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Sample records for unit dose factors

  1. Exposure Scenarios and Unit Dose Factors for the Hanford Immobilized Low Activity Tank Waste Performance Assessment

    Energy Technology Data Exchange (ETDEWEB)

    RITTMANN, P.D.

    1999-12-29

    Exposure scenarios are defined to identify potential pathways and combinations of pathways that could lead to radiation exposure from immobilized tank waste. Appropriate data and models are selected to permit calculation of dose factors for each exposure

  2. Effect of Dietary Intake of Stable Iodine on Dose-per-unit-intake Factors for 99Tc

    Energy Technology Data Exchange (ETDEWEB)

    Strom, Daniel J.

    2003-09-30

    of stable iodine in the diet on the dose per unit intake factors for 99Tc without developing an improved biokinetic model for technetium. Specific experiments should be designed to quantitatively evaluate 99TcO4? metabolism, excretion, and secretion, as well as to evaluate its chemical toxicity It is recommended that the ICRP reexamine its biokinetics models for Tc based on nuclear medicine data that have accumulated over the years. In particular, the ICRP ignores the lactation pathway, the enhanced concentration of Tc in breast and breast milk, and enhanced concentration of Tc (and I) in the salivary glands as well as in the thyroid. The ICRP should also explicitly incorporate the effect of stable iodine in the diet into both its models for iodine and technetium. The effect of concentration of Tc in breast milk needs further study for dosimetric implications to nursing infants whose mothers may ingest 99TcO4? from groundwater sources. The ICRP should also investigate the possibility of enhanced concentration of both I and Tc in the non-lactating female breast. To do these re-evaluations of biokinetic models, new experiments designed specifically to evaluate these questions concerning the biokinetics of Tc and I are needed.

  3. A comparison of dose and dose-rate conversion factors from the Soviet Union, United Kingdom, US Department of Energy, and the Idaho National Engineering Laboratory Fusion Safety Program

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    Rood, A.S.; Abbott, M.L.

    1991-12-01

    Several independent data sets of radiological dose and dose-rate conversion factors (DCF/DRCF) have been tabulated or developed by the international community both for fission and fusion safety purposes. This report compares sets from the US Department of Energy, the Soviet Union, and the United Kingdom with those calculated by the Idaho National Engineering Laboratory Fusion Safety Program. The objectives were to identify trends and potential outlying values for specific radionuclides and contribute to a future benchmark evaluation of the CARR computer code. Fifty-year committed effective dose equivalent factors were compared for the inhalation and ingestion pathways. External effective dose equivalent rates were compared for the air immersion and ground surface exposure pathways. Comparisons were made by dividing dose factors in the different data bases by the values in the FSP data base. Differences in DCF/DRCF values less than a factor of 2 were considered to be in good agreement and are likely due to the use of slightly different decay data, variations in the number of organs considered for calculating CEDE, and rounding errors. DCF/DRCF values that differed by greater than a factor of 10 were considered to be significant. These differences are attributed primarily to the use of different radionuclide decay data, selection and nomenclature for different isomeric states, treatment of progeny radionuclides, differences in calculational methodology, and assumptions on a radionuclide`s chemical form.

  4. A comparison of dose and dose-rate conversion factors from the Soviet Union, United Kingdom, US Department of Energy, and the Idaho National Engineering Laboratory Fusion Safety Program

    Energy Technology Data Exchange (ETDEWEB)

    Rood, A.S.; Abbott, M.L.

    1991-12-01

    Several independent data sets of radiological dose and dose-rate conversion factors (DCF/DRCF) have been tabulated or developed by the international community both for fission and fusion safety purposes. This report compares sets from the US Department of Energy, the Soviet Union, and the United Kingdom with those calculated by the Idaho National Engineering Laboratory Fusion Safety Program. The objectives were to identify trends and potential outlying values for specific radionuclides and contribute to a future benchmark evaluation of the CARR computer code. Fifty-year committed effective dose equivalent factors were compared for the inhalation and ingestion pathways. External effective dose equivalent rates were compared for the air immersion and ground surface exposure pathways. Comparisons were made by dividing dose factors in the different data bases by the values in the FSP data base. Differences in DCF/DRCF values less than a factor of 2 were considered to be in good agreement and are likely due to the use of slightly different decay data, variations in the number of organs considered for calculating CEDE, and rounding errors. DCF/DRCF values that differed by greater than a factor of 10 were considered to be significant. These differences are attributed primarily to the use of different radionuclide decay data, selection and nomenclature for different isomeric states, treatment of progeny radionuclides, differences in calculational methodology, and assumptions on a radionuclide's chemical form.

  5. Topology optimization of inertia driven dosing units

    DEFF Research Database (Denmark)

    Andreasen, Casper Schousboe

    2016-01-01

    This paper presents a methodology for optimizing inertia driven dosing units, sometimes referred to as eductors, for use in small scale flow applications. The unit is assumed to operate at low to moderate Reynolds numbers and under steady state conditions. By applying topology optimization...

  6. Charpak, Garwin, propose unit for radiation dose

    CERN Multimedia

    Feder, Toni

    2002-01-01

    Becquerels, curries, grays, rads, rems, roentgens, sieverts - even for specialists the units of radiation can get confusing. That's why two eminent physicists, Georges Charpak of France, and Richard Garwin, are proposing the DARI as a unit of radiation dose they hope will help the public evaluate the risks associated with low-level radiation exposure (1 page)

  7. Estimation of the Dose and Dose Rate Effectiveness Factor

    Science.gov (United States)

    Chappell, L.; Cucinotta, F. A.

    2013-01-01

    Current models to estimate radiation risk use the Life Span Study (LSS) cohort that received high doses and high dose rates of radiation. Transferring risks from these high dose rates to the low doses and dose rates received by astronauts in space is a source of uncertainty in our risk calculations. The solid cancer models recommended by BEIR VII [1], UNSCEAR [2], and Preston et al [3] is fitted adequately by a linear dose response model, which implies that low doses and dose rates would be estimated the same as high doses and dose rates. However animal and cell experiments imply there should be curvature in the dose response curve for tumor induction. Furthermore animal experiments that directly compare acute to chronic exposures show lower increases in tumor induction than acute exposures. A dose and dose rate effectiveness factor (DDREF) has been estimated and applied to transfer risks from the high doses and dose rates of the LSS cohort to low doses and dose rates such as from missions in space. The BEIR VII committee [1] combined DDREF estimates using the LSS cohort and animal experiments using Bayesian methods for their recommendation for a DDREF value of 1.5 with uncertainty. We reexamined the animal data considered by BEIR VII and included more animal data and human chromosome aberration data to improve the estimate for DDREF. Several experiments chosen by BEIR VII were deemed inappropriate for application to human risk models of solid cancer risk. Animal tumor experiments performed by Ullrich et al [4], Alpen et al [5], and Grahn et al [6] were analyzed to estimate the DDREF. Human chromosome aberration experiments performed on a sample of astronauts within NASA were also available to estimate the DDREF. The LSS cohort results reported by BEIR VII were combined with the new radiobiology results using Bayesian methods.

  8. Effective dose from direct and indirect digital panoramic units

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    Lee, Gun Sun; Kim, Jin Soo; Seo, Yo Seob; Kim, Jae Duk [School of Dentistry, Oral Biology Research Institute, Chosun University, Gwangju (Korea, Republic of)

    2013-06-15

    This study aimed to provide comparative measurements of the effective dose from direct and indirect digital panoramic units according to phantoms and exposure parameters. Dose measurements were carried out using a head phantom representing an average man (175 cm tall, 73.5 kg male) and a limbless whole body phantom representing an average woman (155 cm tall, 50 kg female). Lithium fluoride thermoluminescent dosimeter (TLD) chips were used for the dosimeter. Two direct and 2 indirect digital panoramic units were evaluated in this study. Effective doses were derived using 2007 International Commission on Radiological Protection (ICRP) recommendations. The effective doses of the 4 digital panoramic units ranged between 8.9 {mu}Sv and 37.8 {mu}Sv. By using the head phantom, the effective doses from the direct digital panoramic units (37.8 {mu}Sv, 27.6 {mu}Sv) were higher than those from the indirect units (8.9 {mu}Sv, 15.9 {mu}Sv). The same panoramic unit showed the difference in effective doses according to the gender of the phantom, numbers and locations of TLDs, and kVp. To reasonably assess the radiation risk from various dental radiographic units, the effective doses should be obtained with the same numbers and locations of TLDs, and with standard hospital exposure. After that, it is necessary to survey the effective doses from various dental radiographic units according to the gender with the corresponding phantom.

  9. Effective dose from direct and indirect digital panoramic units.

    Science.gov (United States)

    Lee, Gun-Sun; Kim, Jin-Soo; Seo, Yo-Seob; Kim, Jae-Duk

    2013-06-01

    This study aimed to provide comparative measurements of the effective dose from direct and indirect digital panoramic units according to phantoms and exposure parameters. Dose measurements were carried out using a head phantom representing an average man (175 cm tall, 73.5 kg male) and a limbless whole body phantom representing an average woman (155 cm tall, 50 kg female). Lithium fluoride thermoluminescent dosimeter (TLD) chips were used for the dosimeter. Two direct and 2 indirect digital panoramic units were evaluated in this study. Effective doses were derived using 2007 International Commission on Radiological Protection (ICRP) recommendations. The effective doses of the 4 digital panoramic units ranged between 8.9 µSv and 37.8 µSv. By using the head phantom, the effective doses from the direct digital panoramic units (37.8 µSv, 27.6 µSv) were higher than those from the indirect units (8.9 µSv, 15.9 µSv). The same panoramic unit showed the difference in effective doses according to the gender of the phantom, numbers and locations of TLDs, and kVp. To reasonably assess the radiation risk from various dental radiographic units, the effective doses should be obtained with the same numbers and locations of TLDs, and with standard hospital exposure. After that, it is necessary to survey the effective doses from various dental radiographic units according to the gender with the corresponding phantom.

  10. Patient factors that influence warfarin dose response.

    Science.gov (United States)

    White, Pamela J

    2010-06-01

    Warfarin has long been the mainstay of oral anticoagulation therapy for the treatment and prevention of venous and arterial thrombosis. The narrow therapeutic index of warfarin, and the complex number of factors that influence international normalized ratio (INR) response, makes optimization of warfarin therapy challenging. Determination of the appropriate warfarin dose during initiation and maintenance therapy requires an understanding of patient factors that influence dose response: age, body weight, nutritional status, acute and chronic disease states, and changes in concomitant drug therapy and diet. This review will examine specific clinical factors that can affect the pharmacokinetics and pharmacodynamics of warfarin, as well as the role of pharmacogenetics in optimizing warfarin therapy.

  11. Factors for converting dose measured in polystyrene phantoms to dose reported in water phantoms for incident proton beams

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    Moyers, M. F.; Vatnitsky, A. S.; Vatnitsky, S. M. [Loma Linda University Medical Center, Loma Linda, California 92354 (United States); Guthrie Clinic/Robert Packard Hospital, Sayre, Pennsylvania 18840 (United States); EBG MedAustron, Wiener Neustadt, Austria A2700 (Austria)

    2011-10-15

    Purpose: Previous dosimetry protocols allowed calibrations of proton beamline dose monitors to be performed in plastic phantoms. Nevertheless, dose determinations were referenced to absorbed dose-to-muscle or absorbed dose-to-water. The IAEA Code of Practice TRS 398 recommended that dose calibrations be performed with ionization chambers only in water phantoms because plastic-to-water dose conversion factors were not available with sufficient accuracy at the time of its writing. These factors are necessary, however, to evaluate the difference in doses delivered to patients if switching from calibration in plastic to a protocol that only allows calibration in water. Methods: This work measured polystyrene-to-water dose conversion factors for this purpose. Uncertainties in the results due to temperature, geometry, and chamber effects were minimized by using special experimental set-up procedures. The measurements were validated by Monte Carlo simulations. Results: At the peak of non-range-modulated beams, measured polystyrene-to-water factors ranged from 1.015 to 1.024 for beams with ranges from 36 to 315 mm. For beams with the same ranges and medium sized modulations, the factors ranged from 1.005 to 1.019. The measured results were used to generate tables of polystyrene-to-water dose conversion factors. Conclusions: The dose conversion factors can be used at clinical proton facilities to support beamline and patient specific dose per monitor unit calibrations performed in polystyrene phantoms.

  12. Using hospital pharmacy technicians to check unit dose carts.

    Science.gov (United States)

    Spooner, S H; Emerson, P K

    1994-05-01

    This study was undertaken to evaluate the accuracy of technicians checking unit dose carts as compared with pharmacists checking unit dose carts. The final (after check) fill in both arms of the study was evaluated for accuracy on the same five criteria: 1) correct drug, 2) correct dose, 3) correct dosage form, 4) correct quantity, and 5) expiration date. In the technician arm, 7571 doses were checked with 10 errors, giving a 99.76% (1 error in 420) accuracy. In the pharmacist arm of the study, 3116 doses were checked with 34 total errors, giving a 98.91% (1 error in 92) accuracy. The results of this study indicate that technicians would have as high if not a higher accuracy rate than pharmacists. Using pharmacy technicians in this role should continue the same level of care by maintaining a high accuracy in medication dispensing and provide greater economic benefit to the organization by using technical rather than professional personnel.

  13. Effective dose from direct and indirect digital panoramic units

    OpenAIRE

    Lee, Gun-Sun; Kim, Jin-Soo; Seo, Yo-Seob; Kim, Jae-Duk

    2013-01-01

    Purpose This study aimed to provide comparative measurements of the effective dose from direct and indirect digital panoramic units according to phantoms and exposure parameters. Materials and Methods Dose measurements were carried out using a head phantom representing an average man (175 cm tall, 73.5 kg male) and a limbless whole body phantom representing an average woman (155 cm tall, 50 kg female). Lithium fluoride thermoluminescent dosimeter (TLD) chips were used for the dosimeter. Two d...

  14. Nominal Performance Biosphere Dose Conversion Factor Analysis

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    M.A. Wasiolek

    2005-04-28

    This analysis report is one of the technical reports containing documentation of the Environmental Radiation Model for Yucca Mountain, Nevada (ERMYN), a biosphere model supporting the Total System Performance Assessment (TSPA) for the license application (LA) for the Yucca Mountain repository. This analysis report describes the development of biosphere dose conversion factors (BDCFs) for the groundwater exposure scenario, and the development of conversion factors for assessing compliance with the groundwater protection standards. A graphical representation of the documentation hierarchy for the ERMYN is presented in Figure 1-1. This figure shows the interrelationships among the products (i.e., analysis and model reports) developed for biosphere modeling and provides an understanding of how this analysis report contributes to biosphere modeling. This report is one of two reports that develop BDCFs, which are input parameters for the TSPA-LA model. The ''Biosphere Model Report'' (BSC 2004 [DIRS 169460]) describes in detail the ERMYN conceptual model and mathematical model. The input parameter reports, shown to the right of the ''Biosphere Model Report'' in Figure 1-1, contain detailed description of the model input parameters, their development, and the relationship between the parameters and specific features events and processes (FEPs). This report describes biosphere model calculations and their output, the BDCFs, for the groundwater exposure scenario. This analysis receives direct input from the outputs of the ''Biosphere Model Report'' (BSC 2004 [DIRS 169460]) and the five analyses that develop parameter values for the biosphere model (BSC 2005 [DIRS 172827]; BSC 2004 [DIRS 169672]; BSC 2004 [DIRS 169673]; BSC 2004 [DIRS 169458]; BSC 2004 [DIRS 169459]). The results of this report are further analyzed in the ''Biosphere Dose Conversion Factor Importance and Sensitivity Analysis

  15. Disruptive Event Biosphere Dose Conversion Factor Analysis

    Energy Technology Data Exchange (ETDEWEB)

    M. Wasiolek

    2004-09-08

    This analysis report is one of the technical reports containing documentation of the Environmental Radiation Model for Yucca Mountain, Nevada (ERMYN), a biosphere model supporting the total system performance assessment (TSPA) for the license application (LA) for the Yucca Mountain repository. This analysis report describes the development of biosphere dose conversion factors (BDCFs) for the volcanic ash exposure scenario, and the development of dose factors for calculating inhalation dose during volcanic eruption. A graphical representation of the documentation hierarchy for the ERMYN is presented in Figure 1-1. This figure shows the interrelationships among the products (i.e., analysis and model reports) developed for biosphere modeling and provides an understanding of how this analysis report contributes to biosphere modeling. This report is one of two reports that develop biosphere BDCFs, which are input parameters for the TSPA model. The ''Biosphere Model Report'' (BSC 2004 [DIRS 169460]) describes in detail the ERMYN conceptual model and mathematical model. The input parameter reports, shown to the right of the Biosphere Model Report in Figure 1-1, contain detailed descriptions of the model input parameters, their development and the relationship between the parameters and specific features, events and processes (FEPs). This report describes biosphere model calculations and their output, the BDCFs, for the volcanic ash exposure scenario. This analysis receives direct input from the outputs of the ''Biosphere Model Report'' (BSC 2004 [DIRS 169460]) and from the five analyses that develop parameter values for the biosphere model (BSC 2004 [DIRS 169671]; BSC 2004 [DIRS 169672]; BSC 2004 [DIRS 169673]; BSC 2004 [DIRS 169458]; and BSC 2004 [DIRS 169459]). The results of this report are further analyzed in the ''Biosphere Dose Conversion Factor Importance and Sensitivity Analysis''. The objective of this

  16. Nominal Performance Biosphere Dose Conversion Factor Analysis

    Energy Technology Data Exchange (ETDEWEB)

    M. Wasiolek

    2000-12-21

    The purpose of this report was to document the process leading to development of the Biosphere Dose Conversion Factors (BDCFs) for the postclosure nominal performance of the potential repository at Yucca Mountain. BDCF calculations concerned twenty-four radionuclides. This selection included sixteen radionuclides that may be significant nominal performance dose contributors during the compliance period of up to 10,000 years, five additional radionuclides of importance for up to 1 million years postclosure, and three relatively short-lived radionuclides important for the human intrusion scenario. Consideration of radionuclide buildup in soil caused by previous irrigation with contaminated groundwater was taken into account in the BDCF development. The effect of climate evolution, from the current arid conditions to a wetter and cooler climate, on the BDCF values was evaluated. The analysis included consideration of different exposure pathway's contribution to the BDCFs. Calculations of nominal performance BDCFs used the GENII-S computer code in a series of probabilistic realizations to propagate the uncertainties of input parameters into the output. BDCFs for the nominal performance, when combined with the concentrations of radionuclides in groundwater allow calculation of potential radiation doses to the receptor of interest. Calculated estimates of radionuclide concentration in groundwater result from the saturated zone modeling. The integration of the biosphere modeling results (BDCFs) with the outcomes of the other component models is accomplished in the Total System Performance Assessment (TSPA) to calculate doses to the receptor of interest from radionuclides postulated to be released to the environment from the potential repository at Yucca Mountain.

  17. Unit of measurement used and parent medication dosing errors.

    Science.gov (United States)

    Yin, H Shonna; Dreyer, Benard P; Ugboaja, Donna C; Sanchez, Dayana C; Paul, Ian M; Moreira, Hannah A; Rodriguez, Luis; Mendelsohn, Alan L

    2014-08-01

    Adopting the milliliter as the preferred unit of measurement has been suggested as a strategy to improve the clarity of medication instructions; teaspoon and tablespoon units may inadvertently endorse nonstandard kitchen spoon use. We examined the association between unit used and parent medication errors and whether nonstandard instruments mediate this relationship. Cross-sectional analysis of baseline data from a larger study of provider communication and medication errors. English- or Spanish-speaking parents (n = 287) whose children were prescribed liquid medications in 2 emergency departments were enrolled. Medication error defined as: error in knowledge of prescribed dose, error in observed dose measurement (compared to intended or prescribed dose); >20% deviation threshold for error. Multiple logistic regression performed adjusting for parent age, language, country, race/ethnicity, socioeconomic status, education, health literacy (Short Test of Functional Health Literacy in Adults); child age, chronic disease; site. Medication errors were common: 39.4% of parents made an error in measurement of the intended dose, 41.1% made an error in the prescribed dose. Furthermore, 16.7% used a nonstandard instrument. Compared with parents who used milliliter-only, parents who used teaspoon or tablespoon units had twice the odds of making an error with the intended (42.5% vs 27.6%, P = .02; adjusted odds ratio=2.3; 95% confidence interval, 1.2-4.4) and prescribed (45.1% vs 31.4%, P = .04; adjusted odds ratio=1.9; 95% confidence interval, 1.03-3.5) dose; associations greater for parents with low health literacy and non-English speakers. Nonstandard instrument use partially mediated teaspoon and tablespoon-associated measurement errors. Findings support a milliliter-only standard to reduce medication errors. Copyright © 2014 by the American Academy of Pediatrics.

  18. Nominal Performance Biosphere Dose Conversion Factor Analysis

    Energy Technology Data Exchange (ETDEWEB)

    M. Wasiolek

    2004-09-08

    This analysis report is one of the technical reports containing documentation of the Environmental Radiation Model for Yucca Mountain, Nevada (ERMYN), a biosphere model supporting the Total System Performance Assessment (TSPA) for the license application (LA) for the Yucca Mountain repository. This analysis report describes the development of biosphere dose conversion factors (BDCFs) for the groundwater exposure scenario, and the development of conversion factors for assessing compliance with the groundwater protection standard. A graphical representation of the documentation hierarchy for the ERMYN is presented in Figure 1-1. This figure shows the interrelationships among the products (i.e., analysis and model reports) developed for biosphere modeling and provides an understanding of how this analysis report contributes to biosphere modeling. This report is one of two reports that develop biosphere BDCFs, which are input parameters for the TSPA-LA model. The ''Biosphere Model Report'' (BSC 2004 [DIRS 169460]) describes in detail the ERMYN conceptual model and mathematical model. The input parameter reports, shown to the right of the ''Biosphere Model Report'' in Figure 1-1, contain detailed description of the model input parameters, their development, and the relationship between the parameters and specific features events and processes (FEPs). This report describes biosphere model calculations and their output, the BDCFs, for the groundwater exposure scenario. The objectives of this analysis are to develop BDCFs for the groundwater exposure scenario for the three climate states considered in the TSPA-LA as well as conversion factors for evaluating compliance with the groundwater protection standard. The BDCFs will be used in performance assessment for calculating all-pathway annual doses for a given concentration of radionuclides in groundwater. The conversion factors will be used for calculating gross alpha particle

  19. Development of Landscape Dose Factors for dose assessments in SR-Can

    Energy Technology Data Exchange (ETDEWEB)

    Avila, Rodolfo; Ekstroem, Per-Anders [Facilia AB, Bromma (Sweden); Kautsky, Ulrik [Swedish Nuclear Fuel and Waste Management Co., Stockholm (Sweden)

    2006-08-15

    In previous safety assessments Ecosystem Dose Factors (EDFs), were derived from estimates of doses to the most exposed group resulting from constant unit radionuclide release rates over 10,000 years to various ecosystem types, e.g. mires, agricultural lands, lakes and marine ecosystems. A number of limitations of the EDF approach have been identified. The objectives of this report is to further develop the EDF approach, in order to resolve the identified limitations, and to use the improved approach for deriving Dose Conversion Factors for use in the SR-Can risk assessments. The Dose Conversion Factors derived in this report are named Landscape Dose Factors (LDFs). It involves modelling the fate of the radionuclides in the whole landscape, which develops from a sea to a inland situation during 20,000 years. Both candidate sites studies in SR-Can, Forsmark and Laxemar, are included in the study. As a basis for the modelling, the period starting at the beginning of the last interglacial (8,000 BC) is used, over which releases from a hypothetical repository were assumed to take place. For the present temperate period, the overall development of the biosphere at each site is outlined in a 1,000 year perspective and beyond, essentially based on the ongoing shoreline displacement and the understanding on the impact this has on the biosphere. The past development, i.e. from deglaciation to the present time, is inferred from geological records and associated reconstructions of the shore-line. For each time step of 1,000 years, the landscape at the site is described as a number of interconnected biosphere objects constituting an integrated landscape model of each site. The water fluxes through the objects were estimated from the average run-off at the site, the areas of the objects and their associated catchment areas. Radionuclides in both dissolved and particulate forms were considered in the transport calculations. The transformation between ecosystems was modelled as

  20. Enhanced Engraftment of a Very Low-Dose Cord Blood Unit in an Adult Haemopoietic Transplant by Addition of Six Mismatched Viable Cord Units

    Directory of Open Access Journals (Sweden)

    Stephen J. Proctor

    2010-01-01

    , supported by six mismatched cord blood units (one unit per 10 kg recipient weight. No adverse reaction occurred following the infusion of mismatched units and engraftment of the suboptimal-dose matched unit occurred rapidly, with no molecular evidence of engraftment of mismatched cords. Early molecular remission of ALL was demonstrated using a novel PCR for a mitochondrial DNA mutation in the leukaemic clone. The cell dose of the matched cord was well below that recommended to engraft a 70 kg recipient. We suggest that a factor or factors in the mismatched cords enhanced/supported engraftment of the matched cord.

  1. Dose and Dose-Rate Effectiveness Factor (DDREF); Der Dosis- und Dosisleistungs-Effektivitaetsfaktor (DDREF)

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    Breckow, Joachim [Fachhochschule Giessen-Friedberg, Giessen (Germany). Inst. fuer Medizinische Physik und Strahlenschutz

    2016-08-01

    For practical radiation protection purposes it is supposed that stochastic radiation effects a determined by a proportional dose relation (LNT). Radiobiological and radiation epidemiological studies indicated that in the low dose range a dependence on dose rates might exist. This would trigger an overestimation of radiation risks based on the LNT model. OCRP had recommended a concept to combine all effects in a single factor DDREF (dose and dose-Rate effectiveness factor). There is still too low information on cellular mechanisms of low dose irradiation including possible repair and other processes. The Strahlenschutzkommission cannot identify a sufficient scientific justification for DDREF and recommends an adaption to the actual state of science.

  2. External dose-rate conversion factors for calculation of dose to the public

    Energy Technology Data Exchange (ETDEWEB)

    1988-07-01

    This report presents a tabulation of dose-rate conversion factors for external exposure to photons and electrons emitted by radionuclides in the environment. This report was prepared in conjunction with criteria for limiting dose equivalents to members of the public from operations of the US Department of Energy (DOE). The dose-rate conversion factors are provided for use by the DOE and its contractors in performing calculations of external dose equivalents to members of the public. The dose-rate conversion factors for external exposure to photons and electrons presented in this report are based on a methodology developed at Oak Ridge National Laboratory. However, some adjustments of the previously documented methodology have been made in obtaining the dose-rate conversion factors in this report. 42 refs., 1 fig., 4 tabs.

  3. Calculation of dose conversion factors for thoron decay products

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, Tetsuo [National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555 (Japan); Tokonami, Shinji [National Institute of Radiological Sciences, 4-9-1 Anagawa, Inage-ku, Chiba, 263-8555 (Japan); Nemeth, Csaba [Pannon University, 10 Egyetem St, 8201 Veszprem (Hungary)

    2007-12-15

    The dose conversion factors for short-lived thoron decay products were calculated using a dosimetric approach. The calculations were based on a computer program LUDEP, which implements the ICRP 66 respiratory tract model. The dose per equilibrium equivalent concentration for thoron (EETC) was calculated with respect to (1) equivalent dose to each region of the lung tissues (bronchial, bronchiolar and alveolar), (2) weighted equivalent dose to organs other than lung, and (3) effective dose. The calculations indicated that (1) the most exposed region of the lung tissues was the bronchial for the unattached fraction and the bronchiolar for the attached fraction, (2) the effective dose is dominated by the contribution of lung dose, and (3) the effective dose per EETC was about four times larger than the effective dose per equilibrium equivalent concentration for radon (EERC). The calculated dose conversion factors were applied to the comparative dosimetry for some thoron-enhanced areas where the EERC and EETC have been measured. In the case of a spa in Japan, the dose from thoron decay products was larger than the dose from radon decay products.

  4. Calculation of dose conversion factors for thoron decay products.

    Science.gov (United States)

    Ishikawa, Tetsuo; Tokonami, Shinji; Nemeth, Csaba

    2007-12-01

    The dose conversion factors for short-lived thoron decay products were calculated using a dosimetric approach. The calculations were based on a computer program LUDEP, which implements the ICRP 66 respiratory tract model. The dose per equilibrium equivalent concentration for thoron (EETC) was calculated with respect to (1) equivalent dose to each region of the lung tissues (bronchial, bronchiolar and alveolar), (2) weighted equivalent dose to organs other than lung, and (3) effective dose. The calculations indicated that (1) the most exposed region of the lung tissues was the bronchial for the unattached fraction and the bronchiolar for the attached fraction, (2) the effective dose is dominated by the contribution of lung dose, and (3) the effective dose per EETC was about four times larger than the effective dose per equilibrium equivalent concentration for radon (EERC). The calculated dose conversion factors were applied to the comparative dosimetry for some thoron-enhanced areas where the EERC and EETC have been measured. In the case of a spa in Japan, the dose from thoron decay products was larger than the dose from radon decay products.

  5. Comparison of 50-year and 70-year internal-dose-conversion factors

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    Ryan, M.T.; Dunning, D.E. Jr.

    1981-03-01

    The 50-year inhalation and ingestion dose commitments associated with an acute intake (of a radionuclide) of 3.7 x 10/sup 4/ Bq (1 ..mu..Ci) in one day were compared with the corresponding dose commitments calculated for a 70-year integration period resulting from a chronic intake of the same amount at a rate of 101 Bq/d (0.00274 ..mu..Ci/d) for one year. These values, known as dose conversion factors, estimate the dose accumulated during a given period of time following a unit of intake of a radionuclide. It was demonstrated that the acute intake of 3.7 x 10/sup 4/ Bq in one day and the chronic intake of 101 Bq/d for one year (a total intake of 3.7 x 10/sup 4/ Bq) result in essentially the same dose commitment for a relatively long integration period. Therefore, the comparison of 50-year acute dose conversion factors and 70-year chronic dose conversion factors is essentially only a measure of the additional dose accumulated in the 50 to 70 year period. It was found that for radionuclides with atomic mass less than 200 the percent difference in the 70-year and 50-year dose conversion factors was essentially zero in most cases. Differences of approximately 5 to 50% were obtained for dose conversion factors for most alpha emitters with atomic masses of greater than 200. Comparisons were made on the basis of both organ dose equivalent and effective dose equivalent. The implications and significance of these results are discussed.

  6. Paediatric dose measurement in a full-body digital radiography unit

    Energy Technology Data Exchange (ETDEWEB)

    Maree, Gert J.; Hering, Egbert R. [Groote Schuur Hospital and University of Cape Town, Division of Medical Physics, Cape Town (South Africa); Irving, Benjamin J. [University of Cape Town, MRC/UCT Medical Imaging Research Unit, Department of Human Biology, Cape Town, Western Cape (South Africa)

    2007-10-15

    Ionizing radiation has a detrimental effect on the human body, particularly in children. Thus it is important to minimize the dose. Linear slit-scanning X-ray units offer the possibility of dose reductions. In order to further develop linear slit-scanning radiography, the dose needs to be accurately calculated for various examinations. To measure the entrance dose (free-in-air) and calculate the effective doses for various radiological examinations in children on Lodox Statscan and Shimadzu radiography units. Entrance doses (free-in-air) were measured using a dose meter and ionization chamber on the Statscan and Shimadzu units at two South African hospitals. The entrance doses were measured for a number of common examinations and were used to compute the effective dose using a Monte Carlo program. The standard deviation of the entrance doses was in the range 0-0.6%. The effective dose from the Statscan unit was well below that from the Shimadzu unit as well as that found in other radiological studies from around the world in children. The one exception was chest examination where the dose was similar to that in other studies worldwide due to the use of Chest AP projection compared to Chest PA used in the comparitive studies. Linear slit-scanning systems help reduce the dose in radiological examinations in children. (orig.)

  7. Performance assessment of the BEBIG MultiSource high dose rate brachytherapy treatment unit.

    Science.gov (United States)

    Palmer, Antony; Mzenda, Bongile

    2009-12-21

    A comprehensive system characterisation was performed of the Eckert & Ziegler BEBIG GmbH MultiSource High Dose Rate (HDR) brachytherapy treatment unit with an (192)Ir source. The unit is relatively new to the UK market, with the first installation in the country having been made in the summer of 2009. A detailed commissioning programme was devised and is reported including checks of the fundamental parameters of source positioning, dwell timing, transit doses and absolute dosimetry of the source. Well chamber measurements, autoradiography and video camera analysis techniques were all employed. The absolute dosimetry was verified by the National Physical Laboratory, UK, and compared to a measurement based on a calibration from PTB, Germany, and the supplied source certificate, as well as an independent assessment by a visiting UK centre. The use of the 'Krieger' dosimetry phantom has also been evaluated. Users of the BEBIG HDR system should take care to avoid any significant bend in the transfer tube, as this will lead to positioning errors of the source, of up to 1.0 mm for slight bends, 2.0 mm for moderate bends and 5.0 mm for extreme curvature (depending on applicators and transfer tube used) for the situations reported in this study. The reason for these errors and the potential clinical impact are discussed. Users should also note the methodology employed by the system for correction of transit doses, and that no correction is made for the initial and final transit doses. The results of this investigation found that the uncorrected transit doses lead to small errors in the delivered dose at the first dwell position, of up to 2.5 cGy at 2 cm (5.6 cGy at 1 cm) from a 10 Ci source, but the transit dose correction for other dwells was accurate within 0.2 cGy. The unit has been mechanically reliable, and source positioning accuracy and dwell timing have been reproducible, with overall performance similar to other existing HDR equipment. The unit is capable of high

  8. Age-specific radiation dose commitment factors for a one-year chronic intake

    Energy Technology Data Exchange (ETDEWEB)

    Hoenes, G.R.; Soldat, J.K.

    1977-11-01

    During the licensing process for nuclear facilities, radiation doses and dose commitments must be calculated for people in the environs of a nuclear facility. These radiation doses are determined by examining characteristics of population groups, pathways to people, and radionuclides found in those pathways. The pertinent characteristics, which are important in the sense of contributing a significant portion of the total dose, must then be analyzed in depth. Dose factors are generally available for adults, see Reference 1 for example, however numerous improvements in data on decay schemes and half-lives have been made in recent years. In addition, it is advisable to define parameters for calculation of the radiation dose for ages other than adults since the population surrounding nuclear facilities will be composed of various age groups. Further, since infants, children, and teens may have higher rates of intake per unit body mass, it is conceivable that the maximally exposed individual may not be an adult. Thus, it was necessary to develop new radiation-dose commitment factors for various age groups. Dose commitment factors presented in this report have been calculated for a 50-year time period for four age groups.

  9. Organ-specific external dose coefficients and protective apron transmission factors for historical dose reconstruction for medical personnel.

    Science.gov (United States)

    Simon, Steven L

    2011-07-01

    While radiation absorbed dose (Gy) to the skin or other organs is sometimes estimated for patients from diagnostic radiologic examinations or therapeutic procedures, rarely is occupationally-received radiation absorbed dose to individual organs/tissues estimated for medical personnel; e.g., radiologic technologists or radiologists. Generally, for medical personnel, equivalent or effective radiation doses are estimated for compliance purposes. In the very few cases when organ doses to medical personnel are reconstructed, the data is usually for the purpose of epidemiologic studies; e.g., a study of historical doses and risks to a cohort of about 110,000 radiologic technologists presently underway at the U.S. National Cancer Institute. While ICRP and ICRU have published organ-specific external dose conversion coefficients (DCCs) (i.e., absorbed dose to organs and tissues per unit air kerma and dose equivalent per unit air kerma), those factors have been published primarily for mono-energetic photons at selected energies. This presents two related problems for historical dose reconstruction, both of which are addressed here. It is necessary to derive conversion factor values for (1) continuous distributions of energy typical of diagnostic medical x-rays (bremsstrahlung radiation), and (2) energies of particular radioisotopes used in medical procedures, neither of which are presented in published tables. For derivation of DCCs for bremsstrahlung radiation, combinations of x-ray tube potentials and filtrations were derived for different time periods based on a review of relevant literature. Three peak tube potentials (70 kV, 80 kV, and 90 kV) with four different amounts of beam filtration were determined to be applicable for historic dose reconstruction. The probabilities of these machine settings were assigned to each of the four time periods (earlier than 1949, 1949-1954, 1955-1968, and after 1968). Continuous functions were fit to each set of discrete values of the

  10. Dose factor entry and display tool for BNCT radiotherapy

    Science.gov (United States)

    Wessol, Daniel E.; Wheeler, Floyd J.; Cook, Jeremy L.

    1999-01-01

    A system for use in Boron Neutron Capture Therapy (BNCT) radiotherapy planning where a biological distribution is calculated using a combination of conversion factors and a previously calculated physical distribution. Conversion factors are presented in a graphical spreadsheet so that a planner can easily view and modify the conversion factors. For radiotherapy in multi-component modalities, such as Fast-Neutron and BNCT, it is necessary to combine each conversion factor component to form an effective dose which is used in radiotherapy planning and evaluation. The Dose Factor Entry and Display System is designed to facilitate planner entry of appropriate conversion factors in a straightforward manner for each component. The effective isodose is then immediately computed and displayed over the appropriate background (e.g. digitized image).

  11. Internal dose conversion factors for calculation of dose to the public

    Energy Technology Data Exchange (ETDEWEB)

    1988-07-01

    This publication contains 50-year committed dose equivalent factors, in tabular form. The document is intended to be used as the primary reference by the US Department of Energy (DOE) and its contractors for calculating radiation dose equivalents for members of the public, resulting from ingestion or inhalation of radioactive materials. Its application is intended specifically for such materials released to the environment during routine DOE operations, except in those instances where compliance with 40 CFR 61 (National Emission Standards for Hazardous Air Pollutants) requires otherwise. However, the calculated values may be equally applicable to unusual releases or to occupational exposures. The use of these committed dose equivalent tables should ensure that doses to members of the public from internal exposures are calculated in a consistent manner at all DOE facilities.

  12. Dose reduction factors from a radioactive cloud for large buildings

    Energy Technology Data Exchange (ETDEWEB)

    Grand, J. le; Roux, Y.; Patau, J.P.

    1986-01-01

    A set of complex and accurate computer codes has been established to determine the transport of photons emitted from a radioactive cloud through various media. The geometrical and physical description of large buildings with various numbers of floors and rooms can be done by the user. The codes can calculate, in any room or apartment, the characteristics of the photon fields (photon flux, energy flux and distribution, direction distribution) and whole-body absorbed dose rates in a phantom standing or lying on the floor. The dose reduction factor is then the quotient of the mean absorbed dose rate in the apartment to the absorbed dose rate in the phantom standing on the ground outdoors. Applications to several modern multistorey buildings are presented. The results show the influence of various parameters such as density and composition of building materials, the fraction of the external building surface containing apertures and initial photon energy.

  13. Dose per unit area - a study of elicitation of nickel allergy

    DEFF Research Database (Denmark)

    Fischer, Louise Arup; Menné, Torkil; Johansen, Jeanne Duus

    2007-01-01

    with a patch test and a repeated open application test (ROAT). Nickel was applied on small and large areas. The varying parameters were area, total dose and dose per unit area. RESULTS: In the patch test, at a low concentration [15 microg nickel (microg Ni)/cm(2)], there were significantly higher scores...... concentrations, even though the same dose per unit area is applied.......BACKGROUND: Experimental sensitization depends upon the amount of allergen per unit skin area and is largely independent of the area size. OBJECTIVES: This study aimed at testing if this also applies for elicitation of nickel allergy. PATIENTS/METHODS: 20 nickel allergic individuals were tested...

  14. Ecosystem specific dose conversion factors for Aberg, Beberg and Ceberg

    Energy Technology Data Exchange (ETDEWEB)

    Nordlinder, S.; Bergstroem, U.; Mathiasson, Lena [Studsvik Eco and Safety AB, Nykoeping (Sweden)

    1999-12-01

    The aim of this study was to calculate ecosystem specific dose conversion factors (EDFs) for three hypothetical sites, Aberg, Beberg and Ceberg, used in the safety analysis SR 97. The EDFs can, in combination with calculated releases of radionuclides from the geosphere, be used to illustrate relative differences in doses to the most exposed individual due to accidental leakage of radionuclides from a deep repository for spent nuclear fuel. Maps of the three sites were studied and subdivided into areas, which were characterised according to an earlier developed module system. For each of the identified modules, ecosystem transport and exposure model calculations were performed for release of 1 Bq per year during 10 000 years. 44 radionuclides contained within a deep repository for spent nuclear fuel were considered. A preliminary comparison of the EDFs for the three sites showed that the highest relative doses can be expected in Ceberg due to the high frequency of peat bog modules.

  15. An evaluation of dose/unit area and time as key factors influencing the elicitation capacity of methylchloroisothiazolinone/methylisothiazolinone (MCI/MI) in MCI/MI-allergic patients

    DEFF Research Database (Denmark)

    Zachariae, Claus; Lerbaek, Anne; McNamee, Pauline M

    2006-01-01

    of a repeated open application test (ROAT) experimental design. The study was designed as a double-blind, placebo-controlled, dose-response ROAT preceded by a diagnostic patch testing. 25 subjects with confirmed MCI/MI allergy and 10 healthy, non-MCI/MI allergic control subjects were exposed to 0.025 microg/cm2....... It demonstrated that the elicitation threshold for MCI/MI is expected to be in the proximity of 0.025 microg/cm2 although it was not possible to establish a definitive elicitation threshold for MCI/MI in this study....

  16. Source localisation and dose verification for a novel brachytherapy unit

    Science.gov (United States)

    Metaxas, Marinos G.

    A recent development in the field of radiotherapy has been the introduction of the PRS Intrabeam system (Carl Zeiss Surgical GmbH, Oberkochen, Germany). This is essentially a portable, miniaturised, electron-driven photon generator that allows high intensity, soft-energy x-rays (50 kVp) to be delivered directly to the tumour site in a single fraction. The system has been used for the interstitial radiation treatment of both brain and breast tumours. At present, a standardised in-vivo dose verification technique is not available for the PRS treatments. The isotropical distribution of photons about the tip of the PRS probe inserted in the tissue can effectively be viewed as a point source of radiation buried in the body. This work has looked into ways of localising the PRS source utilising its own radiation field. Moreover, the response of monoenergetic sources, mimicking realistic brachytherapy sources, has also been investigated. The purpose of this project was to attempt to localise the source as well as derive important dosimetric information from the resulting image. A detection system comprised of a well-collimated Germanium detector (HPGe) has been devised in a rotate-translate Emission Computed Tomography (ECT) modality. The superior energy resolving ability of the detection system allowed for energy selective reconstruction to be carried out in the case of the monoenergetic source (241Am). Results showed that the monoenergetic source can be localised to within 1 mm and the continuous PRS x-ray source to within 3mm. For the PRS dose map derivation, Monte Carlo studies have been employed in order to extract information on the dosimetric aspect of the resulting image. The final goal of this work was therefore to formulate a direct mathematical relation (Transform Map) between the image created by the escaping photons and the dose map as predicted by the theoretical model. The formation therefore of the in-vivo PRS image could allow for a real-time monitoring

  17. Doses in sensitive organs during prostate treatment with a 60Co unit.

    Science.gov (United States)

    Vega-Carrillo, H R; Navarro Becerra, J A; Pérez Arrieta, M L; Pérez-Landeros, L H

    2014-01-01

    Using thermoluminiscent dosimeters the absorbed dose in the bladder, rectum and thyroid have been evaluated when 200 cGy was applied to the prostate. The treatment was applied with a (60)Co unit. A water phantom was built and thermoluminiscent dosimeters were located in the position where the prostate, bladder, rectum and thyroid are located. The therapeutic beam was applied in 4 irradiations at 0, 90, 180 and 270° with the prostate at the isocenter. The TLDs readouts were used to evaluate the absorbed dose in each organ. The absorbed doses were used to estimate the effective doses and the probability of developing secondary malignacies in thyroid, rectum and bladder.

  18. Patient size and x-ray technique factors in head computed tomography examinations. I. Radiation doses.

    Science.gov (United States)

    Huda, Walter; Lieberman, Kristin A; Chang, Jack; Roskopf, Marsha L

    2004-03-01

    We investigated how patient age, size and composition, together with the choice of x-ray technique factors, affect radiation doses in head computed tomography (CT) examinations. Head size dimensions, cross-sectional areas, and mean Hounsfield unit (HU) values were obtained from head CT images of 127 patients. For radiation dosimetry purposes patients were modeled as uniform cylinders of water. Dose computations were performed for 18 x 7 mm sections, scanned at a constant 340 mAs, for x-ray tube voltages ranging from 80 to 140 kV. Values of mean section dose, energy imparted, and effective dose were computed for patients ranging from the newborn to adults. There was a rapid growth of head size over the first two years, followed by a more modest increase of head size until the age of 18 or so. Newborns have a mean HU value of about 50 that monotonically increases with age over the first two decades of life. Average adult A-P and lateral dimensions were 186+/-8 mm and 147+/-8 mm, respectively, with an average HU value of 209+/-40. An infant head was found to be equivalent to a water cylinder with a radius of approximately 60 mm, whereas an adult head had an equivalent radius 50% greater. Adult males head dimensions are about 5% larger than for females, and their average x-ray attenuation is approximately 20 HU greater. For adult examinations performed at 120 kV, typical values were 32 mGy for the mean section dose, 105 mJ for the total energy imparted, and 0.64 mSv for the effective dose. Increasing the x-ray tube voltage from 80 to 140 kV increases patient doses by about a factor of 5. For the same technique factors, mean section doses in infants are 35% higher than in adults. Energy imparted for adults is 50% higher than for infants, but infant effective doses are four times higher than for adults. CT doses need to take into account patient age, head size, and composition as well as the selected x-ray technique factors.

  19. Monitor units are not predictive of neutron dose for high-energy IMRT

    Directory of Open Access Journals (Sweden)

    Hälg Roger A

    2012-08-01

    Full Text Available Abstract Background Due to the substantial increase in beam-on time of high energy intensity-modulated radiotherapy (>10 MV techniques to deliver the same target dose compared to conventional treatment techniques, an increased dose of scatter radiation, including neutrons, is delivered to the patient. As a consequence, an increase in second malignancies may be expected in the future with the application of intensity-modulated radiotherapy. It is commonly assumed that the neutron dose equivalent scales with the number of monitor units. Methods Measurements of neutron dose equivalent were performed for an open and an intensity-modulated field at four positions: inside and outside of the treatment field at 0.2 cm and 15 cm depth, respectively. Results It was shown that the neutron dose equivalent, which a patient receives during an intensity-modulated radiotherapy treatment, does not scale with the ratio of applied monitor units relative to an open field irradiation. Outside the treatment volume at larger depth 35% less neutron dose equivalent is delivered than expected. Conclusions The predicted increase of second cancer induction rates from intensity-modulated treatment techniques can be overestimated when the neutron dose is simply scaled with monitor units.

  20. [Phenylephrine dosing error in Intensive Care Unit. Case of the trimester].

    Science.gov (United States)

    2013-01-01

    A real clinical case reported to SENSAR is presented. A patient admitted to the surgical intensive care unit following a lung resection, suffered arterial hypotension. The nurse was asked to give the patient 1 mL of phenylephrine. A few seconds afterwards, the patient experienced a hypertensive crisis, which resolved spontaneously without damage. Thereafter, the nurse was interviewed and a dosing error was identified: she had mistakenly given the patient 1 mg of phenylephrine (1 mL) instead of 100 mcg (1 mL of the standard dilution, 1mg in 10 mL). The incident analysis revealed latent factors (event triggers) due to the lack of protocols and standard operating procedures, communication errors among team members (physician-nurse), suboptimal training, and underdeveloped safety culture. In order to preempt similar incidents in the future, the following actions were implemented in the surgical intensive care unit: a protocol for bolus and short lived infusions (<30 min) was developed and to close the communication gap through the adoption of communication techniques. The protocol was designed by physicians and nurses to standardize the administration of drugs with high potential for errors. To close the communication gap, repeated checks about saying and understanding was proposed ("closed loop"). Labeling syringes with the drug dilution was also recommended. Copyright © 2013 Sociedad Española de Anestesiología, Reanimación y Terapéutica del Dolor. Published by Elsevier España. All rights reserved.

  1. Inadequate doses of hemodialysis. Predisposing factors, causes and prevention

    Directory of Open Access Journals (Sweden)

    Pehuén Fernández

    2017-04-01

    Full Text Available Patients receiving sub-optimal dose of hemodialysis have increased morbidity and mortality. The objectives of this study were to identify predisposing factors and causes of inadequate dialysis, and to design a practical algorithm for the management of these patients. A cross-sectional study was conducted. Ninety patients in chronic hemodialysis at Hospital Privado Universitario de Córdoba were included, during September 2015. Twenty two received sub-optimal dose of hemodialysis. Those with urea distribution volume (V greater than 40 l (72 kg body weight approximately are 11 times more likely (OR = 11.6; CI 95% = 3.2 to 51.7, p < 0.0001 to receive an inadequate dose of hemodialysis, than those with a smaller V. This situation is more frequent in men (OR = 3.5; 95% CI 1.01-15.8; p = 0.0292. V greater than 40 l was the only independent predictor of sub-dialysis in the multivariate analysis (OR = 10.3; 95% CI 2.8-37; p < 0.0004. The main cause of suboptimal dialysis was receiving a lower blood flow (Qb than the prescribed (336.4 ± 45.8 ml/min vs. 402.3 ± 28.8 ml/min respectively, p < 0.0001 (n = 18. Other causes were identified: shorter duration of the session (n = 2, vascular access recirculation (n = 1, and error in the samples (n = 1. In conclusion, the only independent predisposing factor found in this study for sub-optimal dialysis is V greater than 40 l. The main cause was receiving a slower Qb than prescribed. From these findings, an algorithm for the management of these patients was developed

  2. Personal dose equivalent angular response factors for photons with energies up to 1 GeV.

    Science.gov (United States)

    Veinot, K G

    2013-04-01

    When performing personal dosemeter calibrations, the dosemeters are typically irradiated while mounted on slab-type phantoms and oriented facing the source. Performance testing standards or intercomparison studies may also specify various rotational angles to test the response of the dosemeter and associated algorithm as this rotation introduces changes in the quantity of delivered dose. Correction factors for rotational effects are available, but many have not been updated in recent years and were typically calculated using the kerma approximation. The personal dose equivalent, Hp(d), is the quantity recommended by the International Commission on Radiation Units and Measurements to be used as an approximation of the protection quantity effective dose when performing personal dosemeter calibrations. The personal dose equivalent can be defined for any location and depth within the body, but typically the location of interest is the trunk where personal dosemeters are worn and in this instance a suitable approximation is a 30 cm × 30 cm × 15 cm slab-type phantom. In this work personal dose equivalent conversion coefficients for photons with energies up to 1 GeV have been calculated for depths of 0.007, 0.3 and 1.0 cm in the slab phantom for rotational angles ranging from 15° to 75°. Angular response factors have been determined by comparing the conversion coefficients for each angle and energy to those reported in an earlier work for a non-rotational (e.g. perpendicular to the phantom face) geometry. The angular response factors were determined for discrete angles, but fits of the factors are provided.

  3. Biosphere dose conversion Factor Importance and Sensitivity Analysis

    Energy Technology Data Exchange (ETDEWEB)

    M. Wasiolek

    2004-10-15

    This report presents importance and sensitivity analysis for the environmental radiation model for Yucca Mountain, Nevada (ERMYN). ERMYN is a biosphere model supporting the total system performance assessment (TSPA) for the license application (LA) for the Yucca Mountain repository. This analysis concerns the output of the model, biosphere dose conversion factors (BDCFs) for the groundwater, and the volcanic ash exposure scenarios. It identifies important processes and parameters that influence the BDCF values and distributions, enhances understanding of the relative importance of the physical and environmental processes on the outcome of the biosphere model, includes a detailed pathway analysis for key radionuclides, and evaluates the appropriateness of selected parameter values that are not site-specific or have large uncertainty.

  4. Impact of pharmacist antimicrobial dosing adjustments in septic patients on continuous renal replacement therapy in an intensive care unit.

    Science.gov (United States)

    Jiang, Sai-Ping; Zhu, Zheng-Yi; Ma, Kui-Fen; Zheng, Xia; Lu, Xiao-Yang

    2013-12-01

    Correct dosing of antimicrobial drugs in septic patients receiving continuous renal replacement therapy (CRRT) is complex. This study aimed to evaluate the effects of dosing adjustments performed by pharmacists on the length of intensive care unit (ICU) stay, ICU cost, and antimicrobial adverse drug events (ADEs). A single-center, 2-phase (pre-/post-intervention) study was performed in an ICU of a university-affiliated hospital. Septic patients receiving CRRT in the post-intervention phase received a specialized antimicrobial dosing service from critical care pharmacists, whereas patients in the pre-intervention phase received routine medical care without involving pharmacists. The 2 phases were compared to evaluate the outcomes of pharmacist interventions. Pharmacists made 183 antimicrobial dosing adjustment recommendations for septic patients receiving CRRT. Changes in CRRT-related variables (116, 63.4%) were the most common risk factors for dosing errors, and β-lactams (101, 55.2%) were the antimicrobials most commonly associated with dosing errors. Dosing adjustments were related to a reduced length of ICU stay from 10.7 ± 11.1 days to 7.7 ± 8.3 days (p = 0.037) in the intervention group, and to cost savings of $3525 (13,463 ± 12,045 vs. 9938 ± 8811, p = 0.038) per septic patient receiving CRRT in the ICU. Suspected antimicrobial adverse drug events in the intervention group were significantly fewer than in the pre-intervention group (19 events vs. 8 events, p = 0.048). The involvement of pharmacists in antimicrobial dosing adjustments in septic patients receiving CRRT is associated with a reduced length of ICU stay, lower ICU costs, and fewer ADEs. Hospitals may consider employing clinical pharmacists in ICUs.

  5. Range and modulation dependencies for proton beam dose per monitor unit calculations

    Science.gov (United States)

    Hsi, Wen C.; Schreuder, Andries N.; Moyers, Michael F.; Allgower, Chris E.; Farr, Jonathan B.; Mascia, Anthony E.

    2009-01-01

    Calculations of dose per monitor unit (D∕MU) are required in addition to measurements to increase patient safety in the clinical practice of proton radiotherapy. As in conventional photon and electron therapy, the D∕MU depends on several factors. This study focused on obtaining range and modulation dependence factors used in D∕MU calculations for the double scattered proton beam line at the Midwest Proton Radiotherapy Institute. Three dependencies on range and one dependency on modulation were found. A carefully selected set of measurements was performed to discern these individual dependencies. Dependencies on range were due to: (1) the stopping power of the protons passing through the monitor chamber; (2) the reduction of proton fluence due to nuclear interactions within the patient; and (3) the variation of proton fluence passing through the monitor chamber due to different source-to-axis distances (SADs) for different beam ranges. Different SADs are produced by reconfigurations of beamline elements to provide different field sizes and ranges. The SAD effect on the D∕MU varies smoothly as the beam range is varied, except at the beam range for which the first scatterers are exchanged and relocated to accommodate low and high beam ranges. A geometry factor was devised to model the SAD variation effect on the D∕MU. The measured D∕MU variation as a function of range can be predicted within 1% using the three modeled dependencies on range. Investigation of modulated beams showed that an analytical formula can predict the D∕MU dependency as a function of modulation to within 1.5%. Special attention must be applied when measuring the D∕MU dependence on modulation to avoid interplay between range and SAD effects. PMID:19292004

  6. Range and modulation dependencies for proton beam dose per monitor unit calculations

    Energy Technology Data Exchange (ETDEWEB)

    Hsi, Wen C.; Schreuder, Andries N.; Moyers, Michael F.; Allgower, Chris E.; Farr, Jonathan B.; Mascia, Anthony E. [Midwest Proton Radiotherapy Institute, Bloomington, Indiana 47408 and University Florida Proton Therapy Institute, Jacksonville, Florida 32206 (United States); ProCure Treatment Centers, Inc., Bloomington, Indiana 47404 (United States); Proton Therapy, Inc., Colton, California 92324 (United States); Midwest Proton Radiotherapy Institute, Bloomington, Indiana 47408 (United States); Midwest Proton Radiotherapy Institute, Bloomington, Indiana 47408 and Westdeutsches Protonentherapiezentrum, Universitaetsklinikum, Hufelandstrasse 55, 45147 Essen (Germany); Midwest Proton Radiotherapy Institute, Bloomington, Indiana 47408 (United States)

    2009-02-15

    Calculations of dose per monitor unit (D/MU) are required in addition to measurements to increase patient safety in the clinical practice of proton radiotherapy. As in conventional photon and electron therapy, the D/MU depends on several factors. This study focused on obtaining range and modulation dependence factors used in D/MU calculations for the double scattered proton beam line at the Midwest Proton Radiotherapy Institute. Three dependencies on range and one dependency on modulation were found. A carefully selected set of measurements was performed to discern these individual dependencies. Dependencies on range were due to: (1) the stopping power of the protons passing through the monitor chamber; (2) the reduction of proton fluence due to nuclear interactions within the patient; and (3) the variation of proton fluence passing through the monitor chamber due to different source-to-axis distances (SADs) for different beam ranges. Different SADs are produced by reconfigurations of beamline elements to provide different field sizes and ranges. The SAD effect on the D/MU varies smoothly as the beam range is varied, except at the beam range for which the first scatterers are exchanged and relocated to accommodate low and high beam ranges. A geometry factor was devised to model the SAD variation effect on the D/MU. The measured D/MU variation as a function of range can be predicted within 1% using the three modeled dependencies on range. Investigation of modulated beams showed that an analytical formula can predict the D/MU dependency as a function of modulation to within 1.5%. Special attention must be applied when measuring the D/MU dependence on modulation to avoid interplay between range and SAD effects.

  7. Monte Carlo calculation of dose rate conversion factors for external exposure to photon emitters in soil

    CERN Document Server

    Clouvas, A; Antonopoulos-Domis, M; Silva, J

    2000-01-01

    The dose rate conversion factors D/sub CF/ (absorbed dose rate in air per unit activity per unit of soil mass, nGy h/sup -1/ per Bq kg/sup -1/) are calculated 1 m above ground for photon emitters of natural radionuclides uniformly distributed in the soil. Three Monte Carlo codes are used: 1) The MCNP code of Los Alamos; 2) The GEANT code of CERN; and 3) a Monte Carlo code developed in the Nuclear Technology Laboratory of the Aristotle University of Thessaloniki. The accuracy of the Monte Carlo results is tested by the comparison of the unscattered flux obtained by the three Monte Carlo codes with an independent straightforward calculation. All codes and particularly the MCNP calculate accurately the absorbed dose rate in air due to the unscattered radiation. For the total radiation (unscattered plus scattered) the D/sub CF/ values calculated from the three codes are in very good agreement between them. The comparison between these results and the results deduced previously by other authors indicates a good ag...

  8. Neutron dose per fluence and weighting factors for use at high energy accelerators

    Energy Technology Data Exchange (ETDEWEB)

    Cossairt, J.Donald; Vaziri, Kamran; /Fermilab

    2008-07-01

    In June 2007, the United States Department of Energy incorporated revised values of neutron weighting factors into its occupational radiation protection Regulation 10 CFR Part 835 as part of updating its radiation dosimetry system. This has led to a reassessment of neutron radiation fields at high energy proton accelerators such as those at the Fermi National Accelerator Laboratory (Fermilab). Values of dose per fluence factors appropriate for accelerator radiation fields calculated elsewhere are collated and radiation weighting factors compared. The results of this revision to the dosimetric system are applied to americium-beryllium neutron energy spectra commonly used for instrument calibrations. A set of typical accelerator neutron energy spectra previously measured at Fermilab are reassessed in light of the new dosimetry system. The implications of this revision are found to be of moderate significance.

  9. MSCT and C-ARM units: doses to patients in the angiographic procedures

    Energy Technology Data Exchange (ETDEWEB)

    Staniszewska, M.A. [Nofer Institute of Occupational Medicine, Lodz (Poland); Jazwinski, J. [Military Institute of Hygiene and Epidemiology, Warsaw (Poland)

    2006-07-01

    Full text of publication follows: Computed Tomography Angiography (C.T.A.) is an attractive non -invasive alternative to invasive traditional angiography. The coronary arteries are the most frequent angiography procedure. Because of a high resolution and wide possibilities offered by software for image reconstruction, a number of scanner types having sixteen rows of detectors at least make possible to visualise and analyse of the blood flow in the thin vessels, without an aggressive interference into the patient body. This is achieved at the x -rays exposure pattern quite different to that used for the C-arm units. Consequently, both the organ dose values and their spatial distribution are also different for C.T.A. and C-arm conducted procedures, what can influence on a radiation risk to patients. This paper is aimed on evaluation of doses obtained by patients during coronarography performed using multislice computed tomographs (M.S.C.T.) and C-arm units. Materials and Methods The doses were evaluated experimentally, using thermoluminescent dosimeters (TLD) (Polish product, equivalent TLD-100) and anthropomorphic Rando Man phantom (made by Alderson). The measurements were performed for CT protocols covering the coronary arteries used at 16-row and 64-row M.S.C.T. scanners and the C-arm units. Before the use TLDs were calibrated for the two x-ray spectra corresponding to the energies of photon emitted by CT scanners and C -arm units. The organ doses were calculated on the basis of the TLDs readings for the specified volume of the phantom. The effective dose to each the analysed procedure were computed according to the ICRP recommendations given in Publication 60. Results The measurements were carried out for 3 M.S.C.T. scanners. The protocols covering the chest and allowing to achieve a good contrast resolution were checked for the patient dose, i.e.: the chest angiography R.C.T. of the chest and the coronary arteries. The organ doses ranged from the tenths of m

  10. Noncontact Infrared-Mediated Heat Transfer During Continuous Freeze-Drying of Unit Doses.

    Science.gov (United States)

    Van Bockstal, Pieter-Jan; De Meyer, Laurens; Corver, Jos; Vervaet, Chris; De Beer, Thomas

    2017-01-01

    Recently, an innovative continuous freeze-drying concept for unit doses was proposed, based on spinning the vials during freezing. An efficient heat transfer during drying is essential to continuously process these spin frozen vials. Therefore, the applicability of noncontact infrared (IR) radiation was examined. The impact of several process and formulation variables on the mass of sublimed ice after 15 min of primary drying (i.e., sublimation rate) and the total drying time was examined. Two experimental designs were performed in which electrical power to the IR heaters, distance between the IR heaters and the spin frozen vial, chamber pressure, product layer thickness, and 5 model formulations were included as factors. A near-infrared spectroscopy method was developed to determine the end point of primary and secondary drying. The sublimation rate was mainly influenced by the electrical power to the IR heaters and the distance between the IR heaters and the vial. The layer thickness had the largest effect on total drying time. The chamber pressure and the 5 model formulations had no significant impact on sublimation rate and total drying time, respectively. This study shows that IR radiation is suitable to provide the energy during the continuous processing of spin frozen vials.

  11. Effects of activity size distribution on dose conversion factor for radon progeny

    Energy Technology Data Exchange (ETDEWEB)

    Ishikawa, Tetsuo; Tokonami, Shinji; Yonehara, Hidenori; Fukutsu, Kumiko; Yamada, Yuji [National Inst. of Radiological Sciences, Chiba (Japan)

    2001-12-01

    To estimate dose from radon progeny, the effective dose per unit exposure to radon progeny (dose conversion factor, DCF) is needed. A dominant parameter related to DCF is the activity size distribution of radon progeny. In the present study, the DCF was calculated in the wide range of particle diameters (0.5-20 nm [AMTD] and 20-5,000 nm [AMAD]), using a dosimetric approach. The calculations were based on a computer program, LUDEP, which implements an ICRP66 respiratory tract model. The calculated results showed that the DCF is sensitive to particle size distribution. The DCFs calculated for reference conditions in mines and homes were 13.7 mSv WLM{sup -1} and 14.3 mSv WLM{sup -1}, respectively. These values were in good agreement with those reported in a few references. The DCF calculated in the present study is useful for the dose assessment of radon progeny in places that have different aerosol characteristics. (author)

  12. Independent dose per monitor unit review of eight U.S.A. proton treatment facilities

    Energy Technology Data Exchange (ETDEWEB)

    Moyers, M. F., E-mail: MFMoyers@roadrunner.com [Colton, California 92354 (United States); Ibbott, G. S.; Grant, R. L.; Summers, P. A.; Followill, D. S. [Department of Radiation Physics, University of Texas – M. D. Anderson Cancer Center, Houston, Texas 77030 (United States)

    2014-01-15

    Purpose: Compare the dose per monitor unit at different proton treatment facilities using three different dosimetry methods. Methods: Measurements of dose per monitor unit were performed by a single group at eight facilities using 11 test beams and up to six different clinical portal treatment sites. These measurements were compared to the facility reported dose per monitor unit values. Results: Agreement between the measured and reported doses was similar using any of the three dosimetry methods. Use of the ICRU 59 N{sub D,w} based method gave results approximately 3% higher than both the ICRU 59 N{sub X} and ICRU 78 (TRS-398) N{sub D,w} based methods. Conclusions: Any single dosimetry method could be used for multi-institution trials with similar conformity between facilities. A multi-institutional trial could support facilities using both the ICRU 59 N{sub X} based and ICRU 78 (TRS-398) N{sub D,w} based methods but use of the ICRU 59 N{sub D,w} based method should not be allowed simultaneously with the other two until the difference is resolved.

  13. Independent dose per monitor unit review of eight U.S.A. proton treatment facilities.

    Science.gov (United States)

    Moyers, M F; Ibbott, G S; Grant, R L; Summers, P A; Followill, D S

    2014-01-01

    Compare the dose per monitor unit at different proton treatment facilities using three different dosimetry methods. Measurements of dose per monitor unit were performed by a single group at eight facilities using 11 test beams and up to six different clinical portal treatment sites. These measurements were compared to the facility reported dose per monitor unit values. Agreement between the measured and reported doses was similar using any of the three dosimetry methods. Use of the ICRU 59 ND,w based method gave results approximately 3% higher than both the ICRU 59 NX and ICRU 78 (TRS-398) ND,w based methods. Any single dosimetry method could be used for multi-institution trials with similar conformity between facilities. A multi-institutional trial could support facilities using both the ICRU 59 NX based and ICRU 78 (TRS-398) ND,w based methods but use of the ICRU 59 ND,w based method should not be allowed simultaneously with the other two until the difference is resolved.

  14. Applying graphics processor units to Monte Carlo dose calculation in radiation therapy

    Directory of Open Access Journals (Sweden)

    Bakhtiari M

    2010-01-01

    Full Text Available We investigate the potential in using of using a graphics processor unit (GPU for Monte-Carlo (MC-based radiation dose calculations. The percent depth dose (PDD of photons in a medium with known absorption and scattering coefficients is computed using a MC simulation running on both a standard CPU and a GPU. We demonstrate that the GPU′s capability for massive parallel processing provides a significant acceleration in the MC calculation, and offers a significant advantage for distributed stochastic simulations on a single computer. Harnessing this potential of GPUs will help in the early adoption of MC for routine planning in a clinical environment.

  15. Factors affecting the determination of threshold doses for allergenic foods

    DEFF Research Database (Denmark)

    Taylor, Steve L; Hefle, Susan L; Bindslev-Jensen, Carsten

    2002-01-01

    interested parties were invited to participate in a roundtable conference to share existing data on threshold doses and to discuss clinical approaches that would allow the acquisition of that information. RESULTS: Considerable data were identified in clinical files relating to the threshold doses for peanut...

  16. Effect of Medication Label Units of Measure on Parent Choice of Dosing Tool: A Randomized Experiment.

    Science.gov (United States)

    Yin, H Shonna; Parker, Ruth M; Sanders, Lee M; Dreyer, Benard P; Mendelsohn, Alan; Bailey, Stacy; Patel, Deesha A; Jimenez, Jessica J; Kim, Kwang-Youn A; Jacobson, Kara; Hedlund, Laurie; Landa, Rosa; Maness, Leslie; Tailor Raythatha, Purvi; McFadden, Terri; Wolf, Michael S

    Some experts recommend eliminating "teaspoon" and "tablespoon" terms from pediatric medication dosing instructions, because these terms could inadvertently encourage use of nonstandard tools (ie, kitchen spoons), which are associated with dosing errors. We examined whether use of "teaspoon" or "tsp" on prescription labels affects parents' choice of dosing tools, and the role of health literacy and language. Analysis of data collected as part of a controlled experiment (SAFE Rx for Kids [Safe Administration For Every Prescription for Kids] study), which randomized English- and Spanish-speaking parents (n = 2110) of children 8 years of age and younger to 1 of 5 groups, which varied in unit of measurement pairings on medication labels and dosing tools. Outcome assessed was parent self-reported choice of dosing tool. Parent health literacy was measured using the Newest Vital Sign. Seventy-seven percent had limited health literacy (36.0% low, 41.0% marginal); 35.0% completed assessments in Spanish. Overall, 27.7% who viewed labels containing either "tsp" or "teaspoon" units (alone or with "mL") chose nonstandard dosing tools (ie, kitchen teaspoon, kitchen tablespoon), compared with 8.3% who viewed "mL"-only labels (adjusted odds ratio [AOR] = 4.4 [95% confidence interval (CI), 3.3-5.8]). Odds varied based on whether "teaspoon" was spelled out or abbreviated ("teaspoon"-alone: AOR = 5.3 [95% CI, 3.8-7.3]); "teaspoon" with mL: AOR = 4.7 [95% CI, 3.3-6.5]; "tsp" with mL: AOR = 3.3 [95% CI, 2.4-4.7]; P units ("teaspoon" or "tsp") on prescription labels is associated with increased likelihood of parent choice of nonstandard dosing tools. Future studies might be helpful to examine the real-world effect of eliminating teaspoon units from medication labels, and identify additional strategies to promote the safe use of pediatric liquid medications. Copyright © 2016 Academic Pediatric Association. Published by Elsevier Inc. All rights reserved.

  17. Neonatal doses from X ray examinations by birth weight in a neonatal intensive care unit

    Energy Technology Data Exchange (ETDEWEB)

    Ono, K.; Akahane, K.; Aota, T.; Hada, M.; Takano, Y.; Kai, M.; Kusama, T

    2003-07-01

    The aim of this study was to investigate the frequency and type of X ray examinations performed on neonates classified according to their birth weight in a neonatal intensive care unit (NICU). In this study, the radiology records of 2408 neonates who were admitted to the NICU of Oita Prefectural Hospital between January 1994 and September 1999 were investigated. This study revealed that the neonates with earlier gestational ages and lower birth weights required longer NICU stays and more frequent X ray examinations made using a mobile X ray unit. The average number of X ray examinations performed on neonates of less than 750 g birth weight was 26 films per neonate. In regard to computed tomography and fluoroscopy, no significant relationship was found between the birth weight and number of X rays. This study revealed that the entrance-surface dose per neonate was dependent upon the birth weight, while the maximum dose was not dependent upon the birth weight. The average neonatal dose in the NICU was predominantly from computed tomography and fluoroscopy. The individual dose varied widely among neonates. (author)

  18. Dominant unit CD34+ cell dose predicts engraftment after double-unit cord blood transplantation and is influenced by bank practice.

    Science.gov (United States)

    Purtill, Duncan; Smith, Katherine; Devlin, Sean; Meagher, Richard; Tonon, Joann; Lubin, Marissa; Ponce, Doris M; Giralt, Sergio; Kernan, Nancy A; Scaradavou, Andromachi; Stevens, Cladd E; Barker, Juliet N

    2014-11-06

    We investigated the unit characteristics associated with engraftment after double-unit cord blood (CB) transplantation (dCBT) and whether these could be reliably identified during unit selection. Cumulative incidence of neutrophil engraftment in 129 myeloablative dCBT recipients was 95% (95% confidence interval: 90-98%). When precryopreservation characteristics were analyzed, the dominant unit CD34(+) cell dose was the only characteristic independently associated with engraftment (hazard ratio, 1.43; P = .002). When postthaw characteristics were also included, only dominant unit infused viable CD34(+) cell dose independently predicted engraftment (hazard ratio, 1.95; P banks were more likely to have low recovery (P banks and units with cryovolumes other than 24.5 to 26.0 mL were more likely to have poor postthaw viability. Precryopreservation CD34(+) cell dose and banking practices should be incorporated into CB unit selection.

  19. Radiation doses and risks to neonates undergoing radiographic examinations in intensive care units in Tunisia

    Directory of Open Access Journals (Sweden)

    Abir Bouaoun

    2015-12-01

    Full Text Available Purpose: To assess the radiation doses to neonates from diagnostic radiography in order to derive the local diagnostic reference levels (LDRLs for optimisation purposes.Methods: This study was carried out in the neonatal intensive care units (NICU of  two hospitals in Tunis. 134 babies, with weights ranging from 635 g to 6680 g, performed chest-abdomen X-ray examinations. Neonates were categorized into groups of birth weight. For each X-ray examination, patient data and exposure parameters were recorded. Dose area product (DAP was measured and entrance surface dose (ESD was estimated. Effective dose was calculated from the Monte Carlo simulation software PCXMC.Results: DAP values increased with neonatal weight and demonstrated a wide variation (5.0 - 43.0 mGy.cm2, mean 23.4 mGy.cm2 for patient weight from 600 g to 4000 g. A wide variation was also observed for ESD (14 - 93 μGy, mean 55.2 μGy. The LDRLs expressed in term of DAP were estimated to be 17.6 mGy.cm2 and 29.1 mGy.cm2 for the first and the second NICU, respectively. In terms of effective dose, the average value was about 31.6 μSv per single radiological examination. The results show the necessity to use a standardized protocol with high voltage technique combined to lower current time product (mAs values and an adapted collimation which could lead to further reductions in the neonatal doses. Conclusion: This study presents the LDRLs and the effective doses for neonates in two NICUs and demonstrates the necessity to optimize patient protection for this category of patient.

  20. Dose-rate conversion factors for external exposure to photons and electrons

    Energy Technology Data Exchange (ETDEWEB)

    Kocher, D.C.

    1981-08-01

    Dose-rate conversion factors for external exposure to photons and electrons have been calculated for approximately 500 radionuclides of potential importance in environmental radiological assessments. The dose-rate factors were obtained using the DOSFACTER computer code. The results given in this report incorporate calculation of electron dose-rate factors for radiosensitive tissues of the skin, improved estimates of organ dose-rate factors for photons, based on organ doses for monoenergetic sources at the body surface of an exposed individual, and the spectra of scattered photons in air from monoenergetic sources in an infinite, uniformly contaminated atmospheric cloud, calculation of dose-rate factors for other radionuclides in addition to those of interest in the nuclear fuel cycle, and incorporation of updated radioactive decay data for all radionuclides. Dose-rate factors are calculated for three exposure modes - immersion in contaminated air, immersion in contaminated water, and exposure at a height of 1 m above a contaminated ground surface. The report presents the equations used to calculate the external dose-rate factors for photons and electrons, documentation of the revised DOSFACTER computer code, and a complete tabulation of the calculated dose-rate factors. 30 refs., 12 figs.

  1. Total Factor Productivity Convergence in Africa: Panel Unit Root ...

    African Journals Online (AJOL)

    PROF. O. E. OSUAGWU

    2013-09-01

    Sep 1, 2013 ... ... were made. Keywords: Total factor productivity, Convergence, Panel Unit Root. .... variable or labour quality variable. Mankiw et al [31] ... America are increasing in their economic growth rate ... This line of argument centers.

  2. Evaluation of Radiation Dose Received by Premature Neonates Admitted to Neonatal Intensive Care Unit

    Science.gov (United States)

    Aramesh, Mohmmadreza; Zanganeh, Kobra Aria; Dehdashtian, Masoud; Malekian, Arash; Fatahiasl, Jafar

    2017-01-01

    Background This study aimed to evaluate the radiation dose received by premature neonates using diagnostic radiographies. Methods This cross-sectional study was conducted on 116 premature neonates with gestational age from 25 to 37 weeks; with the diagnosis of neonatal respiratory distress syndrome (NRDS) and tachypnea, they were admitted to a neonatal intensive care unit (NICU) at Ahvaz Imam Khomeini Hospital in 2015. For assessing the dose received, the model GR-200 thermoluminescent dosimeter (TLD) was used. For each premature neonate under radiation, three TLDs separately (one for each) were placed on surfaces of Ch1, T1, and G1 (chest, thyroid, and gonad of first newborn, respectively). Moreover, for the adjacent neonate at a distance of 60 - 100 cm, two TLDs were laid in the surfaces of T2 and G2 (thyroid and gonad of second newborn, respectively). The dose received by TLDs for any baby and the adjacent neonate under the entrance surface dose (ESD) was estimated. Results The mean of neonates’ weight under study was 1,950.78 ± 484.9 g. During the hospitalization period, minimum one and maximum three radiographies were done for any premature neonate. The doses received in the premature neonates to Ch1, T1 and G1 were 0.08 ± 0.01, 0.06 ± 0.01, and 0.05 ± 0.01 mSv, respectively and for adjacent infants for T2 and G2 were 0.003 ± 0.001 and 0.002 ± 0.0009 mSv, respectively. Conclusions In the study, radiation dose received by organs at risk of premature neonates was lower than the international criteria and standards, therefore, also due to the lack of radiation damage threshold, to limit collimator, and the use of the proper filtration, kilovoltage and time during radiography of premature neonates are recommended. PMID:28090228

  3. [Drugs dosing in intensive care unit during continuous renal replacement therapy].

    Science.gov (United States)

    Bourquin, Vincent; Ponte, Belén; Saudan, Patrick; Martin, Pierre-Yves

    2009-11-01

    Drug dosing in the intensive care unit can be challenging. Acute kidney injury (AKI) is a common complication of sepsis and a part of multiple organ dysfunction syndrome. Continuous renal replacement therapy (CRRT) is increasingly used as dialysis therapy in this critically ill population. Available data demonstrate that sepsis, AKI and different modalities of CRRT can profoundly change drugs pharmacokinetic. The severity of these changes depends on molecules characteristics (volume of distribution, plasma protein binding, molecular weight, plasma half-life, plasma clearance), patient itself (volemia, residual renal function, tissue perfusion, hepatic dysfunction) and modality of CRRT (diffusion, convection, adsorption). There are no available recommendations to adapt drug dosing in a given critically ill patient with a given modality of CRRT. It is necessary to fully understand the different methods of CRRT and drug pharmacokinetic to prescribe the appropriate dose and to avoid under or potentially toxic overdosing. Monitoring the plasma level of drug - when available - can establish a relation between the blood concentration and its effect; thus, facilitating drug dosing.

  4. Estimating the Quantitative Demand of NOAC Antidote Doses on Stroke Units.

    Science.gov (United States)

    Pfeilschifter, Waltraud; Farahmand, Dana; Niemann, Daniela; Ikenberg, Benno; Hohmann, Carina; Abruscato, Mario; Thonke, Sven; Strzelczyk, Adam; Hedtmann, Günther; Neumann-Haefelin, Tobias; Kollmar, Rainer; Singer, Oliver C; Ferbert, Andreas; Steiner, Thorsten; Steinmetz, Helmuth; Reihs, Anke; Misselwitz, Björn; Foerch, Christian

    2016-01-01

    The first specific antidote for non-vitamin K antagonist oral anticoagulants (NOAC) has recently been approved. NOAC antidotes will allow specific treatment for 2 hitherto problematic patient groups: patients with oral anticoagulant therapy (OAT)-associated intracerebral hemorrhage (ICH) and maybe also thrombolysis candidates presenting on oral anticoagulation (OAT). We aimed to estimate the frequency of these events and hence the quantitative demand of antidote doses on a stroke unit. We extracted data of patients with acute ischemic stroke and ICH (demand for NOAC antidote doses on stroke units. Eighteen percent of ICH patients within 6 h of symptom onset or an unknown symptom onset were on OAT. Given a NOAC share at admission of 40%, about 7% of all ICH patients may qualify for NOAC reversal therapy. Thirteen percent of ischemic stroke patients admitted within 4 h presented on anticoagulation. Given the availability of an appropriate antidote, a NOAC share of 50% could lead to a 6.1% increase in thrombolysis rate. Stroke units serving populations with a comparable demographic structure should prepare to treat up to 1% of all acute ischemic stroke patients and 7% of all acute ICH patients with NOAC antidotes. These numbers may increase with the mounting prevalence of atrial fibrillation and an increasing use of NOAC. © 2016 S. Karger AG, Basel.

  5. A method to adjust radiation dose-response relationships for clinical risk factors

    DEFF Research Database (Denmark)

    Appelt, Ane Lindegaard; Vogelius, Ivan R

    2012-01-01

    Several clinical risk factors for radiation induced toxicity have been identified in the literature. Here, we present a method to quantify the effect of clinical risk factors on radiation dose-response curves and apply the method to adjust the dose-response for radiation pneumonitis for patients...

  6. Naoxintong dose effects on inflammatory factor expression in the rat brain following focal cerebral ischemia

    Institute of Scientific and Technical Information of China (English)

    Xiangjian Zhang; Li Xü; Zuoran Chen; Shuchao Hu; Liying Zhang; Haiyan Li; Ruichun Liu

    2008-01-01

    BACKGROUND: Certain components of tetramethylpyrazine, a traditional Chinese medicine, exhibit protective effects against brain injury.OBJECTIVE: To investigate the effects of different Naoxintong doses on expression of nuclear factor-kappa B (κ B), interleukin-6, tumor necrosis factor-α, and complement 3 in rats following focal cerebral ischemia.DESIGN, TIME AND SETTING: The randomized experiment was performed at the Laboratory of Neurology, Second Hospital of Hebei Medical University from June 2004 to June 2006. MATERIAIS: A total of 150 adult, healthy, male, Sprague Dawley rats, weighing 280-320 g, were selected. Naoxintong powder (mainly comprising szechwan lovage rhizome, milkvetch root, danshen root, and radix angelicae sinensis) was obtained from Buchang Pharmacy Co., Ltd. in Xianyang City of Shanxi Province of China, lot number 040608.METHODS: The rats were randomly assigned into sham operation, saline, high-dose Naoxintong, moderate-dose Naoxintong, and low-dose Naoxintong groups, with 30 rats in each group. Rat models of middle cerebral artery occlusion were established using the suture method, with the exception of the sham operation group. Rats in the high-dose, moderate-dose and low-dose Naoxintong groups received 4, 2, and 1 glkg Naoxintong respectively, by gavage. Rats in the saline group were treated with 1 mL saline by gavage. All rats were administered by garage at 5 and 23 hours following surgery, and subsequently, once per day.MAIN OUTCOME MEASURES: At 6, 24, 48, 72 hours, and 7 days following model establishment, brain water content was measured. Histopathological changes in brain tissues were detected using hematoxylin-eosin staining. Expression of nuclear factor- κB, interleukin-6, tumor necrosis factor-α, and complement 3 was examined by immunohistochemistry.RESULTS: A total of 150 rats were included in the final analysis with no loss. Brain water content was significantly increased in the ischemic hemisphere of rats from the saline, as

  7. Radiation doses received by premature babies in the neonatal intensive care unit; Doses d'irradiation recues par les prematures en service de reanimation

    Energy Technology Data Exchange (ETDEWEB)

    Thierry-Chef, I.; Maccia, C. [Centre d' Assurance de Qualite des Applications Technologiques dans le Domaine de la Sante, 92 - Bourg la Reine (France); Thierry-Chef, I.; Laurier, D.; Tirmarche, M. [Institut de Radioprotection et de Surete Nucleaire (IRSN/DRPH/SRBE/LRPID), 92 - Fontenay-aux-Roses (France); Costil, J. [Hopital Armand Trousseau, Service de Reanimation Neonatale, 75 - Paris (France)

    2005-02-15

    Purpose. Because of frequent radiological investigations performed in 1 neonatal intensive care unit, a dosimetry study was carried out to assess the level of doses received by premature babies. Materials and methods. In vivo measurements were performed and effective doses were evaluated for single radiographs. Individual cumulative doses received over the period of stay were then estimated, for each premature baby entering the intensive care unit in 2002, taking into account the number of radiographs they underwent. Results. On average, babies stayed for a week and more than one radio-graph was taken per day. Results showed that, even if average doses per radiograph were relatively low (25{mu}Sv), cumulative doses strongly depended on the length of stay, and can reach a few mSv. Conclusion. Even if doses per radiograph are in agreement with European recommendations, optimisation of doses is particularly important because premature babies are more sensitive to radiation than adults and because they usually undergo further radiological examinations in other services. On the basis of the results of this dosimetry study, the implementation of a larger study is being discussed. (author)

  8. Genetic Factors Affecting Susceptibility to Low Dose & Low Dose-Rate Radiation

    Energy Technology Data Exchange (ETDEWEB)

    Bedford, Joel

    2014-04-18

    Our laboratory has, among other things, developed and used the gamma H2AX focus assay and other chromosomal and cell killing assays to show that differences in this DNA double strand break (dsb) related response can be clearly and distinctly demonstrated for cells which are mildly hyper-radiosensitive such as those associated with A-T heterozygosity. We have found this level of mild hypersensitivity for cells from some 20 to 30 % of apparently normal individuals and from apparently normal parents of Retinoblastoma patients. We found significant differences in gene expression in somatic cells from unaffected parents of Rb patients as compared with normal controls, suggesting that these parents may harbor some as yet unidentified genetic abnormality. In other experiments we sought to determine the extent of differences in normal human cellular reaponses to radiation depending on their irradiation in 2D monolayer vs 3D organized acinar growth conditions. We exmined cell reproductive death, chromosomal aberration induction, and the levels of γ-H2AX foci in cells after single acute gamma-ray doses and immediately after 20 hours of irradiation at a dose rate of 0.0017 Gy/min. We found no significant differences in the dose-responses of these cells under the 2D or 3D growth conditions. While this does not mean such differences cannot occur in other situations, it does mean that they do not generally or necessarily occur. In another series of studies in collaboration with Dr Chuan Li, with supprt from this current grant. We reported a role for apoptotic cell death in promoting wound healing and tissue regeneration in mice. Apoptotic cells released growth signals that stimulated the proliferation of progenitor or stem cells. In yet another collaboration with Dr, B. Chen with funds from this grant, the relative radiosensitivity to cell killing as well as chromosomal instability of 13 DNA-PKcs site-directed mutant cell lines (defective at phosphorylation sites or kinase

  9. Risk of solid cancer in low dose-rate radiation epidemiological studies and the dose-rate effectiveness factor.

    Science.gov (United States)

    Shore, Roy; Walsh, Linda; Azizova, Tamara; Rühm, Werner

    2017-10-01

    Estimated radiation risks used for radiation protection purposes have been based primarily on the Life Span Study (LSS) of atomic bomb survivors who received brief exposures at high dose rates, many with high doses. Information is needed regarding radiation risks from low dose-rate (LDR) exposures to low linear-energy-transfer (low-LET) radiation. We conducted a meta-analysis of LDR epidemiologic studies that provide dose-response estimates of total solid cancer risk in adulthood in comparison to corresponding LSS risks, in order to estimate a dose rate effectiveness factor (DREF). We identified 22 LDR studies with dose-response risk estimates for solid cancer after minimizing information overlap. For each study, a parallel risk estimate was derived from the LSS risk model using matching values for sex, mean ages at first exposure and attained age, targeted cancer types, and accounting for type of dosimetric assessment. For each LDR study, a ratio of the excess relative risk per Gy (ERR Gy(-1)) to the matching LSS ERR risk estimate (LDR/LSS) was calculated, and a meta-analysis of the risk ratios was conducted. The reciprocal of the resultant risk ratio provided an estimate of the DREF. The meta-analysis showed a LDR/LSS risk ratio of 0.36 (95% confidence interval [CI] 0.14, 0.57) for the 19 studies of solid cancer mortality and 0.33 (95% CI 0.13, 0.54) when three cohorts with only incidence data also were added, implying a DREF with values around 3, but statistically compatible with 2. However, the analyses were highly dominated by the Mayak worker study. When the Mayak study was excluded the LDR/LSS risk ratios increased: 1.12 (95% CI 0.40, 1.84) for mortality and 0.54 (95% CI 0.09, 0.99) for mortality + incidence, implying a lower DREF in the range of 1-2. Meta-analyses that included only cohorts in which the mean dose was radiation exposure. The LDR data provide direct evidence regarding risk from exposures at low dose rates as an important complement to the

  10. Cardiac CT: are we underestimating the dose? A radiation dose study utilizing the 2007 ICRP tissue weighting factors and a cardiac specific scan volume

    Energy Technology Data Exchange (ETDEWEB)

    Gosling, O., E-mail: Oliver.gosling@pms.ac.u [Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth, Devon (United Kingdom); Loader, R.; Venables, P.; Rowles, N.; Morgan-Hughes, G. [Plymouth Hospitals NHS Trust, Derriford Hospital, Plymouth, Devon (United Kingdom); Roobottom, C. [Peninsula College of Medicine and Dentistry, University of Plymouth, Devon (United Kingdom)

    2010-12-15

    Aim: To calculate the effective dose from cardiac multidetector computed tomography (MDCT) using a computer-based model utilizing the latest International Commission on Radiation Protection (ICRP) 103 tissue-weighting factors (2007), to compare this dose with those calculated with previously published chest conversion factors and to produce a conversion factor specific for cardiac MDCT. Materials and methods: An observational study of 152 patients attending for cardiac MDCT as part of their usual clinical care in a university teaching hospital. The dose for each examination was calculated using the computer-based anthropomorphic ImPACT model (the imaging performance assessment of CT scanners) and this was compared with the dose derived from the dose-length product (DLP) and a chest conversion factor. Results: The median effective dose calculated using the ImPACT calculator (4.5 mSv) was significantly higher than the doses calculated with the chest conversion factors (2.2-3 mSv). Conclusion: The use of chest conversion factors significantly underestimates the effective dose when compared to the dose calculated using the ImPACT calculator. A conversion factor of 0.028 would give a better estimation of the effective dose from prospectively gated cardiac MDCT.

  11. A population pharmacokinetic model for perioperative dosing of factor VIII in hemophilia A patients

    Science.gov (United States)

    Hazendonk, Hendrika; Fijnvandraat, Karin; Lock, Janske; Driessens, Mariëtte; van der Meer, Felix; Meijer, Karina; Kruip, Marieke; Gorkom, Britta Laros-van; Peters, Marjolein; de Wildt, Saskia; Leebeek, Frank; Cnossen, Marjon; Mathôt, Ron

    2016-01-01

    The role of pharmacokinetic-guided dosing of factor concentrates in hemophilia is currently a subject of debate and focuses on long-term prophylactic treatment. Few data are available on its impact in the perioperative period. In this study, a population pharmacokinetic model for currently registered factor VIII concentrates was developed for severe and moderate adult and pediatric hemophilia A patients (FVIII levels hemophilia A patients by Bayesian adaptive dosing. PMID:27390359

  12. Landscape dose conversion factors used in the safety assessment SR-Site

    Energy Technology Data Exchange (ETDEWEB)

    Avila, Rodolfo; Ekstroem, Per-Anders; Aastrand, Per-Gustav (Facilia AB (Sweden))

    2010-12-15

    In this report two types of Dose Conversion Factors have been derived: i) a Landscape Dose Conversion Factor (LDF) that is applicable to continuous long-term releases to the biosphere at a constant rate, and ii) a Landscape Dose Conversion Factor for pulse releases (LDF pulse) that is applicable to a radionuclide release that reaches the biosphere in a pulse within years to hundreds of years. In SR-Site these Dose Factors are multiplied with modelled release rates or pulse releases from the geosphere to obtain dose estimates used in assessment of compliance with the regulatory risk criterion. The LDFs were calculated for three different periods of the reference glacial cycle; a period of submerged conditions following the deglaciation, the temperate period, and a prolonged period of periglacial conditions. Additionally, LDFs were calculated for the global warming climate case. The LDF pulse was calculated only for temperate climate conditions. The LDF and LDF pulse can be considered as Best Estimate values, which can be used in calculations of Best Estimate values of doses to a representative individual of the most exposed group from potential releases from a future repository. A systematic analysis of the effects of system, model and parameter uncertainties on the LDFs has been carried out. This analysis has shown that the use of the derived LDF would lead to cautious or realistic dose estimates. The models and methods that were used for derivation of the LDFs and LDF pulse are also described in this report

  13. Intensive Care Unit death and factors influencing family satisfaction of Intensive Care Unit care

    OpenAIRE

    2016-01-01

    Introduction: Family satisfaction of Intensive Care Unit (FS-ICU) care is believed to be associated with ICU survival and ICU outcomes. A review of literature was done to determine factors influencing FS-ICU care in ICU deaths. Results: Factors that positively influenced FS-ICU care were (a) communication: Honesty, accuracy, active listening, emphatic statements, consistency, and clarity; (b) family support: Respect, compassion, courtesy, considering family needs and wishes, and emotional and...

  14. Towards individualized dose constraints: Adjusting the QUANTEC radiation pneumonitis model for clinical risk factors

    DEFF Research Database (Denmark)

    Appelt, Ane L; Vogelius, Ivan R.; Farr, Katherina P.

    2014-01-01

    Background. Understanding the dose-response of the lung in order to minimize the risk of radiation pneumonitis (RP) is critical for optimization of lung cancer radiotherapy. We propose a method to combine the dose-response relationship for RP in the landmark QUANTEC paper with known clinical risk......-only QUANTEC model and the model including risk factors. Subdistribution cumulative incidence functions were compared for patients with high/low-risk predictions from the two models, and concordance indices (c-indices) for the prediction of RP were calculated. Results. The reference dose- response relationship...... factors, in order to enable individual risk prediction. The approach is validated in an independent dataset. Material and methods. The prevalence of risk factors in the patient populations underlying the QUANTEC analysis was estimated, and a previously published method to adjust dose...

  15. SU-E-T-577: Obliquity Factor and Surface Dose in Proton Beam Therapy

    Energy Technology Data Exchange (ETDEWEB)

    Das, I; Andersen, A [Indiana University- School of Medicine, Indianapolis, IN (United States); Coutinho, L [Procure Proton Therapy Center, Somerset, NJ (United States)

    2015-06-15

    Purpose: The advantage of lower skin dose in proton beam may be diminished creating radiation related sequalae usually seen with photon and electron beams. This study evaluates the surface dose as a complex function of beam parameters but more importantly the effect of beam angle. Methods: Surface dose in proton beam depends on the beam energy, source to surface distance, the air gap between snout and surface, field size, material thickness in front of surface, atomic number of the medium, beam angle and type of nozzle (ie double scattering, (DS), uniform scanning (US) or pencil beam scanning (PBS). Obliquity factor (OF) is defined as ratio of surface dose in 0° to beam angle Θ. Measurements were made in water phantom at various beam angles using very small microdiamond that has shown favorable beam characteristics for high, medium and low proton energy. Depth dose measurements were performed in the central axis of the beam in each respective gantry angle. Results: It is observed that surface dose is energy dependent but more predominantly on the SOBP. It is found that as SSD increases, surface dose decreases. In general, SSD, and air gap has limited impact in clinical proton range. High energy has higher surface dose and so the beam angle. The OF rises with beam angle. Compared to OF of 1.0 at 0° beam angle, the value is 1.5, 1.6, 1,7 for small, medium and large range respectively for 60 degree angle. Conclusion: It is advised that just like range and SOBP, surface dose should be clearly understood and a method to reduce the surface dose should be employed. Obliquity factor is a critical parameter that should be accounted in proton beam therapy and a perpendicular beam should be used to reduce surface dose.

  16. Energy Optimization And Calculation Of Dose Absorption Enhancement Factor In Photon Activation Therapy

    Directory of Open Access Journals (Sweden)

    Hassan Ranjbar

    2010-06-01

    Full Text Available Introduction: Secondary radiation such as photoelectrons, Auger electrons and characteristic radiations cause a local boost in dose for a tumor when irradiated with an external X-ray beam after being loaded with elements capable of activating the tumor, e.g.; I and Gd. Materials and Methods:  In this investigation, the MCNPX code was used for simulation and calculation of dose enhancement factor for a tumor loaded with activating elements. The designed model comprised the X-ray source, phantom (target tissue and loaded tumor with activating agent, detector, interactions modeling and results. The source was defined as monochromatic and plane surface situated at 50 cm (z = 50. Phantom geometry was a 10 × 10 × 10 cm3 cube centered at (0, 0, 0 with a 2.2 × 2.2 × 2.2 cm3 cubic tumor with a center located at 3 cm depth inside the phantom Results: Dose enhancement factor and optimum energy in radiotherapy are evaluated using the photon activation therapy method. Result show that the dose enhancement factor increases with activating concentration in the tumor. The maximum dose enhancement factor for iodine in the tumor occurs for photons in the energy range of 50-60 keV. Dose uniformity is less for lower energy photons within the activated region inside the tumor. Results indicate that the dose enhancement factor varies linearly with the activating concentration agent. Discussion and Conclusion: In this study, the obtained results point out a considerable enhancement in dose in the presence of activating agents in the tumor regions.

  17. Factors associated with maternal death in an intensive care unit

    Science.gov (United States)

    Saintrain, Suzanne Vieira; de Oliveira, Juliana Gomes Ramalho; Saintrain, Maria Vieira de Lima; Bruno, Zenilda Vieira; Borges, Juliana Lima Nogueira; Daher, Elizabeth De Francesco; da Silva Jr, Geraldo Bezerra

    2016-01-01

    Objective To identify factors associated with maternal death in patients admitted to an intensive care unit. Methods A cross-sectional study was conducted in a maternal intensive care unit. All medical records of patients admitted from January 2012 to December 2014 were reviewed. Pregnant and puerperal women were included; those with diagnoses of hydatidiform mole, ectopic pregnancy, or anembryonic pregnancy were excluded, as were patients admitted for non-obstetrical reasons. Death and hospital discharge were the outcomes subjected to comparative analysis. Results A total of 373 patients aged 13 to 45 years were included. The causes for admission to the intensive care unit were hypertensive disorders of pregnancy, followed by heart disease, respiratory failure, and sepsis; complications included acute kidney injury (24.1%), hypotension (15.5%), bleeding (10.2%), and sepsis (6.7%). A total of 28 patients died (7.5%). Causes of death were hemorrhagic shock, multiple organ failure, respiratory failure, and sepsis. The independent risk factors associated with death were acute kidney injury (odds ratio [OR] = 6.77), hypotension (OR = 15.08), and respiratory failure (OR = 3.65). Conclusion The frequency of deaths was low. Acute kidney injury, hypotension, and respiratory insufficiency were independent risk factors for maternal death. PMID:28099637

  18. Quantification of confounding factors in MRI-based dose calculations as applied to prostate IMRT

    Science.gov (United States)

    Maspero, Matteo; Seevinck, Peter R.; Schubert, Gerald; Hoesl, Michaela A. U.; van Asselen, Bram; Viergever, Max A.; Lagendijk, Jan J. W.; Meijer, Gert J.; van den Berg, Cornelis A. T.

    2017-02-01

    Magnetic resonance (MR)-only radiotherapy treatment planning requires pseudo-CT (pCT) images to enable MR-based dose calculations. To verify the accuracy of MR-based dose calculations, institutions interested in introducing MR-only planning will have to compare pCT-based and computer tomography (CT)-based dose calculations. However, interpreting such comparison studies may be challenging, since potential differences arise from a range of confounding factors which are not necessarily specific to MR-only planning. Therefore, the aim of this study is to identify and quantify the contribution of factors confounding dosimetric accuracy estimation in comparison studies between CT and pCT. The following factors were distinguished: set-up and positioning differences between imaging sessions, MR-related geometric inaccuracy, pCT generation, use of specific calibration curves to convert pCT into electron density information, and registration errors. The study comprised fourteen prostate cancer patients who underwent CT/MRI-based treatment planning. To enable pCT generation, a commercial solution (MRCAT, Philips Healthcare, Vantaa, Finland) was adopted. IMRT plans were calculated on CT (gold standard) and pCTs. Dose difference maps in a high dose region (CTV) and in the body volume were evaluated, and the contribution to dose errors of possible confounding factors was individually quantified. We found that the largest confounding factor leading to dose difference was the use of different calibration curves to convert pCT and CT into electron density (0.7%). The second largest factor was the pCT generation which resulted in pCT stratified into a fixed number of tissue classes (0.16%). Inter-scan differences due to patient repositioning, MR-related geometric inaccuracy, and registration errors did not significantly contribute to dose differences (0.01%). The proposed approach successfully identified and quantified the factors confounding accurate MRI-based dose calculation in

  19. Towards individualized dose constraints: Adjusting the QUANTEC radiation pneumonitis model for clinical risk factors

    DEFF Research Database (Denmark)

    Appelt, Ane L; Vogelius, Ivan R.; Farr, Katherina P.;

    2014-01-01

    Background. Understanding the dose-response of the lung in order to minimize the risk of radiation pneumonitis (RP) is critical for optimization of lung cancer radiotherapy. We propose a method to combine the dose-response relationship for RP in the landmark QUANTEC paper with known clinical risk...... factors, in order to enable individual risk prediction. The approach is validated in an independent dataset. Material and methods. The prevalence of risk factors in the patient populations underlying the QUANTEC analysis was estimated, and a previously published method to adjust dose......-response relationships for clinical risk factors was employed. Effect size estimates (odds ratios) for risk factors were drawn from a recently published meta-analysis. Baseline values for D50 and γ50 were found. The method was tested in an independent dataset (103 patients), comparing the predictive power of the dose......-only QUANTEC model and the model including risk factors. Subdistribution cumulative incidence functions were compared for patients with high/low-risk predictions from the two models, and concordance indices (c-indices) for the prediction of RP were calculated. Results. The reference dose- response relationship...

  20. Clinical Risk Factors for Gastroduodenal Ulcer in Romanian Low-Dose Aspirin Consumers

    OpenAIRE

    2016-01-01

    Background. Aspirin use for cardiovascular or cancer prevention is limited due to its gastrointestinal side effects. Objective. Our prospective, observational case-control study aims to identify the predictive factors for ulcers in low-dose aspirin consumers (75–325 mg/day). Methods. The study included patients who underwent an upper digestive endoscopy and took low-dose aspirin treatment. Results. We recruited 51 patients with ulcer (ulcer group) and 108 patients with no mucosal lesions (con...

  1. Study of the spatial distribution of the absorbed dose in blood volumes irradiated using a teletherapy unit

    Energy Technology Data Exchange (ETDEWEB)

    Goes, E.G., E-mail: eggoes@terra.com.b [Regional Blood Center of Ribeirao Preto, Ribeirao Preto, SP (Brazil); Nicolucci, P.; Nali, I.C. [Physics and Mathematics Department, University of Sao Paulo, Ribeirao Preto, SP (Brazil); Pela, C.A.; Bruco, J.L. [Physics and Mathematics Department, University of Sao Paulo, Ribeirao Preto, SP (Brazil); Center of Instrumentation, Dosimetry and Radioprotection, University of Sao Paulo, Ribeirao Preto, SP (Brazil); Borges, J.C. [Center of Instrumentation, Dosimetry and Radioprotection, University of Sao Paulo, Ribeirao Preto, SP (Brazil); Covas, D.T. [Regional Blood Center of Ribeirao Preto, Ribeirao Preto, SP (Brazil); Center for Cell-Based Therapy, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP (Brazil)

    2010-06-15

    Blood irradiation can be performed using a dedicated blood irradiator or a teletherapy unit. A thermal device providing appropriate storage conditions during blood components irradiation with a teletherapy unit has been recently proposed. However, the most appropriated volume of the thermal device was not indicated. The goal of this study was to indicate the most appropriated blood volume for irradiation using a teletherapy unit in order to minimize both the dose heterogeneity in the volume and the blood irradiation time using these equipments. Theoretical and experimental methods were used to study the dose distribution in the blood volume irradiated using a linear accelerator and a cobalt-60 therapy machine. The calculation of absorbed doses in the middle plane of cylindrical acrylic volumes was accomplished by a treatment planning system. Experimentally, we also used cylindrical acrylic phantoms and thermoluminescent dosimeters to confirm the calculated doses. The data obtained were represented by isodose curves. We observed that an irradiation volume should have a height of 28 cm and a diameter of 28 cm and a height of 35 cm and a diameter of 35 cm, when the irradiation is to be performed by a linear accelerator and a cobalt-60 teletherapy unit, respectively. Calculated values of relative doses varied from 93% to 100% in the smaller volume, and from 66% to 100% in the largest one. A difference of 5.0%, approximately, was observed between calculated and experimental data. The size of these volumes permits the irradiation of blood bags in only one bath without compromising the homogeneity of the absorbed dose over the irradiated volume. Thus, these irradiation volumes can be recommend to minimize the irradiation time when a teletherapy unit is used to irradiate blood.

  2. Study of the spatial distribution of the absorbed dose in blood volumes irradiated using a teletherapy unit

    Science.gov (United States)

    Góes, E. G.; Nicolucci, P.; Nali, I. C.; Pelá, C. A.; Bruço, J. L.; Borges, J. C.; Covas, D. T.

    2010-06-01

    Blood irradiation can be performed using a dedicated blood irradiator or a teletherapy unit. A thermal device providing appropriate storage conditions during blood components irradiation with a teletherapy unit has been recently proposed. However, the most appropriated volume of the thermal device was not indicated. The goal of this study was to indicate the most appropriated blood volume for irradiation using a teletherapy unit in order to minimize both the dose heterogeneity in the volume and the blood irradiation time using these equipments. Theoretical and experimental methods were used to study the dose distribution in the blood volume irradiated using a linear accelerator and a cobalt-60 therapy machine. The calculation of absorbed doses in the middle plane of cylindrical acrylic volumes was accomplished by a treatment planning system. Experimentally, we also used cylindrical acrylic phantoms and thermoluminescent dosimeters to confirm the calculated doses. The data obtained were represented by isodose curves. We observed that an irradiation volume should have a height of 28 cm and a diameter of 28 cm and a height of 35 cm and a diameter of 35 cm, when the irradiation is to be performed by a linear accelerator and a cobalt-60 teletherapy unit, respectively. Calculated values of relative doses varied from 93% to 100% in the smaller volume, and from 66% to 100% in the largest one. A difference of 5.0%, approximately, was observed between calculated and experimental data. The size of these volumes permits the irradiation of blood bags in only one bath without compromising the homogeneity of the absorbed dose over the irradiated volume. Thus, these irradiation volumes can be recommend to minimize the irradiation time when a teletherapy unit is used to irradiate blood.

  3. Comparison of absorbed dose to air calibration factors for a parallel plate ionization chamber

    Energy Technology Data Exchange (ETDEWEB)

    Bulla, Roseli T.; Caldas, Linda V.E. [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN), Sao Paulo, SP (Brazil)]. E-mail: lcaldas@ipen.br; rtbulla@ig.com.br

    2006-05-15

    Objective: the objective of this study was to compare the absorbed dose to air calibration factors determined in gamma ({sup 60}Co) and electron beams.Objective: an irradiator with a {sup 60}Co source and a Varian, Clinac 2100C linear accelerator with photon and electron beams were utilized. One thimble-type and three parallel-plate ionization chambers were tested. Results: The measurement systems were submitted to preliminary tests (response stability and leakage current), with quite good results. The absorbed dose to air calibration factors were determined using four measurement systems and two types of phantoms. Results were obtained in compliance with the international recommendations.Conclusion: absorbed dose to air calibration factors obtained for parallel plate ionization chambers, determined in {sup 60}Co beams, at maximum, are 1.2% higher than the values obtained in high energy electron beams. (author)

  4. Study of factors influencing dose distribution of brachytherapy in cervical cancer

    Institute of Scientific and Technical Information of China (English)

    Liu Zi; Gao Ying; Luo Wei; Wang Guoqing; Wang Ruihua; Zheng Wei; Liu Rui

    2008-01-01

    Objective To study the factors which influence the dose distribution of brachytherapy in cervical cancer. Methods Ninety-five patients with cervical cancer Ⅱ - Ⅲ b received fundamental radiation therapy including brachytherapy in our department from Aug. 2004 to Nov. 2005. The deviation of isodose curve of brachytherapy was based on A-B reference system, and the deviation of dose was defined by measuring in a practical standard body model. Results The factors influencing isodose offset significantly were parametrial infiltrating degree, and anatomy factor of cervical cancer and operating skill. The degree of isodose offset could not be lowered with the increased frequency of brachytherapy. Conclusion Making simulation in cervical brachythecapy is necessary not only for the identification of the deviation of isodose curve but also for adjusting the dose distribution and revising the plan of radiotherapy.

  5. SU-E-T-516: Measurement of the Absorbed Dose Rate in Water Under Reference Conditions in a CyberKnife Unit

    Energy Technology Data Exchange (ETDEWEB)

    Aragon-Martinez, N; Hernandez-Guzman, A [Instituto de Fisica, Universidad Nacional Autonoma de Mexico, Mexico City, DF (Mexico); Gomez-Munoz, A [Centro Medico Nacional Siglo XXI, Mexico City, DF (Mexico); Massillon-JL, G

    2014-06-01

    Purpose: This paper aims to measure the absorbed-dose-rate in a CyberKnife unit reference-field (6cm diameter) using three ionization chambers (IC) following the new IAEA/AAPM formalism and Gafchromic film (MD-V3-55 and EBT3) protocol according to our work reported previously. Methods: The absorbed-dose-rates were measured at 90cm and 70cm SSD in a 10cmx10cm field and at 70cm SSD in a 5.4cmx5.4cm equivalent to 6cm diameter field using a linac Varian iX. All measurements were performed at 10cm depth in water. The correction factors that account for the difference between the IC response on the reference field and the CyberKnife reference field, k-(Q-msr,Q)^(f-msr,f-ref), were evaluated and Gafchromic film were calibrated using the results obtained above. Under the CyberKnife reference conditions, the factors were used to measure the absorbed-dose-rate with IC according to the new formalism and the calibrated film was irradiated in water. The film calibration curve was used to evaluate the absorbed-dose-rate in the CyberKnife unit. Results: Difference up to 2.56% is observed between dose-rate measured with IC in the reference 10cmx10cm field, depending where the chamber was calibrated, which was not reflected in the correction factor k-(Q-msr,Q)^(f-msr,f-ref ) where variations of ~0.15%-0.5% were obtained. Within measurements uncertainties, maximum difference of 1.8% on the absorbed-dose-rate in the CyberKnife reference field is observed between all IC and the films Conclusion: Absorbed-dose-rate to water was measured in a CyberKnife reference field with acceptable accuracy (combined uncertainties ~1.32%-1.73%, k=1) using three IC and films. The MD-V3-55 film as well as the new IAEA/AAPM formalism can be considered as a suitable dosimetric method to measure absorbed-dose-rate to water in small and non-standard CyberKnife fields used in clinical treatments However, the EBT3 film is not appropriated due to the high uncertainty provided (combined uncertainty ~9%, k=1

  6. Evaluation of a vancomycin dosing protocol for intensive care unit patients

    NARCIS (Netherlands)

    Brinkman, I.; Verstappen, G.; Veeger, N.; Boerma, E. C.; Buter, H.

    2015-01-01

    Vancomycin is a glycopeptide antibiotic that needs to be dosed to achieve target trough levels of 15-20 mg/l. Dosing can be challenging in ICU patients. To optimise therapy, in ICU-pharmacy collaboration, a dosing protocol was introduced on the ICU of the Medical Center Leeuwarden, the Netherlands.

  7. Calculation of conversion factors for effective dose for various interventional radiology procedures

    Energy Technology Data Exchange (ETDEWEB)

    Compagnone, Gaetano; Giampalma, Emanuela; Domenichelli, Sara; Renzulli, Matteo; Golfieri, Rita [Medical Physics Department, S. Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna (Italy); Radiology Department, S. Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna (Italy); Medical Physics Department, S. Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna (Italy); Radiology Department, S. Orsola-Malpighi University Hospital, Via Massarenti 9, 40138 Bologna (Italy)

    2012-05-15

    Purpose: To provide dose-area-product (DAP) to effective dose (E) conversion factors for complete interventional procedures, based on in-the-field clinical measurements of DAP values and using tabulated E/DAP conversion factors for single projections available from the literature. Methods: Nine types of interventional procedures were performed on 84 patients with two angiographic systems. Different calibration curves (with and without patient table attenuation) were calculated for each DAP meter. Clinical and dosimetric parameters were recorded in-the-field for each projection and for all patients, and a conversion factor linking DAP and effective doses was derived for each complete procedure making use of published, Monte Carlo calculated conversion factors for single static projections. Results: Fluoroscopy time and DAP values for the lowest-dose procedure (biliary drainage) were approximately 3-fold and 13-fold lower, respectively, than those for the highest-dose examination (transjugular intrahepatic portosystemic shunt, TIPS). Median E/DAP conversion factors from 0.12 (abdominal percutaneous transluminal angioplasty) to 0.25 (Nephrostomy) mSvGy{sup -1} cm{sup -2} were obtained and good correlations between E and DAP were found for all procedures, with R{sup 2} coefficients ranging from 0.80 (abdominal angiography) to 0.99 (biliary stent insertion, Nephrostomy and TIPS). The DAP values obtained in this study showed general consistency with the values provided in the literature and median E values ranged from 4.0 mSv (biliary drainage) to 49.6 mSv (TIPS). Conclusions: Values of E/DAP conversion factors were derived for each procedure from a comprehensive analysis of projection and dosimetric data: they could provide a good evaluation for the stochastic effects. These results can be obtained by means of a close cooperation between different interventional professionals involved in patient care and dose optimization.

  8. Study of factors influencing dose distribution of brachytherapy in cervical cancer

    Institute of Scientific and Technical Information of China (English)

    2008-01-01

    Objective To study the factors which influence the dose distribution of brachytherapy in cervical cancer.Methods Ninety-five patients with cervical cancer Ⅱ-Ⅲb received fundamental radiation therapy including brachytherapy in our department from Aug.2004 to Nov.2005.The deviation of isodose curve of brachytherapy was based on A-B reference system,and the deviation of dose was defined by measuring in a practical standard body model.Results The factors influencing isodose offset significantly were parametrial...

  9. Obesity in the United States—dysbiosis from exposure to low-dose antibiotics?

    Directory of Open Access Journals (Sweden)

    Lee W Riley

    2013-12-01

    Full Text Available The rapid increase in obesity prevalence in the United States in the last 20 years is unprecedented and not well explained. Here, we explore a hypothesis that the obesity epidemic may be driven by population-wide chronic exposures to low-residue antibiotics that have increasingly entered the American food chain over the same time period. We propose this hypothesis based on two recent bodies of published reports—1 those that provide evidence for the spread of antibiotics into the American food chain, and 2 those that examine the relationship between the gut microbiota and body physiology. The livestock use of antimicrobial agents has sharply increased in the US over the same 20-year period of the obesity epidemic, especially with the expansion of intensified livestock production, such as the concentrated animal feeding operations (CAFOs. Observational and experimental studies support the idea that changes in the intestinal microbiota exert a profound effect on body physiology. We propose that chronic exposures to low-residue antimicrobial drugs in food could disrupt the equilibrium state of intestinal microbiota and cause dysbiosis that can contribute to changes in body physiology. The obesity epidemic in the United States may be partly driven by the mass exposure of Americans to food containing low-residue antimicrobial agents. While this hypothesis cannot discount the impact of diet and other factors associated with obesity, we believe studies are warranted to consider this possible driver of the epidemic.

  10. Esophageal Dose Tolerance to Hypofractionated Stereotactic Body Radiation Therapy: Risk Factors for Late Toxicity

    Energy Technology Data Exchange (ETDEWEB)

    Stephans, Kevin L., E-mail: stephak@ccf.org [Department of Radiation Oncology, Cleveland Clinic, Taussig Cancer Center, Cleveland, Ohio (United States); Djemil, Toufik [Department of Radiation Oncology, Cleveland Clinic, Taussig Cancer Center, Cleveland, Ohio (United States); Diaconu, Claudiu [Cleveland Clinic Learner College of Medicine, Cleveland, Ohio (United States); Reddy, Chandana A.; Xia, Ping; Woody, Neil M.; Greskovich, John [Department of Radiation Oncology, Cleveland Clinic, Taussig Cancer Center, Cleveland, Ohio (United States); Makkar, Vinit [Department of Medical Oncology, Cleveland Clinic, Taussig Cancer Center, Cleveland, Ohio (United States); Videtic, Gregory M.M. [Department of Radiation Oncology, Cleveland Clinic, Taussig Cancer Center, Cleveland, Ohio (United States)

    2014-09-01

    Purpose: To identify factors associated with grade ≥3 treatment related late esophageal toxicity after lung or liver stereotactic body radiation therapy (SBRT). Methods and Materials: This was a retrospective review of 52 patients with a planning target volume within 2 cm of the esophagus from a prospective registry of 607 lung and liver SBRT patients treated between 2005 and 2011. Patients were treated using a risk-adapted dose regimen to a median dose of 50 Gy in 5 fractions (range, 37.5-60 Gy in 3-10 fractions). Normal structures were contoured using Radiation Therapy Oncology Group (RTOG) defined criteria. Results: The median esophageal point dose and 1-cc dose were 32.3 Gy (range, 8.9-55.4 Gy) and 24.0 Gy (range, 7.8-50.9 Gy), respectively. Two patients had an esophageal fistula at a median of 8.4 months after SBRT, with maximum esophageal point doses of 51.5 and 52 Gy, and 1-cc doses of 48.1 and 50 Gy, respectively. These point and 1-cc doses were exceeded by 9 and 2 patients, respectively, without a fistula. The risk of a fistula for point doses exceeding 40, 45, and 50 Gy was 9.5% (n=2/21), 10.5% (n=2/19), and 12.5% (n=2/16), respectively. The risk of fistula for 1-cc doses exceeding 40, 45, and 50 Gy was 25% (n=2/9), 50% (n=2/4), and 50% (n=2/4), respectively. Eighteen patients received systemic therapy after SBRT (11 systemic chemotherapy, and 6 biologic agents, and 1 both). Both patients with fistulas had received adjuvant anti-angiogenic (vascular endothelial growth factor) agents within 2 months of completing SBRT. No patient had a fistula in the absence of adjuvant VEGF-modulating agents. Conclusions: Esophageal fistula is a rare complication of SBRT. In this series, fistula was seen with esophageal point doses exceeding 51 Gy and 1-cc doses greater than 48 Gy. Notably, however, fistula was seen only in those patients who also received adjuvant VEGF-modulating agents after SBRT. The potential interaction of dose and adjuvant therapy

  11. A population pharmacokinetic model for perioperative dosing of factor VIII in hemophilia A patients

    NARCIS (Netherlands)

    Hazendonk, Hendrika; Fijnvandraat, Karin; Lock, Janske; Driessens, Mariette; van der Meer, Felix; Meijer, Karina; Kruip, Marieke; Laros-van Gorkom, Britta; Peters, Marjolein; de Wildt, Saskia; Leebeek, Frank; Cnossen, Marjon; Mathot, Ron

    2016-01-01

    The role of pharmacokinetic-guided dosing of factor concentrates in hemophilia is currently a subject of debate and focuses on long-term prophylactic treatment. Few data are available on its impact in the perioperative period. In this study, a population pharmacokinetic model for currently registere

  12. A population pharmacokinetic model for perioperative dosing of factor VIII in hemophilia A patients

    NARCIS (Netherlands)

    Hazendonk, Hendrika; Fijnvandraat, Karin; Lock, Janske; Driessens, Mariette; van der Meer, Felix; Meijer, Karina; Kruip, Marieke; Laros-van Gorkom, Britta; Peters, Marjolein; de Wildt, Saskia; Leebeek, Frank; Cnossen, Marjon; Mathot, Ron

    2016-01-01

    The role of pharmacokinetic-guided dosing of factor concentrates in hemophilia is currently a subject of debate and focuses on long-term prophylactic treatment. Few data are available on its impact in the perioperative period. In this study, a population pharmacokinetic model for currently

  13. Computerized Dose Range Checking Using Hard and Soft Stop Alerts Reduces Prescribing Errors in a Pediatric Intensive Care Unit.

    Science.gov (United States)

    Balasuriya, Lilanthi; Vyles, David; Bakerman, Paul; Holton, Vanessa; Vaidya, Vinay; Garcia-Filion, Pamela; Westdorp, Joan; Sanchez, Christine; Kurz, Rhonda

    2017-09-01

    An enhanced dose range checking (DRC) system was developed to evaluate prescription error rates in the pediatric intensive care unit and the pediatric cardiovascular intensive care unit. An enhanced DRC system incorporating "soft" and "hard" alerts was designed and implemented. Practitioner responses to alerts for patients admitted to the pediatric intensive care unit and the pediatric cardiovascular intensive care unit were retrospectively reviewed. Alert rates increased from 0.3% to 3.4% after "go-live" (P < 0.001). Before go-live, all alerts were soft alerts. In the period after go-live, 68% of alerts were soft alerts and 32% were hard alerts. Before go-live, providers reduced doses only 1 time for every 10 dose alerts. After implementation of the enhanced computerized physician order entry system, the practitioners responded to soft alerts by reducing doses to more appropriate levels in 24.7% of orders (70/283), compared with 10% (3/30) before go-live (P = 0.0701). The practitioners deleted orders in 9.5% of cases (27/283) after implementation of the enhanced DRC system, as compared with no cancelled orders before go-live (P = 0.0774). Medication orders that triggered a soft alert were submitted unmodified in 65.7% (186/283) as compared with 90% (27/30) of orders before go-live (P = 0.0067). After go-live, 28.7% of hard alerts resulted in a reduced dose, 64% resulted in a cancelled order, and 7.4% were submitted as written. Before go-live, alerts were often clinically irrelevant. After go-live, there was a statistically significant decrease in orders that were submitted unmodified and an increase in the number of orders that were reduced or cancelled.

  14. SU-E-T-517: Investigation of Factors Contributing to Extracranial Radiation Doses From Leksell Gamma Knife

    Energy Technology Data Exchange (ETDEWEB)

    Kon, D [The University of Tokyo Graduate school of Medicine, Tokyo, JP (Japan); Kameda Medical Centre, Chiba, JP (Japan); Nakano, M [The University of Tokyo Graduate school of Medicine, Tokyo, JP (Japan); Nawa, K; Haga, A; Nakagawa, K [University of Tokyo Hospital, Tokyo, JP (Japan)

    2015-06-15

    Purpose The purpose of this study is to investigate dominant factors for doses to extracranial sites in treatment with Leksell Gamma Knife (LGK). Methods Monte Carlo simulation was implemented using EGS5 version 1.4.401. The simulation was divided into two major steps for the purpose of efficiency. As the first step, phase-space files were obtained at a scoring plane located just below patient-side surface of the collimator helmet of LGK. Scored particles were classified into three groups, primary, leakage and scatter, using their history information until their arrival to the scoring plane. Then classification was used at the following second step simulation to investigate which type of particle is dominant in the deposited energy at extra-cranial sites. In the second stage, a cylindrical phantom with a semisphere shaped head was modeled such that the geometrical center of the phantom’s head corresponds to the unit center point (UCP) of LGK. Scoring regions were arranged at 10 cm intervals from the UCP to 70 cm away on the central axis of the phantom. Energy deposition from each type of particles and location of interaction were recorded. Results The dominant factor of deposited energy depended on the collimator size. In the case of smaller collimator size, leakage was dominant. However, contribution of leakage was relatively small in the case of larger collimator size. The contribution of internal scatter varied with the distance from the UCP. In the proximal areas, internal scatter was dominant, whereas in the distal areas, particles interacting with machine components became dominant factor. Conclusion The Result of this study indicates that the dominant factor to dose to an extracranial site can vary with the distance from UCP and with collimator size. This means that the variation of this contribution must be considered for modeling of the extracranial dose especially in the distal area. This work was partly supported by the JSPS Core-to-Core Program (No

  15. Impact of genetic and clinical factors on dose requirements and quality of anticoagulation therapy in Polish patients receiving acenocoumarol: dosing calculation algorithm.

    Science.gov (United States)

    Wolkanin-Bartnik, Jolanta; Pogorzelska, Hanna; Szperl, Małgorzata; Bartnik, Aleksandra; Koziarek, Jacek; Bilinska, Zofia T

    2013-11-01

    Despite the recent emergence of new oral anticoagulants, vitamin K antagonists remain the primary therapy in patients with atrial fibrillation and the only therapy licensed for use in patients with artificial heart valves. The aim of this study was (a) to assess the impact of clinical and genetic factors on acenocoumarol (AC) dose requirements and the percentage of time in therapeutic range (%TTR) and (b) to develop pharmacogenetic-guided AC dose calculation algorithm. We included 235 outpatients of the Institute of Cardiology (Warsaw), mean age 69.3, 46.9% women, receiving AC for artificial heart valves and/or atrial fibrillation. A multiple linear-regression analysis was performed using log-transformed effective AC dose as the dependent variable, and combining CYP2C9 and VKORC1 genotyping with other clinical factors as independent predictors. We identified factors that influenced the AC dose: CYP2C9 polymorphisms (P=0.004), VKORC1 polymorphisms (Pgenetic factors explained 49.0% of AC dose variability. We developed a dosing calculation algorithm that is, to the best of our knowledge, the first one to assess the effect of such clinical factors as creatinine clearance and dietary vitamin K intake on the AC dose. The clinical usefulness of the algorithm was assessed on separate validation group (n=50) with 70% accuracy. Dietary vitamin K intake higher than 200 mcg/day improved international normalized ratio control (%TTR 73.3±17 vs. 67.7±18, respectively, P=0.04). Inclusion of a variety of genetic and clinical factors in the dosing calculation algorithm allows for precise AC dose estimation in most patients and thus improves the efficacy and safety of the therapy.

  16. Hounsfield units variations. Impact on CT-density based conversion tables and their effects on dose distribution

    Energy Technology Data Exchange (ETDEWEB)

    Zurl, B.; Winkler, P.; Kapp, K.S. [University Medical School of Graz, Comprehensive Cancer Center Graz, Department of Therapeutic Radiotherapy and Oncology, Graz (Austria); Tiefling, R.; Kindl, P. [University of Technology, Institute of Materials Physics, Graz (Austria)

    2014-01-15

    Determination of dose error margins in radiation therapy planning due to variations in Hounsfield Units (HU) values dependent on the use of different CT scanning protocols. Based on a series of different CT scanning protocols used in clinical practice, conversion tables for radiation dose calculations were generated and subsequently tested on a phantom. These tables were then used to recalculate the radiation therapy plans of 28 real patients after an incorrect scanning protocol had inadvertently been used for these patients. Different CT parameter settings resulted in errors of HU values of up to 2.6 % for densities of < 1.1 g/cm{sup 3}, but up to 25.6 % for densities of > 1.1 g/cm{sup 3}. The largest errors were associated with changes in the tube voltage. Tests on a virtual water phantom with layers of variable thickness and density revealed a sawtooth-shaped curve for the increase of dose differences from 0.3 to 0.6 % and 1.5 % at layer thicknesses of 1, 3, and 7 cm, respectively. Use of a beam hardening filter resulted in a reference dose difference of 0.6 % in response to a density change of 5 %. The recalculation of data from 28 patients who received radiation therapy to the head revealed an overdose of 1.3 ± 0.4 % to the bone and 0.7 ± 0.1 % to brain tissue. On average, therefore, one monitor unit (range 0-3 MU) per 100 MU more than the correct dose had been given. Use of different CT scanning protocols leads to variations of up to 20 % in the HU values. This can result in a mean systematic dose error of 1.5 %. Specific conversion tables and automatic CT scanning protocol recognition could reduce dose errors of these types. (orig.)

  17. Radiation protection: Radiation dose units and fundamentals. Correct use of radiation dose units, measurements, risk assessment; Dosisbegriffe und Grundlagen im Strahlenschutz. Dosisbegriffe richtig anwenden, Messgroessen bestimmen, Risiken bewerten

    Energy Technology Data Exchange (ETDEWEB)

    Folkerts, K.H.; Wolf, H.

    2005-07-01

    Radiation protection intends to prevent radiation damage by appropriate staff-related and technical measures in accordance with the specifications of the German X-Ray Ordinance (RoV) and Radiation Protection Ordinance (StrlSchV) and in agreement with the ICRLP (International Commission on Radiological Protection). They require that radiation use must be justified, exposure conditions must be optimised, and exposure times must be limited to the shortest time necessary. In practical use, this requires considerable practical and theoretical knowledge from the user concerning the physical properties of radiation sources, interactions with tissue and matter of different types of radiation, and biological effects of radiation. National and international organizations and committees have specified the knowledge which a user must have as follows: Physical fundamentals of radiation protection; Measuring quantities and specified standard units; Organisational and constructional radiation protection; Legal knowledge. (orig.)

  18. Growth factors, glucose and insulin kinetics after low dose growth hormone in HIV - lipodystrophy

    DEFF Research Database (Denmark)

    Haugaard, Steen B; Andersen, Ove; Flyvbjerg, Allan

    2006-01-01

    OBJECTIVES: Low-dose growth hormone (GH) administration has been suggested as a treatment for HIV-lipodystrophy. METHODS: Postglucose GH-secretion, kinetics of insulin-like growth factors (IGFs), insulin, and glucose metabolism were examined in six male HIV-infected lipodystrophic patients (two...... on circulating IGF-I, glucose metabolism, and insulin kinetics, 0.7 mg/day of GH may be expedient for treatment of HIV-infected males with lipodystrophy. Whether the patients' glucose metabolic status matters for the IGF-response to low-dose GH-therapy awaits further investigation....

  19. Human Factors Issues For Multi-Modular Reactor Units

    Energy Technology Data Exchange (ETDEWEB)

    Tuan Q Tran; Humberto E. Garcia; Ronald L. Boring; Jeffrey C. Joe; Bruce P. Hallbert

    2007-08-01

    Smaller and multi-modular reactor (MMR) will be highly technologically-advanced systems allowing more system flexibility to reactors configurations (e.g., addition/deletion of reactor units). While the technical and financial advantages of systems may be numerous, MMR presents many human factors challenges that may pose vulnerability to plant safety. An important human factors challenge in MMR operation and performance is the monitoring of data from multiple plants from centralized control rooms where human operators are responsible for interpreting, assessing, and responding to different system’s states and failures (e.g., simultaneously monitoring refueling at one plant while keeping an eye on another plant’s normal operating state). Furthermore, the operational, safety, and performance requirements for MMR can seriously change current staffing models and roles, the mode in which information is displayed, procedures and training to support and guide operators, and risk analysis. For these reasons, addressing human factors concerns in MMR are essential in reducing plant risk.

  20. Pharmacokinetics and dose requirements of factor VIII over the age range 3-74 years

    DEFF Research Database (Denmark)

    Björkman, Sven; Folkesson, Anna; Jönsson, Siv

    2009-01-01

    PURPOSE: The three aims of this investigation were (1) to develop a population pharmacokinetic (PK) model for factor VIII (FVIII) in haemophilia A patients, with estimates of inter-occasion and inter-individual variance, (2) to investigate whether appropriate dosing of FVIII for regular prophylaxis...... can be calculated according to patient characteristics, and (3) to present dosing recommendations for initiating prophylactic treatment. METHODS: A population PK model was developed using data from four PK studies on patients aged 7-74 years. The model was tested on sparse FVIII data from 42...... outpatient visits by haemophilia prophylaxis patients aged 3-66 years. Dose requirements for prophylaxis were calculated both according to the population model and from empirical Bayesian estimates of FVIII PK in the individual patients. RESULTS: The study data were well characterised by a two-compartment PK...

  1. Assessment of the image contrast improvement and dose reduction in mammography with synchrotron radiation compared to standard units

    CERN Document Server

    Moeckli, R; Fiedler, S; Pachoud, M; Hessler, C; Meuli, R; Valley, J F

    2001-01-01

    An objective method was used to evaluate image quality and dose in mammography with synchrotron radiation and to compare them to standard units. It was performed systematically in the energy range of interest for mammography through the evaluation of the contrast and the measurement of the mean glandular dose. Synchrotron radiation measurements were performed at the ESRF and a slit was placed between the test object and the screen-film system in order to reduce scatter. The conventional films were obtained on mammography units with an anti-scatter grid. In a recent paper, it was shown that the use of synchrotron radiation leads to a noticeable improvement of the image quality-dose relationship (Moeckli et al. Phys. Med. Biol. 45(12)3509). The reason of that enhancement is partly due to the monochromaticity of the synchrotron beam and partly due to the use of a slit instead of a grid. The dose reduction with synchrotron radiation can be attributed to a better X-ray total transmission of the slit and the contra...

  2. Readmission to medical intensive care units: risk factors and prediction.

    Science.gov (United States)

    Jo, Yong Suk; Lee, Yeon Joo; Park, Jong Sun; Yoon, Ho Il; Lee, Jae Ho; Lee, Choon-Taek; Cho, Young-Jae

    2015-03-01

    The objectives of this study were to find factors related to medical intensive care unit (ICU) readmission and to develop a prediction index for determining patients who are likely to be readmitted to medical ICUs. We performed a retrospective cohort study of 343 consecutive patients who were admitted to the medical ICU of a single medical center from January 1, 2008 to December 31, 2012. We analyzed a broad range of patients' characteristics on the day of admission, extubation, and discharge from the ICU. Of the 343 patients discharged from the ICU alive, 33 (9.6%) were readmitted to the ICU unexpectedly. Using logistic regression analysis, the verified factors associated with increased risk of ICU readmission were male sex [odds ratio (OR) 3.17, 95% confidence interval (CI) 1.29-8.48], history of diabetes mellitus (OR 3.03, 95% CI 1.29-7.09), application of continuous renal replacement therapy during ICU stay (OR 2.78, 95% CI 0.85-9.09), white blood cell count on the day of extubation (OR 1.13, 95% CI 1.07-1.21), and heart rate just before ICU discharge (OR 1.03, 95% CI 1.01-1.06). We established a prediction index for ICU readmission using the five verified risk factors (area under the curve, 0.76, 95% CI 0.66-0.86). By using specific risk factors associated with increased readmission to the ICU, a numerical index could be established as an estimation tool to predict the risk of ICU readmission.

  3. Dose-volume factors correlating with trismus following chemoradiation for head and neck cancer.

    Science.gov (United States)

    Rao, Shyam D; Saleh, Ziad H; Setton, Jeremy; Tam, Moses; McBride, Sean M; Riaz, Nadeem; Deasy, Joseph O; Lee, Nancy Y

    2016-01-01

    To investigate the dose-volume factors in mastication muscles that are implicated as possible causes of trismus in patients following treatment with intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy for head and neck cancers. All evaluable patients treated at our institution between January 2004 and April 2009 with chemotherapy and IMRT for squamous cell cancers of the oropharynx, nasopharynx, hypopharynx or larynx were included in this analysis (N = 421). Trismus was assessed using CTCAE 4.0. Bi-lateral masseter, temporalis, lateral pterygoid and medial pterygoid muscles were delineated on axial computed tomography (CT) treatment planning images, and dose-volume parameters were extracted to investigate univariate and multimetric correlations. Forty-six patients (10.9%) were observed to have chronic trismus of grade 1 or greater. From analysis of baseline patient characteristics, toxicity correlated with primary site and patient age. From dose-volume analysis, the steepest dose thresholds and highest correlations were seen for mean dose to ipsilateral masseter (Spearman's rank correlation coefficient Rs = 0.25) and medial pterygoid (Rs = 0.23) muscles. Lyman-Kutcher-Burman modeling showed highest correlations for the same muscles. The best correlation for multimetric logistic regression modeling was with V68Gy to the ipsilateral medial pterygoid (Rs = 0.29). Chemoradiation-induced trismus remains a problem particularly for patients with oropharyngeal carcinoma. Strong dose-volume correlations support the hypothesis that limiting dose to the ipsilateral masseter muscle and, in particular, the medial pterygoid muscle may reduce the likelihood of trismus.

  4. An acenocoumarol dosing algorithm exploiting clinical and genetic factors in South Indian (Dravidian) population.

    Science.gov (United States)

    Krishna Kumar, Dhakchinamoorthi; Shewade, Deepak Gopal; Loriot, Marie-Anne; Beaune, Philippe; Sai Chandran, B V; Balachander, Jayaraman; Adithan, Chandrasekaran

    2015-02-01

    The objective of this study was to determine the influence of CYP2C9, VKORC1, CYP4F2, and GGCX genetic polymorphisms on mean daily dose of acenocoumarol in South Indian patients and to develop a new pharmacogenetic algorithm based on clinical and genetic factors. Patients receiving acenocoumarol maintenance therapy (n = 230) were included in the study. Single nucleotide polymorphisms (SNP) of CYP2C9, VKORC1, CYP4F2, and GGCX were genotyped by real-time polymerase chain reaction (RT-PCR) method. The mean daily acenocoumarol maintenance dose was found to be 3.7 ± 2.3 (SD) mg/day. The CYP2C9 *1*2, CYP2C9 *1*3, and CYP2C9 *2*3 variant genotypes significantly reduced the dose by 56.7 % (2.0 mg), 67.6 % (1.6 mg), and 70.3 % (1.5 mg) than wild-type carriers 4.1 mg, p genetic variants of CYP2C9 and GGCX (rs11676382) were found to be associated with lower acenocoumarol dose, whereas CYP4F2 (rs2108622) was associated with higher doses. Age, body mass index (BMI), variation of CYP2C9, VKORC1, CYP4F2, and GGCX were the major determinants of acenocoumarol maintenance dose, accounting for 61.8 % of its variability (adjusted r (2) = 0.615, p algorithm was established to determine the acenocoumarol dose in South Indian population.

  5. Concord Grape Juice Polyphenols and Cardiovascular Risk Factors: Dose-Response Relationships

    Directory of Open Access Journals (Sweden)

    Jeffrey B. Blumberg

    2015-12-01

    Full Text Available Pure fruit juices provide nutritional value with evidence suggesting some of their benefits on biomarkers of cardiovascular disease risk may be derived from their constituent polyphenols, particularly flavonoids. However, few data from clinical trials are available on the dose-response relationship of fruit juice flavonoids to these outcomes. Utilizing the results of clinical trials testing single doses, we have analyzed data from studies of 100% Concord grape juice by placing its flavonoid content in the context of results from randomized clinical trials of other polyphenol-rich foods and beverages describing the same outcomes but covering a broader range of intake. We selected established biomarkers determined by similar methods for measuring flow-mediated vasodilation (FMD, blood pressure, platelet aggregation, and the resistance of low density lipoprotein cholesterol (LDL to oxidation. Despite differences among the clinical trials in the treatment, subjects, and duration, correlations were observed between the dose and FMD. Inverse dose-response relationships, albeit with lower correlation coefficients, were also noted for the other outcomes. These results suggest a clear relationship between consumption of even modest serving sizes of Concord grape juice, flavonoid intake, and effects on risk factors for cardiovascular disease. This approach to dose-response relationships may prove useful for testing other individual foods and beverages.

  6. Genetic factors associated with patient-specific warfarin dose in ethnic Indonesians

    Directory of Open Access Journals (Sweden)

    Utama Andi

    2011-06-01

    Full Text Available Abstract Background CYP2C9 and VKORC1 are two major genetic factors associated with inter-individual variability in warfarin dose. Additionally, genes in the warfarin metabolism pathway have also been associated with dose variance. We analyzed Single Nucleotide Polymorphisms (SNPs in these genes to identify genetic factors that might confer warfarin sensitivity in Indonesian patients. Methods Direct sequencing method was used to identify SNPs in CYP2C9, VKORC1, CYP4F2, EPHX1, PROC and GGCX genes in warfarin-treated patients. Multiple linear regressions were performed to model the relationship warfarin daily dose requirement with genetic and non-genetic variables measured and used to develop a novel algorithm for warfarin dosing. Results From the 40 SNPs analyzed, CYP2C9 rs17847036 and VKORC1 rs9923231 showed significant association with warfarin sensitivity. In our study population, no significant correlation could be detected between CYP2C9*3, CYP2C9C-65 (rs9332127, CYP4F2 rs2108622, GGCX rs12714145, EPHX1 rs4653436 and PROC rs1799809 with warfarin sensitivity. Conclusions VKORC1 rs9923231 AA and CYP2C9 rs17847036 GG genotypes were associated with low dosage requirements of most patients (2.05 ± 0.77 mg/day and 2.09 ± 0.70 mg/day, respectively. CYP2C9 and VKORC1 genetic variants as well as non-genetic factors such as age, body weight and body height account for 15.4% of variance in warfarin dose among our study population. Additional analysis of this combination could allow for personalized warfarin treatment in ethnic Indonesians.

  7. High-dose anti-histamine use and risk factors in children with urticaria

    Science.gov (United States)

    Uysal, Pınar; Avcil, Sibelnur; Erge, Duygu

    2016-01-01

    Aim The drugs of choice in the treatment of urticaria in children are H1-antihistamines. The aim of the study was to evaluate children with urticaria and define risk factors for requirement of high-dose H1-antihistamines in children with urticaria. Material and Methods The medical data of children who were diagnosed as having urticaria admitted to our outpatient clinic between January 2014 and January 2016 were searched. The medical histories, concomitant atopic diseases, parental atopy histories, medications, treatment responses, blood eosinophil and basophil counts, and serum total IgE levels were recorded. In addition, the urticaria activity score for seven days, autoimmune antibody tests, and skin prick test results were evaluated in children with chronic urticaria. Results The numbers of the children with acute and chronic urticaria were 138 and 92, respectively. The age of the children with chronic urticaria was higher than that of those with acute urticaria (p0.05). There was a negative correlation between blood eosinophil count and the UAS7 score in children with chronic urticaria (r=−0.276, p=0.011). Chronic urticaria and requirement of high dose H1-antihistamines were significant in children aged ≥10 years (purticaria. Conclusion The requirement of high-dose H1-antihistamines was higher with children’s increasing age. Disease severity and basopenia were risk factors for the requirement of high-dose H1-antihistamines. PMID:28123332

  8. Improvement of dose distribution in breast radiotherapy using a reversible transverse magnetic field Linac-MR unit

    Energy Technology Data Exchange (ETDEWEB)

    Esmaeeli, A. D., E-mail: ali-esmaeeli-d@yahoo.com [Department of Physics, Rasht Branch, Islamic Azad University, Rasht, 41476-54919 (Iran, Islamic Republic of); Mahdavi, S. R. [Department of Medical Physics, Tehran University of Medical Sciences, Tehran, 14174 (Iran, Islamic Republic of); Pouladian, M.; Bagheri, S. [Department of Medical Radiation Engineering, Science and Research Branch, Islamic Azad University, Tehran, 14778-93855 (Iran, Islamic Republic of); Monfared, A. S. [Department of Medical Physics, Babol University of Medical Sciences, Babol, 47148-71167 (Iran, Islamic Republic of)

    2014-01-15

    Purpose: To investigate the improvement in dose distribution in tangential breast radiotherapy using a reversible transverse magnetic field that maintains the same direction of Lorentz force between two fields. The investigation has a potential application in future Linac-MR units. Methods: Computed tomography images of four patients and magnetic fields of 0.25–1.5 Tesla (T) were used for Monte Carlo simulation. Two patients had intact breast while the other two had mastectomy. Simulations of planning and chest wall irradiation were similar to the actual clinical process. The direction of superior-inferior magnetic field for the medial treatment beam was reversed for the lateral beam. Results: For the ipsilateral lung and heart mean doses were reduced by a mean (range) of 45.8% (27.6%–58.6%) and 26.0% (20.2%–38.9%), respectively, depending on various treatment plan setups. The mean V{sub 20} for ipsilateral lung was reduced by 55.0% (43.6%–77.3%). In addition acceptable results were shown after simulation of 0.25 T magnetic field demonstrated in dose-volume reductions of the heart, ipsilateral lung, and noninvolved skin. Conclusions: Applying a reversible magnetic field during breast radiotherapy, not only reduces the dose to the lung and heart but also produces a sharp drop dose volume histogram for planning target volume, because of bending of the path of secondary charged particles toward the chest wall by the Lorentz force. The simulations have shown that use of the magnetic field at 1.5 T is not feasible for clinical applications due to the increase of ipsilateral chest wall skin dose in comparison to the conventional planning while 0.25 T is suitable for all patients due to dose reduction to the chest wall skin.

  9. Dose-volume factors correlating with trismus following chemoradiation for head and neck cancer

    OpenAIRE

    Rao, SD; Saleh, ZH; Setton, J; Tam, M; McBride, SM; Riaz, N.; Deasy, JO; Lee, NY

    2016-01-01

    © 2015 Informa Healthcare. Background. To investigate the dose-volume factors in mastication muscles that are implicated as possible causes of trismus in patients following treatment with intensity-modulated radiotherapy (IMRT) and concurrent chemotherapy for head and neck cancers.Material and methods. All evaluable patients treated at our institution between January 2004 and April 2009 with chemotherapy and IMRT for squamous cell cancers of the oropharynx, nasopharynx, hypopharynx or larynx ...

  10. Modern Integration Units: Comparative Analysis Of The Growth Factors

    Directory of Open Access Journals (Sweden)

    Bulat Doskalievich Khusainov

    2015-03-01

    Full Text Available In the article, the results of the research, which purpose is to ground and assess the factors of economic growth of regional integration communities and national economies of member countries that develop them, are presented. The foreign trade, mutual trade turnover, and domestic demand are allocated as such factors. The authors has applied the novelty in their methodology which in contrast to the traditional assessment method of growth factors of integration communities and their participants, is based on comparison of two components — external and domestic demand, based on dividing the external demand on two components: the first one is pure export (the difference between export and import is a component of cumulative demand of goods in integration community, i.e. the pure export of mutual trade; the second one is a pure export of foreign trade of goods outside of the integration association. Scope of the research is seven most known regional integrated units arose at different times and being at different stages of development — the European Union, North American Free Trade Area, Association of Southeast Asian Nations, Southern American Common Market, Asia-Pacific Economic Cooperation, and also member countries of the Eurasian integration — the Customs Union and Common Free Market Zone developed into the Eurasian Economic Union in January 1, 2015. In conclusion, it is noted that the integration develops successfully only in the conditions of the rise in national economies of the participating countries. Crisis economies have to deal more with internal problems than to resolve integration issues.

  11. Antimicrobial selection and dosing in the treatment of wounds in the United Kingdom.

    Science.gov (United States)

    Ross, S E; Duz, M; Rendle, D I

    2016-11-01

    Antimicrobial stewardship within the veterinary profession is recognised by governing and professional bodies as being important; the attitudes and behaviour of veterinary surgeons merit investigation. To investigate levels of protected antimicrobial use and accuracy of antimicrobial dosing in a common clinical scenario in equine practice. Retrospective cohort study. Antimicrobial use was evaluated retrospectively in 113 cases subsequently referred to a single referral hospital for the treatment of limb wounds over a 20-month period. Antimicrobial classification (first-line, alternative or protected) was made according to guidelines produced by the British Equine Veterinary Association. These guidelines also served as the reference for recommended dose rates. Systemic antimicrobials were administered prior to referral in 94/113 (83.2%) horses, of which 8 (8.5%) received the protected third or fourth generation cephalosporins or fluoroquinolones. Forty-eight of 87 (55.2%) horses for which complete dosing data were available received antimicrobials at ≤90% of the recommended dose. Practitioners who held a postgraduate clinical qualification or worked in purely equine practice were no more or less likely to use protected antimicrobials (P = 0.06 and P = 0.64, respectively) or administer inadequate doses (P = 0.75 and P = 0.85, respectively). Veterinary surgeons with more experience were less likely to use protected antimicrobials (P<0.001); however, with the small case numbers, this finding should be interpreted with caution. Heavier horses were more likely to be under-dosed (P<0.002). This study highlights the administration of certain classes of antimicrobials in situations where their use is unlikely to be justified. If these findings reflect more general attitudes and behaviour then greater awareness of, and compliance with, recommendations for responsible antimicrobial use are required among equine practitioners. Bodyweight ought to be measured or estimated

  12. Risk Factors for Upper GI Damage in Low-Dose Aspirin Users and the Interaction Between H. pylori Infection and Low-Dose Aspirin Use.

    Science.gov (United States)

    Iijima, Katsunori; Shimosegawa, Tooru

    2015-01-01

    Nowadays, low-dose aspirin is widely administered at low dose as an antithrombotic drug for the prevention of cerebrovascular and cardiovascular diseases. However, aspirin, even at a low dose, can induce varying degrees of gastroduodenal mucosal injury (erosion, ulcer, ulcer bleeding). Hence, co-prescription of proton pump inhibitors with low-dose aspirin is recommended for those at high risk for adverse gastroduodenal events. At present, a history of peptic ulcer, especially that of complicated ulcer, is the most important risk factor for low-dose aspirin-associated gastroduodenal adverse events. Additionally, concomitant use of non-steroidal anti-inflammatory drugs including COX-2 selective inhibitors, anti-platelet agents, anti-coagulants, and oral corticosteroid is recognized to increase the risk for adverse gastroduodenal events in low-dose aspirin users. H. pylori infection could also be associated with the increased risk for adverse gastroduodenal events in low-dose aspirin users, especially in patients with histories of peptic ulcers. Therefore, eradication therapy for such patients can prevent ulcer recurrence. However, the efficacy of eradication therapy on low-dose aspirin-related gastroduodenal lesions in unselected H. pylori-positive lowdose aspirin users without histories of peptic ulcers remains to be clarified.

  13. Sufentanil and midazolam dosing and pharmacogenetic factors in pediatric analgosedation and withdrawal syndrome.

    Science.gov (United States)

    Hronová, K; Pokorná, P; Posch, L; Slanař, O

    2016-12-21

    Our aim was to describe the effect of dosing and genetic factors on sufentanil- and midazolam-induced analgosedation and withdrawal syndrome (WS) in pediatric population. Analgosedation and withdrawal syndrome development were monitored using COMFORT-neo/-B scores and SOS score. Length of therapy, dosing of sufentanil and midazolam were recorded. Genotypes of selected candidate polymorphisms in CYP3A5, COMT, ABCB1, OPRM1 and PXR were analysed. In the group of 30 neonates and 18 children, longer treatment duration with midazolam of 141 h (2 - 625) vs. 88 h (7 - 232) and sufentanil of 326.5 h (136 - 885) vs. 92 h (22 - 211) (median; range) was found in the patients suffering from WS vs. non-WS group, respectively. Median midazolam cumulative doses were in the respective values of 18.22 mg/kg (6.93 - 51.25) vs. 9.94 mg/kg (2.12 - 49.83); P=0.03, and the respective values for sufentanil were 88.60 microg/kg (20.21 - 918.52) vs. 21.71 microg/kg (4.5 - 162.29); P<0.01. Cut off value of 177 hours for sufentanil treatment duration represented predictive factor for WS development with 81 % sensitivity and 94 % specificity. SNPs in the candidate genes COMT, PXR and ABCB1 affected the dosing of analgosedative drugs, but were not associated with depth of analgosedation or WS. Cumulative dose and length of analgosedative therapy with sufentanil significantly increases the risk of WS in critically ill neonates and children.

  14. Quantitative investigation of physical factors contributing to gold nanoparticle-mediated proton dose enhancement

    Science.gov (United States)

    Cho, Jongmin; Gonzalez-Lepera, Carlos; Manohar, Nivedh; Kerr, Matthew; Krishnan, Sunil; Cho, Sang Hyun

    2016-03-01

    Some investigators have shown tumor cell killing enhancement in vitro and tumor regression in mice associated with the loading of gold nanoparticles (GNPs) before proton treatments. Several Monte Carlo (MC) investigations have also demonstrated GNP-mediated proton dose enhancement. However, further studies need to be done to quantify the individual physical factors that contribute to the dose enhancement or cell-kill enhancement (or radiosensitization). Thus, the current study investigated the contributions of particle-induced x-ray emission (PIXE), particle-induced gamma-ray emission (PIGE), Auger and secondary electrons, and activation products towards the total dose enhancement. Specifically, GNP-mediated dose enhancement was measured using strips of radiochromic film that were inserted into vials of cylindrical GNPs, i.e. gold nanorods (GNRs), dispersed in a saline solution (0.3 mg of GNRs/g or 0.03% of GNRs by weight), as well as vials containing water only, before proton irradiation. MC simulations were also performed with the tool for particle simulation code using the film measurement setup. Additionally, a high-purity germanium detector system was used to measure the photon spectrum originating from activation products created from the interaction of protons and spherical GNPs present in a saline solution (20 mg of GNPs/g or 2% of GNPs by weight). The dose enhancement due to PIXE/PIGE recorded on the films in the GNR-loaded saline solution was less than the experimental uncertainty of the film dosimetry (PIGE, and activation products contribute minimally to GNP/GNR-mediated proton dose enhancement, whereas Auger/secondary electrons contribute significantly but only at short distances (<100 nm) from GNPs/GNRs.

  15. Intensive Care Unit death and factors influencing family satisfaction of Intensive Care Unit care

    Directory of Open Access Journals (Sweden)

    Naveen Salins

    2016-01-01

    Full Text Available Introduction: Family satisfaction of Intensive Care Unit (FS-ICU care is believed to be associated with ICU survival and ICU outcomes. A review of literature was done to determine factors influencing FS-ICU care in ICU deaths. Results: Factors that positively influenced FS-ICU care were (a communication: Honesty, accuracy, active listening, emphatic statements, consistency, and clarity; (b family support: Respect, compassion, courtesy, considering family needs and wishes, and emotional and spiritual support; (c family meetings: Meaningful explanation and frequency of meetings; (d decision-making: Shared decision-making; (e end of life care support: Support during foregoing life-sustaining interventions and staggered withdrawal of life support; (f ICU environment: Flexibility of visiting hours and safe hospital environment; and (g other factors: Control of pain and physical symptoms, palliative care consultation, and family-centered care. Factors that negatively influenced FS-ICU care were (a communication: Incomplete information and unable to interpret information provided; (b family support: Lack of emotional and spiritual support; (c family meetings: Conflicts and short family meetings; (d end of life care support: Resuscitation at end of life, mechanical ventilation on day of death, ICU death of an elderly, prolonged use of life-sustaining treatment, and unfamiliar technology; and (e ICU environment: Restrictive visitation policies and families denied access to see the dying loved ones. Conclusion: Families of the patients admitted to ICU value respect, compassion, empathy, communication, involvement in decision-making, pain and symptom relief, avoiding futile medical interventions, and dignified end of life care.

  16. Intensive Care Unit death and factors influencing family satisfaction of Intensive Care Unit care

    Science.gov (United States)

    Salins, Naveen; Deodhar, Jayita; Muckaden, Mary Ann

    2016-01-01

    Introduction: Family satisfaction of Intensive Care Unit (FS-ICU) care is believed to be associated with ICU survival and ICU outcomes. A review of literature was done to determine factors influencing FS-ICU care in ICU deaths. Results: Factors that positively influenced FS-ICU care were (a) communication: Honesty, accuracy, active listening, emphatic statements, consistency, and clarity; (b) family support: Respect, compassion, courtesy, considering family needs and wishes, and emotional and spiritual support; (c) family meetings: Meaningful explanation and frequency of meetings; (d) decision-making: Shared decision-making; (e) end of life care support: Support during foregoing life-sustaining interventions and staggered withdrawal of life support; (f) ICU environment: Flexibility of visiting hours and safe hospital environment; and (g) other factors: Control of pain and physical symptoms, palliative care consultation, and family-centered care. Factors that negatively influenced FS-ICU care were (a) communication: Incomplete information and unable to interpret information provided; (b) family support: Lack of emotional and spiritual support; (c) family meetings: Conflicts and short family meetings; (d) end of life care support: Resuscitation at end of life, mechanical ventilation on day of death, ICU death of an elderly, prolonged use of life-sustaining treatment, and unfamiliar technology; and (e) ICU environment: Restrictive visitation policies and families denied access to see the dying loved ones. Conclusion: Families of the patients admitted to ICU value respect, compassion, empathy, communication, involvement in decision-making, pain and symptom relief, avoiding futile medical interventions, and dignified end of life care. PMID:27076710

  17. Radiation dose to patients and radiologists during transcatheter arterial embolization: comparison of a digital flat-panel system and conventional unit.

    Science.gov (United States)

    Suzuki, Shigeru; Furui, Shigeru; Kobayashi, Ikuo; Yamauchi, Teiyu; Kohtake, Hiroshi; Takeshita, Koji; Takada, Koichi; Yamagishi, Masafumi

    2005-10-01

    The objective of our study was to evaluate the exposure doses to patients and radiologists during transcatheter arterial embolization (TAE) for hepatocellular carcinoma (HCC) using a new angiographic unit with a digital flat-panel system. Doses were assessed for 24 procedures: 12 using a new unit with a digital flat-panel system and 12 using a conventional unit. Doses to patients' skin were evaluated with thermoluminescent dosimeters behind the left, middle, and right portions of the liver. The doses to the radiologists were measured by an electronic personal dosimeter placed on the chest outside a lead protector. The maximal skin doses to the patients and the dose equivalents, Hp(0.07), to the radiologists were compared between the two procedure groups with each angiographic unit. For procedures with the new unit, the mean maximal skin dose to the patients was 284 +/- 127 (SD) mGy (range, 130-467 mGy), and Hp(0.07) to the radiologists was 62.8 +/- 17.4 muSv. For procedures with the conventional unit, the maximal skin dose to the patients was 1,068 +/- 439 mGy (range, 510-1,882 mGy), and Hp(0.07) to the radiologists was 68.4 +/- 25.7 muSv. The maximal skin dose to the patients was significantly lower with the new unit than with the conventional unit (p < 0.0005). There was no significant difference in the Hp(0.07) to the radiologists between the two procedure groups. The new digital flat-panel system for angiographic imaging can reduce the radiation dose to patients' skin during TAE for HCC as compared with the conventional system.

  18. Low- and high-dose hydrogen peroxide regulation of transcription factor NF-E2-related factor 2

    Institute of Scientific and Technical Information of China (English)

    NING Jiao-lin; MO Li-wen; LAI Xi-nan

    2010-01-01

    Background Reactive oxygen species (ROS) may play both physiological and pathophysiological roles. Transcription factor NF-E2-related factor 2 (Nrf2) regulates antioxidant response element (ARE)-mediated genes expression and coordinates induction of chemoprotective proteins in response to physical and chemical stresses. The exact role of Nrf2 in cellular responses to different levels of oxidative stresses remains unknown.Methods Rat pulmonary microvascular endothelial cells were cultured and treated with 0 mmol/L, 0.125 mmol/L, 0.25 mmol/L, 0.5 mmol/L, 1.0 mmol/L and 2.0 mmol/L hydrogen peroxide solution for 2 hours. Nrf2 gene expression was assayed by reverse transcription-PCR, Nrf2-ARE binding activity was assayed with electrophoretic mobility shift assay (EMSA), and localization of Nrf2 was detected with immunohistochemistry.Results Low and moderate (0.125 mmol/L, 0.25 mmol/L and 0.5 mmol/L) doses hydrogen peroxide exposure of rat pulmonary microvascular endothelial cells led to the nuclear accumulation of Nrf2, increased activity of transcription regulation and up-regulation of ARE-medicated gene expression. In contrast, high doses of hydrogen peroxide (1 mmol/L, 2 mmol/L) exposure of the cells led to the nuclear exclusion of Nrf2, decreased activity transcription regulation and down-regulation of ARE-mediated gene expression.Conclusion Low and moderate doses of hydrogen peroxide play protective roles by increasing transcription activity of Nrf2, whereas high- dose hydrogen peroxide plays a deleterious role by decreasing transcription activity of Nrf2.

  19. Identification and Characterization of Soluble Factors Involved in Delayed Effects of Low Dose Radiation. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Baulch, Janet

    2013-09-11

    This is a 'glue grant' that was part of a DOE Low Dose project entitled 'Identification and Characterization of Soluble Factors Involved in Delayed Effects of Low Dose Radiation'. This collaborative program has involved Drs. David L. Springer from Pacific Northwest National Laboratory (PNNL), John H. Miller from Washington State University, Tri-cities (WSU) and William F. Morgan then from the University of Maryland, Baltimore (UMB). In July 2008, Dr. Morgan moved to PNNL and Dr. Janet E. Baulch became PI for this project at University of Maryland. In November of 2008, a one year extension with no new funds was requested to complete the proteomic analyses. The project stemmed from studies in the Morgan laboratory demonstrating that genomically unstable cells secret a soluble factor or factors into the culture medium, that cause cytogenetic aberrations and apoptosis in normal parental GM10115 cells. The purpose of this project was to identify the death inducing effect (DIE) factor or factors, estimate their relative abundance, identify the cell signaling pathways involved and finally recapitulate DIE in normal cells by exogenous manipulation of putative DIE factors in culture medium. As reported in detail in the previous progress report, analysis of culture medium from the parental cell line, and stable and unstable clones demonstrated inconsistent proteomic profiles as relate to candidate DIE factors. While the proposed proteomic analyses did not provide information that would allow DIE factors to be identified, the analyses provided another important set of observations. Proteomic analysis suggested that proteins associated with the cellular response to oxidative stress and mitochondrial function were elevated in the medium from unstable clones in a manner consistent with mitochondrial dysfunction. These findings correlate with previous studies of these clones that demonstrated functional differences between the mitochondria of stable and

  20. Identification and Characterization of Soluble Factors Involved in Delayed Effects of Low Dose Radiation. Final report

    Energy Technology Data Exchange (ETDEWEB)

    Baulch, Janet

    2013-09-11

    This is a 'glue grant' that was part of a DOE Low Dose project entitled 'Identification and Characterization of Soluble Factors Involved in Delayed Effects of Low Dose Radiation'. This collaborative program has involved Drs. David L. Springer from Pacific Northwest National Laboratory (PNNL), John H. Miller from Washington State University, Tri-cities (WSU) and William F. Morgan then from the University of Maryland, Baltimore (UMB). In July 2008, Dr. Morgan moved to PNNL and Dr. Janet E. Baulch became PI for this project at University of Maryland. In November of 2008, a one year extension with no new funds was requested to complete the proteomic analyses. The project stemmed from studies in the Morgan laboratory demonstrating that genomically unstable cells secret a soluble factor or factors into the culture medium, that cause cytogenetic aberrations and apoptosis in normal parental GM10115 cells. The purpose of this project was to identify the death inducing effect (DIE) factor or factors, estimate their relative abundance, identify the cell signaling pathways involved and finally recapitulate DIE in normal cells by exogenous manipulation of putative DIE factors in culture medium. As reported in detail in the previous progress report, analysis of culture medium from the parental cell line, and stable and unstable clones demonstrated inconsistent proteomic profiles as relate to candidate DIE factors. While the proposed proteomic analyses did not provide information that would allow DIE factors to be identified, the analyses provided another important set of observations. Proteomic analysis suggested that proteins associated with the cellular response to oxidative stress and mitochondrial function were elevated in the medium from unstable clones in a manner consistent with mitochondrial dysfunction. These findings correlate with previous studies of these clones that demonstrated functional differences between the mitochondria of stable and

  1. Effective dose scaling factors for use with cascade impactor sampling data in tenorm inhalation exposures.

    Science.gov (United States)

    Kim, Kwang Pyo; Wu, Chang-Yu; Birky, Brian K; Bolch, Wesley E

    2005-10-01

    When assessing the effective dose to workers following radio-aerosol inhalation exposures, significant reductions in dose uncertainty can be achieved through direct measurement of the particle-size distribution. The University of Washington Mark III cascade impactor is one such air sampling device that permits the user to determine aerosol mass and radioactivity concentrations as a function of particle size within eight different size intervals (each corresponding to a different impactor stage or end filter). Traditionally, dose assessments made using the LUDEP code or other internal dosimetry software utilize this air sampling information by assigning the radioactivity measured at each stage as concentrated at a single representative size central to the size interval. In this study, we explore more realistic assumptions that the measured radioactivity distributes uniformly, linearly increases, or linearly decreases across the particle size interval for each impactor stage. The concept of an effective dose scaling factor, SF(E), is thus introduced whereby (1) the former approach can be used (which requires less computational effort using the LUDEP code), and (2) the resulting values of effective dose per stage can then be rescaled to values appropriate to a linear radioactivity distribution per stage. For a majority of (238)U-series radionuclides, particle size ranges, and absorption classes, differences in these two approaches are less than 10%, and thus no corrections in effective dose per particle stage are needed. Significant corrections, however, were noted in select cases. For uniform or linearly decreasing radioactivity distributions, end-filter particles (0.03 to 0.35 microm) of type F, M, or S radionuclides were assigned values of SF(E) ranging from 1.15 to 1.44, while 3(rd) stage particles (4.5 to 12 microm) of type M and S radionuclides were assigned values of SF(E) ranging from 1.11 to 1.53. When the cascade impactor measurements indicate a linear

  2. 'Doing the right thing': factors influencing GP prescribing of antidepressants and prescribed doses.

    Science.gov (United States)

    Johnson, Chris F; Williams, Brian; MacGillivray, Stephen A; Dougall, Nadine J; Maxwell, Margaret

    2017-06-17

    Antidepressant prescribing continues to increase, with 5-16% of adults receiving antidepressants annually. Total prescribing growth is due in part to increased long-term use, greater selective serotonin re-uptake inhibitor (SSRI) use and the use of higher SSRI doses. Evidence does not support routine use of higher SSRI doses for depression treatment, and factors influencing the use of such doses are not well known. The aim of this study was to explore factors influencing GPs' use of antidepressants and their doses to treat depression. Semi-structured interviews with a purposive sample of 28 practising GPs; sampled by antidepressant prescribing volume, practice size and deprivation level. A topic guide drawing on past literature was used with enough flexibility to allow additional themes to emerge. Interviews were audio-recorded and transcribed verbatim. Framework analysis was employed. Constant comparison and disconfirmation were carried out across transcripts, with data collection being interspersed with analysis by three researchers. The thematic framework was then systematically applied to the data and conceptualised into an overarching explanatory model. Depression treatment involved ethical and professional imperatives of 'doing the right thing' for individuals by striving to achieve the 'right care fit'. This involved medicalised and non-medicalised patient-centred approaches. Factors influencing antidepressant prescribing and doses varied over time from first presentation, to antidepressant initiation and longer-term treatment. When faced with distressed patients showing symptoms of moderate to severe depression GPs were confident prescribing SSRIs which they considered as safe and effective medicines, and ethically and professionally appropriate. Many GPs were unaware that higher doses lacked greater efficacy and onset of action occurred within 1-2 weeks, preferring to wait 8-12 weeks before increasing or switching. Ongoing pressures to maintain

  3. Factors influencing nursing care in a surgical intensive care unit

    Directory of Open Access Journals (Sweden)

    Raj John

    2006-01-01

    Full Text Available Context: The total time spent in nursing care depends on the type of patient and the patient′s condition. We analysed factors that influenced the time spent in nursing a patient. Aims : To analyse the factors in a patient′s condition that influenced time spent in nursing a patient. Materials and Methods: This study was performed in the Surgical Intensive Care Unit of a tertiary referral centre, over a period of one month. The total time spent on a patient in nursing care for the first 24 hours of admission, was recorded. This time was divided into time for routine nursing care, time for interventions, time for monitoring and time for administering medications. Statistical analysis used: A backward stepwise linear regression analysis using the age, sex, diagnosis, type of admission and ventilatory status as variables, was done. Results: Patients admitted after elective surgery required less time (852.4 ± 234.1 minutes, than those admitted after either emergency surgery (1069.5 ± 187.3 minutes, or directly from the ward or the emergency room (1253.7 ± 42.1 minutes. Patients who were ventilated required more time (1111.5 ± 132.5 minutes, than those brought on a T-piece (732.2 ± 134.8 minutes or extubated (639.5 ± 155.6 minutes. The regression analysis showed that only the type of admission and the ventilatory status significantly affected the time. Conclusions : This study showed that the type of admission and ventilatory status significantly influenced the time spent in nursing care. This will help optimal utilization of nursing resources.

  4. Total encephalic irradiation with complementary dose: preliminary results and prognostic factors; Irradiation encephalique en totalite avec complement de dose: resultats preliminaires et facteurs pronostiques

    Energy Technology Data Exchange (ETDEWEB)

    Assouline, A.; Kzrisch, C. [CHU d' Amiens, 80 (France); Assouline, A.; Levy, A.; Chargari, C.; Lamproglou, I.; Mazeron, J.J. [CHU Pitie Salpetriere, 75 - Paris (France); Chargari, C. [Hopital d' instruction des armees du Val-de-Grace, 75 - Paris (France)

    2010-10-15

    The authors report an assessment study of prognostic factors of global survival and of the benefit of a complementary dose delivered by a conventional linear accelerator for brain metastases after a total encephalic irradiation. This study is based on data from 250 patients treated in Amiens hospital for secondary brain metastases of a lung or breast cancer and melanoma. Five prognostic factors have been studied: type of primitive tumour, gender, number of metastases, surgical resection of metastases, and improvement of neurological symptoms after radiotherapy. An analysis is performed on a subgroup to determine whether a complementary dose would improve survival in the group of patients presenting less than three metastases. Short communication

  5. Dose conversion factors for radiation doses at normal operation discharges. E. Exposure pathways and radioecological data; Dosomraekningsfaktorer foer normaldriftutslaepp. C. Exponeringsvaegar och radioekologiska data

    Energy Technology Data Exchange (ETDEWEB)

    Karlsson, Sara; Aquilonius, Karin

    2001-10-01

    A study has been performed in order to develop and extend existing models for dose estimations at emissions of radioactive substances from nuclear facilities in Sweden. This report presents a review of all exposure pathways in the project, in order to secure that no important contributions have been omitted. The radioecological data that should be used in calculating conversion factors for air and water emissions are also reviewed. Nuclid-specific conversion factors have been calculated for radiation doses from inhalation and intake for children in different age groups.

  6. Evolving Adjustments to External (Gamma) Slope Factors for CERCLA Risk and Dose Assessments - 12290

    Energy Technology Data Exchange (ETDEWEB)

    Walker, Stuart [U.S. Environmental Protection Agency (United States)

    2012-07-01

    To model the external exposure pathway in risk and dose assessments of radioactive contamination at Superfund sites, the U.S. Environmental Protection Agency (EPA) uses slope factors (SFs), also known as risk coefficients, and dose conversion factors (DCFs). Without any adjustment these external radiation exposure pathways effectively assumes that an individual is exposed to a source geometry that is effectively an infinite slab. The concept of an 'infinite slab' means that the thickness of the contaminated zone and its aerial extent are so large that it behaves as if it were infinite in its physical dimensions. EPA has been making increasingly complex adjustments to account for the extent of the contamination and its corresponding radiation field to provide more accurate risk and dose assessment modeling when using its calculators. In most instances, the more accurate modeling results derived from these gamma adjustments are less conservative. The notable exception are for some radionuclides in rooms with contaminated walls, ceiling, and floors, and the receptor is in location of the room with the highest amount of radiation exposure, usually the corner of small rooms and the center of large conference rooms. (authors)

  7. Biosphere Dose Conversion Factors for Reasonably Maximally Exposed Individual and Average Member of Critical Group

    Energy Technology Data Exchange (ETDEWEB)

    K. Montague

    2000-02-23

    The purpose of this calculation is to develop additional Biosphere Dose Conversion Factors (BDCFs) for a reasonably maximally exposed individual (RMEI) for the periods 10,000 years and 1,000,000 years after the repository closure. In addition, Biosphere Dose Conversion Factors for the average member of a critical group are calculated for those additional radionuclides postulated to reach the environment during the period after 10,000 years and up to 1,000,000 years. After the permanent closure of the repository, the engineered systems within the repository will eventually lose their abilities to contain radionuclide inventory, and the radionuclides will migrate through the geosphere and eventually enter the local water table moving toward inhabited areas. The primary release scenario is a groundwater well used for drinking water supply and irrigation, and this calculation takes these postulated releases and follows them through various pathways until they result in a dose to either a member of critical group or a reasonably maximally exposed individual. The pathways considered in this calculation include inhalation, ingestion, and direct exposure.

  8. Use of pharmacokinetic modelling to individualize FFP dosing in factor V deficiency.

    Science.gov (United States)

    Shakhnovich, V; Daniel, J; Wicklund, B; Kearns, G; Neville, K

    2013-03-01

    Therapy with fresh frozen plasma (FFP) confers serious risks, such as contraction of blood-borne viruses, allergic reaction, volume overload and development of alloantibodies. The aim of this study was to apply principles of pharmacokinetic (PK) modelling to individual factor content of FFP to optimize individualized dosing, while minimizing potential risks of therapy. We used PK modelling to successfully target individual factor replacement in an 8-month-old patient receiving FFP for treatment of a severe congenital factor V (FV) deficiency. The model fit for the FV activity vs. time data was excellent (r = 0.98) and the model accurately predicted FV activity during the intraoperative and postoperative period. Accurate PK modelling of individual factor activity in FFP has the potential to provide better targeted therapy, enabling clinicians to more precisely dose patients requiring coagulation products, while avoiding wasteful and expensive product overtreatment, minimizing potentially life-threatening complications due to undertreatment and limiting harmful product-associated risks.

  9. Patient dosimetry activities in the United States: the nationwide evaluation of X-ray trends (NEXT) and tissue dose handbooks.

    Science.gov (United States)

    Suleiman, O H; Stern, S H; Spelic, D C

    1999-01-01

    In the United States the Food and Drug Administration (FDA) in collaboration with the Conference of Radiation Control Program Directors (CRCPD) and state and local government agencies surveys clinical facilities about X-ray system air kerma and ancillary data related to patient dosimetry for a variety of diagnostic X-ray examinations. The survey program is known as the Nationwide Evaluation of X-ray Trends (NEXT). The survey utilizes reference patient-equivalent phantoms in the collection of comprehensive technical information. With knowledge of the skin-entrance air kerma, specific tissue doses can be calculated. An overview of NEXT and previously published FDA tissue dose handbooks for diagnostic X-ray examinations is presented.

  10. Pharmacokinetic Comparison of a Unit Dose Dry Powder Inhaler with a Multidose Dry Powder Inhaler for Delivery of Fluticasone Furoate.

    Science.gov (United States)

    Mehta, Rashmi; Moore, Alison; Riddell, Kylie; Joshi, Shashidhar; Chan, Robert

    2017-05-02

    The unit dose dry powder inhaler (UD-DPI) is being considered as an alternative inhaler platform that, if developed, has the potential to improve access to inhaled respiratory medicines in developing countries. This study compared the systemic exposure of fluticasone furoate after delivery from the UD-DPI with that from the ELLIPTA(®) inhaler. This open-label, five-way cross-over, randomized, single-dose study in healthy subjects evaluated fluticasone furoate systemic exposure of three dose strengths (using four inhalations), 4 × 80 μg [320 μg], 4 × 100 μg [400 μg], and 4 × 140 μg [560 μg]), and two percentages of drug in lactose blends (0.6% and 0.8% by weight) after delivery from the UD-DPI compared with systemic exposures from the ELLIPTA inhaler (4 × 100 μg [400 μg] dose, 0.8% lactose blend). The primary treatment comparisons were area under the concentration-time curve from time 0 to 6 hours [AUC0-6] and maximum plasma concentration [Cmax]. After single-dose administration of fluticasone furoate, systemic exposure was lower from all UD-DPI formulations versus the ELLIPTA inhaler in terms of both AUC0-6 [AUC0-6 geometric least squares mean (GLM) ratios confidence interval (90% CI) for: UD-DPI (400 μg 0.8% blend)/ELLIPTA: 0.61 (0.55-0.67) and Cmax GLM (90% CI) for: UD-DPI (400 μg 0.8% blend)/ELLIPTA: 0.56 (0.49-0.64)]. Systemic exposures were ∼10% lower for fluticasone furoate UD-DPI for the 0.8% blend versus the 0.6% blend [GLM ratio (90% CI); 0.90 (0.81-1.00) for AUC0-6 and 0.89 (0.77-1.01) for Cmax], and increasing doses of fluticasone furoate from the UD-DPI showed systemic exposures that were approximately dose proportional. All treatments were well tolerated. Fluticasone furoate systemic exposure was lower from the UD-DPI than from the ELLIPTA inhaler, but the UD-DPI formulations did demonstrate detectable systemic levels and approximate dose proportionality. Together with the good tolerability shown

  11. Pharmacokinetics of Imipenem/Cilastatin Burn Intensive Care Unit Patients Undergoing High-Dose Continuous Venovenous Hemofiltration.

    Science.gov (United States)

    Boucher, Bradley A; Hudson, Joanna Q; Hill, David M; Swanson, Joseph M; Wood, G Christopher; Laizure, S Casey; Arnold-Ross, Angela; Hu, Zhe-Yi; Hickerson, William L

    2016-12-01

    High-dose continuous venovenous hemofiltration (CVVH) is a continuous renal replacement therapy (CRRT) used frequently in patients with burns. However, antibiotic dosing is based on inference from studies assessing substantially different methods of CRRT. To address this knowledge gap for imipenem/cilastatin (I/C), we evaluated the systemic and extracorporeal clearances (CLs) of I/C in patients with burns undergoing high-dose CVVH. Prospective clinical pharmacokinetic study. Ten adult patients with burns receiving I/C for a documented infection and requiring high-dose CVVH were studied. Blood and effluent samples for analysis of I/C concentrations were collected for up to 6 hours after the I/C infusion for calculation of I/C total CL (CLTotal ), CL by CVVH (CLHF ), half-life during CVVH, volume of distribution at steady state (Vdss ), and the percentage of drug eliminated by CVVH. In this patient sample, the mean age was 50 ± 17 years, total body surface area burns was 23 ± 27%, and 80% were male. Nine patients were treated with high-dose CVVH for acute kidney injury and one patient for sepsis. The mean delivered CVVH dose was 52 ± 14 ml/kg/hour (range 32-74 ml/kg/hr). The imipenem CLHF was 3.27 ± 0.48 L/hour, which accounted for 23 ± 4% of the CLTotal (14.74 ± 4.75 L/hr). Cilastatin CLHF was 1.98 ± 0.56 L/hour, which accounted for 45 ± 19% of the CLTotal (5.16 + 2.44 L/hr). The imipenem and cilastatin half-lives were 1.77 ± 0.38 hours and 4.21 ± 2.31 hours, respectively. Imipenem and cilastatin Vdss were 35.1 ± 10.3 and 32.8 ± 13.8 L, respectively. Efficient removal of I/C by high-dose CVVH, a high overall clearance, and a high volume of distribution in burn intensive care unit patients undergoing this CRRT method warrant aggressive dosing to treat serious infections effectively depending on the infection site and/or pathogen. © 2016 Pharmacotherapy Publications, Inc.

  12. Clinical Factors Associated with Dose of Loop Diuretics After Pediatric Cardiac Surgery: Post Hoc Analysis.

    Science.gov (United States)

    Haiberger, Roberta; Favia, Isabella; Romagnoli, Stefano; Cogo, Paola; Ricci, Zaccaria

    2016-06-01

    A post hoc analysis of a randomized controlled trial comparing the clinical effects of furosemide and ethacrynic acid was conducted. Infants undergoing cardiac surgery with cardiopulmonary bypass were included in order to explore which clinical factors are associated with diuretic dose in infants with congenital heart disease. Overall, 67 patients with median (interquartile range) age of 48 (13-139) days were enrolled. Median diuretic dose was 0.34 (0.25-0.4) mg/kg/h at the end of postoperative day (POD) 0 and it significantly decreased (p = 0.04) over the following PODs; during this period, the ratio between urine output and diuretic dose increased significantly (p = 0.04). Age (r -0.26, p = 0.02), weight (r -0.28, p = 0.01), cross-clamp time (r 0.27, p = 0.03), administration of ethacrynic acid (OR 0.01, p = 0.03), and, at the end of POD0, creatinine levels (r 0.3, p = 0.009), renal near-infrared spectroscopy saturation (-0.44, p = 0.008), whole-blood neutrophil gelatinase-associated lipocalin levels (r 0.30, p = 0.01), pH (r -0.26, p = 0.02), urinary volume (r -0.2755, p = 0.03), and fluid balance (r 0.2577, p = 0.0266) showed a significant association with diuretic dose. At multivariable logistic regression cross-clamp time (OR 1.007, p = 0.04), use of ethacrynic acid (OR 0.2, p = 0.01) and blood pH at the end of POD0 (OR 0.0001, p = 0.03) was independently associated with diuretic dose. Early resistance to loop diuretics continuous infusion is evident in post-cardiac surgery infants: Higher doses are administered to patients with lower urinary output. Independently associated variables with diuretic dose in our population appeared to be cross-clamping time, the administration of ethacrynic acid, and blood pH.

  13. Monte Carlo calculations of monoenergetic electron depth dose distributions in LiF chips: Skin dose correction factors for beta rays

    Energy Technology Data Exchange (ETDEWEB)

    Horowitz, Y.S. [Ben Gurion Univ. of the Negev, Beersheva (Israel); Hirning, C.R. [Ontario Hydro, Whitby (Canada); Yuen, P.; Wong, P. [Chalk River Labs., Ontario (Canada)

    1994-10-01

    Monte Carlo calculations have been carried out for monoenergetic electrons from 0.1 to 4 MeV irradiating LiF chips in both perpendicular and isotropic geometry. This enabled the calculation of skin dose correction factors (beta factors) for typical beta energy spectra as measured with a beta-ray spectrometer at CANDU nuclear generating stations. The correction factors were estimated by averaging the depth dose distributions for the monoenergetic electrons over the experimentally measured beta-ray spectra. The calculations illustrate the large uncertainty in beta factors arising from the unknown angular distribution of the beta-ray radiation field and uncertainties in the shape of the beta-ray spectra below 500 keV. 28 refs., 8 figs., 2 tabs.

  14. Clinical Risk Factors for Gastroduodenal Ulcer in Romanian Low-Dose Aspirin Consumers.

    Science.gov (United States)

    Negovan, Anca; Iancu, Mihaela; Moldovan, Valeriu; Voidazan, Septimiu; Bataga, Simona; Pantea, Monica; Sarkany, Kinga; Tatar, Cristina; Mocan, Simona; Banescu, Claudia

    2016-01-01

    Background. Aspirin use for cardiovascular or cancer prevention is limited due to its gastrointestinal side effects. Objective. Our prospective, observational case-control study aims to identify the predictive factors for ulcers in low-dose aspirin consumers (75-325 mg/day). Methods. The study included patients who underwent an upper digestive endoscopy and took low-dose aspirin treatment. Results. We recruited 51 patients with ulcer (ulcer group) and 108 patients with no mucosal lesions (control group). In univariate analysis, factors significantly associated with ulcers were male gender (p = 0.001), anticoagulants (p = 0.029), nonsteroidal anti-inflammatory drugs (p = 0.013), heart failure (p = 0.007), liver (p = 0.011) or cerebrovascular disease (p = 0.004), diabetes mellitus (p = 0.043), ulcer history (p = 0.044), and alcohol consumption (p = 0.018), but not Helicobacter pylori infection (p = 0.2). According to our multivariate regression analysis results, history of peptic ulcer (OR 3.07, 95% CI 1.06-8.86), cotreatment with NSAIDs (OR 8, 95% CI 2.09-30.58) or anticoagulants (OR 4.85, 95% CI 1.33-17.68), male gender (OR 5.2, 95% CI 1.77-15.34), and stroke (OR 7.27, 95% CI 1.40-37.74) remained predictors for ulcer on endoscopy. Conclusions. Concomitant use of NSAIDs or anticoagulants, comorbidities (cerebrovascular disease), and male gender are the most important independent risk factors for ulcer on endoscopy in low-dose aspirin consumers, in a population with a high prevalence of H. pylori infection.

  15. Clinical Risk Factors for Gastroduodenal Ulcer in Romanian Low-Dose Aspirin Consumers

    Directory of Open Access Journals (Sweden)

    Anca Negovan

    2016-01-01

    Full Text Available Background. Aspirin use for cardiovascular or cancer prevention is limited due to its gastrointestinal side effects. Objective. Our prospective, observational case-control study aims to identify the predictive factors for ulcers in low-dose aspirin consumers (75–325 mg/day. Methods. The study included patients who underwent an upper digestive endoscopy and took low-dose aspirin treatment. Results. We recruited 51 patients with ulcer (ulcer group and 108 patients with no mucosal lesions (control group. In univariate analysis, factors significantly associated with ulcers were male gender (p=0.001, anticoagulants (p=0.029, nonsteroidal anti-inflammatory drugs (p=0.013, heart failure (p=0.007, liver (p=0.011 or cerebrovascular disease (p=0.004, diabetes mellitus (p=0.043, ulcer history (p=0.044, and alcohol consumption (p=0.018, but not Helicobacter pylori infection (p=0.2. According to our multivariate regression analysis results, history of peptic ulcer (OR 3.07, 95% CI 1.06–8.86, cotreatment with NSAIDs (OR 8, 95% CI 2.09–30.58 or anticoagulants (OR 4.85, 95% CI 1.33–17.68, male gender (OR 5.2, 95% CI 1.77–15.34, and stroke (OR 7.27, 95% CI 1.40–37.74 remained predictors for ulcer on endoscopy. Conclusions. Concomitant use of NSAIDs or anticoagulants, comorbidities (cerebrovascular disease, and male gender are the most important independent risk factors for ulcer on endoscopy in low-dose aspirin consumers, in a population with a high prevalence of H. pylori infection.

  16. Growth factors, glucose and insulin kinetics after low dose growth hormone in HIV - lipodystrophy

    DEFF Research Database (Denmark)

    Haugaard, Steen B; Andersen, Ove; Flyvbjerg, Allan

    2006-01-01

    and temporary reduction in insulin sensitivity was caused by a reduction in non-oxidative glucose metabolism (n=5). GH-administration reduced hepatic extraction of insulin alleviating the demand for insulin secretion (n=5). No adverse effects of GH were detected. CONCLUSIONS: As judged from effects......OBJECTIVES: Low-dose growth hormone (GH) administration has been suggested as a treatment for HIV-lipodystrophy. METHODS: Postglucose GH-secretion, kinetics of insulin-like growth factors (IGFs), insulin, and glucose metabolism were examined in six male HIV-infected lipodystrophic patients (two...

  17. HIGH-DOSE CHEMOTHERAPY WITH STEM-CELL REINFUSION AND GROWTH-FACTOR SUPPORT FOR SOLID TUMORS

    NARCIS (Netherlands)

    DEVRIES, EGE; DEGRAAF, H; VANDERGRAAF, WTA; MULDER, NH; Boonstra, A.

    1995-01-01

    With the help of stem cell reinfusion and hematopoietic growth factors, it is possible to get up to a ten-fold dose increase for certain chemotherapeutic drugs, A number of reasons may have made high-dose chemotherapy less dangerous and the fore more acceptable in a more upfront treatment setting, O

  18. Safety and efficacy of flexible-dose fesoterodine in British subjects with overactive bladder: insights into factors associated with dose escalation.

    Science.gov (United States)

    Cardozo, Linda; Hall, Timothy; Ryan, John; Ebel Bitoun, Caty; Kausar, Imran; Darekar, Amanda; Wagg, Adrian

    2012-11-01

    This study evaluated the efficacy and safety of flexible-dose fesoterodine and factors associated with dose escalation in subjects with overactive bladder (OAB). In this 12-week, open-label study, 331 adults with OAB symptoms for ≥3 months, ≥8 micturitions and ≥3 urgency episodes per 24 h and who reported at least "some moderate" bladder-related problems were treated with fesoterodine 4 mg once daily for 4 weeks, with the option to escalate to 8 mg for the remaining 8 weeks based on discussion of efficacy and tolerability with the investigator. Factors influencing dose escalation were identified using stepwise logistic regression. Efficacy was assessed via 3-day bladder diaries and patient-reported outcomes. Of the subjects, 59 % dose escalated at week 4; 93 % of escalators cited insufficient clinical response. The decision to escalate was most often made by the subject (alone or with the investigator). Improvements from baseline were observed in diary and patient-reported outcomes at weeks 4 and 12. Smaller improvements in micturition frequency and worse bladder-related problems at week 4 were significantly associated with increased likelihood of dose escalation; baseline micturition frequency, age, sex, body mass index, antimuscarinic-associated adverse events and OAB symptom duration were not. Non-escalators had greater improvement from baseline to week 4 than escalators; by week 12, improvement was similar among escalators and non-escalators. Fesoterodine was well tolerated. Treatment with flexible-dose fesoterodine improved bladder diary and patient-reported outcomes. Lower clinical response was related to dose escalation; after escalation, response in escalators approached that of non-escalators.

  19. Low-dose dopamine reduces inlfammatory factors of acute pancreatitis in rats

    Institute of Scientific and Technical Information of China (English)

    Shun Zhang; Xin-Gang Peng; Chang-Chang Liu; Hong Liu; Yun Lu

    2007-01-01

    BACKGROUND:Acute pancreatitis, especially acute necrotizing pancreatitis (ANP), is a serious disease with a high morbidity because of multiorgan dysfunction. Recent studies have indicated that during the pathogenesis of ANP, changes of the microcirculation play an important role in the worsening of the disease. This study based on a model of acute pancreatitis in Wistar rats was to determine the effect of treatment with low-dose dopamine on acute pancreatitis by the dynamic measurement of serum levels of inlfammatory factors IL-6 and TNF-α. METHODS:Fifty Wistar rats were randomly divided into two groups, and a model of ANP was set up by injecting sodium taurocholate into the pancreatic duct. Rats in the dopamine group (treatment group) were given dopamine by vein and those in the acute pancreatitis group (control group) were given normal saline. To assess the effect of low-dose dopamine (5 μg·kg-1·min-1) on induced acute pancreatitis, the antibody sandwich ELISA method was used to measure the serum levels of IL-6 and TNF-α at different times before and after the induction of ANP. RESULTS:The serum levels of IL-6 and TNF-α in the treatment and control groups before and after ANP induction were signiifcantly different. There was a markedly signiifcant difference in the comparison of the two groups after ANP induction (P0.05). Postoperative pancreatic histopathologic changes in the treatment group were more marked than those in the control group. CONCLUSIONS:Low-dose dopamine is effective in treating ANP by alleviating inlfammatory reactions. This effect may be related to the fact that low-dose dopamine not only can increase the blood lfow of the pancreatic microcirculation but also reduce its permeability.

  20. Multivariate analysis of factors predicting prostate dose in intensity-modulated radiotherapy.

    Science.gov (United States)

    Tomita, Tsuneyuki; Nakamura, Mitsuhiro; Hirose, Yoshinori; Kitsuda, Kenji; Notogawa, Takuya; Miki, Katsuhito; Nakamura, Kiyonao; Ishigaki, Takashi

    2014-01-01

    We conducted a multivariate analysis to determine relationships between prostate radiation dose and the state of surrounding organs, including organ volumes and the internal angle of the levator ani muscle (LAM), based on cone-beam computed tomography (CBCT) images after bone matching. We analyzed 270 CBCT data sets from 30 consecutive patients receiving intensity-modulated radiation therapy for prostate cancer. With patients in the supine position on a couch with the HipFix system, data for center of mass (COM) displacement of the prostate and the state of individual organs were acquired and compared between planning CT and CBCT scans. Dose distributions were then recalculated based on CBCT images. The relative effects of factors on the variance in COM, dose covering 95% of the prostate volume (D95%), and percentage of prostate volume covered by the 100% isodose line (V100%) were evaluated by a backward stepwise multiple regression analysis. COM displacement in the anterior-posterior direction (COMAP) correlated significantly with the rectum volume (δVr) and the internal LAM angle (δθ; R = 0.63). Weak correlations were seen for COM in the left-right (R = 0.18) and superior-inferior directions (R = 0.31). Strong correlations between COMAP and prostate D95% and V100% were observed (R ≥ 0.69). Additionally, the change ratios in δVr and δθ remained as predictors of prostate D95% and V100%. This study shows statistically that maintaining the same rectum volume and LAM state for both the planning CT simulation and treatment is important to ensure the correct prostate dose in the supine position with bone matching. Copyright © 2014 American Association of Medical Dosimetrists. Published by Elsevier Inc. All rights reserved.

  1. Predictive factors for anti-HBs status after 1 booster dose of hepatitis B vaccine.

    Science.gov (United States)

    Lu, I-Cheng; Jean, Mei-Chu Yen; Lin, Chi-Wei; Chen, Wei-Hung; Perng, Daw-Shyong; Lin, Chih-Wen; Chuang, Hung-Yi

    2016-09-01

    In Taiwan, infants need to receive 3 doses of hepatitis B virus (HBV) vaccine under the public health policy from the government. However, there are many young adults who even though received complete HBV vaccination in their childhood would lose the positive response of anti-hepatitis B surface antibody (HBs) and need the booster dose of HBV vaccine. The aim of our study is to determine the powerful predictive factor for screening the candidates who need only 1 booster dose of HB vaccine then they can regain positive postbooster anti-HBs status (≧10 mIU/mL) or protective postbooster anti-HBs status (≧100 mIU/mL).We recruited 103 university freshmen who were born after July 1986 with complete HBV vaccination in childhood, but displayed negative results for hepatitis B surface antigen and anti-HBs levels at their health examinations upon university entry. They received 1 booster dose of HB vaccine, and their anti-HBs titers were rechecked 4 weeks after the booster administration. Multivariate analysis logistic regression for positive postbooster anti-HBs status (≧10 mIU/mL, model 1) and protective postbooster anti-HBs status (≧100 mIU/mL, model 2) was done with predictive factors of prebooster anti-HBs level, body mass index, serum glutamate pyruvate transaminase level, and sex.Twenty-four students got positive postbooster anti-HBs status (10-100 mIU/mL) and 50 students got protective postbooster anti-HBs status (≧100 mIU/mL). In the model of multivariate analysis logistic regression for positive postbooster anti-HBs status (≧10 mIU/mL), prebooster anti-HBs level was the strongest predictive factor. The odds ratio was 218.645 and the P value was 0.001. Even in the model of multivariate analysis logistic regression for protective postbooster anti-HBs status (≧100 mIU/mL), prebooster anti-HBs level was still the strongest predictive factor, but the odds ratio of a protective booster effect was 2.143, with 95% confidence interval between 1

  2. Cryopreserved CD34(+) Cell Dose, but Not Total Nucleated Cell Dose, Influences Hematopoietic Recovery and Extensive Chronic Graft-versus-Host Disease after Single-Unit Cord Blood Transplantation in Adult Patients.

    Science.gov (United States)

    Konuma, Takaaki; Kato, Seiko; Oiwa-Monna, Maki; Tanoue, Susumu; Ogawa, Miho; Isobe, Masamichi; Tojo, Arinobu; Takahashi, Satoshi

    2017-07-01

    Low cryopreserved total nucleated cell (TNC) dose in a cord blood (CB) unit has been shown to be associated with engraftment failure and mortality after single-unit cord blood transplantation (CBT) in adults. Although CB banks offer specific characteristics of cryopreserved cell dose, such as TNC, CD34(+) cells, and colony-forming unit for granulocyte/macrophage (CFU-GM), the impact of each cell dose on engraftment and outcomes after single-unit CBT in adults remains unclear. We retrospectively analyzed the results of 306 CBTs for 261 adult patients in our institution between 1998 and 2016. The median age was 43 years (range, 16 to 68), the median actual body weight (ABW) was 56.2 kg (range, 36.2 to 104.0), the median ideal body weight (IBW) was 62.3 kg (range, 39.7 to 81.3), the median TNC dose was 2.46 × 10(7)/ABW kg (range, 1.07 to 5.69), the median CD34(+) cell dose was .91 × 10(5)/ABW kg (range, .15 to 7.75), and the median CFU-GM dose was 24.46 × 10(3)/ABW kg (range, .04 to 121.81). Among patients who achieved engraftment, the speed of neutrophil, platelet, and red blood cell engraftment significantly correlated with CD34(+) cell dose, but not with TNC and CFU-GM dose, based on both ABW and IBW. In multivariate analysis, the incidence of extensive chronic graft-versus-host disease (GVHD) was significantly higher in patients receiving the highest CD34(+) cell dose, based on both ABW and IBW. Nevertheless, no cell dose was associated with survival, transplantation-related mortality, and relapse. In conclusion, cryopreserved CD34(+) cell dose was the best predictor for hematopoietic recovery and extensive chronic GVHD after CBT. The cryopreserved CD34(+) cell dose should be used for unit selection criteria in single-unit CBT for adults. Copyright © 2017 The American Society for Blood and Marrow Transplantation. Published by Elsevier Inc. All rights reserved.

  3. Infectious Dose of Listeria monocytogenes in Outbreak Linked to Ice Cream, United States, 2015.

    Science.gov (United States)

    Pouillot, Régis; Klontz, Karl C; Chen, Yi; Burall, Laurel S; Macarisin, Dumitru; Doyle, Matthew; Bally, Kären M; Strain, Errol; Datta, Atin R; Hammack, Thomas S; Van Doren, Jane M

    2016-12-01

    The relationship between the number of ingested Listeria monocytogenes cells in food and the likelihood of developing listeriosis is not well understood. Data from an outbreak of listeriosis linked to milkshakes made from ice cream produced in 1 factory showed that contaminated products were distributed widely to the public without any reported cases, except for 4 cases of severe illness in persons who were highly susceptible. The ingestion of high doses of L. monocytogenes by these patients infected through milkshakes was unlikely if possible additional contamination associated with the preparation of the milkshake is ruled out. This outbreak illustrated that the vast majority of the population did not become ill after ingesting a low level of L. monocytogenes but raises the question of listeriosis cases in highly susceptible persons after distribution of low-level contaminated products that did not support the growth of this pathogen.

  4. A study on scattered dose in operation room by C-arm unit

    Energy Technology Data Exchange (ETDEWEB)

    An, Sung Min; Oh, Jung Hwan; Kim, Sung Chul [Gachon Gil College, Incheon (Korea, Republic of)

    2000-04-15

    This paper studied a C-arm's exposure condition and measured scatter rays by thickness and distance. This study reached the following conclusion. Approximately exposure dose for a patient using fluoroscopy is as follows: Mostly, an operating room was not shielding by lead and operator put on only apron without thyroid and facial part protection. 0.5 mmPb equivalent's apron shielded about 99% of scattered rays at 60 cm from x-ray tube. Scattered rays are depended on distance and thickness so operators are should be careful when using fluoroscopy by C-arm and if possible use high frequency equipment that has a large output.

  5. Mean glandular doses in mammography: a comparison of values displayed by a mammography unit with in-house values, both using the method proposed by Dance.

    Science.gov (United States)

    Pasicz, Katarzyna; Fabiszewska, Ewa; Grabska, Iwona; Skrzyński, Witold

    2016-09-01

    The purpose of this work is to compare the mean glandular dose (MGD) displayed by the mammography system and the MGD calculated according to the method proposed by Dance for women. This study also attempts to analyse whether the relationship between the calculated and the displayed values is constant and what factors influence this relationship. Material for this study included data from 1200 exposures (i.e. six series; each series consisting of 200 exposures) performed with one full-field digital mammography unit. Based on collected parameters of exposures, values of the MGD for individual mammography examinations were calculated according to the methods proposed by Dance. Obtained values of the MGD were compared with the values displayed by the mammography system. The MGD displayed by the mammography system and the MGD calculated according to the method proposed by Dance for women are significantly different. This result emphasises the importance of verifying MGD values for patient radiation protection, particularly after machine servicing.

  6. Topical single-dose vascular endothelial growth factor has no effect on soft tissue healing

    Directory of Open Access Journals (Sweden)

    Nilufer Bolukbasi

    2014-01-01

    Full Text Available Background: Vascular endothelial growth factor (VEGF production in dermal wounds has been evaluated for evidence that it plays a probable role in wound healing. Events such as increased vascular permeability and concentration of inflammatory cells on the site of injury, produced by VEGF, were linked to tissue repair. Aim: The present study aimed to evaluate the effects of single-dose topical administration of VEGF on wound healing. Materials and Methods: A total of 30 male Wistar albino rats weighing 250-280 g were used in this study. In addition, 2-cm-long skin incisions were created over bilaterally exposed skin of the tibia region in each rat. VEGF plasmid 2 μg was administered locally into the right side wound bed of each animal. No other procedure besides skin closure was administered on the left side. To determine histologic assessments, skin samples were obtained from six anesthetized rats at each interval (4, 8, 12, 16 and 30 days through excisional biopsy. The tissues were fixed in 10% neutral-buffered formalin for 1 week and then embedded in paraffin wax. Transverse sections of the embedded tissue 5-7 μm thick were stained with hematoxylin and eosin (H and E. Results: There was no significant difference regarding necrosis, epithelialization, inflammation, fibroblast activity, ulcerative formation, or hemorrhage between experimental and control groups. No statistically significant difference was found between the groups regarding granulation tissue formation and epidermal thickness. Conclusion: The administration method and dosage of VEGF is a major factor in terms of its effectiveness. The results of the present study did not evaluate the effectiveness of single-dose 2 μg topical administration of VEGF; however, various doses of VEGF plasmid should be tested in future studies in order to provide beneficial effects from topical administration of VEGF.

  7. Cardiovascular risk factors in children after repeat doses of antenatal glucocorticoids: an RCT.

    Science.gov (United States)

    McKinlay, Christopher J D; Cutfield, Wayne S; Battin, Malcolm R; Dalziel, Stuart R; Crowther, Caroline A; Harding, Jane E

    2015-02-01

    Treatment of women at risk for preterm birth with repeat doses of glucocorticoids reduces neonatal morbidity but could have adverse long-term effects on cardiometabolic health in offspring. We assessed whether exposure to repeat antenatal betamethasone increased risk factors for later cardiometabolic disease in children whose mothers participated in the Australasian Collaborative Trial of Repeat Doses of Corticosteroids. Women were randomized to betamethasone or placebo treatment, ≥ 7 days after an initial course of glucocorticoids, repeated each week that they remained at risk for preterm birth at children were assessed at 6 to 8 years' corrected age for body composition, insulin sensitivity, ambulatory blood pressure, and renal function. Of 320 eligible childhood survivors, 258 were studied (81%; 123 repeat betamethasone group; 135 placebo [single course] group). Children exposed to repeat antenatal betamethasone and those exposed to placebo had similar total fat mass (geometric mean ratio 0.98, 95% confidence interval [CI] 0.78 to 1.23), minimal model insulin sensitivity (geometric mean ratio 0.89, 95% CI 0.74 to 1.08), 24-hour ambulatory blood pressure (mean difference systolic 0 mm Hg, 95% CI -2 to 2; diastolic 0 mm Hg, 95% CI -1 to 1), and estimated glomerular filtration rate (mean difference 1.2 mL/min/1.73 m(2), 95% CI -3.2 to 5.6). Exposure to repeat doses of antenatal betamethasone compared with a single course of glucocorticoids does not increase risk factors for cardiometabolic disease at early school age. Copyright © 2015 by the American Academy of Pediatrics.

  8. A population pharmacokinetic model for perioperative dosing of factor VIII in hemophilia A patients.

    Science.gov (United States)

    Hazendonk, Hendrika; Fijnvandraat, Karin; Lock, Janske; Driessens, Mariëtte; van der Meer, Felix; Meijer, Karina; Kruip, Marieke; Gorkom, Britta Laros-van; Peters, Marjolein; de Wildt, Saskia; Leebeek, Frank; Cnossen, Marjon; Mathôt, Ron

    2016-10-01

    The role of pharmacokinetic-guided dosing of factor concentrates in hemophilia is currently a subject of debate and focuses on long-term prophylactic treatment. Few data are available on its impact in the perioperative period. In this study, a population pharmacokinetic model for currently registered factor VIII concentrates was developed for severe and moderate adult and pediatric hemophilia A patients (FVIII levels modeling was performed using non-linear mixed-effects modeling. Population pharmacokinetic parameters were estimated in 75 adults undergoing 140 surgeries (median age: 48 years; median weight: 80 kg) and 44 children undergoing 58 surgeries (median age: 4.3 years; median weight: 18.5 kg). Pharmacokinetic profiles were best described by a two-compartment model. Typical values for clearance, intercompartment clearance, central and peripheral volume were 0.15 L/h/68 kg, 0.16 L/h/68 kg, 2.81 L/68 kg and 1.90 L/68 kg. Interpatient variability in clearance and central volume was 37% and 27%. Clearance decreased with increasing age (Pmodel describes the perioperative pharmacokinetics of various FVIII concentrates, allowing individualization of perioperative FVIII therapy for severe and moderate hemophilia A patients by Bayesian adaptive dosing. Copyright© Ferrata Storti Foundation.

  9. Youth suicide attempts and the dose-response relationship to parental risk factors: a population-based study

    DEFF Research Database (Denmark)

    Christiansen, E; Goldney, R D; Beautrai, A L;

    2011-01-01

    illness and low level of income were all significant independent risk factors for offspring's suicide attempts. CONCLUSIONS: Knowledge of the effect of multiple risk factors on the likelihood of suicide attempts in children and adolescents is important for risk assessment. Dose-response effects......BACKGROUND: There is a lack of specific knowledge about the dose-response effect of multiple parental risk factors for suicide attempts among children and adolescents. The aim of this study was to determine the dose-response effect of multiple parental risk factors on an offspring's risk...... to each case and a link to the offspring's biological parents was established. RESULTS: There was a dose-response relationship between the number of exposures and the risk of suicide attempts, with the increased risk seeming to be a multiplicative effect. Parental suicide, suicide attempt, psychiatric...

  10. R-Factor for the Coterminous United States

    Data.gov (United States)

    National Oceanic and Atmospheric Administration, Department of Commerce — The rainfall-runoff erosivity factor (R-Factor) quantifies the effects of raindrop impacts and reflects the amount and rate of runoff associated with the rain. The...

  11. Protection against bubonic and pneumonic plague with a single dose microencapsulated sub-unit vaccine.

    Science.gov (United States)

    Elvin, Stephen J; Eyles, James E; Howard, Kenneth A; Ravichandran, Easwaran; Somavarappu, Satyanarayan; Alpar, H Oya; Williamson, E Diane

    2006-05-15

    Protection against virulent plague challenge by the parenteral and aerosol routes was afforded by a single administration of microencapsulated Caf1 and LcrV antigens from Yersinia pestis in BALB/c mice. Recombinant Caf1 and LcrV were individually encapsulated in polymeric microspheres, to the surface of which additional antigen was adsorbed. The microspheres containing either Caf1 or LcrV were blended and used to immunise mice on a single occasion, by either the intra-nasal or intra-muscular route. Both routes of immunisation induced systemic and local immune responses, with high levels of serum IgG being developed in response to both vaccine antigens. In Elispot assays, secretion of cytokines by spleen and draining lymph node cells was demonstrated, revealing activation of both Th1 and Th2 associated cytokines; and spleen cells from animals immunised by either route were found to proliferate in vitro in response to both vaccine antigens. Virulent challenge experiments demonstrated that non-invasive immunisation by intra-nasal instillation can provide strong systemic and local immune responses and protect against high level challenge. Microencapsulation of these vaccine antigens has the added advantage that controlled release of the antigens occurs in vivo, so that protective immunity can be induced after only a single immunising dose.

  12. Analysis of dose perturbation factors of a NACP-02 ionization chamber in clinical electron beams.

    Science.gov (United States)

    Chin, E; Palmans, H; Shipley, D; Bailey, M; Verhaegen, F

    2009-01-21

    For well-guarded plane-parallel ionization chambers, international dosimetry protocols recommend a value of unity for electron perturbation factors in water. However, recent data published by various groups have challenged this. Specifically for the NACP-02 chamber, non-unity electron perturbation factors have already been published by Verhaegen et al (2006 Phys. Med. Biol. 51 1221-35) and Buckley and Rogers (2006 Med. Phys. 33 1788-96). Recently it was found that the mass thickness of the front chamber window can be 35% greater than is listed in the IAEA's TRS-398 absorbed dose protocol (Chin et al 2008 Phys. Med. Biol. 53 N119-26). This study therefore recalculated NACP-02 electron perturbation correction factors for energies 4-18 MeV at depths z(ref) and R(50) to determine the effect of the chamber model change. Results showed that perturbation factors at z(ref) are fairly stable for similar chamber models but become highly sensitive to small changes at deeper depths. The results also showed some dependence on using 1 keV versus 10 keV for the transport cut-off. Additional investigations revealed that the wall perturbation factor, p(wall), is strongly influenced by the chamber back wall at z(ref) and at larger depths small changes in the positioning of the effective point of measurement cause large fluctuations in the final value. Finally, the cavity perturbation factor, p(cav), was found to be primarily influenced by electron backscatter.

  13. Factors Associated with Myelosuppression Related to Low-Dose Methotrexate Therapy for Inflammatory Rheumatic Diseases.

    Directory of Open Access Journals (Sweden)

    Shunsuke Mori

    Full Text Available Severe myelosuppression is a serious concern in the management of rheumatic disease patients receiving methotrexate (MTX therapy. This study was intended to explore factors associated with the development of MTX-related myelosuppression and its disease severity.We retrospectively examined a total of 40 cases of MTX-related myelosuppression that had been filed in the registries of participating rheumatology and hematology divisions. Data before onset were compared with those of 120 controls matched for age and sex. Cytopenia was graded according to the National Cancer Institute criteria for adverse events. Data before and at onset were compared between the severe and non-severe groups.Non-use of folic acid supplements, concurrent medications, and low renal function were significantly associated with the development of myelosuppression (p < 0.001, p < 0.001, and p = 0.002, respectively. In addition, significantly lower MTX dosages, higher blood cell counts, and lower hemoglobin levels were seen in the myelosuppression group (p < 0.001. No patients exhibited leukocytopenia, neutropenia, or thrombocytopenia in routine blood monitoring taken within the past month. One-fourth developed myelosuppression within the first two months (an early-onset period. Myelosuppression was severe in approximately 40% of patients. Hypoalbuminemia and non-use of folic acid supplements were significantly associated with the severity of pancytopenia (p = 0.001 and 0.008, respectively. Besides these two factors, early onset and the use of lower doses of MTX were significantly associated with the severity of neutropenia (p = 0.003, 0.007, 0.003, and 0.002, respectively.Myelosuppression can occur abruptly at any time during low-dose MTX therapy, but severe neutropenia is more likely to occur in the early-onset period of this therapy. Contrary to our expectations, disease severity was not dependent on MTX doses. Serum albumin levels and folic acid supplementation are the

  14. Risk and preventive factors of low-dose aspirin-induced gastroduodenal injuries: a comprehensive review.

    Science.gov (United States)

    Shiotani, Akiko; Manabe, Noriaki; Kamada, Tomoari; Fujimura, Yoshinori; Sakakibara, Takashi; Haruma, Ken

    2012-04-01

    The risk of peptic ulcer complications, particularly bleeding, is increased in association with the use of low-dose aspirin (LDA). Risk factors for upper gastrointestinal (GI) ulcer or bleeding among LDA users include a history of prior GI events, older age, chronic renal failure, combined antithrombotic therapy and nonsteroidal anti-inflammatory drugs (NSAIDs). Helicobacter pylori and aspirin seem to be independent risk factors for peptic ulcer and bleeding. The studies report conflicting findings about the effect of H. pylori infection on NSAID-related ulcers, and proton-pump inhibitors (PPIs) seem to be superior to eradication only to prevent recurrent ulcer bleeding with LDA. Previous studies indicate that hypoacidity related to corpus atrophy, as well as taking PPIs and co-treatment with angiotensin type 1 receptor blockers (ARBs) and statins seem to reduce peptic ulcer among LDA users. In addition, the interleukin-1β (IL-1β)-511 T allele and angiotensinogen (AGT)-20 CC, which work as the high-producer allele of IL-1β and AGT, are significantly associated with ulcer or ulcer bleeding. The SLCO1B1*1b haplotype, which has the highest transport activity, may diminish the preventive effect of statins or ARBs. The data are still lacking and further prospective studies are needed to identify the specific risk or protective factors for upper GI ulcer and its complications associated with LDA.

  15. Assessment of individual dose utilization vs. physician prescribing recommendations for recombinant activated factor VII (rFVIIa) in paediatric and adult patients with congenital haemophilia and alloantibody inhibitors (CHwI): the Dosing Observational Study in Hemophilia (DOSE).

    Science.gov (United States)

    Gruppo, R A; Kessler, C M; Neufeld, E J; Cooper, D L

    2013-07-01

    Recent data from the Dosing Observational Study in Hemophilia diary study has described home treatment with recombinant activated factor VII (rFVIIa) in congenital haemophilia with inhibitors (CHwI). The current analysis compares prescribed and patient/caregiver-reported rFVIIa administration in paediatric and adult CHwI patients in this study. Patients with ≥ 4 bleeding episodes within a 3-month period prescribed rFVIIa as first-line therapy for bleeding episodes were eligible. Patients/caregivers completed a diary for ≥ 90 days or until the patient experienced four bleeds. Initial, total and mean rFVIIa doses reported for each bleeding episode were calculated and compared with the physician-prescribed doses. Of 52 enrolled patients (25 children; 27 adults), 39 (75%) completed the study. Children and adults had similar mean durations of bleeding episodes. Both patient groups were administered higher initial rFVIIa doses for joint bleeds than prescribed: median (range) 215.2 (74.1-400.0) mcg kg(-1) vs. 200.0 (61.0-270.0) mcg kg(-1) for children, and 231.3 (59.3-379.7) mcg kg(-1) vs. 123.0 (81.0-289.0) mcg kg(-1) for adults. The median infused dose for joint bleeds was higher in adults than children (175.2 vs. 148.0 mcg kg(-1) ), but children received significantly more doses per joint bleed than adults (median 6.5 vs. 3.0). The median total dose per joint bleed was higher in children than adults (1248.7 vs. 441.6). For children and adults, both initial and additional doses administered for bleeds were higher than prescribed. Children received higher total doses per bleed due to an increased number of infusions per bleed.

  16. FACTORS IMPLICATED IN AMPHIBIAN POPULATION DECLINES IN THE UNITED STATES

    Science.gov (United States)

    This study identified the factors responsible for the decline of native amphibians in the U.S. The type of land use, the introduction of exotic animal species, and chemical contamination were identified as the most likely causes of decline.

  17. Timing of HPV vaccine intervals among United States teens with consideration to the current ACIP schedule and the WHO 2-dose schedule.

    Science.gov (United States)

    Cloessner, Emily A; Stokley, Shannon; Yankey, David; Markowitz, Lauri E

    2016-06-02

    The current recommendation for human papillomavirus (HPV) vaccination in the United States is for 3 doses to be administered over a 6 month period. In April 2014, the World Health Organization (WHO) recommended adoption of a 2-dose schedule, with doses spaced a minimum of 6 months apart, for teens who begin the series before age 15. We analyzed data from the 2013 National Immunization Survey-Teen to examine the timing of second and third dose receipt among US adolescents. All analyses were restricted to adolescents age 13-17 y who had adequate provider data. The Wilcoxon-Mann-Whitney test measured differences in time to receive vaccine doses among demographic and socioeconomic groups. Logistic regression identified socioeconomic characteristics associated with receiving the second dose of HPV vaccine at least 6 months after the first dose. The median time for teens to receive the second dose of HPV vaccine was 2.6 months after the first dose, and the median time to receive the third dose was 4.9 months after the second dose. Minority teens and teens living below the poverty level took significantly longer to receive doses. Among teens that initiated the HPV vaccine series before age 15 y, 28.6% received the second dose at least 6 months after the first dose. If these teens, who met the WHO criteria for up-to-date HPV vaccination, were classified as having completed the vaccination series, overall coverage in the US would increase 3.9 percentage points, with African American and Hispanic teens having the greatest increases in coverage.

  18. Calculation of indoor effective dose factors in ORNL phantoms series due to natural radioactivity in building materials.

    Science.gov (United States)

    Krstic, D; Nikezic, D

    2009-10-01

    In this paper the effective dose in the age-dependent ORNL phantoms series, due to naturally occurring radionuclides in building materials, was calculated. The absorbed doses for various organs or human tissues have been calculated. The MCNP-4B computer code was used for this purpose. The effective dose was calculated according to ICRP Publication 74. The obtained values of dose conversion factors for a standard room are: 1.033, 0.752 and 0.0538 nSv h-1 per Bq kg-1 for elements of the U and Th decay series and for the K isotope, respectively. The values of effective dose agreed generally with those found in the literature, although the values estimated here for elements of the U series were higher in some cases.

  19. Hippocampal dose from stereotactic radiosurgery for 4 to 10 brain metastases: Risk factors, feasibility of dose reduction via re-optimization, and patient outcomes.

    Science.gov (United States)

    Birer, Samuel R; Olson, Adam C; Adamson, Justus; Hood, Rodney; Susen, Matthew; Kim, Grace; Salama, Joseph K; Kirkpatrick, John P

    2017-07-28

    This study aimed to report hippocampal dose from single-fraction stereotactic radiosurgery (SRS) for 4 to 10 brain metastases and determine feasibility of hippocampal-sparing SRS. Patients with 4 to 10 brain metastases receiving single-isocenter, multi-target single-fraction SRS were identified. Hippocampi were contoured using the Radiation Therapy Oncology Group (RTOG) 0933 atlas. RTOG 0933 dose constraints were converted to a biologically effective dose using an alpha/beta of 2 (D100 421 cGy, Dmax 665 cGy). Number of metastases, total target volume, prescribed dose, and distance of nearest metastasis (dmin) were analyzed as risk factors for exceeding hippocampal constraints. If hippocampi exceeded constraints, the SRS plan was re-optimized. Key dosimetric parameters were compared between original and re-optimized plans. To determine if a single target can exceed constraints, all targets but the closest metastasis were removed from the plan, and dosimetry was compared. Forty plans were identified. Fifteen hippocampi (19%) exceeded constraints in 12 SRS plans. Hippocampal sparing was achieved in 10 of 12 replanned cases (83%). Risk factors associated with exceeding hippocampal constraints were decreasing dmin (24.0 vs 8.0 mm, p = 0.002; odds ratio [OR] 1.14, 95% confidence interval [CI] 1.04 to 1.26) and total target volume (5.46 cm(3)vs 1.98 cm(3), p = 0.03; OR 1.14, 95% CI 1.00 to 1.32). There was no difference in exceeding constraints for 4 to 5 vs 6 to 10 metastases (27% vs 21%, p = 0.409) or prescribed dose (18 Gy, p = 0.58). For re-optimized plans, there were no significant differences in planning target volume (PTV) coverage (99.6% vs 99.0%, p = 0.17) or conformality index (1.47 vs 1.4, p = 0.78). Six (50%) plans exceeded constraints with a single target. A substantial minority of hippocampi receive high radiation dose from SRS for 4 to 10 brain metastases. Decreasing distance of the closest metastasis and total target volume

  20. Comprehensive evaluation of formulation factors for ocular penetration of fluoroquinolones in rabbits using cassette dosing technique

    Science.gov (United States)

    Sharma, Charu; Biswas, Nihar R; Ojha, Shreesh; Velpandian, Thirumurthy

    2016-01-01

    Objective Corneal permeability of drugs is an important factor used to assess the efficacy of topical preparations. Transcorneal penetration of drugs from aqueous formulation is governed by various physiological, physiochemical, and formulation factors. In the present study, we investigated the effect of formulation factors like concentration, pH, and volume of instillation across the cornea using cassette dosing technique for ophthalmic fluoroquinolones (FQs). Materials and methods Sterile cocktail formulations were prepared using four congeneric ophthalmic FQs (ofloxacin, sparfloxacin, pefloxacin mesylate, and gatifloxacin) at concentrations of 0.025%, 0.5%, and 0.1%. Each formulation was adjusted to different pH ranges (4.5, 7.0, and 8.0) and assessed for transcorneal penetration in vivo in rabbit’s cornea (n=4 eyes) at three different volumes (12.5, 25, and 50 μL). Aqueous humor was aspirated through paracentesis after applying local anesthesia at 0, 5, 15, 30, 60, 120, and 240 minutes postdosing. The biosamples collected from a total of 27 groups were analyzed using liquid chromatography–tandem mass spectroscopy to determine transcorneal permeability of all four FQs individually. Results Increase in concentration showed an increase in penetration up to 0.05%; thereafter, the effect of concentration was found to be dependent on volume of instillation as we observed a decrease in transcorneal penetration. The highest transcorneal penetration of all FQs was observed at pH 7.0 at concentration 0.05% followed by 0.025% at pH 4.5. Lastly, increasing the volume of instillation from 12.5 to 50 μL showed a significant fall in transcorneal penetration. Conclusion The study concludes that formulation factors showed discernible effect on transcorneal permeation; therefore, due emphasis should be given on drug development and design of ophthalmic formulation. PMID:26955263

  1. Prolonged high-dose intravenous magnesium therapy for severe tetanus in the intensive care unit: a case series

    Directory of Open Access Journals (Sweden)

    Fligou Fotini

    2010-03-01

    Full Text Available Abstract Introduction Tetanus rarely occurs in developed countries, but it can result in fatal complications including respiratory failure due to generalized muscle spasms. Magnesium infusion has been used to treat spasticity in tetanus, and its effectiveness is supported by several case reports and a recent randomized controlled trial. Case presentations Three Caucasian Greek men aged 30, 50 and 77 years old were diagnosed with tetanus and admitted to a general 12-bed intensive care unit in 2006 and 2007 for respiratory failure due to generalized spasticity. Intensive care unit treatment included antibiotics, hydration, enteral nutrition, early tracheostomy and mechanical ventilation. Intravenous magnesium therapy controlled spasticity without the need for additional muscle relaxants. Their medications were continued for up to 26 days, and adjusted as needed to control spasticity. Plasma magnesium levels, which were measured twice a day, remained in the 3 to 4.5 mmol/L range. We did not observe hemodynamic instability, arrhythmias or other complications related to magnesium therapy in these patients. All patients improved, came off mechanical ventilation, and were discharged from the intensive care unit in a stable condition. Conclusion In comparison with previous reports, our case series contributes the following meaningful additional information: intravenous magnesium therapy was used on patients already requiring mechanical ventilation and remained effective for up to 26 days (significantly longer than in previous reports without significant toxicity in two patients. The overall outcome was good in all our patients. However, the optimal dose, optimal duration and maximum safe duration of intravenous magnesium therapy are unknown. Therefore, until more data on the safety and efficacy of magnesium therapy are available, its use should be limited to carefully selected tetanus cases.

  2. Development and application of a complex numerical model and software for the computation of dose conversion factors for radon progenies.

    Science.gov (United States)

    Farkas, Árpád; Balásházy, Imre

    2015-04-01

    A more exact determination of dose conversion factors associated with radon progeny inhalation was possible due to the advancements in epidemiological health risk estimates in the last years. The enhancement of computational power and the development of numerical techniques allow computing dose conversion factors with increasing reliability. The objective of this study was to develop an integrated model and software based on a self-developed airway deposition code, an own bronchial dosimetry model and the computational methods accepted by International Commission on Radiological Protection (ICRP) to calculate dose conversion coefficients for different exposure conditions. The model was tested by its application for exposure and breathing conditions characteristic of mines and homes. The dose conversion factors were 8 and 16 mSv WLM(-1) for homes and mines when applying a stochastic deposition model combined with the ICRP dosimetry model (named PM-A model), and 9 and 17 mSv WLM(-1) when applying the same deposition model combined with authors' bronchial dosimetry model and the ICRP bronchiolar and alveolar-interstitial dosimetry model (called PM-B model). User friendly software for the computation of dose conversion factors has also been developed. The software allows one to compute conversion factors for a large range of exposure and breathing parameters and to perform sensitivity analyses. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  3. Predictive factors of head and neck squamous cell carcinoma patient tolerance to high-dose cisplatin in concurrent chemoradiotherapy

    OpenAIRE

    Nakano, Kenji; SATO, YASUYOSHI; TOSHIYASU, TAKASHI; SATO, YUKIKO; INAGAKI, LINA; Tomomatsu, Junichi; Sasaki, Toru; SHIMBASHI, WATARU; FUKUSHIMA, HIROFUMI; YONEKAWA, HIROYUKI; Mitani,Hiroki; Kawabata, Kazuyoshi; Takahashi, Shunji

    2015-01-01

    Although high-dose cisplatin is the standard regimen of concurrent chemoradiotherapy (CCRT) for locally advanced head and neck squamous cell carcinoma (HNSCC), varying levels of patient tolerance towards cisplatin have been reported, and the predictive factors of cisplatin tolerance remain to be elucidated. The present study retrospectively reviewed newly diagnosed HNSCC patients who received CCRT. Cisplatin (80 mg/m2) was administered every 3 weeks. The proportion of high-dose cisplatin-tole...

  4. Changes in pulmonary function and influencing factors after high-dose intrathoracic radio(chemo)therapy

    Energy Technology Data Exchange (ETDEWEB)

    Schroeder, Christina [University Clinic Giessen and Marburg, Clinic for Radiotherapy and Radiation Oncology, Marburg (Germany); Ruppiner Kliniken GmbH, Clinic for Radiotherapy and Radiation Oncology, Neuruppin (Germany); Engenhart-Cabillic, Rita; Vorwerk, Hilke [University Clinic Giessen and Marburg, Clinic for Radiotherapy and Radiation Oncology, Marburg (Germany); Schmidt, Michael; Huhnt, Winfried; Blank, Eyck; Sidow, Dietrich; Buchali, Andre [Ruppiner Kliniken GmbH, Clinic for Radiotherapy and Radiation Oncology, Neuruppin (Germany)

    2017-02-15

    Using prospectively collected patient-related, dose-related, and pulmonary function test (PFT) data before radiotherapy (RT) and at several follow-up visits after RT, the time course of PFT changes after high-dose radio(chemo)therapy and influencing factors were analyzed. From April 2012 to October 2015, 81 patients with non-small-cell lung carcinoma (NSCLC), small cell lung carcinoma (SCLC), or esophageal carcinoma where treated with high-dose radio(chemo)therapy. PFT data were collected before treatment and 6 weeks, 12 weeks, and 6 months after RT. The influence of patient- and treatment-related factors on PFT was analyzed. Mean forced expiratory volume in 1 s (FEV1) constantly declined during follow-up (p = 0.001). In total, 68% of patients had a reduced FEV1 at 6 months. Mean vital capacity (VC) didn't change during follow-up (p > 0.05). Mean total lung capacity (TLC) showed a constant decline after RT (p = 0.026). At 6 months, 60% of patients showed a decline in VC and 73% in TLC. The mean diffusion capacity for carbon monoxide (DLCO) declined at 6 and 12 weeks, but recovered slightly at 6 months (p < 0.0005). At 6 months, 86% of patients had a reduced DLCO. After treatment, the partial pressure of CO{sub 2} in the blood (pCO{sub 2}) was increased and pO{sub 2} was decreased (p > 0.05). Only the pretreatment PFT classification had a significant influence on the post-RT FEV1. DLCO seems to be the most reliable indicator for lung tissue damage after thoracic RT. Ventilation parameters appear to be less reliable. Concerning patient- or treatment-related factors, no reliable conclusion can be drawn regarding which factors may be relevant. (orig.) [German] Patientenbezogene, therapiebezogene und Lungenfunktionsdaten (''pulmonary function test'', PFT) wurden vor Radiotherapie (RT) und an verschiedenen Nachsorgeterminen nach RT prospektiv gesammelt, um PFT-Veraenderungen sowie Einflussfaktoren nach Hochdosis-Radio(chemo)therapie zu

  5. Frequency and Risk Factors Associated with Cord Graft Failure after Transplant with Single-Unit Umbilical Cord Cells Supplemented by Haploidentical Cells with Reduced-Intensity Conditioning.

    Science.gov (United States)

    Tsai, Stephanie B; Liu, Hongtao; Shore, Tsiporah; Fan, Yun; Bishop, Michael; Cushing, Melissa M; Gergis, Usama; Godley, Lucy; Kline, Justin; Larson, Richard A; Martinez, Guadalupe; Mayer, Sebastian; Odenike, Olatoyosi; Stock, Wendy; Wickrema, Amittha; van Besien, Koen; Artz, Andrew S

    2016-06-01

    Delayed engraftment and cord graft failure (CGF) are serious complications after unrelated cord blood (UCB) hematopoietic stem cell transplantation (HSCT), particularly when using low-cell-dose UCB units. The haplo-cord HSCT approach allows the use of a lower dose single UCB unit by co-infusion of a CD34(+) selected haploidentical graft, which provides early transient engraftment while awaiting durable UCB engraftment. We describe the frequency, complications, and risk factors of CGF after reduced-intensity conditioning haplo-cord HSCT. Among 107 patients who underwent haplo-cord HSCT, 94 were assessable for CGF, defined as risk of CGF. We conclude that assessing chimerism at day 30 may foretell impending CGF, and avoidance of high haploidentical cell doses may reduce risk of CGF after haplo-cord HSCT. However, long-term survival is possible after CGF because of predominant haploidentical or mixed chimerism and hematopoietic function.

  6. Evaluation of Enoxaparin Dosing as a Risk Factor for Bleeding in Lung Transplant Recipients.

    Science.gov (United States)

    Sofjan, Amelia K; Iuppa, Jennifer A; Bain, K Bennett; Deal, Eli N; Witt, Chad A; Hachem, Ramsey R; Yusen, Roger D

    2016-10-01

    Lung transplant recipients commonly develop complications that lead to anticoagulation. Standard FDA-approved enoxaparin dosing in this population results in a high incidence of above-goal anti-Xa levels, but its association with bleeding remains unclear. To evaluate the association between enoxaparin dosing and bleeding in lung transplant recipients and assess the relationship between dosing and anti-Xa levels. We conducted a single-center retrospective cohort study of adult lung transplant recipients who received therapeutic enoxaparin between 2000 and 2012 at a tertiary academic center. We dichotomized enoxaparin dosing regimens into standard dose (FDA-approved doses with a 10% rounding margin) and reduced dose. Clinicians ordered anti-Xa levels as deemed clinically appropriate. The primary outcome was major bleeding or clinically relevant nonmajor bleeding. Of 222 patients treated with enoxaparin, 33 (14.9%) had bleeding events, of which half (17/33) were major. Bleeding occurred in 25/146 (17.1%) patients who received standard-dose enoxaparin versus 8/76 (10.5%) patients who received reduced-dose enoxaparin (P = 0.190). Multiple logistic regression demonstrated an independent association between standard-dose enoxaparin and bleeding, after adjusting for confounders (adjusted odds ratio = 3.04; 95% CI = 1.14-8.10). The median enoxaparin dose in patients with above-goal versus at-goal anti-Xa levels was 0.89 versus 0.76 mg/kg every 12 hours; P = 0.006. However, doses yielding at-goal anti-Xa levels had an interquartile range of 0.67 to 0.90 mg/kg, which overlapped with doses yielding above- and below-goal anti-Xa levels. Enoxaparin dose reduction and anti-Xa level monitoring can improve drug safety and facilitate individualized dose optimization in lung transplant recipients. © The Author(s) 2016.

  7. Annual effective dose of ionizing radiation from natural sources received by airline aircrew members compared with that received by non-flying residents of the United States

    Science.gov (United States)

    Friedberg, W.; Copeland, K.; O'Brien, K., III

    In evaluating health aspects of the ionizing radiation exposure of aircrews, risk estimates are normally based on the amount of cosmic radiation received in flight. Not considered is that aircrews spend most of their time on the ground. In this report, annual total effective doses of ionizing radiation from natural sources received by aircrews on and off the job, flying between Los Angeles and Tokyo or Chicago and London, are compared with doses to non-flying residents of the United States and non-flying residents of Environmental Protection Agency Region 8 (Montana, North Dakota, South Dakota, Wyoming, Utah, Colorado --- the region in the United States with the highest dose rates of natural ionizing radiation at ground level). Occupational exposure of aircrews to ionizing radiation is thought to increase their risk of fatal cancer. It may not be a significant concern if one considers: (a) the annual dose of ionizing radiation to the crewmembers in our study is only 7-41% higher than that received by non-flying residents of Region 8 (terrestrial gamma and cosmic radiation in the Denver, Colorado, area of Region 8); (b) the dose to non-flying residents of Region 8 is 87% higher than the average dose to non-flying residents of the United States; and (c) the estimated death rate from cancer in the six states in Region 8 is 3-26% lower than the average for the United States. When considering health concerns of aircrew members, one should recognize that the standard risk coefficient for radiation-induced fatal cancer is derived primarily from studies on individuals exposed to radiation at higher doses and dose rates and of generally lower energy, than the galactic cosmic radiation to which aircrews are exposed. These differences are a major reason that epidemiology studies are important in evaluating health aspects of the occupational radiation exposure of aircrews.

  8. Determination of dose factors for external gamma radiation at residences; Determinacao de fatores de dose para radiacao gama externa em residencias

    Energy Technology Data Exchange (ETDEWEB)

    Maduar, Marcelo Francis; Hiromoto, Goro [Instituto de Pesquisas Energeticas e Nucleares (IPEN), Sao Paulo, SP (Brazil)

    1999-11-01

    A significant contribution to the global population exposure to ionizing radiation arises from natural sources, especially from radionuclides present in terrestrial crust. Human activities can eventually concentrate such radionuclides to significant levels from the point of view of radiological protection. Phosphogypsum, a by product of fertilizers industry, shows radionuclide concentrations in these conditions. Therefore, the viability of its use as an alternative material for natural gypsum in dwellings construction is conditioned, among several additional aspects, to optimization studies. This paper presents a methodology for theoretical evaluation of external gamma doses due to radionuclides present in wall in an hypothetical room constructed of phosphogypsum sheets. Assessment of dose is being carried out through the application of photon transport model, taking into account self-absorption and buildup factors. (author) 10 refs., 2 figs.

  9. Determination of dose conversion factors for external gamma radiation in dwellings; Determinacao de fatores de conversao de dose para radiacao gama externa em residencias

    Energy Technology Data Exchange (ETDEWEB)

    Maduar, Marcelo Francis

    2000-07-01

    The use of building materials containing natural radionuclides in dwelling construction may lead to an increment of both external and internal radiation exposure of the population. External exposure in dwellings arises from gamma-emitter radionuclides existing in the walls, floor and ceiling. Mathematical models can be used to predict external dose rates inside the room, provided the radionuclide concentration activities in dwelling constituents and the building geometry are known. In this work, a methodology and a computer code, called EDVOS, for theoretical evaluation of external gamma doses in the air, due to radionuclides present in the constituents of an hypothetical room, were developed. The room is modeled as three pairs of rectangular sheets with finite thickness. Evaluation of doses was performed through the application of a photon transport model, taking into account self-absorption and radiation buildup. The radionuclides were assumed to be uniformly distributed in the building materials. Calculations were performed for concrete walls and results are presented for {sup 40}K, {sup 226} Ra, and {sup 232}Th, taking into account, for dose calculations, all gamma emitters from {sup 226}Ra and {sup 232}Th decay chains. The response of the model to the input parameters was studied by varying each of them within a reasonable range of applicability, while leaving the other ones at fixed selected values. The results obtained showed a good agreement with those presented in the literature and with data obtained by running RESRAD-BUILD code. Dose conversions factors are presented in a form suitable for the use in radiological impact studies applied to practical situations. (author)

  10. Once-weekly prophylactic dosing of recombinant factor IX improves adherence in hemophilia B

    Science.gov (United States)

    Djambas Khayat, Claudia

    2016-01-01

    Regular prophylactic treatment in severe hemophilia should be considered an optimal treatment. There is no general agreement on the optimal prophylaxis regimen, and adherence to prophylaxis is a main challenge due to medical, psychosocial, and cost controversies. Improved approaches in prophylaxis regimen of hemophilia B are needed to make patients’ lives easier. There is some evidence to support the efficacy of once-weekly prophylaxis. Longer sampling schedules are required for the determination of pharmacokinetic (PK) properties of factor IX (FIX). The half-life of FIX seems to be longer than previously described and is expected to be 34 hours. The clinical significance of maintaining a 1% trough level is widely debated in hemophilia B. The overall relationship between factor concentrate levels and incidence of joint bleeding was found to be very weak. Data also indicate that the distribution of FIX into an extravascular FIX compartment may contribute to hemostasis independently of circulating plasma FIX levels. Clinical assessment of the frequency and severity of bleeds remain an important measure of the efficacy of treatment. Role of PK-guided therapy remains to be established. Two prospective randomized studies had evaluated the efficacy and safety of 100 IU/kg once-weekly prophylaxis with nonacog alfa, and this prophylaxis regimen was found to be associated with lower annual bleeding rate compared with on-demand treatment in adolescents and adults with moderately severe-to-severe hemophilia B. Secondary prophylaxis therapy with 100 IU/kg nonacog alfa once weekly reduced annual bleeding rate by 89.4% relative to on-demand treatment. Residual FIX may be supportive of effectiveness. Once-weekly prophylaxis was well tolerated in the two studies, with a safety profile similar to that reported during the on-demand treatment period. To individually tailor treatment to clinical response and to minimize costs of factor concentrate, it would be of interest to

  11. Evaluation of Generic 3X Upper Bound Factor Used in Reconstructing External Gamma Doses to Military Participants at Atmospheric Nuclear Weapons Tests

    Science.gov (United States)

    2009-11-30

    8.1 Published Unit Dose Reconstructions Dose reconstructions for military units at Operation SANDSTONE, which was conducted at Enewetak Atoll ...residence islands at Enewetak and Kwajalein Atolls to residual gamma radiation due to secondary (late-time) fallout from the three shots at this...last shot at this operation) are 57 and 84 mrem on Enewetak and Kwajalein Atoll , respectively, and range from 3 to 49 mrem on 31 ships. These doses

  12. SPECIAL CONSIDERATIONS REGARDING WARFARIN DOSE TITRATION IN PATIENTS WITH ATRIAL FIBRILLATION DEPENDING ON CLINICAL FACTORS

    Directory of Open Access Journals (Sweden)

    E. L. Artanova

    2011-01-01

    Full Text Available Aim. To study the relations of clinical characteristics and individual warfarin dose titration in patients with atrial fibrillation. Material and methods. Period of warfarin dose titration was analyzed in 68 patients with atrial fibrillation due to ischemic heart disease. Adjusted warfarin dose in milligram, duration of dose titration in days and maximal international normalized ratio (INR were taken into account. Sex, age, history of myocardial infarction and stroke, concomitant diseases, amiodarone therapy were considered among clinical characteristics. Results. Adjusted warfarin dose was significantly higher in obesity , and it was lower in case of experienced myocardial infarction. The INR highest levels and maximal amplitudes of its fluctuations were observed in patients with thyroid gland nodes and smokers. Period of warfarin dose titration was longer in patients treated with amiodarone. Conclusion. Warfarin dose titration in patients with atrial fibrillation depends on the presence of myocardial infarction, obesity , thyroid nodular changes, smoking and amiodarone treatment.

  13. Impact of different leaf velocities and dose rates on the number of monitor units and the dose-volume-histograms using intensity modulated radiotherapy with sliding-window technique

    Directory of Open Access Journals (Sweden)

    Hess Clemens F

    2008-09-01

    Full Text Available Abstract Background Intensity modulated radiotherapy (IMRT using sliding window technique utilises a leaf sequencing algorithm, which takes some control system limitations like dose rates (DR and velocity of the leafs (LV into account. The effect of altering these limitations on the number of monitor units and radiation dose to the organs at risk (OAR were analysed. Methods IMRT plans for different LVs from 1.0 cm/sec to 10.0 cm/sec and different DRs from 100 MU/min to 600 MU/min for two patients with prostate cancer and two patients with squamous cell cancer of the scalp (SCCscalp were calculated using the same "optimal fluence map". For each field the number of monitor units, the dose volume histograms and the differences in the "actual fluence maps" of the fields were analysed. Results With increase of the DR and decrease of the LV the number of monitor units increased and consequentially the radiation dose given to the OAR. In particular the serial OARs of patients with SCCscalp, which are located outside the end position of the leafs and inside the open field, received an additional dose of a higher DR and lower LV is used. Conclusion For best protection of organs at risk, a low DR and high LV should be applied. But the consequence of a low DR is both a long treatment time and also that a LV of higher than 3.0 cm/sec is mechanically not applicable. Our recommendation for an optimisation of the discussed parameters is a leaf velocity of 2.5 cm/sec and a dose rate of 300–400 MU/min (prostate cancer and 100–200 MU/min (SCCscalp for best protection of organs at risk, short treatment time and number of monitor units.

  14. A Commentary on: "A History of the United States Department of Energy (DOE) Low Dose Radiation Research Program: 1998-2008".

    Science.gov (United States)

    Brooks, Antone L

    2015-04-01

    This commentary provides a very brief overview of the book "A History of the United States Department of Energy (DOE) Low Dose Radiation Research Program: 1998-2008" ( http://lowdose.energy.gov ). The book summarizes and evaluates the research progress, publications and impact of the U.S. Department of Energy Low Dose Radiation Research Program over its first 10 years. The purpose of this book was to summarize the impact of the program's research on the current thinking and low-dose paradigms associated with the radiation biology field and to help stimulate research on the potential adverse and/or protective health effects of low doses of ionizing radiation. In addition, this book provides a summary of the data generated in the low dose program and a scientific background for anyone interested in conducting future research on the effects of low-dose or low-dose-rate radiation exposure. This book's exhaustive list of publications coupled with discussions of major observations should provide a significant resource for future research in the low-dose and dose-rate region. However, because of space limitations, only a limited number of critical references are mentioned. Finally, this history book provides a list of major advancements that were accomplished by the program in the field of radiation biology, and these bulleted highlights can be found in last part of chapters 4-10.

  15. Survey of doses and frequency of X-ray examinations on children at the intensive care unit of a large reference pediatric hospital

    Energy Technology Data Exchange (ETDEWEB)

    Pedrosa de Azevedo, Ana Cecilia [Fundacao Oswaldo Cruz-FIOCRUZ, Escola Nacional de Saude Publica Sergio Arouca, Centro de Estudos da Saude do Trabalhador e Ecologia Humana-CESTEH, Rua Leopoldo Bulhoes 1480, Manguinhos 21041-210, Rio de Janeiro (Brazil)]. E-mail: acpa@ensp.fiocruz.br; Osibote, Adelaja Otolorin [Fundacao Oswaldo Cruz-FIOCRUZ, Escola Nacional de Saude Publica Sergio Arouca, Centro de Estudos da Saude do Trabalhador e Ecologia Humana-CESTEH, Rua Leopoldo Bulhoes 1480, Manguinhos 21041-210, Rio de Janeiro (Brazil); Bastos Boechat, Marcia Cristina [Instituto Fernandes Figueira, Fundacao Oswaldo Cruz-FIOCRUZ (Brazil)

    2006-12-15

    Objective: This work aims to evaluate the entrance surface dose (ESD), the body organ dose (BOD) and the effective dose (E) resulting from pediatric radiological procedures with the use of portable X-ray equipments. Materials and methods: The software DoseCal was used to evaluate the doses imparted to patients. The children were classified according to their weight and age groups, and the study included three sectors of the intensive care unit of a large reference pediatric hospital in Rio de Janeiro. Results: A total of 518 radiographs have been performed (424 for chest and 94 for abdomen). The statistical data were compared with previously published results. The BOD is presented for the most exposed organs. Conclusion: The mean value of ESD and E varied widely among neonates. The highest number of radiographs per infant peaked 33 for chest examination in the age group 0-1 year.

  16. Delayed High-dose Methotrexate Excretion and Influencing Factors in Osteosarcoma Patients

    Institute of Scientific and Technical Information of China (English)

    Wei Zhang; Qing Zhang; Ting-Ting Zheng; Jian-Cun Zhen; Xiao-Hui Niu

    2016-01-01

    Background:High-dose methotrexate (HD-MTX) with folinic acid (leucovorin) rescue is "gold standard" therapy for osteosarcoma.Plasma concentrations of methotrexate (MTX) are closely related to its efficacy and toxicity.Delayed excretion of MTX can lead to serious adverse reactions that may result in treatment cessation,irreversible organ damage,and death.This study focused on the incidence of delayed excretion of MTX in Chinese osteosarcoma patients.Methods:A total of 1277 osteosarcoma patients were treated with HD-MTX chemotherapy (4291 cycles) from 2010 to 2015.Factors that could influence delayed excretion of MTX (gender,age,number of chemotherapy cycles,and serum concentration of MTX) were analyzed.Results:The incidence of delayed excretion of MTX (serum concentrations at 24 h [C24 h] >5 μmol/L) and severe delayed excretion of MTX (C24 h >20 μmol/L) were 6.19% and 0.86% per patient,and 2.31% and 0.26% per cycle of treatment,respectively.The incidence of severe delayed excretion of MTX was associated with gender,age,and C24 h.Conclusions:Precaution of delayed excretion of MTX is needed during osteosarcoma treatment using HD-MTX.An optimal individualized rescue strategy can be created with consideration of gender,age,and C24 h.

  17. Sensitivity Factor Analysis For Unit Commitment In Loaded Lines

    Directory of Open Access Journals (Sweden)

    Lata Chaudhary

    2016-05-01

    Full Text Available In today’s competitive electricity market, it is not possible to settle all contracted transactions of power because of congestion in transmission lines. Usually, the independent system operator seeks to eliminate congestion by rescheduling output power of the generators. But all generators may not have the same effect (sensitivity on the power flow of the congested lines, so this is not an economical way to reschedule output power of all generators for managing congestion. Therefore, in this paper, active power generator sensitivity factor of the generators to the congested lines have been utilized to ascertain the number of generators participating in congestion management. The effectiveness and feasibility of the proposed algorithm have been tested on IEEE 30 bus system

  18. Evaluation of spin freezing versus conventional freezing as part of a continuous pharmaceutical freeze-drying concept for unit doses.

    Science.gov (United States)

    De Meyer, L; Van Bockstal, P-J; Corver, J; Vervaet, C; Remon, J P; De Beer, T

    2015-12-30

    Spin-freezing as alternative freezing approach was evaluated as part of an innovative continuous pharmaceutical freeze-drying concept for unit doses. The aim of this paper was to compare the sublimation rate of spin-frozen vials versus traditionally frozen vials in a batch freeze-dryer, and its impact on total drying time. Five different formulations, each having a different dry cake resistance, were tested. After freezing, the traditionally frozen vials were placed on the shelves while the spin-frozen vials were placed in aluminum vial holders providing radial energy supply during drying. Different primary drying conditions and chamber pressures were evaluated. After 2h of primary drying, the amount of sublimed ice was determined in each vial. Each formulation was monitored in-line using NIR spectroscopy during drying to determine the sublimation endpoint and the influence of drying conditions upon total drying time. For all tested formulations and applied freeze-drying conditions, there was a significant higher sublimation rate in the spin-frozen vials. This can be explained by the larger product surface and the lower importance of product resistance because of the much thinner product layers in the spin frozen vials. The in-line NIR measurements allowed evaluating the influence of applied drying conditions on the drying trajectories.

  19. Human and technical factors in the doses reduction and optimization at Cogema/Marcoule; Facteurs techniques et humains dans la reduction et l'optimisation des doses a Cogema/Marcoule

    Energy Technology Data Exchange (ETDEWEB)

    Bourgogne, J.L. [Cogema, 30 - Marcoule (France)

    1998-07-01

    In the case of Cogema/Marcoule, the constant decrease of radiation doses is attributed to three factors: technical with a surveillance system and doses optimization, relational with the promotion of confidence in teams of radiation protection services as an acceptation factor of radiation protection techniques and psychological with an evolution of minds towards the ALARA approach. (N.C.)

  20. Radon in indoor air of primary schools: determinant factors, their variability and effective dose.

    Science.gov (United States)

    Madureira, Joana; Paciência, Inês; Rufo, João; Moreira, André; de Oliveira Fernandes, Eduardo; Pereira, Alcides

    2016-04-01

    Radon is a radioactive gas, abundant in granitic areas, such as in the city of Porto at the north-east of Portugal. This gas is a recognized carcinogenic agent, being appointed by the World Health Organization as the leading cause of lung cancer after smoking. The aim of this preliminary survey was to determine indoor radon concentrations in public primary schools, to analyse the main factors influencing their indoor concentration levels and to estimate the effective dose in students and teachers in primary schools. Radon concentrations were measured in 45 classrooms from 13 public primary schools located in Porto, using CR-39 passive radon detectors for about 2-month period. In all schools, radon concentrations ranged from 56 to 889 Bq/m(3) (mean = 197 Bq/m(3)). The results showed that the limit of 100 Bq/m(3) established by WHO IAQ guidelines was exceeded in 92 % of the measurements, as well as 8 % of the measurements exceeded the limit of 400 Bq/m(3) established by the national legislation. Moreover, the mean annual effective dose was calculated as 1.25 mSv/y (ranging between 0.58 and 3.07 mSv/y), which is below the action level (3-10 mSv). The considerable variability of radon concentration observed between and within floors indicates a need to monitor concentrations in several rooms for each floor. A single radon detector for each room can be used, provided that the measurement error is considerably lower than variability of radon concentration between rooms. The results of the present survey will provide useful baseline data for adopting safety measures and dealing effectively with radiation emergencies. In particular, radon remediation techniques should be used in buildings located in the highest radon risk areas of Portugal. The results obtained in the current study concerning radon levels and their variations will be useful to optimize the design of future research surveys.

  1. Is a single infant priming dose of meningococcal serogroup C conjugate vaccine in the United Kingdom sufficient?

    Science.gov (United States)

    Findlow, Helen; Borrow, Ray

    2015-01-01

    In 1999, the UK introduced meningococcal serogroup C conjugate (MCC) vaccination at 2, 3, 4 months of age with a single dose for children 1-18 y In 2006, the schedule was refined to a 2 dose priming schedule with a booster in the second year of life. In 2013, the number of priming doses was reduced to a single priming dose, the booster maintained at 12 months of age and an adolescent booster dose introduced. The paper presents the evidence supporting the reduction in the number of priming doses. A UK study provided evidence for reducing the priming doses of MCC-TT together with the positive correlation of lower quantity of antigen and serum bactericidal antibody (SBA) levels post-primary but a higher magnitude of the booster response. Another UK study, demonstrated one dose of MCC-TT or MCC-CRM197 at 3 months gave comparable responses to 2 doses (SBA titres ≥8) both post-primary vaccination and post-booster Hib/MCC-TT at 12 months. However, the magnitude of the SBA GMT was higher in the MCC-TT primed post-booster. A single priming dose of MCC-TT (at 4 or 6 months) compared to 2 doses (2 and 4 months) gave higher SBA titres in all groups, post-primary and post-booster at 12-13 months, with the highest SBA responses observed in the 4 month single dose group. A study in Malta, comparing one dose of MCC-TT or MCC-CRM197 at (3 months) versus 2 doses of MCC-CRM197 (3 and 4 months), showed a high proportion (>84.72%) of subjects achieving SBA titres ≥8 following a single dose. These studies show that a single-dose priming MCC vaccination in infancy is sufficient.

  2. SU-C-BRC-01: A Monte Carlo Study of Out-Of-Field Doses From Cobalt-60 Teletherapy Units Intended for Historical Correlations of Dose to Normal Tissue

    Energy Technology Data Exchange (ETDEWEB)

    Petroccia, H [University of Florida, Gainesville, FL (United States); Olguin, E [Gainesville, FL (United States); Culberson, W [University of Wisconsin Madison, Madison, WI (United States); Bednarz, B [University of Wisconsin, Madison, WI (United States); Mendenhall, N [UF Health Proton Therapy Institute, Jacksonville, FL (United States); Bolch, W [University Florida, Gainesville, FL (United States)

    2016-06-15

    Purpose: Innovations in radiotherapy treatments, such as dynamic IMRT, VMAT, and SBRT/SRS, result in larger proportions of low-dose regions where normal tissues are exposed to low doses levels. Low doses of radiation have been linked to secondary cancers and cardiac toxicities. The AAPM TG Committee No.158 entitled, ‘Measurements and Calculations of Doses outside the Treatment Volume from External-Beam Radiation Therapy’, has been formed to review the dosimetry of non-target and out-of-field exposures using experimental and computational approaches. Studies on historical patients can provide comprehensive information about secondary effects from out-of-field doses when combined with long-term patient follow-up, thus providing significant insight into projecting future outcomes of patients undergoing modern-day treatments. Methods: We present a Monte Carlo model of a Theratron-1000 cobalt-60 teletherapy unit, which historically treated patients at the University of Florida, as a means of determining doses located outside the primary beam. Experimental data for a similar Theratron-1000 was obtained at the University of Wisconsin’s ADCL to benchmark the model for out-of-field dosimetry. An Exradin A12 ion chamber and TLD100 chips were used to measure doses in an extended water phantom to 60 cm outside the primary field at 5 and 10 cm depths. Results: Comparison between simulated and experimental measurements of PDDs and lateral profiles show good agreement for in-field and out-of-field doses. At 10 cm away from the edge of a 6×6, 10×10, and 20×20 cm2 field, relative out-of-field doses were measured in the range of 0.5% to 3% of the dose measured at 5 cm depth along the CAX. Conclusion: Out-of-field doses can be as high as 90 to 180 cGy assuming historical prescription doses of 30 to 60 Gy and should be considered when correlating late effects with normal tissue dose.

  3. Dose-response relations between occupational exposures to physical and psychosocial factors and the risk of low back pain.

    NARCIS (Netherlands)

    H. Morgenstern; A. Burdorf (Alex); J.P. Jansen (Jeroen)

    2004-01-01

    textabstractAIMS: To assess dose-response relations between occupational exposures to physical and psychosocial factors and the risk of low back pain. METHODS: A cohort of 523 subjects, working in nursing homes and homes for the elderly, was followed prospectively for one year. Phy

  4. Corticotropin releasing factor dose-dependently modulates excitatory synaptic transmission in the noradrenergic nucleus locus coeruleus.

    Science.gov (United States)

    Prouty, Eric W; Waterhouse, Barry D; Chandler, Daniel J

    2017-03-01

    The noradrenergic nucleus locus coeruleus (LC) is critically involved in the stress response and receives afferent input from a number of corticotropin releasing factor (CRF) containing structures. Several in vivo and in vitro studies in rat have shown that CRF robustly increases the firing rate of LC neurons in a dose-dependent manner. While it is known that these increases are dependent on CRF receptor subtype 1 and mediated by effects of cAMP intracellular signaling cascades on potassium conductance, the impact of CRF on synaptic transmission within LC has not been clarified. In the present study, we used whole-cell patch clamp electrophysiology to assess how varying concentrations of bath-applied CRF affect AMPA-receptor dependent spontaneous excitatory post-synaptic currents (sEPSCs). Compared to vehicle, 10, 25, and 100 nm CRF had no significant effects on any sEPSC parameters. Fifty nanomolar CRF, however, significantly increased sEPSC amplitude, half-width, and charge transfer, while these measures were significantly decreased by 200 nm CRF. These observations suggest that stress may differentially affect ongoing excitatory synaptic transmission in LC depending on how much CRF is released from presynaptic terminals. Combined with the well-documented effects of CRF on membrane properties and spontaneous LC discharge, these observations may help explain how stress and CRF release are able to modulate the signal to noise ratio of LC neurons. These findings have implications for how stress affects the fidelity of signal transmission and information flow through LC and how it might impact norepinephrine release in the CNS.

  5. Variability: The common factor linking low dose-induced genomic instability, adaptation and bystander effects

    Energy Technology Data Exchange (ETDEWEB)

    Schwartz, Jeffrey L. [Department of Radiation Oncology, University of Washington Medical Center, 1959 NE Pacific, Box 356069, Seattle, WA 98195-6069 (United States)]. E-mail: jschwart@u.washington.edu

    2007-03-01

    The characteristics of low dose radiation-induced genomic instability, adaptive responses, and bystander effects were compared in order to probe possible underlying mechanisms, and develop models for predicting response to in vivo low dose radiation exposures. While there are some features that are common to all three (e.g., absence of a true dose-response, the multiple endpoints affected by each), other characteristics appear to distinguish one from the other (e.g., TP53 involvement, LET response, influence of DNA repair). Each of the responses is also highly variable; not all cell and tissue models show the same response and there is much interindividual variation in response. Most of these studies have employed in vitro cell culture or tissue explant models, and understanding underlying mechanisms and the biological significance of these low dose-responses will require study of tissue-specific in vivo endpoints. The in vitro studies strongly suggest that modeling low dose radiation effects will be a complex process, and will likely require separate study of each of these low dose phenomena. Knowledge of instability responses, for example, may not aid in predicting other low dose effects in the same tissue.

  6. Basal or bolus dose, which is the key factor in CSII?

    Institute of Scientific and Technical Information of China (English)

    YANG Nai-long; XUE Bing; LIN Peng

    2006-01-01

    Objective: To observe the value of HbA1c level evaluating the total daily basal insulin dose by continuous subcutaneous insulin infusion (CSII) in 268 patients with type 2 diabetes mellitus. Methods: 5-point capillary blood glucose was monitored in pre- and post-CSII and the insulin dose which could stabilize blood glucose was defmed as the total daily dose of insulin,including basal and bolus total dose. Correlation between HbA1c level and total daily dose of insulin in patients with type 2 diabetes mellitus was analyzed. Correlation between HbA1c level and 5-point capillary blood glucose was also analyzed. Results:Obvious correlation was observed between HbA1c level and the basal total daily dose of insulin if HbA1c was more than 9.3%(r=0.635, P<0.05). The average of 5-point capillary blood glucose was best correlated with HbA1c and fasting blood glucose next best. Conclusion: HbA1c level can forecast basal total daily dose of insulin in CSII.

  7. Influence of phantom size on output, peak scatter factor, and percentage depth dose in large-field photon irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Podgorsak, E.B.; Pla, C.; Evans, M.D.C.; Pla, M.

    1985-09-01

    Machine outputs, peak scatter factors, and central axis percentage depth dose distributions were measured for various phantom sizes in large radiation fields produced at extended distances by cobalt, 6-MV, and 10-MV photon beams. The results can be applied to practical total body irradiation procedures which usually involve treatment volumes smaller than the actual field sizes in order to provide a uniform total body exposure to radiation. Our study addresses the question of the appropriate phantom dimension to be used in the calibration of photon beams employed in total body irradiations. The measurements show that the machine outputs are only slightly dependent on phantom size; the percentage depth dose distributions, however, are strongly dependent on the phantom size, suggesting that machine data for total body irradiations should be measured in phantoms whose dimensions approximate the patient during the total body irradiation. Peak scatter factors measured in large-field/small-phantom configurations link up well with the published small-field/large-phantom data. The finite patient thickness lowers the dose to points close to the beam exit surface by a few percent, when compared to dose measured at the same depths in infinitely thick phantoms. The surface doses in large radiation fields are essentially independent of phantom cross sections and range from 40% for the 10-MV beam, to 65% for the 6-MV beam and 80% for the cobalt beam.

  8. Factors affecting warfarin dose requirements and quality of anticoagulation in adult Egyptian patients: role of gene polymorphism.

    Science.gov (United States)

    Bazan, N S; Sabry, N A; Rizk, A; Mokhtar, S; Badary, O A

    2014-06-01

    Warfarin is the mainstay of anticoagulation therapy worldwide. CYP2C9 and VKORC1 are two major genetic factors associated with inter-individual and inter-ethnic variability in the warfarin dose. This study aims to assess the impact of VKORC1-1639G>A polymorphism and the most common CYP2C9 variant alleles (*2 and *3) on warfarin response in Egyptian patients. Genetic analysis of VKORC1-1639G>A and CYP2C9*2, CYP2C9*3 was performed using real-time PCR system. Patients maintained on a constant dose targeting an international normalized ratio range of 2-3.5 for at least three consecutive times were considered as good candidates. A stepwise linear regression analysis was used to determine the independent effects of genetic and non-genetic factors on daily warfarin dose requirements. Patients carrying VKORC1 and CYP2C9 variant genotypes needed a 44.8 % lower mean daily warfarin dose as compared to wild types. Patients with G allele for VKORC1-1639G>A had a significantly higher number of thromboembolic complications per month during therapy. On the first 30 days of therapy, presence of a variant allele either in VKORC1 or in CYP2C9 was associated with increased time required to achieve stable dosing. Multiple regression analysis showed that, VKORC1-1639G>A, age, CYP2C9*3, and smoking status explained 43.4 % of the overall variability in the warfarin dose. VKORC1-1639G>A and CYP2C9 polymorphisms contribute to the difference in warfarin dose requirements and quality of anticoagulation amongst Egyptian patients. Study results support using personalized warfarin treatment in Egyptian patients.

  9. Factors associated with antipsychotic polypharmacy and high-dose antipsychotics among individuals receiving compulsory treatment in the community.

    Science.gov (United States)

    Gisev, Natasa; Bell, J Simon; Chen, Timothy F

    2014-06-01

    Community treatment orders (CTOs) are a form of compulsory treatment of individuals with a mental illness in the community. The objectives of this study were to determine the demographic, clinical, and treatment plan factors associated with antipsychotic polypharmacy and high-dose antipsychotics among individuals issued with a CTO. This was a secondary analysis of all 377 individuals who were prescribed an antipsychotic, extracted from a retrospective study of 378 individuals issued with a CTO by the New South Wales Mental Health Review Tribunal in Australia in 2009. Deidentified information relating to individuals' treatment plans, demographic, and clinical details were systematically extracted. Of the 377 individuals, 121 (32%) were prescribed antipsychotic polypharmacy and 101 (27%) high-dose antipsychotics. Unadjusted and adjusted odds ratios (ORs) and 95% confidence intervals (95% CIs) for factors associated with antipsychotic polypharmacy and high-dose antipsychotics were computed using binary logistic regression. There was a strong association between the use of antipsychotic polypharmacy and high-dose antipsychotics (P polypharmacy and high-dose antipsychotics in adjusted models. Although first-generation long-acting injectable antipsychotics and clozapine were associated with antipsychotic polypharmacy (adjusted OR, 9.12; 95% CI, 4.21-19.74; adjusted OR, 7.97; 95% CI, 2.93-21.72), oral second-generation antipsychotics and risperidone long-acting injection were associated with high-dose antipsychotics (adjusted OR, 5.67; 95% CI, 2.89-11.12; adjusted OR, 8.14; 95% CI, 3.22-20.53). Therefore, the use of antipsychotic polypharmacy and high-dose antipsychotics among individuals issued with CTOs is associated only with the drugs prescribed in their treatment plans and not their individual demographic and clinical characteristics.

  10. Development of Normalization Factors for Canada and the United States and Comparison with European Factors

    DEFF Research Database (Denmark)

    Lautier, Anne; Rosenbaum, Ralph K.; Margni, Manuele

    2010-01-01

    showed that normalized profiles are highly dependent on the selected reference due to differences in the industrial and economic activities. To meet practitioners' needs, Canadian normalization factors have been calculated using the characterization factors from LUCAS (Canadian), IMPACT 2002+ (European...

  11. Optimizing the current therapy for chronic hepatitis C virus: peginterferon and ribavirin dosing and the utility of growth factors.

    Science.gov (United States)

    Shiffman, Mitchell L

    2008-08-01

    Achieving a sustained virologic response depends on the patient achieving three sequential independent milestones: virologic response, maintaining this response throughout treatment, and not relapsing after treatment has been completed. The ability to achieve these milestones depends on the doses of interferon/peginterferon and ribavirin used and on whether treatment with these medications is adjusted, interrupted, or prematurely discontinued in response to adverse events. This review discusses strategies to optimize peginterferon and ribavirin dosing and the impact that growth factors may have on the ability to achieve a sustained virologic response.

  12. Calculating dose distributions and wedge factors for photon treatment fields with dynamic wedges based on a convolution/superposition method.

    Science.gov (United States)

    Liu, H H; McCullough, E C; Mackie, T R

    1998-01-01

    A convolution/superposition based method was developed to calculate dose distributions and wedge factors in photon treatment fields generated by dynamic wedges. This algorithm used a dual source photon beam model that accounted for both primary photons from the target and secondary photons scattered from the machine head. The segmented treatment tables (STT) were used to calculate realistic photon fluence distributions in the wedged fields. The inclusion of the extra-focal photons resulted in more accurate dose calculation in high dose gradient regions, particularly in the beam penumbra. The wedge factors calculated using the convolution method were also compared to the measured data and showed good agreement within 0.5%. The wedge factor varied significantly with the field width along the moving jaw direction, but not along the static jaw or the depth direction. This variation was found to be determined by the ending position of the moving jaw, or the STT of the dynamic wedge. In conclusion, the convolution method proposed in this work can be used to accurately compute dose for a dynamic or an intensity modulated treatment based on the fluence modulation in the treatment field.

  13. Comparison of dose estimates using the buildup-factor method and a Baryon transport code (BRYNTRN) with Monte Carlo results

    Science.gov (United States)

    Shinn, Judy L.; Wilson, John W.; Nealy, John E.; Cucinotta, Francis A.

    1990-01-01

    Continuing efforts toward validating the buildup factor method and the BRYNTRN code, which use the deterministic approach in solving radiation transport problems and are the candidate engineering tools in space radiation shielding analyses, are presented. A simplified theory of proton buildup factors assuming no neutron coupling is derived to verify a previously chosen form for parameterizing the dose conversion factor that includes the secondary particle buildup effect. Estimates of dose in tissue made by the two deterministic approaches and the Monte Carlo method are intercompared for cases with various thicknesses of shields and various types of proton spectra. The results are found to be in reasonable agreement but with some overestimation by the buildup factor method when the effect of neutron production in the shield is significant. Future improvement to include neutron coupling in the buildup factor theory is suggested to alleviate this shortcoming. Impressive agreement for individual components of doses, such as those from the secondaries and heavy particle recoils, are obtained between BRYNTRN and Monte Carlo results.

  14. Effective dose scaling factors for use with uranium series cascade impactor data: a reassessment using the IMBA code.

    Science.gov (United States)

    Kim, Kwang Pyo; Wu, Chang-Yu; Birky, Brian K; Bolch, Wesley E

    2006-10-01

    Air sampling with a multi-stage cascade impactor enables one to assess airborne radioactivity as a function of particle size, significantly enhancing the accuracy of the dose assessment. The application of cascade sampling data to inhalation dose assessments can require more computational effort if something other than a mono-sized distribution per impactor stage is to be considered. To overcome this limitation, Kim et al. (Health Phys 89:359-374; 2005) introduced the concept of an effective dose scaling factor SF(E) enabling one to consider more realistic impactor stage radioactivity distributions (uniform, linearly decreasing, or linearly increasing variations with particle size). The SF(E) is the ratio of the effective dose given under a uniform or linearly changing radioactivity distribution across the particle size interval to that given for a mono-sized radioactivity distribution for the same impactor stage. The latter approach can initially be used (which requires less computational effort) followed by a rescaling of the effective dose either upward or downward by the SF(E) value. In this earlier study, the LUDEP code was employed which utilizes the ICRP 66 human respiratory tract model along the radionuclide biokinetic models given in ICRP Publication 30. In the present study, inhalation dose coefficients and effective dose scaling factors were reexamined for several radionuclides of the (238)U series using the IMBA program, which employs more recent and physiologically realistic biokinetic models published by the ICRP. An update of the effective dose scaling factors is thus the primary focus of this study rather than an extensive inter-comparison of the IMBA and LUDEP codes. Inhalation dose coefficients calculated by the two programs differ by up to a factor of 5 for Type F (238)U and (234)U, but are within only 2% of each other for Type S radionuclides. The ICRP 69 biokinetic model of uranium predicts retention in bone and kidneys that is slightly higher

  15. Radioablation of liver malignancies with interstitial high-dose-rate brachytherapy. Complications and risk factors

    Energy Technology Data Exchange (ETDEWEB)

    Mohnike, Konrad; Wolf, Steffen; Damm, Robert; Seidensticker, Max; Seidensticker, Ricarda; Fischbach, Frank; Pech, Maciej; Ricke, Jens [Otto-von-Guericke-Universitaet, Klinik fuer Radiologie und Nuklearmedizin, Universitaetsklinikum Magdeburg A.oe.R., Magdeburg (Germany); Peters, Nils; Hass, Peter; Gademann, Guenther [Otto-von-Guericke-Universitaet, Klinik fuer Strahlentherapie, Universitaetsklinikum Magdeburg A.oe.R., Magdeburg (Germany)

    2016-05-15

    To evaluate complications and identify risk factors for adverse events in patients undergoing high-dose-rate interstitial brachytherapy (iBT). Data from 192 patients treated in 343 CT- or MRI-guided interventions from 2006-2009 at our institution were analyzed. In 41 %, the largest tumor treated was ≥ 5 cm, 6 % of the patients had tumors ≥ 10 cm. Prior to iBT, 60 % of the patients had chemotherapy, 22 % liver resection, 19 % thermoablation or transarterial chemoembolization (TACE). Safety was the primary endpoint; survival data were obtained as the secondary endpoints. During follow-up, MRI or CT imaging was performed and clinical and laboratory parameters were obtained. The rate of major complications was below 5 %. Five major bleedings (1.5 %) occurred. The frequency of severe bleeding was significantly higher in patients with advanced liver cirrhosis. One patient developed signs of a nonclassic radiation-induced liver disease. In 3 patients, symptomatic gastrointestinal (GI) ulcers were detected. A dose exposure to the GI wall above 14 Gy/ml was a reliable threshold to predict ulcer formation. A combination of C-reactive protein ≥ 165 mg/l and/or leukocyte count ≥ 12.7 Gpt/l on the second day after the intervention predicted infection (sensitivity 90.0 %; specificity 92.8 %.) Two patients (0.6 %) died within 30 days. Median overall survival after the first liver treatment was 20.1 months for all patients and the local recurrence-free surviving proportion was 89 % after 12 months. Image-guided iBT yields a low rate of major complications and is effective. (orig.) [German] Evaluierung der Komplikationsrate und Identifizierung von Risikofaktoren fuer Komplikationen und Nebenwirkungen bei Patienten mit Lebermalignomen, die mit der hochdosierten interstitiellen Brachytherapie (iBT) behandelt wurden. Von 2006 bis 2009 wurden 192 Patienten in 343 CT- oder MRT-gefuehrten Interventionen behandelt und deren Daten ausgewertet. Der groesste behandelte Tumor war in

  16. Use of a graphics processing unit (GPU) to facilitate real-time 3D graphic presentation of the patient skin-dose distribution during fluoroscopic interventional procedures.

    Science.gov (United States)

    Rana, Vijay; Rudin, Stephen; Bednarek, Daniel R

    2012-02-23

    We have developed a dose-tracking system (DTS) that calculates the radiation dose to the patient's skin in real-time by acquiring exposure parameters and imaging-system-geometry from the digital bus on a Toshiba Infinix C-arm unit. The cumulative dose values are then displayed as a color map on an OpenGL-based 3D graphic of the patient for immediate feedback to the interventionalist. Determination of those elements on the surface of the patient 3D-graphic that intersect the beam and calculation of the dose for these elements in real time demands fast computation. Reducing the size of the elements results in more computation load on the computer processor and therefore a tradeoff occurs between the resolution of the patient graphic and the real-time performance of the DTS. The speed of the DTS for calculating dose to the skin is limited by the central processing unit (CPU) and can be improved by using the parallel processing power of a graphics processing unit (GPU). Here, we compare the performance speed of GPU-based DTS software to that of the current CPU-based software as a function of the resolution of the patient graphics. Results show a tremendous improvement in speed using the GPU. While an increase in the spatial resolution of the patient graphics resulted in slowing down the computational speed of the DTS on the CPU, the speed of the GPU-based DTS was hardly affected. This GPU-based DTS can be a powerful tool for providing accurate, real-time feedback about patient skin-dose to physicians while performing interventional procedures.

  17. Use of a graphics processing unit (GPU) to facilitate real-time 3D graphic presentation of the patient skin-dose distribution during fluoroscopic interventional procedures

    Science.gov (United States)

    Rana, Vijay; Rudin, Stephen; Bednarek, Daniel R.

    2012-03-01

    We have developed a dose-tracking system (DTS) that calculates the radiation dose to the patient's skin in realtime by acquiring exposure parameters and imaging-system-geometry from the digital bus on a Toshiba Infinix C-arm unit. The cumulative dose values are then displayed as a color map on an OpenGL-based 3D graphic of the patient for immediate feedback to the interventionalist. Determination of those elements on the surface of the patient 3D-graphic that intersect the beam and calculation of the dose for these elements in real time demands fast computation. Reducing the size of the elements results in more computation load on the computer processor and therefore a tradeoff occurs between the resolution of the patient graphic and the real-time performance of the DTS. The speed of the DTS for calculating dose to the skin is limited by the central processing unit (CPU) and can be improved by using the parallel processing power of a graphics processing unit (GPU). Here, we compare the performance speed of GPU-based DTS software to that of the current CPU-based software as a function of the resolution of the patient graphics. Results show a tremendous improvement in speed using the GPU. While an increase in the spatial resolution of the patient graphics resulted in slowing down the computational speed of the DTS on the CPU, the speed of the GPU-based DTS was hardly affected. This GPU-based DTS can be a powerful tool for providing accurate, real-time feedback about patient skin-dose to physicians while performing interventional procedures.

  18. DETERMINATION OF IN-VITRO LUNG SOLUBILITY AND INTAKE-TO-DOSE CONVERSION FACTOR FOR TRITIATED LANTHANUM NICKEL ALUMINUM ALLOY

    Energy Technology Data Exchange (ETDEWEB)

    Farfan, E.; Labone, T.; Staack, G.; Cheng, Y.; Zhou, Y.; Varallo, T.

    2011-11-11

    A sample of tritiated lanthanum nickel aluminum alloy (LaNi4.25Al0.75 or LANA.75) similar to that used at the Savannah River Site Tritium Facilities was analyzed to estimate the particle size distribution of this metal tritide powder and the rate, at which this material dissolves in the human respiratory tract after it is inhaled. This information is used to calculate the committed effective dose received by a worker after inhaling the material. These doses, which were calculated using the same methodology given in the DOE Tritium Handbook, are presented as inhalation intake-to-dose conversion factors (DCF). The DCF for this metal tritide is less than the DCF for tritiated water and radiation worker bioassay programs designed for tritiated water are adequate to monitor for intakes of this material.

  19. Amikacin Dosing and Monitoring in Spinal Cord Injury Patients: Variation in Clinical Practice Between Spinal Injury Units and Differences in Experts' Recommendations

    Directory of Open Access Journals (Sweden)

    Subramanian Vaidyanathan

    2006-01-01

    Full Text Available The objective of this article was to determine the current practice on amikacin dosing and monitoring in spinal cord injury patients from spinal cord physicians and experts. Physicians from spinal units and clinical pharmacologists were asked to provide protocol for dosing and monitoring of amikacin therapy in spinal cord injury patients. In a spinal unit in Poland, amikacin is administered usually 0.5 g twice daily. A once-daily regimen of amikacin is never used and amikacin concentrations are not determined. In Belgium, Southport (U.K., Spain, and the VA McGuire Medical Center (Richmond, Virginia, amikacin is given once daily. Whereas peak and trough concentrations are determined in Belgium, only trough concentration is measured in Southport. In both these spinal units, modification of the dose is not routinely done with a nomogram. In Spain and the VA McGuire Medical Center, monitoring of serum amikacin concentration is not done unless a patient has renal impairment. In contrast, the dose/interval of amikacin is adjusted according to pharmacokinetic parameters at the Edward Hines VA Hospital (Hines, Illinois, where amikacin is administered q24h or q48h, depending on creatinine clearance. Spinal cord physicians from Denmark, Germany, and the Kessler Institute for Rehabilitation (West Orange, New Jersey state that they do not use amikacin in spinal injury patients. An expert from Canada does not recommend determining serum concentrations of amikacin, but emphasizes the value of monitoring ototoxicity and nephrotoxicity. Experts from New Zealand recommend amikacin in conventional twice- or thrice-daily dosing because of the theoretical increased risk of neuromuscular blockade and apnea with larger daily doses in spinal cord injury patients. On the contrary, experts from Greece, Israel, and the U.S. recommend once-daily dosing and determining amikacin pharmacokinetic parameters for each patient. As there is considerable variation in clinical

  20. Historical development of radiation dose calculations for the public in the vicinity of nuclear sites in the United States

    Energy Technology Data Exchange (ETDEWEB)

    Pettengill, H.L. [USDOE, Washington, DC (United States); Soldat, J.K.; Swinth, K.L. [Pacific Northwest Lab., Richland, WA (United States)

    1994-06-01

    Most Manhattan District (MD) and Atomic Energy Commission (AEC) sites began environmental monitoring programs in the earliest years of their operation. The results were used to establish trends and to monitor for effluent releases that might be otherwise undetected. Very few data concerning radiation doses to the public in the vicinity of the sites were generated prior to 1960. Authoritative guidelines for controlling doses to the public were issued by national and international bodies beginning in the 1950s. In 1957, the Hanford Site began calculating and reporting maximum potential radiation doses to the public from several environmental pathways of exposure. Shortly thereafter, most AEC sites began programs aimed at either determining public doses, or ensuring that the doses were below the regulatory limits. Calculations of radiation doses to Maximally Exposed Individuals (MEI) at the Hanford Site have been recently completed by the Hanford Environmental Dose Reconstruction (HEDR) project. Collective doses for the public at Hanford were generated for this paper by utilizing the data developed by HEDR and approximate demographic data.

  1. Spatial association between dissection density and environmental factors over the entire conterminous United States

    Science.gov (United States)

    Luo, Wei; Jasiewicz, Jaroslaw; Stepinski, Tomasz; Wang, Jinfeng; Xu, Chengdong; Cang, Xuezhi

    2016-01-01

    Previous studies of land dissection density (D) often find contradictory results regarding factors controlling its spatial variation. We hypothesize that the dominant controlling factors (and the interactions between them) vary from region to region due to differences in each region's local characteristics and geologic history. We test this hypothesis by applying a geographical detector method to eight physiographic divisions of the conterminous United States and identify the dominant factor(s) in each. The geographical detector method computes the power of determinant (q) that quantitatively measures the affinity between the factor considered and D. Results show that the factor (or factor combination) with the largest q value is different for physiographic regions with different characteristics and geologic histories. For example, lithology dominates in mountainous regions, curvature dominates in plains, and glaciation dominates in previously glaciated areas. The geographical detector method offers an objective framework for revealing factors controlling Earth surface processes.

  2. Fluence-to-dose equivalent conversion factors for polyethylene-moderated {sup 252}Cf

    Energy Technology Data Exchange (ETDEWEB)

    Tanner, J.E.; Soldat, K.L.; Stewart, R.D. [Pacific Northwest Lab., Richland, WA (United States); Casson, W.H. [Los Alamos National Lab., NM (United States)

    1994-04-01

    Neutron measurements and calculations were conducted to characterize the polyethylene-moderated {sup 252}Cf source at Oak Ridge National Laboratory`s Radiation Calibration Laboratory (RADCAL). The 12-inch-diameter polyethylene sphere produces a highly scattered neutron spectrum which is more representative of most radiation fields found in the workplace than the D{sub 2}O-moderated {sup 252}Cf neutron spectrum typically used for dosimeter calibration. However, the energy-dependent fluence and dose equivalent must be well known before using such a source for radiation protection purposes. The measurements and calculations were performed as independent checks of the desired quantities which were the flux, the absorbed dose rate, the dose equivalent rate, and the average energy. These quantities were determined for the polyethylene sphere with and without an outer cadmium shell and compared with a D{sub 2}O-moderated {sup 252}Cf source.

  3. Final Technical Report for the grant entitled "Genetic Factors Affecting Susceptibility to Low-Dose Radiation"

    Energy Technology Data Exchange (ETDEWEB)

    Morgan, William, F., Ph.D., D.Sc.

    2006-11-22

    The goal of this proposal was to test the hypothesis that mice heterozygous for the Nijmegen Breakage Syndrome (NBS1) gene are genetically susceptible to low doses of ionizing radiation. The rationale for this is that patients with NBS are radiation sensitive, because of defects in cellular responses to radiation induced genetic damage and haploinsufficiency at this genetic locus provides the potential for genetic susceptibility to low doses of ionizing radiation. Wild type and heterozygous NBS1 mice were irradiated and followed over their lifetime for radiation induced genomic instability, carcinogenesis and non-specific life shortening. No differences in cytogenetic damage, cancer induction or life span were observed between the hypomorphic mice indicating that genetic imbalance at the NBS1 loci does not modulate low dose radiation sensitivity.

  4. Radiologic and nuclear medicine studies in the United States and worldwide: frequency, radiation dose, and comparison with other radiation sources--1950-2007.

    Science.gov (United States)

    Mettler, Fred A; Bhargavan, Mythreyi; Faulkner, Keith; Gilley, Debbie B; Gray, Joel E; Ibbott, Geoffrey S; Lipoti, Jill A; Mahesh, Mahadevappa; McCrohan, John L; Stabin, Michael G; Thomadsen, Bruce R; Yoshizumi, Terry T

    2009-11-01

    The U.S. National Council on Radiation Protection and Measurements and United Nations Scientific Committee on Effects of Atomic Radiation each conducted respective assessments of all radiation sources in the United States and worldwide. The goal of this article is to summarize and combine the results of these two publicly available surveys and to compare the results with historical information. In the United States in 2006, about 377 million diagnostic and interventional radiologic examinations and 18 million nuclear medicine examinations were performed. The United States accounts for about 12% of radiologic procedures and about one-half of nuclear medicine procedures performed worldwide. In the United States, the frequency of diagnostic radiologic examinations has increased almost 10-fold (1950-2006). The U.S. per-capita annual effective dose from medical procedures has increased about sixfold (0.5 mSv [1980] to 3.0 mSv [2006]). Worldwide estimates for 2000-2007 indicate that 3.6 billion medical procedures with ionizing radiation (3.1 billion diagnostic radiologic, 0.5 billion dental, and 37 million nuclear medicine examinations) are performed annually. Worldwide, the average annual per-capita effective dose from medicine (about 0.6 mSv of the total 3.0 mSv received from all sources) has approximately doubled in the past 10-15 years.

  5. Concord grape juice polyphenols and cardiovascular risk factors: dose-response relationships

    Science.gov (United States)

    Pure fruit juices provide nutritional value with evidence suggesting some of their benefits on biomarkers of cardiovascular disease risk may be derived from their constituent polyphenols, particularly flavonoids. However, few data from clinical trials are available on the dose-response relationship ...

  6. Isolated battery charger with unit power factor; Carregador de baterias isolado com fator de potencia unitario

    Energy Technology Data Exchange (ETDEWEB)

    Co, Marcio Almeida

    1993-05-01

    This work presents a single phase, isolated AC/DC converter (Battery Charger) with active power factor correction in a single stage of power processing. the topology studied is the fed-current full-bridge, in boost mode operation, at fixed switching frequency. After a complete design of converter and simulations, the results of a 1.500 W e 50 kHz prototype are shown. a Unit Power Factor and Total Harmonic Distortion less than 5% were obtained. (author)

  7. Nosocomial infections and risk factors in intensive care unit of a university hospital

    OpenAIRE

    2015-01-01

    Objective: The aim of this study is to evaluate nosocomial infections (NIs) in intensive care unit (ICU) in terms of site of infection, distribution of pathogens and risk factors for developing infection.Methods: 80 patients staying for more than 48 hours in the ICU were included in the study. Epidemiologic characteristics of the patients, invasive procedures and other risk factors were noted. Cultures, identification of isolates and antibiotic susceptibility tests were made by standard micro...

  8. Successful immune tolerance induction consisting of high-dose factor VIII rich in von Willebrand factor and pulsed intravenous immunoglobulin: a case report

    Directory of Open Access Journals (Sweden)

    Kubisz Peter

    2012-10-01

    Full Text Available Abstract Introduction The development of factor VIII inhibitors is a serious complication of replacement therapy in patients with congenital hemophilia A. Immune tolerance induction has been accepted as the only clinically proven treatment allowing antigen-specific tolerance to factor VIII. However, some of its issues, such as patient selection, timing, factor VIII dosing, use of immunosuppressive or immunomodulatory procedures, still remain the subject of debate. Case presentation A case of a 3-year-old Caucasian boy with severe congenital hemophilia A, intron 22 inversion of the F8 gene and high-titer inhibitor, who underwent an immune tolerance induction according to the modified Bonn regimen (high doses of plasma-derived factor VIII rich in von Willebrand factor and pulsed intravenous immunoglobulin is presented. The treatment lasted for 13 months and led to the eradication of inhibitor. Conclusion Addition of intravenous immunoglobulin did not negatively affect the course of immune tolerance induction and led to the rapid eradication of factor VIII inhibitor.

  9. Dose-dependent effects of procyanidin on nerve growth factor expression following cerebral ischemia/ reperfusion injury in rats

    Institute of Scientific and Technical Information of China (English)

    Feng Li; Hai Xie; Ying Gao; Tongxia Zhan

    2008-01-01

    BACKGROUND: Recently, grape seed procyanidin (GSP) has been shown to be exhibit antioxidant effects, effectively reducing ischemia/reperfusion injury and inhibiting brain cell apoptosis.OBJECTIVE: To study the effects of GSP on nerve growth factor (NGF) expression and neurological function following cerebral ischemia/reperfusion injury in rats.DESIGN: Randomized controlled study based on SD rats.SETTING: Weifang Municipal People's Hospital. MATERIALS: Forty-eight healthy adult SD rats weighing 280-330 g and irrespective of gender were provided by the Experimental Animal Center of Shandong University. GSP derived from grape seed was a new high-effective antioxidant provided by Tianjin Jianfeng Natural Product Researching Company (batch number: 20060107). Rabbit-anti-rat NGF monoclonal antibody was provided by Beijing Zhongshan Biotechnology Co., Ltd., and SABC immunohistochemical staining kit by Wuhan Boster Bioengineering Co., Ltd. METHODS: The present study was performed in the Functional Laboratory of Weifang Medical College from April 2006 to January 2007. Forty-eight SD rats were randomly divided into the sham operation group, ischemia/reperfusion group, high-dose GSP (40 mg/kg) group, or low-dose GSP (10 mg/kg) group (n = 12 per group). Ischemia/reperfusion injury was established using the threading embolism method of the middle cerebral artery. Rats in the ischemia/reperfusion model group were given saline injection (2 mL/kg i.p.) once daily for seven days pre-ischemia/reperfusion, and once more at 15 minutes before reperfusion. Rats in the high-dose and low-dose GSP groups were injected with GSP (20 or 5 mg/mL i.p., respectively, 2 mL/kg) with the same regime as the ischemia/reperfusion model group. The surgical procedures in the sham operation group were as the same as those in the ischemia/reperfusion model group, but the thread was approximately 10 mm long, thus, the middle cerebral artery was not blocked. MAIN OUTCOME MEASURES: NGF expression in the

  10. Quaternary Structure and Functional Unit of Energy Coupling Factor (ECF)-type Transporters

    NARCIS (Netherlands)

    Beek, Josy ter; Duurkens, Ria H.; Erkens, Guus B.; Slotboom, Dirk Jan

    2011-01-01

    ATP-binding cassette (ABC) transporters mediate transport of diverse substrates across membranes. We have determined the quaternary structure and functional unit of the recently discovered ECF-type (energy coupling factor) of ABC transporters, which is widespread among prokaryotes. ECF transporters

  11. International Comparisons of Infant Mortality and Related Factors : United States and Europe, 2010

    NARCIS (Netherlands)

    MacDorman, M.F.; Mathews, T.J.; Mohangoo, A.D.; Zeitlin, J.

    2014-01-01

    OBJECTIVES: This report investigates the reasons for the United States' high infant mortality rate when compared with European countries. Specifically, the report measures the impact on infant mortality differences of two major factors: the percentage of preterm births and gestational age-specific i

  12. The Factors That Influence Dietary Habits among International Students in the United States

    Science.gov (United States)

    Alakaam, Amir A.; Castellanos, Diana C.; Bodzio, Jessica; Harrison, Lee

    2015-01-01

    This study examines the dietary intake changes and factors related to dietary acculturation in international students attending an urban university in the United States. The researchers administered seven focus groups of college-age international students (n = 32) between June and August 2012. The participants were enrolled in Northeastern and…

  13. Important risk factors in melanoma from the Dermato-Oncologic Unit of Brescia, Italy.

    Science.gov (United States)

    Manganoni, Ausilia Maria; Zanotti, Federica; Farisoglio, Camillo; Feroldi, Piero; Facchetti, Fabio; Calzavara-Pinton, Piergiacomo

    2010-01-15

    One of the most significant risk factors for melanoma is a positive family history of the disease. It is estimated that approximately 10 percent of melanoma cases report a first-or second-degree relative with melanoma. We reported the experience of the Dermato-Oncologic Unit of Brescia, Italy.

  14. Factors affecting quality for beta dose rate measurements using ISO 6980 series I reference sources

    Energy Technology Data Exchange (ETDEWEB)

    Burns, R.E. Jr.; O`Brien, J.M. Jr. [Atlan-Tech, Rosewll, GA (United States)

    1993-12-31

    Atlan-Tech, Inc. has performed several calibrations of ISO 6980 Series 1 reference beta sources over the past two to three years. There were many problems encountered in attempting to compare the results of these calibrations with those from other laboratories, indicating the need for more standardization in the methodology employed for the measurement of the absorbed dose rate from ISO 6980 Series 1 reference beta sources. This document describes some of the problems encountered in attempting to intercompare results of beta dose-rate measurements. It proposes some solutions in an attempt to open a dialogue among facilities using reference beta standards for the purpose of promoting better measurement quality assurance through data intercomparison.

  15. Severe tardive dystonia on low dose short duration exposure to atypical antipsychotics: Factors explored

    Directory of Open Access Journals (Sweden)

    Nilanjan C Chandra

    2017-01-01

    Full Text Available Tardive dystonia (TD is a serious side effect of antipsychotic medications, more with typical antipsychotics, that is potentially irreversible in affected patients. Studies show that newer atypical antipsychotics have a lower risk of TD. As a result, many clinicians may have developed a false sense of security when prescribing these medications. We report a case of 20-year-old male with hyperthymic temperament and borderline intellectual functioning, who developed severe TD after low dose short duration exposure to atypical antipsychotic risperidone and then olanzapine. The goal of this paper is to alert the reader to be judicious and cautious before using casual low dose second generation antipsychotics in patient with no core psychotic features, hyperthymic temperament, or borderline intellectual functioning suggestive of organic brain damage, who are more prone to develop adverse effects such as TD and monitor the onset of TD in patients taking atypical antipsychotics.

  16. Severe Tardive Dystonia on Low Dose Short Duration Exposure to Atypical Antipsychotics: Factors Explored

    Science.gov (United States)

    Chandra, Nilanjan C.; Sheth, Shabina A.; Mehta, Ritambhara Y.; Dave, Kamlesh R.

    2017-01-01

    Tardive dystonia (TD) is a serious side effect of antipsychotic medications, more with typical antipsychotics, that is potentially irreversible in affected patients. Studies show that newer atypical antipsychotics have a lower risk of TD. As a result, many clinicians may have developed a false sense of security when prescribing these medications. We report a case of 20-year-old male with hyperthymic temperament and borderline intellectual functioning, who developed severe TD after low dose short duration exposure to atypical antipsychotic risperidone and then olanzapine. The goal of this paper is to alert the reader to be judicious and cautious before using casual low dose second generation antipsychotics in patient with no core psychotic features, hyperthymic temperament, or borderline intellectual functioning suggestive of organic brain damage, who are more prone to develop adverse effects such as TD and monitor the onset of TD in patients taking atypical antipsychotics.

  17. A novel arc welding inverter with unit power factor based on DSP control

    Institute of Scientific and Technical Information of China (English)

    Chen Shujun; Zeng Hua; Du Li; Yin Shuyan; Chen Yonggang

    2006-01-01

    A novel inverter power source is developed characterized with constant output current and unit power factor input.Digital signal processor (DSP) is used to realize power factor correction and control of back-stage inverter bridge of the arc welding inverter. The fore-stage adopts double closed loop proportion and integration (PI) rectifier technique and the backstage adopts digital pulse width modulation (PWM) technique. Simulated waves can be obtained in Matlab/Simulink and validated by experiments. Experiments of the prototype showed that the total harmonic distortion (THD) can be controlled within 10% and the power factor is approximate to 1.

  18. Factors affecting the quality of cardiopulmonary resuscitation in inpatient units: perception of nurses

    Directory of Open Access Journals (Sweden)

    Clairton Marcos Citolino Filho

    2015-12-01

    Full Text Available Abstract OBJECTIVE To identify, in the perception of nurses, the factors that affect the quality of cardiopulmonary resuscitation (CPR in adult inpatient units, and investigate the influence of both work shifts and professional experience length of time in the perception of these factors. METHOD A descriptive, exploratory study conducted at a hospital specialized in cardiology and pneumology with the application of a questionnaire to 49 nurses working in inpatient units. RESULTS The majority of nurses reported that the high number of professionals in the scenario (75.5%, the lack of harmony (77.6% or stress of any member of staff (67.3%, lack of material and/or equipment failure (57.1%, lack of familiarity with the emergency trolleys (98.0% and presence of family members at the beginning of the cardiopulmonary arrest assistance (57.1% are factors that adversely affect the quality of care provided during CPR. Professional experience length of time and the shift of nurses did not influence the perception of these factors. CONCLUSION The identification of factors that affect the quality of CPR in the perception of nurses serves as parameter to implement improvements and training of the staff working in inpatient units.

  19. Determination of attenuation factors for mortar of barite in terms of environmental dose equivalent and effective dose; Determinacao de fatores de atenuacao para argamassa de barita em termos do equivalente de dose ambiental e dose efetiva

    Energy Technology Data Exchange (ETDEWEB)

    Almeida Junior, Airton T.; Campos, L.L.R., E-mail: airtontavares@uol.com.br [Instituto de Pesquisas Energeticas e Nucleares (IPEN/CNEN-SP), Sao Paulo, SP (Brazil); Araujo, F.G.S. [Universidade Federal de Ouro Preto (UFOP), Ouro Preto, MG (Brazil); Santos, M.A.P. [Centro Regional de Ciencias Nucleares do Nordeste (CRCN-NE/CNEN-PE), Recife, PE (Brazil); Nogueira, M.S., E-mail: mnogueira@cdtn.br [Centro de Desenvolvimeto da Tecnologia Nuclear (CDTN/CNEN-MG), Belo Horizonte, MG (Brazil)

    2014-07-01

    This work addresses the characterization of barite mortars used as Xray shielding materials through the following quantities: mass attenuation coefficient, air kerma, effective dose and ambient dose - H⁎(10). The experiment was carried out with the use of the following reference qualities: RQR4, RQR6, RQR9 e RQR10, specified in accordance with norm IEC 61267: Medical diagnostic Xray equipment - radiation conditions for use in the determination of characteristics. In this study values was determined experimentally for the attenuation of the Cream barite (density 2.99g/cm{sup 3}, collected in the state of Sao Paulo), Purple barite (density 2.95g/cm{sup 3}, collected in the state of Bahia) and White barite (density 3.10g/cm{sup 3}, collected in the state of Paraiba). These materials, in the form of mortar, were disposed in the form of squares namely poof bodies, whose dimensions were 10 x 10 cm and thickness ranging from 3 to 15 mm approximately. In the experimental procedure, these proof bodies were irradiated with a Pantak, model HF320 industrial X-ray apparatus. The potentials applied to the respective X-ray tube were: 60kV, 80kV, 120kV and 150kV at a constant current of 1mA. The attenuation responses in function of thickness, for each of the materials analyzed, were used to draw the attenuation and transmission curves. The efficiency of the barite studied concerning the capacity to attenuate X-ray radiation for X-ray beams ranging from 60 to 150 kV indicated.

  20. Pharmacologic doses of ascorbic acid repress specificity protein (Sp) transcription factors and Sp-regulated genes in colon cancer cells.

    Science.gov (United States)

    Pathi, Satya S; Lei, Ping; Sreevalsan, Sandeep; Chadalapaka, Gayathri; Jutooru, Indira; Safe, Stephen

    2011-01-01

    Ascorbic acid (vitamin C) inhibits cancer cell growth, and there is a controversy regarding the cancer chemoprotective effects of pharmacologic doses of this compound that exhibits prooxidant activity. We hypothesized that the anticancer activity of pharmacologic doses of ascorbic acid (colon cancer cell proliferation and induced apoptosis and necrosis, and this was accompanied by downregulation of Sp1, Sp3, and Sp4 proteins. In addition, ascorbic acid decreased expression of several Sp-regulated genes that are involved in cancer cell proliferation [hepatocyte growth factor receptor (c-Met), epidermal growth factor receptor and cyclin D1], survival (survivin and bcl-2), and angiogenesis [vascular endothelial growth factor (VEGF) and its receptors (VEGFR1 and VEGFR2)]. Other prooxidants such as hydrogen peroxide exhibited similar activities in colon cancer cells, and cotreatment with glutathione inhibited these responses. This study demonstrates for the first time that the anticancer activities of ascorbic acid are due, in part, to ROS-dependent repression of Sp transcription factors.

  1. Cardiovascular risk factors in children after repeat doses of antenatal glucocorticoids: an RCT

    National Research Council Canada - National Science Library

    McKinlay, Christopher J D; Cutfield, Wayne S; Battin, Malcolm R; Dalziel, Stuart R; Crowther, Caroline A; Harding, Jane E

    2015-01-01

    .... We assessed whether exposure to repeat antenatal betamethasone increased risk factors for later cardiometabolic disease in children whose mothers participated in the Australasian Collaborative Trial...

  2. Determination of factor Xa inhibition doses of low-molecular heparin, nadroparin and reviparin in urological patients

    Directory of Open Access Journals (Sweden)

    Pavlović Svetlana

    2007-01-01

    Full Text Available Background/Aim. The inhibition of factor Xa (FX by the use of low-molecular heparin (LMH is important clinical procedure in patients with moderate and high risk for the developament of venous thromboembolism (VTE and pulmonary embolism (PE. The aim of this study was to determine the level of inhibition of FXa by the use of prophylactic doses of LMH nadroparin-calcium and reviparine-sodium which were applied in urological patients with moderate risk for VTE and PE. Methods. The examination included 80 urological patients divided into 4 groups after urological, uroradiological and anesthesiological preoperative preparation and categorization of anesthesiological risk according to the ASA III classification. The first two groups, of 20 patients each, received the recommended doses of LMH in accordance with the preoperative risk, and an inhibition of FXa 48 hours after the surgical operation and four hours after the administration of LMH was determined. Heptest and homogenous anti-Xa test were used for monitoring of FXa inhibition. Since the obtained anti-Xa values were not satisfactory, two more groups were formed and given double the recommended doses. In these new groups, inhibition of FXa was in recommended range. Standard descriptive statistical parameters were used for describing the charateristics of the people from the formed groups. Results. All the patients examined were clinically estimated as patients of moderate risk, for VTE and PE. There were no statistically singificant difference in body weight of the patients who received nadroparin-calcium 0.3 ml and reviparine-sodium 0.25 ml and those who received their double doses, respectively. The level of FXa inhibition in the group in which the dose of nadroparin-calcium of 0.6 ml was applied was statistically significantly higher than in the group which received the dose of 0.3 ml (Mann-Whitney U test: Z = 5.416; p < 0.0001. The level of FXa in the group given reviparine-sodium 0.5 ml was

  3. Factors contributing to sleep deprivation in a multidisciplinary intensive care unit in South Africa

    Directory of Open Access Journals (Sweden)

    Valerie J. Ehlers

    2013-02-01

    Full Text Available Patients in intensive care units require rest and sleep to recuperate, but might suffer from sleep deprivation due to ongoing unit activities. The study aimed to identify and describe the factors contributing to sleep deprivation in one multi-disciplinary intensive care unit MDICU in a private hospital in South Africa. Quantitative, descriptive research was conducted to identify factors contributing to sleep deprivation in the research setting, and to make recommendations to enhance these patients’ abilities to sleep. Structured interviewswere conducted with 34 adult non-ventilated patients who had spent at least one night in the MDICU and who gave informed consent. Out of the 34 interviewed patients 70.6% n = 24 indicated that they suffered from sleep deprivation in the MDICU. The five major factors contributing to sleep deprivation in a MDICU were, (1 not knowing nurses’ names, noise caused by alarms, (2 stress, (3 inability to understand medical terms, and (3 blood pressure cuffs that restricted patients’ movements and smelled badly. Patients’ abilities to sleep were enhanced by reassuring nurses whose names they knew and with whom they could communicate. By attending to the identified five major factors, patients’ abilities to sleep in a MDICU could be enhanced enabling patients to recuperate faster. The implementation of such measures need not incur financial costs for the MDICU concerned.

  4. Factors contributing to sleep deprivation in a multidisciplinary intensive care unit in South Africa

    Directory of Open Access Journals (Sweden)

    Valerie J. Ehlers

    2013-01-01

    Full Text Available Patients in intensive care units require rest and sleep to recuperate, but might suffer from sleep deprivation due to ongoing unit activities. The study aimed to identify and describe the factors contributing to sleep deprivation in one multi-disciplinary intensive care unit (MDICU in a private hospital in South Africa. Quantitative, descriptive research was conducted to identify factors contributing to sleep deprivation in the research setting, and to make recommendations to enhance these patients’ abilities to sleep. Structured interviews were conducted with 34 adult non-ventilated patients who had spent at least one night in the MDICU and who gave informed consent. Out of the 34 interviewed patients 70.6% (n = 24 indicated that they suffered from sleep deprivation in the MDICU. The five major factors contributing to sleep deprivation in a MDICU were, (1 not knowing nurses’ names, noise caused by alarms, (2 stress, (3 inability to understand medical terms, and (3 blood pressure cuffs that restricted patients’ movements and smelled badly. Patients’ abilities to sleep were enhanced by reassuring nurses whose names they knew and with whom they could communicate. By attending to the identified five major factors, patients’ abilities to sleep in a MDICU could be enhanced enabling patients to recuperate faster. The implementation of such measures need not incur financial costs for the MDICU concerned.

  5. Nosocomial infection and risk factors in elderly patients in intensive care units

    Directory of Open Access Journals (Sweden)

    Kevser Özdemir

    2015-03-01

    Full Text Available Incidence of nosocomial infections gradually increase in patients over 65 years age population. There is a significant relationship between increased age and predisposition to nosocomial infections. Predisposition to infections in this age group is a result of impaired host defense, underlying chronic diseases, long-term hospitalization, steroids and immunosuppressive therapies and malnutrition. Nevertheless there is not much data about the incidence and risk factors of nosocomial infections in elderly population. In this study we aimed to investigate the incidence and risk factors for nosocomial infections and the factors affecting mortality rates in elderly patients in the medical intensive care units. Nosocomial infection is an important factor causes increased mortality rate and length of hospital stay. Mortality rates and time interval between admission and discharge is significantly higher in nosocomially infected group than others. There are several known independent risk factors for increased mortality rates include increased age and length of hospital stay, impaired conscious levels, co-morbidities, nosocomial infections, immunsupresive conditions such as malnutrition, malignancies, mechanic ventilation and/or central venous catheter usage. As a result nosocomial infection is an important and partially preventable risk factor for mortality among patients treated in intensive care units. Mechanical ventilation, central venous and/or urinary catheterizations are such invasive interventions that may cause higher nosocomial infection rates. In terms of decreasing nosocomial infection rates; less frequently used invasive interventions can help in achieving this purpose of treatment. J Microbiol Infect Dis 2015;5(1: 38-43

  6. Factors associated with mortality and length of stay in the Oporto burn unit (2006-2009).

    Science.gov (United States)

    Bartosch, Isabel; Bartosch, Carla; Egipto, Paula; Silva, Alvaro

    2013-05-01

    Retrospective studies are essential to evaluate and improve the efficiency of care of burned patients. This study analyses the work done in the burn unit of Hospital de S. João in the north of Portugal. A retrospective review was performed in patients admitted from 2006 to 2009. The study population was characterised regarding patient demographics, admissions profile, burn aetiology, burn site, extension and treatment. Multiple linear and logistic regression models were done in order to elucidate which of these factors influenced the mortality and length of stay. The characteristics before and after the creation of the burn unit, as well as the similarities and differences with the published data of other national and international burn units, are analysed.

  7. INCIDENCE AND RISK FACTORS CONTRIBUTING TO ROP: STUDY FROM NEONATAL CARE UNIT- SOUTH INDIA

    Directory of Open Access Journals (Sweden)

    Karthiyaeni

    2016-01-01

    Full Text Available The study was conducted to identify the incidence of retinopathy of prematurity among the preterm neonates treated at neonatal unit and to evaluate the associated risk factors for ROP. DESIGN Prospective observational study. SETTING Neonatal Intensive Care Unit (NICU of Department of Paediatrics at Chengalpattu Medical College. During the study period, 159 babies were treated at the NICU and 111 babies were discharged from the unit. Among those babies who were discharged, 14 neonates were lost for followup for ROP screening. This lost to followup was 12.6% of the study population. In this study 97 infants were screened, out of which 18 infants had ROP. The rate of ROP is 18.6% in our institution and 2 out of 18 babies had threshold ROP (11.1%, who were treated with Laser therapy

  8. RECOVERY OF A TRITIATED LANA SAMPLE FOR DOSE CONVERSION FACTOR DETERMINATION

    Energy Technology Data Exchange (ETDEWEB)

    Staack, G.

    2010-11-12

    The purpose of this work is to develop a technical basis for both estimating the dose of a worker exposed to respirable tritiated LaNi{sub 4.25}Al{sub 0.75} (LANA) and implementing hazard appropriate controls. Savannah River National Laboratory (SRNL) has agreed to provide Lovelace Respiratory Research Institute (LRRI) with a tritiated LANA sample. LRRI will determine the particle size distribution (PSD) as well as perform dissolution rate studies on the sample in serum ultrafiltrate (SUF), a simulated lung fluid. The rate of tritium release from the sample will be measured over a three month period. Tritium release rate information will be used to calculate a DCF for respirable tritiated LANA.

  9. Evolution of radon dose evaluation

    Directory of Open Access Journals (Sweden)

    Fujimoto Kenzo

    2004-01-01

    Full Text Available The historical change of radon dose evaluation is reviewed based on the United Nations Scientific Committee on the Effects of Atomic Radiation (UNSCEAR reports. Since 1955, radon has been recognized as one of the important sources of exposure of the general public. However, it was not really understood that radon is the largest dose contributor until 1977 when a new concept of effective dose equivalent was introduced by International Commission on Radiological Protection. In 1982, the dose concept was also adapted by UNSCEAR and evaluated per caput dose from natural radiation. Many researches have been carried out since then. However, lots of questions have remained open in radon problems, such as the radiation weighting factor of 20 for alpha rays and the large discrepancy of risk estimation among dosimetric and epidemiological approaches.

  10. Peripheral blood morphologic changes after high-dose antineoplastic chemotherapy and recombinant human granulocyte colony-stimulating factor administration.

    Science.gov (United States)

    Kerrigan, D P; Castillo, A; Foucar, K; Townsend, K; Neidhart, J

    1989-09-01

    The peripheral blood morphologic findings in 17 patients with cancer who had received high-dose cytotoxic chemotherapy followed by recombinant human-granulocyte colony-stimulating factor (rh-GCSF) were reviewed and compared with a control group of patients who received only high-dose chemotherapy. Both groups showed dysmyelopoiesis (abnormal granulation and nuclear lobulation) in the granulocytic series during the period of bone marrow recovery that followed the cytotoxic chemotherapy. Most of these morphologic abnormalities were more prominent in the rh-GCSF-treated group. Monocytic cells in both groups showed prominent vacuolation and immature nuclei. The percentages and absolute numbers of large granular lymphocytes were increased in the rh-GCSF group compared with the control group. No quantitative or qualitative abnormalities of eosinophilic or basophilic granulocytes were detected in either group. Both groups showed nonspecific red blood cell abnormalities, and large platelets were present in half of the control group smears. This report provides the first detailed peripheral blood morphologic description in patients treated with rh-GCSF and high-dose chemotherapy.

  11. Low-dose total body irradiation in non-Hodgkin lymphoma: Short- and long-term toxicity and prognostic factor

    Energy Technology Data Exchange (ETDEWEB)

    De Neve, W.J.; Lybeert, M.L.; Meerwaldt, J.H. (A.Z.-V.U.B., Brussels (Belgium))

    1990-08-01

    The toxicity of low-dose total body irradiation (LTBI), the prognostic factors related to survival and relapse-free survival, and the efficacy of treatment given for relapse after LTBI were analyzed in 68 patients with non-Hodgkin lymphoma (NHL) treated at the Rotterdamsch Radiotherapeutisch Instituut. All patients received LTBI between 1973 and 1979. The patient material was heterogeneous with respect to malignancy grade, stage, age, and therapy given before or after LTBI; the unifying principle was that all patients received LTBI and had symptomatic NHL. Analysis of prognostic variables with Cox's model revealed grade (p less than 0.001) and age (p = 0.004) as predictors for survival and grade (p less than 0.001) and dose of LTBI (p = 0.056) as predictors for relapse-free survival after LTBI. No subjective toxicity was observed during or after LTBI treatment. Hematologic toxicity was dose-limiting and was increased if patients had received cytotoxic treatment before LTBI. LTBI-related hematologic toxicity was lower in patients with low-grade NHL than in those with intermediate or high-grade NHL, was limited in time, and recovered in all patients. Patients relapsing after LTBI received a variety of therapies. Response rates were high, but of short duration, especially in intermediate or high-grade NHL. Duration of response was progressively shorter after multiple relapses.

  12. Low-dose total body irradiation in non-Hodgkin lymphoma: short- and long-term toxicity and prognostic factor.

    Science.gov (United States)

    De Neve, W J; Lybeert, M L; Meerwaldt, J H

    1990-08-01

    The toxicity of low-dose total body irradiation (LTBI), the prognostic factors related to survival and relapse-free survival, and the efficacy of treatment given for relapse after LTBI were analyzed in 68 patients with non-Hodgkin lymphoma (NHL) treated at the Rotterdamsch Radiotherapeutisch Instituut. All patients received LTBI between 1973 and 1979. The patient material was heterogeneous with respect to malignancy grade, stage, age, and therapy given before or after LTBI; the unifying principle was that all patients received LTBI and had symptomatic NHL. Analysis of prognostic variables with Cox's model revealed grade (p less than 0.001) and age (p = 0.004) as predictors for survival and grade (p less than 0.001) and dose of LTBI (p = 0.056) as predictors for relapse-free survival after LTBI. No subjective toxicity was observed during or after LTBI treatment. Hematologic toxicity was dose-limiting and was increased if patients had received cytotoxic treatment before LTBI. LTBI-related hematologic toxicity was lower in patients with low-grade NHL than in those with intermediate or high-grade NHL, was limited in time, and recovered in all patients. Patients relapsing after LTBI received a variety of therapies. Response rates were high, but of short duration, especially in intermediate or high-grade NHL. Duration of response was progressively shorter after multiple relapses.

  13. Use of watershed factors to predict consumer surfactant toxic units in the upper Trinity river, Texas

    DEFF Research Database (Denmark)

    Johnson, David; Sanderson, Hans; Atkinson, Sam

    2009-01-01

    for surfactant loading into the environment. The objective of this project was to determine whether surfactant concentrations, expressed as toxic units, in-stream water quality, and aquatic habitat in the upper Trinity River could be predicted based on easily accessible watershed characteristics. Surface water...... surfactant concentrations were determined, and total surfactant toxic units were calculated. GIS models of geospatial, anthropogenic factors (e.g., population density) and natural factors (e.g., soil organic matter) were collected and analyzed according to subwatersheds. Multiple regression analyses using......Surfactants are high production volume chemicals that are used in a wide assortment of "down-the-drain" consumer products. Wastewater treatment plants (WWTPs) generally remove 85 to more than 99% of all surfactants from influents, but residual concentrations are discharged into receiving waters via...

  14. The Bernese Emigration to the United States, 1870–1930: A Quantitative Analysis of Economic Factors

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    Simon Geissbühler

    1999-10-01

    Full Text Available The United States was the most important destination for emigrants from the Swiss canton of Bern during the period of mass emigration in the late 19th and the early 20th century. The present article looks at the economic factors leading to this mass emigration. Using bivariate correlations, this study demonstrates that quantitative analysis is a powerful tool in historical emigration research. The data underlines the two following theses. First, the better the economy in Bern, the lower the rate of emigration to the United States. Secondly, the better the economy in the United States, the higher the rate of emigration from Bern. Hence, both pull and push factors played an important role determining emigration from Bern to the United States. The most closely related to the rate of emigration were the independent variables emigration to the USA in year t-1, the investments in structural engineering in Bern, railroad construction in the USA and the number of Bernese on welfare. The results clearly show that Bernese emigration was primarily a socio-economic mass movement.

  15. A comparison of temporal trends in United States autism prevalence to trends in suspected environmental factors

    OpenAIRE

    Nevison, Cynthia D

    2014-01-01

    Background The prevalence of diagnosed autism has increased rapidly over the last several decades among U.S. children. Environmental factors are thought to be driving this increase and a list of the top ten suspected environmental toxins was published recently. Methods Temporal trends in autism for birth years 1970–2005 were derived from a combination of data from the California Department of Developmental Services (CDDS) and the United States Individuals with Disabilities Education Act (IDEA...

  16. High quality-factor fano metasurface comprising a single resonator unit cell

    Energy Technology Data Exchange (ETDEWEB)

    Sinclair, Michael B.; Warne, Larry K.; Basilio, Lorena I.; Langston, William L.; Campione, Salvatore; Brener, Igal; Liu, Sheng

    2017-06-20

    A new monolithic resonator metasurface design achieves ultra-high Q-factors while using only one resonator per unit cell. The metasurface relies on breaking the symmetry of otherwise highly symmetric resonators to induce intra-resonator mixing of bright and dark modes (rather than inter-resonator couplings), and is scalable from the near-infrared to radio frequencies and can be easily implemented in dielectric materials. The resulting high-quality-factor Fano metasurface can be used in many sensing, spectral filtering, and modulation applications.

  17. Risk factors related to the global burden of disease in Brazil and its Federated Units, 2015.

    Science.gov (United States)

    Malta, Deborah Carvalho; Felisbino-Mendes, Mariana Santos; Machado, Ísis Eloah; Passos, Valéria Maria de Azeredo; Abreu, Daisy Maria Xavier de; Ishitani, Lenice Harumi; Velásquez-Meléndez, Gustavo; Carneiro, Mariangela; Mooney, Meghan; Naghavi, Mohsen

    2017-05-01

    To analyze the global burden of disease related to disability adjusted life years (DALYs) attributed to selected risk factors in Brazil and its 27 Federated Units. Databases from the Global Burden of Disease study in Brazil and its Federated Units were used, estimating the summary exposure value (SEV) for selected environmental, behavioral, and metabolic risk factors (RFs), and their combinations. The DALYs were used as the main metric. The ranking of major RFs between 1990 and 2015 was compiled, comparing data by sex and states. The analyzed RFs account for 38.8% of the loss of DALYs in the country. Dietary risks was the main cause of DALYs in 2015. In men, dietary risks contributed to 12.2% of DALYs and in women, to 11.1%. Other RFs were high systolic blood pressure, high body mass index, smoking, high fasting plasma glucose and, among men, alcohol and drug use. The main RFs were metabolic and behavioral. In most states, dietary risks was the main RF, followed by high blood pressure. Dietary risks leads the RF ranking for Brazil and its Federated Units. Men are more exposed to behavioral risk factors, and women are more exposed to metabolic ones.

  18. Dose-Dependent Differential Effect of Neurotrophic Factors on In Vitro and In Vivo Regeneration of Motor and Sensory Neurons.

    Science.gov (United States)

    Santos, Daniel; Gonzalez-Perez, Francisco; Navarro, Xavier; Del Valle, Jaume

    2016-01-01

    Although peripheral axons can regenerate after nerve transection and repair, functional recovery is usually poor due to inaccurate reinnervation. Neurotrophic factors promote directional guidance to regenerating axons and their selective application may help to improve functional recovery. Hence, we have characterized in organotypic cultures of spinal cord and dorsal root ganglia the effect of GDNF, FGF-2, NGF, NT-3, and BDNF at different concentrations on motor and sensory neurite outgrowth. In vitro results show that GDNF and FGF-2 enhanced both motor and sensory neurite outgrowth, NGF and NT-3 were the most selective to enhance sensory neurite outgrowth, and high doses of BDNF selectively enhanced motor neurite outgrowth. Then, NGF, NT-3, and BDNF (as the most selective factors) were delivered in a collagen matrix within a silicone tube to repair the severed sciatic nerve of rats. Quantification of Fluorogold retrolabeled neurons showed that NGF and NT-3 did not show preferential effect on sensory regeneration whereas BDNF preferentially promoted motor axons regeneration. Therefore, the selective effects of NGF and NT-3 shown in vitro are lost when they are applied in vivo, but a high dose of BDNF is able to selectively enhance motor neuron regeneration both in vitro and in vivo.

  19. Dose-Dependent Differential Effect of Neurotrophic Factors on In Vitro and In Vivo Regeneration of Motor and Sensory Neurons

    Directory of Open Access Journals (Sweden)

    Daniel Santos

    2016-01-01

    Full Text Available Although peripheral axons can regenerate after nerve transection and repair, functional recovery is usually poor due to inaccurate reinnervation. Neurotrophic factors promote directional guidance to regenerating axons and their selective application may help to improve functional recovery. Hence, we have characterized in organotypic cultures of spinal cord and dorsal root ganglia the effect of GDNF, FGF-2, NGF, NT-3, and BDNF at different concentrations on motor and sensory neurite outgrowth. In vitro results show that GDNF and FGF-2 enhanced both motor and sensory neurite outgrowth, NGF and NT-3 were the most selective to enhance sensory neurite outgrowth, and high doses of BDNF selectively enhanced motor neurite outgrowth. Then, NGF, NT-3, and BDNF (as the most selective factors were delivered in a collagen matrix within a silicone tube to repair the severed sciatic nerve of rats. Quantification of Fluorogold retrolabeled neurons showed that NGF and NT-3 did not show preferential effect on sensory regeneration whereas BDNF preferentially promoted motor axons regeneration. Therefore, the selective effects of NGF and NT-3 shown in vitro are lost when they are applied in vivo, but a high dose of BDNF is able to selectively enhance motor neuron regeneration both in vitro and in vivo.

  20. Passive dosing of polycyclic aromatic hydrocarbon (PAH) mixtures to terrestrial springtails: Linking mixture toxicity to chemical activities, equilibrium lipid concentrations, and toxic units

    DEFF Research Database (Denmark)

    Schmidt, Stine Nørgaard; Holmstrup, Martin; Smith, Kilian E. C.

    2013-01-01

    treatments, containing the polycyclic aromatic hydrocarbons (PAHs) naphthalene, phenanthrene, and pyrene. Springtail lethality was then linked to sum chemical activities (∑a), sum equilibrium lipid concentrations (∑Clipid eq.), and sum toxic units (∑TU). In each case, the effects of all 12 mixture treatments...... could be fitted to one sigmoidal exposure-response relationship. The effective lethal chemical activity (La50) of 0.027 was well within the expected range for baseline toxicity of 0.01-0.1. Linking the effects to the lipid-based exposure parameter yielded an effective lethal concentration (LClipid eq....... 50) of 133 mmol kg-1 lipid in good correspondence with the lethal membrane burden for baseline toxicity (40-160 mmol kg-1 lipid). Finally, the effective lethal toxic unit (LTU50) of 1.20 was rather close to the expected value of 1. Altogether, passive dosing provided tightly controlled mixture...

  1. Psychiatric disorders in children attending a Nigerian primary care unit: functional impairment and risk factors

    Directory of Open Access Journals (Sweden)

    Tunde-Ayinmode Mosunmola

    2012-07-01

    Full Text Available Abstract Background There is dearth of data on the level of functional impairment and risk factors for psychiatric morbidity in children attending primary care services in developing countries like Nigeria. The risk factors for psychiatric morbidity and functional impairment in children attending the primary care unit of a teaching hospital in Ilorin, Nigeria was therefore investigated to obtain data that could be used in improving service provision by primary care physicians. Methods A cross-sectional two-stage design was employed for the study. The first stage involved administration of the Child Behavior Questionnaire (CBQ to 350 children while the children’s version of the schedule for affective disorders and schizophrenia was used for the second stage involving 157 children, all high scorers on CBQ (score of ≥ 7 and 30% of low scorers (score  In addition, the Children Global Assessment Scale was used to assess the functional status of the children (score of ≤ 70 indicates functional impairment while the mothers’ mental health status was assessed with the 12-item version of the General Health Questionnaire, a score of 3 or more on this instrument indicate presence of mental morbidity. Results It was observed that 11.4% of the children had diagnosable psychiatric disorders and 7.1% were functionally impaired; and those with psychiatric disorders were more functionally impaired than those without. Thus, significant negative correlation was noted between CBQ scores and CGAS (r = 0.53; p  Conclusions Child psychiatric disorders are prevalent in the primary care unit studied. Many of the risk factors identified in the study population are modifiable. Collaborative efforts between psychiatrists and primary care physicians could therefore help to reduce level of risk and functional impairment and psychiatric morbidity among children attending the primary care unit studied. It could also help improve referral rates of

  2. Factor analysis in optimization of formulation of high content uniformity tablets containing low dose active substance.

    Science.gov (United States)

    Lukášová, Ivana; Muselík, Jan; Franc, Aleš; Goněc, Roman; Mika, Filip; Vetchý, David

    2017-09-11

    Warfarin is intensively discussed drug with narrow therapeutic range. There have been cases of bleeding attributed to varying content or altered quality of the active substance. Factor analysis is useful for finding suitable technological parameters leading to high content uniformity of tablets containing low amount of active substance. The composition of tabletting blend and technological procedure were set with respect to factor analysis of previously published results. The correctness of set parameters was checked by manufacturing and evaluation of tablets containing 1-10mg of warfarin sodium. The robustness of suggested technology was checked by using "worst case scenario" and statistical evaluation of European Pharmacopoeia (EP) content uniformity limits with respect to Bergum division and process capability index (Cpk). To evaluate the quality of active substance and tablets, dissolution method was developed (water; EP apparatus II; 25rpm), allowing for statistical comparison of dissolution profiles. Obtained results prove the suitability of factor analysis to optimize the composition with respect to batches manufactured previously and thus the use of metaanalysis under industrial conditions is feasible. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Marital Relationship and Its Associated Factors in Veterans Exposed to High Dose Chemical Warfare Agents

    Directory of Open Access Journals (Sweden)

    Shervin Assari

    2008-06-01

    Full Text Available Objective: The aim of this study was to determine the associates of marital relationship in mustard exposed veterans.Materials and Methods: Two hundred ninety two married Iranian mustard exposed veterans, who had been exposed to single high dose mustard gas in Iraq-Iran war, were assessed for marital adjustment with Revised Dyadic Adjustment Scale (RDAS. Census sampling was done. The patients' quality of life (SF-36, spirometric measures and war related data were also extracted.Results: A total of 189 subjects (65% completed our study. The mean (±SD of the RDAS Total score, RDAS Dyadic Consensus , RDAS Affectional Expression, RDAS Dyadic Satisfaction , and RDAS Dyadic Cohesion were 50.61 (8.16, 16.67 (2.77, 7.62 (1.84, 14.76 (3.39, and 11.54 (3.79, respectively. RDAS Dyadic satisfaction was correlated with SF-36 and all its sub-scores (p<0.05. RDAS total score showed significant correlation with SF-36 total score and most of its sub-scores (p<0.05. RDAS affective expression was significantly correlated with role limitation, social function, general mental health, vitality, General health perceptions, physical composite score (PCS and mental composite score (MCS (p<0.05. RDAS dyadic consensus was not correlated with any SF-36 sub-scores.Conclusion: Veterans health team including physicians, psychologists and/or psychiatrists should know that poorer marital satisfaction is linked with lower quality of life scores, late after mustard exposure, although marital relationship is independent of spirometric findings, age, duration from exposure and comorbidity score.

  4. Near Real-Time Assessment of Anatomic and Dosimetric Variations for Head and Neck Radiation Therapy via Graphics Processing Unit-based Dose Deformation Framework.

    Science.gov (United States)

    Qi, X Sharon; Santhanam, Anand; Neylon, John; Min, Yugang; Armstrong, Tess; Sheng, Ke; Staton, Robert J; Pukala, Jason; Pham, Andrew; Low, Daniel A; Lee, Steve P; Steinberg, Michael; Manon, Rafael; Chen, Allen M; Kupelian, Patrick

    2015-06-01

    The purpose of this study was to systematically monitor anatomic variations and their dosimetric consequences during intensity modulated radiation therapy (IMRT) for head and neck (H&N) cancer by using a graphics processing unit (GPU)-based deformable image registration (DIR) framework. Eleven IMRT H&N patients undergoing IMRT with daily megavoltage computed tomography (CT) and weekly kilovoltage CT (kVCT) scans were included in this analysis. Pretreatment kVCTs were automatically registered with their corresponding planning CTs through a GPU-based DIR framework. The deformation of each contoured structure in the H&N region was computed to account for nonrigid change in the patient setup. The Jacobian determinant of the planning target volumes and the surrounding critical structures were used to quantify anatomical volume changes. The actual delivered dose was calculated accounting for the organ deformation. The dose distribution uncertainties due to registration errors were estimated using a landmark-based gamma evaluation. Dramatic interfractional anatomic changes were observed. During the treatment course of 6 to 7 weeks, the parotid gland volumes changed up to 34.7%, and the center-of-mass displacement of the 2 parotid glands varied in the range of 0.9 to 8.8 mm. For the primary treatment volume, the cumulative minimum and mean and equivalent uniform doses assessed by the weekly kVCTs were lower than the planned doses by up to 14.9% (P=.14), 2% (P=.39), and 7.3% (P=.05), respectively. The cumulative mean doses were significantly higher than the planned dose for the left parotid (P=.03) and right parotid glands (P=.006). The computation including DIR and dose accumulation was ultrafast (∼45 seconds) with registration accuracy at the subvoxel level. A systematic analysis of anatomic variations in the H&N region and their dosimetric consequences is critical in improving treatment efficacy. Nearly real-time assessment of anatomic and dosimetric variations is

  5. Incidence, risk factors and prognostic factors of acute renal failure in patients admitted to an intensive care unit

    Directory of Open Access Journals (Sweden)

    S.E. Mataloun

    2006-10-01

    Full Text Available The objective of the present study was to assess the incidence, risk factors and outcome of patients who develop acute renal failure (ARF in intensive care units. In this prospective observational study, 221 patients with a 48-h minimum stay, 18-year-old minimum age and absence of overt acute or chronic renal failure were included. Exclusion criteria were organ donors and renal transplantation patients. ARF was defined as a creatinine level above 1.5 mg/dL. Statistics were performed using Pearsons' chi2 test, Student t-test, and Wilcoxon test. Multivariate analysis was run using all variables with P < 0.1 in the univariate analysis. ARF developed in 19.0% of the patients, with 76.19% resulting in death. Main risk factors (univariate analysis were: higher intra-operative hydration and bleeding, higher death risk by APACHE II score, logist organ dysfunction system on the first day, mechanical ventilation, shock due to systemic inflammatory response syndrome (SIRS/sepsis, noradrenaline use, and plasma creatinine and urea levels on admission. Heart rate on admission (OR = 1.023 (1.002-1.044, male gender (OR = 4.275 (1.340-13642, shock due to SIRS/sepsis (OR = 8.590 (2.710-27.229, higher intra-operative hydration (OR = 1.002 (1.000-1004, and plasma urea on admission (OR = 1.012 (0.980-1044 remained significant (multivariate analysis. The mortality risk factors (univariate analysis were shock due to SIRS/sepsis, mechanical ventilation, blood stream infection, potassium and bicarbonate levels. Only potassium levels remained significant (P = 0.037. In conclusion, ARF has a high incidence, morbidity and mortality when it occurs in intensive care unit. There is a very close association with hemodynamic status and multiple organ dysfunction.

  6. Factors responsible for mortality variation in the United States: A latent variable analysis

    Directory of Open Access Journals (Sweden)

    Christopher Tencza

    2014-07-01

    Full Text Available Background: Factors including smoking, drinking, substance abuse, obesity, and health care have all been shown to affect health and longevity. The relative importance of each of these factors is disputed in the literature, and has been assessed through a number of methods. Objective: This paper uses a novel approach to identify factors responsible for interstate mortality variation. It identifies factors through their imprint on mortality patterns and can therefore identify factors that are difficult or impossible to measure directly, such as sensitive health behaviors. Methods: The analysis calculates age-standardized death rates by cause of death from 2000-2009 for white men and women separately. Only premature deaths between ages 20-64 are included. Latent variables responsible for mortality variation are then identified through a factor analysis conducted on a death-rate-by-state matrix. These unobserved latent variables are inferred from observed mortality data and interpreted based on their correlations with individual causes of death. Results: Smoking and obesity, substance abuse, and rural/urban residence are the three factors that make the largest contributions to state-level mortality variation among males. The same factors are at work for women but are less vividly revealed. The identification of factors is supported by a review of epidemiologic studies and strengthened by correlations with observable behavioral variables. Results are not sensitive to the choice of factor-analytic method used. Conclusions: The majority of interstate variation in mortality among white working-age adults in the United States is associated with a combination of smoking and obesity, substance abuse and rural/urban residence.

  7. Improved simulation design factors for unconventional crude vacuum units : cracked gas make and stripping section performance

    Energy Technology Data Exchange (ETDEWEB)

    Remesat, D. [Koch-Glitsch Canada LP, Calgary, AB (Canada)

    2008-10-15

    Operating data for unconventional heavy oil vacuum crude units were reviewed in order to optimize the design of vacuum columns. Operational data from heavy crude vacuum units operating with stripping and velocity were used to investigate the application of a proven vacuum distillation tower simulation topology designed for use with heavy oil and bitumen upgrader feeds. Design factors included a characterization of the crude oils or bitumens processed in the facility; the selection of thermodynamic models; and the non-equilibrium simulation topology. Amounts of generated cracked gas were calculated, and entrainment and stripping section performance was evaluated. Heater designs for ensuring the even distribution of heat flux were discussed. Data sets from vacuum units processing crude oils demonstrated that the amount of offgas flow increased as the transfer line temperature increased. The resulting instability caused increased coke generation and light hydrocarbon formation. Results also indicated that overhead vacuum ejector design and size as well as heat transfer capabilities of quench and pumparound zones must be considered when designing vacuum column units. Steam stripping lowered hydrocarbon partial pressure to allow materials to boil at lower temperatures. It was concluded that setting appropriate entrainment values will ensure the accuracy of sensitivity analyses for transfer line designs, inlet feed devices, and wash bed configurations. 9 refs., figs.

  8. Output factor determination for dose measurements in axial and perpendicular planes using a silicon strip detector

    Science.gov (United States)

    Abou-Haïdar, Z.; Bocci, A.; Alvarez, M. A. G.; Espino, J. M.; Gallardo, M. I.; Cortés-Giraldo, M. A.; Ovejero, M. C.; Quesada, J. M.; Arráns, R.; Prieto, M. Ruiz; Vega-Leal, A. Pérez; Nieto, F. J. Pérez

    2012-04-01

    In this work we present the output factor measurements of a clinical linear accelerator using a silicon strip detector coupled to a new system for complex radiation therapy treatment verification. The objective of these measurements is to validate the system we built for treatment verification. The measurements were performed at the Virgin Macarena University Hospital in Seville. Irradiations were carried out with a Siemens ONCOR™ linac used to deliver radiotherapy treatment for cancer patients. The linac was operating in 6 MV photon mode; the different sizes of the fields were defined with the collimation system provided within the accelerator head. The output factor was measured with the silicon strip detector in two different layouts using two phantoms. In the first, the active area of the detector was placed perpendicular to the beam axis. In the second, the innovation consisted of a cylindrical phantom where the detector was placed in an axial plane with respect to the beam. The measured data were compared with data given by a commercial treatment planning system. Results were shown to be in a very good agreement between the compared set of data.

  9. In vivo measurement of Pu dissolution parameters of MOX aerosols and related uncertainties in the values of the dose per unit intake.

    Science.gov (United States)

    Ramounet-Le Gall, B; Rateau, G; Abram, M C; Grillon, G; Ansoborlo, E; Bérard, P; Delforge, J; Fritsch, P

    2003-01-01

    The aim of this study was to compare dissolution parameter values for Pu from industrial MOX with different Pu contents. For this purpose, preliminary results obtained after inhalation exposure of rats to MOX containing 2.5% Pu are reported and compared to those obtained previously with MOX containing 5% Pu. Dissolution parameter values appear to increase when the amount of Pu decreases. Rapid fractions, f(r), of 4 x 10(-3) (s.d. = 2 x 10(-3)) and 1 x 10(-3) (s.d. = 6 x 10(-4)) and slow dissolution rates, s(s) of 2 x 10(-4) d(-1) (standard deviation, sigma = 5 x 10(-5)) and 5 x 10(-5) d(-1) (sigma = 1 x 10(-5)) were derived for MOX containing 2.5 and 5% of Pu, respectively. Simulations were performed to assess uncertainties on dose due to experimental errors. The relative standard deviations of the dose per unit intake (DPUI) due to f(r) (4-8%), are far less than those due to s(s) (about 20%), which is the main parameter altering the dose. Although quite different dissolution parameter values were derived, similar DPUIs were obtained for MOX aerosols containing 2.5 and 5% Pu which appear close to that for default Type S values.

  10. Factors related to obesity and overweight among Black adolescent girls in the United States.

    Science.gov (United States)

    Winkler, Megan R; Bennett, Gary G; Brandon, Debra H

    2017-02-01

    In the United States, Black adolescents have the highest prevalence of pediatric obesity and overweight among girls. While Black girls are disproportionately affected, the reasons for this health disparity remain unclear. The authors conducted a systematic review to investigate the factors related to obesity and overweight among Black adolescent girls. The authors searched four databases for relevant English-language publications using all publication years through 2015. Fifty-one studies met the inclusion criteria and were used for this review. Using a configuration approach to synthesis, three categories were identified, paralleling the bioecological theory of human development: (1) individual, (2) interpersonal, and (3) community and societal factors. A description of each factor's association with obesity among Black adolescent girls is presented. From this review, the authors identified a diverse and vast set of individual, interpersonal, and community and societal factors explored for their relationship with obesity and overweight. Given the insufficient repetition and limited significant findings among most factors, the authors believe that multiple gaps in knowledge exist across all categories regarding the factors related to obesity and overweight among Black adolescent girls. To improve the quality of research in this area, suggested research directions and methodological recommendations are provided.

  11. Low back pain and work-related factors among nurses in intensive care units.

    Science.gov (United States)

    June, Kyung Ja; Cho, Sung-Hyun

    2011-02-01

    To examine the relationship of low back pain prevalence and treatment to personal and work-related characteristics among intensive care unit nurses. Back pain is the most common work-related health problem among nurses. A cross-sectional study including a survey conducted in 2007. The study sample included 1345 nurses in 65 intensive care units in 22 South Korean hospitals. Back pain prevalence was measured by the frequency of back pain (always, once a week, once a month or once in two or more months) during the past year. Multilevel logistic regression analyses were conducted to examine the relationship between back pain and personal and work-related characteristics. The mean age of nurses was 27.2 years. Overall, 90.3% of nurses had back pain at least once a month (21.9% always, 40.7% once a week and 27.7% once a month). Only 18.3% had received medical treatment for their back pain. Compared with neonatal intensive care unit nurses, who had the lowest prevalence, nurses in other specialties, excluding paediatric intensive care units, had a greater likelihood of back pain. Specialty medical (e.g. cardiology, neurology) intensive care unit nurses had the greatest probability of back pain and treatment. Perceiving staffing as inadequate and working 6 or more night shifts per month were related to a 64% increase (OR = 1.64; 95% CI =1.16-2.33) and 48% increase (OR =1.48; 95% CI = 1.10-1.99) in back pain, respectively. Nurses with 2-4 years of working experience in intensive care units had the greatest probability of back pain and treatment. A high prevalence of back pain was found in intensive care unit nurses, even though they comprise a very young workforce in Korea. Improving nurse staffing, reducing the frequency of night shifts and assessing risk factors in specific intensive care unit specialties are suggested to decrease back pain prevalence. © 2010 The Authors. Journal compilation © 2010 Blackwell Publishing Ltd.

  12. OPTIMAL SIZING OF DG UNITS USING EXACT LOSS FORMULA AT OPTIMAL POWER FACTOR

    Directory of Open Access Journals (Sweden)

    P.Sobha Rani

    2012-09-01

    Full Text Available Distributed generators are beneficial in reducing the losses effectively compared to other methods of loss reduction. The challenge of identifying the optimal locations and sizes of DG has generated research interests all over the world and many efforts have been made in this direction. Studies have indicated that inappropriatelocations and sizes of DG may lead to higher system losses than the ones in the existing network. In this paper IEEE 33-bus system is selected for locating and sizing of optimal distributed generation source. The DG unit size is calculated using exact loss formula. With the optimal size of DG unit at a suitable location and at optimalpower factor, it resulted in reduction in power losses and improvement in voltage profile.

  13. Knowledge of carbohydrate counting and insulin dose calculations among hospital staff in a regional general paediatrics unit.

    Science.gov (United States)

    O'Gorman, Jennifer R; O'Leary, Orla; Finner, Natalie; Quinn, Anne; O'Gorman, Clodagh S

    2015-01-01

    The aim of this study was to assess the carbohydrate and insulin knowledge of the staff at Children's Ark at the University Hospital, Limerick. Carbohydrate counting and insulin dose calculations based on carbohydrates and blood sugars are integral to intensive insulin management of type 1 diabetes mellitus (T1DM). The PedCarbQuiz, a validated questionnaire, was modified, and applied to the staff on our general paediatrics ward. 48/70 eligible staff responded (rate 68 %). Overall knowledge was good: 75.5 % was the average score for correctly identifying foods containing carbohydrate. However, poor scores were obtained for calculating multiple items and meal values (average score 29 %), and exact values of insulin required (average score 38 %). These results highlight the need for re-education among staff on a general paediatrics ward, to empower ward staff to contribute effectively to the education and management of patients with T1DM.

  14. Effects of Arbutin on Radiation-Induced Micronuclei in Mice Bone Marrow Cells and Its Definite Dose Reduction Factor

    Directory of Open Access Journals (Sweden)

    Saba Nadi

    2016-05-01

    Full Text Available Background: Interactions of free radicals from ionizing radiation with DNA can induce DNA damage and lead to mutagenesis and carsinogenesis. With respect to radiation damage to human, it is important to protect humans from side effects induced by ionizing radiation. In the present study,the effects of arbutin were investigated by using the micronucleus test for anti-clastogenic activity, to calculate the ratio of polychromatic erythrocyte to polychromatic erythrocyte plus normochromatic erythrocyte (PCE/PCE+NCE in order to show cell proliferation activity. Methods: Arbutin (50, 100, and 200 mg/kg was intraperitoneally (ipadministered to NMRI mice two hours before gamma radiation at 2 and 4 gray (Gy. The frequency of micronuclei in 1000 PCEs (MnPCEs and the ratio of PCE/PCE+NCE were calculated for each sample. Data were statistically evaluated using one-way ANOVA,Tukey HSD test, and t-test. Results: The findings indicated that gamma radiation at 2 and 4 Gy extremely increased the frequencies of MnPCE (P<0.001 while reducing PCE/PCE+NCE (P<0.001 compared to the control group. All three doses of arbutin before irradiation significantly reduced the frequencies of MnPCEs and increased the ratio of PCE/PCE+NCE in mice bone marrow compared to the non-drug-treated irradiated control (P<0.001. All three doses of arbutin had no toxicity effect on bone marrow cells. The calculated dose reduction factor (DRF showed DRF=1.93 for 2Gy and DRF=2.22 for 4 Gy. Conclusion: Our results demonstrated that arbutin gives significant protection to rat bone against the clastogenic and cytotoxic effects of gamma irradiation.

  15. Influence of photon beam energy on the dose enhancement factor caused by gold and silver nanoparticles: An experimental approach

    Energy Technology Data Exchange (ETDEWEB)

    Guidelli, Eder José, E-mail: ederguidelli@pg.ffclrp.usp.br; Baffa, Oswaldo [Departamento de Física, Faculdade de Filosofia, Ciências e Letras de Ribeirão Preto, Universidade de São Paulo, Av. Bandeirantes, 3900, 14040-901 Ribeirão Preto, SP (Brazil)

    2014-03-15

    Purpose: Noble metal nanoparticles have found several medical applications in the areas of radiation detection; x-ray contrast agents and cancer radiation therapy. Based on computational methods, many papers have reported the nanoparticle effect on the dose deposition in the surrounding medium. Here the authors report experimental results on how silver and gold nanoparticles affect the dose deposition in alanine dosimeters containing several concentrations of silver and gold nanoparticles, for five different beam energies, using electron spin resonance spectroscopy (ESR). Methods: The authors produced alanine dosimeters containing several mass percentage of silver and gold nanoparticles. Nanoparticle sizes were measured by dynamic light scattering and by transmission electron microscopy. The authors determined the dose enhancement factor (DEF) theoretically, using a widely accepted method, and experimentally, using ESR spectroscopy. Results: The DEF is governed by nanoparticle concentration, size, and position in the alanine matrix. Samples containing gold nanoparticles afford a DEF higher than 1.0, because gold nanoparticle size is homogeneous for all gold concentrations utilized. For samples containing silver particles, the silver mass percentage governs the nanoparticles size, which, in turns, modifies nanoparticle position in the alanine dosimeters. In this sense, DEF decreases for dosimeters containing large and segregated particles. The influence of nanoparticle size-position is more noticeable for dosimeters irradiated with higher beam energies, and dosimeters containing large and segregated particles become less sensitive than pure alanine (DEF < 1). Conclusions: ESR dosimetry gives the DEF in a medium containing metal nanoparticles, although particle concentration, size, and position are closely related in the system. Because this is also the case as in many real systems of materials containing inorganic nanoparticles, ESR is a valuable tool for

  16. The predictive factors of α1-D/A adrenoceptor antagonist, naftopidil, dose increase therapy for male lower urinary tract symptoms caused by benign prostatic hyperplasia: INFORM study.

    Science.gov (United States)

    Tanuma, Yasushi; Tanaka, Yoshinori; Takeyama, Ko; Okamoto, Tomoshi

    2017-01-01

    We evaluated the predictive factors which affect the efficacy of naftopidil 50 mg/day therapy and dose increase therapy to administration of 75 mg/day after an initial dose of 50 mg/day. A total of 92 patients with male lower urinary tract symptoms/benign prostatic hyperplasia were administrated naftopidil 50 mg/day for 4 weeks (50 mg therapy). At week 4, the patients were divided into an effective and an ineffective group (Group E and Group I, respectively). For further 4 weeks, the dosage of naftopidil was increased to 75 mg/day in all patients. At week 8, the patients of Group E and Group I were divided into an effective and an ineffective group (Group EE, Group EI, Group IE, and Group II, respectively). Postvoid residual (PVR) urine volume at baseline was a predictive factor for efficacy of 50 mg therapy. In Group E, change in International Prostate Symptom Score storage symptoms subscore from baseline to week 4 was a predictive factor for efficacy of this dose increase therapy. In Group I, change in maximum flow rate from baseline to week 4 was a predictive factor for efficacy of this dose increase therapy. The short term of naftopidil 50 mg therapy was ineffective for the patients who had large PVR. The predictive factor of this dose increase therapy might be a dynamic variable in 50 mg/day of dose period, but not a baseline variable at the time of 75 mg/day dosage starts.

  17. Factors associated with the process of adaptation among Pakistani adolescent females living in United States.

    Science.gov (United States)

    Khuwaja, Salma A; Selwyn, Beatrice J; Mgbere, Osaro; Khuwaja, Alam; Kapadia, Asha; McCurdy, Sheryl; Hsu, Chiehwen E

    2013-04-01

    This study explored post-migration experiences of recently migrated Pakistani Muslim adolescent females residing in the United States. In-depth, semi-structured interviews were conducted with thirty Pakistani Muslim adolescent females between the ages of 15 and 18 years living with their families in Houston, Texas. Data obtained from the interviews were evaluated using discourse analysis to identify major reoccurring themes. Participants discussed factors associated with the process of adaptation to the American culture. The results revealed that the main factors associated with adaptation process included positive motivation for migration, family bonding, social support networks, inter-familial communication, aspiration of adolescents to learn other cultures, availability of English-as-second-language programs, participation in community rebuilding activities, and faith practices, English proficiency, peer pressure, and inter-generational conflicts. This study provided much needed information on factors associated with adaptation process of Pakistani Muslim adolescent females in the United States. The results have important implications for improving the adaptation process of this group and offer potential directions for intervention and counseling services.

  18. Comparative Study of Effective Factors on Students’ Interests in Fashion at Islamic Azad University Arak Unit and South Tehran Unit Academic Year 2010-2011

    OpenAIRE

    Tahmineh Zareei

    2013-01-01

    This paper intends to provide a comparative study of effective factors on students’ interests in fashion at Faculty of Human Sciences – Islamic Azad University – Arak unit and also Islamic Azad University- South Tehran Unit through academic year 2010- 2011. According to the findings, it is obvious that fashion and any interests in fashion changed into a great social problem among university students. This paper used any thoughts of different specialists including Siemel and Veblen as the high...

  19. Routine Multimodal Antiemesis Including Low-Dose Perphenazine in an Ambulatory Surgery Unit of a University Hospital: A 10-Year History

    Directory of Open Access Journals (Sweden)

    Brian A. Williams

    2007-01-01

    Full Text Available For 10 years, we have used intravenous and oral perphenazine as part of a multimodal antiemetic prophylaxis care plan for at least 10,000 outpatients. We have never encountered an adverse event, to our knowledge, when the intravenous dose was less than or equal to 2 mg, or when the single preoperative oral dose did not exceed 8 mg (with no repeated dosing. As a single-dose component of multimodal antiemetic prophylaxis therapy, we believe that this track record of anecdotal safety in adults who meet certain criteria (age 14–70, no less than 45 kg, no history of extrapyramidal reactions or of Parkinson disease, and no Class III antidysrhythmic coadministered for coexisting disease constitutes a sufficient patient safety basis for formal prospective study. We believe that future perphenazine studies should include routine coadministration with prospectively established multimodal antiemetics (i.e., dexamethasone and a 5-HT3 antagonist. In settings where droperidol is still routinely used and deemed acceptable by local scientific ethics committees, we believe that oral perphenazine 8 mg should be compared head to head with droperidol 0.625–1.25 mg in patients receiving coadministered dexamethasone and 5-HT3 antagonists in order to determine differences in synergistic efficacy, if any. Similar trials should be performed, individually evaluating cyclizine, transdermal scopolamine, and aprepitant in combination with coadministered dexamethasone and a 5-HT3 antagonist. Such studies should also quantify efficacy in preventing nausea and vomiting after discharge home, and also quantify the extent to which the prophylaxis plans reduce postanesthesia care unit (PACU requirements (i.e., increase PACU bypass, reduce the need for any nursing interventions for postoperative nausea and/or vomiting (PONV, and influence the extent to which any variable costs of postoperative nursing care are reduced.

  20. Perinatal risk factors and neonatal complications in discordant twins admitted to the neonatal intensive care unit

    Institute of Scientific and Technical Information of China (English)

    ZHANG Xiao-rui; LIU Jie; ZENG Chao-mei

    2013-01-01

    Background Many studies have shown a relationship between birth weight discordance and adverse perinatal outcomes.This study aimed to investigate the perinatal risk factors and neonatal complications of discordant twins who are admitted to the neonatal intensive care unit.Methods A total of 87 sets of twins were enrolled in this retrospective study,of which 22 sets were discordant twins and 65 sets were concordant twins.Binary Logistic regression analysis was used to identify the risk factors associated with the occurrence of discordant twins.The common neonatal complications of discordant twins were also investigated.Results Multivariate analysis showed that the use of assisted reproductive techniques,pregnancy-induced hypertension,and unequal placental sharing were risk factors for the occurrence of discordant twins.The incidence of small for gestational age infants and very low birth weight infants of discordant twins was significantly higher,while the birth weight of discordant twins was significantly lower than those of concordant twins.The duration of hospitalization of discordant twins was longer than that of concordant twins.The incidence of several neonatal complications,such as neonatal respiratory distress syndrome and intracranial hemorrhage,was higher in discordant twins than that in concordant twins.The percentage of those requiring pulmonary surfactant and mechanical ventilation was significantly higher in discordant twins than that in concordant twins.Conclusions Use of assisted reproductive techniques,pregnancy-induced hypertension,and unequal placental sharing are perinatal risk factors of discordant twins who are admitted to the neonatal intensive care unit.These infants are also much more likely to suffer from various neonatal complications,especially respiratory and central nervous system diseases.It is important to prevent the occurrence of discordant twins by decreasing these risk factors and timely treatment should be given to discordant

  1. Serum levels of brain-derived neurotrophic factor in alcohol-dependent patients receiving high-dose baclofen.

    Science.gov (United States)

    Geisel, Olga; Hellweg, Rainer; Müller, Christian A

    2016-06-30

    The neurotrophin brain-derived neurotrophic factor (BDNF) has been suggested to be involved in the development and maintenance of addictive and other psychiatric disorders. Also, interactions of γ-aminobutyric acid (GABA)-ergic compounds and BDNF have been reported. The objective of this study was to investigate serum levels of BDNF over time in alcohol-dependent patients receiving individually titrated high-dose treatment (30-270mg/d) with the GABA-B receptor agonist baclofen or placebo for up to 20 weeks. Serum levels of BDNF were measured in patients of the baclofen/placebo group at baseline (t0), 2 weeks after reaching individual high-dose of baclofen/placebo treatment (t1) and after termination of study medication (t2) in comparison to carefully matched healthy controls. No significant differences in serum levels of BDNF between the baclofen and the placebo group or healthy controls were found at t0, t1, or at t2. Based on these findings, it seems unlikely that baclofen exerts a direct effect on serum levels of BDNF in alcohol-dependent patients. Future studies are needed to further explore the mechanism of action of baclofen and its possible relationship to BDNF in alcohol use disorders.

  2. Measurement and analysis of the field dose using cobalt-60 therapy unit%钴-60治疗机射野剂量的测量分析

    Institute of Scientific and Technical Information of China (English)

    苗利; 李新民

    2012-01-01

    目的 通过测量钻-60治疗机在射野内的输出剂量率及其分布,获得当前剂量率的大小,并分析剂量分布的均匀性包括射野平坦度和对称性,以此来指导临床肿瘤放射治疗和放射医学实验.方法 用指形电离室剂量计在源皮距80 cm处对20 cm×20 cm射野Cross-Plane和In-Plane方向取点测量,通过数据分析来评估钴-60治疗机的剂量率和射野内剂量的均匀性.结果 得到5个方形野内当前的平均剂量率,可提供给使用者作为参考数据.钴-60治疗机的平坦度与对称性标准要求偏差±3%以内,分析结果基本符合.结论 该钴-60治疗机的射野剂量分布较均匀,对肿瘤治疗或者放射医学实验的影响较小.%Objective Measuring the field dose rate of cobalt-60 therapy unit to obtain the current dose rate and analyse the uniformity, including flatness and symmetry, of the dose distribution. Then the data can be used as guidance in tumor radiation therapy and radiation medical experiment. Methods U-sing thimble chamber to measure dose rate of radiation field(20 cm ×20 cm) at 80cm of source skin distance, including Cross-Plane and In-Plane direction, and analyse the flatness and symmetry. Results Five current mean dose rates of five square fields were obtained as user' s reference data. According to the tolerant deviation ( ±3% ) , the analysis results showed that the deviation accorded with the criterion basically. Conclusion It can be thought that,the dose distribution of radiation field is uniform. It has little influence on tumor therapy or radiation medical experiment.

  3. Factors associated with Anaplasma spp. seroprevalence among dogs in the United States.

    Science.gov (United States)

    McMahan, Christopher S; Wang, Dongmei; Beall, Melissa J; Bowman, Dwight D; Little, Susan E; Pithua, Patrick O; Sharp, Julia L; Stich, Roger W; Yabsley, Michael J; Lund, Robert B

    2016-03-22

    Dogs in the United States are hosts to a diverse range of ticks and tick-borne pathogens, including A. phagocytophilum, an important emerging canine and human pathogen. Previously, a Companion Animal Parasite Council (CAPC)-sponsored workshop proposed factors purported to be associated with the infection risk for tick-transmitted pathogens in dogs in the United States, including climate conditions, socioeconomic characteristics, local topography, and vector distribution. Approximately four million test results from routine veterinary diagnostic tests from 2011-2013, which were collected on a county level across the contiguous United States, are statistically analyzed with the proposed factors via logistic regression and generalized estimating equations. Spatial prevalence maps of baseline Anaplasma spp. prevalence are constructed from Kriging and head-banging smoothing methods. All of the examined factors, with the exception of surface water coverage, were significantly associated with Anaplasma spp. prevalence. Overall, Anaplasma spp. prevalence increases with increasing precipitation and forestation coverage and decreases with increasing temperature, population density, relative humidity, and elevation. Interestingly, socioeconomic status and deer/vehicle collisions were positively and negatively correlated with canine Anaplasma seroprevalence, respectively. A spatial map of the canine Anaplasma hazard is an auxiliary product of the analysis. Anaplasma spp. prevalence is highest in New England and the Upper Midwest. The results from the two posited statistical models (one that contains an endemic areas assumption and one that does not) are in general agreement, with the major difference being that the endemic areas model estimates a larger prevalence in Western Texas, New Mexico, and Colorado. As A. phagocytophilum is zoonotic, the results of this analysis could also help predict areas of high risk for human exposure to this pathogen.

  4. Mitochondrial protection by low doses of insulin-like growth factor- Ⅰ in experimental cirrhosis

    Institute of Scientific and Technical Information of China (English)

    Raquel Pérez; María García-Fernández; Matías Díaz-Sánchez; Juan E Puche; Gloria Delgado; Marian Conchillo; Jordi Muntané; Inma Castilla-Cortázar

    2008-01-01

    AIM:To characterize the mitochondrial dysfunction in experimental cirrhosis and to study whether insulin-like growth factor- I (IGF-I) therapy (4 wk) is able to in-duce beneficial effects on damaged mitochondria leading to cellular protection.METHODS:Wistar rats were divided into three groups:Control group,untreated cirrhotic rats and cirrhotic rats treated with IGF-I treatment (2 μg/100 g bw/d).Mitochondrial function was analyzed by flow cytometry in isolated hepatic mitochondria,caspase 3 activation was assessed by Western blot and apoptosis by TUNEL in the three experimental groups.RESULTS:Untreated cirrhotic rats showed a mitochondrial dysfunction characterized by a significant reduction of mitochondrial membrane potential (in status 4 and 3);an increase of intramitochondrial reactive oxigen species (ROS) generation and a significant reduction of ATPase activity.IGF-Ⅰ therapy normalized mitochondrial function by increasing the membrane potential and ATPase activity and reducing the intramitochondrial free radical production.Activity of the electron transport complexes Ⅰ and Ⅲ was increased in both cirrhotic groups.In addition,untreated cirrhotic rats showed an increase of caspase 3 activation and apoptosis.IGF- Ⅰ therapy reduced the expression of the active peptide of caspase 3 and resulted in reduced apoptosis.CONCLUSION:These results show that IGF- Ⅰ exerts a mitochondrial protection in experimental cirrhosis leading to reduced apoptosis and increased ATP production.

  5. Treatment of early arthritis using arthrofoon (ultra-low doses of antibodies to tumor necrosis factor

    Directory of Open Access Journals (Sweden)

    Lyudmila V Sizova

    2011-01-01

    Full Text Available The main aim of treatment of early rheumatoid arthritis (RA should be to achieve clinical remission to prevent structural damage and physical disability. Arthrofoon modifies production/activity of endogenous inhibitors of tumor necrosis factor-α (TNF-α. The sublingual rout is the most acceptable to ambulatory treatment because it does not produce the adverse reactions associated with intravenous therapy. The treatment with arthrofoon in outpatient with early RA is analyzed here. This report is devoted to the 28-year-old Russian woman who received arthrofoon due to suspicion of early RA. The strategy of early prescription of ultra-low doses of TNF-α antibody within two years was confirmed by the clinical improvement and delay of radiological disease progression in patient with undifferentiated arthritis or probable RA initially.

  6. Removal of Pathogens by Membrane Bioreactors: A Review of the Mechanisms, Influencing Factors and Reduction in Chemical Disinfectant Dosing

    Directory of Open Access Journals (Sweden)

    Faisal I. Hai

    2014-11-01

    Full Text Available The continued depletion of fresh drinking water resources throughout the world has increased the need for a variety of water treatment and recycling strategies. Conventional wastewater treatment processes rely on extensive chemical post-disinfection to comply with the stringent microbiological safety for water reuse. When well designed and operated, membrane bioreactors (MBRs can consistently achieve efficient removals of suspended solids, protozoa and coliform bacteria. Under optimal conditions, MBR systems can also significantly remove various viruses and phages. This paper provides an in-depth overview of the mechanisms and influencing factors of pathogen removal by MBR and highlights practical issues, such as reduced chemical disinfectant dosing requirements and associated economic and environmental benefits. Special attention has been paid to the aspects, such as membrane cleaning, membrane imperfections/breach and microbial regrowth, in the distribution system on the overall pathogen removal performance of MBR.

  7. Stress, coping and burnout among Intensive Care Unit nursing staff: associated factors.

    Science.gov (United States)

    Andolhe, Rafaela; Barbosa, Ricardo Luis; Oliveira, Elaine Machado de; Costa, Ana Lúcia Siqueira; Padilha, Katia Grillo

    2015-02-01

    Objective To investigate emotional stress, coping and burnout among nursing staff and their association with biosocial factors and characteristics of work in Intensive Care Units (ICU). Method This was a cross-sectional study, conducted in eight ICUs at a teaching hospital in the city of São Paulo, Brazil, in October 2012. Biosocial data and information about the professionals' work was gathered, and they were given the Scale of Occupational Stress, Scale of Occupational Coping, List of Signs and Symptoms of Stress and the Maslach Burnout Inventory. Results The study sample consisted of 287 subjects, predominately women, with partners and children. Most professionals presented moderate stress levels and control as a coping strategy (74.47% and 79.93%, respectively), and burnout was present among 12.54%. Factors associated with stress were related to working conditions. The most prevalent protective factors were having a partner, working in the clinical ICU and liking work, while adequate amount of sleep was a protective factor for burnout. Conclusion Control of the working environment and adequate sleep are decisive and protective factors in dealing with situations of occupational stress.

  8. External dose-rate conversion factors of radionuclides for air submersion, ground surface contamination and water immersion based on the new ICRP dosimetric setting.

    Science.gov (United States)

    Yoo, Song Jae; Jang, Han-Ki; Lee, Jai-Ki; Noh, Siwan; Cho, Gyuseong

    2013-01-01

    For the assessment of external doses due to contaminated environment, the dose-rate conversion factors (DCFs) prescribed in Federal Guidance Report 12 (FGR 12) and FGR 13 have been widely used. Recently, there were significant changes in dosimetric models and parameters, which include the use of the Reference Male and Female Phantoms and the revised tissue weighting factors, as well as the updated decay data of radionuclides. In this study, the DCFs for effective and equivalent doses were calculated for three exposure settings: skyshine, groundshine and water immersion. Doses to the Reference Phantoms were calculated by Monte Carlo simulations with the MCNPX 2.7.0 radiation transport code for 26 mono-energy photons between 0.01 and 10 MeV. The transport calculations were performed for the source volume within the cut-off distances practically contributing to the dose rates, which were determined by a simplified calculation model. For small tissues for which the reduction of variances are difficult, the equivalent dose ratios to a larger tissue (with lower statistical errors) nearby were employed to make the calculation efficient. Empirical response functions relating photon energies, and the organ equivalent doses or the effective doses were then derived by the use of cubic-spline fitting of the resulting doses for 26 energy points. The DCFs for all radionuclides considered important were evaluated by combining the photon emission data of the radionuclide and the empirical response functions. Finally, contributions of accompanied beta particles to the skin equivalent doses and the effective doses were calculated separately and added to the DCFs. For radionuclides considered in this study, the new DCFs for the three exposure settings were within ±10 % when compared with DCFs in FGR 13.

  9. Dose optimization for different medical imaging tasks from exposure index, exposure control factor, and MAS in digital radiography.

    Science.gov (United States)

    Zhang, Menglong; Zhao, Bin; Wang, Yaying; Chen, Weixia; Hou, Lixia

    2012-09-01

    In radiographic examination, not all medical imaging tasks require the same level of image quality or diagnostic information. Criteria should be established for different imaging tasks to avoid excessive doses where there is no clear net benefit in the diagnosis or the image quality. An exposure index provided by manufacturers would be a useful tool for this purpose. This study aims to establish an optimum exposure index to be used as a guideline for clinical imaging tasks to minimize radiation exposure for chest digital radiography. A three-level classification of image quality (high, medium, and low) for chest imaging tasks was carried out. An anthropomorphic phantom was employed to establish minimum exposure index and exposure (mAs) for clinical imaging task type I (corresponding to high image quality). The exposures of medium and low quality images derived from it. Thirty patients were exposed consecutively with these optimized exposure factors, and clinical tasks were considered, while another 30 patients were exposed with the exposure factors routinely used in practice. Image quality was assessed objectively by a consensus panel. The optimized exposure provided a significant reduction of the mean exposure index from 1,556 to 1,207 (p < 0.0001) and mean patient's entrance surface dose from 0.168 mGy to 0.092 mGy (p < 0.0001). The results show that a clinical-task-determined radiographic procedure is more conducive to radiation protection of patients. In this study, the posteroanterior chest imaging examination was chosen as an example. This procedure can also apply to other body parts and views.

  10. Rethinking the Concepts of Fluence (UV Dose) and Fluence Rate: The Importance of Photon-based Units - A Systemic Review.

    Science.gov (United States)

    Bolton, James R; Mayor-Smith, Ian; Linden, Karl G

    2015-11-01

    After a critical review of the fundamental equations describing photobiological and photochemical processes occurring in a medium exposed to a quasi-collimated monochromatic UV light beam, the analysis in this review is extended to analogous processes driven by polychromatic UV light, such as that emitted by medium pressure mercury-vapor arc lamps. The analysis is based on the Second Law of Photochemistry, namely that all photochemical events must be independent, and the rate of such events must be proportional to the rate of photon absorption. A consistent application of the Second Law of Photochemistry leads to a concept change; hence it is proposed herein to use photon fluence and photon fluence rate, rather than fluence (UV dose) and fluence rate, respectively, in the analysis and interpretation of photobiological and photochemical processes. As a consequence, many equations that have been used in the past must be revised, and some experimental information (e.g. action spectra) needs to be re-analyzed. © 2015 The American Society of Photobiology.

  11. PROGNOSTIC FACTORS FOR PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMAS TREATED WITH HIGH-DOSE METHOTREXATE-BASED CHEMO-RADIOTHERAPY

    Science.gov (United States)

    Nagane, Motoo; Lee, Jeunghun; Shishido-Hara, Yukiko; Suzuki, Kaori; Shimizu, Saki; Umino, Michiru; Kobayashi, Keiichi; Shiokawa, Yoshiaki

    2014-01-01

    BACKGROUND: Chemotherapy with high-dose methotrexate (HD-MTX) followed by whole brain radiotherapy (WBRT) is a conventional approach to treat primary central nervous system lymphomas (PCNSL), but some tumors relapse early leading to unfavorable outcome. Several biomarkers have been identified as prognostic factors in PCNSL, however, the correlation of both clinical factors including those related to MTX metabolism and B-cell differentiation and oncogenic biomarkers with response to and outcome by therapy is yet unclear. METHODS: We investigated 32 immunocompetent patients (19 males, 13 females) with PCNSL (all diffuse large B-cell type) treated with HD-MTX based therapy with or without WBRT since 2000 in our institution. Paraffin-embedded formalin-fixed tumor tissue sections were stained immunohistochemically with antibodies against following factors: B-cell differentiation markers (CD10, Bcl-6, Mum-1, CD138); MTX metabolism-related (MRP family, LRP, DHFR); cell cycle-related (p27KIP1, MIB-1); drug resistance-related (MGMT, MLH1, MSH2, MSH6, PMS2); and oncogenes (Myc, Bcl-2). Correlation between positivity of these factors and clinical outcomes were evaluated using logrank test and cox regression analysis. RESULTS: Among these factors, complete response to HD-MTX was significantly associated with longer progression-free survival (PFS)(P = 0.0012), while Bcl-6 expression as well as histological subtype (non-germinal center B-cell, non-GCB) was closely correlated with shorter PFS. Age (>60) (P = 0.006) and MSH2 expression (P = 0.017) were found to be better predictor for overall survival (OS), but in multivariate analysis, they were no longer significant. Other factors involved in MTX metabolism, DNA repair enzymes, and oncogenes did not affect outcome. CONCLUSIONS: Non-GCB subtype and Bcl-6 expression may be associated with worse outcome in patients with PCNSL treated with HD-MTX, while MTX-metabolism related factors did not influence prognosis. Further

  12. [The profile of fragility and associated factors among the elderly registered in a Family Health Unit].

    Science.gov (United States)

    Santos, Patrícia Honório Silva; Fernandes, Marcos Henrique; Casotti, Cezar Augusto; Coqueiro, Raildo da Silva; Carneiro, José Ailton Oliveira

    2015-06-01

    The scope of this study was to identify the profile of fragility and associated factors among the elderly registered in a Family Health Unit. It involved an observational, exploratory, household -based and cross-sectional study conducted with 139 elderly individuals. The data were collected using a structured questionnaire requesting the following information: personal history, family and self-reported diseases, socio-demographic information, level of physical activity, behavior variables, number of falls in the last year, depressive symptoms, unintentional weight loss and fatigue. Anthropometric measurements (weight and height) were also taken and the body mass index (BMI) was calculated. Descriptive analyses and Pearson's chi-square test or Fisher's exact test were performed, with a significance level of p fragility among the elderly was: frail (16.9%), pre-frail (61.8%) and non-frail (21.3%), respectively. The fragility profile was associated with: age (p factors associated with this syndrome.

  13. Economic benefits of using a dose dispensing system at hospital units of the Mexican Institute of Social Security.

    Directory of Open Access Journals (Sweden)

    Rocío Ofelia-Uc Coyoc

    2014-05-01

    Full Text Available Objective. To estimate the potential economic benefits at The Mexican Institute of Social Security (IMSS per its abbreviation in spanish according to the drug expenditure of using drug dispensing system, based on literature information. Materials and methods. A systematic review was performed to identify savings from drugs and reduction of medication errors. The total and mean health expenditure by level of medical attention was calculated using the dispensed collective prescriptions at IMSS during 2009. Three savings scenarios were applied. Results. The total drug savings were in a range of 870.49 Mexican million pesos to 4050.05 Mexican million pesos. Reductions of medication errors can contribute with additional savings up to 3455.56 Mexican million pesos. Conclusion. The drug dispensing system unit generates savings opportunities at the second and third level of attention. The maximum economic benefit was observed in the last level.

  14. What factors predict length of stay in a neonatal unit: a systematic review

    Science.gov (United States)

    Seaton, Sarah E; Barker, Lisa; Jenkins, David; Draper, Elizabeth S; Abrams, Keith R; Manktelow, Bradley N

    2016-01-01

    Objective In the UK, 1 in 10 babies require specialist neonatal care. This care can last from hours to months depending on the need of the baby. The increasing survival of very preterm babies has increased neonatal care resource use. Evidence from multiple studies is crucial to identify factors which may be important for predicting length of stay (LOS). The ability to predict LOS is vital for resource planning, decision-making and parent counselling. The objective of this review was to identify which factors are important to consider when predicting LOS in the neonatal unit. Design A systematic review was undertaken which searched MEDLINE, EMBASE and Scopus for papers from 1994 to 2016 (May) for research investigating prediction of neonatal LOS. Strict inclusion and exclusion criteria were applied. Quality of each study was discussed, but not used as a reason for exclusion from the review. Main outcome measure Prediction of LOS in the neonatal unit. Results 9 studies were identified which investigated the prediction of neonatal LOS indicating a lack of evidence in the area. Inherent factors, particularly birth weight, sex and gestational age allow for a simple and objective prediction of LOS, which can be calculated on the first day of life. However, other early occurring factors may well also be important and estimates may need revising throughout the baby's stay in hospital. Conclusions Predicting LOS is vital to aid the commissioning of services and to help clinicians in their counselling of parents. The lack of evidence in this area indicates a need for larger studies to investigate methods of accurately predicting LOS. PMID:27797978

  15. The influence of united psychosomatic factors on clinical features of acne vulgaris

    Directory of Open Access Journals (Sweden)

    Dejanović Lidija

    2014-01-01

    Full Text Available Acne is a chronic inflammatory disorder of the pilosebaceal unit. Dermatological disorders are often associated with a variety of psychological problems which the patient have. Psichodermatologic disorders (acne are associated with skin problems that are not directly connected to the mind, but that react to emotional states, such as stress. The aim of this article is to show if there is any psychological characteristic which are common for the whole group of ill-patients from acne, as well as whether there is correlation between any type of acne and psychological parameters. Own exploration consist at thirty patients with three clinical type of acne. Personality test-Kornel index were used for identification and diagnostic psychosomatic disorders. The results are: neurastenic parameters, parameters of conversion and parameters of psychopathy in different percent at both sex, and different clinical features. We show correlation united 2-6 psichosomatic disorders in male sex with softly type of acne. In female sex with any type of acne are responsible 7-12 united findings. The association of several psychosomatic factors could possibly be responsible for the onset of acne at any type.

  16. Different school placements following language unit attendance: which factors affect language outcome?

    Science.gov (United States)

    Conti-Ramsden, Gina; Botting, Nicola; Knox, Emma; Simkin, Zoë

    2002-01-01

    The study compared the outcomes of two groups of children who were attending language unit provision at 7 years of age. Of 242 children in the original study, 62 (28%) transferred to mainstream school placements at age 8 years. These children were then closely matched to children still attending language unit provision at this age using measures of non-verbal IQ, expression and comprehension. These two groups of children were compared on outcome at 11 years in the areas of language skill, non-verbal IQ and social behaviour. Teacher/speech-language therapist opinions of placement were also examined as factors affecting outcome. Results show that children who moved to mainstream provision at 8 years were more likely to be attending mainstream at 11 years, although the majority received extra support. No further differences were evident in outcome according to placement type. However, there was a main effect of teacher/therapist opinion on outcome--children whose teachers were not entirely happy with the 8-year placement performed more poorly at 11 years on language measures. There were no differences on any other measures. The findings suggest that follow-on placements for children attending language units need to be more closely in line with teacher's opinions and that more flexibility needs to be evident in school placement policy in order that appropriate educational settings can be arranged.

  17. Risk factors for aminoglycoside-associated nephrotoxicity in surgical intensive care unit patients

    Science.gov (United States)

    Gerlach, Anthony T; Stawicki, Stanislaw P; Cook, Charles H; Murphy, Claire

    2011-01-01

    Background: Aminoglycosides are commonly used antibiotics in the intensive care unit (ICU), but are associated with nephrotoxicity. This study evaluated the development of aminoglycoside-associated nephrotoxicity (AAN) in a single surgical intensive care unit. Materials and Methods: Adult patients in our surgical ICU who received more than two doses of aminoglycosides were retrospectively reviewed for demographics, serum creatinine, receipt of nephrotoxins [angiotensin converting enzyme (ACE) inhibitors, angiotensin-II receptor blockers, diuretics, non-steroidal anti-inflammatory drugs, cyclosporine, tacrolimus, vasopressors, vancomycin and intravenous iodinated contrast] and the need for dialysis. AAN was defined as an increase in serum creatinine >0.5 mg/dL on at least 2 consecutive days. Univariate and multiple regression analyses were performed. Results: Sixty-one patients (43 males) receiving aminoglycoside were evaluated. Mean age, weight, initial serum creatinine, and duration of aminoglycoside therapy were 58.7 (±15) years, 83.3 (±24.4) kg, 0.9 (±0.5) mg/dL, and 4 (±2.3) days, respectively. Thirty-one (51%) aminoglycoside recipients also received additional nephrotoxins. Seven aminoglycoside recipients (11.5%) developed AAN, four of whom required dialysis and all had received additional nephrotoxins. Only concurrent use of vasopressors (P = 0.041) and vancomycin (P = 0.002) were statistically associated with AAN. Receipt of vasopressors or vancomycin were independent predictors of acute kidney insufficiency (AKI) with odds ratios of 19.9 (95% CI: 1.6–245, P = 0.019) and 49.8 (95% CI: 4.1–602, P = 0.002), respectively. Four patients (6.6%) required dialysis. Conclusions: In critically ill surgical patients receiving aminoglycosides, AAN occurred in 11.5% of the patients. Concurrent use of aminoglycosides with other nephrotoxins increased the risk of AAN. PMID:22096769

  18. Psychosocial factors and prevalence of burnout syndrome among nursing workers in intensive care units.

    Science.gov (United States)

    da Silva, Jorge Luiz Lima; Soares, Rafael da Silva; Costa, Felipe dos Santos; Ramos, Danusa de Souza; Lima, Fabiano Bittencourt; Teixeira, Liliane Reis

    2015-01-01

    To evaluate the prevalence of burnout syndrome among nursing workers in intensive care units and establish associations with psychosocial factors. This descriptive study evaluated 130 professionals, including nurses, nursing technicians, and nursing assistants, who performed their activities in intensive care and coronary care units in 2 large hospitals in the city of Rio de Janeiro, Brazil. Data were collected in 2011 using a self-reported questionnaire. The Maslach Burnout Inventory was used to evaluate the burnout syndrome dimensions, and the Self Reporting Questionnaire was used to evaluate common mental disorders. The prevalence of burnout syndrome was 55.3% (n = 72). In the quadrants of the demand-control model, low-strain workers exhibited a prevalence of 64.5% of suspected cases of burnout, whereas high-strain workers exhibited a prevalence of 72.5% of suspected cases (p = 0.006). The prevalence of suspected cases of common mental disorders was 27.7%; of these, 80.6% were associated with burnout syndrome (burnout syndrome. Psychosocial factors were associated with the development of burnout syndrome in this group. These results underscore the need for the development of further studies aimed at intervention and the prevention of the syndrome.

  19. Mosquito vectors of dog heartworm in the United States: vector status and factors influencing transmission efficiency.

    Science.gov (United States)

    Ledesma, Nicholas; Harrington, Laura

    2011-11-01

    Dog heartworm (Dirofilaria immitis) is dependent on mosquito vectors for its maintenance and transmission among vertebrate hosts. Consequently, D. immitis abundance and distribution are closely linked with mosquito vector biology and ecology. Information on the important dog heartworm vectors in the United States is limited and no comprehensive surveillance of dog heartworm in US mosquitoes has been undertaken to date. Here, we review information gleaned from a number of field surveys documenting heartworm presence in wild mosquito populations as well as laboratory assessments of mosquito vector capacity. Various biological and ecological factors likely contribute to the relative importance of different vector species. We describe some of these factors, rank the leading criteria for efficient vectors, and present the most likely vector species found across the United States. Considering the recent emergence of drug resistance among D. immitis strains, practical knowledge of heartworm vector biology and control should be incorporated into heartworm disease management programs. We conclude by proposing that heartworm control would benefit by targeting mosquito vectors, and we suggest ways in which veterinarians can incorporate the recognition of vector importance into heartworm prevention recommendations imparted to clients. Copyright © 2011 Elsevier Inc. All rights reserved.

  20. A macroepigenetic approach to identify factors responsible for the autism epidemic in the United States

    Directory of Open Access Journals (Sweden)

    Dufault Renee

    2012-04-01

    Full Text Available Abstract The number of children ages 6 to 21 in the United States receiving special education services under the autism disability category increased 91% between 2005 to 2010 while the number of children receiving special education services overall declined by 5%. The demand for special education services continues to rise in disability categories associated with pervasive developmental disorders. Neurodevelopment can be adversely impacted when gene expression is altered by dietary transcription factors, such as zinc insufficiency or deficiency, or by exposure to toxic substances found in our environment, such as mercury or organophosphate pesticides. Gene expression patterns differ geographically between populations and within populations. Gene variants of paraoxonase-1 are associated with autism in North America, but not in Italy, indicating regional specificity in gene-environment interactions. In the current review, we utilize a novel macroepigenetic approach to compare variations in diet and toxic substance exposure between these two geographical populations to determine the likely factors responsible for the autism epidemic in the United States.

  1. Individual host factors associated with Onchocerca volvulus microfilarial densities 15, 80 and 180 days after a first dose of ivermectin.

    Science.gov (United States)

    Pion, Sébastien D S; Grout, Lise; Kamgno, Joseph; Nana-Djeunga, Hugues; Boussinesq, Michel

    2011-09-01

    Reduction in Onchocerca volvulus skin microfilarial densities after treatment with ivermectin shows wide between-host variation. Data from two separate studies conducted in Cameroon on onchocerciasis patients treated for the first time with ivermectin were analyzed to identify host factors associated with microfilarial density at different time-points after treatment. In one site (Nkam valley), the dataset included 103 adult males for whom age, number of palpable onchocercal nodules and microfilarial densities on D0 (pre-treatment), D15, D80 and D180 were available. In the other site (Vina valley), analyses were conducted on 965 individuals of both sexes aged 5 years and over; in this dataset, available information included age, gender, exact dose of ivermectin received, onchocerciasis endemicity level in the village of residence and microfilarial densities on D0 and D180. Negative binomial regression models of microfilarial density at the different intervals post-treatment were fitted, using maximum likelihood, with the available independent variables. Gender and age were found to be associated with microfilarial density on D180. The initial microfilarial density influenced post-treatment densities at all the time-points. All other things being equal, microfilarial densities on D180 were higher in individuals harbouring a higher number of nodules or living in communities with high endemicity levels. This study demonstrates that O. volvulus microfilarial density measured after a first treatment with ivermectin, and thus probably the rate of skin repopulation by microfilariae (mf) varies according to several host factors. Should such factors also influence ivermectin efficacy after repeated treatment, then they should be taken into account to determine whether sub-optimal responses to treatment reported from various areas in Africa are actually due to parasite-related factors, particularly to the emergence of resistant populations.

  2. Factors related to building loss due to wildfires in the conterminous United States.

    Science.gov (United States)

    Alexandre, Patricia M; Stewart, Susan I; Keuler, Nicholas S; Clayton, Murray K; Mockrin, Miranda H; Bar-Massada, Avi; Syphard, Alexandra D; Radeloff, Volker C

    2016-10-01

    Wildfire is globally an important ecological disturbance affecting biochemical cycles and vegetation composition, but also puts people and their homes at risk. Suppressing wildfires has detrimental ecological effects and can promote larger and more intense wildfires when fuels accumulate, which increases the threat to buildings in the wildland-urban interface (WUI). Yet, when wildfires occur, typically only a small proportion of the buildings within the fire perimeter are lost, and the question is what determines which buildings burn. Our goal was to examine which factors are related to building loss when a wildfire occurs throughout the United States. We were particularly interested in the relative roles of vegetation, topography, and the spatial arrangement of buildings, and how their respective roles vary among ecoregions. We analyzed all fires that occurred within the conterminous United States from 2000 to 2010 and digitized which buildings were lost and which survived according to Google Earth historical imagery. We modeled the occurrence as well as the percentage of buildings lost within clusters using logistic and linear regression. Overall, variables related to topography and the spatial arrangement of buildings were more frequently present in the best 20 regression models than vegetation-related variables. In other words, specific locations in the landscape have a higher fire risk, and certain development patterns can exacerbate that risk. Fire policies and prevention efforts focused on vegetation management are important, but insufficient to solve current wildfire problems. Furthermore, the factors associated with building loss varied considerably among ecoregions suggesting that fire policy applied uniformly across the United States will not work equally well in all regions and that efforts to adapt communities to wildfires must be regionally tailored.

  3. Occupational Risk Factors and Health Problems Faced by Nurses that Working Dialysis Unit and Nephrology Service

    Directory of Open Access Journals (Sweden)

    Mehtap Curcani

    2009-08-01

    Full Text Available AIM: This study is carried out descriptively with the aim of determining occupational risks the nurses working in dialysis units and nephrology services. METHOD: 47 nurses working in dialysis and nephrology units of the hospitals in Erzurum were included in the study content. In the collection of the data, questionnaire form prepared in the light of literature and including the preventions taken by nurses themselves or their organizations against the professional risks they faced, or personal problems the nurses experienced, professional risk or professional-personal features was used. RESULTS: In the result of the study, it was detected that 48.9% of the nurses was at 28-32 age group, and that 38.3% of the nurses graduated from nursing higher school, and that 72.3% of the nurses worked in dialysis unit. It was found out that while practicing their professions, the nurses expressed that infection risk (97.9%, stress (83%, verbal abuse (80.9%, psychiatric trauma (66%, allergic substance (63.8%, the noise (36.2%, and physical abuse (23.4% were the risk factors they raced in working medium .In the health problem seen in the nurses, in the first row is lumbago. CONCLUSION: In the result of the study, it was found out that while practicing their professions, the nurses expressed that infection risk was the highest rate among the risk factors they raced in working medium and, in the health problem seen in the nurses, in the first row is lumbago and that the nurses and organizations’ attempts which will reduce the risks were not sufficient. [TAF Prev Med Bull 2009; 8(4.000: 339-344

  4. [Cognitive-behavioral specialized units: predictive factors of readmissions within three months].

    Science.gov (United States)

    Baudemont, Céline; Merlet, Isabelle; du Boisgueheneuc, Foucaud; Liuu, Évelyne; Tartarin, Florence; Ragot, Stéphanie; Paccalin, Marc

    2012-09-01

    Behavioral and psychological symptoms of dementia (BPSD) are frequent and belong to the natural evolution of the disease. Specialized cognitive-behavioral units (Unités cognitivo-comportementales) were created, in France (plan Alzheimer 2008-2012), to cope with this problem. Despite a stay in such a unit, some patients have to be rehospitalized. The main aim of the current study was to highlight the predictive factors of readmissions. Descriptive, retrospective study of demented patients ≥75 years, hospitalized between January 2010 and April 2011. We compared patients that had to be rehospitalized within 3 months (group 1), with the patients that did not need to be rehospitalized or after 3 months of time (group 2). Patients characteristics included: basic daily living activities (French GIR score), MMSE score, neuropsychiatric inventory score, type of BPSD, length of stay and antipsychotropic drugs. Two hundred thirty-five patients were included including, 147 women (62.5%), with mean age of 82.74±7.13 years. SPCD was the main reason for hospitalization. Thirty patients (12.77%) belonged to group 1. The mean number of psychotropic treatments increased during the stay (p=0.02), particularly in group 2 (p=0.01). The NPI score decreased during the hospitalization in both groups. Linear regression analysis showed that behavioral type of symptoms (OR: 3.18; 95% CI 1.32-7.65) and association of antidepressant and antipsychotic drugs (OR: 4.77; 95% CI 1.35-16.83) were significantly predictive of an early readmission. The risk of readmission also significantly decreased as the length of stay increased. This work confirms the specificity and the need for such units. The results will help improving the outcome of demented patients with BPSD and treated with different antipsychotropic drugs.

  5. The chicken vitellogenin II gene is flanked by a GATA factor-dependent estrogen response unit.

    Science.gov (United States)

    Davis, D L; Burch, J B

    1996-08-01

    The chicken vitellogenin II (VTGII) gene is flanked by an imperfect estrogen response element (ERE) at -350 and a perfect ERE at -620. In the present study we show that this imperfect ERE lies within an estrogen response unit (ERU) that requires a GATA factor and the estrogen receptor to function as an estrogen-dependent enhancer. We infer that GATA-6 contributes to the estrogen-dependent and liver-specific regulation of the endogenous VTGII gene since this is the predominant GATA factor expressed in adult liver. Our analysis of the VTGII ERU revealed four salient points. First, this ERU is comprised of an ERE and a bank of functionally redundant GATA-binding sites. Second, the GATA-6 transactivation domain is necessary (and sufficient, when tethered near the ERE) to render this ERU functional. Third, ERU enhancer activity is dependent on GATA 6, regardless of whether the resident ERE is imperfect or perfect. Fourth, in contrast to a report that the estrogen receptor antagonizes the activity of another GATA factor (GATA-1), we show that these two factors can function in a synergistic manner within the context of the VTGII ERU.

  6. The Correlation of Age Factor, Administration, and Metformin Dose Against Risk of Side Effect on Type 2 Diabetes Mellitus

    Directory of Open Access Journals (Sweden)

    Magdarita Riwu

    2015-09-01

    Full Text Available Metformin is an antidiabetic oral medicine commonly recommended as first line treatment on type 2 diabetes mellitus. Metformin can caused drug related problems (DRPs such as gastrointestinal disorders, e.g. diarrhea, nausea, and flatulence. This study aimed to analyze correlation profiles on age, administration, and metformin dosage factors against risk of gastrointestinal disorders among newly diagnosed diabetic outpatients of National Health Insurance in RSAU Dr. M. Salamun Bandung. This study was an analytic observational study with a cross sectional method. The study was carried out in the internal medicine outpatient clinic and data were extracted from patients medical records from April to June 2014. Metformin-treated patients were interviewed using a form check. The number of patients were 65 with the median rate was 48 years old. Side effect reported were flatulence (58.46% and nausea (41.54%. Administration and metformin dosage factors were correlated to the risk of side effects such as nausea and flatulence on type 2 diabetes mellitus (p0.05. The administration of metformin is recommended after meals and with a lower initial dose titrated slowly to reduce and avoid the side effects of nausea and flatulence in patients with type 2 diabetes mellitus.

  7. Prevalence and independent factors for gastroduodenal ulcers/erosions in asymptomatic patients taking low-dose aspirin and gastroprotective agents: the OITA-GF study.

    Science.gov (United States)

    Tamura, A; Murakami, K; Kadota, J

    2011-02-01

    Although it is well known that aspirin causes gastroduodenal mucosal injury and that aspirin-induced gastroduodenal mucosal injury is often asymptomatic, the prevalence and independent factors for gastroduodenal mucosal injury have not been clarified in asymptomatic patients taking low-dose aspirin and gastroprotective agents. To clarify the prevalence and independent factors for gastroduodenal ulcers/erosions in asymptomatic patients taking low-dose aspirin and gastroprotective agents. Prospective observational study. We performed endoscopy in 150 asymptomatic patients taking low-dose aspirin and gastroprotective agents for at least 3 months. Gastroduodenal ulcers/erosions were observed in 37.3% [ulcers (4.0%); erosions (34.0%)]. Univariate logistic regression analyses showed that proton-pump inhibitor (PPI) use was negatively associated with gastroduodenal ulcers/erosions [odds ratio (OR) 0.35, 95% confidence interval (95% CI) 0.17-0.75, P=0.007]. A multivariate logistic regression analysis selected PPI use as the only independent factor for gastroduodenal ulcers/erosions (OR 0.35, 95% CI 0.14-0.86, P=0.02). None of the 53 patients with PPI use had any gastroduodenal ulcers, and 11 with standard-dose PPI use tended to have a lower prevalence of gastroduodenal erosions than 42 with low-dose PPI use (0% vs. 28.6%, P=0.052). Gastroduodenal ulcers/erosions were observed in about one-third of asymptomatic patients taking low-dose aspirin and gastroprotective agents, and PPI use was a negative independent factor for gastroduodenal ulcers/erosions in those patients. In addition, standard-dose PPI therapy might be more effective in the prevention of aspirin-induced gastroduodenal mucosal injury than low-dose PPI therapy.

  8. Discount factors for public sector investment projects using the sum of discounted consumption flows -- estimates for the United Kingdom

    OpenAIRE

    E Kula

    1984-01-01

    In this article a model to estimate a discount factor matrix is derived for discount rates between 1% and 15% for the United Kingdom on the basis of a public-sector project evaluation method known as the sum of discounted consumption flows. These factors can readily be used by project analysts working on United Kingdom projects, especially those in which costs and benefits extend over many years.

  9. Conversion and correction factors for historical measurements of iodine-131 in Hanford-area vegetation, 1945--1947. Hanford Environmental Dose Reconstruction Project

    Energy Technology Data Exchange (ETDEWEB)

    Mart, E.I.; Denham, D.H.; Thiede, M.E.

    1993-12-01

    This report is a result of the Hanford Environmental Dose Reconstruction (HEDR) Project whose goal is to estimate the radiation dose that individuals could have received from emissions since 1944 at the U.S. Department of Energy`s (DOE) Hanford Site near Richland, Washington. The HEDR Project is conducted by Battelle, Pacific Northwest Laboratories (BNW). One of the radionuclides emitted that would affect the radiation dose was iodine-131. This report describes in detail the reconstructed conversion and correction factors for historical measurements of iodine-131 in Hanford-area vegetation which was collected from the beginning of October 1945 through the end of December 1947.

  10. Dose tailoring of anti-tumour necrosis factor-alpha therapy delivers useful clinical efficacy in Crohn disease patients experiencing loss of response.

    Science.gov (United States)

    Ghaly, S; Costello, S; Beswick, L; Pudipeddi, A; Agarwal, A; Sechi, A; Antoniades, S; Headon, B; Connor, S; Lawrance, I C; Sparrow, M; Walsh, A J; Andrews, J M

    2015-02-01

    'Dose tailoring' of anti-tumour necrosis factor alpha (TNF-α) therapy in Crohn disease (CD), by dose escalation, or shortening of dosing intervals, has been suggested to regain clinical response following a flare in a proportion of patients. However, reported outcome data are sparse and none exists from Australia. In an observational multicentre, retrospective study, the impact of anti-TNF-α dose tailoring on corticosteroid use, the need for surgery and physician perception of clinical efficacy was examined in a real-world setting at six Australian adult teaching hospitals. Demographics, disease characteristics, medications, indication for and duration of dose tailoring were documented. Fifty-five CD patients were identified as requiring dose tailoring and secondary loss of response was the indication in 96%. Either adalimumab (64%) or infliximab (36%) was dose escalated for a median of 5 months (range 1-47), with a median of 20 months follow up (range 3-65). At 3 months, dose tailoring reduced the mean number of days on high-dose corticosteroids (45 vs 23, P = 0.01). Most (78%) patients remained resection free, and 73% of physicians reported good clinical efficacy of dose tailoring. Of those who de-escalated therapy due to induction of remission, long-term (>12 months) follow up and complete data on steroid use were available in 15/28, with 12/15 (80%) remaining steroid free at 1 year. Short-term dose tailoring regains disease response in the majority of patients with CD. Of these, most will remain free of corticosteroids at 1 year after de-escalating therapy. © 2014 Royal Australasian College of Physicians.

  11. Multiple exposures to indoor contaminants: Derivation of benchmark doses and relative potency factors based on male reprotoxic effects.

    Science.gov (United States)

    Fournier, K; Tebby, C; Zeman, F; Glorennec, P; Zmirou-Navier, D; Bonvallot, N

    2016-02-01

    Semi-Volatile Organic Compounds (SVOCs) are commonly present in dwellings and several are suspected of having effects on male reproductive function mediated by an endocrine disruption mode of action. To improve knowledge of the health impact of these compounds, cumulative toxicity indicators are needed. This work derives Benchmark Doses (BMD) and Relative Potency Factors (RPF) for SVOCs acting on the male reproductive system through the same mode of action. We included SVOCs fulfilling the following conditions: detection frequency (>10%) in French dwellings, availability of data on the mechanism/mode of action for male reproductive toxicity, and availability of comparable dose-response relationships. Of 58 SVOCs selected, 18 induce a decrease in serum testosterone levels. Six have sufficient and comparable data to derive BMDs based on 10 or 50% of the response. The SVOCs inducing the largest decrease in serum testosterone concentration are: for 10%, bisphenol A (BMD10 = 7.72E-07 mg/kg bw/d; RPF10 = 7,033,679); for 50%, benzo[a]pyrene (BMD50 = 0.030 mg/kg bw/d; RPF50 = 1630), and the one inducing the smallest one is benzyl butyl phthalate (RPF10 and RPF50 = 0.095). This approach encompasses contaminants from diverse chemical families acting through similar modes of action, and makes possible a cumulative risk assessment in indoor environments. The main limitation remains the lack of comparable toxicological data.

  12. Hypoxia-Inducible Factor Pathway Inhibition Resolves Tumor Hypoxia and Improves Local Tumor Control After Single-Dose Irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Helbig, Linda [OncoRay–National Center for Radiation Research in Oncology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden (Germany); Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden (Germany); Koi, Lydia [OncoRay–National Center for Radiation Research in Oncology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden (Germany); Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden (Germany); Deutsches Konsortium für Translationale Krebsforschung, Site Dresden, Dresden (Germany); Brüchner, Kerstin [Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden (Germany); Institute of Radiooncology Helmholtz-Zentrum Dresden-Rossendorf, Dresden (Germany); Gurtner, Kristin [Department of Radiation Oncology, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden (Germany); Hess-Stumpp, Holger; Unterschemmann, Kerstin [Global Drug Discovery, Bayer Pharma, Berlin (Germany); Pruschy, Martin [Radiation Oncology, University of Zurich, Zurich (Switzerland); and others

    2014-01-01

    Purpose: To study the effects of BAY-84-7296, a novel orally bioavailable inhibitor of mitochondrial complex I and hypoxia-inducible factor 1 (HIF-1) activity, on hypoxia, microenvironment, and radiation response of tumors. Methods and Materials: UT-SCC-5 and UT-SCC-14 human squamous cell carcinomas were transplanted subcutaneously in nude mice. When tumors reached 4 mm in diameter BAY-84-7296 (Bayer Pharma AG) or carrier was daily administered to the animals. At 7 mm tumors were either excised for Western blot and immunohistologic investigations or were irradiated with single doses. After irradiation animals were randomized to receive BAY-84-7296 maintenance or carrier. Local tumor control was evaluated 150 days after irradiation, and the dose to control 50% of tumors (TCD{sub 50}) was calculated. Results: BAY-84-7296 decreased nuclear HIF-1α expression. Daily administration of inhibitor for approximately 2 weeks resulted in a marked decrease of pimonidazole hypoxic fraction in UT-SCC-5 (0.5% vs 21%, P<.0001) and in UT-SCC-14 (0.3% vs 19%, P<.0001). This decrease was accompanied by a significant increase in fraction of perfused vessels in UT-SCC-14 but not in UT-SCC-5. Bromodeoxyuridine and Ki67 labeling indices were significantly reduced only in UT-SCC-5. No significant changes were observed in vascular area or necrosis. BAY-84-7296 before single-dose irradiation significantly decreased TCD{sub 50}, with an enhancement ratio of 1.37 (95% confidence interval [CI] 1.13-1.72) in UT-SCC-5 and of 1.55 (95% CI 1.26-1.94) in UT-SCC-14. BAY-84-7296 maintenance after irradiation did not further decrease TCD{sub 50}. Conclusions: BAY-84-7296 resulted in a marked decrease in tumor hypoxia and substantially reduced radioresistance of tumor cells with the capacity to cause a local recurrence after irradiation. The data suggest that reduction of cellular hypoxia tolerance by BAY-84-7296 may represent the primary biological mechanism underlying the observed enhancement of

  13. Committed equivalent organ doses and committed effective doses from intakes of radionuclides

    CERN Document Server

    Phipps, A W; Kendall, G M; Silk, T J; Stather, J W

    1991-01-01

    This report contains details of committed equivalent doses to individual organs for intakes by ingestion and inhalation of 1 mu m AMAD particles of 359 nuclides by infants aged 3 months, by children aged 1, 5, 10 and 15 years, and by adults. It complements NRPB-R245 which describes the changes which have taken place since the last NRPB compendium of dose per unit intake factors (dose coefficients) and gives summary tables. Information on the way committed doses increase with the integration period is given in NRPB-M289. The information given in these memoranda is also available as a microcomputer package - NRPB-SR245.

  14. Risk Factors of anemia in head and neck cancer patients undergoing chemotherapy with high-dose cisplatin

    Directory of Open Access Journals (Sweden)

    Johan Kurnianda

    2008-12-01

    Full Text Available Cisplatin is well-known for its effectiveness against cancer, as well as its toxicity to human tissues. Of several documented side effects, anemia was reported to have significant association with decreased quality of life. This study was conducted to investigate development of cisplatin-induced anemia, and to identify independent factors contributing to anemia. Clinical data from head and neck cancer patients treated with high-dose cisplatin between December 2002 and December 2005 were obtained in this study. Incidence and risk factors of anemia were assessed in a model including age, sex, baseline hemoglobin level, baseline creatinine clearance, and occurrence of distant metastases. Multivariate logistic regression was used to define independent predictors of anemia. Among 86 eligible patients, 26 (30.2% developed anemia, defined as Hb level lower than 11 g/dL. Age > 55 years old (RR = 2.2, 95% CI, 1.2-4.0, female sex (RR = 2.0, 95% CI, 1.2-3.8, baseline Hb ≤ 13 g/dL (RR = 4.2, 95% CI, 1.9-9.4 and baseline CrCl < 50 mL/min (RR = 2.9, 95% CI, 1.7-5.1 were significantly correlated with incidence of anemia (P < 0.05. In multivariate analysis, baseline Hb and baseline CrCl were identified as independent risk factors for anemia. However, considerable confounding was observed in baseline CrCl after stratified by age (aRR = 2.2, 95% CI, 1.1-4.7. Thus, baseline Hb level was the strongest predictor of anemia. The findings suggested that baseline Hb and CrCl were useful to recognize cisplatin-treated patients at risk for anemia who might benefits from preventive measures. (Med J Indones 2008; 17: 248-54Keywords: anemia, cisplatin, chemotherapy, hemoglobin, creatinine clearance

  15. Risk factors for the development of hospital infections in the intensive care units

    Directory of Open Access Journals (Sweden)

    Mijović Biljana

    2005-01-01

    Full Text Available Background. Patients admitted to intensive-care units (ICU are at a high risk of nosocomial infections (NI due to susceptibility associated with severity of their condition, but also the invasive medical procedures they undergo. Aim. To determine the frequency of NI at the ICU of the General Hospital Užice, and to identify the risk factors for their development. Methods. A prospective surveillance study of NI, conducted between June 27 and December 31 2001, included 914 patients who spent at least 24 hours in the ICU (total of 2 615 days. The surveillance of NI in the ICU was carried out daily. Follow-up period covered the time from the ICU admission to 48 hours after the ICU discharge. To assess risk factors for NI, we performed a case-control study. The variables measuring of extrinsic and intrinsic risk factors for NI were collected. Results. In a six-month prospective surveillance study, the incidence of NI was 16.7% or 58.5 per 1,000 patient-day, respectively. The most frequent were the infections of the surgery wounds (32.6%, urinary tract infections (23.5%, and infections of the blood (7.1%. The identified independent risk factors for NI were: surgical intervention (OR = 5.74; CI = 2.01-16.41, endotracheal tubes (OR = 3.40; CI = 1.07-10.89, cystoscopy (OR = 2.35; CI = 1.38- 4.02, obesity (OR = 1.98; CI = 1.27-3.11, and the duration of the infusion (OR = 1.34; CI = 1.23-1.46. Conclusions. The most important risk factors for NI at ICU were surgical interventions and endotracheal tubes.

  16. [Pneumocystis jiroveci pneumonia: Clinical characteristics and mortality risk factors in an Intensive Care Unit].

    Science.gov (United States)

    Solano L, M F; Alvarez Lerma, F; Grau, S; Segura, C; Aguilar, A

    2015-01-01

    To describe the epidemiological characteristics of the population with Pneumocystis jiroveci (P. jiroveci) pneumonia, analyzing risk factors associated with the disease, predisposing factors for admission to an intensive care unit (ICU), and prognostic factors of mortality. A retrospective observational study was carried out, involving a cohort of patients consecutively admitted to a hospital in Spain from 1 January 2007 to 31 December 2011, with a final diagnosis of P. jiroveci pneumonia. The ICU and hospitalization service of Hospital del Mar, Barcelona (Spain). We included 36 patients with pneumonia due to P. jiroveci. Of these subjects, 16 required ICU admission (44.4%). The average age of the patients was 41.3 ± 12 years, and 23 were men (63.9%). A total of 86.1% had a history of human immunodeficiency virus (HIV) infection, and the remaining 13.9% presented immune-based disease subjected to immunosuppressive therapy. Risk factors associated to hospital mortality were age (51.8 vs. 37.3 years, P=.002), a higher APACHE score upon admission (17 vs. 13 points, P=.009), the need for invasive mechanical ventilation (27.8% vs. 11.1%, P=.000), requirement of vasoactive drugs (25.0% vs. 11.1%, P=.000), fungal coinfection (22.2% vs. 11.1%, P=.001), pneumothorax (16.7% vs. 83.3%, P=.000) and admission to the ICU (27.8% vs. 72.2% P=.000). The high requirement of mechanical ventilation and vasoactive drugs associated with fungal coinfection and pneumothorax in patients admitted to the ICU remain as risk factors associated with mortality in patients with P. jiroveci pneumonia. Copyright © 2013 Elsevier España, S.L.U. y SEMICYUC. All rights reserved.

  17. CORRELATION BETWEEN THE DAMPING FACTOR PER UNIT MASS AND THE FREE LENGTH FOR COMPOSITE SANDWICH BARS. EXPERIMENTAL INVESTIGATIONS

    Directory of Open Access Journals (Sweden)

    Cristian-Oliviu BURADA

    2015-05-01

    Full Text Available In this paper we have build some composite sandwich bars in this way: the core is made with polypropylene honeycomb (its thickness is 10, 15 and 20 mm reinforced with 1 layer of carbon fiber (on the sample upper and lower sides. For these samples we have determined, by experimental means, the damping factor per unit mass and per unit length. Then, by using the regression analysis, we have established correlations between the damping factor per unit mass and the bars free length. In order to obtain these correlations, we have considered the next free lengths of the bars: 200, 230, 260, 290, 320, 350.

  18. What Factors Control the Trend of Increasing AAOD Over the United States in the Last Decade?

    Science.gov (United States)

    Zhang, Li; Henze, Daven K.; Grell, Georg A.; Torres, Omar; Jethva, Hiren; Lamsal, Lok N.

    2017-01-01

    We examine the spatial and temporal trends of absorbing aerosol optical depth (AAOD) in the last decade over the United States (U.S.) observed by the Ozone Monitoring Instrument (OMI). Monthly average OMI AAOD has increased over broad areas of the central U.S. from 2005 to 2015, by up to a factor of 4 in some grid cells (60 km resolution). The AAOD increases in all seasons, although the percentage increases are larger in summer (June-July-August) than in winter (December-January-February) by a factor of 3. Despite enhancements in AAOD, OMI AOD exhibits insignificant trend over most of the U.S. except parts of the central and western U.S., the latter which may partly be due to decreases in precipitation. Trends in AAOD contrast with declining trends in surface concentrations of black carbon (BC) aerosol. Interannual variability of local biomass burning emissions of BC may contribute to the positive trend in AAOD over the western U.S. Changes in both dust aerosol measured at the surface (in terms of concentration and size) and dust AAOD indicate distinct enhancements, especially over the central U.S. by 50-100%, which appears to be one of the major factors that impacts positive trends in AAOD.

  19. What Factors Control the Trend of Increasing AAOD Over the United States in the Last Decade?

    Science.gov (United States)

    Zhang, Li; Henze, Daven K.; Grell, Georg A.; Torres, Omar; Jethva, Hiren; Lamsal, Lok N.

    2017-01-01

    We examine the spatial and temporal trends of absorbing aerosol optical depth (AAOD) in the last decade over the United States (U.S.) observed by the Ozone Monitoring Instrument (OMI). Monthly average OMI AAOD has increased over broad areas of the central U.S. from 2005 to 2015, by up to a factor of 4 in some grid cells (60 km resolution). The AAOD increases in all seasons, although the percentage increases are larger in summer (June-July-August) than in winter (December-January-February) by a factor of 3. Despite enhancements in AAOD, OMI AOD exhibits insignificant trend over most of the U.S. except parts of the central and western U.S., the latter which may partly be due to decreases in precipitation. Trends in AAOD contrast with declining trends in surface concentrations of black carbon (BC) aerosol. Interannual variability of local biomass burning emissions of BC may contribute to the positive trend in AAOD over the western U.S. Changes in both dust aerosol measured at the surface (in terms of concentration and size) and dust AAOD indicate distinct enhancements, especially over the central U.S. by 50-100%, which appears to be one of the major factors that impacts positive trends in AAOD.

  20. What factors control the trend of increasing AAOD over the United States in the last decade?

    Science.gov (United States)

    Zhang, Li; Henze, Daven K.; Grell, Georg A.; Torres, Omar; Jethva, Hiren; Lamsal, Lok N.

    2017-02-01

    We examine the spatial and temporal trends of absorbing aerosol optical depth (AAOD) in the last decade over the United States (U.S.) observed by the Ozone Monitoring Instrument (OMI). Monthly average OMI AAOD has increased over broad areas of the central U.S. from 2005 to 2015, by up to a factor of 4 in some grid cells ( 60 km resolution). The AAOD increases in all seasons, although the percentage increases are larger in summer (June-July-August) than in winter (December-January-February) by a factor of 3. Despite enhancements in AAOD, OMI AOD exhibits insignificant trend over most of the U.S. except parts of the central and western U.S., the latter which may partly be due to decreases in precipitation. Trends in AAOD contrast with declining trends in surface concentrations of black carbon (BC) aerosol. Interannual variability of local biomass burning emissions of BC may contribute to the positive trend in AAOD over the western U.S. Changes in both dust aerosol measured at the surface (in terms of concentration and size) and dust AAOD indicate distinct enhancements, especially over the central U.S. by 50-100%, which appears to be one of the major factors that impacts positive trends in AAOD.

  1. Postoperative delirium and factors related in a cardiac surgery unit care

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    Julia de las Pozas Abril

    2011-07-01

    Full Text Available Objective: Describe the incidence of postoperative delirium and related risk factors associated with this complication in patients undergoing cardiac surgery. Method: Cohort study conducted for 3 months in a sample of 105 patients undergoing cardiac surgery in a hospital in Madrid. The emergence of delirium with scale ICDSC (Intensive Care Delirium Screening Checklist was measured during the first five days of postoperative and collected data on preoperative, intra-operative and post-operative factors to relate to the emergence of delirium. Results: 95 Patients studied, 15 of them developed delirium, which means an incidence of 15.7%. We found that there was a significant relationship between delirium appearance and age of the patients, the presence of atrial fibrillation, intubation orotraqueal time and the administration of adrenaline during the immediate post-operative management. The multivariable model showed the duration of orotraqueal intubation to be independently associated with delirium. Conclusions: The incidence of delirium found in this study as well as the identification of the time of orotraqueal intubation as independent risk factor supposes a new contribution to the knowledge of this postoperative complication and allow us to begin to evaluate its importance in the unit of cardiac surgery.

  2. High risk factors for pulmonary fungous infection in intensive care units of neurosurgery

    Institute of Scientific and Technical Information of China (English)

    ZHU Wenyu; TAN Liping; CHEN Xiangfeng; HUANG Qiang; LAN Qing

    2007-01-01

    By analyzing the high risk factors for pulmonary fungous infection in intensive care units of neurosurgery,the strategy of early diagnosis and treatment was explored.According to the domestic diagnostic standard on pulmonary fungous infection.clinical data on 58 patients with the infection in our department were analyzed.One hundred and seventeen strains of fungi were separated from the 58 cases.Candidiasis was the most frequent type,accounting for 92.3% of the cases.Conditions such as the severity of primary diseases,long-time coma,long-term use of broad-spectrum antibiotic,abuse of glucocorticoid,the open airway,and some invasive intubations,may be regarded as high risk factors for pulmonary fungous infection.Fluconazole showed good clinical effects on the treatment of fungous infection.Tb eliminate these high risk factors,early diagnosis and the use of prophylactic antifungal agents can help reduce the incidence of pulmonary fungous infection.

  3. Factors impacting influenza vaccination of urban low-income Latino children under nine years requiring two doses in the 2010–2011 season

    Science.gov (United States)

    Hofstetter, Annika M.; Barrett, Angela; Stockwell, Melissa S.

    2015-01-01

    Background The Advisory Committee on Immunization Practices (ACIP) recommends that certain children under nine years of age receive two influenza vaccine doses in a season for optimal protection. Recent data indicate that many of these children fail to receive one or both of these needed doses. Contributing factors to under-vaccination of this population remain unclear. Methods Caregivers of children aged 6 months-8 years requiring two influenza vaccine doses in the 2010–2011 season were identified from households enrolled in four urban Head Start programs. Recruitment and survey administration were conducted between March and June 2011. The impact of caregiver, provider, and practice-based factors on influenza vaccine receipt (0, 1, or 2 doses) was assessed using bivariate and multivariable logistic regression analyses. Results Caregivers (n=128) were predominantly mothers, Latina, Spanish-speaking, and non-U.S. born. Few children received one (31%) or both (7%) influenza vaccine doses. Caregivers who discussed influenza vaccination with providers were more likely to know their child needed two doses (55% vs. 36%, p<0.05) and have a fully vaccinated child (11% vs. 0%, p<0.05). Among caregivers whose child received the first dose, those who reported being told when to return for the second dose were also more likely to have a fully vaccinated child (35% vs. 0%, p=0.05). Belief in influenza vaccine effectiveness was positively associated with vaccination (p<0.001), while safety concerns were negatively associated (p<0.05). Discussion This study highlights the importance of provider-family communication about the two-dose regimen as well as influenza vaccine effectiveness and safety. PMID:25082482

  4. Analysis of the main factors affecting the evaluation of the dose in workplaces: the case of tourist caves

    Energy Technology Data Exchange (ETDEWEB)

    Sainz, C.; Santiago Quindos, L.; Fuente, I.; Nicolas, J.; Quindos, L. [Cantabria Univ., Dept. of Medical Physics. RADON Group, Faculty of Medicine, (Spain)

    2006-07-01

    Since 2001, Spanish law incorporated EURATOM basic standards for radiological protection, which include a request at the European Communities Member States to determine the working places on which exposure to natural radiation is significant. On Title VII (BOE 178/2001) radiation coming from natural sources has analogous role than radiation emitted from artificial ones used to. High concentrations of radon exist in several workplaces like tourist caves mainly because of the low ventilation rates existing at these enclosures. In this sense, in its 1990 publication, the ICRP recommended that high exposures of radon in workplace could be regarded as the responsibility of the operating management and should be considered as occupational exposure. In developed caves in which guides provide tours for the general public great care is needed for taking remedial actions concerning radon, because in some circumstances forced ventilation may alter the humidity inside the cave affecting the some of the formations or paintings that attract tourists. Tourist guides can work about 1900 hours per year, so the only option to protect them and other cave workers from radon exposure is to apply an appropriate system of radiation protection mainly based on limitation of exposure by restricting the amount of time spent in the cave. The information needed for carrying out the above mentioned protecting actions is related with the specific characteristics of the cave concerning the behaviour of radon and it decay products. In order to perform a precise effective dose calculation, factors like unattached progeny fraction (fp), equilibrium factor (F) and particle concentration (Z) are of main importance. One of the specific characteristic of the caves is the high unattached fraction due to very low particle concentration. The fp values can be higher than 0.1, for places with low ventilation and without additional aerosol sources, with Z < 4 103 particle cm{sup -3}.In this work the results

  5. Conversion factors for determining organ doses received by paediatric patients in high-resolution single slice computed tomography with narrow collimation

    Energy Technology Data Exchange (ETDEWEB)

    Seidenbusch, Michael C.; Schneider, Karl [Muenchen Univ. (Germany). Paediatric Radiology; Harder, Dietrich [Goettingen Univ. (Germany). Medical Physics and Biophysics; Regulla, Dieter F. [Helmholtz Zentrum Muenchen German Research Center for Environmental Health, Neuherberg (Germany). Research Unit Medical Radiation Physics and Diagnostics

    2014-09-01

    Estimations of organ doses D{sub T} received during computed tomographic examinations are usually performed by applying conversion factors to basic dose indicators like the computed tomography dose index (CTDI) or the dose-length-product (DLP). In addition to the existing conversion factors for beam apertures of 5 mm or 10 mm, we present new DLP-D{sub T} conversion factors adapted to high-resolution CT (HRCT) examinations of infants and young children with beam apertures of the order of 1 mm and under consideration of bow tie filtration. Calculations are performed on mathematical MIRD phantoms for an age range from 0, 1, 5, 10, 15 up to (for comparison) 30 years by adapting PCXMC, a Monte Carlo algorithm originally developed by STUK (Helsinki, Finland) for dose reconstructions in projection radiography. For this purpose, each single slice CT examination is approximated by a series of corresponding virtual planar radiographies comprising all focus positions. The transformation of CT exposure parameters into exposure parameters of the series of corresponding planar radiographies is performed by a specially developed algorithm called XCT. The DLP values are evaluated using the EGSRay code. The new method is verified at a beam aperture of 10 mm by comparison with formerly published conversion factors. We show that the higher spatial resolution leads to an enhanced DLP-D{sub T} conversion factor if a small organ (e.g. thyroid gland, mammae, uterus, ovaries, testes) is exactly met by the chosen CT slice, while the conversion factor is drastically reduced if the chosen CT slice is positioned above or below the organ. This effect is utilized for dose-saving examinations with only a few single slices instead a full scan, which technique is applied in about 10% of all paediatric chest CT examinations. (orig.)

  6. Cases of organophosphate poisoning treated with high-dose of atropine in an intensive care unit and the novel treatment approaches.

    Science.gov (United States)

    Karakus, Ali; Celik, Muhammet Murat; Karcioglu, Murat; Tuzcu, Kasim; Erden, Ersin Sukru; Zeren, Cem

    2014-06-01

    Organophosphate poisoning is a life-threatening condition, which is being responsible for the symptoms due to cholinergic effects. Clinical status and blood levels of cholinesterase are used its diagnosis. While atropine and pralidoxime (PAM) appear as essential medications, hemofiltration treatments and lipid solutions have been widely studied in recent years. In this study, the importance of high-dose atropine therapy and early intervention and novel treatment approaches are discussed. Records of a total of 25 patients treated for organophosphate poisoning in the intensive care unit (ICU) between April 2007 and December 2011 were evaluated retrospectively. Of the 25 patients, 14 (56%) were male and 11 (44%) were female with a mean age of 34.8 ± 17.66 years (range: 14-77 years). The patients were most frequently admitted in June (n = 4) and July (n = 4) (16%). Of the 25 patients, 22 patients (88%) were poisoned by oral intake, two (8%) by inhalation, and one (4%) by dermal route. Of them, 20 patients (80%) took organophosphates intentionally for suicidal purposes, while five (20%) cases poisoned due to accidental exposure. The scores of Glasgow Coma Scale of nine patients (36%) were below 8 point upon admission to hospital. The highest dose of atropine given was 100 mg intravenously on admission and 100 mg/h/day during follow-up. The total dose given was 11.6 g/12 days. A total of 11 patients (44%) were on mechanical ventilation for a mean duration of 5.73 ± 4.83 days. The mean duration of ICU stay was 6.52 ± 4.80 days. Of all, 23 patients (92%) were discharged in good clinical condition and one patient (4%) was referred to another hospital. This study suggests that atropine can be administered until secretions disappear and intensive care should be exerted in follow-up of these patients. In addition, in case of necessity for high doses, sufficient amounts of atropine and PAM should be available in hospitals.

  7. Fatal parasitosis in blackbucks (Antilope cervicapra: a possible factor risk in hunting units

    Directory of Open Access Journals (Sweden)

    Ned de la Cruz-Hernández

    2015-11-01

    Full Text Available In February 2012, a reproductive group of 60 adult blackbucks (Antilope cervicapra from Veracruz, Mexico was relocated to hunting units in eastern and northeastern Mexico. Seven individuals died due to hemorrhagic parasitic, abomasitis and enteritis caused by Haemonchus spp., Setaria spp., and Trichostrongylids. Deaths were associated with hepatic necrosis, bilateral congestive distention of heart and fibrinonecrotic bronchopneumonia. Also Anaplasma marginale was identified. The blackbucks’ population displayed a general mortality rate of 11.67%, where 25% of total male and 9.62% of total female died. The mortality was controlled by segregation of all remaining blackbucks and the treatment for internal and external parasites (biting flies and ticks. After the treatment, no fatality cases related to parasitosis were recorded. The results presented here exhibit the high relevance of parasitosis as possible factor risk in the survival of tis specie.

  8. Failure factors in non-life insurance companies in United Kingdom

    Science.gov (United States)

    Samsudin, Humaida Banu

    2013-04-01

    Failure in insurance company is a condition of financial distress where a company has difficulty paying off its financial obligations to its creditors. This study continues the research from the study in identifying the determinants for run-off non-life insurance companies in United Kingdom. The analysis continues to identify other variables that could lead companies to financial distress that is macroeconomic factors (GDP rates, inflation rates and interest rates); total companies failed a year before and average size for failed companies'. The result from the analysis indicates that inflation rates, interest rates, total companies failed a year before and average sizes for failed companies are the best predictors. An early detection of failure can prevent companies from bankruptcy and allow management to take action to reduce the failure costs.

  9. Predictive factors for the admission of a newborn in an intensive care unit

    Directory of Open Access Journals (Sweden)

    Carla Danielle Ribeiro Lages

    2014-04-01

    Full Text Available Analytical documentary and retrospective study aiming at determining association between predictive factors for admission of a newborn in a public Intensive Care Unit and maternal features. The study sample had 376 neonates admitted in 2009. Results showed: mothers aged between 19 and 25 years (43.4%, primary education (52.4%, living with a partner (66.2%. Prenatal care was done by 84.8% of them, and 62% presented gestational pathologies. Out of all neonates, 55.1% were male, 85.4% preterm, 83% underweight, 57.2% presented respiratory problems. The bivariate analysis showed a significant association between birth weight and growth (p = 0.04 between maternal age and Apgar in the 1st minute (p = 0.04 and maternal age and Apgar score in the 5th minute (p = 0.01. Maternal age and number of prenatal appointments influence on the admission of the neonates to the Intensive Care Unit because they are related to birth weight and Apgar scores.

  10. Immunity to nerve growth factor and the effect on motor unit reinnervation in the rabbit.

    Science.gov (United States)

    Finkelstein, D I; Luff, A R; Schuijers, J A

    1992-05-01

    The trophic effects of nerve growth factor (NGF) on sympathetic, peripheral afferent, and other neural crest-derived cells have been intensively investigated. More recently, NGF has been shown to have an influence on motoneurons. This study was undertaken to investigate whether NGF had any influence on the mechanical or histological properties of reinnervated motor units. Three groups of rabbits were used: normal rabbits, rabbits in which the nerve to medial gastrocnemius (MG) was cut and allowed to reinnervate for 56 days, and rabbits in which the MG nerve reinnervated in the presence of immunity to NGF. Immunity to NGF did not affect the ability of motor axons to reinnervate a muscle, nor were the contractile characteristics of the motor units altered. The size of horseradish peroxidase-labeled motoneurons was not influenced by immunization against NGF; however, the distribution of afferent neuron sizes was altered. Conduction velocity of motor axons proximal to the neuroma was significantly faster after immunization against NGF. Transection and subsequent reinnervation by a peripheral nerve normally causes an increase in myelin thickness proximal to the neuroma. However, immunization against NGF appeared to decrease the magnitude of myelin thickening. It was concluded that immunization against NGF affects motor axonal conduction velocity via an influence on the neural crest-derived Schwann cells.

  11. Community unit performance: factors associated with childhood diarrhea and appropriate treatment in Nyanza Province, Kenya.

    Science.gov (United States)

    Kawakatsu, Yoshito; Tanaka, Junichi; Ogawa, Kazuya; Ogendo, Kenneth; Honda, Sumihisa

    2017-02-16

    The government of Kenya launched its community health strategy in 2006 to improve certain aspects of its community health program. Under the strategy, community units (CUs) were established as level one of the Kenyan health system. A core member at this level is the community health worker (CHW). The objective of this study was to assess the relationship among the performance of the CUs, the prevalence of childhood diarrhea and appropriate treatment for it by controlling individual and community-level factors. The main dataset used in this study was the 2011 Nyanza Province county-based Multiple Indicator Cluster Survey (MICS). In addition, based on the list of community units in Nyanza Province, Kenya, we identified the area's CUs and their performance. MICS data and data on CUs were merged using sub-location names. There were 17 individual and two community-level independent variables in this study. Bivariate analysis and a multilevel logistic regression were performed. Factors significantly associated with a lower prevalence of diarrhea among children under five were the child's increasing age, middle-aged household heads, children who received more attention, water treatment and rural versus urban area residence, while male children and highly performing CUs were significantly associated with a higher prevalence of diarrhea. In addition, middle wealth index, severity of diarrhea and middle- and high-CU performance were significantly associated with appropriate treatment for childhood diarrhea. Although this study found that children living in areas of high CU performance were more likely to have diarrhea, these areas would have been identified as being more at risk for diarrhea prevalence and other health concerns, prioritized for the establishment of a CU and allocated more resources to improve the performance of CUs. A higher CU performance was significantly associated with the appropriate treatment. It was suggested that CHWs could have a positive effect on

  12. Incidence of and Risk Factors for Skin Cancer in Organ Transplant Recipients in the United States.

    Science.gov (United States)

    Garrett, Giorgia L; Blanc, Paul D; Boscardin, John; Lloyd, Amanda Abramson; Ahmed, Rehana L; Anthony, Tiffany; Bibee, Kristin; Breithaupt, Andrew; Cannon, Jennifer; Chen, Amy; Cheng, Joyce Y; Chiesa-Fuxench, Zelma; Colegio, Oscar R; Curiel-Lewandrowski, Clara; Del Guzzo, Christina A; Disse, Max; Dowd, Margaret; Eilers, Robert; Ortiz, Arisa Elena; Morris, Caroline; Golden, Spring K; Graves, Michael S; Griffin, John R; Hopkins, R Samuel; Huang, Conway C; Bae, Gordon Hyeonjin; Jambusaria, Anokhi; Jennings, Thomas A; Jiang, Shang I Brian; Karia, Pritesh S; Khetarpal, Shilpi; Kim, Changhyun; Klintmalm, Goran; Konicke, Kathryn; Koyfman, Shlomo A; Lam, Charlene; Lee, Peter; Leitenberger, Justin J; Loh, Tiffany; Lowenstein, Stefan; Madankumar, Reshmi; Moreau, Jacqueline F; Nijhawan, Rajiv I; Ochoa, Shari; Olasz, Edit B; Otchere, Elaine; Otley, Clark; Oulton, Jeremy; Patel, Parth H; Patel, Vishal Anil; Prabhu, Arpan V; Pugliano-Mauro, Melissa; Schmults, Chrysalyne D; Schram, Sarah; Shih, Allen F; Shin, Thuzar; Soon, Seaver; Soriano, Teresa; Srivastava, Divya; Stein, Jennifer A; Sternhell-Blackwell, Kara; Taylor, Stan; Vidimos, Allison; Wu, Peggy; Zajdel, Nicholas; Zelac, Daniel; Arron, Sarah T

    2017-03-01

    Skin cancer is the most common malignancy occurring after organ transplantation. Although previous research has reported an increased risk of skin cancer in solid organ transplant recipients (OTRs), no study has estimated the posttransplant population-based incidence in the United States. To determine the incidence and evaluate the risk factors for posttransplant skin cancer, including squamous cell carcinoma (SCC), melanoma (MM), and Merkel cell carcinoma (MCC) in a cohort of US OTRs receiving a primary organ transplant in 2003 or 2008. This multicenter retrospective cohort study examined 10 649 adult recipients of a primary transplant performed at 26 centers across the United States in the Transplant Skin Cancer Network during 1 of 2 calendar years (either 2003 or 2008) identified through the Organ Procurement and Transplantation Network (OPTN) database. Recipients of all organs except intestine were included, and the follow-up periods were 5 and 10 years. Incident skin cancer was determined through detailed medical record review. Data on predictors were obtained from the OPTN database. The incidence rates for posttransplant skin cancer overall and for SCC, MM, and MCC were calculated per 100 000 person-years. Potential risk factors for posttransplant skin cancer were tested using multivariate Cox regression analysis to yield adjusted hazard ratios (HR). Overall, 10 649 organ transplant recipients (mean [SD] age, 51 [12] years; 3873 women [36%] and 6776 men [64%]) contributed 59 923 years of follow-up. The incidence rates for posttransplant skin cancer was 1437 per 100 000 person-years. Specific subtype rates for SCC, MM, and MCC were 812, 75, and 2 per 100 000 person-years, respectively. Statistically significant risk factors for posttransplant skin cancer included pretransplant skin cancer (HR, 4.69; 95% CI, 3.26-6.73), male sex (HR, 1.56; 95% CI, 1.34-1.81), white race (HR, 9.04; 95% CI, 6.20-13.18), age at transplant 50 years or older (HR, 2

  13. First outbreak with MRSA in a Danish neonatal intensive care unit: risk factors and control procedures.

    Directory of Open Access Journals (Sweden)

    Benedicte Grenness Utke Ramsing

    Full Text Available INTRODUCTION: The purpose of the study was to describe demographic and clinical characteristics and outbreak handling of a large methicillin-resistant Staphylococcus aureus (MRSA outbreak in a neonatal intensive care unit (NICU in Denmark June 25(th-August 8(th 2008, and to identify risk factors for MRSA transmission. METHODS: Data were collected retrospectively from medical records and the Danish Neobase database. All MRSA isolates obtained from neonates, relatives and NICU health care workers (HCW as well as environmental cultures were typed. RESULTS: During the 46 day outbreak period, 102 neonates were admitted to the two neonatal wards. Ninety-nine neonates were subsequently sampled, and 32 neonates (32% from 25 families were colonized with MRSA (spa-type t127, SCCmec V, PVL negative. Thirteen family members from 11 of those families (44% and two of 161 HCWs (1% were colonized with the same MRSA. No one was infected. Five environmental cultures were MRSA positive. In a multiple logistic regression analysis, nasal Continuous Positive Airway Pressure (nCPAP treatment (p = 0.006 and Caesarean section (p = 0.016 were independent risk factors for MRSA acquisition, whereas days of exposure to MRSA was a risk factors in the unadjusted analysis (p = 0.04. CONCLUSIONS: MRSA transmission occurs with high frequency in the NICU during hospitalization with unidentified MRSA neonates. Caesarean section and nCPAP treatment were identified as risk factors for MRSA colonization. The MRSA outbreak was controlled through infection control procedures.

  14. Personal risk factors for carpal tunnel syndrome in female visual display unit workers

    Directory of Open Access Journals (Sweden)

    Matteo Riccò

    2016-12-01

    Full Text Available Objectives: Carpal tunnel syndrome (CTS is the most common nerve entrapment syndrome, which since the beginning of the seventies has been linked to the keyboard and visual display unit (VDU. The objective of this study was to investigate the prevalence and personal factors associated with CTS in female VDU workers in Italy. Material and Methods: Participants in this study were female adult subjects, working ≥ 20 h/week (N = 631, mean age 38.14±7.81 years, mean working age 12.9±7.24 years. Signs and symptoms were collected during compulsory occupational medical surveillance. The binary logistic regression was used to estimate adjusted odds ratios for the factors of interest. Results: Diagnosis of CTS was reported in 48 cases (7.6%, 11 of them or 1.7% after a surgical correction for the incidence of 5.94/1000 person-years. In general, signs and symptoms of CTS were associated with the following demographic factors: previous trauma of upper limb (adjusted odds ratio (ORa = 8.093, 95% confidence interval (CI: 2.347–27.904, history (> 5 years of oral contraceptives therapy/hormone replacement therapy (ORa = 3.77, 95% CI: 1.701–8.354 and cervical spine signs/symptoms (ORa = 4.565, 95% CI: 2.281–9.136. Conclusions: The prevalence of CTS was similar to the estimates for the general population of Italy. Among personal risk factors, hormone therapy, previous trauma of the upper limb and signs/symptoms of the cervical spine appeared to be associated with a higher risk of CTS syndrome. Eventually, the results reinforce interpretation of CTS in VDU workers as a work-related musculoskeletal disorder rather than a classical occupational disease. Int J Occup Med Environ Health 2016;29(6:927–936

  15. Personal risk factors for carpal tunnel syndrome in female visual display unit workers.

    Science.gov (United States)

    Riccò, Matteo; Cattani, Silvia; Signorelli, Carlo

    2016-11-18

    Carpal tunnel syndrome (CTS) is the most common nerve entrapment syndrome, which since the beginning of the seventies has been linked to the keyboard and visual display unit (VDU). The objective of this study was to investigate the prevalence and personal factors associated with CTS in female VDU workers in Italy. Participants in this study were female adult subjects, working ≥ 20 h/week (N = 631, mean age 38.14±7.81 years, mean working age 12.9±7.24 years). Signs and symptoms were collected during compulsory occupational medical surveillance. The binary logistic regression was used to estimate adjusted odds ratios for the factors of interest. Diagnosis of CTS was reported in 48 cases (7.6%, 11 of them or 1.7% after a surgical correction) for the incidence of 5.94/1000 person-years. In general, signs and symptoms of CTS were associated with the following demographic factors: previous trauma of upper limb (adjusted odds ratio (ORa) = 8.093, 95% confidence interval (CI): 2.347-27.904), history (> 5 years) of oral contraceptives therapy/hormone replacement therapy (ORa = 3.77, 95% CI: 1.701-8.354) and cervical spine signs/symptoms (ORa = 4.565, 95% CI: 2.281-9.136). The prevalence of CTS was similar to the estimates for the general population of Italy. Among personal risk factors, hormone therapy, previous trauma of the upper limb and signs/symptoms of the cervical spine appeared to be associated with a higher risk of CTS syndrome. Eventually, the results reinforce interpretation of CTS in VDU workers as a work-related musculoskeletal disorder rather than a classical occupational disease. Int J Occup Med Environ Health 2016;29(6):927-936.

  16. LM-type tests for idiosyncratic and common unit roots in the exact factor model with AR(1) dynamics

    NARCIS (Netherlands)

    Solberger, M.; Zhou, X.

    2013-01-01

    Recent developments within the panel unit-root literature have illustrated how the exact factor model serves as a parsimonious framework and allows for consistent maximum likelihood inference even when it is misspecified contra the more general approximate factor model. In this paper we consider an

  17. The beliefs in the inheritance of risk factors for suicide scale (BIRFSS): cross-cultural validation in Estonia, Malaysia, Romania, the United Kingdom, and the United States.

    Science.gov (United States)

    Voracek, Martin; Loibl, Lisa Mariella; Swami, Viren; Vintilă, Mona; Kõlves, Kairi; Sinniah, Dhachayani; Pillai, Subash Kumar; Ponnusamy, Subramaniam; Sonneck, Gernot; Furnham, Adrian; Lester, David

    2008-12-01

    The genetics of suicide is increasingly recognized and relevant for mental health literacy, but actual beliefs may lag behind current knowledge. We examined such beliefs in student samples (total N = 686) from Estonia, Malaysia, Romania, the United Kingdom, and the United States with the Beliefs in the Inheritance of Risk Factors for Suicide Scale. Cultural effects were small, those of key demographics nil. Several facets of construct validity were demonstrated. Marked differences in perceived plausibility of evidence about the genetics of suicide according to research design, observed in all samples, may be of general interest for investigating lay theories of abnormal behavior and communicating behavioral and psychiatric genetic research findings.

  18. SU-E-T-559: Monte Carlo Simulation of Cobalt-60 Teletherapy Unit Modeling In-Field and Out-Of-Field Doses for Applications in Computational Radiation Dosimetry

    Energy Technology Data Exchange (ETDEWEB)

    Petroccia, H; Bolch, W [J. Crayton Pruitt Family of Biomedical Engineering, University of Florida, Gainesville, FL (United States); Li, Z; Mendenhall, N [Radiation Oncology, UF Health Proton Therapy Institute, Jacksonville, FL (United States)

    2015-06-15

    Purpose: Mean organ doses from structures located in field and outside of field boundaries during radiotherapy treatment must be considered when looking at secondary effects. Treatment planning in patients with 40 years of follow-up does not include 3-D treatment planning images and did not estimate dose to structures out of the direct field. Therefore, it is of interest to correlate actual clinical events with doses received. Methods: Accurate models of radiotherapy machines combined with whole body computational phantoms using Monte Carlo methods allow for dose reconstructions intended for studies on late radiation effects. The Theratron-780 radiotherapy unit and anatomically realistic hybrid computational phantoms are modeled in the Monte Carlo radiation transport code MCNPX. The major components of the machine including the source capsule, lead in the unit-head, collimators (fixed/adjustable), and trimmer bars are simulated. The MCNPX transport code is used to compare calculated values in a water phantom with published data from BJR suppl. 25 for in-field doses and experimental data from AAPM Task Group No. 36 for out-of-field doses. Next, the validated cobalt-60 teletherapy model is combined with the UF/NCI Family of Reference Hybrid Computational Phantoms as a methodology for estimating organ doses. Results: The model of Theratron-780 has shown to be agree with percentage depth dose data within approximately 1% and for out of field doses the machine is shown to agree within 8.8%. Organ doses are reported for reference hybrid phantoms. Conclusion: Combining the UF/NCI Family of Reference Hybrid Computational Phantoms along with a validated model of the Theratron-780 allows for organ dose estimates of both in-field and out-of-field organs. By changing field size, position, and adding patient-specific blocking more complicated treatment set-ups can be recreated for patients treated historically, particularly those who lack both 2D/3D image sets.

  19. An influential factor for external radiation dose estimation for residents after the Fukushima Daiichi Nuclear Power Plant accident-time spent outdoors for residents in Iitate Village.

    Science.gov (United States)

    Ishikawa, Tetsuo; Yasumura, Seiji; Ohtsuru, Akira; Sakai, Akira; Akahane, Keiichi; Yonai, Shunsuke; Sakata, Ritsu; Ozasa, Kotaro; Hayashi, Masayuki; Ohira, Tetsuya; Kamiya, Kenji; Abe, Masafumi

    2016-06-01

    Many studies have been conducted on radiation doses to residents after the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Time spent outdoors is an influential factor for external dose estimation. Since little information was available on actual time spent outdoors for residents, different values of average time spent outdoors per day have been used in dose estimation studies on the FDNPP accident. The most conservative value of 24 h was sometimes used, while 2.4 h was adopted for indoor workers in the UNSCEAR 2013 report. Fukushima Medical University has been estimating individual external doses received by residents as a part of the Fukushima Health Management Survey by collecting information on the records of moves and activities (the Basic Survey) after the accident from each resident. In the present study, these records were analyzed to estimate an average time spent outdoors per day. As an example, in Iitate Village, its arithmetic mean was 2.08 h (95% CI: 1.64-2.51) for a total of 170 persons selected from respondents to the Basic Survey. This is a much smaller value than commonly assumed. When 2.08 h is used for the external dose estimation, the dose is about 25% (23-26% when using the above 95% CI) less compared with the dose estimated for the commonly used value of 8 h.

  20. The influence of particle size distribution on dose conversion factors for radon progeny in the underground excavations of hard coal mine.

    Science.gov (United States)

    Skubacz, Krystian; Wojtecki, Łukasz; Urban, Paweł

    2016-10-01

    In Polish underground mines, hazards caused by enhanced natural radioactivity occur. The sources of radiation exposure are short-lived radon decay products, mine waters containing radium (226)Ra and (228)Ra and the radioactive sediments that can precipitate out of these waters. For miners, the greatest exposure is usually due to short-lived radon decay products. The risk assessment is based on the measurement of the total potential alpha energy concentration (PAEC) and the evaluation of the related dose by using the dose conversion factor as recommended by relevant legal requirements. This paper presents the results of measurements of particle size distributions of ambient aerosols in an underground hard coal mine, the assessment of the radioactive particle size distribution of the short-lived radon decay products and the corresponding values of dose conversion factors. The measurements of the ambient airborne particle size distribution were performed in the range from a few nanometers to about 20 μm. The study therefore included practically the whole class of respirable particles. The results showed that the high concentration of ultrafine and fine aerosols measured can significantly affect the value of the dose conversion factors, and consequently the corresponding committed effective dose, to which the miners can be exposed. Copyright © 2016 Elsevier Ltd. All rights reserved.

  1. Molecular biological study-effects of prolonged irradiation by low dose-rate ionizing radiation on the production of growth factors in murine bone marrow cells

    Energy Technology Data Exchange (ETDEWEB)

    Saito, Mikio; Yamada, Yutaka; Nakamura, Shingo [Inst. for Environmental Sciences, Dept. of Radiobiology, Rokkasho, Aomori (JP)] [and others

    2001-07-01

    To evaluate effects of prolonged irradiation by low dose-rate ionizing radiation on the production of growth factors of cells, the gene expression of five cytokines, interleukin-1{alpha} (IL-1{alpha}), IL-6, IL-11 stem cell factor (SCF) and granulocyte-macrophage colony stimulating factor (GM-CSF), of mice was measured at accumulated doses between 1 and 8 Gy, with the dose interval of 1 Gy. Ten specific-pathogen-free (SPF) C3H/HeN female mice (8 w.o.) per experimental group were irradiated with {sup 137}Cs {gamma}-rays with the doses of 5 - 8 Gy at the dose rate of 20 mGy/(22 h-day), and the gene expression of five cytokines (IL-1{alpha}, IL-6, IL-11, SCF and GM-CSF) in bone marrow and two cytokines (IL-6 and GM-CSF) in spleen cells from the mice was measured semiquantitatively by both the reverse transcriptase-polymerase chain reaction (RT-PCR) and TaqMan Real-Time PCR method. (author)

  2. Risk factors for nosocomial infection in a Brazilian neonatal intensive care unit

    Directory of Open Access Journals (Sweden)

    Ana Carolina Vieira Costa Fernandes Távora

    2008-02-01

    Full Text Available This study was designed to describe the epidemiology and risk factors for nosocomial infection (NI in a Brazilian neonatal intensive care unit (NICU. This study was a retrospective cohort from January to December, 2003. All neonates admitted to the NICU. Infection surveillance was conducted according to the NNIS, CDC. Chi-square test and logistic regression model were performed for statistical analyses. The study was conducted at a public, tertiary referral NICU of a teaching hospital in the Northeast of Brazil. A total of 948 medical records were reviewed. Overall NI incidence rate was 34%. The main neonatal NI was bloodstream infection (68.1%, with clinical sepsis accounting for 47.2%, and pneumonia was the second most common NI (8.6%. Multivariate analysis identified seven independent risk factors for NIs: birth weight, exposure to parenteral nutrition, percutaneous catheter, central venous catheter or mechanical ventilation, abruptio placentae and mother's sexually transmitted disease (STD. Neonates from mothers with STD or abruptio placentae, those weighing less than 1,500 g at birth or those who used invasive devices were at increased risk for acquiring NI.

  3. Exploratory factor analysis for differentiating sensory and mechanical variables related to muscle-tendon unit elongation

    Directory of Open Access Journals (Sweden)

    Mauro H. Chagas

    2016-01-01

    Full Text Available ABSTRACT Background Stretching exercises are able to promote adaptations in the muscle-tendon unit (MTU, which can be tested through physiological and biomechanical variables. Identifying the key variables in MTU adaptations is crucial to improvements in training. Objective To perform an exploratory factor analysis (EFA involving the variables often used to evaluate the response of the MTU to stretching exercises. Method Maximum joint range of motion (ROMMAX, ROM at first sensation of stretching (FSTROM, peak torque (torqueMAX, passive stiffness, normalized stiffness, passive energy, and normalized energy were investigated in 36 participants during passive knee extension on an isokinetic dynamometer. Stiffness and energy values were normalized by the muscle cross-sectional area and their passive mode assured by monitoring the EMG activity. Results EFA revealed two major factors that explained 89.68% of the total variance: 53.13% was explained by the variables torqueMAX, passive stiffness, normalized stiffness, passive energy, and normalized energy, whereas the remaining 36.55% was explained by the variables ROMMAX and FSTROM. Conclusion This result supports the literature wherein two main hypotheses (mechanical and sensory theories have been suggested to describe the adaptations of the MTU to stretching exercises. Contrary to some studies, in the present investigation torqueMAX was significantly correlated with the variables of the mechanical theory rather than those of the sensory theory. Therefore, a new approach was proposed to explain the behavior of the torqueMAX during stretching exercises.

  4. Factors influencing the implementation of school wellness policies in the United States, 2009.

    Science.gov (United States)

    Budd, Elizabeth L; Schwarz, Cynthia; Yount, Byron W; Haire-Joshu, Debra

    2012-01-01

    The quality of school wellness policy implementation varies among schools in the United States. The objective of this study was to characterize the school wellness policy environment nationally and identify factors influencing the quality and effectiveness of policy implementation. We invited school administrators from 300 high schools to complete a questionnaire; 112 administrators responded. We performed a 2-step cluster analysis to help identify factors influencing the implementation of school wellness policies. Eighty-two percent of schools reported making staff aware of policy requirements; 77% established a wellness committee or task force, 73% developed administrative procedures, and 56% trained staff for policy implementation. Most commonly reported challenges to implementation were lack of time or coordination of policy team (37% of respondents) and lack of monetary resources (33%). The core domains least likely to be implemented were communication and promotion (63% of respondents) and evaluation (54%). Cluster 1, represented mostly by schools that have taken action toward implementing policies, had higher implementation and effectiveness ratings than Cluster 2, which was defined by taking fewer actions toward policy implementation. In Cluster 1, accountability was also associated with high ratings of implementation quality and effectiveness. The development of organizational capacity may be critical to ensuring an environment that promotes high-quality policy implementation. Assessing, preventing, and addressing challenges; establishing clear definitions and goals; and requiring accountability for enacting policy across all core domains are critical to ensuring high-quality implementation.

  5. Supply and Demand Factors in Understanding the Educational Earnings Differentials: West Germany and the United States

    Directory of Open Access Journals (Sweden)

    Gulgun Bayaz Ozturk

    2011-12-01

    Full Text Available This paper uses data from the March Current Population Survey and German Socio-Economic Panel to investigate the role of market forces and the institutional constraints in explaining the educational earnings differentials in the United States and West Germany. We make use of simple supply and demand framework to differentiate the effects of market forces from wage-setting institutions. Results indicate that differential growth in the relative employment of skilled workers is responsible for the differences in returns to skill in both countries over the period of analysis. In particular, rising educational attainment is the major factor underlying the changes in the employment of skilled workers in each country and it is followed by institutional factors. However, in addition to the differential growth in relative demand for skilled labor, differences in wage-setting institutions explain most of the cross-country differences in skill premia. We also provide evidence for polarization of jobs which is a recent phenomenon in both labor markets.

  6. Obstetric patients in a surgical intensive care unit: prognostic factors and outcome.

    Science.gov (United States)

    Mjahed, K; Hamoudi, D; Salmi, S; Barrou, L

    2006-07-01

    The objective of this study was to assess the incidence, prognostic factors and the outcome of obstetric patients admitted in a surgical intensive care unit (SICU) during the ante-partum or postpartum period (within 6 weeks of delivery). Between 1995 and 2002, the patients transferred from the department of obstetrics were retrospectively included into the study. Demographics included: obstetric data, medical and surgical histories, diagnosis, simplified acute physiology score (SAPS II), acute physiology and chronic health evaluation system APACHE II score; and the occurrence of organ failure, therapeutic interventions, length of stay in the SICU and outcome were recorded. During the study period, 364 obstetric patients were admitted to the SICU. Obstetric admissions to the SICU represented 0.6% of all deliveries and the SICU utilisation rate was 14.96%. The main indications for admission were eclampsia (70.6%) and postpartum haemorrhage (16.2%). The overall mortality rate was 16.7% (n = 61). In a logistic regression model, risk factors for death included organ system failure (odds ratio (OR) = 3.95 confidence interval (CI) [1.84 - 8.48], bilirubin >12 mg/l (OR = 1.017 CI [1.00 - 1.03]), and prolonged prothrombin time (OR = 0.97 CI [0.95 - 0.99]). Median length of stay was longer in non- survivors (6.5 +/- 7.3 vs 5.5 +/- 4.6 days). Maternal condition on admission and associated complications are the major determinant of maternal outcome.

  7. Prevalence of major risk factors and use of screening tests for cancer in the United States.

    Science.gov (United States)

    Fedewa, Stacey A; Sauer, Ann Goding; Siegel, Rebecca L; Jemal, Ahmedin

    2015-04-01

    Much of the suffering and death from cancer could be prevented by more systematic efforts to reduce tobacco use, improve diet, increase physical activity, reduce obesity, and expand the use of established screening tests. Monitoring the prevalence of cancer risk factors and screening is important to measure progress and strengthen cancer prevention and early detection efforts. In this review article, we provide recent prevalence estimates for several cancer risk factors, including tobacco, obesity, physical activity, nutrition, ultraviolet radiation exposure as well as human papillomavirus and hepatitis B vaccination coverage and cancer screening prevalence in the United States. In 2013, cigarette smoking prevalence was 17.8% among adults nationally, but ranged from 10.3% in Utah to 27.3% in West Virginia. In addition, 15.7% of U.S. high school students were current smokers. In 2011-2012, obesity prevalence was high among both adults (34.9%) and adolescents (20.5%), but has leveled off since 2002. About 20.2% of high school girls were users of indoor tanning devices, compared with 5.3% of boys. In 2013, cancer screening prevalence ranged from 58.6% for colorectal cancer to 80.8% for cervical cancer and remains low among the uninsured, particularly for colorectal cancer screening where only 21.9% of eligible adults received recommended colorectal cancer screening. ©2015 American Association for Cancer Research.

  8. Risk factors associated with swine dysentery in East-European pig production units

    Directory of Open Access Journals (Sweden)

    Mirko C.P.

    2005-01-01

    Full Text Available The objective of the present study was to determine the risk factors for swine dysentery in East-European middle-size to large farrow to finish units with separate breeding and grower-finisher facilities. Ten breeding animals (3-10% of the female inventory and 10 grower tinisher pigs (80-140 days-of age were sampled in each herd for polymerase chain reaction testing (PCR for Brachyspira hyodysenteriae (B hyo in their feces. Of 139 farrow to finish units, 51 (36.7% were positive, 49 (35,3% were negative, and 39 (28.1% were inconclusive for B hyo by PCR. In breeding subunits, twelve variables passed the screening criterion for risk factors (P<.2 for B hyo PCR positivity. The odds of the breeding subunits being B hyo PCR positive were 3.5 times greater when the grower-finisher subunit was positive and the fiber content of the diet was >6%. Use of "all in all out" farrowing policy and having >60% multiparous sows, each reduced the odds of being B hyo PCR positive about fourfold. In growing-finishing subunits, fourteen variables passed the screening criterion for risk factors (P<-2 for B hyo PCR positivity. B hyo PCR positive status of the breeding subunits and higher fiber content of the diet were the most influential variable, with the odds of the grower-finisher subunits being B hyo PCR positive almost eight times greater when the breeding subunit was also B hyo PCR positive. Grower-finisher B hyo PCR positivity was also associated with the percentage of pigs housed on concrete slats, with the odds of being positive 7.5 times higher for subunits where more that 70% of the animals were kept on concrete slats compared to all other floor types. There was a strong association between grower-finisher status and whether the animals were in outdoor lots with the odds of being B hyo PCR positive substantially lower for pigs in outdoor lots compared with all other surfaces.

  9. Acoustic dose and acoustic dose-rate.

    Science.gov (United States)

    Duck, Francis

    2009-10-01

    Acoustic dose is defined as the energy deposited by absorption of an acoustic wave per unit mass of the medium supporting the wave. Expressions for acoustic dose and acoustic dose-rate are given for plane-wave conditions, including temporal and frequency dependencies of energy deposition. The relationship between the acoustic dose-rate and the resulting temperature increase is explored, as is the relationship between acoustic dose-rate and radiation force. Energy transfer from the wave to the medium by means of acoustic cavitation is considered, and an approach is proposed in principle that could allow cavitation to be included within the proposed definitions of acoustic dose and acoustic dose-rate.

  10. A breast-specific, negligible-dose scatter correction technique for dedicated cone-beam breast CT: a physics-based approach to improve Hounsfield Unit accuracy

    Science.gov (United States)

    Yang, Kai; Burkett, George, Jr.; Boone, John M.

    2014-11-01

    The purpose of this research was to develop a method to correct the cupping artifact caused from x-ray scattering and to achieve consistent Hounsfield Unit (HU) values of breast tissues for a dedicated breast CT (bCT) system. The use of a beam passing array (BPA) composed of parallel-holes has been previously proposed for scatter correction in various imaging applications. In this study, we first verified the efficacy and accuracy using BPA to measure the scatter signal on a cone-beam bCT system. A systematic scatter correction approach was then developed by modeling the scatter-to-primary ratio (SPR) in projection images acquired with and without BPA. To quantitatively evaluate the improved accuracy of HU values, different breast tissue-equivalent phantoms were scanned and radially averaged HU profiles through reconstructed planes were evaluated. The dependency of the correction method on object size and number of projections was studied. A simplified application of the proposed method on five clinical patient scans was performed to demonstrate efficacy. For the typical 10-18 cm breast diameters seen in the bCT application, the proposed method can effectively correct for the cupping artifact and reduce the variation of HU values of breast equivalent material from 150 to 40 HU. The measured HU values of 100% glandular tissue, 50/50 glandular/adipose tissue, and 100% adipose tissue were approximately 46, -35, and -94, respectively. It was found that only six BPA projections were necessary to accurately implement this method, and the additional dose requirement is less than 1% of the exam dose. The proposed method can effectively correct for the cupping artifact caused from x-ray scattering and retain consistent HU values of breast tissues.

  11. Nosocomial infections and risk factors in intensive care unit of a university hospital

    Directory of Open Access Journals (Sweden)

    Zuhal Yesilbağ

    2015-09-01

    Full Text Available Objective: The aim of this study is to evaluate nosocomial infections (NIs in intensive care unit (ICU in terms of site of infection, distribution of pathogens and risk factors for developing infection. Methods: 80 patients staying for more than 48 hours in the ICU were included in the study. Epidemiologic characteristics of the patients, invasive procedures and other risk factors were noted. Cultures, identification of isolates and antibiotic susceptibility tests were made by standard microbiologic methods. Results: Of 56 patients who have developed NIs, 26 (50% had pneumonia, 15 (28.8% had bloodstream infections and 6 (11.5% had urinary tract infections. Klebsiella pneumoniae (23.5%, Pseudomonas aeruginosa (19.6%, and Acinetobacter spp. (15.6% were the most frequently isolated microorganisms, respectively. For Klebsiella pneumoniae isolates, extended spectrum beta lactamase (ESBL rate was 91.6%, carbapenem resistance rate was 15.6% and for Pseudomonas aeruginosa and Acinetobacter spp. carbapenem resistance rates were 60% and 100% respectively. Hemodialysis, enteral nutrition, total parenteral nutrition and prolonged hospitalization for more than 10 days were determined as independent risk factors for developing NI. Additionally Acute Physiology and Chronic Health Evaluation (APACHE II score, length of ICU stay and lenght of hospital stay before ICU were found to be high in the NI group. Conclusion: Pneumonia is the most common NI and carbapenem resistance in Gram-negative bacilli was remarkably high in our ICU. It was considered that infection control measures must be applied carefully, invasive procedures should be used in correct indications and we should avoid long-term hospitalization if unnecessary. J Clin Exp Invest 2015; 6 (3: 233-239

  12. Risk factors for legal induced abortion-related mortality in the United States.

    Science.gov (United States)

    Bartlett, Linda A; Berg, Cynthia J; Shulman, Holly B; Zane, Suzanne B; Green, Clarice A; Whitehead, Sara; Atrash, Hani K

    2004-04-01

    To assess risk factors for legal induced abortion-related deaths. This is a descriptive epidemiologic study of women dying of complications of induced abortions. Numerator data are from the Abortion Mortality Surveillance System. Denominator data are from the Abortion Surveillance System, which monitors the number and characteristics of women who have legal induced abortions in the United States. Risk factors examined include age of the woman, gestational length of pregnancy at the time of termination, race, and procedure. Main outcome measures include crude, adjusted, and risk factor-specific mortality rates. During 1988-1997, the overall death rate for women obtaining legally induced abortions was 0.7 per 100000 legal induced abortions. The risk of death increased exponentially by 38% for each additional week of gestation. Compared with women whose abortions were performed at or before 8 weeks of gestation, women whose abortions were performed in the second trimester were significantly more likely to die of abortion-related causes. The relative risk (unadjusted) of abortion-related mortality was 14.7 at 13-15 weeks of gestation (95% confidence interval [CI] 6.2, 34.7), 29.5 at 16-20 weeks (95% CI 12.9, 67.4), and 76.6 at or after 21 weeks (95% CI 32.5, 180.8). Up to 87% of deaths in women who chose to terminate their pregnancies after 8 weeks of gestation may have been avoidable if these women had accessed abortion services before 8 weeks of gestation. Although primary prevention of unintended pregnancy is optimal, among women who choose to terminate their pregnancies, increased access to surgical and nonsurgical abortion services may increase the proportion of abortions performed at lower-risk, early gestational ages and help further decrease deaths. II-2

  13. Draft audit report, human factors engineering control room design review: Saint Lucie Nuclear Power Plant, Unit No. 2

    Energy Technology Data Exchange (ETDEWEB)

    Peterson, L.R.; Lappa, D.A.; Moore, J.W.

    1981-09-03

    A human factors engineering preliminary design review of the Saint Lucie Unit 2 control room was performed at the site on August 3 through August 7, 1981. This design review was carried out by a team from the Human Factors Engineering Branch, Division of Human Factors Safety. This report was prepared on the basis of the HFEB's review of the applicant's Preliminary Design Assessment and the human factors engineering design review/audit performed at the site. The review team included human factors consultants from BioTechnology, Inc., Falls Church, Virginia, and from Lawrence Livermore National Laboratory (University of California), Livermore, California.

  14. Study of factors controlling exposure dose and image quality of C-arm in operation room according to detector size of it (Mainly L-Spine AP study)

    Energy Technology Data Exchange (ETDEWEB)

    Chui, Sung Hyun; Jo, Hwang Woo [Dept. of Radiology, Kyung Hee University Hospital at Gangdong, Seoul (Korea, Republic of); Chun, Woon Kwan; Song, Ha Jin [Dept. of Nuclear Engineering, Chosun University, Gwangju (Korea, Republic of); Dong, Kyung Rae [Dept. of Radiological Technology, Gwangju Health University, Gwangju (Korea, Republic of); Choi, Eun Jin [Dept. of Public Health and Medicine, Dongshin University, Naju (Korea, Republic of)

    2015-02-15

    Time of operation has been reduced and accuracy of operation has been improved since C-arm, which offer real-time image of patient, was introduced in operation room. However, because of the contamination of patient, C-arm could not be used more appropriately. Therefore, this study is to know factors of controlling exposure dose, image quality and the exposed dose of health professional in operation room. Height of Wilson frame (bed for operation) was fixed at 130 cm. Then, Model 76-2 Phantom, which was set by assembling manual of Fluke Company, was set on the bed. Head/Spine Fluoroscopy AEC mode was set for exposure condition. According to detector size of C-arm, the absorbed dose per min was measured in the 7 steps OFD (cm) from 10 cm to 40 cm (10, 15, 20, 25, 30, 35, 40 cm). In each step of OFD, the absorbed dose per min of same diameter of collimation was measured. Moreover, using Nero MAX Model 8000, exposure dose per min was measured according to 3 step of distance from detector (20 cm, 60 cm, 100 cm). Finally, resolution was measured by CDRH Disc Phantom and magnification of each OFD was measured by aluminum stick bar. According to detector size of C-arm, difference of absorbed dose shows that the dose of 20 cm OFD is 1.750 times higher than the dose of 40 cm OFD. It means that the C-arm, which has smaller size of detector, shows the bigger difference of absorbed dose per min (p<0.05). In the difference of absorbed dose in the same step of OFD (from 20 cm to 40 cm), the absorbed dose of 9 inch detect or C-arm was 1.370 times higher than 12 inch' s (p<0.05). When OFD was set to 20 cm OFD, the absorbed dose of non-collimation case was approximately 0.816 times lower than the absorbed dose of collimation cases (p<0.05). When the distance was 20 cm from detector, exposed does includes first-ray and scatter-ray. When the distance was 60 cm and 100 cm from detector, exposed does includes just scatter-ray. So, there was the 2.200 times difference of absorbed

  15. Factors influencing haematological recovery following high-dose chemotherapy and peripheral stem-cell transplantation for haematological malignancies : 1-year analysis

    NARCIS (Netherlands)

    Nieboer, P; de Vries, EGE; Vellenga, E; van der Graaf, WTA; Mulder, NH; Sluiter, WJ; de Wolf, JTM

    2004-01-01

    Peripheral blood Counts and factors influencing haematological recovery in 98 patients with a relapse-free survival of greater than or equal to 1 year treated with high-dose chemotherapy (HDC) and peripheral stem-cell transplantation (PSCT) for haematological malignancies were analysed. One year aft

  16. Growth factor treatment prior to low-dose total body irradiation increases donor cell engraftment after bone marrow transplantation in mice

    NARCIS (Netherlands)

    Noach, EJK; Ausema, A; Dillingh, JH; Dontje, B; Weersing, E; Akkerman, [No Value; Vellenga, E; Haan, GC

    2002-01-01

    Low-toxicity conditioning regimens prior to bone marrow transplantation (BMT) are widely explored. We developed a new protocol using hematopoietic growth factors prior to low-dose total body irradiation (TBI) in recipients of autologous transplants to establish high levels of long-term donor cell en

  17. Factors influencing catheter-related infections in the Dutch multicenter study on high-dose chemotherapy followed by peripheral SCT in high-risk breast cancer patients

    NARCIS (Netherlands)

    Nieboer, P; de Vries, Elisabeth G. E.; Mulder, Nanno; Rodenhuis, S; Bontenbal, M; van der Wall, E; van Hoesel, Q G; Smit, W M; Hupperets, P; Voest, E E; Nooij, M A; Boezen, H M; van der Graaf, W T A

    2008-01-01

    Neutropenia following high-dose chemotherapy leads to a high incidence of infectious complications, of which central venous catheter-related infections predominate. Catheter-related infections and associated risk factors in 392 patients participating in a randomized adjuvant breast cancer trial and

  18. Factors influencing catheter-related infections in the Dutch multicenter study on high-dose chemotherapy followed by peripheral SCT in high-risk breast cancer patients.

    NARCIS (Netherlands)

    Nieboer, P.; Vries, E.G. de; Mulder, N.H.; Rodenhuis, S.; Bontenbal, M.; Wall, E. van der; Hoesel, Q.G.C.M. van; Smit, W.M.; Hupperets, P.; Voest, E.E.; Nooij, M.A.; Boezen, H.M.; Graaf, W.T.A. van der

    2008-01-01

    Neutropenia following high-dose chemotherapy leads to a high incidence of infectious complications, of which central venous catheter-related infections predominate. Catheter-related infections and associated risk factors in 392 patients participating in a randomized adjuvant breast cancer trial and

  19. Comment on `Update of 40K and 226Ra and 232Th series $\\gamma$-to-dose conversion factors for soil'

    CERN Document Server

    Malins, Alex; Saito, Kimiaki

    2015-01-01

    A letter to the editor of the Journal of Environmental Radioactivity on the article: E. Gasser, A. Nachab, A. Nourreddine, Ch. Roy, and A. Sellam, `Update of 40K and 226Ra and 232Th series $\\gamma$-to-dose conversion factors for soil', J. Environ. Radioactiv. 138, 68-71 (2014), DOI: 10.1016/j.jenvrad.2014.08.002.

  20. The costs of peripheral blood progenitor cell reinfusion mobilised by granulocyte colony-stimulating factor following high dose melphalan as compared with conventional therapy in multiple myeloma

    NARCIS (Netherlands)

    C.A. Uyl-de Groot (Carin); G.J. Ossenkoppele (Gert); A.A.P.M. van Riet (A. A P M); F.F.H. Rutten (Frans)

    1994-01-01

    textabstractIn a retrospective study, we calculated the treatment costs of 26 patients, who received either high dose melphalan combined with granulocyte colony-stimulating factor (G-CSF; filgrastim)(n=7) or without G-CSF (n=11) or alternatively, peripheral blood progenitor cell reinfusion (PBPC) mo

  1. Low skeletal muscle mass is a predictive factor for chemotherapy dose-limiting toxicity in patients with locally advanced head and neck cancer

    NARCIS (Netherlands)

    Wendrich, Anne W; Swartz, Justin E; Bril, Sandra I; Wegner, Inge; de Graeff, Alexander|info:eu-repo/dai/nl/187695997; Smid, Ernst J; de Bree, Remco; Pothen, Ajit J

    OBJECTIVES: Low skeletal muscle mass (SMM) or sarcopenia is emerging as an adverse prognostic factor for chemotherapy dose-limiting toxicity (CLDT) and survival in cancer patients. Our aim was to determine the impact of low SMM on CDLT in patients with locally advanced head and neck squamous cell

  2. Transcription factors binding to the cis-elements of GADD45 gene in ML-1 cells after low-dose irradiation

    Energy Technology Data Exchange (ETDEWEB)

    Daino, Kazuhiro [Chiba Univ., Faculty of Science, Chiba (Japan); Ichimura, Sachiko; Nenoi, Mitsuru [National Inst. of Radiological Sciences, Chiba (Japan)

    2003-07-01

    Several stress-responsive genes, including p53-target genes, are induced by low-dose of ionizing radiation ranging from 0.02 to 0.5 Gy. We show here that 0.5 Gy of X-rays increase the transcription rate of the GADD45 gene, with maximum induction at 0.5 to 1 h after irradiation, much earlier than the maximum accumulation of stabilized p53 protein. It could be suggested that some transcription factors cooperate with p53 in regulating the GADD45 gene at an early time after low-dose irradiation. This idea is supported by the studies that showed GKLF and Spl are required for p53-dependent transcriptional activation of the p21{sup WAFI/Cipl} and BAX genes, respectively. To examine the possible involvement of cooperating transcription factors in regulation of the GADD45 gene after low-dose radiation, we attempted a comprehensive EMSA, in which 136 species of double-stranded DNA probes were used to identify X-ray-inducible factor-bindings to the upstream and the third intron regions of the gene after exposure to 0.5 Gy of X-rays in human myeloblastic leukemia ML-1 cells. Several X-ray-inducible DNA-protein complexes were observed. The factors related to forkhead transcription factors, POU domain transcription factors and kruppel-like factors were putatively identified by the competition assay. It is possible that these factors cooperate with p53 to mediate the transcriptional regulation of the GADD45 genes after low-dose irradiation. (author)

  3. Factors influencing ground-water recharge in the eastern United States

    Science.gov (United States)

    Nolan, B.T.; Healy, R.W.; Taber, P.E.; Perkins, K.; Hitt, K.J.; Wolock, D.M.

    2007-01-01

    Ground-water recharge estimates for selected locations in the eastern half of the United States were obtained by Darcian and chloride-tracer methods and compared using statistical analyses. Recharge estimates derived from unsaturated-zone (RUZC) and saturated-zone (RSZC) chloride mass balance methods are less variable (interquartile ranges or IQRs are 9.5 and 16.1 cm/yr, respectively) and more strongly correlated with climatic, hydrologic, land use, and sediment variables than Darcian estimates (IQR = 22.8 cm/yr). The unit-gradient Darcian estimates are a nonlinear function of moisture content and also reflect the uncertainty of pedotransfer functions used to estimate hydraulic parameters. Significance level is 0.3. Estimates of RSZC were evaluated using analysis of variance, multiple comparison tests, and an exploratory nonlinear regression (NLR) model. Recharge generally is greater in coastal plain surficial aquifers, fractured crystalline rocks, and carbonate rocks, or in areas with high sand content. Westernmost portions of the study area have low recharge, receive somewhat less precipitation, and contain fine-grained sediment. The NLR model simulates water input to the land surface followed by transport to ground water, depending on factors that either promote or inhibit water infiltration. The model explains a moderate amount of variation in the data set (coefficient of determination = 0.61). Model sensitivity analysis indicates that mean annual runoff, air temperature, and precipitation, and an index of ground-water exfiltration potential most influence estimates of recharge at sampled sites in the region. Soil characteristics and land use have less influence on the recharge estimates, but nonetheless are significant in the NLR model. ?? 2006 Elsevier B.V. All rights reserved.

  4. Monitoring low molecular weight heparins at therapeutic levels: dose-responses of, and correlations and differences between aPTT, anti-factor Xa and thrombin generation assays.

    Directory of Open Access Journals (Sweden)

    Owain Thomas

    Full Text Available Low molecular weight heparins (LMWH's are used to prevent and treat thrombosis. Tests for monitoring LMWH's include anti-factor Xa (anti-FXa, activated partial thromboplastin time (aPTT and thrombin generation. Anti-FXa is the current gold standard despite LMWH's varying affinities for FXa and thrombin.To examine the effects of two different LMWH's on the results of 4 different aPTT-tests, anti-FXa activity and thrombin generation and to assess the tests' concordance.Enoxaparin and tinzaparin were added ex-vivo in concentrations of 0.0, 0.5, 1.0 and 1.5 anti-FXa international units (IU/mL, to blood from 10 volunteers. aPTT was measured using two whole blood methods (Free oscillation rheometry (FOR and Hemochron Jr (HCJ and an optical plasma method using two different reagents (ActinFSL and PTT-Automat. Anti-FXa activity was quantified using a chromogenic assay. Thrombin generation (Endogenous Thrombin Potential, ETP was measured on a Ceveron Alpha instrument using the TGA RB and more tissue-factor rich TGA RC reagents.Methods' mean aPTT at 1.0 IU/mL LMWH varied between 54s (SD 11 and 69s (SD 14 for enoxaparin and between 101s (SD 21 and 140s (SD 28 for tinzaparin. ActinFSL gave significantly shorter aPTT results. aPTT and anti-FXa generally correlated well. ETP as measured with the TGA RC reagent but not the TGA RB reagent showed an inverse exponential relationship to the concentration of LMWH. The HCJ-aPTT results had the weakest correlation to anti-FXa and thrombin generation (Rs0.62-0.87, whereas the other aPTT methods had similar correlation coefficients (Rs0.80-0.92.aPTT displays a linear dose-response to LMWH. There is variation between aPTT assays. Tinzaparin increases aPTT and decreases thrombin generation more than enoxaparin at any given level of anti-FXa activity, casting doubt on anti-FXa's present gold standard status. Thrombin generation with tissue factor-rich activator is a promising method for monitoring LMWH's.

  5. Comparison of Risk Factors in Necrotizing Enterocolitis among Infants in Neonatal Intensive Care Unit

    Directory of Open Access Journals (Sweden)

    Ferda Ozlu

    2013-08-01

    Full Text Available Purpose: Necrotizing enterocolitis is one of the important problems of premature infants. The incidence is about 1-5% in infants followed in neonatal care units and inversely related to gestational age and birth weight. Materials and Methods: In this study, 31 infants with necrotizing enterocolitis and 31 infants with similar gestational age and birth weight as control group hospitalized in Cukurova University Neonatal Care Unit between 1 January 2001-31 January 2004 were evaluated. Results: The incidence of necrotizing enterocolitis in this period was 1.4 (31/2214 admission. Mean gestational age was 30.5  3.2 weeks (25-36, mean birth weight was 1331  384 (730-2150 grams while 71% was younger than 32 gestational weeks and 67.7% was under 1500 grams. The signs of NEC were detected at a mean of 11.2  10. (2-38 days. Twenty-six (83.9% were being fed at the time of the necrotizing enterocolitis signs appeared. According to the Walsh and Kliegman classification, 19 (61.3% infants were in stage 1 (17 were 1a, 2 were 1b; 3 (9.6% infants were in stage 2a, 9 (%29.1 infants were in stage 3 (7 were in 3b. Blood culture was positive in 7 (%22.6 infants with predominance of gram negative microorganisms (5 infants. Eleven (%35.5 infants were exitus, 12 were discharged. Hypoxia, respiratory distress syndrome, intraventricular hemorrhage and umbilical catheterization were significant risk factors in necrotizing enterocolitis . Thrombocytopenia, leucopenia and high C-reactive protein levels were significantly high in necrotizing enterocolitis group. Breast feeding is significantly high in control group. Conclusion: Necrotizing enterocolitis, is a leading cause of morbidity and mortality in neonatal intensive care units. Early breast feeding with small amounts, increasing amount of milk slowly, antenatal steroids, caring hygiene rules can prevent the development of it. [Cukurova Med J 2013; 38(4.000: 642-647

  6. Preliminary results of the average glandular dose to the breast with TLDS measure is computed as the conversion factors; Resultados preliminares da dose glandular media na mama medida com TLDS e calculada atraves de fatores de conversao

    Energy Technology Data Exchange (ETDEWEB)

    Sardo, Luiz T.L.; Almeida, Claudio D.; Coutinho, Celia M.C., E-mail: ltsardo@yahoo.com.br, E-mail: claudio@ird.gov.br, E-mail: celia@ird.gov.br [Instituto de Radioprotecao e Dosimetria (IRD/CNEN-RJ), Rio de Janeiro, RJ (Brazil)

    2013-07-01

    At mammography exams there is a risk of a breast cancer induced from the absorbed dose by the glandular tissue. According to the National Institute of Cancer, INCA, breast cancer is the second type most frequent in the world and the most common among women, therefore the necessity of monitoring the mean glandular dose, D{sub G}. Measuring methods of D{sub G} were established by some authors. Among the established methods the method of Dance is one of the most known. In this study was utilized a measurement method realized with TL dosimeters inserted in a breast tissue equivalent phantom, BTE, with 46% of glandularity and exposed using Mo/Mo and Mo/Rh target/filter combination and 28kV. To ensure this measurement method the results were compared with a calculation method, used by Dance, of D{sub G} from the measurement of incident air kerma, K{sub i}, and conversion factors to consider mainly the beam quality, the compressed thickness and the glandularity of the breast. The results of the comparison of the D{sub G} measurement with the obtained dose by the method of Dance demonstrated that for the thickness of 4.0 and 6.0 cm the doses were consistent. For the thickness of 5.0 cm the difference was higher, indicating that the glandularity may influence, suggesting further investigation. (author)

  7. United States Marine Corps Career Designation Board: Significant Factors in Predicting Selection

    Science.gov (United States)

    2014-03-01

    Total Force Data Warehouse USMC United States Marine Corps USNA United States Naval Academy WTI Weapons and Tactics Instructor XO...Tactics Instructor ( WTI ), Professional Military Education (PME) complete, and Special Education/Advanced Degree Programs’ graduates had a

  8. Entrance dose measurements for in-vivo diode dosimetry: Comparison of correction factors for two types of commercial silicon diode detectors.

    Science.gov (United States)

    Zhu, X R

    2000-01-01

    Silicon diode dosimeters have been used routinely for in-vivo dosimetry. Despite their popularity, an appropriate implementation of an in-vivo dosimetry program using diode detectors remains a challenge for clinical physicists. One common approach is to relate the diode readout to the entrance dose, that is, dose to the reference depth of maximum dose such as d(max) for the 10x10 cm(2) field. Various correction factors are needed in order to properly infer the entrance dose from the diode readout, depending on field sizes, target-to-surface distances (TSD), and accessories (such as wedges and compensate filters). In some clinical practices, however, no correction factor is used. In this case, a diode-dosimeter-based in-vivo dosimetry program may not serve the purpose effectively; that is, to provide an overall check of the dosimetry procedure. In this paper, we provide a formula to relate the diode readout to the entrance dose. Correction factors for TSD, field size, and wedges used in this formula are also clearly defined. Two types of commercial diode detectors, ISORAD (n-type) and the newly available QED (p-type) (Sun Nuclear Corporation), are studied. We compared correction factors for TSDs, field sizes, and wedges. Our results are consistent with the theory of radiation damage of silicon diodes. Radiation damage has been shown to be more serious for n-type than for p-type detectors. In general, both types of diode dosimeters require correction factors depending on beam energy, TSD, field size, and wedge. The magnitudes of corrections for QED (p-type) diodes are smaller than ISORAD detectors.

  9. Successful immune tolerance induction with low-dose coagulation factor VIII in a patient with hemophilia A from a developing country.

    Science.gov (United States)

    Ay, Yilmaz; Ersin, Toret; Yesim, Oymak; Hilkay, Karapinar Tuba; Dilek, Ince; Gulcihan, Ozek; Ahmet, Koc

    2016-09-01

    Inhibitor development is the most frequent and serious complication of the treatment in patients with hemophilia. Immune tolerance induction (ITI) is the only option of treatment for the eradication of factor VIII (FVIII) inhibitor. We would like to present our case with hemophilia whose FVIII inhibitor eradication was done by a low-dose ITI regimen. Our patient has been applied on-demand therapy until 8 years of age. Secondary prophylaxis was began because of having hemophilic arthropathy. A low titer of FVIII inhibitor (4.2 BU/ml) was detected in the fifth month of the prophylaxis. The peak inhibitor titer of patient was 4.6 BU/ml, and there was no decrease in inhibitor titer in the follow-up duration. The low-dose ITI (50 IU/kg, 3 days a week) was started. His inhibitor level was detected negative and the recovery test was ameliorated in the 15th of the ITI therapy. High-dose regimen ITI could not be given particularly in developing countries such as Turkey in view of the high cost of treatment. Patients who had good risk factors might be successfully treated by using low-dose ITI regimen as effective as high-dose ITI regimen.

  10. STUDY OF VENTILATOR ASSOCIATED PNEUMONIA IN NEONATAL INTESIVE CARE UNIT: CHARACTERISTICS, RISK FACTORS AND OUTCOME

    Directory of Open Access Journals (Sweden)

    Dr. Shalini Tripathi

    2010-01-01

    Full Text Available Ventilator Associated Pneumonia (VAP, the nosocomial pneumonia developing in mechanically ventilated patients after 48 hours of mechanical ventilation, is the second most common nosocomial infection. Therefore, there is a vital need to study the etiology and risk factors associated with VAP in neonates. Neonates admitted to neonatal intensive care unit (NICU, over a period of 1 year and who required mechanical ventilation for more than 48 hours were enrolled consecutively into the study. Diagnosis of VAP was made by the guidelines given by National Nosocomial infection Surveillance System (NNIS, 1996. Semi-quantitative assay of endotracheal aspirate was used for microbiological diagnoses of VAP. 105CFU/ml was taken as the cut off between evidence of pathological infection and colonization. The risk factors such as birth weight, prematurity (gestational age < 37 weeks, duration of mechanical ventilation, number of reintubations, length of hospital stay, primary diagnosis of neonate, postnatal age and small for gestational age (SGA were studied for the development of VAP. Risk factors found significant on bivariate analysis were subjected to multiple regression analysis to determine the most important predictors of VAP. The study group comprised of 98 neonates out of which, 30 neonates developed VAP (30.6%. VAP rates were 37.2 per 1000 days of mechanical ventilation. Most common bacterial isolated from endotracheal aspirate of VAP patients was Klebsiella spp (32.8%, E.coli (23.2% and Acinetobacter (17.8% being the other two common organisms. Very low birth weight (< 1500 grams, prematurity (gestational age < 37 week, duration of mechanical ventilation, number of reintubations and length of NICU stay were significantly associated with VAP in bivariate analysis. Multiple regression analysis revealed that duration of mechanical ventilation (OR 1.10, 95% CI 1.02, 1.21; P = 0.021 and very low birth weight (OR 3.88, 95% CI 1.05, 14.34; P = 0.042 were

  11. Factors Associated With Chest Wall Toxicity After Accelerated Partial Breast Irradiation Using High-Dose-Rate Brachytherapy

    Energy Technology Data Exchange (ETDEWEB)

    Brown, Sheree, E-mail: shereedst32@hotmail.com [Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, Georgia (United States); Vicini, Frank [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Vanapalli, Jyotsna R.; Whitaker, Thomas J.; Pope, D. Keith [Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, Georgia (United States); Lyden, Maureen [BioStat International, Inc., Tampa, Florida (United States); Bruggeman, Lisa; Haile, Kenneth L.; McLaughlin, Mark P. [Department of Radiation Oncology, WellStar Kennestone Hospital, Marietta, Georgia (United States)

    2012-07-01

    Purpose: The purpose of this analysis was to evaluate dose-volume relationships associated with a higher probability for developing chest wall toxicity (pain) after accelerated partial breast irradiation (APBI) by using both single-lumen and multilumen brachytherapy. Methods and Materials: Rib dose data were available for 89 patients treated with APBI and were correlated with the development of chest wall/rib pain at any point after treatment. Ribs were contoured on computed tomography planning scans, and rib dose-volume histograms (DVH) along with histograms for other structures were constructed. Rib DVH data for all patients were sampled at all volumes {>=}0.008 cubic centimeter (cc) (for maximum dose related to pain) and at volumes of 0.5, 1, 2, and 3 cc for analysis. Rib pain was evaluated at each follow-up visit. Patient responses were marked as yes or no. No attempt was made to grade responses. Eighty-nine responses were available for this analysis. Results: Nineteen patients (21.3%) complained of transient chest wall/rib pain at any point in follow-up. Analysis showed a direct correlation between total dose received and volume of rib irradiated with the probability of developing rib/chest wall pain at any point after follow-up. The median maximum dose at volumes {>=}0.008 cc of rib in patients who experienced chest wall pain was 132% of the prescribed dose versus 95% of the prescribed dose in those patients who did not experience pain (p = 0.0035). Conclusions: Although the incidence of chest wall/rib pain is quite low with APBI brachytherapy, attempts should be made to keep the volume of rib irradiated at a minimum and the maximum dose received by the chest wall as low as reasonably achievable.

  12. Factors associated with dose escalation of fesoterodine for treatment of overactive bladder in people >65 years of age: A post hoc analysis of data from the SOFIA study.

    Science.gov (United States)

    Wagg, Adrian; Darekar, Amanda; Arumi, Daniel; Khullar, Vik; Oelke, Matthias

    2015-06-01

    To investigate factors which may influence dose escalation of antimuscarinics for overactive bladder (OAB) in older patients and how dose escalation affects treatment efficacy. A post hoc analysis of data from the 12-week randomized, placebo controlled phase of the SOFIA study investigating treatment with fesoterodine in older people with OAB. Predictors and outcomes in patients aged ≥65 years with OAB who did or did not choose to escalate from fesoterodine 4 to 8 mg before the first dose-escalation choice point (week 4) and at the end of the study (week 12) were assessed. Variables which significantly increased likelihood of dose escalation were, at baseline, body mass index (OR: 1.06, 95% CI 1.01, 1.12; P = 0.0222), and male gender (OR: 2.06, 95% CI 1.28, 3.32; P = 0.0028) and at week 4, change from baseline in urgency episodes (OR: 1.12, 95% CI 1.05, 1.20; P = 0.0008), patient perception of bladder control (PPBC) (OR: 1.44, 95% CI 1.12, 1.84; P = 0.004). At week 12, dose escalation was associated with slightly reduced treatment outcomes compared to week 4 non-escalators. No baseline disease related factor associated with dose escalation was identified. Magnitude of change in urgency episodes and reduction in PPBC at 4 weeks were associated with dose escalation. These data may be of use to healthcare providers as they allow judgement to be made in individual patients, allowing treatment decisions to be made. At end of treatment, improvements in efficacy and quality of life were achieved in both escalators and non-escalators. © 2014 Wiley Periodicals, Inc.

  13. Dose-rate effects of protons on in vivo activation of nuclear factor-kappa B and cytokines in mouse bone marrow cells

    Energy Technology Data Exchange (ETDEWEB)

    Rithidech, K.N.; Rusek, A.; Reungpatthanaphong, P.; Honikel, L.; Simon, S.R.

    2010-05-28

    The objective of this study was to determine the kinetics of nuclear factor-kappa B (NF-{kappa}B) activation and cytokine expression in bone marrow (BM) cells of exposed mice as a function of the dose rate of protons. The cytokines included in this study are pro-inflammatory [i.e., tumor necrosis factor-alpha (TNF-{alpha}), interleukin-1beta (IL-1{beta}), and IL-6] and anti-inflammatory cytokines (i.e., IL-4 and IL-10). We gave male BALB/cJ mice a whole-body exposure to 0 (sham-controls) or 1.0 Gy of 100 MeV protons, delivered at 5 or 10 mGy min{sup -1}, the dose and dose rates found during solar particle events in space. As a reference radiation, groups of mice were exposed to 0 (sham-controls) or 1 Gy of {sup 137}Cs {gamma} rays (10 mGy min{sup -1}). After irradiation, BM cells were collected at 1.5, 3, 24 h, and 1 month for analyses (five mice per treatment group per harvest time). The results indicated that the in vivo time course of effects induced by a single dose of 1 Gy of 100 MeV protons or {sup 137}Cs {gamma} rays, delivered at 10 mGy min{sup -1}, was similar. Although statistically significant levels of NF-{kappa}B activation and pro-inflammatory cytokines in BM cells of exposed mice when compared to those in the corresponding sham controls (Student's t-test, p < 0.05 or < 0.01) were induced by either dose rate, these levels varied over time for each protein. Further, only a dose rate of 5 mGy min{sup -1} induced significant levels of anti-inflammatory cytokines. The results indicate dose-rate effects of protons.

  14. EURISOL-DS multi-MW target unit: Neutronics performance and shielding assessment, dose rate and material activation calculations for the MAFF configuration

    CERN Document Server

    Romanets, Y; Kadi, Y; Luis, R; Goncalves, I F; Tecchio, L; Kharoua, C; Vaz, P; Ene, D; David, J C; Rocca, R; Negoita, F

    2010-01-01

    One of the objectives of the EURISOL (EURopean Isotope Separation On-Line Radioactive Ion Beam) Design Study consisted of providing a safe and reliable facility layout and design for the following operational parameters and characteristics: (a) a 4 MW proton beam of 1 GeV energy impinging on a mercury target (the converter); (b) high neutron fluxes (similar to 3 x 10(16) neutrons/s) generated by spallation reactions of the protons impinging in the converter and (c) fission rate on fissile U-235 targets in excess of 10(15) fissions/s. In this work, the state-of-the-art Monte Carlo codes MCNPX (Pelowitz, 2005) and FLUKA (Vlachoudis, 2009; Ferrari et al., 2008) were used to characterize the neutronics performance and to perform the shielding assessment (Herrera-Martinez and Kadi, 2006; Cornell, 2003) of the EURISOLTarget Unit and to provide estimations of dose rate and activation of different components, in view of the radiation safety assessment of the facility. Dosimetry and activation calculations were perfor...

  15. Million hearts: prevalence of leading cardiovascular disease risk factors--United States, 2005-2012.

    Science.gov (United States)

    Ritchey, Matthew D; Wall, Hilary K; Gillespie, Cathleen; George, Mary G; Jamal, Ahmed

    2014-05-30

    Each year, approximately 1.5 million U.S. adults have a heart attack or stroke, resulting in approximately 30 deaths every hour and, for nonfatal events, often leading to long-term disability. Overall, an estimated 14 million survivors of heart attacks and strokes are living in the United States. In 2011, the U.S. Department of Health and Human Services, in collaboration with nonprofit and private organizations, launched Million Hearts (http://www.millionhearts.hhs.gov), an initiative focused on implementing clinical and community-level evidence-based strategies to reduce cardiovascular disease (CVD) risk factors and prevent a total of 1 million heart attacks and strokes during the 5-year period 2012-2016. From 2005-2006 to the period with the most current data, analysis of the Million Hearts four "ABCS" clinical measures (for aspirin, blood pressure, cholesterol, and smoking) showed 1) no statistically significant change in the prevalence of aspirin use for secondary prevention (53.8% in 2009-2010), 2) an increase to 51.9% in the prevalence of blood pressure control (in 2011-2012), 3) an increase to 42.8% in the prevalence of cholesterol management (in 2011-2012), and 4) no statistically significant change in the prevalence of smoking assessment and treatment (22.2% in 2009-2010). In addition, analysis of two community-level indicators found 1) a decrease in current tobacco product smoking (including cigarette, cigar, or pipe use) prevalence to 25.1% in 2011-2012 and 2) minimal change in mean daily sodium intake (3,594 mg/day in 2009-2010). Although trends in some measures are encouraging, further reductions of CVD risk factors will be needed to meet Million Hearts goals by 2017.

  16. Delirium Frequency and Risk Factors Among Patients With Cancer in Palliative Care Unit.

    Science.gov (United States)

    Şenel, Gülcin; Uysal, Neşe; Oguz, Gonca; Kaya, Mensure; Kadioullari, Nihal; Koçak, Nesteren; Karaca, Serife

    2017-04-01

    Introductıon: Delirium is a complex but common disorder in palliative care with a prevalence between 13% and 88% but a particular frequency at the end of life yet often remains insufficiently diagnosed and managed. The aim of our study is to determine the frequency of delirium and identify factors associated with delirium at palliative care unit. Two hundred thirteen consecutive inpatients from October 1, 2012, to March 31, 2013, were studied prospectively. Age, gender, Palliative Performance Scale (PPS), Palliative Prognostic Index (PPI), length of stay in hospital, and delirium etiology and subtype were recorded. Delirium was diagnosed with using Delirium Rating Scale (DRS) and Diagnostic and Statistical Manual of Mental Disorders, 4th Edition Text Revision ( DSM-IV TR) criteria. The incidence of delirium among the patients with cancer was 49.8%. Mean age was 60.3 ± 14.8 (female 41%, male 59%, PPS 39.8%, PPI 5.9 ± 3.0, length of stay in hospital 8.6 ± 6.9 days). Univariate logistic regression analysis indicated that use of opioids, anticonvulsants, benzodiazepines, steroids, polypharmacy, infection, malnutrition, immobilization, sleep disturbance, constipation, hyperbilirubinemia, liver/renal failure, pulmonary failure/hypoxia, electrolyte imbalance, brain cancer/metastases, decreased PPS, and increased PPI were risk factors. Subtypes of delirium included hypoactive 49%, mixed 41%, and hyperactive 10%. The communicative impediments associated with delirium generate distress for the patient, their family, and health care practitioners who might have to contend with agitation and difficulty in assessing pain and other symptoms. To manage delirium in patients with cancer, clinicians must be able to diagnose it accurately and undertake appropriate assessment of underlying causes.

  17. The Dynamic Analysis of Hydropower House and Unit System in Coupled Hydraulic-mechanical-electric Factors

    Science.gov (United States)

    MA, Z. Y.; Wu, Q. Q.

    2016-11-01

    A hydraulic-mechanical-electric and structures coupled model of hydropower station system including subsystem models of the penstock, hydro-turbine model, speed governor, synchronous generator as well as grid, rotor-bearing system and powerhouse structure is established. This model is used to simulate the small fluctuation transient process of 10% load-up in the part load condition for hydropower station. Mechanical eccentric force, unbalanced magnetic pull and vortex pressure fluctuation at inlet of draft tube are considered in the numerical calculation. The interaction between hydraulic-mechanical-electric coupled factors and structural vibration properties during the small fluctuation transient process is studied. The results indicate that the speed regulation for turbine has very litter impact on the transient process of generator. In the process of small fluctuation with loading method in this paper, structure of powerhouse is greatly influenced by vortex pressure pulse in the draft tube, and the vibration of unit is excited by loads which caused by itself rotating.

  18. Determination of absorbed dose in water: evaluation of dosimetric factors calibration sets used in radiotherapy; Determinacao da dose absorvida na agua: avaliacao dos fatores de calibracao de conjuntos dosimetricos de uso em radioterapia

    Energy Technology Data Exchange (ETDEWEB)

    Fernandes, Marco A.R. [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Faculdade de Medicina. Departamento de Dermatologia e Radioterapia; Fontana, Julia M.; Santos, Vitor H.P.; Nunes, Isabella P.F.; Okawabata, Francine S., E-mail: marfernandes@fmb.unesp.br [Universidade Estadual Paulista Julio de Mesquita Filho (UNESP), Botucatu, SP (Brazil). Instituto de Biociencia

    2014-12-15

    This paper presents a methodology for measuring the dose rate (cGy/min) in a telecobaltotherapy beam, looking emphasize the need for calibration of dosimetric set used and the importance of conducting periodic clinical megavoltage dosimetry of these beams. Two dosimetric set with their respective calibration factors were used. The correction parameters indicated in dosimetry protocols were determined by ionization chambers used. The difference between the value of the dose rate used in the calculation of the service routine and the values obtained in this work with both dosimetric sets proved to be less than 1.5%, and therefore satisfies the maximum recommended tolerance on quality control protocols for this type of therapeutic beam. (author)

  19. Field Derived Emission Factors For Formaldehyde and other Volatile Organic Compounds in FEMA Temporary Housing Units

    Energy Technology Data Exchange (ETDEWEB)

    Parthasarathy, Srinandini; Maddalena, Randy L.; Russell, Marion L.; Apte, Michael G.

    2010-10-01

    Sixteen previously occupied temporary housing units (THUs) were studied to assess emissions of volatile organic compounds. The whole trailer emission factors wereevaluated for 36 VOCs including formaldehyde. Indoor sampling was carried out in the THUs located in Purvis staging yard in Mississippi, USA. Indoor temperature andrelative humidity (RH) were also measured in all the trailers during sampling. Indoor temperatures were varied (increased or decreased) in a selection of THUs using theheating, ventilation and air conditioning (HVAC) systems. Indoor temperatures during sampling ranged from 14o C to 33o C, and relative humidity (RH) varied between 35percentand 74percent. Ventilation rates were increased in some trailers using bathroom fans and vents during some of the sampling events. Ventilation rates measured during some aselection of sampling events varied from 0.14 to 4.3 h-1. Steady state indoor formaldehyde concentrations ranged from 10 mu g-m-3 to 1000 mu g-m-3. The formaldehyde concentrations in the trailers were of toxicological significance. The effects of temperature, humidity and ventilation rates were also studied. A linearregression model was built using log of percentage relative humidity, inverse of temperature (in K-1), and inverse log ACH as continuous independent variables, trailermanufacturer as a categorical independent variable, and log of the chemical emission factors as the dependent variable. The coefficients of inverse temperature, log relativehumidity, log inverse ACH with log emission factor were found to be statistically significant for all the samples at the 95percent confidence level. The regression model wasfound to explain about 84percent of the variation in the dependent variable. Most VOC concentrations measured indoors in the Purvis THUs were mostly found to be belowvalues reported in earlier studies by Maddalena et al.,1,2 Hodgson et al.,3 and Hippelein4. Emissions of TMPB-DIB (a plasticizer found in vinyl products) were found

  20. A comparison of traditional vs. Canadian tailored prophylaxis dosing of prophylactic factor infusions in children with haemophilia A and B in a single hemophilia treatment center.

    Science.gov (United States)

    Dodd, C; Watts, R G

    2012-07-01

    Prophylactic infusion of clotting factor concentrates is a developing standard of care for individuals with haemophilia. The ideal schedule and techniques of prophylactic infusions remain incompletely defined. Our aim was to determine the optimal techniques and schedules for factor prophylaxis in paediatric patients. A retrospective electronic medical record review of all children treated with prophylactic factor infusions in a single Haemophilia Treatment Center was conducted. Comparison of traditional vs. Canadian dosing regimens and primary vs. secondary prophylaxis was made. Failure of prophylaxis was defined as the first serious bleed. A total of 58 children were identified for review. Five cases were excluded (four due to high titre inhibitors and one due to repeated non-compliance), thus there were 53 total cases: 46 with severe haemophilia, 2 with moderate haemophilia, 5 with mild haemophilia, 44 with haemophilia A and 9 with haemophilia B; 32 Traditional dosing and 21 Canadian dosing regimens. Patients on primary prophylaxis had a decreased failure rate (25%) compared to children treated with secondary prophylaxis (67%) regardless of technique of prophylaxis. When compared to a 'Traditional' factor prophylaxis schedule, the 'Canadian' tailored prophylaxis protocol was comparable with the exception of a decreased use of implanted venous devices in the 'Canadian' group. Ongoing bleeding (primarily joint bleeds) occurs with all prophylactic regimens. The lowest incidence of treatment failure was noted in children who began primary prophylaxis at a young age and before initial joint bleeds. Primary prophylaxis is superior to secondary prophylaxis regardless of dosing regimen. Traditional and Canadian dosing regimens were equivalent in outcome when measured over several years of follow-up.

  1. ACCEPTABILITY EVALUATION FOR USING ICRP TISSUE WEIGHTING FACTORS TO CALCULATE EFFECTIVE DOSE VALUE FOR SEPARATE GENDER-AGE GROUPS OF RUSSIAN FEDERATION

    Directory of Open Access Journals (Sweden)

    L. V. Repin

    2013-01-01

    Full Text Available An article describes radiation risk factors for several gender-age population groups according to Russian statistical and medical-demographic data, evaluates the lethality rate for separate nosologic forms of malignant neoplasms based on Russian cancer registries according to the method of the International Agency for Cancer Research. Relative damage factors are calculated for the gender-age groups under consideration. The tissue weighting factors recommended by ICRP to calculate effective doses are compared with relative damage factors calculated by ICRP for the nominal population and with similar factors calculated in this work for separate population cohorts in theRussian Federation. The significance of differences and the feasibility of using tissue weighting factors adapted for the Russian population in assessing population risks in cohorts of different gender-age compositions have been assessed.

  2. Dose-rate conversion factors for external exposure to photon and electron radiation from radionuclides occurring in routine releases from nuclear fuel cycle facilities. [Conversion factors are given for dose rates to 21 organs from 240 different radionuclides for 3 different modes of exposure

    Energy Technology Data Exchange (ETDEWEB)

    Kocher, D.C.

    1979-02-01

    Dose-rate conversion factors for external exposure to photon and electron radiation have been calculated for 240 radionuclides of potential importance in routine releases from nuclear fuel cycle facilities. Dose-rate conversion factors for immersion in contaminated air, immersion in contaminated water, and exposure to a contaminated ground surface are estimated for tissue-equivalent material at the body surface of an exposed individual. For each exposure mode, photon dose-rate conversion factors are also estimated for 22 body organs. The calculations assume that the contaminated air, water, and ground surface are infinite in extent and that the radionuclide concentration is uniform. Dose-rate conversion factors for immersion in contaminated air and water are based on the requirement that all energy emitted in the decay of a radionuclide is absorbed in the infinite medium. Dose-rate conversion factors for ground-surface exposure are calculated for a height of 1 m using the point-kernel integration method and known specific absorbed fractions for photons and electrons in air. The computer code DOSFACTER written to perform the calculations is described and documented.

  3. How much is enough? Modulation of dose-response curve for steroid receptor-regulated gene expression by changing concentrations of transcription factor.

    Science.gov (United States)

    Simons, S Stoney

    2006-01-01

    The position of the dose-response curve for steroid-regulated gene expression determines how much variation in response will accompany the normal physiological changes in circulating steroid. Over the last several years, it has become clear that the concentration of steroid hormone required for half-maximal induction or repression by a given receptor-steroid complex, which is normally called the EC50, is not constant for all responsive genes. Thus, the position of the dose-response curve can change so that a single concentration of steroid produces very different percentages of maximal activity. This, in turn, allows for the differential expression of genes by a common steroid hormone concentration during development, differentiation, and homeostasis. Here we review the variety of factors that influence the EC50 and position of the dose-response curve for steroid hormone receptors, discuss what is known about the mechanisms, and highlight promising areas for future research.

  4. Mobilization and collection of CD34+ cells for autologous transplantation of peripheral blood hematopoietic progenitor cells in children: analysis of two different granulocyte-colony stimulating factor doses

    Directory of Open Access Journals (Sweden)

    Kátia Aparecida de Brito Eid

    2015-06-01

    Full Text Available Introduction: The use of peripheral hematopoietic progenitor cells (HPCs is the cell choice in autologous transplantation. The classic dose of granulocyte-colony stimulating factor (G- CSF for mobilization is a single daily dose of 10 µg/kg of patient body weight. There is a theory that higher doses of granulocyte-colony stimulating factor applied twice daily could increase the number of CD34+ cells collected in fewer leukapheresis procedures. Objective: The aim of this study was to compare a fractionated dose of 15 µg G-CSF/kg of body weight and the conventional dose of granulocyte-colony stimulating factor in respect to the number of leukapheresis procedures required to achieve a minimum collection of 3 × 106 CD34+ cells/kg body weight. Methods: Patients were divided into two groups: Group 10 - patients who received a single daily dose of 10 µg G-CSF/kg body weight and Group 15 - patients who received a fractioned dose of 15 µg G-CSF/kg body weight daily. The leukapheresis procedure was carried out in an automated cell separator. The autologous transplantation was carried out when a minimum number of 3 × 106 CD34+ cells/kg body weight was achieved. Results: Group 10 comprised 39 patients and Group 15 comprised 26 patients. A total of 146 apheresis procedures were performed: 110 (75.3% for Group 10 and 36 (24.7% for Group 15. For Group 10, a median of three (range: 1-7 leukapheresis procedures and a mean of 8.89 × 106 CD34+ cells/kg body weight (±9.59 were collected whereas for Group 15 the corresponding values were one (range: 1-3 and 5.29 × 106 cells/kg body weight (±4.95. A statistically significant difference was found in relation to the number of apheresis procedures (p-value <0.0001. Conclusions: To collect a minimum target of 3 × 106 CD34+ cells/kg body weight, the administration of a fractionated dose of 15 µg G-CSF/kg body weight significantly decreased the number of leukapheresis procedures performed.

  5. Sustainability in a global context: How does local factor affect the outcomes of CSR activities in international business units?

    DEFF Research Database (Denmark)

    Thomsen, Christa; Lauring, Jakob

    In recent years CSR has become increasingly important for the activities and branding of MNCs. While some studies have investigated CSR management and branding in domestic situations, fewer studies exist in the case of international business units (subsidiaries, joint ventures, and franchises...... as CSR branding outcomes). Our findings show that local values were positively associated with external CSR engagement and that employee relations were positively related to both internal and external CSR engagement. None of the local factors were significantly associated with CSR branding outcomes......). In this study, we use a sample consisting of 119 Danish business units that are located in China. We set out to investigate the relationship between local factors (the local business unit’s Chinese values and internal employee relations in the unit) and CSR outcomes (internal and external CSR engagement as well...

  6. Factors in the Development of School Libraries in Great Britain and the United States: A Comparative Study.

    Science.gov (United States)

    Knuth, Rebecca

    1995-01-01

    Provides an overview of school library development in Great Britain and the United States and discusses five factors that have facilitated or retarded school library development in each country: standards, staffing and certification, government support, rationale for school libraries, and professional organizations. (Author/LRW)

  7. Universal Beliefs and Specific Practices: Students' Math Self-Efficacy and Related Factors in the United States and China

    Science.gov (United States)

    Wu, Yin

    2016-01-01

    This study intends to compare and contrast student and school factors that are associated with students' mathematics self-efficacy in the United States and China. Using hierarchical linear regressions to analyze the Programme for International Student Assessment (PISA) 2012 data, this study compares math self-efficacy, achievement, and variables…

  8. The Context of Military Environments: An Agenda for Basic Research on Social and Organizational Factors Relevant to Small Units

    Science.gov (United States)

    2014-06-01

    currently in play ( Samuelson and Zeckhauser, 1988). A related notion is regret avoidance: since people experience greater regret for action than for...for Basic Research on Social and Organizational Factors Relevant to Small Units 56 THE CONTEXT OF MILITARY ENVIRONMENTS Samuelson , W., and R. Zeckhauser

  9. Evaluating ergonomic risk factors in non-regulated stone carving units of Jaipur.

    Science.gov (United States)

    Mukhopadhyay, Prabir; Srivastava, Saurabh

    2010-01-01

    Stone carving at Jaipur in Rajasthan state of India, is a traditional craft employing a large number of local youths. As an unorganized sector problems are many ranging from lack of benefits to occupational ergonomic issues of Work Related Musculoskeletal Disorders(WMSDs) and injury to body parts. Twenty five male workers were selected in each of the three sections of a stone carving unit. The focus was to identify different ergonomic risk factors associated in this profession from the field. Still photography and video photography was used to record different activities. Different types of non invasive tools like Rapid Entire Body Assessment (REBA), Rapid Upper Limb Assessment (RULA), Occupational Repetitive Action Index (OCRA) were used. Psychophysical measures were investigated by Body part discomfort map, rated perceived exertion scale and visual analogue scale. Objective measurements (heart arte and skin temperature) were recorded with stop watch and digital thermometer. The working heart rate after 30 minutes of work was 112.4 beats per minute categorizing the work as moderately heavy. Postural analysis by REBA indicated high score (13/13). Similarly postural analysis by RULA showed high score (7/7). These indicate vulnerability of many of the postures to musculoskeletal disorders and injury. The study indicates that majority of the activities are in the high risk category and demands immediate ergonomic intervention in the form of tool, workstation and process design. This could be done by involving different Non Government Organizations (NGOs), political parties, and the Human Rights Department both at the center and at the state level.

  10. Dose in sensitive organs during the prostate treatment with a {sup 60}Co unit; Dosis en organos sensibles durante el tratamiento de prostata con una unidad de {sup 60}Co

    Energy Technology Data Exchange (ETDEWEB)

    Vega C, H. R. [Universidad Autonoma de Zacatecas, Unidad Academica de Estudios Nucleares, Apdo. Postal 336, 98000 Zacatecas (Mexico); Navarro B, J. A. [Universidad Autonoma de Zacatecas, Unidad Academica de Fisica, Carretera a la Bufa s/n, Zacatecas (Mexico); Perez A, M. L.; Perez L, L. H., E-mail: fermineutron@yahoo.com [Instituto Zacatecano del Tumor, A. C., Lago de la Encantada No. 294, Fracc. Lomas del Lago, Zacatecas (Mexico)

    2012-10-15

    The absorbed dose by the bladder, the rectum and the gland thyroid was measured during a treatment applied for prostate cancer by means of a Cobalt 60 unit. The dose was measured using thermoluminescent dosimeters of the type TLD 100, with the values of the absorbed the values of the effective dose were calculated and was determined the probability of the development of a secondary cancer. Because these measurements cannot be made -in vivo- a phantom or mannequin was built with water that represents the hip and part of the torso of the human body and to represent the neck was used polyethylene. The study was carried out in the Instituto Zacatecano del Tumor that has a -cobalt bomb- which is used to treat oncology patients, during the phantom irradiation a dose of 200 c Gy was applied of this dose the bladder received 96.7%, the rectum 100.8% and the gland thyroid 0.3%. The dose received by the rectum and the bladder is due to the therapeutic beam while the dose received by the thyroid is due to the dispersed radiation by the phantom. The probability that in these organs a new neoplasm is developed is of 0.033% for the bladder, 0.157% for the rectum and 7.8 x 10{sup -5}% for the thyroid case. (Author)

  11. Push Factor in Mexican Migration to the United States: The Background to Migration.

    Science.gov (United States)

    1980-07-01

    of mig’ants to the United States; and (4) Valsequillo, a densely populated area in Puebla . Roberts describes each region with the following variables...wages. Geographic information from the southwestern United States and from all of Mexico (by municipio ), including income and minimum wage data were used

  12. MUTUAL INHIBITION OF MURINE ERYTHROPOIESIS AND GRANULOPOIESIS DURING COMBINED ERYTHROPOIETIN, GRANULOCYTE-COLONY-STIMULATING FACTOR, AND STEM-CELL FACTOR ADMINISTRATION - IN-VIVO INTERACTIONS AND DOSE-RESPONSE SURFACES

    NARCIS (Netherlands)

    DEHAAN, G; ENGEL, C; DONTJE, B; NIJHOF, W; LOEFFLER, M

    1994-01-01

    We investigated the in vivo effects of erythropoietin (EPO) on granulopoiesis and, conversely, the effect of granulocyte colony-stimulating factor (G-CSF) treatment on erythropoiesis. Recombinant human EPO at four different doses in combination with recombinant human G-CSF also at four different dos

  13. Ion recombination correction factors (P(ion)) for Varian TrueBeam high-dose-rate therapy beams.

    Science.gov (United States)

    Kry, Stephen F; Popple, Richard; Molineu, Andrea; Followill, David S

    2012-11-08

    Ion recombination is approximately corrected for in the Task Group 51 protocol by Pion, which is calculated by a two-voltage measurement. This measurement approach may be a poor estimate of the true recombination, particularly if Pion is large (greater than 1.05). Concern exists that Pion in high-dose-per-pulse beams, such as flattening filter free (FFF) beams, may be unacceptably high, rendering the two-voltage measurement technique inappropriate. Therefore, Pion was measured for flattened beams of 6, 10, 15, and 18 MV and for FFF beams of 6 and 10 MV. The values for the FFF beams were verified with 1/V versus 1/Q curves (Jaffé plots). Pion was also measured for electron beams of 6, 12, 16, 18, and 20 MeV on a traditional accelerator, as well as on the high-dose-rate Varian TrueBeam accelerator. The measurements were made at a range of depths and with PTW, NEL, and Exradin Farmer-type chambers. Consistent with the increased dose per pulse, Pion was higher for FFF beams than for flattening filter beams. However, for all beams, measurement locations, and chambers examined, Pion never exceeded 1.018. Additionally, Pion was always within 0.3% of the recombination calculated from the Jaffé plots. We conclude that ion recombination can be adequately accounted for in high-dose-rate FFF beams using Pion determined with the standard two-voltage technique.

  14. CLINICAL-EXPERIENCE WITH HIGH-DOSE TUMOR-NECROSIS-FACTOR-ALPHA IN REGIONAL THERAPY OF ADVANCED MELANOMA

    NARCIS (Netherlands)

    LEJEUNE, F; LIENARD, D; EGGERMONT, A; KOOPS, HS; KROON, B; GERAIN, J; ROSENKAIMER, F; SCHMITZ, P

    1994-01-01

    Isolated perfusion of the limbs (ILP) allows the delivery of high dose rTNF alpha in a closed system with acceptable side-effects. A protocol with a triple-drug regimen was based on the reported synergism of rTNF alpha with chemotherapy, with interferon-gamma, and with hyperthermia. In melanoma-in-t

  15. Committed effective doses at various times after intakes of radionuclides

    CERN Document Server

    Phipps, A W; Kendall, G M; Silk, T J; Stather, J W

    1991-01-01

    This report contains details of committed effective doses at nine times after intake from intakes by ingestion and inhalation of 1 mu 1 AMAD particles by adults. Data are given for various chemical forms of 359 nuclides. It complements NRPB-R245 which describes the changes which have taken place since the last NRPB compendium of dose per unit intake factors (dose coefficients) and gives summary tables. Information on committed equivalent doses to organs is given in NRPB-M288. The information given in these memoranda is also available as a microcomputer package - NRPB-SR245.

  16. Plasma quetiapine in relation to prescribed dose and other factors: data from a therapeutic drug monitoring service, 2000–2011

    Science.gov (United States)

    Bowskill, Sally V.J.; Patel, Maxine X.; Flanagan, Robert J.

    2013-01-01

    Objective: Suggested predose plasma quetiapine target ranges for effective therapy in schizophrenia lie between 50 and 500 µg/l. We aimed to examine data from a quetiapine therapeutic drug monitoring (TDM) service to assess the plasma quetiapine concentrations attained at specified doses in clinical practice. Method: We studied TDM data from patients given immediate-release quetiapine in the period 2000–2011. Results: There were 946 samples from 487 patients (257 males, age at time of first sample, median [range] 34 [14–87] years, and 230 females, age at time of first sample, median [range] 38 [10–92] years). The plasma quetiapine concentration was <50 and <100 µg/l in 30% and 50% of samples, respectively (no quetiapine detected in 9% of samples). The relationship between dose and plasma quetiapine was poor. The mean (95% confidence interval [CI]) quetiapine dose was higher (t = 3.6, df = 446, p <0.01) in males versus females (641 [600–1240] and 548 [600–943] mg/day, respectively), although there was no difference in median dose (600 mg/day) or in the mean (95% CI) plasma quetiapine concentrations attained. Smoking habit had no discernible effect on plasma quetiapine concentration. Conclusions: There was a poor relationship between dose and plasma quetiapine concentration in this study, as found by others. This is probably because of the short plasma half-life of the drug, at least in part. Nevertheless, quetiapine TDM can help assess adherence and measurement of quetiapine metabolites, notably N-desalkylquetiapine, as well as quetiapine itself may enhance the value of quetiapine TDM in future. PMID:24167685

  17. Composition of growth factors and cytokines in lysates obtained from fresh versus stored pathogen-inactivated platelet units.

    Science.gov (United States)

    Sellberg, Felix; Berglund, Erik; Ronaghi, Martin; Strandberg, Gabriel; Löf, Helena; Sommar, Pehr; Lubenow, Norbert; Knutson, Folke; Berglund, David

    2016-12-01

    Platelet lysate is a readily available source of growth factors, and other mediators, which has been used in a variety of clinical applications. However, the product remains poorly standardized and the present investigation evaluates the composition of platelet lysate obtained from either fresh or stored pathogen-inactivated platelet units. Platelet pooled units (n = 10) were obtained from healthy blood donors and tested according to standard procedures. All units were pathogen inactivated using amotosalen hydrochloride and UVA exposure. Platelet lysate was subsequently produced at two separate time-points, either from fresh platelet units or after 5 days of storage, by repeated freeze-thaw cycles. The following mediators were determined at each time-point: EGF, FGF-2, VEGF, IGF-1, PDGF-AB/BB, BMP-2, PF4, TGF-β isoform 1, IL-1β, IL-2, IL-6, IL-10, IL-12p70, 1L-17A, TNF-α, and IFN-γ. The concentration of growth factors and cytokines was affected by time in storage. Notably, TGF-β, PDGF-AB/BB, and PF4 showed an increase of 27.2% (p concentrations and all other growth factors remained stable with time in storage. The composition of mediators in platelet lysate obtained from pathogen-inactivated platelet units differs when produced from fresh and stored platelet units, respectively. This underscores the need for further standardization and optimization of this important product, which potentially may influence the clinical effects. Copyright © 2016. Published by Elsevier Ltd.

  18. SU-E-T-366: Estimation of Whole Body Dose From Cranial Irradiation From C and Perfexion Series Gamma Knife Units

    Energy Technology Data Exchange (ETDEWEB)

    Srivastava, S [Indiana University Health Methodist Hospital, Indianapolis, IN (United States); Indiana University School of Medicine, Indianapolis, IN, University Hospitals Case Medical Center, Cleaveland, OH (United States); Andersen, A; Lulu, B; Das, I [Indiana University School of Medicine, Indianapolis, IN, University Hospitals Case Medical Center, Cleaveland, OH (United States); Cheng, C

    2015-06-15

    Purpose: The Leksell Gamma Knife (GK) B & C series contains 201 Cobalt-60 sources with a helmet. The new model, Perfexion uses 192 Cobalt-60 sources without a helmet; using IRIS system for collimation and stereotactic guidance to deliver SRS to brain tumors. Relative dose to extracranial organs at risk (OARs) is measured in phantom in this study for Perfexion and C-series GK. Materials & Methods: Measurements were performed in a Rando anthropomorphic phantom on both systems using a large ion chamber (Keithley-175) for each collimator. The Keithley-175 cc ion chamber was sandwiched between phantom slices at various locations in the phantom to correspond to different extracranial OARs (thyroid, heart, kidney, ovary and testis, etc.) The dose measurement was repeated with OSL detectors for each position and collimator. Results: A large variation is observed in the normalized dose between these two systems. The dose beyond the housing falls off exponentially for Perfexion. Dose beyond the C-series GK housing falls off exponentially from 0–20cm then remains relatively constant from 20–40cm and again falls off with distance but less rapidly. The variation of extracranial dose with distance for each collimator is found to be parallel to each other for both systems. Conclusion: Whole body dose is found to vary significantly between these systems. It is important to measure the extracranial dose, especially for young patients. It is estimated that dose falls off exponentially from the GK housing and is about 1% for large collimators at 75 cm. The dose is two-orders of magnitude smaller for the 4mm collimator. However, this small dose for patient may be significant radiologically.

  19. Isoeffective dose: a concept for biological weighting of absorbed dose in proton and heavier-ion therapies

    CERN Document Server

    Wambersie, A; Menzel, H G; Gahbauer, R; DeLuca, P M; Hendry, J H; Jones, D T L

    2011-01-01

    When reporting radiation therapy procedures, International Commission on Radiation Units and Measurements (ICRU) recommends specifying absorbed dose at/in all clinically relevant points and/or volumes. In addition, treatment conditions should be reported as completely as possible in order to allow full understanding and interpretation of the treatment prescription. However, the clinical outcome does not only depend on absorbed dose but also on a number of other factors such as dose per fraction, overall treatment time and radiation quality radiation biology effectiveness (RBE). Therefore, weighting factors have to be applied when different types of treatments are to be compared or to be combined. This had led to the concept of `isoeffective absorbed dose', introduced by ICRU and International Atomic Energy Agency (IAEA). The isoeffective dose D(IsoE) is the dose of a treatment carried out under reference conditions producing the same clinical effects on the target volume as those of the actual treatment. It i...

  20. Coronary calcium score in 12-year breast cancer survivors after adjuvant radiotherapy with low to moderate heart exposure - Relationship to cardiac radiation dose and cardiovascular risk factors.

    Science.gov (United States)

    Tjessem, Kristin Holm; Bosse, Gerhard; Fosså, Kristian; Reinertsen, Kristin V; Fosså, Sophie D; Johansen, Safora; Fosså, Alexander

    2015-03-01

    We explored the relation between coronary artery calcium (CAC) and cardiac radiation doses in breast cancer survivors (BCS) treated with radiotherapy (RT). Additionally, we examined the impact of other risk factors and biomarkers of coronary artery disease (CAD). 236 BCS (median age 51years [range 30-70], median observation time 12years [9.2-15.7]), treated with 4-field RT of 50GY, were included and examined in 2004 (T1), 2007 (T2) and 2011 (T3) with clinical examination, blood tests and questionnaires. At T3, cardiac computed tomography was performed with quantification of CAC using Agatston score (AS). For 106 patients cardiac dose volume histograms were available. The cohort-based median of the mean cardiac dose was 2.5 (range 0.5-7.0) Gy. There was no correlation between measures of cardiac dose and AS. AS was correlated with high cholesterol at T1/T2 (p=0.022), high proBNP at T1/T2 (p<0.022) and T3 (p<0.022) and high HbA1c at T3 (p=0.022). In addition, a high AS was significantly associated with hypertension (p=0.022). Age (p<0.001) and cholesterol at T1/T2 (p=0.001) retained significant associations in multivariate analysis. Traditional, modifiable risk factors of CAD correlate with CAC and may be important for the long term risk of CAD after RT. With low to moderate cardiac radiation exposure, a contribution of radiation dose to CAC could not be demonstrated. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  1. Prevalence and factors associated with breast milk donation in banks that receive human milk in primary health care units.

    Science.gov (United States)

    Meneses, Tatiana Mota Xavier de; Oliveira, Maria Inês Couto de; Boccolini, Cristiano Siqueira

    To estimate the prevalence and to analyze factors associated with breast milk donation at primary health care units in order to increase the human milk bank reserves. Cross-sectional study carried out in 2013 in Rio de Janeiro, Brazil. A representative sample of 695 mothers of children younger than 1 year attended to at the nine primary health care units with human milk donation services were interviewed. A hierarchical approach was used to obtain adjusted prevalence ratios (APR) by Poisson regression with robust variance. The final model included the variables associated with breast milk donation (p≤0.05). 7.3% of the mothers had donated breast milk. Having been encouraged to donate breast milk by healthcare professionals, relatives, or friends (APR=7.06), receiving information on breast milk expression by the primary health care unit (APR=3.65), and receiving help from the unit professionals to breastfeed (APR=2.24) were associated with a higher prevalence of donation. Admission of the newborn to the neonatal unit was associated with a lower prevalence of donation (APR=0.09). Encouragement to breast milk donation, and information and help provided by primary health care unit professionals to breastfeeding were shown to be important for the practice of human milk donation. Copyright © 2017. Published by Elsevier Editora Ltda.

  2. Comparing the effect of non-medical mechanical restraint preventive factors between psychiatric units in Denmark and Norway

    DEFF Research Database (Denmark)

    Bak, Jesper; Zoffmann, V.; Sestoft, D.M.;

    2015-01-01

    -medical origin may explain the differing number of MR episodes between Denmark and Norway. METHODS: This study is a cross-sectional survey of psychiatric units. Linear regression was used to assess the confounding effects of the MR preventive factors, i.e. whether a difference in the impact of these factors......BACKGROUND: The use of mechanical restraint (MR) is controversial, and large differences regarding the use of MR are often found among countries. In an earlier study, we observed that MR was used twice as frequently in Denmark than Norway. AIMS: To examine how presumed MR preventive factors of non......-staff ratio (- 11%), and the identification of the patient's crisis triggers (- 10%). CONCLUSIONS: These six MR preventive factors might partially explain the difference in the frequency of MR episodes observed in the two countries, i.e. higher numbers in Denmark than Norway. One MR preventive factor...

  3. Identification of two independent risk factors for lupus within the MHC in United Kingdom families.

    Directory of Open Access Journals (Sweden)

    Michelle M A Fernando

    2007-11-01

    Full Text Available The association of the major histocompatibility complex (MHC with SLE is well established yet the causal variants arising from this region remain to be identified, largely due to inadequate study design and the strong linkage disequilibrium demonstrated by genes across this locus. The majority of studies thus far have identified strong association with classical class II alleles, in particular HLA-DRB1*0301 and HLA-DRB1*1501. Additional associations have been reported with class III alleles; specifically, complement C4 null alleles and a tumor necrosis factor promoter SNP (TNF-308G/A. However, the relative effects of these class II and class III variants have not been determined. We have thus used a family-based approach to map association signals across the MHC class II and class III regions in a cohort of 314 complete United Kingdom Caucasian SLE trios by typing tagging SNPs together with classical typing of the HLA-DRB1 locus. Using TDT and conditional regression analyses, we have demonstrated the presence of two distinct and independent association signals in SLE: HLA-DRB1*0301 (nominal p = 4.9 x 10(-8, permuted p < 0.0001, OR = 2.3 and the T allele of SNP rs419788 (nominal p = 4.3 x 10(-8, permuted p < 0.0001, OR = 2.0 in intron 6 of the class III region gene SKIV2L. Assessment of genotypic risk demonstrates a likely dominant model of inheritance for HLA-DRB1*0301, while rs419788-T confers susceptibility in an additive manner. Furthermore, by comparing transmitted and untransmitted parental chromosomes, we have delimited our class II signal to a 180 kb region encompassing the alleles HLA-DRB1*0301-HLA-DQA1*0501-HLA-DQB1*0201 alone. Our class III signal importantly excludes independent association at the TNF promoter polymorphism, TNF-308G/A, in our SLE cohort and provides a potentially novel locus for future genetic and functional studies.

  4. Key Factors Influencing the Decision on the Number of Brayton Units for the Prometheus Space Reactor

    Science.gov (United States)

    Ashcroft, John; Belanger, Sean; Burdge, Wayne; Clementoni, Eric; Jensen, Krista; Proctor, N. Beth; Zemo-Fulkerson, Annie

    2007-01-01

    The Naval Reactors (NR) Program and its DOE Laboratories, KAPL and Bettis, were assigned responsibility to develop space reactor systems for the Prometheus Program. After investigating all of the potential reactor and energy conversion options, KAPL and Bettis selected a direct gas Brayton system as the reference approach for the nuclear electric propulsion missions, including the Jupiter Icy Moons Orbiter (JIMO). In order to determine the optimal plant architecture for the direct gas system, KAPL and Bettis investigated systems with one or two active Brayton units and up to two spare units. No final decision was made on the optimal system configuration for the NEP gas-Brayton system prior to closeout of the project. The two most promising options appear to be a single system without spares and a three Brayton system with two operating units, each producing half of the required load, with a single spare unit. The studies show that a single Brayton system, without spares, offers the lowest mass system, with potential for lower operating temperature, and a minimum of system and operational complexity. The lower required mass and increased system efficiency inherent in the single Brayton system may be exploited to satisfy other design objectives such as reduced reactor and radiator operating temperatures. While Brayton system lifetimes applicable to a JIMO or other nuclear electric propulsion (NEP) mission have not been demonstrated, there is no fundamental limit on the lifetime of the Brayton hardware. Use of additional Brayton units with installed spares will allow for continued operation in the event of a failure of an individual Brayton unit. However, preliminary system reliability evaluations do not point to any substantial reliability benefit provided by carrying spare Brayton units. If a spare unit is used, operating two of the units at full power with an unpowered spare proved more efficient than operating all three units at a reduced power and temperature

  5. The impact of variation in scaling factors on the estimation of internal dose metrics: a case study using bromodichloromethane (BDCM)

    Science.gov (United States)

    Many physiologically based pharmacokinetic (PBPK) models include values for metabolic rate parameters extrapolated from in vitro metabolism studies using scaling factors such as mg of microsomal protein per gram of liver (MPPGL) and liver mass (FVL). Variation in scaling factor ...

  6. Fatores associados ao trauma mamilar na maternidade Factors associated with nipple trauma in the maternity unit

    Directory of Open Access Journals (Sweden)

    Kelly Pereira Coca

    2009-08-01

    Full Text Available OBJETIVO: Identificar os fatores associados ao trauma mamilar em mulheres em aleitamento materno exclusivo na maternidade. MÉTODOS: Estudo caso-controle com 146 puérperas internadas nas enfermarias de alojamento conjunto, sendo 73 casos, definidos como mulheres com trauma mamilar, e 73 controles, definidos como ausência da patologia. Diariamente buscaram-se mulheres em aleitamento materno exclusivo com diagnóstico de lesão mamilar, identificada por meio de lupa. Foram estudadas variáveis sociodemográficas, obstétricas e neonatais. Na análise estatística, utilizou-se modelo de regressão logística. RESULTADOS: Casos e controles mostraram-se semelhantes quanto às variáveis sociodemográficas, embora a ausência do companheiro tenha sido mais frequente no grupo de mulheres com trauma mamilar. As variáveis primiparidade (OR 3,16; IC95% 1,19-8,42, ausência do companheiro (OR 3,25; IC95% 1,18-8,93, mama túrgida e/ou ingurgitada (OR 12,31; IC95% 4,48-33,78, mamilo semiprotruso e/ou malformado (OR 4,69; IC95% 1,50-14,62 e despigmentação dos mamilos (OR 13,98; IC95% 4,43-44,06 comportaram-se como fatores associados ao trauma mamilar. CONCLUSÃO: Primiparidade, ausência do companheiro, mamas túrgidas e ingurgitadas, mamilos semiprotrusos e/ou malformados e despigmentados estão associados ao trauma mamilar.OBJECTIVE: To identify factors associated with nipple trauma in women breastfeeding exclusively in a maternity unit. METHODS: This was a case-control study that recruited 146 recently-delivered mothers in rooming-in wards: 73 cases, defined as women with nipple trauma, and 73 controls, defined as women free from this pathology. Women breastfeeding exclusively were tested daily for a diagnosis of nipple injury, identified using a magnifying glass. Sociodemographic, obstetric and neonatal variables were studied. A logistic regression model was used for statistical analysis. RESULTS: Cases and controls proved to be comparable in terms

  7. Systems Biology Model of Interactions between Tissue Growth Factors and DNA Damage Pathways: Low Dose Response and Cross-Talk in TGFβ and ATM Signaling

    Energy Technology Data Exchange (ETDEWEB)

    Cucinotta, Francis A [Univ. of Nevada, Las Vegas, NV (United States)

    2016-09-01

    The etiology of radiation carcinogenesis has been described in terms of aberrant changes that span several levels of biological organization. Growth factors regulate many important cellular and tissue functions including apoptosis, differentiation and proliferation. A variety of genetic and epigenetic changes of growth factors have been shown to contribute to cancer initiation and progression. It is known that cellular and tissue damage to ionizing radiation is in part initiated by the production of reactive oxygen species, which can activate cytokine signaling, and the DNA damage response pathways, most notably the ATM signaling pathway. Recently the transforming growth factor β (TGFβ) pathway has been shown to regulate or directly interact with the ATM pathway in the response to radiation. The relevance of this interaction with the ATM pathway is not known although p53 becomes phosphorylated and DNA damage responses are involved. However, growth factor interactions with DNA damage responses have not been elucidated particularly at low doses and further characterization of their relationship to cancer processes is warranted. Our goal will be to use a systems biology approach to mathematically and experimentally describe the low dose responses and cross-talk between the ATM and TGFβ pathways initiated by low and high LET radiation. We will characterize ATM and TGFβ signaling in epithelial and fibroblast cells using 2D models and ultimately extending to 3D organotypic cell culture models to begin to elucidate possible differences that may occur for different cell types and/or inter-cellular communication. We will investigate the roles of the Smad and Activating transcription factor 2 (ATF2) proteins as the potential major contributors to crosstalk between the TGFβ and ATM pathways, and links to cell cycle control and/or the DNA damage response, and potential differences in their responses at low and high doses. We have developed various experimental approaches

  8. Systems Biology Model of Interactions Between Tissue Growth Factors and DNA Damage Pathways: Low Dose Response and Cross-Talk in TGFbeta and ATM Signaling

    Energy Technology Data Exchange (ETDEWEB)

    O' Neill, Peter [University of Oxford; Anderson, Jennifer [University of Oxford

    2014-10-02

    The etiology of radiation carcinogenesis has been described in terms of aberrant changes that span several levels of biological organization. Growth factors regulate many important cellular and tissue functions including apoptosis, differentiation and proliferation. A variety of genetic and epigenetic changes of growth factors have been shown to contribute to cancer initiation and progression. It is known that cellular and tissue damage to ionizing radiation is in part initiated by the production of reactive oxygen species, which can activate cytokine signaling, and the DNA damage response pathways, most notably the ATM signaling pathway. Recently the transforming growth factor β (TGFβ) pathway has been shown to regulate or directly interact with the ATM pathway in the response to radiation. The relevance of this interaction with the ATM pathway is not known although p53 becomes phosphorylated and DNA damage responses are involved. However, growth factor interactions with DNA damage responses have not been elucidated particularly at low doses and further characterization of their relationship to cancer processes is warranted. Our goal will be to use a systems biology approach to mathematically and experimentally describe the low dose responses and cross-talk between the ATM and TGFβ pathways initiated by low and high LET radiation. We will characterize ATM and TGFβ signaling in epithelial and fibroblast cells using 2D models and ultimately extending to 3D organotypic cell culture models to begin to elucidate possible differences that may occur for different cell types and/or inter-cellular communication. We will investigate the roles of the Smad and Activating transcription factor 2 (ATF2) proteins as the potential major contributors to cross- talk between the TGFβ and ATM pathways, and links to cell cycle control and/or the DNA damage response, and potential differences in their responses at low and high doses. We have developed various experimental

  9. Factors that elevate the internal radionuclide and chemical retention, dose and health risks to infants and children in a radiological-nuclear emergency.

    Science.gov (United States)

    Richardson, Richard B

    2009-06-01

    The factors that influence the dose and risk to vulnerable population groups from exposure and internal uptake of chemicals are examined and, in particular, the radionuclides released in chemical, biological, radiological, nuclear and explosive events. The paper seeks to identify the areas that would benefit from further research. The intake and body burdens of carbon and calcium were assessed as surrogates for contaminants that either act like or bind to hydrocarbons (e.g. tritium and (14)C) or bone-seeking radionuclides (e.g. (90)Sr and (239)Pu). The shortest turnover times for such materials in the whole body were evaluated for the newborn: 11 d and 0.5 y for carbon and calcium, respectively. However, their biokinetic behaviour is complicated by a particularly high percentage of the gut-absorbed dietary intake of carbon (approximately 16%) and calcium (approximately 100%) that is incorporated into the soft tissue and skeleton of the growing neonate. The International Commission on Radiological Protection dose coefficients (Sv Bq(-1)) were examined for 14 radionuclides, including 9 of concern because of their potential use in radiological dispersal devices. The dose coefficients for a 3-month-old are greater than those for adults (2-56 times more for ingestion and 2-12 times for inhalation). The age-dependent dose and exposure assessment of contaminant intakes would improve by accounting for gender and growth where it is currently neglected. Health risk is evaluated as the product of the exposure and hazard factors, the latter being about 10-fold greater in infants than in adults. The exposure factor is also approximately 10-fold higher for ingestion by infants than by adults, and unity for inhalation varying with the contaminant. Qualitative and quantitative physiological and epidemiological evidence supports infants being more vulnerable to cancer and neurological deficit than older children.

  10. Mobilization of peripheral blood progenitor cells by chemotherapy and granulocyte-macrophage colony-stimulating factor for hematologic support after high-dose intensification for breast cancer.

    Science.gov (United States)

    Elias, A D; Ayash, L; Anderson, K C; Hunt, M; Wheeler, C; Schwartz, G; Tepler, I; Mazanet, R; Lynch, C; Pap, S

    1992-06-01

    High-dose therapy with autologous marrow support results in durable complete remissions in selected patients with relapsed lymphoma and leukemia who cannot be cured with conventional dose therapy. However, substantial morbidity and mortality result from the 3- to 6-week period of marrow aplasia until the reinfused marrow recovers adequate hematopoietic function. Hematopoietic growth factors, particularly used after chemotherapy, can increase the number of peripheral blood progenitor cells (PBPCs) present in systemic circulation. The reinfusion of PBPCs with marrow has recently been reported to reduce the time to recovery of adequate marrow function. This study was designed to determine whether granulocyte-macrophage colony-stimulating factor (GM-CSF)-mobilized PBPCs alone (without marrow) would result in rapid and reliable hematopoietic reconstitution. Sixteen patients with metastatic breast cancer were treated with four cycles of doxorubicin, 5-fluorouracil, and methotrexate (AFM induction). Patients responding after the first two cycles were administered GM-CSF after the third and fourth cycles to recruit PBPCs for collection by two leukapheresis per cycle. These PBPCs were reinfused as the sole source of hematopoietic support after high doses of cyclophosphamide, thiotepa, and carboplatin. No marrow or hematopoietic cytokines were used after progenitor cell reinfusion. Granulocytes greater than or equal to 500/microL was observed on a median of day 14 (range, 8 to 57). Transfusion independence of platelets greater than or equal to 20,000/microL occurred on a median day of 12 (range, 8 to 134). However, three patients required the use of a reserve marrow for slow platelet engraftment. In retrospect, these patients were characterized by poor baseline bone marrow cellularity and poor platelet recovery after AFM induction therapy. When compared with 29 historical control patients who had received the same high-dose intensification chemotherapy using autologous

  11. Evaluation of wall correction factor of INER's air-kerma primary standard chamber and dose variation by source displacement for HDR ¹⁹²Ir brachytherapy.

    Science.gov (United States)

    Lee, J H; Wang, J N; Huang, T T; Su, S H; Chang, B J; Su, C H; Hsu, S M

    2013-01-01

    The aim of the present study was to estimate the wall effect of the self-made spherical graphite-walled cavity chamber with the Monte Carlo method for establishing the air-kerma primary standard of high-dose-rate (HDR) ¹⁹²Ir brachytherapy sources at the Institute of Nuclear Energy Research (INER, Taiwan). The Monte Carlo method established in this paper was also employed to respectively simulate wall correction factors of the ¹⁹²Ir air-kerma standard chambers used at the National Institute of Standards and Technology (NIST, USA) and the National Physical Laboratory (NPL, UK) for comparisons and verification. The chamber wall correction calculation results will be incorporated into INER's HDR ¹⁹²Ir primary standard in the future. For the brachytherapy treatment in the esophagus or in the bronchi, the position of the isotope may have displacement in the cavity. Thus the delivered dose would differ from the prescribed dose in the treatment plan. We also tried assessing dose distribution due to the position displacement of HDR ¹⁹²Ir brachytherapy source in a phantom with a central cavity by the Monte Carlo method. The calculated results could offer a clinical reference for the brachytherapy within the human organs with cavity.

  12. Assessing dose rate distributions in VMAT plans

    Science.gov (United States)

    Mackeprang, P.-H.; Volken, W.; Terribilini, D.; Frauchiger, D.; Zaugg, K.; Aebersold, D. M.; Fix, M. K.; Manser, P.

    2016-04-01

    Dose rate is an essential factor in radiobiology. As modern radiotherapy delivery techniques such as volumetric modulated arc therapy (VMAT) introduce dynamic modulation of the dose rate, it is important to assess the changes in dose rate. Both the rate of monitor units per minute (MU rate) and collimation are varied over the course of a fraction, leading to different dose rates in every voxel of the calculation volume at any point in time during dose delivery. Given the radiotherapy plan and machine specific limitations, a VMAT treatment plan can be split into arc sectors between Digital Imaging and Communications in Medicine control points (CPs) of constant and known MU rate. By calculating dose distributions in each of these arc sectors independently and multiplying them with the MU rate, the dose rate in every single voxel at every time point during the fraction can be calculated. Independently calculated and then summed dose distributions per arc sector were compared to the whole arc dose calculation for validation. Dose measurements and video analysis were performed to validate the calculated datasets. A clinical head and neck, cranial and liver case were analyzed using the tool developed. Measurement validation of synthetic test cases showed linac agreement to precalculated arc sector times within  ±0.4 s and doses  ±0.1 MU (one standard deviation). Two methods for the visualization of dose rate datasets were developed: the first method plots a two-dimensional (2D) histogram of the number of voxels receiving a given dose rate over the course of the arc treatment delivery. In similarity to treatment planning system display of dose, the second method displays the dose rate as color wash on top of the corresponding computed tomography image, allowing the user to scroll through the variation over time. Examining clinical cases showed dose rates spread over a continuous spectrum, with mean dose rates hardly exceeding 100 cGy min-1 for conventional

  13. Geological Factors Affecting Flow Spatial Continuity in Water Injection of Units Operating in the LGITJ–0102 Ore Body

    Directory of Open Access Journals (Sweden)

    Ilver M. Soto-Loaiza

    2016-05-01

    Full Text Available The objective of the investigation was to identify the geological factors affecting the spatial continuity of the flow during the process of flank water injection in the units operating in the Lower Lagunilla Hydrocarbon Ore Body. This included the evaluation of the recovery factor, the petro-physic properties such as porosity, permeability, water saturation and rock type and quality in each flow unit. it was observed that the rock type of the geologic structure in the ore body is variable. The lowest values for the petro-physic properties were found in the southern area while a high variability of these parameters was observed in the northern and central areas. It was concluded that the northern area has a great potential for the development of new injection projects for petroleum recovery.

  14. Risk factors associated with fatal injuries in Thoroughbred racehorses competing in flat racing in the United States and Canada.

    Science.gov (United States)

    Georgopoulos, Stamatis P; Parkin, Tim D H

    2016-10-15

    OBJECTIVE To identify risk factors associated with fatal injuries in Thoroughbred racehorses in the United States and Canada. DESIGN Retrospective study. ANIMALS 1,891,483 race starts by 154,527 Thoroughbred racehorses at 89 racetracks in the United States and Canada from 2009 to 2013. PROCEDURES Data were extracted from the Equine Injury Database, which contained information for 93.9% of all official flat racing events in the United States and Canada during the 5-year observation period. Forty-four possible risk factors were evaluated by univariate then multivariable logistic regression to identify those that were significantly associated with fatal injury (death or euthanasia of a horse within 3 days after sustaining an injury during a race). RESULTS 3,572 race starts ended with a fatal injury, resulting in a period incidence rate of 1.9 fatal injuries/1,000 race starts. Twenty-two risk factors were significantly associated with fatal injury. Risk of fatal injury was greater for stallions than for mares and geldings and increased as the number of previous nonfatal injuries and race withdrawals and level of competitiveness (eg, horse's winning percentage and race purse) of the horse or race increased. CONCLUSIONS AND CLINICAL RELEVANCE Results identified several risk factors associated with fatal injuries in Thoroughbred racehorses. This information can be used as a guideline for the identification of racehorses at high risk of sustaining a fatal injury and in the design and implementation of preventative measures to minimize the number of fatal injuries sustained by horses competing in flat racing in the United States and Canada.

  15. Frequency and severity of low back pain in nurses working in intensive care units and influential factors.

    Science.gov (United States)

    Ovayolu, Ozlem; Ovayolu, Nimet; Genc, Mehtap; Col-Araz, Nilgun

    2014-01-01

    The purpose of this research was to determine the frequency and severity of low back pain and influencing factors in nurses working in intensive care units. This research was conducted as a cross-sectional study with 114 nurses working in the intensive care units in the province of Gaziantep, Turkey. Study data were collected using a questionnaire form and visual analogue scale. It was found that 84.2% of the nurses experienced low back pain, and 66.7% of the nurses evaluated this pain as "a pain with moderate severity". It was determined that nurses who had not received any education on low back pain, who remained standing for long periods of time, who performed interventions that required bending forward, who lifted and repositioned patients, and who did not use any aiding equipment during interventions, experienced more pain and had higher average pain scores. In addition, average pain scores were higher among nurses with master's and doctorate degrees, and those working in internal medicine and pediatric intensive care units and working in shifts. It was observed that many of the nurses working in intensive care units experienced low back pain, and especially those working in internal medicine and pediatric intensive care units and working in shifts had higher average pain scores.

  16. NESHAP Area-Specific Dose-Release Factors for Potential Onsite Member-of-the-Public Locations at SRS using CAP88-PC Version 4.0

    Energy Technology Data Exchange (ETDEWEB)

    Trimor, P. [Savannah River Site (SRS), Aiken, SC (United States). Savannah River National Lab. (SRNL)

    2017-08-09

    The Environmental Protection Agency (EPA) requires the use of the computer model CAP88-PC to estimate the total effective doses (TED) for demonstrating compliance with 40 CFR 61, Subpart H (EPA 2006), the National Emission Standards for Hazardous Air Pollutants (NESHAP) regulations. As such, CAP88 Version 4.0 was used to calculate the receptor dose due to routine atmospheric releases at the Savannah River Site (SRS). For estimation, NESHAP dose-release factors (DRFs) have been supplied to Environmental Compliance and Area Closure Projects (EC&ACP) for many years. DRFs represent the dose to a maximum receptor exposed to 1 Ci of a specified radionuclide being released into the atmosphere. They are periodically updated to include changes in the CAP88 version, input parameter values, site meteorology, and location of the maximally exposed individual (MEI). In this report, the DRFs were calculated for potential radionuclide atmospheric releases from 13 SRS release points. The three potential onsite MEI locations to be evaluated are B-Area, Three Rivers Landfill (TRL), and Savannah River Ecology Lab Conference Center (SRELCC) with TRL’s onsite workers considered as members-of-the-public, and the potential future constructions of dormitories at SRELCC and Barracks at B-Area. Each MEI location was evaluated at a specified compass sector with different area to receptor distances and was conducted for both ground-level and elevated release points. The analysis makes use of area-specific meteorological data (Viner 2014). The resulting DRFs are compared to the 2014 NESHAP offsite MEI DRFs for three operational areas; A-Area, H-Area, and COS for a release rate of 1 Ci of tritium oxide at 0 ft. elevation. CAP88 was executed again using the 2016 NESHAP MEI release rates for 0 and 61 m stack heights to determine the radionuclide dose at TRL from the center-of-site (COS).

  17. A bivalent Neisseria meningitidis recombinant lipidated factor H binding protein vaccine in young adults: results of a randomised, controlled, dose-escalation phase 1 trial.

    Science.gov (United States)

    Richmond, P C; Nissen, M D; Marshall, H S; Lambert, S B; Roberton, D; Gruber, W C; Jones, T R; Arora, A

    2012-09-21

    Neisseria meningitidis is a leading cause of meningitis and septicaemia, but a broadly-protective vaccine against endemic serogroup B disease is not licensed and available. The conserved, outer-membrane lipoprotein factor H binding protein (fHBP, also known as LP2086) is expressed as one of two subfamily variants in virtually all meningococci. This study investigated the safety, tolerability, and immunogenicity of a recombinant-expressed bivalent fHBP (r-fHBP) vaccine in healthy adults. Participants (N=103) aged 18-25 years were recruited into three ascending dose level cohorts of 20, 60, and 200μg of a bivalent r-fHBP vaccine formulation and randomised to receive vaccine or placebo at 0, 1, and 6 months. The vaccine was well tolerated. Geometric mean titres (GMTs) for r-fHBP subfamily-specific IgG antibodies increased 19-168-fold from pre-vaccination to post-dose 2 in a dose level-dependent manner. In addition, robust serum bactericidal assay using human complement (hSBA) responses for strains expressing both homologous and heterologous fHBP variants were observed. After three vaccinations, 16-52% of the placebo group and 47-90%, 75-100%, and 88-100%, of the 20, 60, and 200μg dose levels, respectively, had seroprotective (≥ 1:4) hSBA titres against six serogroup B strains. The bivalent r-fHBP vaccine was well tolerated and induced robust bactericidal activity against six diverse serogroup B strains in young adults at the 60 and 200μg dose levels.

  18. Effective Teaching Factors and Student Reading Strategies as Predictors of Student Achievement in PISA 2009: The Case of China and the United States

    Science.gov (United States)

    Meng, Lingqi; Muñoz, Marco; King Hess, Kristin; Liu, Shujie

    2017-01-01

    This study investigated effective teaching factors and student reading strategies as predictors of student reading achievement in the United States and China. Participants were 10,348 students in the 2009 Program for International Student Assessment (PISA) study, 5115 from China and 5233 from the United States. Exploratory factor analysis (EFA)…

  19. Nosocomial infections in a neonatal intensive care unit : Incidence and risk factors

    NARCIS (Netherlands)

    Nagata, E; Brito, ASJ; Matsuo, T

    2002-01-01

    Background: Nosocomial infections (Nls) have become a matter of major concern in neonatal intensive care units (NICUs). The objectives of this study were to determine the incidence rate and the most frequent sites of infection in a Brazilian NICU from January 1999 to March 2000 and to study the risk

  20. Factors That Influence Human Behavior And Negatively Affect Energy Consumption In USMC Ground Units During Operations

    Science.gov (United States)

    2016-09-01

    Boston: Prentice Hall Bulanow, Peter, Paul Tabler, and Shawn Charchan. 2011. Expeditionary Energy Assessment: Environmental Control Unit Alternatives...U.S. ARMY Rapid Equipping Force. Kotter, John P., and Leonard Schlesinger. 2008. “Choosing Strategies for Change.” Harvard Business Review 86.7

  1. Trends in Risk and Protective Factors for Child Bullying Perpetration in the United States

    Science.gov (United States)

    Shetgiri, Rashmi; Lin, Hua; Flores, Glenn

    2013-01-01

    This study examines trends in prevalence and factors associated with bullying perpetration among children 10-17 years old, using the 2003 and 2007 National Survey of Children's Health. A parent-reported bullying measure and NSCH-designed questions were used to measure factors associated with bullying. The 2003 (n = 48,639) and 2007 (n = 44,152)…

  2. Human factors review of CFMS displays for Ulchin Nuclear Power Unit 3 and 4

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee; Baek, Seung Min; Kim, Jung Taek; Park, Jae Chang; Lee, Jung Woon; Oh, In Suk; Lee, Joon Whan; Jung, Kwang Tae; Cha, Hye Young [Korea Atomic Energy Research Institute, Taejon (Korea, Republic of)

    1996-11-01

    This report describes the human factors review of CFMS displays for Ulchin 3 and 4 by the following four subjects; At first, by reviewing issues regarding the design process of present CFMS, human factors engineering program plan (HFEPP) and human factors verification and validation plan Were proposed to accomplish the completeness of design word; Secondly, researches and developments were integrated into the review results at the point of suitability of CFMS design concept and basic function; For the third, availability and suitability were assessed according to human factors evaluation criteria on the CFMS display design, and overall effectiveness was also evaluated in parts; For the fourth, recommendations were made to human factors problems in accordance with their importance and an implementation plan was suggested for the resolution of problems. 54 refs., 34 tabs., 42 figs. (author)

  3. Dose calculation for asymmetric fields and irregular fields with multileaf collimators. Approximation of tissue-maximum ratio and field factor using modified Day`s calculation method

    Energy Technology Data Exchange (ETDEWEB)

    Nakata, Manabu; Okada, Takashi; Komai, Yoshinori; Nohara, Hiroki [Kyoto Univ. (Japan). Hospital

    1996-08-01

    Modern linear accelerators have four independent jaws and multileaf collimators (MLC) of 1 cm width at the isocenter. Asymmetric fields defined by such independent jaws and irregular multileaf collimated fields can be used to match adjacent fields or to spare the spinal cord in external photon beam radiotherapy. We have developed a new approximate algorithm for depth dose calculations at the collimator rotation axis. The program is based on Clarkson`s principle, and uses a more accurate modification of Day`s method for asymmetric fields. Using this method, tissue-maximum ratios (TMR) and field factors of ten kinds of asymmetric fields and ten different irregular multileaf collimated fields were calculated and compared with the measured data for 6 MV and 15 MV photon beams. The dose accuracy with the general A/Pe method was about 3%, however, with the new modified Day`s method, accuracy was within 1.7% for TMR and 1.2% for field factors. The calculated TMR and field factors were found to be in good agreement with measurements for both the 6 MV and 15 MV photon beams. (author)

  4. Augmentation of the effect of doxorubicin with low-dose tumor necrosis factor in experimental liver metastasis.

    Science.gov (United States)

    Bloom, N D; Norbergs, D A; Sherman, B; Sadjadi, M; Ramaswamy, G; Jacobs, R; Ackerman, N

    1990-06-01

    The antitumor activity of recombinant human tumor necrosis factor was studied in vivo as a single agent and in combination with a conventional chemotherapeutic agent. Dosages of tumor necrosis factor of 100 micrograms, 50 micrograms, and 25 micrograms were injected intraportally in Sprague-Dawley rats containing hepatic implants of Walker carcinosarcoma. An effect on the tumor was seen but was associated with a significant acute mortality. Lower dosages of tumor necrosis factor, 10 micrograms, 5 micrograms, and 1 microgram, administered with 10 mg/kg of doxorubicin (Adriamycin) significantly enhanced the antitumor effect of doxorubicin without an acute mortality. This suggests that lower dosages of tumor necrosis factor with conventional chemotherapy may augment the latter's effect without any added toxicity.

  5. Historical and Contemporary Factors Contributing to the Plight of Migrant Farmworkers in the United States

    OpenAIRE

    Martin Thomas Donohoe; Safina Koreishi

    2010-01-01

    Abstract: Migrant farmworkers provide an essential service and perform jobs that many Americans are unwilling to do. Immigration practices and policies dictate the extent to which undocumented migrant farmworkers have access to governmental health and social services, and are ever-changing based on the political climate. This paper reviews historical and contemporary United States government policies relevant to migrant farmworkers. It refutes some of the common myths regarding documented and...

  6. Food waste in the United States: A contributing factor toward environmental instability

    OpenAIRE

    Michael eHickey; Gulnihal eOzbay

    2014-01-01

    The world's population continues to increase at record rates along with corresponding nutritional needs and related agricultural consequences. In the United States, food waste levels serve as dominant components of land-fill masses, oil and freshwater waste, methane and CO2 emissions, damage to wildlife ecosystems, and substantial financial losses. Agricultural effects on the environment were investigated through various research studies, referenced in this document, and efforts made toward f...

  7. Organizational factors impacting job strain and mental quality of life in emergency and critical care units

    Directory of Open Access Journals (Sweden)

    Gauthier Bellagamba

    2015-04-01

    Full Text Available Objectives: This study measures the association between hospital staff’s job strain (JS, mental quality of life (MQL and how they are influenced by the organization models within emergency and critical care units. Material and Methods: This study describes workers employed in emergency departments and intensive care units of a French public hospital. A selfadministered questionnaire was used to survey the demographic and organizational characteristics of their work, as well as work-related mental stress, psychosocial and organizational constraints, and their MQL. Results: Among 145 workers participating in the study, 59.3% of them report job strain and 54.5% of them have low MQL scores. The majority of staff with job strain has reported working more than 2 weekends per month, were regularly on-call, worked in dysfunctional environments and did not participate in regular meetings. The staff with low MQL worked more frequently in dysfunctional environments, had significant complaints regarding employer’s efforts to promote communications or provide adequate staffing levels than the workers with a high MQL score. Conclusions: If stress reduction and improved MQL in emergency and intensive care units is to be achieved, hospital management needs to design work schedules that provide a better balance between working and non-working hours. Additionally, ergonomic design, functional environments and improved communications needs to be implemented.

  8. Organizational factors impacting job strain and mental quality of life in emergency and critical care units.

    Science.gov (United States)

    Bellagamba, Gauthier; Gionta, Guillaume; Senergue, Julie; Bèque, Christine; Lehucher-Michel, Marie-Pascale

    2015-01-01

    This study measures the association between hospital staff's job strain (JS), mental quality of life (MQL) and how they are influenced by the organization models within emergency and critical care units. This study describes workers employed in emergency departments and intensive care units of a French public hospital. A selfadministered questionnaire was used to survey the demographic and organizational characteristics of their work, as well as work-related mental stress, psychosocial and organizational constraints, and their MQL. Among 145 workers participating in the study, 59.3% of them report job strain and 54.5% of them have low MQL scores. The majority of staff with job strain has reported working more than 2 weekends per month, were regularly on-call, worked in dysfunctional environments and did not participate in regular meetings. The staff with low MQL worked more frequently in dysfunctional environments, had significant complaints regarding employer's efforts to promote communications or provide adequate staffing levels than the workers with a high MQL score. If stress reduction and improved MQL in emergency and intensive care units is to be achieved, hospital management needs to design work schedules that provide a better balance between working and non-working hours. Additionally, ergonomic design, functional environments and improved communications needs to be implemented. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

  9. Current trends in reducing cardiovascular risk factors in the United States: focus on worksite health and wellness.

    Science.gov (United States)

    Cahalin, Lawrence P; Myers, Jonathan; Kaminsky, Leonard; Briggs, Paige; Forman, Daniel E; Patel, Mahesh J; Pinkstaff, Sherry O; Arena, Ross

    2014-01-01

    Health care in the United States (US) is changing with a broad provision of health care services to every American due to the Affordable Care Act (ACA) slated to begin in January of 2014. An important aspect of the ACA is that US companies may begin to offer health insurance incentives to employees for participating in health and wellness initiatives. Moreover, since US employers directly absorb many of the financial costs associated with the high degree of cardiovascular (CV) risk factors present in their personnel, employers may be financially vested in improving employee health. However, employers must also consider the costs of developing and maintaining programs to improve employee health and their return on investment (ROI). This review will identify key risk factors to address in a worksite health and wellness program and to examine the performance of such programs in improving CV risk factors and their ROI.

  10. Perceived and actual key success factors: A study of the yoghurt market in Denmark, Germany and the United Kingdom

    DEFF Research Database (Denmark)

    Grunert, Klaus G.; Sørensen, Elin

    /high degree of innovativeness, extensive marketing activities, (abundant) financial resources, s production, good logistics management, good product portfolio management, non-complex organisation, low retail prices, good relations with trade, extensive market knowledge. 4. According to managers' perceptions......Executive summary 1. We define a key success factor as a skill or resource that a business can invest in, which, on the market the business is operating on, explains a major part of the observable differences in perceived value and/or relative costs. The key success factors as perceived by managers...... need not be identical with the actual key success factors in a market. 2. Depth interviews with managers in yoghurt-producing companies in Denmark, Germany and the United Kingdom showed considerable variation in both substance and degree of detail in their perceptions of the determinants of success...

  11. Breast Cancer Risk From Modifiable and Nonmodifiable Risk Factors Among White Women in the United States

    DEFF Research Database (Denmark)

    Maas, Paige; Barrdahl, Myrto; Joshi, Amit D;

    2016-01-01

    Importance: An improved model for risk stratification can be useful for guiding public health strategies of breast cancer prevention. Objective: To evaluate combined risk stratification utility of common low penetrant single nucleotide polymorphisms (SNPs) and epidemiologic risk factors. Design, ...

  12. Risk factors for domestic minor sex trafficking in the United States: a literature review.

    Science.gov (United States)

    Choi, Kristen R

    2015-01-01

    Domestic minor sex trafficking (DMST) is an important social and public health problem, but it has received little attention from healthcare professionals in research, practice, and policy. Prevention and early victim identification efforts for this population are severely limited or entirely absent. The aim of this study was to integrate evidence on risk factors for DMST and critically appraise the quality and quantity of nursing literature on DMST. This literature review was reported using PRISMA criteria. Three databases (CINAHL, PsychInfo, and PubMed) were searched using various terms for (a) human trafficking, (b) risk factors, and (c) children. Demographic factors were not important predictors of DMST. Childhood maltreatment trauma and running away from home were the most important risk factors for trafficking victimization. There was little nursing literature on the topic of DMST. Nurses and other healthcare professionals must engage in confronting DMST by improving early identification of victims and conducting high-quality research to inform practice.

  13. Comparative pharmacokinetics of single-dose administration of mammalian and bacterially-derived recombinant human granulocyte-macrophage colony-stimulating factor.

    Science.gov (United States)

    Hovgaard, D; Mortensen, B T; Schifter, S; Nissen, N I

    1993-01-01

    Pharmacokinetics of recombinant human non-glycosylated bacterially-synthesized (E. coli) granulocyte-macrophage colony-stimulating factor (GM-CSF) were studied following single intravenous (i.v.) and subcutaneous (s.c.) bolus injection, and compared to equivalent doses of glycosylated mammalian-derived CHO-GM-CSF. Each route of administration gave a different GM-CSF concentration-time profile. The highest peak serum concentrations (Cmax) were observed following i.v. bolus injection. After i.v. administration, a two-phase decline in concentration was noted for both types of GM-CSF with a significantly shorter t1/2 alpha of 7.8 minutes for the E. coli GM-CSF versus 20.0 min for the CHO-GM-CSF, while no significant difference was observed for the terminal phase. Following s.c. administration of equivalent doses, a higher peak serum concentration was observed in the E. coli-treated patients and, again, a faster elimination where pretreatment serum levels were reached after 16-20 h, versus more than 48 h after administration of CHO-GM-CSF. Although the non-glycosylated E. coli GM-CSF thus seems to undergo a faster elimination that the glycosylated CHO-GM-CSF no significant difference could be demonstrated in the in vivo effect of corresponding doses of the two compounds with respect to stimulation of granulopoiesis--with reservation for small patient numbers and a large individual variations in response.

  14. [Detection of vascular risk factors and unknown atrial fibrillation in patients hospitalised in the stroke unit].

    Science.gov (United States)

    Jiménez-Caballero, Pedro E; López-Espuela, Fidel; Portilla-Cuenca, Juan C; Jiménez-Gracia, M Antonia; Casado-Naranjo, Ignacio

    2013-05-01

    Introduccion. Existe una serie de factores de riesgo cerebrovascular modificables, como son la hipertension arterial, la diabetes mellitus, dislipidemias y la fibrilacion auricular, cuyo reconocimiento y control es fundamental para disminuir la aparicion de enfermedades cerebrovasculares. En ocasiones, el ictus puede ser el sintoma de presentacion de estos factores de riesgo. Pacientes y metodos. Estudio observacional prospectivo de los pacientes que ingresan en la unidad de ictus de nuestro hospital por enfermedad cerebrovascular aguda –accidente isquemico transitorio e ictus isquemico– para conocer el porcentaje de pacientes con hipertension arterial, diabetes mellitus, dislipidemias y fibrilacion auricular no diagnosticadas previamente. Resultados. Se selecciono a 186 pacientes, de los que 24 presentaban hipertension arterial no conocida (12,9%); 11, diabetes mellitus no conocida (5,9%); 49, hipercolesterolemia no conocida (26,3%); 15, hipertrigliceridemia no conocida (8,1%), y 22 tenian fibrilacion auricular no conocida (11,8%). En total, 96 pacientes (51,6%) tenian alguno de estos factores de riesgo cerebrovascular. La existencia de un factor de riesgo no diagnosticado previamente era mayor en el medio rural, en los sujetos que no habian fallecido a los seis meses y en los ataques isquemicos transitorios respecto a los ictus isquemicos. Conclusiones. Mas de la mitad de los sujetos que sufren un evento cerebrovascular tienen un factor de riesgo que no se ha diagnosticado previamente. Se deben realizar campanas para implementar la deteccion de estos factores, asi como incidir en el control de estos para disminuir la aparicion y recidiva de patologia vascular.

  15. Dose of Phenobarbital and Age of Treatment at Early Life are Two Key Factors for the Persistent Induction of Cytochrome P450 Enzymes in Adult Mouse Liver.

    Science.gov (United States)

    Tien, Yun-Chen; Liu, Ke; Pope, Chad; Wang, Pengcheng; Ma, Xiaochao; Zhong, Xiao-bo

    2015-12-01

    Drug treatment of neonates and infants and its long-term consequences on drug responses have emerged in recent years as a major challenge for health care professionals. In the current study, we use phenobarbital as a model drug and mouse as an in vivo model to demonstrate that the dose of phenobarbital and age of treatment are two key factors for the persistent induction of gene expression and consequential increases of enzyme activities of Cyp2b, Cyp2c, and Cyp3a in adult livers. We show that phenobarbital treatment at early life of day 5 after birth with a low dose (phenobarbital treatment with a high dose (>200 mg/kg) significantly increases expression and enzyme activities of these P450s in adult liver. We also demonstrate that phenobarbital treatment before day 10 after birth, but not at later ages, significantly increases mRNAs, proteins, and enzyme activities of the tested P450s. Such persistent induction of P450 gene expression and enzyme activities in adult livers by phenobarbital treatment only occurs within a sensitive age window early in life. The persistent induction in gene expression and enzyme activities is higher in female mice than in male mice for Cyp2b10 but not for Cyp2c29 and Cyp3a11. These results will stimulate studies to evaluate the long-term impacts of drug treatment with different doses at neonatal and infant ages on drug metabolism, therapeutic efficacy, and drug-induced toxicity throughout the rest of life. Copyright © 2015 by The American Society for Pharmacology and Experimental Therapeutics.

  16. Dose-response association of uncontrolled blood pressure and cardiovascular disease risk factors with hyperuricemia and gout.

    Directory of Open Access Journals (Sweden)

    Stephen P Juraschek

    Full Text Available First-line therapy of hypertension includes diuretics, known to exert a multiplicative increase on the risk of gout. Detailed insight into the underlying prevalence of hyperuricemia and gout in persons with uncontrolled blood pressure (BP and common comorbidities is informative to practitioners initiating antihypertensive agents. We quantify the prevalence of hyperuricemia and gout in persons with uncontrolled BP and additional cardiovascular disease (CVD risk factors.We performed a cross-sectional study of non-institutionalized US adults, 18 years and older, using the National Health and Nutrition Examination Surveys in 1988-1994 and 1999-2010. Hyperuricemia was defined as serum uric acid >6.0 mg/dL in women; >7.0 mg/dL in men. Gout was ascertained by self-report of physician-diagnosed gout. Uncontrolled BP was based on measured systolic BP≥140 mmHg and diastolic BP≥90 mmHg. Additional CVD risk factors included obesity, reduced glomerular filtration rate, and dyslipidemia. The prevalence of hyperuricemia was 6-8% among healthy US adults, 10-15% among adults with uncontrolled BP, 22-25% with uncontrolled BP and one additional CVD risk factor, and 34-37% with uncontrolled BP and two additional CVD risk factors. Similarly, the prevalence of gout was successively greater, at 1-2%, 4-5%, 6-8%, and 8-12%, respectively, across these same health status categories. In 2007-2010, those with uncontrolled BP and 2 additional CVD risk factors compared to those without CVD risk factors had prevalence ratios of 4.5 (95% CI 3.5-5.6 and 4.5 (95% CI: 3.1-6.3 for hyperuricemia and gout respectively (P<0.01.Health care providers should be cognizant of the incrementally higher prevalence of hyperuricemia and gout among patients with uncontrolled BP and additional CVD risk factors. With one in three people affected by hyperuricemia among those with several CVD risk factors, physicians should consider their anti-hypertensive regimens carefully and potentially

  17. Factors Associated With Use of ASAM Criteria and Service Provision in a National Sample of Outpatient Substance Abuse Treatment Units.

    Science.gov (United States)

    Chuang, Emmeline; Wells, Rebecca; Alexander, Jeffrey A; Friedmann, Peter D; Lee, I-Heng

    2009-09-01

    Standardized patient placement criteria such as those developed by the American Society of Addiction Medicine are increasingly common in substance abuse treatment, but it is unclear what factors are associated with their use or with treatment units' provision of related services. This study examined these issues in the context of a national survey of outpatient substance abuse treatment units. Regressions using 2005 data revealed that both public and private managed care were associated with a greater likelihood of using American Society of Addiction Medicine criteria to develop client treatment plans. However, only public managed care was associated with a greater likelihood of offering more resource-intensive services. Associations between client population severity and resource-intensive service provision were sparse but positive.

  18. Risk factors associated with bus accident severity in the United States: A generalized ordered logit model

    DEFF Research Database (Denmark)

    Kaplan, Sigal; Prato, Carlo Giacomo

    2012-01-01

    Introduction: Recent years have witnessed a growing interest in improving bus safety operations worldwide. While in the United States buses are considered relatively safe, the number of bus accidents is far from being negligible, triggering the introduction of the Motor-coach Enhanced Safety Act...... that accident severity increases: (i) for young bus drivers under the age of 25; (ii) for drivers beyond the age of 55, and most prominently for drivers over 65 years old; (iii) for female drivers; (iv) for very high (over 65 mph) and very low (under 20 mph) speed limits; (v) at intersections; (vi) because...

  19. Risk factors, characteristics, and outcomes of candidemia in an adult intensive care unit in Turkey.

    Science.gov (United States)

    Tukenmez Tigen, Elif; Bilgin, Huseyin; Perk Gurun, Hande; Dogru, Arzu; Ozben, Beste; Cerikcioglu, Nilgun; Korten, Volkan

    2017-06-01

    Thirty-six patients with candidemia and 37 control patients were included consecutively to determine the characteristics of candidemia episodes. The patients with candidemia had higher mortality with higher Sequential Organ Failure Assessment scores and frequency of use of a central venous catheter, total parenteral nutrition, and broad-spectrum antibiotics; chronic renal failure with replacement therapy; and longer stay in an intensive care unit. Candida albicans was the predominant species followed by Candida glabrata, Candida tropicalis, and Candida parapsilosis. All isolates of C glabrata were itraconazole-resistant. Copyright © 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved.

  20. Factors for Microbial Carbon Sources in Organic and Mineral Soils from Eastern United States Deciduous Forests

    Energy Technology Data Exchange (ETDEWEB)

    Stitt, Caroline R. [Mills College, Oakland, CA (United States)

    2013-09-16

    Forest soils represent a large portion of global terrestrial carbon; however, which soil carbon sources are used by soil microbes and respired as carbon dioxide (CO2) is not well known. This study will focus on characterizing microbial carbon sources from organic and mineral soils from four eastern United States deciduous forests using a unique radiocarbon (14C) tracer. Results from the dark incubation of organic and mineral soils are heavily influenced by site characteristics when incubated at optimal microbial activity temperature. Sites with considerable differences in temperature, texture, and location differ in carbon source attribution, indicating that site characteristics play a role in soil respiration.

  1. Radiation doses from computed tomography in Australia

    Energy Technology Data Exchange (ETDEWEB)

    Thomson, J.E.M.; Tingey, D.R.C

    1997-11-01

    Recent surveys in various countries have shown that computed tomography (CT) is a significant and growing contributor to the radiation dose from diagnostic radiology. Australia, with 332 CT scanners (18 per million people), is well endowed with CT equipment compared to European countries (6 to 13 per million people). Only Japan, with 8500 units (78 per million people), has a significantly higher proportion of CT scanners. In view of this, a survey of CT facilities, frequency of examinations, techniques and patient doses has been performed in Australia. It is estimated that there are 1 million CT examinations in Australia each year, resulting in a collective effective dose of 7000 Sv and a per caput dose of 0.39 mSv. This per caput dose is much larger than found in earlier studies in the UK and New Zealand but is less than 0.48 mSv in Japan. Using the ICRP risk factors, radiation doses from CT could be inducing about 280 fatal cancers per year in Australia. CT is therefore a significant, if not the major, single contributor to radiation doses and possible risk from diagnostic radiology. (authors) 28 refs., 11 tabs., 10 figs.

  2. Effects of different doses of atorvastatin on NF-κB, inflammatory factors and insulin resistance in elderly patients with early diabetic nephropathy

    Institute of Scientific and Technical Information of China (English)

    Ying Liu; Ying Zhou; Hai-Yan Yang; Hai-Na Zhang; Zhi-E Wang

    2016-01-01

    Objective:To explore the effects of different doses of atorvastatin on NF-κB, inflammatory factors and insulin resistance in elderly patients with early diabetic nephropathy.Methods:A total of 150 cases with elderly early diabetic nephropathy were randomly divided into two groups according to the random number table method. Group A (n=75) was treated with atorvastatin tablets at a dose of 10 mg/d, while group B (n=75) was treated at a dose of 20 mg/d. The NF-κB, inflammatory factors and insulin resistance were detected and compared between the two groups.Results: After treatment, UAER (52.87±7.78) μg/min, SCr (70.43±6.76) μmol/L and BUN (4.04±0.40) mmol/L of group B were significantly decreased compared with before treatment and post-treated group A (P<0.05); phosphorylation level of NF-κB p65 after treatment was (0.80±0.17) μg/min in the peripheral blood of patients from group B, which was significantly reduced compared with before treatment and post-treated group A (P<0.05); inflammatory factors including TNF-α(52.80±7.78) ng/L, IL-6 (70.43±6.76) ng/L and Hs-CRP (4.04±0.40) mg/L of group B after treatment also declined significantly compared with before treatment and post-treated group A (P<0.05); while HbAlc and FBG were not significantly changed after treatment in both groups, and there was no significant difference in each group before and after treatment; FINS (9.88±0.85) mU/L and HOMA-IR (3.36±0.33) of group B after treatment were significantly lowered compared with before treatment and post-treated group A (P<0.05).Conclusions:High dose atorvastatin can inhibit the activity of NF-κB p65 and levels of inflammation, and improve renal function and insulin resistance in elderly patients with early diabetic nephropathy, making it a promising means for clinical application.

  3. Factors affecting stream nutrient loads: A synthesis of regional SPARROW model results for the continental United States

    Science.gov (United States)

    Preston, Stephen D.; Alexander, Richard B.; Schwarz, Gregory E.; Crawford, Charles G.

    2011-01-01

    We compared the results of 12 recently calibrated regional SPARROW (SPAtially Referenced Regressions On Watershed attributes) models covering most of the continental United States to evaluate the consistency and regional differences in factors affecting stream nutrient loads. The models - 6 for total nitrogen and 6 for total phosphorus - all provide similar levels of prediction accuracy, but those for major river basins in the eastern half of the country were somewhat more accurate. The models simulate long-term mean annual stream nutrient loads as a function of a wide range of known sources and climatic (precipitation, temperature), landscape (e.g., soils, geology), and aquatic factors affecting nutrient fate and transport. The results confirm the dominant effects of urban and agricultural sources on stream nutrient loads nationally and regionally, but reveal considerable spatial variability in the specific types of sources that control water quality. These include regional differences in the relative importance of different types of urban (municipal and industrial point vs. diffuse urban runoff) and agriculture (crop cultivation vs. animal waste) sources, as well as the effects of atmospheric deposition, mining, and background (e.g., soil phosphorus) sources on stream nutrients. Overall, we found that the SPARROW model results provide a consistent set of information for identifying the major sources and environmental factors affecting nutrient fate and transport in United States watersheds at regional and subregional scales. ?? 2011 American Water Resources Association. This article is a U.S. Government work and is in the public domain in the USA.

  4. Emerging risk factors and the dose-response relationship between physical activity and lone atrial fibrillation: a prospective case-control study.

    Science.gov (United States)

    Calvo, Naiara; Ramos, Pablo; Montserrat, Silvia; Guasch, Eduard; Coll-Vinent, Blanca; Domenech, Mònica; Bisbal, Felipe; Hevia, Sara; Vidorreta, Silvia; Borras, Roger; Falces, Carles; Embid, Cristina; Montserrat, Josep Maria; Berruezo, Antonio; Coca, Antonio; Sitges, Marta; Brugada, Josep; Mont, Lluís

    2016-01-01

    The role of high-intensity exercise and other emerging risk factors in lone atrial fibrillation (Ln-AF) epidemiology is still under debate. The aim of this study was to analyse the contribution of each of the emerging risk factors and the impact of physical activity dose in patients with Ln-AF. Patients with Ln-AF and age- and sex-matched healthy controls were included in a 2:1 prospective case-control study. We obtained clinical and anthropometric data transthoracic echocardiography, lifetime physical activity questionnaire, 24-h ambulatory blood pressure monitoring, Berlin questionnaire score, and, in patients at high risk for obstructive sleep apnoea (OSA) syndrome, a polysomnography. A total of 115 cases and 57 controls were enrolled. Conditional logistic regression analysis associated height [odds ratio (OR) 1.06 [1.01-1.11

  5. Factors potentially associated with the decision of admission to the intensive care unit in a middle-income country: a survey of Brazilian physicians

    Science.gov (United States)

    Ramos, João Gabriel Rosa; Passos, Rogerio da Hora; Baptista, Paulo Benigno Pena; Forte, Daniel Neves

    2017-01-01

    Objective To evaluate the factors potentially associated with the decision of admission to the intensive care unit in Brazil. Methods An electronic survey of Brazilian physicians working in intensive care units. Fourteen variables that were potentially associated with the decision of admission to the intensive care unit were rated as important (from 1 to 5) by the respondents and were later grouped as "patient-related," "scarcity-related" and "administrative-related" factors. The workplace and physician characteristics were evaluated for correlation with the factor ratings. Results During the study period, 125 physicians completed the survey. The scores on patient-related factors were rated higher on their potential to affect decisions than scarcity-related or administrative-related factors, with a mean ± SD of 3.42 ± 0.7, 2.75 ± 0.7 and 2.87 ± 0.7, respectively (p < 0.001). The patient's underlying illness prognosis was rated by 64.5% of the physicians as always or frequently affecting decisions, followed by acute illness prognosis (57%), number of intensive care unit beds available (56%) and patient's wishes (53%). After controlling for confounders, receiving specific training on intensive care unit triage was associated with higher ratings of the patient-related factors and scarcity-related factors, while working in a public intensive care unit (as opposed to a private intensive care unit) was associated with higher ratings of the scarcity-related factors. Conclusions Patient-related factors were more frequently rated as potentially affecting intensive care unit admission decisions than scarcity-related or administrative-related factors. Physician and workplace characteristics were associated with different factor ratings.

  6. Food waste in the United States: A contributing factor toward environmental instability

    Directory of Open Access Journals (Sweden)

    Michael eHickey

    2014-11-01

    Full Text Available The world’s population continues to increase at record rates along with corresponding nutritional needs and related agricultural consequences. In the United States, food waste levels serve as dominant components of land-fill masses, oil and freshwater waste, methane and CO2 emissions, damage to wildlife ecosystems, and substantial financial losses. Agricultural effects on the environment were investigated through various research studies, referenced in this document, and efforts made toward food waste recycling were discussed as noteworthy models concerning improvements in sustainable agricultural practices. Food waste levels in the United States can be traced as faults of consumers, agricultural businesses, as well as federal legislation and there is an evident need for reform to maintain consumer health, viable foreign affairs, and environmental sustainability. Present agricultural practices are intense and rapid, increasing the risk of soil infertility and commercial alterations in production yields; repercussions well documented in neighboring nations. Experts argue that food waste in developed countries damages food availability around the world and, based on current agricultural practices and production, there is debate conc

  7. ECOG Phase II trial of graded-dose peginterferon α-2b in patients with metastatic melanoma over-expressing basic fibroblast growth factor (E2602)

    Science.gov (United States)

    Go, Ronald S.; Lee, Sandra J.; Shin, Donghoon; Callister, Steven M.; Jobe, Dean A.; Conry, Robert M.; Tarhini, Ahmad A.; Kirkwood, John M.

    2013-01-01

    Purpose We investigated use of graded-dose peginterferon α-2b (Peg-IFN) in patients with stage IV melanoma overexpressing basic fibroblast growth factor (FGF-2). The primary objective was suppression of plasma FGF-2 to within normal range (≤7.5 pg/mL). Experimental Design Plasma FGF-2 was measured at baseline (Step 1), and patients with concentrations ≥15 pg/mL were eligible for study treatment (Step 2). Peg-IFN was given weekly at starting dose of 0.5 μg/kg/wk with increment every 3 weeks based on serial FGF-2 concentrations. Results Two hundred seven patients entered Step 1; 45 (22%) overexpressed FGF-2 (median=22 pg/dL). Twenty-nine eligible patients entered Step 2 and received treatment. Patients’ median age was 64 years (range, 29–84 years). Most had >2 prior therapies. FGF-2 decreased in 28 (97%) patients, with suppression to normal range in 10 (35%). Median time to FGF-2 suppression was 30 days. The best clinical responses were partial response (7%) and stable disease (17%). Median progression-free survival (PFS) and overall survival (OS) were 2.0 and 9.7 months, respectively. Patients who achieved FGF-2 suppression were more likely than those who did not to have a response or stable disease (P = 0.03). Vascular endothelial growth factor (VEGF) concentrations decreased in 27 patients (93%) during treatment and paralleled those of FGF-2 over time. We found no compensatory rise in VEGF among those with FGF-2 suppression. Conclusions Graded-dose Peg-IFN suppresses FGF-2 in patients with metastatic melanoma who overexpress FGF-2. Over a third of patients had complete suppression of plasma FGF-2, which correlated with clinical response to this therapy. PMID:24122792

  8. Prevention of Tracheal High-Dose Tolerance Induction by Granulocyte-Macrophage Colony Stimulating Factor- Dependent Restoration of Antigen-Presenting Cell Function

    Directory of Open Access Journals (Sweden)

    Kanna Haneda

    2000-01-01

    Full Text Available The intrusion of airborne allergens into airways elicits eosinophilic inflammation, as represented by bronchial asthma. It has been shown that excessive amounts of allergen in murine trachea lead to an unexpected evasion of deleterious eosinophilic inflammation by inducing T cell tolerance. In the present study, the mechanisms of tracheal high-dose tolerance are examined with regard to accessory cell functions and the effects of pro-inflammatory cytokines on tolerance. Antigen-induced tracheal eosinophilia was suppressed on instillation of high doses of antigen into the trachea, while concurrent instillation of granulocyte-macrophage colony stimulating factor (GM-CSF with the antigen restored the diminished responses. The restoration of eosinophilic infiltration by GM-CSF occurred in parallel with an increase in interleukin (IL-4 production by CD4+ T cells from the mediastinal lymph nodes. This was found to reflect the empowerment of antigen-presenting cells by GM-CSF, because the impaired ability of Ia+ cells from the tolerant mice to stimulate IL-4-producing T cells is restored by GM-CSF administration. The prevention of tolerance by up-regulating accessory cell functions is a feature unique to GM-CSF, because another pro-inflammatory cytokine, IL-iβ, failed to empower antigen-presenting cells. Thus, besides the induction of transforming growth factor-β-secreting CD4+ T cells, high-dose tolerance in the trachea includes an impairment of the accessory cell functions that support IL-4 production from T cells, which was reversed by GM-CSF. This report is the first demonstration that GM-CSF breaks the T cell tolerance of IL-4-producing T helper cells.

  9. High-dose-rate Intracavitary Radiotherapy in the Management of Cervical Intraepithelial Neoplasia 3 and Carcinoma In Situ Presenting With Poor Histologic Factors After Undergoing Excisional Procedures

    Energy Technology Data Exchange (ETDEWEB)

    Kim, Yong Bae, E-mail: ybkim3@yuhs.ac [Department of Radiation Oncology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Kim, Young Tae [Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Cho, Nam Hoon [Department of Pathology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Koom, Woong Sub [Department of Radiation Oncology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Kim, Sunghoon; Kim, Sang Wun; Nam, Eun Ji [Department of Obstetrics and Gynecology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of); Kim, Gwi Eon [Department of Radiation Oncology, Severance Hospital, Yonsei University, College of Medicine, Seoul (Korea, Republic of)

    2012-09-01

    Purpose: To assess the effectiveness of high-dose-rate intracavitary radiotherapy (HDR-ICR) in patients with cervical intraepithelial neoplasia 3 (CIN 3) and carcinoma in situ (CIS) presenting with poor histologic factors for predicting residual disease after undergoing diagnostic excisional procedures. Methods and Materials: This study was a retrospective analysis of 166 patients with CIN 3 (n=15) and CIS (n=151) between October 1986 and December 2005. They were diagnosed by conization (n=158) and punch biopsy (n=8). Pathologic analysis showed 135 cases of endocervical gland involvement (81.4%), 74 cases of positive resection margins (44.5%), and 52 cases of malignant cells on endocervical curettage (31.3%). All patients were treated with HDR-ICR using Co{sup 60} or Ir{sup 192} at a cancer center. The dose was prescribed at point A located 2 cm superior to the external os and 2 cm lateral to the axis of the tandem for intact uterus. Results: Median age was 61 years (range, 29-77). The median total dose of HDR-ICR was 30 Gy/6 fractions (range, 30-52). At follow-up (median, 152 months), 2 patients developed recurrent diseases: 1 CIN 2 and 1 invasive carcinoma. One hundred and forty patients survived and 26 patients died, owing to nonmalignant intercurrent disease. Rectal bleeding occurred in one patient; however, this symptom subsided with conservative management. Conclusions: Our data showed HDR-ICR is an effective modality for CIN 3 and CIS patients presenting with poor histologic factors after excisional procedures. HDR-ICR should be considered as a definitive treatment in CIN 3 and CIS patients with possible residual disease after undergoing excisional procedures.

  10. Analysis of the main factors affecting the evaluation of the radon dose in workplaces: The case of tourist caves

    Energy Technology Data Exchange (ETDEWEB)

    Sainz, Carlos [Department of Medical Physics, RADON Group, Faculty of Medicine, University of Cantabria, c/Cardenal Herrera Oria s/n, 39011 Santander (Spain); Quindos, Luis Santiago [Department of Medical Physics, RADON Group, Faculty of Medicine, University of Cantabria, c/Cardenal Herrera Oria s/n, 39011 Santander (Spain)]. E-mail: quindosl@unican.es; Fuente, Ismael [Department of Medical Physics, RADON Group, Faculty of Medicine, University of Cantabria, c/Cardenal Herrera Oria s/n, 39011 Santander (Spain); Nicolas, Jorge [Department of Medical Physics, RADON Group, Faculty of Medicine, University of Cantabria, c/Cardenal Herrera Oria s/n, 39011 Santander (Spain); Quindos, Luis [Department of Medical Physics, RADON Group, Faculty of Medicine, University of Cantabria, c/Cardenal Herrera Oria s/n, 39011 Santander (Spain)

    2007-07-16

    High concentrations of radon exist in several workplaces like tourist caves mainly because of the low ventilation rates existing at these enclosures. In this sense, in its 1990 publication, the ICRP recommended that high exposures of radon in workplaces should be considered as occupational exposure. In developed caves in which guides provide tours for the general public great care is needed for taking remedial actions concerning radon, because in some circumstances forced ventilation may alter the humidity inside the cave affecting some of the formations or paintings that attract tourists. Tourist guides can work about 1900 h per year, so the only option to protect them and other cave workers from radon exposure is to apply an appropriate system of radiation protection mainly based on limitation of exposure by restricting the amount of time spent in the cave. Because of the typical environmental conditions inside the caves, the application of these protecting actions requires to know some indoor air characteristics like particle concentration, as well as radon progeny behaviour in order to get more realistic effective dose values In this work the results of the first two set of radon measurements program carried out in 10 caves located in the region of Cantabria (Spain) are presented.

  11. Analysis of the main factors affecting the evaluation of the radon dose in workplaces: the case of tourist caves.

    Science.gov (United States)

    Sainz, Carlos; Quindós, Luis Santiago; Fuente, Ismael; Nicolás, Jorge; Quindós, Luis

    2007-07-16

    High concentrations of radon exist in several workplaces like tourist caves mainly because of the low ventilation rates existing at these enclosures. In this sense, in its 1990 publication, the ICRP recommended that high exposures of radon in workplaces should be considered as occupational exposure. In developed caves in which guides provide tours for the general public great care is needed for taking remedial actions concerning radon, because in some circumstances forced ventilation may alter the humidity inside the cave affecting some of the formations or paintings that attract tourists. Tourist guides can work about 1900 h per year, so the only option to protect them and other cave workers from radon exposure is to apply an appropriate system of radiation protection mainly based on limitation of exposure by restricting the amount of time spent in the cave. Because of the typical environmental conditions inside the caves, the application of these protecting actions requires to know some indoor air characteristics like particle concentration, as well as radon progeny behaviour in order to get more realistic effective dose values In this work the results of the first two set of radon measurements program carried out in 10 caves located in the region of Cantabria (Spain) are presented.

  12. Automated treatment planning for a dedicated multi-source intra-cranial radiosurgery treatment unit accounting for overlapping structures and dose homogeneity

    Energy Technology Data Exchange (ETDEWEB)

    Ghobadi, Kimia; Ghaffari, Hamid R. [Department of Mechanical and Industrial Engineering, University of Toronto, Ontario M5S 3G8 (Canada); Aleman, Dionne M. [Department of Mechanical and Industrial Engineering, University of Toronto, Ontario M5S 3G8 (Canada); Institute of Health Policy, Management and Evaluation, University of Toronto, Ontario M5T 3M6 (Canada); Techna Institute, University Health Network, Ontario M5G 1P5 (Canada); Jaffray, David A. [Radiation Medicine Program, Princess Margaret Hospital, University Health Network, Ontario M5T 2M9 (Canada); Department of Radiation Oncology, University of Toronto, Ontario M5S 3E2 (Canada); Department of Medical Biophysics, University of Toronto, Ontario M5G 2M9 (Canada); Institute of Biomaterial and Biomedical Engineering, University of Toronto, Ontario M5S 2J7 (Canada); Techna Institute, University Health Network, Ontario M5G 1P5 (Canada); Ontario Cancer Institute, Ontario M5G 0A3 (Canada); Ruschin, Mark [Department of Medical Physics, Odette Cancer Centre, Toronto, Ontario M4N 3M5 (Canada); Department of Radiation Oncology, University of Toronto, Toronto, Ontario M5S 3E2 (Canada)

    2013-09-15

    Purpose: The purpose of this work is to advance the two-step approach for Gamma Knife{sup ®} Perfexion™ (PFX) optimization to account for dose homogeneity and overlap between the planning target volume (PTV) and organs-at-risk (OARs).Methods: In the first step, a geometry-based algorithm is used to quickly select isocentre locations while explicitly accounting for PTV-OARs overlaps. In this approach, the PTV is divided into subvolumes based on the PTV-OARs overlaps and the distance of voxels to the overlaps. Only a few isocentres are selected in the overlap volume, and a higher number of isocentres are carefully selected among voxels that are immediately close to the overlap volume. In the second step, a convex optimization is solved to find the optimal combination of collimator sizes and their radiation duration for each isocentre location.Results: This two-step approach is tested on seven clinical cases (comprising 11 targets) for which the authors assess coverage, OARs dose, and homogeneity index and relate these parameters to the overlap fraction for each case. In terms of coverage, the mean V{sub 99} for the gross target volume (GTV) was 99.8% while the V{sub 95} for the PTV averaged at 94.6%, thus satisfying the clinical objectives of 99% for GTV and 95% for PTV, respectively. The mean relative dose to the brainstem was 87.7% of the prescription dose (with maximum 108%), while on average, 11.3% of the PTV overlapped with the brainstem. The mean beam-on time per fraction per dose was 8.6 min with calibration dose rate of 3.5 Gy/min, and the computational time averaged at 205 min. Compared with previous work involving single-fraction radiosurgery, the resulting plans were more homogeneous with average homogeneity index of 1.18 compared to 1.47.Conclusions: PFX treatment plans with homogeneous dose distribution can be achieved by inverse planning using geometric isocentre selection and mathematical modeling and optimization techniques. The quality of the

  13. Chronic inflammation and low-dose glucocorticoid effects on glucose metabolism in premenopausal females with rheumatoid arthritis free of conventional metabolic risk factors.

    Science.gov (United States)

    Penesová, A; Rádiková, Z; Vlček, M; Kerlik, J; Lukáč, J; Rovenský, J; Imrich, R

    2013-01-01

    Chronic systemic inflammation is associated with increased cardiovascular mortality in patients with rheumatoid arthritis (RA). The aim of our study was to investigate association of glucose metabolism and inflammatory markers in a group of patients with rheumatoid arthritis free of other metabolic risk factors. Twenty-two premenopausal RA females (11 patients on low-dose GC (glucocorticoid therapy) and 15 age- and BMI-matched healthy females underwent the oral glucose tolerance test. The insulin sensitivity indices according Matsuda (ISI(MAT)) and Cederholm (ISI(CED)) as well as HOMA2 %S were calculated. Cytokines, lipid profile, non-esterified fatty acids (NEFA) and plasminogen activator inhibitor-1 (PAI-1) were measured in baseline blood samples. Despite elevated interleukin IL-6 and TNF alpha, glucose, insulin and C-peptide responses to oral glucose load as well as ISI(MAT), ISI(CED), PAI-1 and NEFA were comparable in both RA groups and healthy controls. HOMA2 %S correlated with disease activity. In conclusions, low-dose glucocorticoid treatment does not lead to glucose metabolism impairment in RA patients without other metabolic risk factors. Increased cardiovascular mortality and morbidity is probably due to a direct effect of systemic inflammation on myocardium and/or blood vessels.

  14. Intermittent auscultation versus continuous fetal monitoring: exploring factors that influence birthing unit nurses' fetal surveillance practice using theoretical domains framework.

    Science.gov (United States)

    Patey, Andrea M; Curran, Janet A; Sprague, Ann E; Francis, Jill J; Driedger, S Michelle; Légaré, France; Lemyre, Louise; Pomey, Marie-Pascale A; Grimshaw, Jeremy M

    2017-09-25

    Intermittent Auscultation (IA) is the recommended method of fetal surveillance for healthy women in labour. However, the majority of women receive continuous electronic monitoring. We used the Theoretical Domains Framework (TDF) to explore the views of Birthing Unit nurses about using IA as their primary method of fetal surveillance for healthy women in labour. Using a semi-structured interview guide, we interviewed a convenience sample of birthing unit nurses throughout Ontario, Canada to elicit their views about fetal surveillance. Interviews were recorded and transcribed verbatim. Transcripts were content analysed using the TDF and themes were framed as belief statements. Domains potentially key to changing fetal surveillance behaviour and informing intervention design were identified by noting the frequencies of beliefs, content, and their reported influence on the use of IA. We interviewed 12 birthing unit nurses. Seven of the 12 TDF domains were perceived to be key to changing birthing unit nurses' behaviour The nurses reported that competing tasks, time constraints and the necessity to multitask often limit their ability to perform IA (domains Beliefs about capabilities; Environmental context and resources). Some nurses noted the decision to use IA was something that they consciously thought about with every patient while others stated it their default decision as long as there were no risk factors (Memory, attention and decision processes, Nature of behaviour). They identified positive consequences (e.g. avoid unnecessary interventions, mother-centered care) and negative consequences of using IA (e.g. legal concerns) and reported that the negative consequences can often outweigh positive consequences (Beliefs about consequences). Some reported that hospital policies and varying support from care teams inhibited their use of IA (Social influences), and that support from the entire team and hospital management would likely increase their use (Social

  15. Adverse drug reactions in internal medicine units and associated risk factors

    OpenAIRE

    Sánchez Muñoz-Torrero, Juan Francisco; Barquilla, Paloma; Velasco, Raul; Fernández Capitan, Maria Del Carmen; Pacheco, Nazaret; Vicente, Lucia; Chicón, Jose Luis; Trejo, Sara; Zamorano, Jose; Lorenzo Hernandez, Alicia

    2010-01-01

    Abstract Objectives This study was designed to assess the prevalence of adverse drug reactions (ADRs) in the internal medicine wards of two teaching Hospitals, identify the most common ADRs, the principal medications involved, and determine the risk factors implicated in the occurrence of such ADRs. Methods All admissions over 10 weeks were followed prospectively using an intensive drug surveillance method...

  16. Ethnic Differences in Risk Factors for Obesity among Adults in California, the United States.

    Science.gov (United States)

    Wang, Liang; Southerland, Jodi; Wang, Kesheng; Bailey, Beth A; Alamian, Arsham; Stevens, Marc A; Wang, Youfa

    2017-01-01

    Little attention has been given to differences in obesity risk factors by racial/ethnic groups. Using data from the 2011-2012 California Health Interview Survey, we examined differences in risk factors for obesity among Whites, Latinos, Asians, and African Americans among 42,935 adults (24.8% obese). Estimates were weighted to ensure an unbiased representation of the Californian population. Multiple logistic and linear regression analyses were used to examine the differences in risk factors for obesity. Large ethnic disparities were found in obesity prevalence: Whites (22.0%), Latinos (33.6%), African Americans (36.1%), and Asians (9.8%). Differences in risk factors for obesity were also observed: Whites (gender, age, physical activity, smoking, arthritis, and diabetes medicine intake), Latinos (age, arthritis, and diabetes medicine intake), Asians (age, binge drinking, arthritis, and diabetes medicine intake), and African Americans (gender, physical activity, smoking, binge drinking, and diabetes medicine intake). Females were more likely to be obese among African Americans (odds ratio (OR) = 1.43, 95% confidence interval (CI) = 1.05-1.94), but less likely among Whites (OR = 0.80, 95% CI = 0.74-0.87). Race/ethnicity should be considered in developing obesity prevention strategies.

  17. Ethnic Differences in Risk Factors for Obesity among Adults in California, the United States

    Directory of Open Access Journals (Sweden)

    Liang Wang

    2017-01-01

    Full Text Available Little attention has been given to differences in obesity risk factors by racial/ethnic groups. Using data from the 2011-2012 California Health Interview Survey, we examined differences in risk factors for obesity among Whites, Latinos, Asians, and African Americans among 42,935 adults (24.8% obese. Estimates were weighted to ensure an unbiased representation of the Californian population. Multiple logistic and linear regression analyses were used to examine the differences in risk factors for obesity. Large ethnic disparities were found in obesity prevalence: Whites (22.0%, Latinos (33.6%, African Americans (36.1%, and Asians (9.8%. Differences in risk factors for obesity were also observed: Whites (gender, age, physical activity, smoking, arthritis, and diabetes medicine intake, Latinos (age, arthritis, and diabetes medicine intake, Asians (age, binge drinking, arthritis, and diabetes medicine intake, and African Americans (gender, physical activity, smoking, binge drinking, and diabetes medicine intake. Females were more likely to be obese among African Americans (odds ratio (OR = 1.43, 95% confidence interval (CI = 1.05–1.94, but less likely among Whites (OR = 0.80, 95% CI = 0.74–0.87. Race/ethnicity should be considered in developing obesity prevention strategies.

  18. RENO, NV, JANUARY 15, 2004: FACTORS IMPLICATED IN AMPHIBIAN POPULATION DECLINES IN THE UNITED STATES

    Science.gov (United States)

    Factors known or suspected to be adversely affecting native amphibian populations in the US were identified using information from 267 species accounts written in a standardized format by multiple authors in the forthcoming book, 'Status and Conservation of U.S. Amphibians'. Spec...

  19. Factors Related to Performance of Health Practices Among Asian Adolescents in the United States

    Directory of Open Access Journals (Sweden)

    Cynthia G. Ayres, PhD, RN

    2010-06-01

    Conclusions: Study findings extend existing knowledge and contribute to a more comprehensive knowledge base regarding health practices among Asian adolescents. Having this knowledge base provides practitioners with a better understanding of the factors related to health practices in Asian adolescents and assists them in developing culturally sensitive interventions aimed at promoting PHP in this population.

  20. Entering the United States Federal Procurement Market: success factors and barriers for foreign firms.

    NARCIS (Netherlands)

    Vehof, Tim; Ruel, Huub; Telgen, Jan; Ruel, H.J.M.

    2012-01-01

    The US federal procurement market is the largest procurement market in the world. Therefore, it is an attractive market for foreign companies to enter. Existing literature indicates the success factors and barriers for public procurement market entry in general, however not for the US procurement ma

  1. Burnout syndrome in nurses working in palliative care units: An analysis of associated factors.

    Science.gov (United States)

    Rizo-Baeza, Mercedes; Mendiola-Infante, Susana Virginia; Sepehri, Armina; Palazón-Bru, Antonio; Gil-Guillén, Vicente Francisco; Cortés-Castell, Ernesto

    2017-07-11

    To analyse the association between psychological, labour and demographic factors and burnout in palliative care nursing. There is a lack of published research evaluating burnout in palliative care nursing. This observational cross-sectional study involved 185 palliative care nurses in Mexico. The primary variables were burnout defined by its three dimensions (emotional exhaustion, depersonalization and personal accomplishment). As secondary variables, psychological, labour and demographic factors were considered. A binary logistic regression model was constructed to determine factors associated with burnout. A total of 69 nurses experienced high emotional exhaustion (37.3%), 65 had high depersonalization (35.1%) and 70 had low personal performance (37.8%). A higher proportion of burnout was found in the participants who were single parents, working >8 hr per day, with a medium/high workload, a lack of a high professional quality of life and a self-care deficit. Our multivariate models were very accurate in explaining burnout in palliative care nurses. These models must be externally validated to predict burnout and prevent future complications of the syndrome accurately. Nurses who present the factors found should be the focus of interventions to reduce work stress. © 2017 John Wiley & Sons Ltd.

  2. Notes from the field: prevalence of risk factors for suicide among veterinarians - United States, 2014.

    Science.gov (United States)

    Nett, Randall J; Witte, Tracy K; Holzbauer, Stacy M; Elchos, Brigid L; Campagnolo, Enzo R; Musgrave, Karl J; Carter, Kris K; Kurkjian, Katie M; Vanicek, Cole; O'Leary, Daniel R; Pride, Kerry R; Funk, Renee H

    2015-02-13

    Veterinarians are believed to be at increased risk for suicide compared with the general population. Few data on the occurrence of suicidal behavior and suicide risk factors among U.S. veterinarians are available. Veterinarians participating in two wellness summits held during September 2013 concluded that more research is needed on veterinarians and their mental health.

  3. Factors associated with bat mortality at wind energy facilities in the United States

    Science.gov (United States)

    Thompson, Maureen; Beston, Julie A.; Etterson, Matthew A.; Diffendorfer, James E.; Loss, Scott R.

    2017-01-01

    Hundreds of thousands of bats are killed annually by colliding with wind turbines in the U.S., yet little is known about factors causing variation in mortality across wind energy facilities. We conducted a quantitative synthesis of bat collision mortality with wind turbines by reviewing 218 North American studies representing 100 wind energy facilities. This data set, the largest compiled for bats to date, provides further evidence that collision mortality is greatest for migratory tree-roosting species (Hoary Bat [Lasiurus cinereus], Eastern Red Bat [Lasiurus borealis], Silver-haired Bat [Lasionycteris noctivagans]) and from July to October. Based on 40 U.S. studies meeting inclusion criteria and analyzed under a common statistical framework to account for methodological variation, we found support for an inverse relationship between bat mortality and percent grassland cover surrounding wind energy facilities. At a national scale, grassland cover may best reflect openness of the landscape, a factor generally associated with reduced activity and abundance of tree-roosting species that may also reduce turbine collisions. Further representative sampling of wind energy facilities is required to validate this pattern. Ecologically informed placement of wind energy facilities involves multiple considerations, including not only factors associated with bat mortality, but also factors associated with bird collision mortality, indirect habitat-related impacts to all species, and overall ecosystem impacts.

  4. Stability of Vancomycin 25 mg/mL in Ora-Sweet and Water in Unit-Dose Cups and Plastic Bottles at 4°C and 25°C.

    Science.gov (United States)

    Ensom, Mary H H; Decarie, Diane; Lakhani, Anisha

    2010-09-01

    Solutions of vancomycin for oral administration are not available commercially in Canada or the United States but are needed for patients who cannot swallow capsules. To evaluate the stability of vancomycin solutions stored in unit-dose cups and plastic bottles under refrigeration (4°C) and at room temperature (25°C) for up to 75 days. Vancomycin 25 mg/mL in Ora-Sweet vehicle and water (1:1 ratio by volume) was dispensed into opaque blue polyethylene unit-dose cups with aluminum seal (14 replicates) or amber plastic prescription bottles (6 replicates). Seven cups and 3 bottles were refrigerated (4°C), and the remainder of the containers were stored at room temperature (25°C). At the time of preparation and at 15, 30, 40, 50, 63, and 75 days, 3 aliquots were collected from one of the cups and from every bottle and were stored frozen (-85°C) until the time of analysis. Physical characteristics were evaluated at each time point, including measurement of pH and visual assessment of colour and precipitation. After thawing, the samples were analyzed in triplicate by a validated stability-indicating high-performance liquid chromatography method. A solution was considered stable if 90% of the initial concentration of vancomycin was maintained. No notable changes in colour, taste, or pH were observed in vancomycin solutions stored in the unit-dose cups at 4°C or 25°C or in the plastic bottles stored at 4°C over the 75-day study period. Starting on day 63, a white precipitate was observed in the solutions stored in plastic bottles at 25°C, but there were no notable changes in taste or pH during the 75-day period. The 95% confidence interval of the slope of the curve relating concentration to time, determined by linear regression, indicated that vancomycin solutions stored in cups or bottles at 4°C would maintain at least 93.6% of the initial vancomycin concentration for 75 days and that solutions stored at 25°C would maintain at least 90.0% of the initial

  5. Sustainability in a global context: How does local factor affect the outcomes of CSR activities in international business units?

    DEFF Research Database (Denmark)

    Thomsen, Christa; Lauring, Jakob

    In recent years CSR has become increasingly important for the activities and branding of MNCs. While some studies have investigated CSR management and branding in domestic situations, fewer studies exist in the case of international business units (subsidiaries, joint ventures, and franchises...... as CSR branding outcomes). Our findings show that local values were positively associated with external CSR engagement and that employee relations were positively related to both internal and external CSR engagement. None of the local factors were significantly associated with CSR branding outcomes...

  6. Predictive Factors for Delayed Extubation in the Intensive Care Unit after Coronary Artery Bypass Grafting; A Southern Iranian Experience

    Directory of Open Access Journals (Sweden)

    Shahrbanoo Shahbazi

    2012-12-01

    Full Text Available Background: Early extubation is implemented in cardiothoracic units worldwide for its advantages such as decreased mortality, morbidity, and hospitalization costs. We conducted a retrospective study to evaluate potential factors which may affect extubation time. Methods: The records of 334 eligible patients who underwent elective coronary artery bypass grafting (CABG in 2008 in Kowsar Hospital in Shiraz, southern Iran were evaluated to find the factors that can affect the extubation time. The patients were divided to early (equal or less than 6 hours and late extubation groups. The patients’ demographic data and operative variables were extracted from the records. We excluded patients with difficult intubation, severe acid base disturbance, neurological problems, and cardiovascular instability; and those who used intra-aortic balloon pump, had underwent emergency operation, or had another concomitant surgery. Results: Multiple logistic regressions comparing age, sex, number of grafts, ejection fraction, pump time, hematocrit, number of risk factors, and number of inotropic drugs, identified only age as a predictor of delayed extubation (odds ratio=1.07, CI 95%=1.04-1.10, P<0.001. Also, in both studied groups the men to women ratio was higher (P<0.05.Conclusion: Although in our study age was the only predictive factor for delayed extubation, a comprehensive study including preoperative, perioperative, and postoperative factors is recommended in our area.

  7. Human Factors Evaluation of Man-Machine Interface for Periodic Safety Review of Yonggwang Unit no. 1, 2

    Energy Technology Data Exchange (ETDEWEB)

    Lee, Yong Hee; Lee, Jung Woon; Park, Jae Chang (and others)

    2006-01-15

    This report describes the research results of human factors assessment on the MMI(Man Machine Interface) equipment as part of Periodic Safety Review(PSR) of Yonggwang Unit no. 1, 2. As MMI is a key factor among human factors to be reviewed in PSR, we reviewed the MMI components of nuclear power plants in aspect of human factors engineering. The availability, suitability, and effectiveness of the MMI devices were chosen to be reviewed. The MMI devices were investigated through the review of design documents related to the MMI, survey of control panels, evaluation of experts, and experimental assessment. Checklists were used to perform this assessment and record the review results. The items mentioned by the expert comments to review in detail in relation with task procedures were tested by experiments with operators' participation. For some questionable issues arisen during this MMI review, operator workload and possibility of errors in operator actions were analysed. The reviewed MMI devices contain MCR(Main Control Room), SPDS(Safety Parameter Display System), RSP(Remote Shutdown Panel), and the selected LCBs(Local Control Boards) importantly related to safety. As results of the assessments, any significant problem challenging the safety was not found on human factors in the MMI devices. However, several small items to be changed and improved in suitability of MMI devices were discovered. An action plan is recommended to accommodate the suggestions and review comments. It will enhance the plant safety on MMI area.

  8. Factors controlling threshold friction velocity in semiarid and arid areas of the United States

    Science.gov (United States)

    Marticorena, Beatrice; Bergametti, Gilles; Gillette, Dale; Belnap, Jayne

    1997-10-01

    A physical model was developed to explain threshold friction velocities u*t for particles of the size 60-120 μm lying on a rough surface in loose soils for semiarid and arid parts of the United States. The model corrected for the effect of momentum absorption by the nonerodible roughness. For loose or disturbed soils the most important parameter that controls u*t is the aerodynamic roughness height z0. For physical crusts damaged by wind the size of erodible crust pieces is important along with the roughness. The presence of cyanobacteriallichen soil crusts roughens the surface, and the biological fibrous growth aggregates soil particles. Only undisturbed sandy soils and disturbed soils of all types would be expected to be erodible in normal wind storms. Therefore disturbance of soils by both cattle and humans is very important in predicting wind erosion as confirmed by our measurements.

  9. The lowest-dose, extended-cycle combined oral contraceptive pill with continuous ethinyl estradiol in the United States: a review of the literature on ethinyl estradiol 20 µg/levonorgestrel 100 µg + ethinyl estradiol 10 µg

    Directory of Open Access Journals (Sweden)

    Sheila Krishnan

    2010-08-01

    Full Text Available Sheila Krishnan, Jessica KileyDepartment of Obstetrics and Gynecology, Northwestern University, Chicago, Illinois, USAAbstract: Extended-cycle oral contraceptives (OCs are increasing in popularity in the United States. A new extended-cycle OC that contains the lowest doses of ethinyl estradiol (EE and levonorgestrel (LNG + continuous EE throughout the cycle is now available. It provides 84 days of a low-dose, combined active pill containing levonorgestrel 100 µg and ethinyl estradiol 20 µg. Instead of 7 days of placebo following the active pills, the regimen delivers 7 days of ethinyl estradiol 10 µg. Existing studies reveal a similar efficacy and adverse effect profile compared with other extended-regimen OCs. Specifically, the unscheduled bleeding profile is similar to other extended-cycle OCs and improves with the increase in the duration of use. Although lower daily doses of hormonal exposure have potential benefit, to our knowledge, there are no published studies indicating that this specific regimen offers a lower incidence of hormone-related side effects or adverse events. In summary, this new extended-cycle OC provides patients a low-dose, extended-regimen OC option without sacrificing efficacy or tolerability.Keywords: continuous regimen, ethinyl estradiol, extended cycle, oral contraceptive

  10. Factors affecting the infectivity of tissues from pigs with classical swine fever: thermal inactivation rates and oral infectious dose.

    Science.gov (United States)

    Cowan, Lucie; Haines, Felicity J; Everett, Helen E; Crudgington, Bentley; Johns, Helen L; Clifford, Derek; Drew, Trevor W; Crooke, Helen R

    2015-03-23

    Outbreaks of classical swine fever are often associated with ingestion of pig meat or products derived from infected pigs. Assessment of the disease risks associated with material of porcine origin requires knowledge on the likely amount of virus in the original material, how long the virus may remain viable within the resulting product and how much of that product would need to be ingested to result in infection. Using material from pigs infected with CSFV, we determined the viable virus concentrations in tissues that comprise the majority of pork products. Decimal reduction values (D values), the time required to reduce the viable virus load by 90% (or 1 log10), were determined at temperatures of relevance for chilling, cooking, composting and ambient storage. The rate of CSFV inactivation varied in different tissues. At lower temperatures, virus remained viable for substantially longer in muscle and serum compared to lymphoid and fat tissues. To enable estimation of the temperature dependence of inactivation, the temperature change required to change the D values by 90% (Z values) were determined as 13 °C, 14 °C, 12 °C and 10 °C for lymph node, fat, muscle and serum, respectively. The amount of virus required to infect 50% of pigs by ingestion was determined by feeding groups of animals with moderately and highly virulent CSFV. Interestingly, the virulent virus did not initiate infection at a lower dose than the moderately virulent strain. Although higher than for intranasal inoculation, the amount of virus required for infection via ingestion is present in only a few grams of tissue from infected animals.

  11. SU-E-I-22: Dependence On Calibration Phantom and Field Area of the Conversion Factor Used to Calculate Skin Dose During Neuro-Interventional Fluoroscopic Procedures

    Energy Technology Data Exchange (ETDEWEB)

    Rana, V K; Vijayan, S [Physiology and Biophysics, Toshiba Stroke and Vascular Research Center, University at Buffalo (State University of New York), Buffalo, NY (United States); Rudin, S R; Bednarek, D R [Department of Radiology, Physiology and Biophysics, Toshiba Stroke and Vascular Research Center, University at Buffalo (State University of New York), Buffalo, NY (United States)

    2014-06-01

    Purpose: To determine the appropriate calibration factor to use when calculating skin dose with our real-time dose-tracking system (DTS) during neuro-interventional fluoroscopic procedures by evaluating the difference in backscatter from different phantoms and as a function of entrance-skin field area. Methods: We developed a dose-tracking system to calculate and graphically display the cumulative skin-dose distribution in real time. To calibrate the DTS for neuro-interventional procedures, a phantom is needed that closely approximates the scattering properties of the head. We compared the x-ray backscatter from eight phantoms: 20-cm-thick solid water, 16-cm diameter water-filled container, 16-cm CTDI phantom, modified-ANSI head phantom, 20-cm-thick PMMA, Kyoto-Kagaku PBU- 50 head, Phantom-Labs SK-150 head, and RSD RS-240T head. The phantoms were placed on the patient table with the entrance surface at 15 cm tube-side from the isocenter of a Toshiba Infinix C-arm, and the entrance-skin exposure was measured with a calibrated 6-cc PTW ionization chamber. The measurement included primary radiation, backscatter from the phantom and forward scatter from the table and pad. The variation in entrance-skin exposure was also measured as a function of the skin-entrance area for a 30x30 cm by 20-cm-thick PMMA phantom and the SK-150 head phantom using four different added beam filters. Results: The entranceskin exposure values measured for ei