications

    Science.gov (United States)

    Silva, Pedro Sá; Trigo, António; Varajão, João; Pinto, Tiago

    Simulation in last decades has been widely used to analyze the impact of different scenarios in several areas like, for instance, health, military, business, and many others. When well used, it is an excellent tool to analyze alternative actions and to anticipate their impact, in order to rationalize the spending of resources. This paper introduces and resumes some of the main concepts of simulation, identifying and describing: systems; models; entities and attributes; resources; contexts of use; and, in particularly, the discrete-event simulation.

  7. 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.

  8. 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

  9. 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.

  10. 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

  11. Concepts of electrodynamics

    CERN Document Server

    Kumar, Vinay

    2016-01-01

    The present book entitled Concepts of Electrodynamics meets the demand of students of all engineering, graduate, honours and postgraduate courses in a single volume. This book covers all the topics on electrodynamics as per the new syllabus prescribed by UGC and AICTE and we do hope that this book will revive interest in the study of various topics on electrodynamics which will carries the reader to a high level of understanding. The text is enriched with a large number of solved examples apart from appropriate illustrations and examples in each chapter.

  12. Indian concepts on sexuality.

    Science.gov (United States)

    Chakraborty, Kaustav; Thakurata, Rajarshi Guha

    2013-01-01

    India is a vast country depicting wide social, cultural and sexual variations. Indian concept of sexuality has evolved over time and has been immensely influenced by various rulers and religions. Indian sexuality is manifested in our attire, behavior, recreation, literature, sculptures, scriptures, religion and sports. It has influenced the way we perceive our health, disease and device remedies for the same. In modern era, with rapid globalization the unique Indian sexuality is getting diffused. The time has come to rediscover ourselves in terms of sexuality to attain individual freedom and to reinvest our energy to social issues related to sexuality.

  13. 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.

  14. 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...

  15. Neuropathic pain - Current concepts

    African Journals Online (AJOL)

    Department of Family Medicine, University of Pretoria and Kalafong Hospital ... The aim of treatment is to assist the patient in managing the pain and to improve function ..... The incidence of true addiction to strong opioids in the management.

  16. Advanced microwave processing concepts

    Energy Technology Data Exchange (ETDEWEB)

    Lauf, R.J.; McMillan, A.D.; Paulauskas, F.L. [Oak Ridge National Laboratory, TN (United States)

    1995-05-01

    The purpose of this work is to explore the feasibility of several advanced microwave processing concepts to develop new energy-efficient materials and processes. The project includes two tasks: (1) commercialization of the variable-frequency microwave furnace; and (2) microwave curing of polymer composites. The variable frequency microwave furnace, whose initial conception and design was funded by the AIC Materials Program, will allow us, for the first time, to conduct microwave processing studies over a wide frequency range. This novel design uses a high-power traveling wave tube (TWT) originally developed for electronic warfare. By using this microwave source, one can not only select individual microwave frequencies for particular experiments, but also achieve uniform power densities over a large area by the superposition of many different frequencies. Microwave curing of thermoset resins will be studied because it hold the potential of in-situ curing of continuous-fiber composites for strong, lightweight components. Microwave heating can shorten curing times, provided issues of scaleup, uniformity, and thermal management can be adequately addressed.

  17. 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...

  18. ATR performance modeling concepts

    Science.gov (United States)

    Ross, Timothy D.; Baker, Hyatt B.; Nolan, Adam R.; McGinnis, Ryan E.; Paulson, Christopher R.

    2016-05-01

    Performance models are needed for automatic target recognition (ATR) development and use. ATRs consume sensor data and produce decisions about the scene observed. ATR performance models (APMs) on the other hand consume operating conditions (OCs) and produce probabilities about what the ATR will produce. APMs are needed for many modeling roles of many kinds of ATRs (each with different sensing modality and exploitation functionality combinations); moreover, there are different approaches to constructing the APMs. Therefore, although many APMs have been developed, there is rarely one that fits a particular need. Clarified APM concepts may allow us to recognize new uses of existing APMs and identify new APM technologies and components that better support coverage of the needed APMs. The concepts begin with thinking of ATRs as mapping OCs of the real scene (including the sensor data) to reports. An APM is then a mapping from explicit quantized OCs (represented with less resolution than the real OCs) and latent OC distributions to report distributions. The roles of APMs can be distinguished by the explicit OCs they consume. APMs used in simulations consume the true state that the ATR is attempting to report. APMs used online with the exploitation consume the sensor signal and derivatives, such as match scores. APMs used in sensor management consume neither of those, but estimate performance from other OCs. This paper will summarize the major building blocks for APMs, including knowledge sources, OC models, look-up tables, analytical and learned mappings, and tools for signal synthesis and exploitation.

  19. Borehole disposal design concept

    International Nuclear Information System (INIS)

    RANDRIAMAROLAHY, J.N.

    2007-01-01

    In Madagascar, the sealed radioactive sources are used in several socioeconomic sectors such as medicine, industry, research and agriculture. At the end of their useful lives, these radioactive sources become radioactive waste and can be still dangerous because they can cause harmful effects to the public and the environment. This work entitled 'Borehole disposal design concept' consists in putting in place a site of sure storage of the radioactive waste, in particular, sealed radioactive sources. Several technical aspects must be respected to carry out such a site like the geological, geomorphologic, hydrogeologic, geochemical, meteorological and demographic conditions. This type of storage is favorable for the developing countries because it is technologically simple and economic. The cost of construction depends on the volume of waste to store and the depth of the Borehole. The Borehole disposal concept provides a good level of safety to avoid the human intrusion. The future protection of the generations against the propagation of the radiations ionizing is then assured. [fr

  20. PRSEUS Structural Concept Development

    Science.gov (United States)

    Velicki, Alex; Jegley, Dawn

    2014-01-01

    A lighter, more robust airframe is one of the key technological advancements necessary for the successful launch of any large next-generation transport aircraft. Such a premise dictates that considerable improvements beyond current state-of-the-art aluminum structures is needed, and that improvements of this magnitude will require an extensive use of composite materials that are not only lightweight, but also economical to produce. To address this challenge, researchers at NASA and The Boeing Company are developing a novel structural concept called the Pultruded Rod Stitched Efficient Unitized Structure (PRSEUS) under the Environmentally Responsible Aviation (ERA) Project. It is an integrally stiffened panel concept that is stitched together and designed to maintain residual load-carrying capabilities under a variety of damage scenarios. In addition to improved structural performance, an important facet of this unique arrangement of stitched carbon fibers is its innovative manufacturing method that has the potential to lower fabrication costs by eliminating fasteners and autoclave cures. The rationale and development status for this new approach forms the basis of the work described in this paper. The test specimens described herein were fabricated, or are currently being fabricated, by The Boeing Company, while the structural analyses and testing tasks are being performed by NASA and Boeing personnel.

  1. The Concept of

    Directory of Open Access Journals (Sweden)

    ANCA VELICU

    2010-01-01

    Full Text Available The active publics issue and the question of the construction of publics are relatively recent in communication studies. After an initial period, when mass communication was seen as aiming at a holistic public, massified and passive and, thus, supposedly influenced via "targeted" messages, now the views on what "publics" mean is becoming diversified and nuanced under the influence of literary theories, cultural studies and what was later called "reception studies". Thus, from the "mass public" we got to the concept of "publics". However, in some recent studies, the mere existence of these publics is being questioned.In this paper, we detail the history of theories on the "public" - from the perspective of the public-as-spectator which later became public-as-audience and public-as-actor - and we set ourselves to show how, from theories on the re-active publics, we arrived, through the transformation of television and the emergence of the new IT&C, to the concept of publics as pro-active as a result of media efforts to build this activism.

  2. 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.

  3. Sellafield repository design concept

    International Nuclear Information System (INIS)

    1998-01-01

    Between 1989 and 1997, UK Nirex Ltd carried out a programme of investigations to evaluate the potential of a site adjacent to the BNFL Sellafield works to host a deep repository for the United Kingdom's intermediate-level and certain low-level radioactive waste. The programme of investigations was wound down following the decision in March 1997 to uphold the rejection of the Company's planning application for the Rock Characterisation Facility (RCF), an underground laboratory which would have allowed further investigations to confirm whether or not the site would be suitable. Since that time, the Company's efforts in relation to the Sellafield site have been directed towards documenting and publishing the work carried out. The design concept for a repository at Sellafield was developed in parallel with the site investigations through an iterative process as knowledge of the site and understanding of the repository system performance increased. This report documents the Sellafield repository design concept as it had been developed, from initial design considerations in 1991 up to the point when the RCF planning application was rejected. It shows, from the context of a project at that particular site, how much information and experience has been gained that will be applicable to the development of a deep waste repository at other potential sites

  4. The EXTRAP concept

    International Nuclear Information System (INIS)

    Lehnert, D.

    1976-11-01

    A review is given of a recently suggested axially symmetric, quasi-steady, closed, high-beta confinement system. A toroidal pinch of non-circular cross section is supposed to be immersed in the strong, inhomogenous poloidal vacuum field from a set of ring-shaped conductors, all carrying currents in the opposite direction of the plasma current. Preliminary experiments are reported. This 'EXTRAP' concept is expected to have some important advantages, as compared to magnetic bottles based on a main toroidal field component. Concerning plasma equilibrium, there are closed local and average guiding center orbits, beta values of order unity should become available, there is no magnetic surface splitting limit, cyclotron radiation should be kept at an acceptably low level, and bootstrap operation may become possible. Concerning plasma stability, the system should not become sensitive to magnetic island formation and asymmetries, and the short magnetic connection lengths as well as the strong vacuum field gradients should favour stabilization of flute-type, kink, and other magnetohydrodynamic modes. Concerning reactor technology, high power densities are expected to be reached, superconducting coils should not become necessary, the coil stresses are moderate, and repair and replacement are facilitated by the coil geometry. Before a final judgement can be made on this concept, however, extensive experiments and further theoretical analysis are ndeeded. (Auth.)

  5. Copies, Concepts and Time

    Directory of Open Access Journals (Sweden)

    Anne Eriksen

    2017-09-01

    Full Text Available Copies are defined by their relation to an original. The understanding and evaluation of this relationship has been changing over time. A main argument of this article is that originals and copies are phenomena with no "natural" or essential meaning outside of their specific historical settings. The idea to be explored is how changing historicity regimes have transformed notions of originals and copies over time and how these differences also are reflected in the intrinsically temporal relation between the two concepts. The discussion will be framed by two theory sets. The first is Alexander Nagel and Christopher Woods investigation of two kinds of temporality that vied for dominance in works of art in the late Middle Ages and the Renaissance. The second is Walter Benjamins discussion of artwork in the "age of mechanical reproduction", i.e. the twentieth century. The second half of the article seeks to add to the historical complexity described by both theory sets by introducing a concept of tradition and discussing the early modern ideals of exemplarity, emulation and copiousness.

  6. Concepts of magnetospheric convection

    International Nuclear Information System (INIS)

    Vasyliunas, V.M.

    1975-01-01

    Magnetospheric physics, which grew out of attempts to understand the space environment of the Earth, is becoming increasingly applicable to other systems in the Universe. Among the planets, in addition to the Earth, Jupiter, Mercury, Mars and (in a somewhat different way) Venus are now known to have magnetospheres. The magnetospheres of pulsars have been regarded as an essential part of the pulsar phenomenon. Other astrophysical systems, such as supernova remnant shells or magnetic stars and binary star systems, may be describable as magnetospheres. The major concepts of magnetospheric physics thus need to be formulated in a general way not restricted to the geophysical context in which they may have originated. Magnetospheric convection has been one of the most important and fruitful concepts in the study of the Earth's magnetosphere. This paper describes the basic theoretical notions of convection in a manner applicable to magnetospheres generally and discusses the relative importance of convective corotational motions, with particular reference to the comparison of the Earth and Jupiter. (Auth.)

  7. 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.

  8. Online Exhibits & Concept Maps

    Science.gov (United States)

    Douma, M.

    2009-12-01

    Presenting the complexity of geosciences to the public via the Internet poses a number of challenges. For example, utilizing various - and sometimes redundant - Web 2.0 tools can quickly devour limited time. Do you tweet? Do you write press releases? Do you create an exhibit or concept map? The presentation will provide participants with a context for utilizing Web 2.0 tools by briefly highlighting methods of online scientific communication across several dimensions. It will address issues of: * breadth and depth (e.g. from narrow topics to well-rounded views), * presentation methods (e.g. from text to multimedia, from momentary to enduring), * sources and audiences (e.g. for experts or for the public, content developed by producers to that developed by users), * content display (e.g. from linear to non-linear, from instructive to entertaining), * barriers to entry (e.g. from an incumbent advantage to neophyte accessible, from amateur to professional), * cost and reach (e.g. from cheap to expensive), and * impact (e.g. the amount learned, from anonymity to brand awareness). Against this backdrop, the presentation will provide an overview of two methods of online information dissemination, exhibits and concept maps, using the WebExhibits online museum (www.webexhibits.org) and SpicyNodes information visualization tool (www.spicynodes.org) as examples, with tips on how geoscientists can use either to communicate their science. Richly interactive online exhibits can serve to engage a large audience, appeal to visitors with multiple learning styles, prompt exploration and discovery, and present a topic’s breadth and depth. WebExhibits, which was among the first online museums, delivers interactive information, virtual experiments, and hands-on activities to the public. While large, multidisciplinary exhibits on topics like “Color Vision and Art” or “Calendars Through the Ages” require teams of scholars, user interface experts, professional writers and editors

  9. [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.

  10. Can We Feel Physics Concepts?

    Science.gov (United States)

    Su, Yucheng

    2010-01-01

    There are many ways to improve students' understanding of physics concepts. This article focused on drawing students' attention with picture-embedded questions. Pictures give students a direct impression or feeling about the corresponding concepts, which really makes a difference. However, the effects are limited. Some physics concepts are…

  11. 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…

  12. Disentangling The Thick Concept Argument

    DEFF Research Database (Denmark)

    Blomberg, Olle

    2007-01-01

    Critics argue that non-cognitivism cannot adequately account for the existence and nature of some thick moral concepts. They use the existence of thick concepts as a lever in an argument against non-cognitivism, here called the Thick Concept Argument (TCA). While TCA is frequently invoked...

  13. 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…

  14. 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

  15. 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

  16. COMPETING CONCEPTIONS OF GLOBALIZATION

    Directory of Open Access Journals (Sweden)

    Leslie Sklair

    2015-08-01

    Full Text Available Globalization is a relatively new idea in the social sciences, although people who work in and write about the mass media, transnational corporations and international business have been using it for some time. The purpose of this paper is to critically review the ways in which sociologists and other social scientists use ideas of globalization and to evaluate the fruitfulness of these competing conceptions. The central feature of the idea of globalization is that many contemporary problems cannot be adequately studied at the level of nation-states, that is, in terms of each country and its inter-national relations. Instead, they need to be conceptualized in terms of global processes. Some have even gone so far as to predict that global forces, by which they usually mean transnational corporations and other global economic institutions, global culture or globalizing belief systems/ideologies of various types, or a combination of all of these, are becoming so powerful that the continuing existence of the nation-state is in serious doubt. This is not a necessary consequence of most theories of globalization. The argument of this paper is that much of the globalization literature is confused because not all those who use the term distinguish it clearly enough from internation-alization, and some writers appear to use the two terms interchangeably. I argue that a clear distinction must be drawn between the inter-national and the global. The hyphen in inter-national is to distinguish (inadequate conceptions of the global' founded on the existing even if changing system of nation-states, from (genuine conceptions of the global based on the emergence of global processes and a global system of social relations not founded on national characteristics or nation-states. This global system theory is the framework for my own research. Globalization studies can be categorized on the basis of four research clusters:1. The world-systems approach; 2. The global

  17. 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.

  18. The concept of outcome.

    Science.gov (United States)

    Hunt, S

    1997-01-01

    The Enuresis Resource and Information Centre in the UK has recently launched a second edition of Guidelines on Minimum Standards of Practice in the Treatment of Enuresis. The purpose of the Guidelines is to provide a blueprint for service delivery in the UK, leading to enuresis services that offer effective, accessible and dependable treatment. In particular, these Guidelines propose minimum and target standards that enuresis services should aim to achieve, relating to referral, assessment and treatment, as well as catchment area appointments, research and referral. In addition, the Guidelines may be used to provide a framework within which enuresis services can be audited and evaluated. Successive cycles of observation, appraisal and action should encourage a continual improvement process in each clinic, resulting in a progressive development of the service offered.

  19. 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...

  20. 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.

  1. 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

  2. Football injuries: current concepts.

    Science.gov (United States)

    Olson, David E; Sikka, Robby Singh; Hamilton, Abigail; Krohn, Austin

    2011-01-01

    Football is one of the most popular sports in the United States and is the leading cause of sports-related injury. A large focus in recent years has been on concussions, sudden cardiac death, and heat illness, all thought to be largely preventable health issues in the young athlete. Injury prevention through better understanding of injury mechanisms, education, proper equipment, and practice techniques and preseason screening may aid in reducing the number of injuries. Proper management of on-field injuries and health emergencies can reduce the morbidity associated with these injuries and may lead to faster return to play and reduced risk of future injury. This article reviews current concepts surrounding frequently seen football-related injuries.

  3. 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.

  4. 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.

  5. 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.

  6. 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.

  7. 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

  8. Advocacy: exploring the concept.

    Science.gov (United States)

    Mardell, A

    1996-10-01

    The concept of the nurse as the patient's advocate is one that has become popular in the last fifteen years or so in both North America and the United Kingdom, having its basis in nursing theory. The UKCC first embraced the concept, stating in the Code of Professional Conduct that nurses must; 'act always in such a manner so as to promote and safeguard the interests and well being of patients and clients'. This is a laudable principle and one that nurses cannot dispute as there are many members of our society who are weak and vulnerable and may be unable to speak up for themselves. But are nurses always in a position to be an advocate for their patients? As the nature of nursing is so diverse then the nature of advocacy will be different in the multifarious settings in which nurses practise. Can theatre nurses ever be in a position to act as an advocate for a patient who is often anaesthetised? What precisely is advocacy and is the Concise Oxford Dictionary definition of 'one who pleads for another' appropriate in the nursing context? Then there is the position of nurses in the healthcare organisation in which they practise. In advocating for their patients, nurses may find they are pleading a case for a patient, or a group of patients, that could bring the nurse into conflict with their medical colleagues or with the management of the organisation by whom they are employed. Additionally, they may not posses the skills and knowledge to advocate effectively under such circumstances. Nursing is littered with the casualties of such conflicts over the years, the most publicised of whom, in the UK, was probably Graham Pink who lost his job as a charge nurse after drawing public attention to what he considered to be an unacceptable standard of care in the hospital in which he worked.

  9. 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.

  10. 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

  11. 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...

  12. 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…

  13. 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.

  14. The PHOENIX Concept

    International Nuclear Information System (INIS)

    Van Tuyle, G.J.; Takahashi, H.; Todosow, M.; Aronson, A.L.; Slovik, G.C.; Horak, W.C.

    1991-01-01

    A proposed means of transmuting key long-lived radioactive isotopes, primarily the so-called minor actinides (Np, Am, Cm), using a hybrid proton-accelerator-sub-critical lattice, is described. It is argued that by partitioning the components of the light water reactor (LWR) spent fuel and by transmuting key elements, such as the plutonium, the minor actinides, and a few of the long-lived fission products, that some of the most significant challenges in building a waste repository can be substantially reduced. If spent fuel partitioning and transmutation were fully implemented, the time required to reduce the waste stream toxicity below that of uranium ore would be reduced from more than 10,000 years to approximately 30 years. The proposed machine, based on the described PHOENIX Concept, would transmute the minor actinides and much of the iodine produced by 75 LWRs, and would generate usable electricity (beyond that required to run the large accelerator) of 850 MW e . 14 refs., 29 figs

  15. 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

  16. 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

  17. 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.

  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. Geological disposal concept hearings

    International Nuclear Information System (INIS)

    1996-01-01

    The article outlines the progress to date on AECL spent-nuclear fuel geological disposal concept. Hearings for discussion, organised by the federal Environmental Assessment Review Panel, of issues related to this type of disposal method occur in three phases, phase I focuses on broad societal issues related to long term management of nuclear fuel waste; phase II will focus on the technical aspects of this method of disposal; and phase III will consist of community visits in New Brunswick, Quebec, Ontario, Manitoba and Saskatchewan. This article provides the events surrounding the first two weeks of phase I hearings (extracted from UNECAN NEWS). In the first week of hearings, where submissions on general societal issues was the focus, there were 50 presentations including those by Natural Resources Canada, Energy Probe, Ontario Hydro, AECL, Canadian Nuclear Society, Aboriginal groups, environmental activist organizations (Northwatch, Saskatchewan Environmental Society, the Inter-Church Uranium Committee, and the Canadian Coalition for Nuclear responsibility). In the second week of hearings there was 33 presentations in which issues related to siting and implementation of a disposal facility was the focus. Phase II hearings dates are June 10-14, 17-21 and 27-28 in Toronto

  20. SCWR Concept in Russia

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2014-08-15

    An increase in the efficiency of NPPs with light-water reactors through ‘nuclear’ steam superheating was one of the problems solved in the field of nuclear power industry. The commissioning of the Beloyarsk NPP, Units 1&2 with the channel-type reactor in the sixties of the 20th century showed the potential of realization of this idea and the necessity to solve a series of problems in technology and materials science. The NPP operation experience, elaboration and operational experience of steam superheating channels are extremely important in choosing the ways of design development of Generation IV reactors with supercritical pressure coolant water. The first technical proposal on a supercritical water cooled reactor of vessel type made in Russia in 1986 was the design of a two-circuit reactor plant (RP). The concept of the two-circuit RP of integrated type VVER-SCP-I with electric power of 500 MW was proposed in 1990. The design activities on these projects were performed at OKB GIDROPRESS and the analyses were carried out at the RRC Kurchatov Institute. The State Science Center of the Russian Federation Institute of Physics and Power Engineering (SSC RF IPPE) has been performing the computational studies of a single-circuit RP VVER-SCP since 2001. In 2006 OKB GIDROPRESS launched the design effort and computational analyses to corroborate the design of a single loop RP.

  1. 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)

  2. [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.

  3. 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

  4. 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.

  5. 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.

  6. 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

  7. SCWR Concept in Canada

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2014-08-15

    AECL is designing the Canadian SCWR concept, which has evolved from the well-established pressuretube type CANDU® reactor. The Canadian SCWR is designed to produce electrical energy as the main product, plus process heat, hydrogen, industrial isotopes, and drinking water (through the desalination process) as supplementary products, all within a more compact reactor building. Another potential application of the available co-generated process heat is the extraction and refining of oil sands, which is presently achieved using co-generation with natural gas turbines and process heat. The extraction and upgrading process requires: thermal power to lower the viscosity and extract the oil; electric power for separation and refining equipment; and hydrogen gas for upgrading the oil product prior to transport. A National Program has been established in Canada to support R&D studies for the Canadian SCWR design. It covers key areas of interest (such as thermal hydraulics, safety, materials, and chemistry) to participants in the Generation-IV International Forum (GIF) SCWR designs. Results generated from the program are contributed to the GIF SCWR project management boards (PMBs). For example, heat transfer correlations have been derived using experimental data primarily obtained from fossil-plant related studies (which were started as early as 1930s. Materials and chemistry studies have evolved from operating experience of fossil-fired power plants to a) develop, and perform targeted testing of, materials for key components, in particular in-core reactor components that will be exposed to conditions not encountered in a fossil-fired boiler (such as irradiation and water radiolysis), and b) develop a suitable water chemistry to minimize corrosion and corrosion product transport.

  8. 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.

  9. 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.

  10. [Mass casualty incidents - current concepts and developments].

    Science.gov (United States)

    Savinsky, Godo; Stuhr, Markus; Kappus, Stefan; Trümpler, Stefan; Wenderoth, Stephan; Wohlers, Jan-Hauke; Paschen, Hans-Richard; Kerner, Thoralf

    2014-12-01

    Medical concepts and strategies are permanently changing. Due to the emergency response in a mass casualty incident everyone who is involved has to work together with different organisations and public authorities, which are not part of the regular emergency medical service. Within the last 25 years throughout the whole country of Germany the role of a "chief emergency physician" has been implemented and in preparation for the FIFA World Cup 2006 mobile treatment units were set up. In 2007, special units of the "Medical Task Force" - funded by the german state - were introduced and have been established by now. They will be a permanent part of regional plannings for mass casualty incidents. This article highlights current concepts and developments in different parts of Germany. © Georg Thieme Verlag Stuttgart · New York.

  11. Fourth Generation Reactor Concepts

    International Nuclear Information System (INIS)

    Furtek, A.

    2008-01-01

    Concerns over energy resources availability, climate changes and energy supply security suggest an important role for nuclear energy in future energy supplies. So far nuclear energy evolved through three generations and is still evolving into new generation that is now being extensively studied. Nuclear Power Plants are producing 16% of the world's electricity. Today the world is moving towards hydrogen economy. Nuclear technologies can provide energy to dissociate water into oxygen and hydrogen and to production of synthetic fuel from coal gasification. The introduction of breeder reactors would turn nuclear energy from depletable energy supply into an unlimited supply. From the early beginnings of nuclear energy in the 1940s to the present, three generations of nuclear power reactors have been developed: First generation reactors: introduced during the period 1950-1970. Second generation: includes commercial power reactors built during 1970-1990 (PWR, BWR, Candu, Russian RBMK and VVER). Third generation: started being deployed in the 1990s and is composed of Advanced LWR (ALWR), Advanced BWR (ABWR) and Passive AP600 to be deployed in 2010-2030. Future advances of the nuclear technology designs can broaden opportunities for use of nuclear energy. The fourth generation reactors are expected to be deployed by 2030 in time to replace ageing reactors built in the 1970s and 1980s. The new reactors are to be designed with a view of the following objectives: economic competitiveness, enhanced safety, minimal radioactive waste production, proliferation resistance. The Generation IV International Forum (GIF) was established in January 2000 to investigate innovative nuclear energy system concepts. GIF members include Argentina, Brazil, Canada, Euratom, France Japan, South Africa, South Korea, Switzerland, United Kingdom and United States with the IAEA and OECD's NEA as permanent observers. China and Russia are expected to join the GIF initiative. The following six systems

  12. COMET concept; COMET-Konzept

    Energy Technology Data Exchange (ETDEWEB)

    Alsmeyer, H.; Tromm, W.

    1995-08-01

    Studies of the COMET core catcher concept developed for a future PWR have been continued. The concept is based on the spreading of a core melt on a sacrificial layer and its erosion, until a subsequent addition of water from below causes a fragmentation of the melt. A porous solidification of the melt would then admit a complete flooding within a short period. (orig.)

  13. Science Club--A Concept

    Science.gov (United States)

    Wegner, Claas; Issak, Nicole; Tesch, Katharina; Zehne, Carolin

    2016-01-01

    The following article presents a concept of a science club which was developed by two master's students as a part of their thesis and which has been developed and improved ever since. The extra-curricular concept emphasises pupils' individuality through focusing on problem based leaning, station learning, and mixed age groups. Having joined the…

  14. Green economy and related concepts

    NARCIS (Netherlands)

    Loiseau, Eleonore; Saikku, Laura; Antikainen, Riina; Droste, Nils; Hansjürgens, Bernd; Pitkänen, Kati; Leskinen, Pekka; Kuikman, Peter; Thomsen, Marianne

    2016-01-01

    For the last ten years, the notion of a green economy has become increasingly attractive to policy makers. However, green economy covers a lot of diverse concepts and its links with sustainability are not always clear. In this article, we focus on definitions of green economy and related concepts

  15. Abstract concepts in grounded cognition

    NARCIS (Netherlands)

    Lakens, D.

    2010-01-01

    When people think about highly abstract concepts, they draw upon concrete experiences to structure their thoughts. For example, black knights in fairytales are evil, and knights in shining armor are good. The sensory experiences black and white are used to represent the abstract concepts of good and

  16. Zero energy Tunnel-concept

    NARCIS (Netherlands)

    Dzhusupova, R.

    2012-01-01

    Creating a zero energy environment is a hot topic. The developments in this field are based on the concept of the "Trias Energetica": reducing energy consumption, using renewable energy sources, and efficiently using fossil fuels. A zero energy concept can also be applied to road tunnels to improve

  17. A Chemistry Concept Reasoning Test

    Science.gov (United States)

    Cloonan, Carrie A.; Hutchinson, John S.

    2011-01-01

    A Chemistry Concept Reasoning Test was created and validated providing an easy-to-use tool for measuring conceptual understanding and critical scientific thinking of general chemistry models and theories. The test is designed to measure concept understanding comparable to that found in free-response questions requiring explanations over…

  18. Perceived parental efficacy: concept analysis.

    Science.gov (United States)

    Montigny, Francine; Lacharité, Carl

    2005-02-01

    This paper describes a concept analysis carried out to remove some of the ambiguity surrounding the conceptual meaning of perceived parental efficacy and to distinguish it from related concepts such as parental confidence and parental competence. Constructing parental efficacy is a crucial step for family members after the birth of their first child. For some authors, perceived parental efficacy is a motor for adequate parental practices. Confusion about the definition and measurement of this concept has hindered both psychology and nursing practice and research. Concept delineation and concept clarification are required in order to further the development of the concept of perceived parental efficacy. A literature search using a variety of online databases yielded 113 articles between the years 1980 and 2000. The final sample (n=60) consisted of 30 articles from two disciplines: nursing and psychology. A content analysis of the literature was done using Rodger's evolutionary concept analysis method. Content analysis of the literature yielded four contributors to perceived parental efficacy: positive enactive mastery experiences, vicarious experiences, verbal persuasion and an appropriate physiological and affective state. Perceived parental efficacy can thus be defined as 'beliefs or judgements a parent holds of their capabilities to organize and execute a set of tasks related to parenting a child'. This conceptual analysis has allowed perceived parental efficacy to be distinguished from parental confidence and parental competence. Both nursing and psychology research, practice and education will benefit from a more precise and delineated concept.

  19. Concept Maps in Introductory Statistics

    Science.gov (United States)

    Witmer, Jeffrey A.

    2016-01-01

    Concept maps are tools for organizing thoughts on the main ideas in a course. I present an example of a concept map that was created through the work of students in an introductory class and discuss major topics in statistics and relationships among them.

  20. Developing the Concept of Metalearning

    Science.gov (United States)

    Jackson, Norman

    2004-01-01

    The idea of metalearning was originally used by John Biggs (1985) to describe the state of 'being aware of and taking control of one's own learning'. This paper explores the concept through collaborative enquiry involving researchers and higher education teachers. An evolved conception is proposed in which metalearning is a subconcept within…

  1. The 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 exploits the inherent properties of liquid metal cooling and metallic fuel to achieve breakthroughs in economics and inherent safety. This paper describes the key features and potential advantages of the IFR concept, its technology development status, fuel cycle economics potential, and its future development path

  2. Intracranial atherosclerosis: current concepts.

    Science.gov (United States)

    Arenillas, Juan F

    2011-01-01

    The most relevant ideas discussed in this article are described here. Intracranial atherosclerotic disease (ICAD) represents the most common cause of ischemic stroke worldwide. Its importance in whites may have been underestimated. New technical developments, such as high-resolution MRI, allow direct assessment of the intracranial atherosclerotic plaque, which may have a profound impact on ICAD diagnosis and therapy in the near future. Early detection of ICAD may allow therapeutic intervention while the disease is still asymptomatic. The Barcelonès Nord and Maresme Asymptomatic Intracranial Atherosclerosis Study is presented here. The main prognostic factors that characterize the patients who are at a higher risk for ICAD recurrence are classified and discussed. The best treatment for ICAD remains to be established. The Stenting Versus Aggressive Medical Management for Preventing Recurrent Stroke in Intracranial Stenosis Study is currently ongoing to address this crucial issue. These and other topics will be discussed at the Fifth International Intracranial Atherosclerosis Conference (Valladolid, Spain, autumn 2011).

  3. Current Concepts of Bruxism.

    Science.gov (United States)

    Manfredini, Daniele; Serra-Negra, Junia; Carboncini, Fabio; Lobbezoo, Frank

    Bruxism is a common phenomenon, and emerging evidence suggests that biologic, psychologic, and exogenous factors have greater involvement than morphologic factors in its etiology. Diagnosis should adopt the grading system of possible, probable, and definite. In children, it could be a warning sign of certain psychologic disorders. The proposed mechanism for the bruxism-pain relationship at the individual level is that stress sensitivity and anxious personality traits may be responsible for bruxism activities that may lead to temporomandibular pain, which in turn is modulated by psychosocial factors. A multiple-P (plates, pep talk, psychology, pills) approach involving reversible treatments is recommended, and adult prosthodontic management should be based on a common-sense cautionary approach.

  4. Marijuana: Current concepts

    Directory of Open Access Journals (Sweden)

    Donald eGreydanus

    2013-10-01

    Full Text Available Marijuana (cannabis remains a controversial drug in the 21st century. This paper considers current research on use of Cannabis sativa and its constituents such as the cannabinoids. Topics reviewed include prevalence of cannabis use, other drugs consumed with pot, the endocannabinoid system, use of medicinal marijuana, medical adverse effects of cannabis, and psychiatric adverse effects of cannabis use. Treatment of cannabis withdrawal and dependence is difficult and remains mainly based on psychological therapy; current research on pharmacologic management of problems related to cannabis consumption is also considered. The potential role of specific cannabinoids for medical benefit will be revealed as the 21st century matures. However, potential dangerous adverse effects from smoking marijuana are well known and should be clearly taught to a public often confused by a media-driven, though false message and promise of benign pot consumption.

  5. Reactor concepts for laser fusion

    International Nuclear Information System (INIS)

    Meier, W.R.; Maniscalco, J.A.

    1977-07-01

    Scoping studies were initiated to identify attractive reactor concepts for producing electric power with laser fusion. Several exploratory reactor concepts were developed and are being subjected to our criteria for comparing long-range sources of electrical energy: abundance, social costs, technical feasibility, and economic competitiveness. The exploratory concepts include: a liquid-lithium-cooled stainless steel manifold, a gas-cooled graphite manifold, and fluidized wall concepts, such as a liquid lithium ''waterfall'', and a ceramic-lithium pellet ''waterfall''. Two of the major reactor vessel problems affecting the technical feasibility of a laser fusion power plant are: the effects of high-energy neutrons and cyclical stresses on the blanket structure and the effects of x-rays and debris from the fusion microexplosion on the first-wall. The liquid lithium ''waterfall'' concept is presented here in more detail as an approach which effectively deals with these damaging effects

  6. Health Habit: A Concept Analysis.

    Science.gov (United States)

    Opalinski, Andra S; Weglicki, Linda S; Gropper, Sareen S

    2018-01-01

    The aim of this article is to provide clarity of the concept of health habit. Using Walker and Avant's (1983; 2010) method for conducting a concept analysis, the authors identify the attributes and characteristics of health habit, its theoretical and practical application to nursing, and sample cases to further illustrate the concept. Empirical and conceptual literature was used to inform this concept analysis. Articles and one book from 1977 to 2014 were reviewed from PsycINFO, Medline, Cumulative Index to Nursing Health Literature (CINAHL), Science Direct, EBSCOhost and Web of Science. Offering a clear definition and conceptual model of health habit provide the foundation to identify/develop appropriate measures of the concept and guide further investigation of understanding the development and sustainability of healthy habits. Additional research is needed to test the conceptual relationships between health habits and outcome variables as they apply to different groups across the age continuum. © 2017 Wiley Periodicals, Inc.

  7. Ayurvedic concepts related to psychotherapy.

    Science.gov (United States)

    Behere, Prakash B; Das, Anweshak; Yadav, Richa; Behere, Aniruddh P

    2013-01-01

    The perfect balance of mind, body and soul is considered as complete health in Ayurveda. Ayurveda has its own identity as most ancient and traditional System of Medicine in India. Even Ayurveda emphasizes its treatment modalities into three parts viz. Satwawajay Chikitsa, Yuktivyapashray and Daivyapashray Chikitsa. Sattvavajaya therapy mentioned in Charakasamhita and it used as new concept of psychotherapy in Ayurveda. The effectiveness of "traditional mental health promoting practices" was identified as health regimens (swasthvrtt), correct behavior (sadvrtt), and yoga. Sattvavajaya as psychotherapy, is the mental restraint, or a "mind control" as referred by Caraka, is achieved through "spiritual knowledge, philosophy, fortitude, remembrance and concentration. Ayurvedic psychotherapy would play a dual role: First, as a revival of authentic medical culture, the exercise of a practice with an assumed primordial dimension, and second as a discovery of authentic subjectivity, the revelation of a self with an assumed interior depth. When we integrate the contemporary art of psychotherapy with the ancient science of Ayurveda, it becomes a powerful combination that is called Psycho Veda. The integration of Psycho and Veda is motivated by the complete integration of the immense but fairly contemporary view of the mind, emotions and psyche and how this performs in our lives. Integrating Psychotherapy and Vedic principles teaches us how to rediscover critical knowledge and awareness of the natural forces and rhythms that compliment and strengthen our human experience, through the understanding of the psyche and what our inner experiences are and also involving practical daily activities with thorough attention to our total environment to bring about radical changes in our mental outlook and in physical health.

  8. Tratamiento del concepto de valores humanos desde un enfoque de las ciencias de la educación A treatment of the concept of Human Values from a focus of the sciences of the education

    Directory of Open Access Journals (Sweden)

    Alberto Bujardón Mendoza

    2008-04-01

    Full Text Available El trabajo se centra en destacar la necesidad de la educación en valores, demuestra para poder desarrollar este proceso es imprescindible definir los valores humanos desde las perspectivas de la Ciencias de la Educación. En la bibliografía consultada la definición de los valores se hace desde un enfoque filosófico y de alli se simplifica hacía el objeto de cada una de las Ciencias de la Educación, es decir, la Didáctica, la Psico-pedagogía, la Sociología. Se destaca la necesidad de hacerlo desde las orientaciones metodológicas brindada por la Dialéctica Materialista y utilizando como instrumento la interdisciplinariedad, se trata como un proceso complejo y multidisciplinario, de la otra manera cada ciencia absolutiza su campo y mutila el proceso formativo. Se pretende brindar una serie de artículos que brinden elementos teóricos y metodológicos para el tratamiento del tema.The work is centered in highlighting the necessity of the education in values, but demonstrating that, to be able to develop this process, it is indispensable to define the human values from the perspectives of the Sciences of the Education. In the consulted bibliography, the definition of the values is made from a philosophical focus, and from there, it is simplified to the object of each of the sciences of the education, that is to say, the didactics, the psycho-pedagogy, the sociology, etc, but what is it about is of making it from the methodological orientations provided by the Materialistic Dialectics and using as an instrument the inter-disciplinarity, seeing it as a complex and multidisciplinary process; in the other way, each science absolutize its field and mutilates the formative process. We pretend to provide a series of articles that may offer theoretical-methodological elements for the treatment of the topic.

  9. Evolving Concepts of Asthma

    Science.gov (United States)

    Ray, Anuradha; Wenzel, Sally E.

    2015-01-01

    Our understanding of asthma has evolved over time from a singular disease to a complex of various phenotypes, with varied natural histories, physiologies, and responses to treatment. Early therapies treated most patients with asthma similarly, with bronchodilators and corticosteroids, but these therapies had varying degrees of success. Similarly, despite initial studies that identified an underlying type 2 inflammation in the airways of patients with asthma, biologic therapies targeted toward these type 2 pathways were unsuccessful in all patients. These observations led to increased interest in phenotyping asthma. Clinical approaches, both biased and later unbiased/statistical approaches to large asthma patient cohorts, identified a variety of patient characteristics, but they also consistently identified the importance of age of onset of disease and the presence of eosinophils in determining clinically relevant phenotypes. These paralleled molecular approaches to phenotyping that developed an understanding that not all patients share a type 2 inflammatory pattern. Using biomarkers to select patients with type 2 inflammation, repeated trials of biologics directed toward type 2 cytokine pathways saw newfound success, confirming the importance of phenotyping in asthma. Further research is needed to clarify additional clinical and molecular phenotypes, validate predictive biomarkers, and identify new areas for possible interventions. PMID:26161792

  10. [New concepts in hyperactive malarial splenomegaly].

    Science.gov (United States)

    Moraes, M F; Soares, M; Arroz, M J; Do Rosário, V E; Da Graça, J Pimenta; Abecasis, P

    2003-01-01

    Hyperreactive malarial splenomegaly is thought to represent an immunological dysfunction due to recurrent episodes of malaria. The authors present a case of hyperreactive malarial splenomegaly in a patient from São Tomé e Príncipe and discuss aspects of its differential diagnosis and treatment. A revision is made of recent concepts related to its pathogenesis and relationship with lymphoproliferative disorders. Malarial DNA was found in the absence of parasite forms in the peripheral blood. This may indicate that latent infection plays a role in its pathogenesis.

  11. The Concept of Respite Care.

    Science.gov (United States)

    Whitmore, Kim E

    2017-07-01

    The aim of this article is to analyze the concept of respite care in the context of caring for a child with special healthcare needs. Respite care has often been identified as an important resource for caregivers of children with special healthcare needs. It can help provide a break from the constant demands of caregiving. A concept analysis was conducted using an evolutionary approach. The data source for the concept analysis was a review of literature addressing respite care for caregivers of children with special healthcare needs. A review of the literature was conducted and a concept model was developed using an evolutionary approach. A theoretical definition of respite care is provided and the defining attributes, related concepts, antecedents, and consequences of respite care are shown in a diagram of the concept of respite care. The conceptual model provides a framework to help nurses better understand the concept of respite care in order to educate caregivers, provide appropriate referrals, serve as providers of respite care, and advocate for policy changes related to the provision of respite care services for caregivers of children with special healthcare needs. © 2016 Wiley Periodicals, Inc.

  12. Suicide Lethality: A Concept Analysis.

    Science.gov (United States)

    DeBastiani, Summer; De Santis, Joseph P

    2018-02-01

    Suicide is a significant health problem internationally. Those who complete suicide may have different behaviors and risk factors than those who attempt a non-fatal suicide. The purpose of this article is to analyze the concept of suicide lethality and propose a clear definition of the concept through the identification of antecedents, attributes, and consequences. A literature search for articles published in the English language between 1970 and 2016 was conducted using MEDLINE, the Cochrane Library, Pubmed, Psychlit, Ovid, PsycINFO, and Proquest. The bibliographies of all included studies were also reviewed to identify additional relevant citations. A concept analysis was conducted on the literature findings using six stages of Walker and Avant's method. The concept analysis differentiated between suicide, lethality, suicidal behavior, and suicide lethality. Presence of a suicide plan or a written suicide note was not found to be associated with the majority of completed suicides included in the definition of suicide lethality. There are a few scales that measure the lethality of a suicide attempt, but none that attempt to measure the concept of suicide lethality as described in this analysis. Clarifying the concept of suicide lethality encourages awareness of the possibility of different suicidal behaviors associated with different suicide outcomes and will inform the development of future nursing interventions. A clearer definition of the concept of suicide lethality will guide clinical practice, research, and policy development aimed at suicide prevention.

  13. ETHICAL FASHION CONCEPT AND DESIGNERS

    Directory of Open Access Journals (Sweden)

    Pinar GOKLUBERK OZLU

    2015-01-01

    Full Text Available Some problems like rapidly developing industrialization, irregular population growth, environmental pollution and to feel the impact of global warming as seriously, has been giving significant damage to the earth. People has realized that, after polluting to clean is harder than polluting of the measures to be taken before. And again people showed the sensitivity to the environment through different reactions and sanctions, took measures and created the new concepts about the enviroment. "Ethical Fashion" concept was created by the conscious and responsible individuals in the last two decades. However, that are being implemented as a concept is noticeable. Textile and fashion industry cover "Ethical Fashion"; ecological product, working conditions, fair trade and sustainable product are all in that concept. "Ethical Fashion" appeared and developed especially in United Kingdom, the USA and the other European countries. Nowadays, we may see a lot of textile and fashion designers, fabric and clothing collections, fairs and some specific courses at the universities about "Ethical Fashion". In this research contains "Ethical Fashion" concept, it's development processes and fashion designers who is working for this concept at the present time, also the main target is in this research, semtinizing "Ethical Fashion" concept.

  14. Concept mapping learning strategy to enhance students' mathematical connection ability

    Science.gov (United States)

    Hafiz, M.; Kadir, Fatra, Maifalinda

    2017-05-01

    The concept mapping learning strategy in teaching and learning mathematics has been investigated by numerous researchers. However, there are still less researchers who have scrutinized about the roles of map concept which is connected to the mathematical connection ability. Being well understood on map concept, it may help students to have ability to correlate one concept to other concept in order that the student can solve mathematical problems faced. The objective of this research was to describe the student's mathematical connection ability and to analyze the effect of using concept mapping learning strategy to the students' mathematical connection ability. This research was conducted at senior high school in Jakarta. The method used a quasi-experimental with randomized control group design with the total number was 72 students as the sample. Data obtained through using test in the post-test after giving the treatment. The results of the research are: 1) Students' mathematical connection ability has reached the good enough level category; 2) Students' mathematical connection ability who had taught with concept mapping learning strategy is higher than who had taught with conventional learning strategy. Based on the results above, it can be concluded that concept mapping learning strategycould enhance the students' mathematical connection ability, especially in trigonometry.

  15. Introductory remote sensing principles and concepts principles and concepts

    CERN Document Server

    Gibson, Paul

    2013-01-01

    Introduction to Remote Sensing Principles and Concepts provides a comprehensive student introduction to both the theory and application of remote sensing. This textbook* introduces the field of remote sensing and traces its historical development and evolution* presents detailed explanations of core remote sensing principles and concepts providing the theory required for a clear understanding of remotely sensed images.* describes important remote sensing platforms - including Landsat, SPOT and NOAA * examines and illustrates many of the applications of remotely sensed images in various fields.

  16. Software testing concepts and operations

    CERN Document Server

    Mili, Ali

    2015-01-01

    Explores and identifies the main issues, concepts, principles and evolution of software testing, including software quality engineering and testing concepts, test data generation, test deployment analysis, and software test managementThis book examines the principles, concepts, and processes that are fundamental to the software testing function. This book is divided into five broad parts. Part I introduces software testing in the broader context of software engineering and explores the qualities that testing aims to achieve or ascertain, as well as the lifecycle of software testing. Part II c

  17. An Introduction to Statistical Concepts

    CERN Document Server

    Lomax, Richard G

    2012-01-01

    This comprehensive, flexible text is used in both one- and two-semester courses to review introductory through intermediate statistics. Instructors select the topics that are most appropriate for their course. Its conceptual approach helps students more easily understand the concepts and interpret SPSS and research results. Key concepts are simply stated and occasionally reintroduced and related to one another for reinforcement. Numerous examples demonstrate their relevance. This edition features more explanation to increase understanding of the concepts. Only crucial equations are included. I

  18. The integral fast reactor concept

    International Nuclear Information System (INIS)

    Chang, Yoon I.; Marchaterre, J.F.

    1987-01-01

    The Integral Fast Reactor (IFR) is an innovative liquid metal reactor concept being developed at Argonne National Laboratory. It seeks to specifically exploit the inherent properties of liquid metal cooling and metallic fuel in a way that leads to substantial improvements in the characteristics of the complete reactor system. The IFR concept consists of four technical features: (1) liquid sodium cooling, (2) pool-type reactor configuration, (3) metallic fuel, and (4) an integral fuel cycle, based on pyrometallurgical processing and injection-cast fuel fabrication, with the fuel cycle facility collocated with the reactor, if so desired. This paper gives a review of the IFR concept

  19. The Concept "System of Philosophy"

    DEFF Research Database (Denmark)

    Catana, Leo

    2005-01-01

    of philosophy’ as a methodological tool in the history of philosophy. I shall argue that the interdisciplinary nature of much pre-modern philosophy makes Brucker’s methodological concept ‘system of philosophy’ inadequate, and that we may be better off leaving it behind in our future exploration of pre-modern......In this article I shall examine and discuss the concept ‘system of philosophy’ as a methodological tool in the history of philosophy. I shall do so in two moves. First I shall analyze the historical origin of the concept in the seventeenth and eighteenth centuries. Thereafter I shall undertake...... a discussion of its methodological weaknesses — a discussion, which is not only relevant to the writing of history of philosophy in the seventeenth and eighteenth centuries, but also to the writing of history of philosophy in our times, where the concept remains an important methodological tool. My first move...

  20. Alternative cask maintenance facility concepts

    International Nuclear Information System (INIS)

    Attaway, C.R.; Pope, R.B.; Wiliamson, A.C.; Medley, L.G.; Shappert, L.B.

    1992-01-01

    In this paper, the results of three trade-off studies of alternative concepts for performing cask maintenance for Civilian Radioactive Waste Management System casks are presented. An earlier study resulted in a recommendation that a submerged pool concept for cask internal component removal be used in the design of a Cask Maintenance Facility. The first trade-off study resulted in confirming the previous recommendation that a submerged pool concept be used rather than an isolation cell; the basis for this continued recommendation is discussed. The second study provides an evaluation of the previously proposed facility for the capability of handling an increased quantity of OCRWM casks. The third study provides a preliminary concept for adding the capability to repaint the exterior cylindrical portions of casks