Sample records for viable long-term strategy

  1. Winning market positioning strategies for long term care facilities. (United States)

    Higgins, L F; Weinstein, K; Arndt, K


    The decision to develop an aggressive marketing strategy for its long term care facility has become a priority for the management of a one-hundred bed facility in the Rocky Mountain West. Financial success and lasting competitiveness require that the facility in question (Deer Haven) establish itself as the preferred provider of long term care for its target market. By performing a marketing communications audit, Deer Haven evaluated its present market position and created a strategy for solidifying and dramatizing this position. After an overview of present conditions in the industry, we offer a seven step process that provides practical guidance for positioning a long term care facility. We conclude by providing an example application.

  2. 40 CFR 52.29 - Visibility long-term strategies. (United States)


    ... of this part. (b) Definitions. For the purposes of this section, all terms shall have the meaning as ascribed to them in the Clean Air Act, or in the protection of visibility program (40 CFR 51.301). (c) Long... retrofit technology (BART) and meeting other schedules set forth in the long-term strategy; (vi) The impact...

  3. China's rapidly aging population creates policy challenges in shaping a viable long-term care system. (United States)

    Feng, Zhanlian; Liu, Chang; Guan, Xinping; Mor, Vincent


    In China, formal long-term care services for the large aging population have increased to meet escalating demands as demographic shifts and socioeconomic changes have eroded traditional elder care. We analyze China's evolving long-term care landscape and trace major government policies and private-sector initiatives shaping it. Although home and community-based services remain spotty, institutional care is booming with little regulatory oversight. Chinese policy makers face mounting challenges overseeing the rapidly growing residential care sector, given the tension arising from policy inducements to further institutional growth, a weak regulatory framework, and the lack of enforcement capacity. We recommend addressing the following pressing policy issues: building a balanced system of services and avoiding an "institutional bias" that promotes rapid growth of elder care institutions over home or community-based care; strengthening regulatory oversight and quality assurance with information systems; and prioritizing education and training initiatives to grow a professionalized long-term care workforce.

  4. Long-term global nuclear energy and fuel cycle strategies

    Energy Technology Data Exchange (ETDEWEB)

    Krakowski, R.A. [Los Alamos National Lab., NM (United States). Technology and Safety Assessment Div.


    The Global Nuclear Vision Project is examining, using scenario building techniques, a range of long-term nuclear energy futures. The exploration and assessment of optimal nuclear fuel-cycle and material strategies is an essential element of the study. To this end, an established global E{sup 3} (energy/economics/environmental) model has been adopted and modified with a simplified, but comprehensive and multi-regional, nuclear energy module. Consistent nuclear energy scenarios are constructed using this multi-regional E{sup 3} model, wherein future demands for nuclear power are projected in price competition with other energy sources under a wide range of long-term demographic (population, workforce size and productivity), economic (price-, population-, and income-determined demand for energy services, price- and population-modified GNP, resource depletion, world-market fossil energy prices), policy (taxes, tariffs, sanctions), and top-level technological (energy intensity and end-use efficiency improvements) drivers. Using the framework provided by the global E{sup 3} model, the impacts of both external and internal drivers are investigated. The ability to connect external and internal drivers through this modeling framework allows the study of impacts and tradeoffs between fossil- versus nuclear-fuel burning, that includes interactions between cost, environmental, proliferation, resource, and policy issues.

  5. Gap filling strategies for long term energy flux data sets

    NARCIS (Netherlands)

    Falge, E.; Baldocchi, D.; Olson, R.; Anthoni, P.; Aubinet, M.; Bernhofer, C.; Burba, G.; Ceulemans, R.; Clement, R.; Dolman, H.; Granier, A.; Gross, P.; Grünwald, T.; Hollinger, D.; Jensen, N.O.; Katul, G.; Keronen, P.; Kowalski, A.; Lai, C.T.; Law, B.E.; Meyers, T.; Moncrieff, J.; Moors, E.J.; Munger, J.W.; Pilegaard, K.; Rebmann, C.; Suyker, A.; Tenhunen, J.; Tu, K.


    At present a network of over 100 field sites are measuring carbon dioxide, water vapor and sensible heat fluxes between the biosphere and atmosphere, on a nearly continuous basis. Gaps in the long term measurements of evaporation and sensible heat flux must be filled before these data can be used

  6. Gap filling strategies for long term energy flux data sets

    DEFF Research Database (Denmark)

    Falge, E.; Baldocchi, D.; Olson, R.


    At present a network of over 100 field sites are measuring carbon dioxide, water vapor and sensible heat fluxes between the biosphere and atmosphere, on a nearly continuous basis. Gaps in the long term measurements of evaporation and sensible heat flux must be filled before these data can be used...... for hydrological and meteorological applications. We adapted methods of gap filling for NEE (net ecosystem exchange of carbon) to energy fluxes and applied them to data sets available from the EUROFLUX and AmeriFlux eddy covariance databases. The average data coverage for the sites selected was 69% and 75......% for latent heat (lambdaE) and sensible heat (H). The methods were based on mean diurnal variations (half-hourly binned means of fluxes based on previous and subsequent days, MDV) and look-up tables for fluxes during assorted meteorological conditions (LookUp), and the impact of different gap filling methods...

  7. Rodent model for long-term maintenance and development of the viable cysticerci of Taenia saginata asiatica (United States)

    Wang, I.C.; Chung, W.C.; Lu, S.C.


    Although oncospheres of Taenia saginata asiatica can develop into cysticerci in immunodeficiency, immunosuppressed, and normal mice, no detailed information on the development features of these cysticerci from SCID mice is available. In the present study, the tumor-like cyst was found in the subcutaneous tissues of each of 10 SCID mice after 38-244 days inoculation with 39,000 oncospheres of T. s. asiatica. These cysts weighed 2.0-9.6 gm and were 1.5-4.3 cm in diameter. The number of cysticerci were collected from these cysts ranged from 125 to 1,794 and the cysticercus recovery rate from 0.3% to 4.6%. All cysticerci were viable with a diameter of 1-6 mm and 9 abnormal ones each with 2 evaginated protoscoleces were also found. The mean length and width of scolex, protoscolex, and bladder were 477 × 558, 756 × 727, and 1,586 × 1,615 µm, respectively. The diameters of suckers and rostellum were 220 µm and 70 µm, respectively. All cysticerci had two rows of rostellar hooks. These findings suggest that the SCID mouse model can be employed as a tool for long-term maintenance of the biological materials for advanced studies of immunodiagnosis, vaccine development, and evaluation of cestocidal drugs which would be most benefit for the good health of the livestocks. PMID:11138316

  8. A Recommitment Strategy for Long Term Private Equity Fund Investors

    NARCIS (Netherlands)

    G.J. de Zwart (Gerben); B. Frieser (Brian); D.J.C. van Dijk (Dick)


    textabstractThis paper develops a reinvestment strategy for private equity which aims to keep its portfolio weight equal to a desired strategic allocation, while taking into account the illiquid nature of private equity. Historical simulations (1980-2005) show that our dynamic strategy is capable of

  9. Memory Vocabulary Learning Strategies and Long-Term Retention ...

    African Journals Online (AJOL)

    The results indicated that the students in the experimental group outperformed those in the control group both in short-term and longterm scores. As many learners do not develop sufficient mastery of the vocabulary, explicit instruction of memory strategies can help them to store and retrieve new vocabulary items. Also, by ...

  10. Formation of manganese phosphate and manganese carbonate during long-term sorption of Mn2+ by viable Shewanella putrefaciens: effects of contact time and temperature

    NARCIS (Netherlands)

    Chubar, N.; Avramut, C.; Visser, T.

    The influence of temperature (5, 10, 22 and 30 C) on the long-term (30 days) sorption of Mn2+ by viable Shewanella putrefaciens was studied by FTIR and EXAFS. The additional Mn-removal capacity of these bacteria was found to result from the surface precipitation of Mn-containing inorganic phases.

  11. [Participation as Target of Social Medicine and Nursing Care: - Legal Definition of Long-Term Care Dependency - Strategies to Prevent Long-Term Care Dependency]. (United States)

    Nüchtern, Elisabeth; Gansweid, Barbara; Gerber, Hans; von Mittelstaedt, Gert


    Objective: By the "Second Bill to Strengthen Long-Term Care", a new concept of long-term care dependency will be introduced, valid from 2017. Long-term care dependency according to Social Code XI will be defined covering more aspects than today. Therefore, the working group "Nursing Care" of the division "Social Medicine in Practice and Rehabilitation" in the German Society for Social Medicine and Prevention presents their results after working on the social medicine perspective of the definition and prevention of long-term care dependency. Methods: Both the definition and strategies to prevent long-term care dependency are systematically taken into consideration from the point of view of social medicine on the basis of the International Classification of Functioning, Disability and Health (ICF), as long-term care dependency means a defined condition of disability. Results: Both the current and the new concept of long-term care dependency focus activity limitations. The perspective of social medicine considers the interactions of health condition, its effects on daily activities and personal as well as environmental factors. From this point of view approaches for social benefits concerning prevention and rehabilitation can be identified systematically so as to work against the development and progression of long-term care dependency. The reference to the ICF can facilitate the communication between different professions. The new "graduation" of long-term care dependency would allow an international "translation" referring to the ICF. Conclusion: Experts from the field of social medicine as well as those of nursing care, care-givers and nursing researchers have in common the objective that persons in need of nursing care can participate in as many aspects of life of importance to them in an autonomous and self-determined way. The point of view of social medicine on long-term care dependency is fundamental for all occupational groups that are involved and for their

  12. Strategies for discontinuing long-term benzodiazepine use: meta-analysis.

    NARCIS (Netherlands)

    Oude Voshaar, R.C.; Couvee, J.E.; Balkom, A.J.L.M. van; Mulder, P.G.H.; Zitman, F.G.


    BACKGROUND: The prevalence of benzodiazepine consumption in European countries remains at 2-3% of the general population despite the well-documented disadvantages of long-term use. AIMS: To review systematically the success rates of different benzodiazepine discontinuation strategies. METHOD:

  13. Innovative Strategy For Long Term Monitoring Of Metal And Radionuclide Plumes

    Energy Technology Data Exchange (ETDEWEB)

    Eddy-Dilek, Carol; Millings, Margaret R.; Looney, Brian B.; Denham, Miles E.


    Many government and private industry sites that were once contaminated with radioactive and chemical wastes cannot be cleaned up enough to permit unrestricted human access. The sites will require long term management, in some cases indefinitely, leaving site owners with the challenge of protecting human health and environmental quality at these "legacy" sites. Long-term monitoring of groundwater contamination is one of the largest projected costs in the life cycle of environmental management at the Savannah River Site, the larger DOE complex, and many large federal and private sites. There is a need to optimize the performance and manage the cost of long term surveillance and monitoring at their sites. Currently, SRNL is initiating a pilot field test using alternative protocols for long term monitoring of metals and radionuclides. A key component of the approach is that monitoring efforts are focused on measurement of low cost metrics related to hydrologic and chemical conditions that control contaminant migration. The strategy combines careful monitoring of hydrologic boundary conditions with measurement of master variables such as chemical surrogates along with a smaller number of standard well analyses. In plumes contaminated with metals, master variables control the chemistry of the groundwater system, and include redox variables (ORP, DO, chemicals), pH, specific conductivity, biological community (breakdown/decay products), and temperature. Significant changes in these variables will result in conditions whereby the plume may not be stable and therefore can be used to predict possible plume migration. Conversely, concentration measurements for all types of contaminants in groundwater are a lagging indicator plume movement - major changes contaminant concentrations indicate that contamination has migrated. An approach based on measurement of master variables and explicit monitoring of hydrologic boundary conditions combined with traditional metrics should lead

  14. Contribution Of Labor Flexibility As A Strategy To Achieve Long Term Organization Goals




    This research is design to understand the contribution of labor flexibility as a strategy to achieve long term organizational goals. The organizations give liberty to its employees to work according to their style because each employee has its own behavior and working style. So to give satisfaction to them dealers give them liberty to work accordingly so that they will adapt themselves for the working conditions. To cope with the changing dynamics of the market downsizing, restructuring, merg...

  15. Developing and analyzing long-term fuel management strategies for an advanced Small Modular PWR

    Energy Technology Data Exchange (ETDEWEB)

    Hedayat, Afshin, E-mail:


    Highlights: • Comprehensive introduction and supplementary concepts as a review paper. • Developing an integrated long-term fuel management strategy for a SMR. • High reliable 3-D core modeling over fuel pins against the traditional LRM. • Verifying the expert rules of large PWRs for an advanced small PWR. • Investigating large numbers of safety parameters coherently. - Abstract: In this paper, long-term fuel management (FM) strategies are introduced and analyzed for a new advanced Pressurized Light Water Reactor (PWR) type of Small Modular Reactors (SMRs). The FM strategies are developed to be safe and practical for implementation as much as possible. Safety performances, economy of fuel, and Quality Assurance (QA) of periodic equilibrium conditions are chosen as the main goals. Flattening power density distribution over fuel pins is the major method to ensure safety performance; also maximum energy output or permissible discharging burn up indicates economy of fuel fabrication costs. Burn up effects from BOC to EOC have been traced, studied, and highly visualized in both of transport lattice cell calculations and diffusion core calculations. Long-term characteristics are searched to gain periodical equilibrium characteristics. They are fissile changes, neutron spectrum, refueling pattern, fuel cycle length, core excess reactivity, average, and maximum burn up of discharged fuels, radial Power Peaking Factors (PPF), total PPF, radial and axial power distributions, batch effects, and enrichment effects for fine regulations. Traditional linear reactivity model have been successfully simulated and adapted via fine core and burn up calculations. Effects of high burnable neutron poison and soluble boron are analyzed. Different numbers of batches via different refueling patterns have been studied and visualized. Expert rules for large type PWRs have been influenced and well tested throughout accurate equilibrium core calculations.

  16. Long-term energy capture and the effects of optimizing wind turbine operating strategies (United States)

    Miller, A. H.; Formica, W. J.


    Methods of increasing energy capture without affecting the turbine design were investigated. The emphasis was on optimizing the wind turbine operating strategy. The operating strategy embodies the startup and shutdown algorithm as well as the algorithm for determining when to yaw (rotate) the axis of the turbine more directly into the wind. Using data collected at a number of sites, the time-dependent simulation of a MOD-2 wind turbine using various, site-dependent operating strategies provided evidence that site-specific fine tuning can produce significant increases in long-term energy capture as well as reduce the number of start-stop cycles and yawing maneuvers, which may result in reduced fatigue and subsequent maintenance.

  17. Gastric bypass patients' goal-strategy-monitoring networks for long-term dietary management. (United States)

    Lynch, Amanda; Bisogni, Carole A


    Following gastric bypass surgery, patients must make dramatic dietary changes, but little is known about patients' perspectives on long-term dietary management after this surgery. This grounded theory, qualitative study sought to advance conceptual understanding of food choice by examining how gastric bypass patients constructed personal food systems to guide food and eating behaviors 12 months post-surgery. Two in-depth interviews were conducted with each of 16 adults, purposively sampled from bariatric support groups. Using constant comparative analysis of verbatim interview transcripts, researchers identified participants' goal-strategy-monitoring networks representing how participants used specific food and eating behaviors towards their main goals of: Weight Management, Overall Health, Avoiding Negative Reactions to Eating, and Integrating Dietary Changes with Daily Life. Linked to each main goal was a hierarchy of intermediary goals, strategies, and tactics. Participants used monitoring behaviors to assess strategy effectiveness towards goal achievement. Individuals' Weight Management networks were compared to uncover similarities and differences among strategy use and monitoring methods among those who maintained weight loss and those who regained weight. The complex, multilevel goal-strategy-monitoring networks identified illustrate the "work" involved in constructing new personal food systems after surgery, as well as advance understanding of strategies as a component of people's personal food systems. These findings provide researchers and practitioners with insight into the long-term dietary issues that gastric bypass patients face and a potential method for representing how people relate deliberate dietary behaviors to their goals. Copyright © 2014 Elsevier Ltd. All rights reserved.

  18. Justification of remediation strategies in the long term after the Chernobyl accident. (United States)

    Fesenko, S; Jacob, P; Ulanovsky, A; Chupov, A; Bogdevich, I; Sanzharova, N; Kashparov, V; Panov, A; Zhuchenka, Yu


    Following the accident at the nuclear power plant in Chernobyl a number of different remedial actions were developed and implemented in Belarus, Russia, and Ukraine. Recommendations on the application of countermeasures and remedial actions were published by the IAEA as "Guidelines for agricultural countermeasures following an accidental release of radionuclides" in 1994. Since then, new information on the behaviour of radionuclides in the environment and effectiveness of countermeasures in the long term has been obtained and reviewed by many projects, including the Chernobyl Forum. Additionally, new approaches to derive remediation strategies were developed and successfully implemented in the most affected countries. This paper describes a justification of the remediation strategies suggested for rehabilitation of the areas most affected by the Chernobyl accident based on this experience. Copyright © 2010 Elsevier Ltd. All rights reserved.

  19. Modeling Long-term Vaccination Strategies With MenAfriVac in the African Meningitis Belt. (United States)

    Karachaliou, Andromachi; Conlan, Andrew J K; Preziosi, Marie-Pierre; Trotter, Caroline L


    The introduction of MenAfriVac in campaigns targeting people aged 1-29 years across the African meningitis belt has successfully reduced meningitis incidence and carriage due to Neisseria meningitidis group A (MenA). It is important to consider how best to sustain population protection in the long term. We created a mathematical model of MenA transmission and disease to investigate the potential impact of a range of immunization strategies. The model is age structured; includes classes of susceptible, carrier, ill, and immune people (who may be vaccinated or unvaccinated); and incorporates seasonal transmission and a stochastic forcing term that models between year variation in rates of transmission. Model parameters were primarily derived from African sources. The model can describe the typical annual incidence of meningitis in the prevaccine era, with irregular epidemics of varying size. Parameter and structural uncertainty were explored in sensitivity analyses. Following MenAfriVac introduction at high uptake, the model predicts excellent short-term disease control. With no subsequent immunization, strong resurgences in disease incidence were predicted after approximately 15 years (assuming 10 years' average vaccine protection). Routine immunization at 9 months of age resulted in lower average annual incidence than regular mass campaigns of 1- to 4-year-olds, provided coverage was above approximately 60%. The strategy with the lowest overall average annual incidence and longest time to resurgence was achieved using a combination strategy of introduction into the Expanded Programme on Immunization at 9 months, 5 years after the initial mass campaigns, with a catch-up targeting unvaccinated 1- to 4-year-olds. These results can be used to inform policy recommendations for long-term vaccination strategies with MenAfriVac. © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America.

  20. Strategies for discontinuing long-term benzodiazepine use: meta-analysis. (United States)

    Voshaar, Richard C Oude; Couvée, Jaap E; van Balkom, Anton J L M; Mulder, Paul G H; Zitman, Frans G


    The prevalence of benzodiazepine consumption in European countries remains at 2-3% of the general population despite the well-documented disadvantages of long-term use. To review systematically the success rates of different benzodiazepine discontinuation strategies. Meta-analysis of comparable intervention studies. Twenty-nine articles met inclusion criteria. Two groups of interventions were identified; minimal intervention (e.g. giving simple advice in the form of a letter or meeting to a large group of people; n=3), and systematic discontinuation (defined as treatment programmes led by a physician or psychologist; n=26). Both were found to be significantly more effective than treatment as usual: minimal interventions (pooled OR=2.8, 95% CI 1.6-5.1); systematic discontinuation alone (one study, OR=6.1, 95% CI 2.0-18.6). Augmentation of systematic discontinuation with imipramine (two studies, OR=3.1, 95% CI 1.1-9.4) or group cognitive-behavioural therapy for patients with insomnia (two studies, OR=5.5, 95% CI 2.3-14.2) was superior to systematic discontinuation alone. Evidence was found for the efficacy of stepped care (minimal intervention followed by systematic discontinuation alone) in discontinuing long-term benzodiazepine use.

  1. Effect of long-term farming strategies on soil microbiota and soil health (United States)

    Sommermann, Loreen; Babin, Doreen; Sandmann, Martin; Smalla, Kornelia; Schellenberg, Ingo; Grosch, Rita; Geistlinger, Joerg


    Increasing food and energy demands have resulted in considerable intensification of farming practices, which brought about severe consequences for agricultural soils, e.g. loss of fertility, erosion and enrichment of soil-borne plant diseases. In order to maintain soil quality and health for the future, the development of more extensive and sustainable farming strategies is urgently needed. The soil microbiome is regarded as a key player in soil ecosystem functions, particularly the natural ability of soils to suppress plant pathogens (suppressiveness). Recent studies showed that soil microbial communities are influenced by agricultural management. To further analyze the effects of farming strategies on soil suppressiveness and plant performance, agricultural soils from three long-term field trials in Thyrow, Bernburg (both in Germany) and Therwil (Switzerland) were sampled and subjected to molecular profiling of soil bacteria and fungi using marker genes and high-throughput amplicon sequencing. Significant effects on bacterial as well as fungal community composition, including plant pathogenic and beneficial taxa, were observed among variants of tillage and crop rotation. The least effect on both communities had fertilization, with no significance between variants. Subsequently, the same soils were subjected to growth chamber pot experiments with lettuce as a model (Lactuca sativa). After a growth period of six weeks significant differences in lettuce shoot and soil microbial biomass were observed among soil samples of the different long-term trials. Furthermore, the lettuce rhizosphere exhibited diverse bacterial community compositions as observed by DGGE (denaturing gradient gel electrophoresis). Using group-specific PCR-DGGE fingerprints, bacterial responders to fertilization, soil management and crop rotation were identified among different taxonomic groups. Currently, bacterial and fungal amplicon sequencing of rhizosphere and bulk soil from these pot

  2. Survival or revival: long-term preservation induces a reversible viable but non-culturable state in methane-oxidizing bacteria.

    Directory of Open Access Journals (Sweden)

    Sven Hoefman

    Full Text Available Knowledge on long-term preservation of micro-organisms is limited and research in the field is scarce despite its importance for microbial biodiversity and biotechnological innovation. Preservation of fastidious organisms such as methane-oxidizing bacteria (MOB has proven difficult. Most MOB do not survive lyophilization and only some can be cryopreserved successfully for short periods. A large-scale study was designed for a diverse set of MOB applying fifteen cryopreservation or lyophilization conditions. After three, six and twelve months of preservation, the viability (via live-dead flow cytometry and culturability (via most-probable number analysis and plating of the cells were assessed. All strains could be cryopreserved without a significant loss in culturability using 1% trehalose in 10-fold diluted TSB (TT as preservation medium and 5% DMSO as cryoprotectant. Several other cryopreservation and lyophilization conditions, all of which involved the use of TT medium, also allowed successful preservation but showed a considerable loss in culturability. We demonstrate here that most of these non-culturables survived preservation according to viability assessment indicating that preservation induces a viable but non-culturable (VBNC state in a significant fraction of cells. Since this state is reversible, these findings have major implications shifting the emphasis from survival to revival of cells in a preservation protocol. We showed that MOB cells could be significantly resuscitated from the VBNC state using the TT preservation medium.

  3. Long term leaf phenology and leaf exchange strategies of a cerrado savanna community (United States)

    de Camargo, Maria Gabriela G.; Costa Alberton, Bruna; de Carvalho, Gustavo H.; Magalhães, Paula A. N. R.; Morellato, Leonor Patrícia C.


    Leaf development and senescence cycles are linked to a range of ecosystem processes, affecting seasonal patterns of atmosphere-ecosystem carbon and energy exchanges, resource availability and nutrient cycling. The degree of deciduousness of tropical trees and communities depend on ecosystems characteristics such as amount of biomass, species diversity and the strength and length of the dry season. Besides defining the growing season, deciduousness can also be an indicator of species response to climate changes in the tropics, mainly because severity of dry season can intensify leaf loss. Based on seven-years of phenological observations (2005 to 2011) we describe the long-term patterns of leafing phenology of a Brazilian cerrado savanna, aiming to (i) identify leaf exchange strategies of species, quantifying the degree of deciduousness, and verify whether these strategies vary among years depending on the length and strength of the dry seasons; (ii) define the growing seasons along the years and the main drivers of leaf flushing in the cerrado. We analyzed leafing patterns of 107 species and classified 69 species as deciduous (11 species), semi-deciduous (29) and evergreen (29). Leaf exchange was markedly seasonal, as expected for seasonal tropical savannas. Leaf fall predominated in the dry season, peaking in July, and leaf flushing in the transition between dry to wet seasons, peaking in September. Leafing patterns were similar among years with the growing season starting at the end of dry season, in September, for most species. However, leaf exchange strategies varied among years for most species (65%), except for evergreen strategy, mainly constant over years. Leafing patterns of cerrado species were strongly constrained by rainfall. The length of the dry season and rainfall intensity were likely affecting the individuals' leaf exchange strategies and suggesting a differential resilience of species to changes of rainfall regime, predicted on future global

  4. Long-term effects of antibiotics on the elimination of chemical oxygen demand, nitrification, and viable bacteria in laboratory-scale wastewater treatment plants. (United States)

    Schmidt, Susan; Winter, Josef; Gallert, Claudia


    Antibiotics and other pharmaceuticals are contaminants of the environment because of their widespread use and incomplete removal by microorganisms during wastewater treatment. The influence of a mixture of ciprofloxacin (CIP), gentamicin (GM), sulfamethoxazole (SMZ)/trimethoprim (TMP), and vancomycin (VA), up to a final concentration of 40 mg/L, on the elimination of chemical oxygen demand (COD), nitrification, and survival of bacteria, as well as the elimination of the antibiotics, was assessed in a long-term study in laboratory treatment plants (LTPs). In the presence of 30 mg/L antibiotics, nitrification of artificial sewage by activated sludge ended at nitrite. Nitrate formation was almost completely inhibited. No nitrification at all was possible in the presence of 40 mg/L antibiotics. The nitrifiers were more sensitive to antibiotics than heterotrophic bacteria. COD elimination in antibiotic-stressed LTPs was not influenced by ≤20 mg/L antibiotics. Addition of 30 mg/L antibiotic mixture decreased COD removal efficiency for a period, but the LTPs recovered. Similar results were obtained with 40 mg/L antibiotic mixture. The total viable count of bacteria was not affected negatively by the antibiotics. It ranged from 2.2 × 10(6) to 8.2 × 10(6) colony-forming units per milliliter (CFU/mL) compared with the control at 1.4 × 10(6)-6.3 × 10(6) CFU/mL. Elimination of the four antibiotics during phases of 2.4-30 mg/L from the liquid was high for GM (70-90 %), much lower for VA, TMP, and CIP (0-50 %), and highly fluctuating for SMZ (0-95 %). The antibiotics were mainly adsorbed to the sludge and not biodegraded.

  5. Norovirus Disease in Older Adults Living in Long-Term Care Facilities: Strategies for Management. (United States)

    Chen, Yingxi; Hall, Aron J; Kirk, Martyn D


    Noroviruses are the most common cause of gastroenteritis outbreaks in long-term care facility (LTCFs). This review summarizes the most up-to-date knowledge on norovirus infection in LTCFs with the aim of identifying potential strategies for management. LTCF residents are at greater risk of norovirus infection. Early identification of norovirus infection and prompt initiation of appropriate supportive therapy are required to reduce morbidity and mortality. Measures to prevent outbreaks and reduce the risk of norovirus infection in LTCFs include timely diagnosis and implementation of infection control interventions to limit virus transmission. Current guidelines for prevention and control are based on generic principles of infection control. Real-time reverse transcription-quantitative polymerase chain reaction assays have been the gold standard for the rapid and sensitive detection of noroviruses. With the recent breakthroughs of human norovirus in vitro culture, doors are now opened to evaluate the efficacy of environmental disinfectants and hand hygiene options. Additionally, development of licensed vaccines against noroviruses may provide another important tool for infection prevention among high-risk individuals.

  6. [Long-term care in Europe. Challenges and strategies in nursing staff management]. (United States)

    Kuhlmann, E; Larsen, C


    Across Europe, long-term care (LTC) is one of the most challenging areas of social policy. Despite a growing awareness of the problems and improved data, current institutional reforms are an ineffective response to demographic change. This article aims to provide an overview of the challenges of future nursing and care staff in LTC in Europe, and to discuss the German case in a wider European context. We focus on the nursing workforce and on the link between current and prospective analyses on the demand and offer of LTC services and LTC professionals/nursing staff. We draw on a secondary analysis of the literature and public statistics, especially OECD data. The European comparison shows a high variation in the future demand for LTC. In Germany, a number of problematic trends create a negative scenario: the growing demand for LTC meets with a decrease in nursing staff on the supply side. We conclude by suggesting intervention strategies that may reduce this negative scenario.

  7. Multimessenger signals of long-term core-collapse supernova simulations: synergetic observation strategies (United States)

    Nakamura, Ko; Horiuchi, Shunsaku; Tanaka, Masaomi; Hayama, Kazuhiro; Takiwaki, Tomoya; Kotake, Kei


    The next Galactic supernova is expected to bring great opportunities for the direct detection of gravitational waves (GW), full flavour neutrinos, and multiwavelength photons. To maximize the science return from such a rare event, it is essential to have established classes of possible situations and preparations for appropriate observations. To this end, we use a long-term numerical simulation of the core-collapse supernova (CCSN) of a 17 M⊙ red supergiant progenitor to self-consistently model the multimessenger signals expected in GW, neutrino, and electromagnetic messengers. This supernova model takes into account the formation and evolution of a protoneutron star, neutrino-matter interaction, and neutrino transport, all within a two-dimensional shock hydrodynamics simulation. With this, we separately discuss three situations: (i) a CCSN at the Galactic Center, (ii) an extremely nearby CCSN within hundreds of parsecs, and (iii) a CCSN in nearby galaxies within several Mpc. These distance regimes necessitate different strategies for synergistic observations. In a Galactic CCSN, neutrinos provide strategic timing and pointing information. We explore how these in turn deliver an improvement in the sensitivity of GW analyses and help to guarantee observations of early electromagnetic signals. To facilitate the detection of multimessenger signals of CCSNe in extremely nearby and extragalactic distances, we compile a list of nearby red supergiant candidates and a list of nearby galaxies with their expected CCSN rates. By exploring the sequential multimessenger signals of a nearby CCSN, we discuss preparations for maximizing successful studies of such an unprecedented stirring event.

  8. Predicting Long-Term Growth in Students' Mathematics Achievement: The Unique Contributions of Motivation and Cognitive Strategies (United States)

    Murayama, Kou; Pekrun, Reinhard; Lichtenfeld, Stephanie; vom Hofe, Rudolf


    This research examined how motivation (perceived control, intrinsic motivation, and extrinsic motivation), cognitive learning strategies (deep and surface strategies), and intelligence jointly predict long-term growth in students' mathematics achievement over 5 years. Using longitudinal data from six annual waves (Grades 5 through 10;…

  9. Long-term survival following coronary artery bypass grafting: off-pump versus on-pump strategies. (United States)

    Kim, Joon Bum; Yun, Sung-Cheol; Lim, Jae Wong; Hwang, Soo Kyung; Jung, Sung-Ho; Song, Hyun; Chung, Cheol Hyun; Lee, Jae Won; Choo, Suk Jung


    This study sought to compare long-term survival after off- and on-pump coronary artery bypass grafting (CABG). Although several large-scale clinical trials have compared the surgical outcomes between off- and on-pump CABG, the long-term survival has not been compared between the 2 surgical strategies in a reasonably sized cohort. We evaluated long-term survival data in 5,203 patients (age 62.9 ± 9.1 years, 1,340 females) who underwent elective isolated CABG (off-pump: n = 2,333; on-pump: n = 2,870) from 1989 through 2012. Vital statuses were validated using the Korean National Registry of Vital Statistics. Long-term survival was compared with the use of propensity scores and inverse probability weighting to adjust selection bias. Patients undergoing on-pump CABG had a higher number of distal anastomoses than those undergoing off-pump CABG (3.7 ± 1.2 vs. 3.0 ± 1.1; p compared with those undergoing on-pump CABG. In subgroup analyses, on-pump CABG conferred survival benefits in most demographic, clinical, and anatomic subgroups compared with off-pump CABG. In patients undergoing elective isolated CABG, on-pump strategy conferred a long-term survival advantage compared with off-pump strategy. Copyright © 2014 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

  10. Behavior Change Strategies for Successful Long-Term Weight Loss: Focusing on Dietary and Physical Activity Adherence, Not Weight Loss (United States)

    Hongu, Nobuko; Kataura, Martha P.; Block, Linda M.


    This article helps Extension professionals guide individuals in a successful long-term weight loss program. A program should focus on behavioral changes (improving eating habits and physical activity), not just weight loss. In order to do this, Extension professionals should implement behavior change strategies that motivate individuals to…

  11. A discrete event modelling framework for simulation of long-term outcomes of sequential treatment strategies for ankylosing spondylitis

    NARCIS (Netherlands)

    Tran-Duy, A.; Boonen, A.; Laar, M.A.F.J.; Franke, A.C.; Severens, J.L.


    Objective To develop a modelling framework which can simulate long-term quality of life, societal costs and cost-effectiveness as affected by sequential drug treatment strategies for ankylosing spondylitis (AS). Methods Discrete event simulation paradigm was selected for model development. Drug

  12. Power and Liberty: A Long-Term Course Planning Strategy to Encourage the Contextualization of Events in American History (United States)

    Endacott, Jason L.


    Applying a consistent historical theme throughout a social studies course is an effective long-term planning strategy that can promote student engagement, retention of information, and contextualized knowledge of history's continuity and change. This article demonstrates how one such theme, power and liberty, might be incorporated into a secondary…

  13. Lessons learnt from applying action research to support strategy formation processes in long-term care networks

    NARCIS (Netherlands)

    Cramer, Hendrik; Dewulf, Geert P.M.R.; Voordijk, Johannes T.


    This study demonstrates how action research (AR) that is aimed at scaling-up experiments can be applied to support a strategy formation process (SFP) in a subsidized long-term care network. Previous research has developed numerous AR frameworks to support experiments in various domains, but has

  14. An integrated modelling framework to assess long-term impacts of water management strategies steering soil subsidence in peatlands

    NARCIS (Netherlands)

    van Hardeveld, H. A.; Driessen, P. P.J.; Schot, P. P.; Wassen, M. J.


    Around the world many peatlands are managed unsustainably. Drainage of the peat causes soil subsidence and a range of negative societal impacts. Integrated strategies are required to ensure more sustainable long-term settings, based on impact assessment models that simulate the interrelated dynamics

  15. Effects of simple long-term respiratory care strategies in older men with COPD

    Directory of Open Access Journals (Sweden)

    Fabrício Zambom-Ferraresi

    Full Text Available ABSTRACT Objective: To evaluate a 24-month supervised, community-based maintenance exercise program after 3 months of pulmonary rehabilitation (PR in comparison with a 27-month physical activity counseling program, in terms of the effects on maximal muscle strength, muscle power output, and exercise capacity, in individuals with COPD. Methods: Sixty-three men with moderate-to-severe COPD were recruited from two previous studies. Of those 63 participants, 31 were offered 3 months of PR followed by a 24-month supervised maintenance exercise program (24MME group and 32 were offered a 27-month physical activity counseling program (27MPAC group. Measurements at 3 months and at the end of the study period included maximal strength of the upper and lower limbs, power output of the lower limbs, six-minute walk distance (6MWD, and quality of life. Results: At 27 months, the improvements in maximal strength of the upper and lower limbs were greater in the 24MME group than in the 27MPAC group (37.6 ± 28.3% and 28.4 ± 13.3%, respectively, vs. 8.8 ± 16% and 13.6 ± 16.4%, respectively; p < 0.05, as was the improvement in power output of the lower limbs (24.6 ± 18.4% vs. −2.3 ± 28.5%; p < 0.01. The increase in the 6MWD after 3 months was also greater in the 24MME group than in the 27MPAC group (33.2 ± 36.6 m vs. 2.9 ± 34.7 m; p < 0.05, although there were no differences between the two groups in terms of the Δ6MWD at 27 months (vs. baseline. Conclusions: A supervised, community-based maintenance program is a successful long-term strategy to preserve the benefits of PR on peripheral muscle function and exercise capacity in individuals with COPD. However, physical activity counseling can maintain maximal muscle strength and exercise capacity in such individuals.

  16. Multi-messenger signals of long-term core-collapse supernova simulations : synergetic observation strategies


    Nakamura, Ko; Horiuchi, Shunsaku; Tanaka, Masaomi; Hayama, Kazuhiro; Takiwaki, Tomoya; Kotake, Kei


    The next Galactic supernova is expected to bring great opportunities for the direct detection of gravitational waves (GW), full flavor neutrinos, and multi-wavelength photons. To maximize the science return from such a rare event, it is essential to have established classes of possible situations and preparations for appropriate observations. To this end, we use a long-term numerical simulation of the core-collapse supernova (CCSN) of a 17 solar-mass red supergiant progenitor to self-consiste...

  17. Biochemical Mechanisms and Energy Strategies of Geobacter sulfurreducens for Long- Term Survival (United States)

    Helmus, R. A.; Liermann, L. J.; Brantley, S. L.; Tien, M.


    Numerous species of bacteria have been observed to exhibit a growth advantage in stationary phase (GASP) phenotype, indicating that microorganisms starved of an energy source may adapt to allow for long-term survival. Understanding how Geobacter sulfurreducens persists using various metal forms as energy sources and whether a GASP phenotype develops during long-term growth are important for efficient application of this bacterium to sites requiring engineered bioremediation of soluble metals. Thus, we investigated the growth kinetics and survival of G. sulfurreducens. The growth rate of G. sulfurreducens was highest when cultured with soluble iron and generally higher on iron oxide than manganese oxide, suggesting that soluble metal forms are more readily utilized as energy sources by G. sulfurreducens. By monitoring the abundance of G. sulfurreducens in batch cultures for >6 months, distinct growth, stationary, and prolonged starvation phases were observed and a cell density of 105- 106 cells/mL persisted under long-term starvation conditions. The outgrowth of an aged G. sulfurreducens strain co-cultured with a young strain was monitored as a measure of the existence of the GASP phenotype. As the strains aged, the rpoS gene was cloned and sequenced at different stages of growth to identify mutations corresponding to a growth advantage. The results of these studies provide insight into the use of various metal forms for growth by G. sulfurreducens and its ability to persist when starved of energy sources.

  18. Long term post-flood damage assessments to analyze the strategies of adaptation at individual scale (United States)

    Brémond, Pauline; Bonte, Bruno; Erdlenbruch, Katrin; Grelot, Frédéric; Richert, Claire


    RETINA is a project which studies the opportunity for adaptation in the aftermath of flood events. To handle this research question, we consider adaptation to flood risk at individual and collective scale as well as the influence of the urban planning regulation (Flood risk mapping). For the purpose of this research, collective adaptation means actions that are undertaken at collective scale such as dikes, relocation of collective infrastructures (roads, treatment plant...) and individual adaptation means actions decided at individual level (households, enterprises or farmers) such as relocation, elevation of critical components, new organization.... In this presentation, we focus on individual adaptation and analyse which are the mechanisms that incite or constrain the adaptation to flood risk of individual assets considering their own trajectory. The originality of our approach is to carry out long term post-flood assessments and comprehensive interviews at individual scale. To catch the drivers of adaptation, we sequenced the interview guide in three periods: 1/ the situation before the reference event occurred, 2/ what happened during and just after the flood event, 3/ what happened from the flood event until the moment of the interview. Two case studies have been chosen. The first case study is the Aude department where an exceptional flooding occurred in 1999. The second case study is the Var department where more recent and frequent flood events occurred in 2010, 2011, 2014. On each case study, we plan to conduct about fifty interviews including households and economic activities. In this presentation, we will develop methodological aspects on long term post-flood damage assessments. Carrying out a long term post-flood assessment enabled us to consider adaptation to flood risk among the whole of strategic decisions a household or an enterprise has to take. Moreover, we found out that contrary to what is usually assumed, the fact that the reference event was

  19. Developing Service Operations Strategy for Optimal Delivery of Long-Term Service Agreements Using an Integrated Risk Framework


    Aparna Gupta; Chaipat Lawsirirat


    Long-term service agreements (LTSAs) for the maintenance of capital-intensive products are gaining popularity. Without a thorough understanding of risk exposures and their impact on the service delivery, the providers can be exposed to the possibility of extensive losses and financial ruin, as well as endanger the products’ end-consumers. This article develops a rigorous risk assessment and management framework for developing an optimal service operations strategy for the delivery of LTSAs....

  20. Is Fibre an Effective Strategy to Improve Laxation in Long-Term Care Residents? (United States)

    Dahl, Wendy J; Mendoza, Daniela Rivero


    The high prevalence of constipation in long-term care (LTC) residents has been a long-standing issue for caregivers, attending health professionals, and the residents themselves. The traditional medical response has been to utilize pharmaceutical laxatives, enemas, and suppositories for treatment. The purpose of this review was to determine if fibre supplementation (including fibre added to foods) is effective in increasing stool frequency, improving stool consistency, and decreasing laxative use in LTC residents. A systematic search was conducted using PubMed and CINAHL databases, inclusive to March 2017. Search terms included: "long-term care" or "nursing home" AND "fiber (fibre)," "bran," "psyllium," "inulin," or "prebiotic." Intervention trials of fibre supplementation with ≥5 LTC residents were included. The search generated 456 articles following removal of duplicates; 8 studies met the inclusion criteria. Three additional trials were identified through a hand search of references of pertinent articles. Current evidence suggests that added fibre may be effective in increasing stool frequency and/or decreasing laxative use in LTC residents and, thus, may lessen the burden of constipation. However, randomized controlled trials are needed to clearly demonstrate the effects of adding fibre to foods, particularly insoluble and less fermentable sources, on constipation in LTC residents.

  1. The SCIDIP-ES project - towards an international collaboration strategy for long term preservation of earth science data (United States)

    Riddick, Andrew; Glaves, Helen; Marelli, Fulvio; Albani, Mirko; Tona, Calogera; Marketakis, Yannis; Tzitzikas, Yannis; Guarino, Raffaele; Giaretta, David; Di Giammatteo, Ugo


    The capability for long term preservation of earth science data is a key requirement to support on-going research and collaboration within and between many earth science disciplines. A number of critically important current research directions (e.g. understanding climate change, and ensuring sustainability of natural resources) rely on the preservation of data often collected over several decades in a form in which it can be accessed and used easily. Another key driver for strategic long term data preservation is that key research challenges (such as those described above) frequently require cross disciplinary research utilising raw and interpreted data from a number of earth science disciplines. Effective data preservation strategies can support this requirement for interoperability and collaboration, and thereby stimulate scientific innovation. The SCIDIP-ES project (EC FP7 grant agreement no. 283401) seeks to address these and other data preservation challenges by developing a Europe wide infrastructure for long term data preservation comprising appropriate software tools and infrastructure services to enable and promote long term preservation of earth science data. Because we define preservation in terms of continued usability of the digitally encoded information, the generic infrastructure services will allow a wide variety of data to be made usable by researchers from many different domains. This approach promotes international collaboration between researchers and will enable the cost for long-term usability across disciplines to be shared supporting the creation of strong business cases for the long term support of that data. This paper will describe our progress to date, including the results of community engagement and user consultation exercises designed to specify and scope the required tools and services. Our user engagement methodology, ensuring that we are capturing the views of a representative sample of institutional users, will be described. Key

  2. A long-term perspective on anthropogenic activities and management strategies in a prairie wetland (United States)

    Hobbs, J. M.; Hobbs, W.; LaFrancois, T.; Edlund, M.; Theissen, K. M.; Zimmer, K.; Hanson, M.


    Multiple stressors to shallow lake/wetland ecosystems have the ability to control the relative stability of alternative states (clear, macrophyte-dominated or turbid, algal dominated). As a consequence, the use of remedial biomanipulations to induce trophic cascades and shift a turbid lake to a clear state is often only a temporary solution. Here we show the instability of short-term manipulations in the shallow Lake Christina (a Class V wetland in the prairie ecoregion of western Minnesota, USA) is governed by the long-term state following a regime shift in the lake. During the modern, managed period of the lake, three top-down manipulations (fish kills) were undertaken inducing temporary (5-10 years) unstable clear-water states. Paleoecological remains of diatoms, along with proxies of primary production (total chlorophyll a and total organic carbon accumulation rate) and trophic state (total P) from sediment records clearly show a single regime shift in the lake during the early 1950s; following this shift, the functioning of the lake ecosystem is dominated by a persistent turbid state. We find that multiple stressors contributed to the regime shift. First, the lake began to eutrophy (from agricultural land use and/or increased waterfowl populations), leading to a dramatic increase in primary production. Soon after, the construction of a dam in 1936 effectively doubled the depth of the lake, compounded by increases in regional humidity; this resulted in an increase in planktivorous and benthivorous fish reducing phytoplankton grazers. These factors further conspired to increase the stability of a turbid regime during the modern managed period, such that switches to a clear-water state were inherently unstable and the lake consistently returned to a turbid state. We conclude that while top-down manipulations have had measurable impacts on the lake state, they have not been effective in providing a return to an ecosystem similar to the stable historical period

  3. Long-term citrus organic farming strategy results in soil organic matter recovery (United States)

    Novara, Agata; Pereira, Paulo; Barone, Ettore; Giménez Morera, Antonio; Keesstra, Saskia; Gristina, Luciano; Jordán, Antonio; Parras-Alcantara, Luis; Cerdà, Artemi


    ABSTRACT Soils play a key role in the Earth System (Keesstra et al., 2012; Brevick et al., 2015). Soils are a key resource for the human societies (Mol and Keesstra, 2012) and they are relevant to achieve the sustainability such as the United Nations Goals highlight (Keesstra et al., 2016). Agriculture soils, especially those under conventional tillage, are prone to organic matter mineralization, soil erosion, compaction and increase of greenhouse gases emission (Novara et al., 2011; Bruun et al., 2015; de Moraes et al., 2015; Choudhury et al., 2016; del Mar et al., 2016). The adoption of organic farming and sustainable management practices may provide a sustainable crop productivity, and in the meanwhile mitigate the negative impact of agriculture on ecosystem services benefits (Laudicina et al., 2015; Parras-Alcantara et al., 2015; 2016). The aim of this study was to examine, under field conditions, the long-term changes of soil organic matter under organic farming management in citrus orchards in Mediterranean environment and evaluate the ecosystem service on C sequestration in terms of economic benefits. The research was carried out at the Alcoleja Experimental Station located in the Cànyoles river watershed in the Eastern Spain on 45year old citrus plantation. Soil Organic Matter (SOM) content was monitored for 20 years at 6 different soil depth. The profitability of citrus plantation was estimated under conventional and organic management. Results showed that SOM in the 0-30 cm soil depth was the double after 20 years of organic farming management, ranging from 0.8 g kg-1 in 1995 to 1.5 g kg-1 in 2006. The highest SOM increase was in the top soil layer (368% of SOM increase in comparison to the initial SOM content) and decreased with soil depth. The effect of organic farming was relevant after 5 years since land management change, indicating that in Mediterranean environment the duration of long term studies should be higher than five years and proper policy

  4. Long-term strategies for increased recycling of automotive aluminum and its alloying elements. (United States)

    Løvik, Amund N; Modaresi, Roja; Müller, Daniel B


    Aluminum recycling currently occurs in a cascading fashion, where some alloys, used in a limited number of applications, absorb most of the end-of-life scrap. An expected increase in scrap supply in coming decades necessitates restructuring of the aluminum cycle to open up new recycling paths for alloys and avoid a potential scrap surplus. This paper explores various interventions in end-of-life management and recycling of automotive aluminum, using a dynamic substance flow analysis model of aluminum and its alloying elements with resolution on component and alloy level (vehicle-component-alloy-element model). It was found that increased component dismantling before vehicle shredding can be an effective, so far underestimated, intervention in the medium term, especially if combined with development of safety-relevant components such as wheels from secondary material. In the long term, automatic alloy sorting technologies are most likely required, but could at the same time reduce the need for magnesium removal in refining. Cooperation between the primary and secondary aluminum industries, the automotive industry, and end-of-life vehicle dismantlers is therefore essential to ensure continued recycling of automotive aluminum and its alloying elements.

  5. How Can We Prevent Violence Becoming a Viable Political Strategy?


    Patricia Justino


    A basic issue that conflict analysis investigates is how non-peaceful ways of living and governing become viable political strategies. Macro-level studies provide some important insights but micro-level analysis is vital to understand the mechanisms that make violence possible. This briefing outlines some preliminary findings in this respect from MICROCON, a major research programme analysing violent conflict at the micro level. It also discusses their implications for policies aimed at preve...

  6. Long-Term Instrumentation, Information, and Control Systems (II&C) Modernization Future Vision and Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Kenneth Thomas


    Life extension beyond 60 years for the U.S operating nuclear fleet requires that instrumentation and control (I&C) systems be upgraded to address aging and reliability concerns. It is impractical for the legacy systems based on 1970's vintage technology operate over this extended time period. Indeed, utilities have successfully engaged in such replacements when dictated by these operational concerns. However, the replacements have been approached in a like-for-like manner, meaning that they do not take advantage of the inherent capabilities of digital technology to improve business functions. And so, the improvement in I&C system performance has not translated to bottom-line performance improvement for the fleet. Therefore, wide-scale modernization of the legacy I&C systems could prove to be cost-prohibitive unless the technology is implemented in a manner to enable significant business innovation as a means of off-setting the cost of upgrades. A Future Vision of a transformed nuclear plant operating model based on an integrated digital environment has been developed as part of the Advanced Instrumentation, Information, and Control (II&C) research pathway, under the Light Water Reactor (LWR) Sustainability Program. This is a research and development program sponsored by the U.S. Department of Energy (DOE), performed in close collaboration with the nuclear utility industry, to provide the technical foundations for licensing and managing the long-term, safe and economical operation of current nuclear power plants. DOE's program focus is on longer-term and higher-risk/reward research that contributes to the national policy objectives of energy security and environmental security . The Advanced II&C research pathway is being conducted by the Idaho National Laboratory (INL). The Future Vision is based on a digital architecture that encompasses all aspects of plant operations and support, integrating plant systems, plant work processes, and plant workers in a

  7. Long-Term Instrumentation, Information, and Control Systems (II&C) Modernization Future Vision and Strategy

    Energy Technology Data Exchange (ETDEWEB)

    Kenneth Thomas; Bruce Hallbert


    Life extension beyond 60 years for the U.S operating nuclear fleet requires that instrumentation and control (I&C) systems be upgraded to address aging and reliability concerns. It is impractical for the legacy systems based on 1970’s vintage technology operate over this extended time period. Indeed, utilities have successfully engaged in such replacements when dictated by these operational concerns. However, the replacements have been approached in a like-for-like manner, meaning that they do not take advantage of the inherent capabilities of digital technology to improve business functions. And so, the improvement in I&C system performance has not translated to bottom-line performance improvement for the fleet. Therefore, wide-scale modernization of the legacy I&C systems could prove to be cost-prohibitive unless the technology is implemented in a manner to enable significant business innovation as a means of off-setting the cost of upgrades. A Future Vision of a transformed nuclear plant operating model based on an integrated digital environment has been developed as part of the Advanced Instrumentation, Information, and Control (II&C) research pathway, under the Light Water Reactor (LWR) Sustainability Program. This is a research and development program sponsored by the U.S. Department of Energy (DOE), performed in close collaboration with the nuclear utility industry, to provide the technical foundations for licensing and managing the long-term, safe and economical operation of current nuclear power plants. DOE’s program focus is on longer-term and higher-risk/reward research that contributes to the national policy objectives of energy security and environmental security . The Advanced II&C research pathway is being conducted by the Idaho National Laboratory (INL). The Future Vision is based on a digital architecture that encompasses all aspects of plant operations and support, integrating plant systems, plant work processes, and plant workers in a

  8. Implications of renewable energy technologies in the Bangladesh power sector. Long-term planning strategies

    Energy Technology Data Exchange (ETDEWEB)

    Mondal, Alam Hossain


    Bangladesh is facing daunting energy challenges: Security concerns over growing fuel imports, limited domestic energy resources for power generation, and projected demands for electricity that will exceed domestic supply capabilities within a few years. By acknowledging the potential of renewable energy resources, the country could possibly meet its unprecedented energy demand, thus increasing electricity accessibility for all and enhancing energy security through their advancement. The integration of renewable energy technologies in the power sector through national energy planning would, therefore, be a step in the right direction, not only for sustainable development of the country but also as part of Bangladesh's responsibility toward the global common task of environmental protection. This study estimates the potential of renewable energy sources for power generation in Bangladesh from the viewpoint of different promising available technologies. Future long-term electricity demand in Bangladesh is projected based on three economic growth scenarios. The energy planning model LEAP is applied to forecast the energy requirements from 2005 to 2035. Different policy scenarios, e.g., accelerated renewable energy production, null coal import, CO2 emission reduction targets and carbon taxes in the power sector from 2005 to 2035 are explored. The analyses are based on a long-term energy system model of Bangladesh using the MARKAL model. Prospects for the power sector development of the country are identified, which ensure energy security and mitigate environmental impacts. The technical potential of grid-connected solar photovoltaic and wind energy are estimated at 50174 MW and 4614 MW, respectively. The potential of energy from biomass and small hydro power plants is estimated at 566 MW and 125 MW, respectively. Total electricity consumption was 18 TWh in 2005 and is projected to increase about 7 times to 132 TWh by 2035 in the low GDP growth scenario. In the

  9. Nuclear Waste Disposal and Strategies for Predicting Long-Term Performance of Material

    Energy Technology Data Exchange (ETDEWEB)

    Wicks, G G


    Ceramics have been an important part of the nuclear community for many years. On December 2, 1942, an historic event occurred under the West Stands of Stagg Field, at the University of Chicago. Man initiated his first self-sustaining nuclear chain reaction and controlled it. The impact of this event on civilization is considered by many as monumental and compared by some to other significant events in history, such as the invention of the steam engine and the manufacturing of the first automobile. Making this event possible and the successful operation of this first man-made nuclear reactor, was the use of forty tons of UO2. The use of natural or enriched UO2 is still used today as a nuclear fuel in many nuclear power plants operating world-wide. Other ceramic materials, such as 238Pu, are used for other important purposes, such as ceramic fuels for space exploration to provide electrical power to operate instruments on board spacecrafts. Radioisotopic Thermoelectric Generators (RTGs) are used to supply electrical power and consist of a nuclear heat source and converter to transform heat energy from radioactive decay into electrical power, thus providing reliable and relatively uniform power over the very long lifetime of a mission. These sources have been used in the Galileo spacecraft orbiting Jupiter and for scientific investigations of Saturn with the Cassini spacecraft. Still another very important series of applications using the unique properties of ceramics in the nuclear field, are as immobilization matrices for management of some of the most hazardous wastes known to man. For example, in long-term management of radioactive and hazardous wastes, glass matrices are currently in production immobilizing high-level radioactive materials, and cementious forms have also been produced to incorporate low level wastes. Also, as part of nuclear disarmament activities, assemblages of crystalline phases are being developed for immobilizing weapons grade plutonium, to

  10. Army Transformation: Its Long-Term Ability to Support the National Security Strategy

    National Research Council Canada - National Science Library

    Limberg, Daniel


    ..., interconnected and risky than ever before". The Cold War containment strategy is no longer effective in an environment of rogue nations, strong nationalistic sentiments, international criminal and terrorist organizations, and the proliferation...

  11. Long-Term Effect of Different Carbon Management Strategies on Water Flow and Related Processes for Three Loamy Soils

    DEFF Research Database (Denmark)

    Vendelboe, Anders Lindblad; Schjønning, Per; de Jonge, Lis Wollesen


    flow patterns showed a rapid breakthrough of irrigation water but only little or negligible effect in reducing the risk of colloid loss and chemicals leaching from the root zone, despite 20 to 30 years of different management strategies with this aim. Previous studies reported in the literature have...... emphasized high SOC contents and grass ley soils to significantly reduce nonequilibrium water flow. Our results thus indicate the need for more effective management options than those addressed in this study....... on preferential flow and loss of colloids during heavy irrigation events. The field sites were all under long-term management and therefore represent up to 30 years of pairwise different management strategies. One field in each field pair was managed with a more C-repleting strategy (HighC) than the other (Low...

  12. Low Grade Gliomas in Eloquent Locations – Implications for Surgical Strategy, Survival and Long Term Quality of Life (United States)

    Jakola, Asgeir S.; Unsgård, Geirmund; Myrmel, Kristin S.; Kloster, Roar; Torp, Sverre H.; Lindal, Sigurd; Solheim, Ole


    Background Surgical management of suspected LGG remains controversial. A key factor when deciding a surgical strategy is often the tumors’ perceived relationship to eloquent brain regions Objective To study the association between tumor location, survival and long-term health related quality of life (HRQL) in patients with supratentorial low-grade gliomas (LGG). Methods Adults (≥18 years) operated due to newly diagnosed LGG from 1998 through 2009 included from two Norwegian university hospitals. After review of initial histopathology, 153 adults with supratentorial WHO grade II LGG were included in the study. Tumors’ anatomical location and the relationship to eloquent regions were graded. Survival analysis was adjusted for known prognostic factors and the initial surgical procedure (biopsy or resection). In long-term survivors, HRQL was assessed with disease specific questionnaires (EORTC QLQ-C30 and BN20) as well as a generic questionnaire (EuroQol 5D). Results There was a significant association between eloquence and survival (log-rank, peloquent tumors, 71% in intermediate located tumors and 54% in eloquent tumors. In the adjusted analysis the hazard ratio of increasing eloquence was 1.5 (95% CI 1.1–2.0, p = 0.022). There were no differences in HRQL between patients with eloquent and non-eloquent tumors. The most frequent self-reported symptoms were related to fatigue, cognition, and future uncertainty. Conclusion Eloquently located LGGs are associated with impaired survival compared to non-eloquently located LGG, but in long-term survivors HRQL is similar. Although causal inference from observational data should be done with caution, the findings illuminate the delicate balance in surgical decision making in LGGs, and add support to the probable survival benefits of aggressive surgical strategies, perhaps also in eloquent locations. PMID:23251537

  13. Low grade gliomas in eloquent locations - implications for surgical strategy, survival and long term quality of life. (United States)

    Jakola, Asgeir S; Unsgård, Geirmund; Myrmel, Kristin S; Kloster, Roar; Torp, Sverre H; Lindal, Sigurd; Solheim, Ole


    Surgical management of suspected LGG remains controversial. A key factor when deciding a surgical strategy is often the tumors' perceived relationship to eloquent brain regions To study the association between tumor location, survival and long-term health related quality of life (HRQL) in patients with supratentorial low-grade gliomas (LGG). Adults (≥18 years) operated due to newly diagnosed LGG from 1998 through 2009 included from two Norwegian university hospitals. After review of initial histopathology, 153 adults with supratentorial WHO grade II LGG were included in the study. Tumors' anatomical location and the relationship to eloquent regions were graded. Survival analysis was adjusted for known prognostic factors and the initial surgical procedure (biopsy or resection). In long-term survivors, HRQL was assessed with disease specific questionnaires (EORTC QLQ-C30 and BN20) as well as a generic questionnaire (EuroQol 5D). There was a significant association between eloquence and survival (log-rank, peloquent tumors, 71% in intermediate located tumors and 54% in eloquent tumors. In the adjusted analysis the hazard ratio of increasing eloquence was 1.5 (95% CI 1.1-2.0, p = 0.022). There were no differences in HRQL between patients with eloquent and non-eloquent tumors. The most frequent self-reported symptoms were related to fatigue, cognition, and future uncertainty. Eloquently located LGGs are associated with impaired survival compared to non-eloquently located LGG, but in long-term survivors HRQL is similar. Although causal inference from observational data should be done with caution, the findings illuminate the delicate balance in surgical decision making in LGGs, and add support to the probable survival benefits of aggressive surgical strategies, perhaps also in eloquent locations.

  14. Mechanisms of soil organic carbon accumulation from long-term fertilization strategies in two soils: Evidence from nuclear magnetic resonance spectroscopy analysis (United States)

    Long-term fertilization strategies have been proven to significantly influence soil organic carbon (SOC) accumulation, while the underlying mechanism remains unclear. Using two long-term (>20 y) field experiments of a double-cropped maize-wheat rotation on a Calcaric Fluvisol and paddy rice on a Hyd...

  15. Immigrants, family strategies and long-term settlement: the lessons of the crisis in rural areas

    Directory of Open Access Journals (Sweden)

    Rosario Sampedro Gallego


    Full Text Available The settlement of foreign born immigrants in Spanish rural areas in the last decades has been considered like an opportunity to stop depopulation and improve social and economic life in rural towns and villages. After the burst out of economic crisis in 2008 a lot of questions arise about factors that enhance or hinder the permanence of these newcomers in rural areas. In this paper we analyze the evolution of foreign born population in Castilla y Leon from 2007 to 2014, using data from Spanish Register of Inhabitants and from the Spanish Population Census of 2011. We relate the observed evolution of five national groups of immigrants with their family migration strategies and labour patterns. Data suggest that certain family migration strategies —those linked to transnational families and to marriage with Spaniards— and certain labour patterns —with a clear gendered pattern of employment— are connected with the permanence of immigrants in rural areas.

  16. Long-term Utilization of Interaction by Young EFL Learners: The Effects of Strategy Training

    Directory of Open Access Journals (Sweden)

    Mohammad Mahdi Hajmalek


    Full Text Available The bulk of research within the interactionist framework seems to be consensually pointing to the beneficial effects of interaction in SLA. However, few studies have investigated the role of training in providing and perceiving interactional feedback, especially among young learners. This study probed the effects of training prior to engagement in interaction in case of young learners acquiring polar questions in an EFL context. Sixty learners aged 9-14 in three intact groups were exposed to instruction followed by peer interaction in case of the experimental groups while the control group simply received traditional teacher-fronted practice. Also, while one treatment group received prior training in interactional feedback strategies, the other group did not. The pre-test, immediate post-test, and delayed post-test were administered. The results of mixed between-within subjects ANOVA (SPANOVA showed that engaging in interaction, regardless of any prior training, could significantly improve learners’ immediate mastery over the target form. However, in the long run, only the group trained in feedback strategies could maintain its superiority over the control group. The findings suggest that although engaging in peer interaction can be beneficial for young learners, sustained interlanguage development can result only if learners are trained in feedback strategies.

  17. Obesity: Risk factors, complications, and strategies for sustainable long-term weight management. (United States)

    Fruh, Sharon M


    The aims of this article are to review the effects of obesity on health and well-being and the evidence indicating they can be ameliorated by weight loss, and consider weight-management strategies that may help patients achieve and maintain weight loss. Narrative review based on literature searches of PubMed up to May 2016 with no date limits imposed. Search included terms such as "obesity," "overweight," "weight loss," "comorbidity," "diabetes," cardiovascular," "cancer," "depression," "management," and "intervention." Over one third of U.S. adults have obesity. Obesity is associated with a range of comorbidities, including diabetes, cardiovascular disease, obstructive sleep apnea, and cancer; however, modest weight loss in the 5%-10% range, and above, can significantly improve health-related outcomes. Many individuals struggle to maintain weight loss, although strategies such as realistic goal-setting and increased consultation frequency can greatly improve the success of weight-management programs. Nurse practitioners have key roles in establishing weight-loss targets, providing motivation and support, and implementing weight-loss programs. With their in-depth understanding of the research in the field of obesity and weight management, nurse practitioners are well placed to effect meaningful changes in weight-management strategies deployed in clinical practice. ©2017 American Association of Nurse Practitioners.

  18. Modeling and analysis of long-term energy scenarios for sustainable strategies of Ethiopia

    Energy Technology Data Exchange (ETDEWEB)

    Senshaw, Dereje Azemraw


    Despite robust economic growth, Ethiopia is one of the countries with poor energy accesses. Contributing factors are poor availability of energy, unreliable and insufficient quality of energy, and insufficient policy. Recognizing that energy access and security are indispensable to economic transformation, Ethiopia needs to cope with key challenges related to energy security, climate change mitigation and also diversification of energy supply. In order to achieve these targets and strive towards sustainable energy for all, Ethiopia's energy system requires a major transformation. The main achievement of this research has been the development of alternative energy options under different conditions for Ethiopia up to 2050. To identify an energy pathway that would meet Ethiopia's energy needs in a sustainable manner, three scenarios are considered: the business-as usual (BAU), moderate shift (Scenario1) and the advanced shift scenario (Scenario 2). The scenarios were developed, quantified and analyzed using a bottom-up model for Long Term Alternative Energy Planning (LEAP). These scenarios represent a range of energy policy measures that Ethiopia could adopt to achieve its sustainable development goals. The BAU scenario reflects a continuation of the current policy trend and considers on economic growth rate of 7%, while Scenario 1 and Scenario 2 represent moderate and advanced levels of commitment in economic growth, energy diversity and reduction of energy import dependency and CO{sub 2} emissions limits, respectively. The scenario analysis shows that the primary energy requirements for Ethiopia's socio-economic development will increase sharply over the period (2010-2050) in all three scenarios. BAU, Scenario 1 and Scenario 2 show an expected to growth at annual rates of 4.1, 4.9 and 5.7% respectively. If the current policy trends (as represented by BAU) continue, the total energy demand in Ethiopia is expected to reach 6,553 Petajoule (PJ) by 2050

  19. Future Perspective and Long-Term Strategy of the Indian EO Programme (United States)

    Rao, Mukund; Jayaraman, V.; Sridhara Murthi, K. R.; Kasturirangan, K.

    the future. The continuity of the EO services in India is the fundamental requirement for sustenance and further development of the technology and its utilisation, the stage is now set for transitioning the EO technology by initiating policy adjustments for the commercial use of space-based EO. Orientation needs to change from a "facility concept", which was the adage for the "promotional" era, to "Services concept" for the RS technology. The orientation also needs to change from RS data to Spatial Information and GIS databases. Demand for information would increase with a larger involvement of players in the developmental activities and catering to the information needs is what would be the driver for the commercial development. To that extent, the commercial development of Spatial Information needs to be thrusted forward and RS technology will be the back-bone for this information services initiative, because EO has the capability to provide accurate and timely information at large-scales in a repeated manner which is directly amenable to GIS manipulation. The thrust has to be towards developing an independent sector for Spatial Information with the active involvement of users, private entrepreneurs and other agencies to develop space-based RS market segments. This paper discusses the policy adjustments that will be required to be done for developing a viable and effective commercial EO programme in the country with a major thrust of initial government and industry partnership ultimately leading to a true industry sector for Spatial Information services.

  20. Study on transport infrastructure as mechanism of long-term urban planning strategies (United States)

    Popova, Olga; Martynov, Kirill; Khusnutdinov, Rinat


    In this article, the authors carry out the research of the transport infrastructure. The authors have developed an algorithm for quality assessment of transport networks and connectivity of urban development areas. The results of the research are presented on the example of several central city quarters of Arkhangelsk city. The analysis was carried out by clustering objects (separate quarters of the Arkhangelsk city) using of SOM in comparable groups with a high level of similarity of characteristics inside each group. The result of clustering was 5 clusters with different levels of transport infrastructure. The novelty of the study is to justification for advantages of applying structural analysis for qualitative ranking of areas. The advantage of the proposed methodology is that it gives the opportunity both to compare the transport infrastructure quality of different city quarters and to determine the strategy for its development with a list of specific activities.

  1. Detroit Works Long-Term Planning Project: Engagement Strategies for Blending Community and Technical Expertise

    Directory of Open Access Journals (Sweden)

    Toni L. Griffin


    Full Text Available In January 2013, civic leaders, community stakeholders, and residents came together to release Detroit Future City: 2012 Detroit Strategic Framework Plan, a guiding blueprint for transforming Detroit from its current state of population loss and excessive vacancy into a model for the reinvention of post-industrial American cities. Three years prior, the U.S. Census had reported that the city had lost 24% of its population over the last decade and had experienced a 20% increase in vacant and abandoned property, bringing total vacancy to roughly the size of Manhattan. In addition to physical and economic challenges, Detroiters had also acknowledged significant barriers to effective civic engagement. Foremost among these barriers were a profound sense of immobilization, planning fatigue, and a general perception of cynicism about planning and engagement efforts. These challenges were compounded by historic racial dynamics and tension. This case study elaborates on the comprehensive and innovative civic engagement executed in a citywide planning process called the Detroit Works Project, which took place from late 2010 through late 2012. For the citywide planning process to be successful and sustainable, civic leaders and project funders committed to a planning initiative that would be different from previous efforts, in large part because the “owners” of the process would be diverse and inclusive across all community sectors. The case study, written by three of the key consultants from the project, describes four key civic engagement strategies deployed in the creation of the strategic framework: (1 addressing profound challenges of culture, race, and politics by deliberately building trust; (2 elevating community expertise by fostering a sense of ownership of the process; (3 blending technical and community expertise; and (4 viewing civic engagement as an ongoing two-way conversation rather than a series of large-scale episodic events. This

  2. Long-term impacts of air capture technologies on optimal climate strategies under economic uncertainties (United States)

    Ghasemi, F.


    Despite widespread attention to the consequences of climate change, tangible and concerted progress toward mitigation of the adverse effects of greenhouse-gas (GHG) emissions has yet to be coordinated among various national and international agents. The energy objectives set by such initiatives as 'Sustainable Energy for All' partially help slow down the global warming in short term, but the risks posed by GHG emissions would persist for a long time. This fact makes negative emission solutions more appealing as a part of the climate protection efforts. Here I use integrated assessment modeling to investigate the potential added value of air capture technologies as a complement for more conventional solutions such as carbon capture and storage, and the use of renewables. Thermodynamic limits of air capture technologies are used as a general guideline for the estimation of the performance of air capture technologies. Optimal long-run climate strategies are discussed taking into account the uncertainties in the impact of CO2 concentration on the Global Wealth Product, and possible scenarios that result in an overshoot beyond the 2°C warming limit.

  3. FRAX or fiction: determining optimal screening strategies for treatment of osteoporosis in residents in long-term care facilities. (United States)

    Greenspan, Susan L; Perera, Subashan; Nace, David; Zukowski, Kimberly S; Ferchak, Mary A; Lee, Carroll J; Nayak, Smita; Resnick, Neil M


    To examine screening strategies for osteoporosis and fractures for treatment of long-term care residents. Cross-sectional analysis to examine screening strategies for treatment. Assisted living and skilled care facilities. Two hundred two frail women aged 65 and older (mean 85), excluding those receiving bisphosphonates. Clinical fractures of the hip or spine (Clin Fx); Clin Fx or bone mineral density (BMD); Clin Fx, BMD, or vertebral fractures (VF) assessed according to dual-energy X-ray absorptiometry-based vertebral fracture assessments; fracture risk algorithm using femoral neck BMD (FRAX-FN); fracture risk algorithm using body mass index (FRAX-BMI); or Clin Fx or heel ultrasound (heel US). Treatment eligibility ranged from 17% (Clin Fx) to 98% (FRAX-BMI). VFs were found in 47%, 74% of which were silent. Criteria with Clin Fx, BMD, or VF identified 73% of study participants for treatment. FRAX-FN suggested treatment in 81% but would have missed approximately 10% of individuals with silent VFs. Clin Fx or heel US suggested that 39% of participants were eligible for treatment. Long-term care residents eligible for osteoporosis treatment ranged from fewer than 20% to roughly all residents depending on screening criteria. VFs are common and identify a subset of residents missed by conventional BMD scans or FRAX-FN. A reasonable clinical approach could consider treatment for those with Clin Fx of the hip or spine, radiological evidence of a VF, or osteoporosis according to BMD classification. Prospective studies are needed to determine optimal screening strategies for treatment in this cohort. © 2012, Copyright the Authors Journal compilation © 2012, The American Geriatrics Society.


    DEFF Research Database (Denmark)

    Evans, Robert Harry


    Teacher development aimed at increasing the use of inquiry based methods in schools is an important way to reach science learning goals. To this end, the EC has promoted inquiry based science teaching (IBST) within the Seventh Framework Program (FP7). One dimension, typically absent from the FP7...... products, is the personal capacity belief of self- efficacy which has been shown to be important to personal behavioral change. The purpose of this research was to develop and test a model of teacher professional development (TPD) which adds specific elements for altering teacher self...... included strategies for increasing participant’s self-efficacies. Pre and post assessments showed consistently improved personal self-efficacy scores in all of the workshops. In addition, and unlike other long-term studies of teachers, these self-efficacy scores did not significantly diminish over six...

  5. Long-term outcomes of treat-to-target strategy in established rheumatoid arthritis: a daily practice prospective cohort study. (United States)

    de Andrade, Nicole Pamplona Bueno; da Silva Chakr, Rafael Mendonça; Xavier, Ricardo Machado; Viecceli, Daniela; Correa, Ricardo Henrique Bilycz; de Oliveira Filho, Cilomar Martins; Brenol, Claiton Viegas


    To examine disease activity and physical function after implementation of treat-to-target (T2T) strategy in patients with established rheumatoid arthritis (RA) over a long-term period. Patients with RA were started on a T2T strategy in 2005 and followed through 2014. Patients were seen every 3-4 months until remission/low disease activity was achieved and every 6 months thereafter. Disease activity was measured by the DAS28 and CDAI, and physical function by the HAQ-DI. Results were presented as all observed data, without imputation for missing values. Changes in disease activity and physical function were evaluated by generalized estimating equations (GEE). Two hundred and twenty-nine patients were included, with a mean (SD) disease duration of 10.6 (7.4) years. Significant improvements were seen in both composite scores during the follow-up period, as demonstrated by DAS28 (β coefficient = 0.19; 95% CI = 0.16-0.21; p strategy, was associated with improvement in disease activity and physical function.

  6. Developing Strategies to Improve Advance Care Planning in Long Term Care Homes: Giving Voice to Residents and Their Family Members

    Directory of Open Access Journals (Sweden)

    Kimberly Ramsbottom


    Full Text Available Long term care (LTC homes, also known as residential care homes, commonly care for residents until death, making palliative care and advance care planning (ACP important elements of care. However, limited research exists on ACP in LTC. In particular, research giving voice to family members and substitute decision makers is lacking. The objective of this research was to understand experiences, perspectives, and preferences to guide quality improvement of ACP in LTC. This qualitative descriptive study conducted 34 individual semistructured interviews in two LTC homes, located in Canada. The participants were 31 family members and three staff, consisting of a front line care worker, a registered nurse, and a nurse practitioner. All participants perceived ACP conversations as valuable to provide “resident-centred care”; however, none of the participants had a good understanding of ACP, limiting its effectiveness. Strategies generated through the research to improve ACP were as follows: educating families and staff on ACP and end-of-life care options; better preparing staff for ACP conversations; providing staff skills training and guidelines; and LTC staff initiating systematic, proactive conversations using careful timing. These strategies can guide quality improvement of palliative care and development of ACP tools and resources specific to the LTC home sector.

  7. The Comparison between Contextual Guessing Strategies vs. Memorizing a List of Isolated Words in Vocabulary Learning Regarding Long Term Memory

    Directory of Open Access Journals (Sweden)

    Leyla Vakili S AMIYAN


    Full Text Available Guessing the meaning of unknown vocabularies within a text is a way of learning new words which is named textual vocabulary acquisition. The main purpose of this study is to investigate the effectiveness of a textual guessing strategy on vocabulary learning at the intermediate le vel. Textual guessing strategy is to guess the meaning of vocabularies with the help of surrounding words or sentences in the co - text without any translation. This paper reports the findings of two quantitative studies conducted on English language learner s with the Intermediate 2 level of proficiency in Kavosh foreign language institute, Mashhad, Iran. Twenty male and female attendants were selected and assigned to ’context’ and ‘non - context’ groups. The context group received an instruction to infer the m eaning of new words while the non - context participants were treated as learning new vocabularies individually (autonomously. The result of the independent sample t - test at the post - test stage revealed that the probability value of t - test with an equality of variances assumption is lower than 0.05 (0.04700. So this result represented that there is a meaningful difference between the experimental group and the control group considering their amount of learning. The results indicated that textual guessing s trategy had more effect on their long term memory. It was also revealed that the words learned through context are used more frequently than those learned in isolation in the speaking repertoire of the participants.

  8. Long-term persistence of quality improvements for an intensive care unit communication initiative using the VALUE strategy. (United States)

    Wysham, Nicholas G; Mularski, Richard A; Schmidt, David M; Nord, Shirley C; Louis, Deborah L; Shuster, Elizabeth; Curtis, J Randall; Mosen, David M


    Communication in the intensive care unit (ICU) is an important component of quality ICU care. In this report, we evaluate the long-term effects of a quality improvement (QI) initiative, based on the VALUE communication strategy, designed to improve communication with family members of critically ill patients. We implemented a multifaceted intervention to improve communication in the ICU and measured processes of care. Quality improvement components included posted VALUE placards, templated progress note inclusive of communication documentation, and a daily rounding checklist prompt. We evaluated care for all patients cared for by the intensivists during three separate 3 week periods, pre, post, and 3 years following the initial intervention. Care delivery was assessed in 38 patients and their families in the pre-intervention sample, 27 in the post-intervention period, and 41 in follow-up. Process measures of communication showed improvement across the evaluation periods, for example, daily updates increased from pre 62% to post 76% to current 84% of opportunities. Our evaluation of this quality improvement project suggests persistence and continued improvements in the delivery of measured aspects of ICU family communication. Maintenance with point-of-care-tools may account for some of the persistence and continued improvements. Copyright © 2014 Elsevier Inc. All rights reserved.

  9. Long-term prognosis of chronic kidney disease in non-ST elevation acute coronary syndrome treated with invasive strategy. (United States)

    Roldán Torres, Ildefonso; Salvador Mercader, Inmaculada; Cabadés Rumbeu, Claudia; Díez Gil, José Luis; Ferrando Cervelló, José; Monteagudo Viana, Marta; Fernández Galera, Rubén; Mora Llabata, Vicente

    Patients with chronic kidney disease (CKD) have an increased risk of adverse cardiovascular outcomes after non-ST elevation acute coronary syndrome (NSTEACS). However, the information available on this specific population, is scarce. We evaluate the impact of CKD on long-term prognosis in patients with NSTEACS managed with invasive strategy. We conduct a prospective registry of patients with NSTEACS and coronary angiography. CKD was defined as a glomerular filtration rate < 60ml/min/1,73m2. The composite primary end-point was cardiac death and non fatal cardiovascular readmission. We estimated the cumulative probability and hazard rate (HR) of combined primary end-point at 3-years according to the presence or absence of CKD. We included 248 p with mean age of 66.9 years, 25% women. CKD was present at baseline in 67 patients (27%). Patients with CKD were older (74.9 vs. 63.9 years; P<.0001) with more prevalence of hypertension (89.6 vs. 66.3%; P<.0001), diabetes (53.7 vs. 35.9%; P=.011), history of heart failure (13.4 vs. 3.9%; P=.006) and anemia (47.8 vs. 16%; P<.0001). No differences in the extent of coronary artery disease. CKD was associated with higher cumulative probability (49.3 vs. 28.2%; log-rank P=.001) and HR of the primary combined end-point (HR: 1.94; CI95%: 1.12-3.27; P=.012). CKD was an independent predictor of adverse cardiovascular outcomes at 3-years (HR: 1.66; CI95%: 1.05-2.61; P=.03). In NSTEACS patients treated with invasive strategie CKD is associated independently with an increased risk of adverse cardiovascular outcomes at 3years. Copyright © 2016 Sociedad Española de Nefrología. Published by Elsevier España, S.L.U. All rights reserved.

  10. Working Memory Capacity and Recall from Long-Term Memory: Examining the Influences of Encoding Strategies, Study Time Allocation, Search Efficiency, and Monitoring Abilities (United States)

    Unsworth, Nash


    The relation between working memory capacity (WMC) and recall from long-term memory (LTM) was examined in the current study. Participants performed multiple measures of delayed free recall varying in presentation duration and self-reported their strategy usage after each task. Participants also performed multiple measures of WMC. The results…

  11. Oral health care in older people in long term care facilities : A systematic review of implementation strategies

    NARCIS (Netherlands)

    Weening-Verbree, L.; Huisman-de Waal, G.; van Dusseldorp, L.; van Achterberg, T.; Schoonhoven, L.

    Objectives: Oral hygiene is necessary to maintain oral health and quality of life. However, the oral hygiene and the oral health care of older people in long term care facilities are poor. This indicates that care is not in compliance with the available guidelines and protocols, and stresses the

  12. Internal and external validation strategies for the evaluation of long-term effects in NIR calibration models. (United States)

    Sileoni, Valeria; van den Berg, Frans; Marconi, Ombretta; Perretti, Giuseppe; Fantozzi, Paolo


    Some of the practical aspects of long-term calibration-set building are presented in this study. A calibration model able to predict the Kolbach index for brewing malt is defined, and four different validations and resampling schemes were applied to determine its real predictive power. The results obtained demonstrated that one single performance criterion might be not sufficient and can lead to over- or underestimation of the model quality. Comparing a simple leave-one-sample-out cross-validation (CV) with two more challenging CVs with leave-N-samples-out, where the resamplings were repeated 200 times, it is demonstrated that the error of prediction value has an uncertainty, and these values change according to the type and the number of validation samples. Then, two kinds of test-set validations were applied, using data blocks based on the sample collection's year, demonstrating that it is necessary to consider long-term effects on NIR calibrations and to be conservative in the number of factors selected. The conclusion is that one should be modest in reporting the prediction error because it changes according to the type of validation used to estimate it and it is necessary to consider the long-term effects.

  13. Decomposition of 15N-labelled ryegrass in soils from a long-term field experiment with different manuring strategies

    DEFF Research Database (Denmark)

    Jensen, B.K.; Jensen, E.S.; Magid, J.


    The cycling of nitrogen in agroecosystems is influenced by the amount and quality of organic matter applied to soils. The N-mineralization of N-15-labelled ryegrass (Lolium perenne L.) was significantly slightly higher in a soil with long-term application of a high amount of farmyard manure (FYM......) than in soils receiving either mineral fertilizer, a low amount of FYM or no manure. However, in general the decomposition of ryegrass in the selected soils varied only slightly. The microbial decomposition processes differed somewhat in the soil manured with a low amount of FYM from those receiving...

  14. Long-term effects of early parasite exposure on song duration and singing strategy in great tits


    Bischoff, Linda L.; Tschirren, Barbara; Richner, Heinz


    Song is a sexually selected trait in many bird species and has been suggested to function as a signal of a male's health and parasite resistance. Here we present an experimental field study on the long-term effects of parasite exposure early in life on adult bird song. We exposed nestling great tits (Parus major) to ectoparasitic hen fleas (Ceratophyllus gallinae) and on their recruitment into the local breeding population assessed the response to a playback of a challenging male in their bre...

  15. Long-term effects of early parasite exposure on song duration and singing strategy in great tits


    Bischoff, Linda; Tschirren, Barbara; Richner, Heinz


    Song is a sexually selected trait in many bird species and has been suggested to function as a signal of a male's health and parasite resistance. Here we present an experimental field study on the long-term effects of parasite exposure early in life on adult bird song. We exposed nestling great tits (Parus major) to ectoparasitic hen fleas (Ceratophyllus gallinae) and on their recruitment into the local breeding population assessed the response to a playback of a challenging male in their bre...

  16. Enabling Strategy Formulation by ICT: A Viable Systems Approach

    NARCIS (Netherlands)

    Vriens, D.J.; Achterbergh, J.M.I.M.


    In this chapter the role of ICT for competitive intelligence is approached from the perspective of strategy formulation. The authors hold the view that competitive intelligence can be seen as knowledge necessary for the process of strategy formulation. To determine the role of ICT, it is proposed to

  17. Is Microcredit a Viable Strategy for Empowering Women?

    African Journals Online (AJOL)

    target women and provide accompanying education on health, nutrition, family planning, financial planning and budgeting and microenterprise development. The strategy for credit delivery differs from microcredit to microcredit. An important policy of credit schemes is the establishment of loan beneficiary selection criteria.

  18. Strategy for identifying natural analogs of the long-term performance of low-level waste disposal sites

    Energy Technology Data Exchange (ETDEWEB)

    Chatters, J.C.; Waugh, W.J.; Foley, M.G.; Kincaid, C.T.


    The US Department of Energy's Low-Level Waste (LLW) Management Program has asked Pacific Northwest Laboratory (PNL) to explore the feasibility of using natural analogs of anticipated waste site and conditions to help validate predictions of the performance of LLW disposal sites. Current regulations require LLW facilities to control the spread of hazardous substances into the environment for at least the next 500 years. Natural analog studies can provide information about processes affecting waste containment that cannot be fully explored through laboratory experimentation and modeling because of the extended period of required performance. For LLW applications, natural analogs include geochemical systems, pedogenic (soil formation) indicators, proxy climate data, and ecological and archaeological settings that portray long-term changes in disposal site environments and the survivability of proposed waste containment materials and structures. Analog data consist of estimates of performance assessment (PA) model input parameters that define possible future environmental states of waste sites, validation parameters that can be predicted by PA models, and descriptive information that can build public confidence in waste disposal practices. This document describes PNL's overall stategy for identifying analogs for LLW disposal systems, reviews lessons learned from past analogs work, outlines the findings of the workshop, and presents examples of analog studies that workshop participants found to be applicable to LLW performance assessment. The lessons from the high-level waste analogs experience and workshop discussions will be used to develop detailed study plans during FY 1990. 39 refs.

  19. Measuring success in obesity prevention: a synthesis of Health Promotion Switzerland's long-term monitoring and evaluation strategy. (United States)

    Ackermann, Günter; Kirschner, Michael; Guggenbühl, Lisa; Abel, Bettina; Klohn, Axel; Mattig, Thomas


    Since 2007, Health Promotion Switzerland has implemented a national priority program for a healthy body weight. This article provides insight into the methodological challenges and results of the program evaluation. Evaluation of the long-term program required targeted monitoring and evaluation projects addressing different outcome levels. The evaluation was carried out according to the Swiss Model for Outcome Classification (SMOC), a model designed to classify the effects of health promotion and prevention efforts. The results presented in this article emphasize both content and methods. The national program successfully achieved outcomes on many different levels within complex societal structures. The evaluation system built around the SMOC enabled assessment of program progress and the development of key indicators. However, it is not possible to determine definitively to what extent the national program helped stabilize the prevalence of obesity in Switzerland. The model has shown its utility in providing a basis for evaluation and monitoring of the national program. Continuous analysis of data from evaluation and monitoring has made it possible to check the plausibility of suspected causal relationships as well as to establish an overall perspective and assessment of effectiveness supported by a growing body of evidence. © 2015 S. Karger GmbH, Freiburg.

  20. [Usefulness of group work as a teaching strategy for long-term practical training in the 6-year pharmaceutical education]. (United States)

    Kubo, Kazuko; Okazaki, Hiromi; Ichikawa, Hiroki; Nishihara, Shigeki; Nawa, Hideki; Okazaki, Masatoshi; Kawasaki, Yoichi; Nakura, Hironori; Matsunaga, Hisashi; Sendo, Toshiaki


    At the initiation of long-term practical training in the 6-year pharmaceutical education, there are many issues to be solved. For example, it is necessary for teaching pharmacists, who are in charge of both staffing and teaching pharmacy students, to manage their workload with other staff pharmacists. To overcome this situation and to improve the motivation of teaching pharmacists towards student practical training, we twice held group work (GW) sessions for teaching pharmacists, and then evaluated whether such training was effective for their understanding of the Model Core Curriculum for Practical Training and for promoting a higher level of motivation. During the two-day GW discussions, teaching pharmacists, who work daily in the dispensing area, were separated into two groups to discuss teaching skills. A questionnaire survey was completed by participants before and after each GW session. According to the survey, more than 90% of the pharmacists had a higher motivation level for practical training after the sessions. Particularly in the second GW training, the response rate of "being actively involved" improved from 40% to 70%. Furthermore, "The Educational Evaluation Testing" was conducted, which confirmed the increased participant comprehension. The median scores of the comprehensive exams significantly (pmotivating teaching pharmacists involved in the practical training of students. We hope that this exercise will lead to higher student motivation and satisfaction during their practical training.

  1. Measuring Success in Obesity Prevention: A Synthesis of Health Promotion Switzerland's Long-Term Monitoring and Evaluation Strategy

    Directory of Open Access Journals (Sweden)

    Günter Ackermann


    Full Text Available Aims: Since 2007, Health Promotion Switzerland has implemented a national priority program for a healthy body weight. This article provides insight into the methodological challenges and results of the program evaluation. Methods: Evaluation of the long-term program required targeted monitoring and evaluation projects addressing different outcome levels. The evaluation was carried out according to the Swiss Model for Outcome Classification (SMOC, a model designed to classify the effects of health promotion and prevention efforts. Results: The results presented in this article emphasize both content and methods. The national program successfully achieved outcomes on many different levels within complex societal structures. The evaluation system built around the SMOC enabled assessment of program progress and the development of key indicators. However, it is not possible to determine definitively to what extent the national program helped stabilize the prevalence of obesity in Switzerland. Conclusion: The model has shown its utility in providing a basis for evaluation and monitoring of the national program. Continuous analysis of data from evaluation and monitoring has made it possible to check the plausibility of suspected causal relationships as well as to establish an overall perspective and assessment of effectiveness supported by a growing body of evidence.


    Directory of Open Access Journals (Sweden)

    Elena Mikhaylovna Galishnikova


    Full Text Available This article deals with the development and implementation of a long-term strategy of the organization of independent work of undergraduate and graduate students by means of a foreign language, which allows designing a vector for further professional and personal development of the future specialist. The proposed strategy is based on a four-step approach, providing for the integration of communication means of training and information technology, streamlining effective means and forms of implementation of the independent work and the control, strengthening the relationships between a student and a teacher, the principle of continuity and consistency. The methods of theoretical and empirical studies were used; there were described the stages of the approach, that is the basis of the strategy itself. Based on the stages, the sequence of the controlled independent work systematic elements was defined; its forms and types were grouped and specified. The mastery performance criteria for competence in the discipline “Foreign language” were defined and refined. The authors cite data of the experimental studies proving the positive impact of the implementation of the long-term strategy of the organization of independent work of students on formation of professional foreign language competence.

  3. Cognitive Strategy Use and Measured Numeric Ability in Immediate- and Long-Term Recall of Everyday Numeric Information (United States)

    Bermingham, Douglas; Hill, Robert D.; Woltz, Dan; Gardner, Michael K.


    The goals of this study were to assess the primary effects of the use of cognitive strategy and a combined measure of numeric ability on recall of every-day numeric information (i.e. prices). Additionally, numeric ability was assessed as a moderator in the relationship between strategy use and memory for prices. One hundred participants memorized twelve prices that varied from 1 to 6 digits; they recalled these immediately and after 7 days. The use of strategies, assessed through self-report, was associated with better overall recall, but not forgetting. Numeric ability was not associated with either better overall recall or forgetting. A small moderating interaction was found, in which higher levels of numeric ability enhanced the beneficial effects of strategy use on overall recall. Exploratory analyses found two further small moderating interactions: simple strategy use enhanced overall recall at higher levels of numeric ability, compared to complex strategy use; and complex strategy use was associated with lower levels of forgetting, but only at higher levels of numeric ability, compared to the simple strategy use. These results provide support for an objective measure of numeric ability, as well as adding to the literature on memory and the benefits of cognitive strategy use. PMID:23483964

  4. A novel HPLC-MRM strategy to discover unknown and long-term metabolites of stanozolol for expanding analytical possibilities in doping-control. (United States)

    Wang, Zhe; Zhou, Xinmiao; Liu, Xin; Dong, Ying; Zhang, Jinlan


    Stanozolol is one of the most commonly abused anabolic androgenic steroids (AAS) by athletes and usually detected by its parent drug and major metabolites. However, its metabolic pathway is complex, varied and individually different, it is important to characterize its overall metabolic profiles and discover new and long-term metabolites for the aims of expanding detection windows. High performance liquid chromatography coupled with triple quadrupole mass spectrometer (HPLC-MS/MS) was used to analyze the human urine after oral administration of stanozolol. Multiple reaction monitoring (MRM), one of the scan modes of triple quadrupole mass spectrometer showing extremely high sensitivity was well used to develop a strategy for metabolic profiles characterization and long-term metabolites detection based on typical precursor to product ion transitions of parent drug and its major metabolites. Utilizing the characteristic fragment ions of stanozolol and its major metabolites as the product ions, and speculating unknown precursor ions based on the possible phase I and phase II metabolic reactions in human body, the metabolite profiles of stanozolol could be comprehensively discovered, especially for those unknown and low concentration metabolites in human urine. Then these metabolites were further well structure identified by targeted high resolution MS/MS scan of quadrupole-time of flight mass spectrometry (Q-TOF). Applying this strategy, 27 phase I and 21 phase II metabolites of stanozolol were identified, in which 13 phase I and 14 phase II metabolites have not been reported previously. The 9 out of 48 metabolites could be detected over 15days post drug administration. This strategy could be employed effectively to characterize AAS metabolic profiles and discover unknown and long-term metabolites in sports drug testing. Copyright © 2016 Elsevier B.V. All rights reserved.

  5. Public strategies for improving eHealth integration and long-term sustainability in public health care systems: Findings from an Italian case study. (United States)

    De Rosis, Sabina; Nuti, Sabina


    eHealth is expected to contribute in tackling challenges for health care systems. However, it also imposes challenges. Financing strategies adopted at national as well regional levels widely affect eHealth long-term sustainability. In a public health care system, the public actor is among the main "buyers" eHealth. However, public interventions have been increasingly focused on cost containment. How to match these 2 aspects? This article explores some central issues, mainly related to financial aspects, in the development of effective and valuable eHealth strategies in a public health care system: How can the public health care system (as a "buyer") improve long-term success and sustainability of eHealth solutions? What levers are available to match in the long period different interests of different stakeholders in the eHealth field? A case study was performed in the Region of Tuscany, Italy. According to our results, win-win strategies should be followed. Investments should take into account the need to long-term finance solutions, for sustaining changes in health care organizations for obtaining benefits. To solve the interoperability issues, the concept of the "platform approach" emerged, based on collaboration within and between organizations. Private sector as well as beneficiaries and final users of the eHealth solutions should participate in their design, provision, and monitoring. For creating value for all, the evidence gap and the financial needs could be addressed with a pull mechanism of funding, aimed at paying according to the outcomes produced by the eHealth solution, on the base of an ongoing monitoring, measurement, and evaluation of the outcomes. © 2017 The Authors. The International Journal of Health Planning and Management published by John Wiley & Sons Ltd.

  6. Long-term effectiveness of the integrated schistosomiasis control strategy with emphasis on infectious source control in China: a 10-year evaluation from 2005 to 2014. (United States)

    Wang, Xiaoli; Wang, Wei; Wang, Peng


    Schistosomiasis is a neglected tropical parasitic disease of great public health significance worldwide. Currently, mass drug administration with praziquantel remains the major strategy for global schistosomiasis control programs. Since 2005, an integrated strategy with emphasis on infectious source control was implemented for the control of schistosomiasis japonica, a major public health concern in China, and pilot studies have demonstrated that such a strategy is effective to reduce the prevalence of Schistosoma japonicum infection in both humans and bovines. However, there is little knowledge on the long-term effectiveness of this integrated strategy for controlling schistosomiasis japonica. The aim of this study was to evaluate the long-term effectiveness of the integrated strategy for schistosomiasis control following the 10-year implementation, based on the data from the national schistosomiasis control program released by the Ministry of Health, People's Republic of China. In 2014, there were 5 counties in which the transmission of schistosomiasis japonica had not been interrupted, which reduced by 95.2% as compared to that in 2005 (105 counties). The number of schistosomiasis patients and acute cases reduced by 85.5 and 99.7% in 2014 (115,614 cases and 2 cases) as compared to that in 2005 (798,762 cases and 564 cases), and the number of bovines and S. japonicum-infected bovines reduced by 47.9 and 98% in 2014 (919,579 bovines and 666 infected bovines) as compared to that in 2005 (1,764,472 bovines and 33,736 infected bovines), respectively. During the 10-year implementation of the integrated strategy, however, there was a minor fluctuation in the area of Oncomelania hupensis snail habitats, and there was only a 5.6% reduction in the area of snail habitats in 2014 relative to in 2005. The results of the current study demonstrate that the 10-year implementation of the integrated strategy with emphasis on infectious source has greatly reduced schistosomiasis

  7. Nova estratégia de desenvolvimento para o Brasil: um enfoque de longo prazo New development strategy for Brazil: a long-term vision

    Directory of Open Access Journals (Sweden)

    João Paulo de Almeida Magalhães


    Full Text Available The foremost aim of the article is to propose a new development strategy for Brazil, replacing the neoliberal model presently used. In short, the point is to recover a long term vision of the economic policies. And for that it is indispensable to take into consideration the recent evolution of the Development Economics which considers the existence of market, instead of the availability of savings, as the main condition in economic development policies. The acceptance of the market as the basic condition for successful development policies has as one of its consequences the unacceptability of the process of globalization with its present characteristics.

  8. Depressive symptoms among older adults with long-term spinal cord injury: Associations with secondary health conditions, sense of coherence, coping strategies and physical activity

    Directory of Open Access Journals (Sweden)

    Sophie Jörgensen


    Full Text Available Objectives: To assess the presence of depressive symptoms among older adults with long-term spinal cord injury and investigate the association with sociodemographic and injury characteristics; and to determine how potentially modifiable factors, i.e. secondary health conditions, sense of coherence, coping strategies and leisure-time physical activity, are associated with depressive symptoms. Design: Cross-sectional study. Subjects: A total of 122 individuals (70% men, injury levels C1–L5, American Spinal Injury Association Impairment Scale A–D, mean age 63 years, mean time since injury 24 years. Methods: Data from the Swedish Aging with Spinal Cord Injury Study, collected using the Geriatric Depression Scale-15, the 13-item Sense of Coherence Scale, the Spinal Cord Lesion-related Coping Strategies Questionnaire and the Physical Activity Recall Assessment for people with Spinal Cord Injury. Associations were analysed using multivariable linear regression. Results: A total of 29% reported clinically relevant depressive symptoms and 5% reported probable depression. Sense of coherence, the coping strategy Acceptance, neuropathic pain and leisure-time physical activity explained 53% of the variance in depressive symptoms. Conclusion: Older adults with long-term spinal cord injury report a low presence of probable depression. Mental health may be supported through rehabilitation that strengthens the ability to understand and confront life stressors, promotes acceptance of the injury, provides pain management and encourages participation in leisure-time physical activity.

  9. New Strategies To Combat Long-Term Unemployment in Belgium, Denmark and the United Kingdom. Synthesis Report = Nouvelles strategies de lutte contre le chomage de longue duree en Belgigue, au Danemark, et au Royaume-Uni. Rapport de synthese. (United States)

    Geers, Frederik; And Others

    This synthesis report provides information to policy makers, practitioners, and researchers on the new strategies and measures adopted in Belgium, Denmark, and the United Kingdom to combat long-term unemployment. It begins with a summary of strategies and measures adopted in each of the three countries. Each country report highlights the following…

  10. Long-term collections

    CERN Multimedia

    Collectes à long terme


    The Committee of the Long Term Collections (CLT) asks for your attention for the following message from a young Peruvian scientist, following the earthquake which devastated part of her country a month ago.

  11. Gene therapy strategy for long-term myocardial protection using adeno-associated virus-mediated delivery of heme oxygenase gene. (United States)

    Melo, Luis G; Agrawal, Reitu; Zhang, Lunan; Rezvani, Mojgan; Mangi, Abeel A; Ehsan, Afshin; Griese, Daniel P; Dell'Acqua, Giorgio; Mann, Michael J; Oyama, Junichi; Yet, Shaw-Fang; Layne, Matthew D; Perrella, Mark A; Dzau, Victor J


    Ischemia and oxidative stress are the leading mechanisms for tissue injury. An ideal strategy for preventive/protective therapy would be to develop an approach that could confer long-term transgene expression and, consequently, tissue protection from repeated ischemia/reperfusion injury with a single administration of a therapeutic gene. In the present study, we used recombinant adeno-associated virus (rAAV) as a vector for direct delivery of the cytoprotective gene heme oxygenase-1 (HO-1) into the rat myocardium, with the purpose of evaluating this strategy as a therapeutic approach for long-term protection from ischemia-induced myocardial injury. Human HO-1 gene (hHO-1) was delivered to normal rat hearts by intramyocardial injection. AAV-mediated transfer of the hHO-1 gene 8 weeks before acute coronary artery ligation and release led to a dramatic reduction (>75%) in left ventricular myocardial infarction. The reduction in infarct size was accompanied by decreases in myocardial lipid peroxidation and in proapoptotic Bax and proinflammatory interleukin-1beta protein abundance, concomitant with an increase in antiapoptotic Bcl-2 protein level. This suggested that the transgene exerts its cardioprotective effects in part by reducing oxidative stress and associated inflammation and apoptotic cell death. This study documents the beneficial therapeutic effect of rAAV-mediated transfer, before myocardial injury, of a cytoprotective gene that confers long-term myocardial protection from ischemia/reperfusion injury. Our data suggest that this novel "pre-event" gene transfer approach may provide sustained tissue protection from future repeated episodes of injury and may be beneficial as preventive therapy for patients with or at risk of developing coronary ischemic events.

  12. Simulation of Long-Term Carbon and Nitrogen Dynamics in Grassland-Based Dairy Farming Systems to Evaluate Mitigation Strategies for Nutrient Losses. (United States)

    Shah, Ghulam Abbas; Groot, Jeroen C J; Shah, Ghulam Mustafa; Lantinga, Egbert A


    Many measures have been proposed to mitigate gaseous emissions and other nutrient losses from agroecosystems, which can have large detrimental effects for the quality of soils, water and air, and contribute to eutrophication and global warming. Due to complexities in farm management, biological interactions and emission measurements, most experiments focus on analysis of short-term effects of isolated mitigation practices. Here we present a model that allows simulating long-term effects at the whole-farm level of combined measures related to grassland management, animal housing and manure handling after excretion, during storage and after field application. The model describes the dynamics of pools of organic carbon and nitrogen (N), and of inorganic N, as affected by farm management in grassland-based dairy systems. We assessed the long-term effects of delayed grass mowing, housing type (cubicle and sloping floor barns, resulting in production of slurry and solid cattle manure, respectively), manure additives, contrasting manure storage methods and irrigation after application of covered manure. Simulations demonstrated that individually applied practices often result in compensatory loss pathways. For instance, methods to reduce ammonia emissions during storage like roofing or covering of manure led to larger losses through ammonia volatilization, nitrate leaching or denitrification after application, unless extra measures like irrigation were used. A strategy of combined management practices of delayed mowing and fertilization with solid cattle manure that is treated with zeolite, stored under an impermeable sheet and irrigated after application was effective to increase soil carbon stocks, increase feed self-sufficiency and reduce losses by ammonia volatilization and soil N losses. Although long-term datasets (>25 years) of farm nutrient dynamics and loss flows are not available to validate the model, the model is firmly based on knowledge of processes and

  13. Simulation of Long-Term Carbon and Nitrogen Dynamics in Grassland-Based Dairy Farming Systems to Evaluate Mitigation Strategies for Nutrient Losses.

    Directory of Open Access Journals (Sweden)

    Ghulam Abbas Shah

    Full Text Available Many measures have been proposed to mitigate gaseous emissions and other nutrient losses from agroecosystems, which can have large detrimental effects for the quality of soils, water and air, and contribute to eutrophication and global warming. Due to complexities in farm management, biological interactions and emission measurements, most experiments focus on analysis of short-term effects of isolated mitigation practices. Here we present a model that allows simulating long-term effects at the whole-farm level of combined measures related to grassland management, animal housing and manure handling after excretion, during storage and after field application. The model describes the dynamics of pools of organic carbon and nitrogen (N, and of inorganic N, as affected by farm management in grassland-based dairy systems. We assessed the long-term effects of delayed grass mowing, housing type (cubicle and sloping floor barns, resulting in production of slurry and solid cattle manure, respectively, manure additives, contrasting manure storage methods and irrigation after application of covered manure. Simulations demonstrated that individually applied practices often result in compensatory loss pathways. For instance, methods to reduce ammonia emissions during storage like roofing or covering of manure led to larger losses through ammonia volatilization, nitrate leaching or denitrification after application, unless extra measures like irrigation were used. A strategy of combined management practices of delayed mowing and fertilization with solid cattle manure that is treated with zeolite, stored under an impermeable sheet and irrigated after application was effective to increase soil carbon stocks, increase feed self-sufficiency and reduce losses by ammonia volatilization and soil N losses. Although long-term datasets (>25 years of farm nutrient dynamics and loss flows are not available to validate the model, the model is firmly based on knowledge of

  14. Strategies for Successful Long-Term Engagement of Adults With Phenylalanine Hydroxylase Deficiency Returning to the Clinic

    Directory of Open Access Journals (Sweden)

    Janet Thomas MD


    Full Text Available Nearly half of all patients diagnosed with phenylalanine hydroxylase (PAH deficiency, also known as phenylketonuria, are lost to follow-up (LTFU; most are adults who stopped attending clinic after the age of 18 years. To understand why adult patients with PAH deficiency disengage from their clinic, a focus group of 8 adults with PAH deficiency who had been LTFU for 2 or more years was held in March 2016. Ten clinicians observed the focus group and discussed strategies for successfully reengaging adult patients and encouraging lifelong management of PAH deficiency. Four strategies were proposed: (1 create a safe, supportive environment, (2 acknowledge patients as partners in their care, (3 develop individualized management plans, and (4 provide patients with additional resources. These strategies provide a framework to motivate change in clinical practice to meet the unique needs of adults with PAH deficiency.

  15. Strategies to reduce long-term postchemoradiation dysphagia in patients with head and neck cancer: an evidence-based review.

    NARCIS (Netherlands)

    Paleri, V.; Roe, J.W.; Strojan, P.; Corry, J.; Gregoire, V.; Hamoir, M.; Eisbruch, A.; Mendenhall, W.M.; Silver, C.E.; Rinaldo, A.; Takes, R.P.; Ferlito, A.


    BACKGROUND: Swallowing dysfunction following chemoradiation for head and neck cancer is a major cause of morbidity and reduced quality of life. This review discusses 3 strategies that may improve posttreatment swallowing function. METHODS: The literature was assessed by a multiauthor team that

  16. Seven ‘corporate venturing’ strategies to foster innovation (and create an environment for long-term growth)

    NARCIS (Netherlands)

    Vermeulen, Erik; Fenwick, Mark


    Seven “Corporate Venturing” Strategies to Foster Innovation tackles the question: What should companies do to accelerate innovation and remain relevant? Or, stated differently: What should companies do to avoid being disrupted by more agile and innovative startups? One answer is corporate venturing.

  17. Long-Term Effects of Haematopoietic Stem Cell Transplantation after Pediatric Cancer: A Qualitative Analysis of Life Experiences and Adaptation Strategies

    Directory of Open Access Journals (Sweden)

    Magali Lahaye


    Full Text Available Haematopoietic stem cell transplantation (HSCT improves the survival rate of children and adolescents with malignant and non-malignant conditions; however, the physical, psychological and social burden of such a procedure is considerable both during and after treatment. The present qualitative study investigated the long-term effects of HSCT after pediatric cancer. Thirty adolescent and young adult (AYA survivors (Mage = 23.61 years, SD = 5.21 participated in individual interviews and were invited to speak about their life experiences following their treatment and strategies they use to deal with their past medical experiences and the long-term sequelae. Our results showed the presence of ongoing physical and psychosocial consequences of their past illness and its treatments with wide ranging psychosocial impacts, such as affected self-image, social withdrawal, sense of lack of choice, and need for specific attention. Different strategies were reported to overcome these consequences, such as talking about illness, giving a sense to their past medical experiences, and developing meaningful social relationships. Clinical and research implications are also discussed.

  18. Long-term energy and climate implications of carbon capture and storage deployment strategies in the US coal-fired electricity fleet. (United States)

    Sathre, Roger; Masanet, Eric


    To understand the long-term energy and climate implications of different implementation strategies for carbon capture and storage (CCS) in the US coal-fired electricity fleet, we integrate three analytical elements: scenario projection of energy supply systems, temporally explicit life cycle modeling, and time-dependent calculation of radiative forcing. Assuming continued large-scale use of coal for electricity generation, we find that aggressive implementation of CCS could reduce cumulative greenhouse gas emissions (CO(2), CH(4), and N(2)O) from the US coal-fired power fleet through 2100 by 37-58%. Cumulative radiative forcing through 2100 would be reduced by only 24-46%, due to the front-loaded time profile of the emissions and the long atmospheric residence time of CO(2). The efficiency of energy conversion and carbon capture technologies strongly affects the amount of primary energy used but has little effect on greenhouse gas emissions or radiative forcing. Delaying implementation of CCS deployment significantly increases long-term radiative forcing. This study highlights the time-dynamic nature of potential climate benefits and energy costs of different CCS deployment pathways and identifies opportunities and constraints of successful CCS implementation.

  19. Polymer-Based Surfaces Designed to Reduce Biofilm Formation: From Antimicrobial Polymers to Strategies for Long-Term Applications. (United States)

    Riga, Esther K; Vöhringer, Maria; Widyaya, Vania Tanda; Lienkamp, Karen


    Contact-active antimicrobial polymer surfaces bear cationic charges and kill or deactivate bacteria by interaction with the negatively charged parts of their cell envelope (lipopolysaccharides, peptidoglycan, and membrane lipids). The exact mechanism of this interaction is still under debate. While cationic antimicrobial polymer surfaces can be very useful for short-term applications, they lose their activity once they are contaminated by a sufficiently thick layer of adhering biomolecules or bacterial cell debris. This layer shields incoming bacteria from the antimicrobially active cationic surface moieties. Besides discussing antimicrobial surfaces, this feature article focuses on recent strategies that were developed to overcome the contamination problem. This includes bifunctional materials with simultaneously presented antimicrobial and protein-repellent moieties; polymer surfaces that can be switched from an antimicrobial, cell-attractive to a cell-repellent state; polymer surfaces that can be regenerated by enzyme action; degradable antimicrobial polymers; and antimicrobial polymer surfaces with removable top layers. © 2017 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  20. Long-Term Collections

    CERN Multimedia

    Comité des collectes à long terme


    It is the time of the year when our fireman colleagues go around the laboratory for their traditional calendars sale. A part of the money of the sales will be donated in favour of the long-term collections. We hope that you will welcome them warmly.

  1. Human resources for health strategies adopted by providers in resource-limited settings to sustain long-term delivery of ART: a mixed-methods study from Uganda. (United States)

    Zakumumpa, Henry; Taiwo, Modupe Oladunni; Muganzi, Alex; Ssengooba, Freddie


    Human resources for health (HRH) constraints are a major barrier to the sustainability of antiretroviral therapy (ART) scale-up programs in Sub-Saharan Africa. Many prior approaches to HRH constraints have taken a top-down trend of generalized global strategies and policy guidelines. The objective of the study was to examine the human resources for health strategies adopted by front-line providers in Uganda to sustain ART delivery beyond the initial ART scale-up phase between 2004 and 2009. A two-phase mixed-methods approach was adopted. In the first phase, a survey of a nationally representative sample of health facilities (n = 195) across Uganda was conducted. The second phase involved in-depth interviews (n = 36) with ART clinic managers and staff of 6 of the 195 health facilities purposively selected from the first study phase. Quantitative data was analysed based on descriptive statistics, and qualitative data was analysed by coding and thematic analysis. The identified strategies were categorized into five themes: (1) providing monetary and non-monetary incentives to health workers on busy ART clinic days; (2) workload reduction through spacing ART clinic appointments; (3) adopting training workshops in ART management as a motivation strategy for health workers; (4) adopting non-physician-centred staffing models; and (5) devising ART program leadership styles that enhanced health worker commitment. Facility-level strategies for responding to HRH constraints are feasible and can contribute to efforts to increase country ownership of HIV programs in resource-limited settings. Consideration of the human resources for health strategies identified in the study by ART program planners and managers could enhance the long-term sustainment of ART programs by providers in resource-limited settings.

  2. Long-term consequences of selected competitive strategies during deregulation of the United States electric utility industry: System dynamics modeling and simulation (United States)

    Khalil, Yehia Fahim

    Currently, U.S. investor-owned utilities (IOUs) are facing major reforms in their business environment similar to the airlines, telecommunications, banking, and insurance industries. As a result, IOUs are gearing up for fierce price competition in the power generation sector, and are vying for electricity customers outside their franchised service territories. Energy experts predict that some IOUs may suffer fatal financial setbacks (especially those with nuclear plants), while others may thrive under competition. Both federal and state energy regulators anticipate that it may take from five to ten years to complete the transition of America's electric utility industry from a regulated monopoly to a market-driven business. During this transition, utility executives are pursuing aggressive business strategies to confront the upcoming price wars. The most compelling strategies focus on cutting operation and maintenance (O&M) costs of power production, downsizing the work force, and signing bilateral energy agreements with large price-sensitive customers to retain their business. This research assesses the impact of the three pivotal strategies on financial performance of utilities during transition to open market competition. A system-dynamics-based management flight simulator has been developed to predict the dynamic performance of a hypothetical IOU organization preparing for market competition. The simulation results show that while the three business strategies lead to short-lived gains, they also produce unanticipated long-term consequences that adversely impact the organization's operating revenues. Generally, the designed flight simulator serves as a learning laboratory which allows management to test new strategies before implementation.

  3. Long-term weight loss maintenance

    National Research Council Canada - National Science Library

    Wing, Rena R; Phelan, Suzanne


    ...% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss...

  4. Long-Term Collections

    CERN Multimedia

    Staff Association


    45 years helping in developing countries! CERN personnel have been helping the least fortunate people on the planet since 1971. How? With the Long-Term Collections! Dear Colleagues, The Staff Association’s Long-Term Collections (LTC) Committee is delighted to share this important milestone in the life of our Laboratory with you. Indeed, whilst the name of CERN is known worldwide for scientific discoveries, it also shines in the many humanitarian projects which have been supported by the LTC since 1971. Several schools and clinics, far and wide, carry its logo... Over the past 45 years, 74 projects have been supported (9 of which are still ongoing). This all came from a group of colleagues who wanted to share a little of what life offered them here at CERN, in this haven of mutual understanding, peace and security, with those who were less fortunate elsewhere. Thus, the LTC were born... Since then, we have worked as a team to maintain the dream of these visionaries, with the help of regular donat...

  5. Long-Term Collection

    CERN Multimedia

    Staff Association


    Dear Colleagues, As previously announced in Echo (No. 254), your delegates took action to draw attention to the projects of the Long-Term Collections (LTC), the humanitarian body of the CERN Staff Association. On Tuesday, 11 October, at noon, small Z-Cards were widely distributed at the entrances of CERN restaurants and we thank you all for your interest. We hope to have achieved an important part of our goal, which was to inform you, convince you and find new supporters among you. We will find out in the next few days! An exhibition of the LTC was also set up in the Main Building for the entire week. The Staff Association wants to celebrate the occasion of the Long-Term Collection’s 45th anniversary at CERN because, ever since 1971, CERN personnel have showed great support in helping the least fortunate people on the planet in a variety of ways according to their needs. On a regular basis, joint fundraising appeals are made with the Directorate to help the victims of natural disasters around th...

  6. Collectes à long terme

    CERN Multimedia

    Collectes à long terme


    En cette fin d’année 2014 qui approche à grands pas, le Comité des Collectes à Long Terme remercie chaleureusement ses fidèles donatrices et donateurs réguliers pour leurs contributions à nos actions en faveur des plus démunis de notre planète. C’est très important, pour notre Comité, de pouvoir compter sur l’appui assidu que vous nous apportez. Depuis plus de 40 ans maintenant, le modèle des CLT est basé principalement sur des actions à long terme (soit une aide pendant 4-5 ans par projet, mais plus parfois selon les circonstances), et sa planification demande une grande régularité de ses soutiens financiers. Grand MERCI à vous ! D’autres dons nous parviennent au cours de l’année, et ils sont aussi les bienvenus. En particulier, nous tenons à remercier...

  7. The connection between long-term and short-term risk management strategies: examples from land-use planning and emergency management in four European case studies (United States)

    Prenger-Berninghoff, K.; Cortes, V. J.; Sprague, T.; Aye, Z. C.; Greiving, S.; Głowacki, W.; Sterlacchini, S.


    The need for continuous adaptation to complex and unforeseen events requires enhancing the links between planning and preparedness phases to reduce future risks in the most efficient way. In this context, the legal-administrative and cultural context has to be taken into account. This is why four case study areas of the CHANGES1 project (Nehoiu Valley in Romania, Ubaye Valley in France, Val Canale in Italy, and Wieprzówka catchment in Poland) serve as examples to highlight currently implemented risk management strategies for land-use planning and emergency preparedness. The strategies described in this paper were identified by means of exploratory and informal interviews in each study site. Results reveal that a dearth or, in very few cases, a weak link exists between spatial planners and emergency managers. Management strategies could benefit from formally intensifying coordination and cooperation between emergency services and spatial planning authorities. Moreover, limited financial funds urge for a more efficient use of resources and better coordination towards long-term activities. The research indicates potential benefits to establishing or, in some cases, strengthening this link and provides suggestions for further development in the form of information and decision support systems as a key connection point. Aside from the existent information systems for emergency management, it was found that a common platform, which integrates involvement of these and other relevant actors could enhance this connection and address expressed stakeholder needs. 1 Marie Curie ITN CHANGES - Changing Hydro-meteorological Risks as Analyzed by a New Generation of European Scientists.

  8. An investigation on the chemical stability and a novel strategy for long-term stabilization of diphenylalanine nanostructures in aqueous solution

    Directory of Open Access Journals (Sweden)

    H. Nezammahalleh


    Full Text Available The stability of diphenylalanine (FF microwires and microtubes in phosphate buffer solution was investigated and a novel strategy was developed for their chemical stabilization. This stability investigation was carried out by optical microscopy and by high performance liquid chromatography (HPLC. These microstructures dissolve in the solution depending upon their degree of FF saturation. The dissolution mechanisms of the structures in kinetically limited processes were found by accurately fitting the experimental dissolution data to a theoretical kinetic equation. The dissolution data were well fitted to the particular Avrami-Erofe’ev kinetic expression (R2 > 0.98. These findings suggest that the structures can be stabilized by a decrease in the hydration of the constituent molecules thorough a chemical conformational induced transition upon heat treatment. The stable microtubes were fabricated in a novel three step procedure consisting of the reduction of silver ions in unstable FF microtubes by a citrate reductant, the stabilization by chemical conformational induced transition upon heat treatment, and the consequent oxidation of the reduced silver by a persulfate oxidant. These materials were characterized by electron microscopy and powder X-ray diffraction techniques. The long-term stability of both structures was also confirmed by optical microscopy and HPLC.

  9. A BTLA-mediated bait-and-switch strategy permits Listeria expansion in CD8α+ DCs to promote long term T cell responses (United States)

    Yang, Xuanming; Zhang, Xunmin; Sun, Yonglian; Tu, Tony; Fu, May Lynne; Miller, Mendy; Fu, Yang-Xin


    SUMMARY Listeria monocytogenes infected CD8α+ DCs in the spleen are essential for CD8+ T cell generation. CD8α+ DCs are also necessary for Listeria expansion and dissemination within the host. The mechanisms that regulate CD8α+ DCs to allow Listeria expansion are unclear. We find that activating the B and T lymphocyte attenuator (BTLA), a co-inhibitory receptor on CD8α+ DCs, suppresses, while blocking BTLA enhances both the primary and memory CD8 T cell responses against Listeria. Btla−/− mice have lower effector and memory CD8+ T cells while paradoxically also being more resistant to Listeria. Although bacterial entry into Btla−/− CD8α+ DCs is unaffected, Listeria fails to expand within these cells. BTLA signaling limits Fas/FasL-mediated suppression of Listeria expansion within CD8α+ DCs to more effectively alert adaptive immune cells. This study uncovers a BTLA-mediated strategy used by the host that permits Listeria proliferation to enable increasing T cell responses for long-term protection. PMID:25011109

  10. Quiet eye training aids the long-term learning of throwing and catching in children: Preliminary evidence for a predictive control strategy. (United States)

    Miles, C A L; Wood, G; Vine, S J; Vickers, J N; Wilson, M R


    Quiet eye training (QET) may be a more effective method for teaching children to catch than traditional training (TT) methods, but it is unclear if the benefits accrued persist in the long term. Thirty children were randomly allocated into a QET or TT group and, while wearing a mobile eye tracker, underwent baseline testing, training and two retention tests over a period of eight weeks, using a validated throw and catch task. During training, movement-related information was provided to both groups, while the QET group received additional instruction to increase the duration of their targeting fixation (QE1) on the wall prior to the throw, and pursuit tracking (QE2) period on the ball prior to catching. In both immediate (R1) and delayed (R2, six weeks later) retention tests, the QET group had a significantly longer QE1 duration and an earlier and longer QE2 duration, compared to the TT group, who revealed no improvements. A performance advantage was also found for the QET compared to the TT group at both R1 and R2, revealing the relatively robust nature of the visuomotor alterations. Regression analyses suggested that only the duration of QE1 predicted variance in catch success post-training, pointing to the importance of a pre-programming visuomotor strategy for successful throw and catch performance.

  11. Science framework for conservation and restoration of the sagebrush biome: Linking the Department of the Interior’s Integrated Rangeland Fire Management Strategy to long-term strategic conservation actions (United States)

    J.C. Chambers; J.L. Beck; J.B. Bradford; J. Bybee; S. Campbell; J. Carlson; T.J. Christiansen; K.J. Clause; G. Collins; M.R. Crist; J.B. Dinkins; K.E. Doherty; F. Edwards; S. Espinosa; K.A. Griffin; P. Griffin; J.R. Haas; S.E. Hanser; D.W. Havlina; K.F. Henke; J.D. Hennig; L.A. Joyce; F.M. Kilkenny; S.M. Kulpa; L.L. Kurth; J.D. Maestas; M. Manning; K.E. Mayer; B.A. Mealor; C. McCarthy; M. Pellant; M.A. Perea; K.L. Prentice; D.A. Pyke; L.A. Wiechman; A. Wuenschel


    The Science Framework is intended to link the Department of the Interior’s Integrated Rangeland Fire Management Strategy with long-term strategic conservation actions in the sagebrush biome. The Science Framework provides a multiscale approach for prioritizing areas for management and determining effective management strategies within the sagebrush biome. The emphasis...

  12. Long-term scenarios and strategies for the deployment of renewable energies in Germany in view of European and global developments. Summary of the final report

    Energy Technology Data Exchange (ETDEWEB)

    Nitsch, Joachim; Pregger, Thomas; Scholz, Yvonne [Deutsches Zentrum fuer Luft- und Raumfahrt, Stuttgart (Germany). Abt. Systemanalyse und Technikbewertung] [and others


    The German Federal government's ''Energy Concept'' [Energiekonzept 2010] of 28 September 2010 and the subsequent energy laws of summer 2011 presented a long-term political timetable for climate protection and the transformation of the energy supply in Germany [the ''Energiewende'']. It calls for emissions of greenhouse gases in Germany to be reduced by 80% to 95% from the 1990 level by the year 2050. For energy-related CO{sub 2} emissions alone, this target requires a reduction of at least 85%, aiming in the final result at a power supply that is almost emission-free. A transformation of the power supply to renewable sources of energy, accompanied by a substantial increase in energy efficiency, is the appropriate strategy for this. The challenges presented by this transformation of the power system are considerable, and their full extent has not yet been grasped. This study presents results of systems-analysis examinations of the transformation of electricity, heat, and fuel generation that were developed as part of a three-year research project for the Federal Ministry of the Environment (final report [Nitsch et al. 2012]). The work is based on projects carried out in previous years by the DLR with varying project partners for the Federal Ministry for the Environment, Nature Conservation, and Nuclear Safety (BMU) and the Federal Environment Agency (UBA). In essence, self-consistent energy scenarios for long-term expansion of renewables and for the remaining supply of energy, and the structural and economic effects to be derived from these, were developed. In addition, the project partners, the DLR in Stuttgart and the Fraunhofer Institut fur Windenergie und Energiesystemtechnik (IWES) in Kassel, performed simulations of the future electricity supply as it develops over time, some of them with spatial resolution. This enabled the scenarios for electricity generation to be validated with respect to load coverage, and also

  13. A Two-Component DNA-Prime/Protein-Boost Vaccination Strategy for Eliciting Long-Term, Protective T Cell Immunity against Trypanosoma cruzi.

    Directory of Open Access Journals (Sweden)

    Shivali Gupta


    Full Text Available In this study, we evaluated the long-term efficacy of a two-component subunit vaccine against Trypanosoma cruzi infection. C57BL/6 mice were immunized with TcG2/TcG4 vaccine delivered by a DNA-prime/Protein-boost (D/P approach and challenged with T. cruzi at 120 or 180 days post-vaccination (dpv. We examined whether vaccine-primed T cell immunity was capable of rapid expansion and intercepting the infecting T. cruzi. Our data showed that D/P vaccine elicited CD4+ (30-38% and CD8+ (22-42% T cells maintained an effector phenotype up to 180 dpv, and were capable of responding to antigenic stimulus or challenge infection by a rapid expansion (CD8>CD4 with type 1 cytokine (IFNγ+ and TFNα+ production and cytolytic T lymphocyte (CTL activity. Subsequently, challenge infection at 120 or 180 dpv, resulted in 2-3-fold lower parasite burden in vaccinated mice than was noted in unvaccinated/infected mice. Co-delivery of IL-12- and GMCSF-encoding expression plasmids provided no significant benefits in enhancing the anti-parasite efficacy of the vaccine-induced T cell immunity. Booster immunization (bi with recombinant TcG2/TcG4 proteins 3-months after primary vaccine enhanced the protective efficacy, evidenced by an enhanced expansion (1.2-2.8-fold increase of parasite-specific, type 1 CD4+ and CD8+ T cells and a potent CTL response capable of providing significantly improved (3-4.5-fold control of infecting T. cruzi. Further, CD8+T cells in vaccinated/bi mice were predominantly of central memory phenotype, and capable of responding to challenge infection 4-6-months post bi by a rapid expansion to a poly-functional effector phenotype, and providing a 1.5-2.3-fold reduction in tissue parasite replication. We conclude that the TcG2/TcG4 D/P vaccine provided long-term anti-T. cruzi T cell immunity, and bi would be an effective strategy to maintain or enhance the vaccine-induced protective immunity against T. cruzi infection and Chagas disease.

  14. VAC therapy with long term continuous saline infusion for secondary septic peritonitis: A new strategy for the reduction of perioperative risks?

    Directory of Open Access Journals (Sweden)

    Fulvio Nisi


    Conclusion: Conservative therapy with antibiotic therapy and use of the Vacuum-Assisted Closure® (VAC Therapy with a long term continuous saline infusion led to the resolution of the septic shock and to the wound healing.

  15. Long-Term Management Strategy for Dredged Material Disposal for Naval Facilities at Pearl Harbor, Hawaii Phase III - Analysis of Alternatives and Development of an LTMS

    National Research Council Canada - National Science Library

    Palermo, Michael


    This report documents Phase III of a three-phase study to develop a Long-Term Management Study for disposal of dredged material unsuitable for ocean disposal from Pearl Harbor Naval Complex for the next 30 years...

  16. A Strategy to Conduct an Analysis of the Long-Term Performance of Low-Activity Waste Glass in a Shallow Subsurface Disposal System at Hanford

    Energy Technology Data Exchange (ETDEWEB)

    BP McGrail, WL Ebert, DH Bacon, DM Strachan


    Privatized services are being procured to vitrify low-activity tank wastes for eventual disposal in a shallow subsurface facility at the Hanford Site. Over 500,000 metric tons of low-activity waste glass will be generated, which is among the largest volumes of waste within the U.S. Department of Energy (DOE) complex and is one of the largest inventories of long-lived radionuclides planned for disposal in a low-level waste facility. Before immobilized waste can be disposed, DOE must approve a "performance assessment," which is a document that describes the impacts of the disposal facility on public health and environmental resources. Because the release rate of radionuclides from the glass waste form is a key factor determining these impacts, a sound scientific basis for determining their long-term release rates must be developed if this disposal action is to be accepted by regulatory agencies, stakeholders, and the public. In part, the scientific basis is determined from a sound testing strategy. The foundation of the proposed testing strategy is a well accepted mechanistic model that is being used to calculate the glass corrosion behavior over the geologic time scales required for performance assessment. This model requires that six parameters be determined, and the testing program is defined by an appropriate set of laboratory experiments to determine these parameters, and is combined with a set of field experiments to validate the model as a whole. Three general classes of laboratory tests are proposed in this strategy: 1) characterization, 2) accelerated, and 3) service condition. Characterization tests isolate and provide specific information about processes or parameters in theoretical models. Accelerated tests investigate corrosion behavior that will be important over the regulated service life of a disposal system within a laboratory time frame of a few years or less. Service condition tests verify that the techniques used in accelerated tests do not change

  17. Long-term follow-up study and long-term care of childhood cancer survivors

    Directory of Open Access Journals (Sweden)

    Hyeon Jin Park


    Full Text Available The number of long-term survivors is increasing in the western countries due to remarkable improvements in the treatment of childhood cancer. The long-term complications of childhood cancer survivors in these countries were brought to light by the childhood cancer survivor studies. In Korea, the 5-year survival rate of childhood cancer patients is approaching 70%; therefore, it is extremely important to undertake similar long-term follow-up studies and comprehensive long-term care for our population. On the basis of the experiences of childhood cancer survivorship care of the western countries and the current Korean status of childhood cancer survivors, long-term follow-up study and long-term care systems need to be established in Korea in the near future. This system might contribute to the improvement of the quality of life of childhood cancer survivors through effective intervention strategies.


    CERN Multimedia



    ACKNOWLEDGMENTS The Long-Term Collections (CLT) committee would like to warmly thank its faithful donors who, year after year, support our actions all over the world. Without you, all this would not be possible. We would like to thank, in particular, the CERN Firemen’s Association who donated 5000 CHF in the spring thanks to the sale of their traditional calendar, and the generosity of the CERN community. A huge thank you to the firemen for their devotion to our cause. And thank you to all those who have opened their door, their heart, and their purses! Similarly, we warmly thank the CERN Yoga Club once again for its wonderful donation of 2000 CHF we recently received. We would also like to tell you that all our projects are running well. Just to remind you, we are currently supporting the activities of the «Réflexe-Partage» Association in Mali; the training centre of «Education et Développement» in Abomey, Benin; and the orphanage and ...

  19. Scenario Analysis to Identify Viable Conservation Strategies in Paraguay's Imperiled Atlantic Forest

    Directory of Open Access Journals (Sweden)

    Matthew J. Carlson


    Full Text Available A common challenge facing land use planning is assessment of the future performance of land use options. The challenge can be acute in developing regions where land use is expanding rapidly and funding and data needed for planning are scarce. To inform land use planning for a biosphere reserve located in Paraguay's Atlantic forest region, a scenario analysis explored the relative merits of conventional and conservation agricultural practices, sustained yield forestry, and protection. Simulations compared the long-term impacts on land cover, biotic carbon, and income of the area's residents. Ecological and economic decline were projected under conventional practices. Protection and forestry scenarios achieved only small relative improvements to ecological indicators at the cost of reduced economic performance. By addressing the underlying issue of land degradation, conservation agriculture including no-tillage was the most successful land use strategy both ecologically and economically. Identification of conservation agriculture as the most promising land use strategy prioritizes issues that must be addressed to achieve sustainability, most importantly the provision of education and funding to smallholder farmers. We conclude that scenario analysis offers a flexible strategy to integrate available data for the purpose of informing land use planning in data-limited regions such as Paraguay's Atlantic forest.

  20. Recovery in Remitted First-Episode Psychosis at 7 Years of Follow-up of an Early Dose Reduction/Discontinuation or Maintenance Treatment Strategy Long-term Follow-up of a 2-Year Randomized Clinical Trial

    NARCIS (Netherlands)

    Wunderink, Lex; Nieboer, Roeline M.; Wiersma, Durk; Sytema, Sjoerd; Nienhuis, Fokko J.

    IMPORTANCE Short-term outcome studies of antipsychotic dose-reduction/discontinuation strategies in patients with remitted first-episode psychosis (FEP) showed higher relapse rates but no other disadvantages compared with maintenance treatment; however, long-term effects on recovery have not been

  1. Colistin and tobramycin resistance during long- term use of selective decontamination strategies in the intensive care unit : A post hoc analysis

    NARCIS (Netherlands)

    Wittekamp, Bastiaan H J; Oostdijk, Evelien A N; De Smet, Anne Marie G A; Bonten, Marc J M


    Introduction: Selective decontamination of the digestive tract (SDD) and selective oropharyngeal decontamination (SOD) have been shown to improve intensive care unit (ICU) patients' outcomes. The aim of this study was to determine the effects of long-term use of SDD and SOD on colistin and

  2. Colistin and tobramycin resistance during long-term use of selective decontamination strategies in the intensive care unit : a post hoc analysis

    NARCIS (Netherlands)

    Wittekamp, Bastiaan H. J.; Oostdijk, Evelien A. N.; de Smet, Anne Marie G. A.; Bonten, Marc J. M.


    Introduction: Selective decontamination of the digestive tract (SDD) and selective oropharyngeal decontamination (SOD) have been shown to improve intensive care unit (ICU) patients' outcomes. The aim of this study was to determine the effects of long-term use of SDD and SOD on colistin and

  3. Short- and long-term efficacy of intra-articular injections with betamethasone as part of a treat-to-target strategy in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Østergaard, Mikkel; Ejbjerg, Bo


    OBJECTIVE: To investigate the short-term and long-term efficacy of intra-articular betamethasone injections, and the impact of joint area, repeated injections, MRI pathology, anticyclic citrullinated peptide (CCP) and immunoglobulin M rheumatoid factor (IgM-RF) status in patients with early...

  4. A national strategy for a long-term monitoring of permafrost and periglacial processes and their relationship to natural hazard prevention in Austria (United States)

    Kellerer-Pirklbauer, Andreas; Bartsch, Annett; Gitschthaler, Christoph; Reisenhofer, Stefan; Weyss, Gernot; Riedl, Claudia; Avian, Michael


    About 2.5% (~2000 km²) of the national territory of Austria is influenced by permafrost conditions. A slightly smaller area of Austria is additionally affected by deep seasonal frost which is, however, similarly exposed to intensive physical weathering and related geomorphic processes. Currently, 23 skiing resorts, 31 water reservoirs and 42 mountain huts are either directly or indirectly influenced by permafrost and associated processes in Austria as determined from regional permafrost models. Ground thermal changes most likely affect the ground stability and infrastructure in those areas. Therefore, changes in the distribution and characteristics of permafrost and seasonal frost are of high economic and ecological importance. A range of Austrian institutions are interested in systematic permafrost monitoring (several universities, geological surveys, the Austrian torrent and avalanche control agency or several different alpine clubs). However, to date no coordinated monitoring network has been established on a national scale and a strategy for long-term permafrost/periglacial observation did not exist so far. Such a national strategy has been developed in 2015 within the permAT project funded through the StartClim2014-program. During permAT an extensive literature review and data search as well as a workshop with 40 participants (scientists, stakeholder and policy maker) were accomplished. The workshop allowed the integration of national as well as international colleagues into the strategy development. Results of permAT clearly demonstrate that the number of present permafrost/periglacial monitoring sites is far too little in Austria. Only few alpine areas of Austria are well represented by the existing monitoring activities but large areas lack such instrumentations. Furthermore, permafrost boreholes exist at only three sites in central Austria (all contribution to the GTN-P network) and there is a lack of knowledge about thermal conditions and recent changes

  5. Survival Strategy of Erwinia amylovora against Copper: Induction of the Viable-but-Nonculturable State (United States)

    Ordax, Mónica; Marco-Noales, Ester; López, María M.; Biosca, Elena G.


    Copper compounds, widely used to control plant-pathogenic bacteria, have traditionally been employed against fire blight, caused by Erwinia amylovora. However, recent studies have shown that some phytopathogenic bacteria enter into the viable-but-nonculturable (VBNC) state in the presence of copper. To determine whether copper kills E. amylovora or induces the VBNC state, a mineral medium without copper or supplemented with 0.005, 0.01, or 0.05 mM Cu2+ was inoculated with 107 CFU/ml of this bacterium and monitored over 9 months. Total and viable cell counts were determined by epifluorescence microscopy using the LIVE/DEAD kit and by flow cytometry with 5-cyano-2,3-ditolyl tetrazolium chloride and SYTO 13. Culturable cells were counted on King's B nonselective solid medium. Changes in the bacterial morphology in the presence of copper were observed by scanning electron microscopy. E. amylovora entered into the VBNC state at all three copper concentrations assayed, much faster when the copper concentration increased. The addition of different agents which complex copper allowed the resuscitation (restoration of culturability) of copper-induced VBNC cells. Finally, copper-induced VBNC cells were virulent only for the first 5 days, while resuscitated cells always regained their pathogenicity on immature fruits over 9 months. These results have shown, for the first time, the induction of the VBNC state in E. amylovora as a survival strategy against copper. PMID:16672494

  6. Long term effectiveness of once-daily unboosted atazanavir plus abacavir/lamivudine as a switch strategy in subjects with virological suppression

    Directory of Open Access Journals (Sweden)

    Josep M Llibre


    might be considered in those with long-term suppression and without prior PI failure. Larger cohorts are required to further define the appropriate selection criteria.

  7. Long-Term Mechanical Ventilation. (United States)

    Sahetya, Sarina; Allgood, Sarah; Gay, Peter C; Lechtzin, Noah


    Although precise numbers are difficult to obtain, the population of patients receiving long-term ventilation has increased over the last 20 years, and includes patients with chronic lung diseases, neuromuscular diseases, spinal cord injury, and children with complex disorders. This article reviews the equipment and logistics involved with ventilation outside of the hospital. Discussed are common locations for long-term ventilation, airway and secretion management, and many of the potential challenges faced by individuals on long-term ventilation. Published by Elsevier Inc.

  8. Long term complications of diabetes (United States)

    ... Long-term complications of diabetes To use the sharing features on this page, ... other tests. All these may help you keep complications of diabetes away. You will need to check your blood ...

  9. [Early invasive strategy no better than a selective invasive strategy for patients with non-ST-segment elevation acute coronary syndromes and elevated cardiac troponin T levels: long-term follow-up results of the ICTUS trial]. (United States)

    Windhausen, F; Hirsch, A; Tijssen, J G P; Verheugt, F W A; Cornel, J H; de Winter, R J


    To determine whether routine coronary angiography followed by revascularisation where appropriate is better than initial drug treatment in patients with non-ST-segment elevation acute coronary syndromes (nSTE-ACS) and elevated troponin T concentrations. Multicentre randomised clinical trial (www.controlled-trials. com, number: SRCTN82153174). Patients with nSTE-ACS and elevated cardiac troponin were randomly assigned to an early invasive strategy or a selective invasive strategy. The early invasive strategy consisted of coronary angiography and revascularisation as indicated within 48 hours. The selective invasive strategy consisted of initial drug therapy; catheterisation was performed if the patient developed refractory angina or recurrent ischaemia. The main endpoints were a composite of death, recurrent myocardial infarction and rehospitalisation for anginal symptoms within 3 years, and all-cause mortality within 4 years. A total of 1200 patients were enrolled from 42 hospitals in the Netherlands. The in-hospital revascularisation rate was 76% in the early invasive group and 40% in the selective invasive group. After 3 years, the cumulative rate for the composite endpoint was 30.0% in the early invasive group and 26.0% in the selective invasive group (hazard ratio 1.21; 95% CI: 0.97-1.50; p = 0.09). The 4-year all-cause mortality rate was similar in both treatment groups (7.9% vs 7.7%; p = 0.62). Long-term follow-up of this trial suggests that an early invasive strategy is not better than a selective invasive strategy in patients with nSTE-ACS and elevated cardiac troponin. Therefore, implementation of either strategy is acceptable in these patients.

  10. Workshop on long-term contraceptives. (United States)


    The National Population Council Secretariat (NPCS) of Ghana held a three-day workshop on long-term contraceptives in 1996 in collaboration with the Ministry of Health, the Association of Voluntary Surgical Contraception, and the Johns Hopkins Population Communication Services. The session was funded by USAID. The executive director of NPCS, Dr. Richard Turkson, said that the slow rate of contraceptive acceptance was an obstacle to population control despite political concern that rapid population growth exerted an adverse impact on the economy. Only 10% of married women were using long-term or permanent methods of contraception. The hope was voiced that the participants would devise practical and cost-effective education, information, and communication (IEC) strategies to boost the demand for long-term contraceptive methods among sexually active people in Ghana. It was essential that these strategies and activities were based on a realist assessment of the demographic and social situation of the country. The examination of case studies in cultures similar to Ghana would also offer valuable lessons. The factors that hinder the acceptance of long-term methods include misconceptions, myths, and false rumors rooted in a general lack of knowledge among the people. Participants were urged to come up with strategies to counter these problems, and service providers were encouraged to improve their knowledge about contraceptive methods and counseling skills. Male involvement in contraception was also advocated. Statistics show that most Ghanians practicing contraception were using short-term methods such as foaming tablets, pills, and condoms. However, it is necessary to shift to long-term methods such as injectables, implants, and sterilization in order to achieve significant reductions in fertility.

  11. Mineral vs. organic amendments: microbial community structure, activity and abundance of agriculturally relevant microbes are driven by long-term fertilization strategies

    Directory of Open Access Journals (Sweden)

    Davide Francioli


    Full Text Available Soil management is fundamental to all agricultural systems and fertilization practices have contributed substantially to the impressive increases in food production. Despite the pivotal role of soil microorganisms in agro-ecosystems, we still have a limited understanding of the complex response of the soil microbiota to organic and mineral fertilization in the very long-term. Here we report the effects of different fertilization regimes (mineral, organic and combined mineral and organic fertilization, carried out for more than a century, on the structure and activity of the soil microbiome. Organic matter content, nutrient concentrations and microbial biomass carbon were significantly increased by mineral, and even more strongly by organic fertilization. Pyrosequencing revealed significant differences between the structures of bacterial and fungal soil communities associated to each fertilization regime. Organic fertilization increased bacterial diversity, and stimulated microbial groups (Firmicutes, Proteobacteria and Zygomycota that are known to prefer nutrient-rich environments, and that are involved in the degradation of complex organic compounds. In contrast, soils not receiving manure harbored distinct microbial communities enriched in oligotrophic organisms adapted to nutrient-limited environments, as Acidobacteria. The fertilization regime also affected the relative abundances of plant beneficial and detrimental microbial taxa, which may influence productivity and stability of the agroecosystem. As expected, the activity of microbial exoenzymes involved in carbon, nitrogen and phosphorous mineralization were enhanced by both types of fertilization. However, in contrast to comparable studies, the highest chitinase and phosphatase activities were observed in the solely mineral fertilized soil. Interestingly, these two enzymes showed also a particular high biomass-specific activities and a strong negative relation with soil pH. As many soil

  12. Continuous Fermentation of Clostridium tyrobutyricum with Partial Cell Recycle as a Long-Term Strategy for Butyric Acid Production

    Directory of Open Access Journals (Sweden)

    Edgar C. Clausen


    Full Text Available In making alternative fuels from biomass feedstocks, the production of butyric acid is a key intermediate in the two-step production of butanol. The fermentation of glucose via Clostridium tyrobutyricum to butyric acid produces undesirable byproducts, including lactic acid and acetic acid, which significantly affect the butyric acid yield and productivity. This paper focuses on the production of butyric acid using Clostridium tyrobutyricum in a partial cell recycle mode to improve fermenter yield and productivity. Experiments with fermentation in batch, continuous culture and continuous culture with partial cell recycle by ultrafiltration were conducted. The results show that a continuous fermentation can be sustained for more than 120 days, which is the first reported long-term production of butyric acid in a continuous operation. Further, the results also show that partial cell recycle via membrane ultrafiltration has a great influence on the selectivity and productivity of butyric acid, with an increase in selectivity from ≈9% to 95% butyric acid with productivities as high as 1.13 g/Lh. Continuous fermentation with low dilution rate and high cell recycle ratio has been found to be desirable for optimum productivity and selectivity toward butyric acid and a comprehensive model explaining this phenomenon is given.

  13. Towards a Long-Term Strategy for Voluntary-Based Internal Radiation Contamination Monitoring: Representativeness of the Monitoring Results in Fukushima, Japan

    Directory of Open Access Journals (Sweden)

    Shuhei Nomura


    Full Text Available Following Japan’s 2011 Fukushima nuclear incident, voluntary participation, rather than mandatory, was adopted as the default scenario for individual radiation monitoring. We evaluated the representativeness of the internal monitoring results from voluntary participants in Minamisoma City, which is located 10–40 km from the Fukushima nuclear plant. Of approximately 70,000 individuals who were residing in Minamisoma City before the incident, a total of 19,263 residents (aged ≥21 years participated in the monitoring from 1 October 2011 to 31 March 2015. Based on regression projection techniques with the available data obtained from the voluntary participants, the modeled probabilities of radiocesium (Cs detection in October 2011 for Cs-137 and Cs-134 were 66.9% and 52.9%, respectively, which declined dramatically within a year following the incident. The rate of decline had stagnated since mid-2012, and the probability was close to zero after mid-2014. Sufficient agreement between the modeled probabilities of Cs detection (for the whole population versus the measured Cs levels (for voluntary participants was observed, except for Cs-134 in October 2011, indicating that the voluntary monitoring participant group was a good representative sample. Our findings affirmed the clinical importance of voluntary-based monitoring as a screening and dose-assessment tool in a post-nuclear incident. Our study informs societal decision-making regarding the long-term maintenance of the monitoring program under the current low exposure levels.

  14. Long-Term Outcome in Patients With Ductal Carcinoma In Situ Treated With Breast-Conserving Therapy: Implications for Optimal Follow-up Strategies

    Energy Technology Data Exchange (ETDEWEB)

    Shaitelman, Simona F. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Wilkinson, J. Ben [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Kestin, Larry L. [Department of Radiation Oncology, University of Texas MD Anderson Cancer Center, Houston, Texas (United States); Ye Hong [Department of Radiation Oncology, William Beaumont Hospital, Royal Oak, Michigan (United States); Goldstein, Neal S. [Advanced Diagnostics Laboratory, Redford, Michigan (United States); Martinez, Alvaro A. [Michigan HealthCare Professionals, Pontiac, Michigan (United States); Vicini, Frank A., E-mail: [Michigan HealthCare Professionals, Pontiac, Michigan (United States)


    Purpose: To determine 20-year rates of local control and outcome-associated factors for ductal carcinoma in situ (DCIS) after breast-conserving therapy (BCT). Methods and Materials: All DCIS cases receiving BCT between 1980 and 1993 were reviewed. Patient demographics and pathologic factors were analyzed for effect on outcomes, including ipsilateral breast tumor recurrence (IBTR) and survival. Results: One hundred forty-five cases were evaluated; the median follow-up time was 19.3 years. IBTR developed in 25 patients, for 5-, 10-, 15-, and 20-year actuarial rates of 9.9%, 12.2%, 13.7%, and 17.5%, respectively. One third of IBTRs were elsewhere failures, and 68% of IBTRs occurred <10 years after diagnosis. Young age and cancerization of lobules predicted for IBTR at <10 years, and increased slide involvement and atypical ductal hyperplasia were associated with IBTR at later time points. Conclusions: Patients with DCIS treated with BCT have excellent long-term rates of local control. Predictors of IBTR vary over time, and the risk of recurrence seems highest within 10 to 12 years after diagnosis.

  15. Co-administration of walnut (Juglans regia) prevents systemic hypertension induced by long-term use of dexamethasone: a promising strategy for steroid consumers. (United States)

    Joukar, Siyavash; Ebrahimi, Sahar; Khazaei, Majid; Bashiri, Alireza; Shakibi, Mohammad Reza; Naderi, Vida; Shahouzehi, Beydolah; Alasvand, Masoud


    The long-term consumption of glucocorticoids (GCs) may induce serious adverse effects such as hypertension. There is sufficient evidence related to the benefit of walnuts on the cardiovascular system. This study assesses the effect of methanol extract of walnut [Juglans regia L. (Juglandaceae)] on dexamethasone-induced hypertension and the possible mechanisms in Wistar rats. Animals were randomized into control, kernel extract (100 and 200 mg/kg/d, orally), dexamethasone (0.03 mg/kg/d, subcutaneously), dexamethasone + kernel (100 and 200 mg/kg/d, separately), and dexamethasone + captopril (25 mg/kg/d, orally) groups. Animals were treated with water, kernel extract or captopril by gavage 4 d before and during 11 d of saline or dexamethasone treatment. On the 16th day, blood pressure (BP) was recorded and blood samples were collected to measure nitric oxide (NO). Animal hearts were frozen for measurement of malondialdehyde (MDA) and glutathione peroxidase (GPX). Dexamethasone increased the diastolic BP and MDA/GPX ratio in comparison with control group (128 ± 7 vs. 105 ± 3 mmHg, p dexamethasone and walnut (200 mg/kg) prevented the dexamethasone-induced diastolic hypertension (109 ± 3 vs. 128 ± 7 mmHg; p dexamethasone-induced hypertension. A part of this beneficial effect apparently involves maintaining balance of the redox system and NO production.

  16. The Long-Term Retention of Knowledge and Skills

    National Research Council Canada - National Science Library

    Healy, Alice


    .... The second class of guidelines concerned ways to optimize the strategies used. We found that in tasks that require deliberate retrieval from memory, training that promotes efficient encoding strategies maximizes long-term retention...

  17. Melanocortin agonism as a viable strategy to control alveolar bone loss induced by oral infection. (United States)

    Madeira, Mila F M; Queiroz-Junior, Celso M; Montero-Melendez, Trinidad; Werneck, Silvia M C; Corrêa, Jôice D; Soriani, Frederico M; Garlet, Gustavo P; Souza, Daniele G; Teixeira, Mauro M; Silva, Tarcilia A; Perretti, Mauro


    Alveolar bone loss is a result of an aggressive form of periodontal disease (PD) associated with Aggregatibacter actinomycetemcomitans (Aa) infection. PD is often observed with other systemic inflammatory conditions, including arthritis. Melanocortin peptides activate specific receptors to exert antiarthritic properties, avoiding excessing inflammation and modulating macrophage function. Recent work has indicated that melanocortin can control osteoclast development and function, but whether such protection takes place in infection-induced alveolar bone loss has not been investigated. The purpose of this study was to evaluate the role of melanocortin in Aa-induced PD. Mice were orally infected with Aa and treated with the melanocortin analog DTrp8-γMSH or vehicle daily for 30 d. Then, periodontal tissue was collected and analyzed. Aa-infected mice treated with DTrp8-γMSH presented decreased alveolar bone loss and a lower degree of neutrophil infiltration in the periodontium than vehicle-treated animals; these actions were associated with reduced periodontal levels of TNF-α, IFN-γ, and IL-17A. In vitro experiments with cells differentiated into osteoclasts showed that osteoclast formation and resorptive activity were attenuated after treatment with DTrp8-γMSH. Thus, melanocortin agonism could represent an innovative way to tame overexuberant inflammation and, at the same time, preserve bone physiology, as seen after Aa infection.-Madeira, M. F. M., Queiroz-Junior, C. M., Montero-Melendez, T., Werneck, S. M. C., Corrêa, J. D., Soriani, F. M., Garlet, G. P., Souza, D. G., Teixeira, M. M., Silva, T. A., Perretti, M. Melanocortin agonism as a viable strategy to control alveolar bone loss induced by oral infection. © FASEB.

  18. High- Versus Low-Gradient Severe Aortic Stenosis: Demographics, Clinical Outcomes, and Effects of the Initial Aortic Valve Replacement Strategy on Long-Term Prognosis. (United States)

    Taniguchi, Tomohiko; Morimoto, Takeshi; Shiomi, Hiroki; Ando, Kenji; Kanamori, Norio; Murata, Koichiro; Kitai, Takeshi; Kawase, Yuichi; Izumi, Chisato; Miyake, Makoto; Mitsuoka, Hirokazu; Kato, Masashi; Hirano, Yutaka; Matsuda, Shintaro; Inada, Tsukasa; Nagao, Kazuya; Murakami, Tomoyuki; Takeuchi, Yasuyo; Yamane, Keiichiro; Toyofuku, Mamoru; Ishii, Mitsuru; Minamino-Muta, Eri; Kato, Takao; Inoko, Moriaki; Ikeda, Tomoyuki; Komasa, Akihiro; Ishii, Katsuhisa; Hotta, Kozo; Higashitani, Nobuya; Kato, Yoshihiro; Inuzuka, Yasutaka; Maeda, Chiyo; Jinnai, Toshikazu; Morikami, Yuko; Saito, Naritatsu; Minatoya, Kenji; Kimura, Takeshi


    There is considerable debate on the management of patients with low-gradient severe aortic stenosis (LG-AS), defined as aortic valve area strategy: n=977, and conservative strategy: n=1120) with high-gradient severe aortic stenosis (HG-AS) and 1712 patients (initial AVR strategy: n=219, and conservative strategy: n=1493) with LG-AS. AVR was more frequently performed in HG-AS patients than in LG-AS patients (60% versus 28%) during the entire follow-up. In the comparison between the initial AVR and conservative groups, the propensity score-matched cohorts were developed in both HG-AS (n=887 for each group) and LG-AS (n=218 for each group) strata. The initial AVR strategy when compared with the conservative strategy was associated with markedly lower risk for a composite of aortic valve-related death or heart failure hospitalization in both HG-AS and LG-AS strata (hazard ratio, 0.30; 95% confidence interval, 0.25-0.37; Pstrategy was associated with a better outcome than the conservative strategy (adjusted hazard ratio, 0.37; 95% confidence interval, 0.23-0.59; Pstrategy was associated with better outcomes than the conservative strategy in both HG-AS and LG-AS patients, although AVR was less frequently performed in LG-AS patients than in HG-AS patients. The favorable effect of initial AVR strategy was also seen in patients with LG-AS with preserved left ventricular ejection fraction. URL: Unique identifier: UMIN000012140. © 2017 American Heart Association, Inc.

  19. [Treatment methods for discontinuation of long-term benzodiazepine use

    NARCIS (Netherlands)

    Oude Voshaar, R.C.; Gorgels, W.J.M.J.; Mol, A.J.J.; Couvée, J.E.; Balkom, A.J.L.M. van; Zitman, F.G.


    Treatment strategies for discontinuing long-term benzodiazepine usage can be divided into minimal interventions and gradual discontinuation programs. Minimal interventions invite patients to quit their long-term benzodiazepine usage on their own by making them aware of the adverse effects. This type

  20. Long-term data archiving

    Energy Technology Data Exchange (ETDEWEB)

    Moore, David Steven [Los Alamos National Laboratory


    Long term data archiving has much value for chemists, not only to retain access to research and product development records, but also to enable new developments and new discoveries. There are some recent regulatory requirements (e.g., FDA 21 CFR Part 11), but good science and good business both benefit regardless. A particular example of the benefits of and need for long term data archiving is the management of data from spectroscopic laboratory instruments. The sheer amount of spectroscopic data is increasing at a scary rate, and the pressures to archive come from the expense to create the data (or recreate it if it is lost) as well as its high information content. The goal of long-term data archiving is to save and organize instrument data files as well as any needed meta data (such as sample ID, LIMS information, operator, date, time, instrument conditions, sample type, excitation details, environmental parameters, etc.). This editorial explores the issues involved in long-term data archiving using the example of Raman spectral databases. There are at present several such databases, including common data format libraries and proprietary libraries. However, such databases and libraries should ultimately satisfy stringent criteria for long term data archiving, including readability for long times into the future, robustness to changes in computer hardware and operating systems, and use of public domain data formats. The latter criterion implies the data format should be platform independent and the tools to create the data format should be easily and publicly obtainable or developable. Several examples of attempts at spectral libraries exist, such as the ASTM ANDI format, and the JCAMP-DX format. On the other hand, proprietary library spectra can be exchanged and manipulated using proprietary tools. As the above examples have deficiencies according to the three long term data archiving criteria, Extensible Markup Language (XML; a product of the World Wide Web

  1. Long Term Planning at IQ Metal

    DEFF Research Database (Denmark)


    This is a Danish version. This case about long term planning at the owner-managed manufacturing firm IQ Metal shows how the future management and ownership may be organized to utilize owner assets and minimize roadblocks. Initially, the owner-manager Bo Fischer Larsen explains how he acquired...... in The Owner Strategy Map into the questionnaire available on Lastly, the Owner Strategy Map's recommendation of how to organize the future management and ownership of IQ Metal is explained....

  2. Long-term survival after gemcitabine and cisplatin in patients with locally advanced transitional cell carcinoma of the bladder: focus on supplementary treatment strategies

    DEFF Research Database (Denmark)

    Als, Anne Birgitte; Sengelov, Lisa; von der Maase, Hans


    OBJECTIVE: The objective was to evaluate response and survival, as well as efficacy of subsequent supplementary treatment and follow-up strategy in patients with locally advanced transitional cell carcinoma of the bladder following combination chemotherapy with gemcitabine and cisplatin (GC...

  3. Infliximab "Top-Down" Strategy is Superior to "Step-Up" in Maintaining Long-Term Remission in the Treatment of Pediatric Crohn Disease. (United States)

    Lee, Yoo Min; Kang, Ben; Lee, Yoon; Kim, Mi Jin; Choe, Yon Ho


    We aimed to compare the efficacy of remission maintenance between infliximab "top-down" and "step-up" strategies in moderate to severe pediatric Crohn disease during 3 years. We also aimed to determine prognostic factors that may influence the relapse-free rate in these patients. The present study was a retrospective review of a prospective cohort, based on an infliximab treatment protocol for pediatric Crohn disease used at Samsung Medical Center. A total of 31 patients (group A) were treated with early infliximab induction ("top-down" strategy) and 20 patients (group B) refractory to conventional therapy underwent infliximab treatment ("step-up" strategy). The efficacy of infliximab treatment was assessed by relapse-free rate and remission period rate for 3 years. A total of 11 prognostic factors that may influence the relapse-free rate were further analyzed. The relapse-free rates at 3 years were 35.5% (95% confidence interval [CI] 0.194-0.519) in group A and 15.0% (95% CI 0.037-0.335) in group B (P = 0.0094). Overall remission period rate for 3 years also showed a significant difference between the 2 groups (92.1%  ± 7.2% vs 78.3%  ± 16.6%; P = 0.005). Multivariable analysis revealed that the duration from the initial diagnosis to infliximab infusion was the only factor associated with relapse-free remission for 3 years (hazard ratio = 1.077; 95% CI 1.025-1.131). "Top-down" strategy had a longer remission period compared with the "step-up" strategy in pediatric Crohn disease during a study period of 3 years, based on relapse-free rate and remission period rate. Earlier introduction of infliximab is recommended in pediatric patients with moderate to severe Crohn disease.

  4. Long-Term Weight Maintenance Strategies Are Experienced as a Burden by Persons Who Have Lost Weight Compared to Persons with a lifetime Normal, Stable Weight

    Directory of Open Access Journals (Sweden)

    Maaike Kruseman


    Full Text Available Objective: To assess dietary intake, eating patterns, physical activity and eating behaviors, and to explore strategies and perceptions of the experience of weight maintenance in weight loss maintainers (weight loss maintenance (WLM ≥ 10% weight loss maintained for ≥1 year and in matched controls with a lifetime stable normal weight. Methods: Volunteers (32 were recruited by a snowball procedure in this cross-sectional, mixed-methods study. Diet, physical activity, and eating behaviors were assessed with validated questionnaires. Strategies and experiences were investigated during interviews. Descriptive coding, thematic analysis (qualitative data as well as descriptive analysis and t-tests (quantitative data were performed. Results: Both groups had similar energy and macronutrient consumption. Those in the WLM group reported higher levels of exercise and scored higher on several dimensions of eating disorders. Four themes - ‘food choices,' ‘quantities and portion control,' ‘physical activity', and ‘burden' - emerged from the qualitative data. Both groups used similar weight maintenance strategies, but those in the WLM group experienced a higher burden, expressing effortful control which contrasted with the control group's confidence in their internal cues. Conclusion: Our results show an additional burden related with maintaining weight loss compared to keeping a stable normal weight. They provide evidence to devise interventions that will address the difficulty of regulating intake.

  5. Recovery in remitted first-episode psychosis at 7 years of follow-up of an early dose reduction/discontinuation or maintenance treatment strategy: long-term follow-up of a 2-year randomized clinical trial. (United States)

    Wunderink, Lex; Nieboer, Roeline M; Wiersma, Durk; Sytema, Sjoerd; Nienhuis, Fokko J


    Short-term outcome studies of antipsychotic dose-reduction/discontinuation strategies in patients with remitted first-episode psychosis (FEP) showed higher relapse rates but no other disadvantages compared with maintenance treatment; however, long-term effects on recovery have not been studied before. To compare rates of recovery in patients with remitted FEP after 7 years of follow-up of a dose reduction/discontinuation (DR) vs maintenance treatment (MT) trial. Seven-year follow-up of a 2-year open randomized clinical trial comparing MT and DR. One hundred twenty-eight patients participating in the original trial were recruited from 257 patients with FEP referred from October 2001 to December 2002 to 7 mental health care services in a 3.2 million-population catchment area. Of these, 111 patients refused to participate and 18 patients did not experience remission. PARTICIPANTS After 7 years, 103 patients (80.5%) of 128 patients who were included in the original trial were located and consented to follow-up assessment. After 6 months of remission, patients were randomly assigned to DR strategy or MT for 18 months. After the trial, treatment was at the discretion of the clinician. Primary outcome was rate of recovery, defined as meeting the criteria of symptomatic and functional remission. Determinants of recovery were examined using logistic regression analysis; the treatment strategy (MT or DR) was controlled for baseline parameters. The DR patients experienced twice the recovery rate of the MT patients (40.4% vs 17.6%). Logistic regression showed an odds ratio of 3.49 (P = .01). Better DR recovery rates were related to higher functional remission rates in the DR group but were not related to symptomatic remission rates. Dose reduction/discontinuation of antipsychotics during the early stages of remitted FEP shows superior long-term recovery rates compared with the rates achieved with MT. To our knowledge, this is the first study showing long-term gains of an early

  6. Long term stability of power systems

    Energy Technology Data Exchange (ETDEWEB)

    Kundur, P.; Gao, B. [Powertech Labs. Inc., Surrey, BC (Canada)


    Power system long term stability is still a developing subject. In this paper we provide our perspectives and experiences related to long term stability. The paper begins with the description of the nature of the long term stability problem, followed by the discussion of issues related to the modeling and solution techniques of tools for long term stability analysis. Cases studies are presented to illustrate the voltage stability aspect and plant dynamics aspect of long term stability. (author) 20 refs., 11 figs.

  7. Ecosystem and human health assessment to define environmental management strategies: The case of long-term human impacts on an Arctic lake. (United States)

    Moiseenko, T I; Voinov, A A; Megorsky, V V; Gashkina, N A; Kudriavtseva, L P; Vandish, O I; Sharov, A N; Sharova, Yu; Koroleva, I N


    There are rich deposits of mineral and fossil natural resources in the Arctic, which make this region very attractive for extracting industries. Their operations have immediate and vast consequences for ecological systems, which are particularly vulnerable in this region. We are developing a management strategy for Arctic watersheds impacted by industrial production. The case study is Lake Imandra watershed (Murmansk oblast, Russia) that has exceptionally high levels of economic development and large numbers of people living there. We track the impacts of toxic pollution on ecosystem health and then--human health. Three periods are identified: (a) natural, pre-industrial state; (b) disturbed, under rapid economic development; and (c) partial recovery, during recent economic meltdown. The ecosystem is shown to transform into a qualitatively new state, which is still different from the original natural state, even after toxic loadings have substantially decreased. Fish disease where analyzed to produce and integral evaluation of ecosystem health. Accumulation of heavy metals in fish is correlated with etiology of many diseases. Dose-effect relationships are between integral water quality indices and ecosystem health indicators clearly demonstrates that existing water quality standards adopted in Russia are inadequate for Arctic regions. Health was also poor for people drinking water from the Lake. Transport of heavy metals from drinking water, into human organs, and their effect on liver and kidney diseases shows the close connection between ecosystem and human health. A management system is outlined that is based on feedback from indices of ecosystem and human health and control over economic production and/or the amount of toxic loading produced. We argue that prospects for implementation of such a system are quite bleak at this time, and that more likely we will see a continued depopulation of these Northern regions.

  8. Navigating Long-Term Care

    Directory of Open Access Journals (Sweden)

    James D. Holt MD


    Full Text Available Americans over age 65 constitute a larger percentage of the population each year: from 14% in 2010 (40 million elderly to possibly 20% in 2030 (70 million elderly. In 2015, an estimated 66 million people provided care to the ill, disabled, and elderly in the United States. In 2000, according to the Centers for Disease Control and Prevention (CDC, 15 million Americans used some form of long-term care: adult day care, home health, nursing home, or hospice. In all, 13% of people over 85 years old, compared with 1% of those ages 65 to 74, live in nursing homes in the United States. Transitions of care, among these various levels of care, are common: Nursing home to hospital transfer, one of the best-studied transitions, occurs in more than 25% of nursing home residents per year. This article follows one patient through several levels of care.

  9. The connection between long-term and short-term risk management strategies for flood and landslide hazards: examples from land-use planning and emergency management in four European case studies (United States)

    Prenger-Berninghoff, K.; Cortes, V. J.; Sprague, T.; Aye, Z. C.; Greiving, S.; Głowacki, W.; Sterlacchini, S.


    Adaptation to complex and unforeseen events requires enhancing the links between planning and preparedness phases to reduce future risks in the most efficient way. In this context, the legal-administrative and cultural context has to be taken into account. This is why four case study areas of the CHANGES1 project (Nehoiu Valley in Romania, Ubaye Valley in France, Val Canale in Italy, and Wieprzówka catchment in Poland) serve as examples to highlight currently implemented risk management strategies for land-use planning and emergency preparedness. The focus is particularly on flood and landslide hazards. The strategies described in this paper were identified by means of exploratory and informal interviews in each study site. Results reveal that a dearth or, in very few cases, a weak link exists between spatial planners and emergency managers. Management strategies could benefit from formally intensifying coordination and cooperation between emergency services and spatial planning authorities. Moreover, limited financial funds urge for a more efficient use of resources and better coordination towards long-term activities. The research indicates potential benefits to establishing or, in some cases, strengthening this link through contextual changes, e.g., in organizational or administrative structures, that facilitate proper interaction between risk management and spatial planning. It also provides suggestions for further development in the form of information and decision support systems as a key connection point. 1 Marie Curie ITN CHANGES - Changing Hydro-meteorological Risks as Analyzed by a New Generation of European Scientists

  10. Long-Term Scenario of International Developments

    Directory of Open Access Journals (Sweden)

    Alexey I. Podberezkin


    Full Text Available This paper proposes an approach to long-term scenario building in international relations, based on the analysis of changes in the dialectics of war and peace. Long-term trends in the development of forms and manifestations of violence in international relations, as well as the methods and approaches to its control and management determines the development of international relations. In solving the methodological problem of long-term forecasting, it must be as-sumed that the mere mechanical extrapolation even in the medium term has no meaning. The key current trend in terms of political violence is a blurring of the distinction between war and peace. This trend can be described as networking of war. Network war theory is a model of military strategy in the context of postmodernism. As a model of the new economy based on information and high technologies demonstrates its superiority over traditional capitalist and socialist models of the industrial age, and network war claims qualitative superiority over previous strategic concept of the industrial era. In modern political networks violent and non-violent instruments of influence co-exist in undifferentiated form. Network politics becomes total. Victory in the network war is the fact that the opponent should become part of the network. Since the network is formed around shared values, the network war can be reduced to a war of values. The clash between the networks will most likely wear un-compromising nature, so that in the end there will be only one network. Uncompromising network war is like the uncompromising religious wars and clashes of civilizations.

  11. Science framework for conservation and restoration of the sagebrush biome: Linking the Department of the Interior’s Integrated Rangeland Fire Management Strategy to long-term strategic conservation actions, Part 1. Science basis and applications (United States)

    Chambers, Jeanne C.; Beck, Jeffrey L.; Bradford, John B.; Bybee, Jared; Campbell, Steve; Carlson, John; Christiansen, Thomas J; Clause, Karen J.; Collins, Gail; Crist, Michele R.; Dinkins, Jonathan B.; Doherty, Kevin E; Edwards, Fred; Espinosa, Shawn; Griffin, Kathleen A.; Griffin, Paul; Haas, Jessica R.; Hanser, Steve; Havlina, Douglas W.; Henke, Kenneth F.; Hennig, Jacob D.; Joyce, Linda A; Kilkenny, Francis F.; Kulpa, Sarah M; Kurth, Laurie L; Maestas, Jeremy D; Manning, Mary; Mayer, Kenneth E.; Mealor, Brian A.; McCarthy, Clinton; Pellant, Mike; Perea, Marco A.; Prentice, Karen L.; Pyke, David A.; Wiechman , Lief A.; Wuenschel, Amarina


    The Science Framework is intended to link the Department of the Interior’s Integrated Rangeland Fire Management Strategy with long-term strategic conservation actions in the sagebrush biome. The Science Framework provides a multiscale approach for prioritizing areas for management and determining effective management strategies within the sagebrush biome. The emphasis is on sagebrush (Artemisia spp.) ecosystems and Greater sage-grouse (Centrocercus urophasianus). The approach provided in the Science Framework links sagebrush ecosystem resilience to disturbance and resistance to nonnative, invasive plant species to species habitat information based on the distribution and abundance of focal species. A geospatial process is presented that overlays information on ecosystem resilience and resistance, species habitats, and predominant threats and that can be used at the mid-scale to prioritize areas for management. A resilience and resistance habitat matrix is provided that can help decisionmakers evaluate risks and determine appropriate management strategies. Prioritized areas and management strategies can be refined by managers and stakeholders at the local scale based on higher resolution data and local knowledge. Decision tools are discussed for determining appropriate management actions for areas that are prioritized for management. Geospatial data, maps, and models are provided through the U.S. Geological Survey (USGS) ScienceBase and Bureau of Land Management (BLM) Landscape Approach Data Portal. The Science Framework is intended to be adaptive and will be updated as additional data become available on other values and species at risk. It is anticipated that the Science Framework will be widely used to: (1) inform emerging strategies to conserve sagebrush ecosystems, sagebrush dependent species, and human uses of the sagebrush system, and (2) assist managers in prioritizing and planning on-the-ground restoration and mitigation actions across the sagebrush biome.

  12. Long term study of mechanical

    Directory of Open Access Journals (Sweden)

    Ahmed M. Diab


    Full Text Available In this study, properties of limestone cement concrete containing different replacement levels of limestone powder were examined. It includes 0%, 5%, 10%, 15%, 20% and 25% of limestone powder as a partial replacement of cement. Silica fume was added incorporated with limestone powder in some mixes to enhance the concrete properties. Compressive strength, splitting tensile strength and modulus of elasticity were determined. Also, durability of limestone cement concrete with different C3A contents was examined. The weight loss, length change and cube compressive strength loss were measured for concrete attacked by 5% sodium sulfate using an accelerated test up to 525 days age. The corrosion resistance was measured through accelerated corrosion test using first crack time, cracking width and steel reinforcement weight loss. Consequently, for short and long term, the use of limestone up to 10% had not a significant reduction in concrete properties. It is not recommended to use blended limestone cement in case of sulfate attack. The use of limestone cement containing up to 25% limestone has insignificant effect on corrosion resistance before cracking.

  13. Long-term outcome after an early invasive versus selective invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome and elevated cardiac troponin T (the ICTUS trial): a follow-up study. (United States)

    Hirsch, Alexander; Windhausen, Fons; Tijssen, Jan G P; Verheugt, Freek W A; Cornel, Jan Hein; de Winter, Robbert J


    The ICTUS trial was a study that compared an early invasive with a selective invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome (nSTE-ACS). The study reported no difference between the strategies for frequency of death, myocardial infarction, or rehospitalisation after 1 year. We did a follow-up study to assess the effects of these treatment strategies after 4 years. 1200 patients with nSTE-ACS and an elevated cardiac troponin were enrolled from 42 hospitals in the Netherlands. Patients were randomly assigned either to an early invasive strategy, including early routine catheterisation and revascularisation where appropriate, or to a more selective invasive strategy, where catheterisation was done if the patient had refractory angina or recurrent ischaemia. The main endpoints for the current follow-up study were death, recurrent myocardial infarction, or rehospitalisation for anginal symptoms within 3 years after randomisation, and cardiovascular mortality and all-cause mortality within 4 years. Analysis was by intention-to-treat. This study is registered as an International Standard Randomised Controlled Trial, number ISRCTN82153174. The in-hospital revascularisation rate was 76% in the early invasive group and 40% in the selective invasive group. After 3 years, the cumulative rate for the combined endpoint was 30.0% in the early invasive group compared with 26.0% in the selective invasive group (hazard ratio 1.21; 95% CI 0.97-1.50; p=0.09). Myocardial infarction was more frequent in the early invasive strategy group (106 [18.3%] vs 69 [12.3%]; HR 1.61; 1.19-2.18; p=0.002). Rates of death or spontaneous myocardial infarction were not different (76 [14.3%] patients in the early invasive and 63 [11.2%] patients in the selective invasive strategy [HR 1.19; 0.86-1.67; p=0.30]). No difference in all-cause mortality (7.9%vs 7.7%; p=0.62) or cardiovascular mortality (4.5%vs 5.0%; p=0.97) was seen within 4 years. Long-term follow-up of

  14. Is political behavior a viable coping strategy to perceived organizational politics? Unveiling the underlying resource dynamics. (United States)

    Sun, Shuhua; Chen, Huaizhong


    [Correction Notice: An Erratum for this article was reported in Vol 102(10) of Journal of Applied Psychology (see record 2017-34254-001). In the article, Table 1 contained a formatting error. Correlation coefficient values in the last four cells of column 6 were misplaced with correlation coefficient values in the last four cells of column 7. All versions of this article have been corrected.] We conduct a theory-driven empirical investigation on whether political behavior, as a coping strategy to perceived organizational politics, creates resource trade-offs in moderating the relationship between perceived organizational politics and task performance. Drawing on conservation of resources theory, we hypothesize that political behavior mitigates the adverse effect of perceived organizational politics on task performance via psychological empowerment, yet exacerbates its adverse effect on task performance via emotional exhaustion. Three-wave multisource data from a sample of 222 employees and their 75 supervisors were collected for hypothesis testing. Findings supported our hypotheses. Our study enhances understandings of the complex resource dynamics of using political behavior to cope with perceived organizational politics and highlights the need to move stress-coping research from a focus on the stress-buffering effect of coping on outcomes to a focus on the underlying competing resource dynamics. (PsycINFO Database Record (c) 2017 APA, all rights reserved).


    Directory of Open Access Journals (Sweden)

    Ewa Kułagowska


    Full Text Available The considerable proportion of the elderly, the chronically ill and the disabled in community is an economic and organizational challenge for the state social policy. It requires a large, steadily increasing financing from the public funds and creating an optional care model to fulfill the needs of citizens and guarantee high quality services. Development of the long-term care is one of the problems to be solved. This paper presents: – a long-term care forms, organization and tasks; – a role of long-term care but particularly home longterm care to protect health in Poland; – problems related with home long-term care functioning.

  16. The Protease Inhibitor Monotherapy Versus Ongoing Triple Therapy (PIVOT) trial: a randomised controlled trial of a protease inhibitor monotherapy strategy for long-term management of human immunodeficiency virus infection. (United States)

    Paton, Nicholas I; Stöhr, Wolfgang; Oddershede, Lars; Arenas-Pinto, Alejandro; Walker, Simon; Sculpher, Mark; Dunn, David T


    Standard-of-care antiretroviral therapy (ART) for human immunodeficiency virus (HIV) infection uses a combination of drugs, until now considered essential to minimise treatment failure and development of drug resistance. Protease inhibitors (PIs) are potent with a high genetic barrier to resistance and have the potential for use as monotherapy after viral load (VL) suppression achieved on combination therapy. However, longer-term resistance and toxicity risks are uncertain. To compare the effectiveness, toxicity profile and cost-effectiveness of PI monotherapy with those of standard-of-care triple therapy in a pragmatic long-term clinical trial. Open-label, parallel-group, randomised controlled trial. Forty-three HIV clinical centres in the UK NHS. HIV-positive adults taking standard combination ART with a suppressed VL for ≥ 6 months. Patients were randomised to maintain ongoing triple therapy (OT) or switch to a strategy of physician-selected ritonavir-boosted PI monotherapy (PI-mono), with prompt return to combination therapy in the event of VL rebound. The primary outcome was reduction of future drug options, defined as new intermediate-/high-level resistance to one or more drugs to which the patient's virus was considered to be sensitive at trial entry (non-inferiority comparison, 10% margin). Secondary outcomes included confirmed virological rebound, serious drug- or disease-related complications, total grade 3 or 4 adverse events (AEs), neurocognitive function change, cluster of differentiation 4 (CD4) cell count change, change in health-related quality of life, cardiovascular risk change, health-care costs and health economic analysis. In total, 587 participants were randomised (77% male, 68% white) to OT (n = 291) or PI-mono (n = 296) and followed for a median of 44 months, of whom 2.7% withdrew/were lost to follow-up. One or more episodes of confirmed VL rebound were observed in eight patients (Kaplan-Meier estimate 3.2%) in the OT group and

  17. Long-term survival after perforated diverticulitis

    NARCIS (Netherlands)

    J. Vermeulen (Jan); M.P. Gosselink (Martijn Pieter); W.C.J. Hop (Wim); E. van der Harst (Erwin); B.E. Hansen (Bettina); G.H.H. Mannaerts (Guido); P-P. Coene (Peter Paul); W.F. Weidema (Wibo); J.F. Lange (Johan)


    textabstractAim: Short-term survival after emergency surgery for perforated diverticulitis is poor. Less is known about long-term survival. The aims of this study were to evaluate long-term survival after discharge from hospital and to identify factors associated with prognosis. Method: All patients

  18. Virtual Models of Long-Term Care (United States)

    Phenice, Lillian A.; Griffore, Robert J.


    Nursing homes, assisted living facilities and home-care organizations, use web sites to describe their services to potential consumers. This virtual ethnographic study developed models representing how potential consumers may understand this information using data from web sites of 69 long-term-care providers. The content of long-term-care web…

  19. The Long-Term Swap Rate and a General Analysis of Long-Term Interest Rates


    Francesca Biagini; Alessandro Gnoatto; Maximilian H\\"artel


    We introduce here for the first time the long-term swap rate, characterised as the fair rate of an overnight indexed swap with infinitely many exchanges. Furthermore we analyse the relationship between the long-term swap rate, the long-term yield, see [4], [5], and [25], and the long-term simple rate, considered in [8] as long-term discounting rate. We finally investigate the existence of these long-term rates in two term structure methodologies, the Flesaker-Hughston model and the linear-rat...

  20. Metyrapone for Long-Term Medical Management of Cushing's Syndrome (United States)

    Traina, Andrea N.; Farr, Ashley; Malik, Ritu; Bingham, Robert J.


    Cushing's syndrome is characterized by any cause of excess cortisol in the blood and produces many physiologic consequences. Left untreated, Cushing's is associated with significant morbidity and mortality. Seventy percent of endogenous cases of Cushing's syndrome are secondary to a pituitary tumor; because of this, the primary mode of management is surgical resection of the tumor. Should hypercortisolism persist following surgical resection, further treatment options are limited. Metyrapone is an orphan medication that is often used in the diagnosis of the disease and occasionally for short-term treatment prior to surgery. Long-term treatment with metyrapone is usually discouraged due to the contradictory increase in ACTH production, acne, hirsutism, hyperkalemia, edema, and other mineralocorticoid effects. We present a patient with refractory Cushing's syndrome successfully treated for nearly 6 years with metyrapone with minimal adverse effects. This orphan medication may be a viable long-term treatment option for this difficult disease. PMID:24416602

  1. Canine porous resurfacing hip arthroplasty. Long-term results. (United States)

    Amstutz, H C; Kim, W C; O'Carroll, P F; Kabo, J M


    Long-term experimental data support the hypothesis that biologic bone ingrowth into porous surfaces in a hip-resurfacing model is a viable alternative to stem-type porous implants. Ingrowth of bone was demonstrated in long-term canine arthroplasty. The components were well fixed and stable at the time of sacrifice, although ingrowth occurred to varying degrees. The ingrowth and quality of remodeling was influenced by stress. Dislocations were overcome by a change in surgical technique. Loosening and neck fractures were associated with insufficient stability at operation or to component impingement (prevented by modifications of design). The formation of metal debris-filled cysts is a concern and appeared to be associated with the poor quality of porous sintering and possibly abrasion. The effects of increased surface area of the porous components such as increased corrosion products on biologic compatibility are still not well defined and require further research and longer follow-up examination.

  2. The Effect of Overlearning on Long-Term Retention (United States)

    Rohrer, Doug; Taylor, Kelli; Pashler, Harold; Wixted, John T.; Cepeda, Nicholas J.


    Once material has been learned to a criterion of one perfect trial, further study within the same session constitutes overlearning. Although overlearning is a popular learning strategy, its effect on long-term retention is unclear. In two experiments presented here, 218 college students learned geography facts (Experiment 1) or word definitions…

  3. The effect of Presynch-Ovsynch protocol with or without estrus detection on reproductive performance by parity, and the long-term effect of these different management strategies on milk production, reproduction, health and survivability of dairy cows. (United States)

    Machado, V S; Neves, R C; Lima, F S; Bicalho, R C


    During the Presynch-Ovsynch protocol, at least half of the cows enrolled display signs of estrus, which can present as an opportunity for cows to be inseminated before the completion of the protocol. The primary objective of this study is to compare two management strategies for first service using the Presynch-Ovsynch protocol: insemination at completion of the Presynch-Ovsynch program (TAIonly) or insemination after estrus detection during the Presynch-Ovsynch protocol, with the remainder of cows being inseminated at timed artificial insemination (ED + TAI). Cows inseminated at completion of the protocol have a longer voluntary waiting period, which could potentially extend their lactation length, allowing them to recover BCS at the end of their lactation and ultimately impacting their subsequent lactation. Therefore, this study has a secondary objective to evaluate the long term impact of these two strategies on reproductive outcomes, culling, milk production and health during the subsequent lactation. A total randomized field trial study design was used, and a total of 3489 cows were randomly enrolled to one of the treatment groups: ED + TAI or TAIonly. Cows enrolled in the TAIonly started the Presynch protocol receiving two injections of PGF2α at 55 ± 3 and 69 ± 3 DIM. They were subsequently submitted to the Ovsynch protocol: GnRH at 81 ± 3 DIM, PGF2α at 88 ± 3 DIM, and GnRH at 90 ± 3 DIM, and then inseminated at fixed time at 91 ± 3 DIM. Cows enrolled in the ED + TAI were submitted to the same synchronization protocol, but they were eligible to be inseminated at any time after the beginning of the synchronization protocol, if detected in estrous. During the experimental lactation, the effect of treatment on first service conception rate (FSCR) was conditional to parity: no difference among primiparous cows, but for multiparous cows, the FSCR was 41.2% and 35.3% for TAIonly and ED + TAI, respectively. Although TAIonly strategy

  4. Long-term Internship through Cooperative Education with Regional Industries (United States)

    Takahashi, Kenzo; Hase, Hiroyuki

    The long term internship is one of special educational programs for graduate students of Graduate School of Engineering in University of Fukui. This is a collaborative program between university and industries where selected post-graduate students are dispatched to companies for a long term and educated in real business environments. It is the final goal of the program to develop sophisticated specialists who would be able to catch the business strategy in industries and solve any problems by themselves. The program is managed in a semester (6 months) and contains 1.5 month prior education of preliminary special knowledge, ethics and secrecy, about 3 month dispatch with long-term internship, and 1.5 month post-education for complementary education and presentation. This paper presents the effect of this program which has been evolving since 2005.


    Directory of Open Access Journals (Sweden)

    Andrea Erika NYÁRÁDI


    Full Text Available The way how we choose our pricing strategy has a significant impact on company’s success. Nowadays companies more and more adopt a new way of thinking in pricing, namely pricing for a long term period in order to bring higher profitability, to build an efficient pricing strategy. Marketers have only recently begun to focus seriously on effective pricing. These companies are the so called progressive companies. They have begun doing more than just worrying about pricing. To increase profitability many are abandoning traditional reactive pricing procedures in favor of proactive pricing, making explicit corporate decisions to change their focus to growth in top-line sales to growth in profitability. The long-term implications of price strategies are still under-researched, and managers should be aware of shifts in customer reactions that may result from frequent adoption of certain strategies. The company pricing strategy should be seen in relation to developments in the company variables, internal ones (capital strength, competencies, organizational conditions, efficiency of the work force etc. as well as external ones (customers, competitors, the technological development etc., adopting strategic pricing. In this paper I will present the most effective pricing strategies leading to long term profitability, and also suggest practical conditions for pricing strategies to maximize profit in the long run.

  6. Long-Term Ownership by Industrial Foundations

    DEFF Research Database (Denmark)

    Børsting, Christa Winther; Kuhn, Johan Moritz; Poulsen, Thomas


    in several respects. Foundations hold on to their shares for longer. Foundation-owned companies replace managers less frequently. They have more conservative capital structures with less leverage. Their companies survive longer. Their business decisions appear to be more long term. This paper supports...... in Denmark. Industrial foundations are independent legal entities without owners or members typically with the dual objective of preserving the company and using excess profits for charity. We use a unique Danish data set to examine the governance of foundation-owned companies. We show that they are long-term......Short-termism has become a serious concern for businesses and policy makers and this has inspired a search for governance arrangement to promote long term decision making. In this paper we study a particularly long-term ownership structure, which is fairly common in Northern Europe, particularly...

  7. Reforming long-term care in Europe

    National Research Council Canada - National Science Library

    Costa-i-Font, Joan


    .... Offers the very latest analysis of long-term care reform agendas in Europe. Compares countries comparatively less studied with the experiences of reform in Germany, the UK, Netherlands and Sweden...

  8. Long Term Care Minimum Data Set (MDS) (United States)

    U.S. Department of Health & Human Services — The Long-Term Care Minimum Data Set (MDS) is a standardized, primary screening and assessment tool of health status that forms the foundation of the comprehensive...

  9. Pituitary diseases : long-term clinical consequences

    NARCIS (Netherlands)

    Klaauw, Agatha Apolonia van der


    This thesis describes various studies during the long-term follow-up of patients after treatment for pituitary diseases. The focus of this thesis is acromegaly, growth hormone deficiency, sleep and quality of life. Various aspects are described.

  10. Manganese in long term paediatric parenteral nutrition.


    Reynolds, A P; Kiely, E; Meadows, N


    The current practice of providing manganese supplementation to neonates on long term parenteral nutrition is leading to a high incidence of hypermanganesaemia. Magnetic resonance imaging (MRI) studies in adults on long term manganese parenteral nutrition have shown changes in TI weighted MRI images and similar findings in a neonate receiving trace element supplementation are reported here. Whole blood manganese concentration in the infant was 1740 nmol/l (or 8.3 times upper reference limit). ...

  11. Long-term outcomes after severe shock. (United States)

    Pratt, Cristina M; Hirshberg, Eliotte L; Jones, Jason P; Kuttler, Kathryn G; Lanspa, Michael J; Wilson, Emily L; Hopkins, Ramona O; Brown, Samuel M


    Severe shock is a life-threatening condition with very high short-term mortality. Whether the long-term outcomes among survivors of severe shock are similar to long-term outcomes of other critical illness survivors is unknown. We therefore sought to assess long-term survival and functional outcomes among 90-day survivors of severe shock and determine whether clinical predictors were associated with outcomes. Seventy-six patients who were alive 90 days after severe shock (received ≥1 μg/kg per minute of norepinephrine equivalent) were eligible for the study. We measured 3-year survival and long-term functional outcomes using the Medical Outcomes Study 36-Item Short-Form Health Survey, the EuroQOL 5-D-3L, the Hospital Anxiety and Depression Scale, the Impact of Event Scale-Revised, and an employment instrument. We also assessed the relationship between in-hospital predictors and long-term outcomes. The mean long-term survival was 5.1 years; 82% (62 of 76) of patients survived, of whom 49 were eligible for follow-up. Patients who died were older than patients who survived. Thirty-six patients completed a telephone interview a mean of 5 years after hospital admission. The patients' Physical Functioning scores were below U.S. population norms (P shock had a high 3-year survival rate. Patients' long-term physical and psychological outcomes were similar to those reported for cohorts of less severely ill intensive care unit survivors. Anxiety and depression were relatively common, but only a few patients had symptoms of posttraumatic stress disorder. This study supports the observation that acute illness severity does not determine long-term outcomes. Even extremely critically ill patients have similar outcomes to general intensive care unit survivor populations.

  12. Current Perspectives on Long-term Obesity Pharmacotherapy. (United States)

    Wharton, Sean


    Approximately 1 in 4 adult Canadians are obese and, thus, are at an elevated risk for developing type 2 diabetes, cardiovascular disease and other conditions. Current treatment guidelines recommend that obese individuals lose 5% to 10% of their starting weights to minimize the risk factors for cardiovascular disease and reduce the risk for developing type 2 diabetes or hypertension. All obesity-management strategies involve lifestyle management, but few patients will lose a significant amount of weight and manage to keep it off over the long term using just this strategy. Bariatric surgery is associated with significant long-term weight loss but is restricted to subjects with very high body mass indices, who often wait many years to undergo the procedure. Recent breakthroughs in understanding the mechanisms underlying the development and maintenance of elevated body fat have led to the arrival of new obesity pharmacotherapies. These novel antiobesity therapies, which work by reducing energy intake or through increasing satiety, decreasing hunger, or reducing absorption of calories, may be used indefinitely once patients have demonstrated significant responses (usually defined as ≥5% weight loss) over the first 12 weeks of treatment. To date, 2 long-term obesity pharmacotherapies have been approved and are available in Canada: liraglutide and orlistat. Here, I summarize the mechanisms and clinical features of medications for long-term obesity management that are available in Canada, as well as those available in other jurisdictions or are currently in development. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  13. Long-term perspective underscores need for stronger near-term policies on climate change (United States)

    Marcott, S. A.; Shakun, J. D.; Clark, P. U.; Mix, A. C.; Pierrehumbert, R.; Goldner, A. P.


    Despite scientific consensus that substantial anthropogenic climate change will occur during the 21st century and beyond, the social, economic and political will to address this global challenge remains mired in uncertainty and indecisiveness. One contributor to this situation may be that scientific findings are often couched in technical detail focusing on near-term changes and uncertainties and often lack a relatable long-term context. We argue that viewing near-term changes from a long-term perspective provides a clear demonstration that policy decisions made in the next few decades will affect the Earth's climate, and with it our socio-economic well-being, for the next ten millennia or more. To provide a broader perspective, we present a graphical representation of Earth's long-term climate history that clearly identifies the connection between near-term policy options and the geological scale of future climate change. This long view is based on a combination of recently developed global proxy temperature reconstructions of the last 20,000 years and model projections of surface temperature for the next 10,000 years. Our synthesis places the 20th and 21st centuries, when most emissions are likely to occur, into the context of the last twenty millennia over which time the last Ice Age ended and human civilization developed, and the next ten millennia, over which time the projected impacts will occur. This long-term perspective raises important questions about the most effective adaptation and mitigation policies. For example, although some consider it economically viable to raise seawalls and dikes in response to 21st century sea level change, such a strategy does not account for the need for continuously building much higher defenses in the 22nd century and beyond. Likewise, avoiding tipping points in the climate system in the short term does not necessarily imply that such thresholds will not still be crossed in the more distant future as slower components

  14. Nutritional deficit and Long Term Potentiation alterations

    Directory of Open Access Journals (Sweden)

    M. Petrosino


    Full Text Available In the present work we examined the ability of prenatally malnourished offspring to produce and maintain long-term potentiation (LTP of the perforant path/dentate granule cell synapse in freely moving rats at 15,30, and 90 days of age. Population spike amplitude (PSA was calculated from dentate field potential recordings prior to and at 15, 30, 60 min. and 3, 5, 18 and 24 h following tetanization of the perforant pathway. All animals of both malnourished and well-nourished diet groups at 15 days of age showed potentiation of PSA measures but the measures obtained from 15-day-old prenatally malnourished animals were significantly less than that of age-matched, well-nourished controls. At 30 days of age, remarkable effect of tetanization was likely observed from PSA measures for this age group followed much the same pattern. At 90 days of age, PSA measures obtained from malnourished animals decreased from pretetanization levels immediately following tetanization. At this age, however, at three hours time recordings, this measure growing up to a level which did not differ significantly from that of the control group. These results indicate that the width of tetanization induced enhancement of dentate granule cell response in preweanling rats (15-day-old animals is signifacantly affected fromgestational protein malnutrition and this trend is kept in animals tested at 30 and 90 days of age. The fact, however, that considerable limitation in LTP generation was gained from prenatally malnourished animals at 90 days of age, implying that dietary rehabilitation starting at birth is an intervention strategy not capable to imbrove the effects of the gestational stress.

  15. Long term cultivation of larger benthic Foraminifera (United States)

    Wöger, Julia; Eder, Wolfgang; Kinoshita, Shunichi; Antonino, Briguglio; Carles, Ferrandes-Cañadell; Hohenegger, Johann


    Benthic Foraminifera are used in a variety of applications employing numerous different methods, i.e. ecological monitoring, studying the effects of ocean acidification, reconstructing palaeo-bathymetry or investigating palaeo-salinity and palaeo-temperature to name only a few. To refine our understanding of ecological influences on larger benthic foraminiferal biology and to review inferences from field observations, culture experiments have become an indispensable tool. While culture experiments on smaller benthic foraminifera have become increasingly frequent in the past century, reports of the cultivation of symbiont bearing larger Foraminifera are rare. Generally, cultivation experiments can be divided into two groups: Culturing of populations and cultivation of single specimens allowing individual investigation. The latter differ form the former by several restrictions resulting from the need to limit individual motility without abridging microenvironmental conditions in the Foraminiferans artificial habitat, necessary to enable the individual to development as unfettered as possible. In this study we present first experiences and preliminary results of the long-term cultivation of larger benthic Foraminifera conducted at the 'Tropical Biosphere Research Station Sesoko Island, University of the Ryukyus', Japan, trying to reproduce natural conditions as closely as possible. Individuals of three species of larger benthic Foraminifera (Heterostegina depressa, Palaeonummulites venosus and Operculina complanata) have been cultured since April 2014. At the time of the general assembly the cultivation experiments will have been going on for more than one year, with the aim to investigate growth rates, longevities and reproduction strategies for comparison with results statistically inferred from application of the of the 'natural laboratory' method. The most important factor influencing foraminiferal health and development was found to be light intensity and light

  16. Long-term prisoner in prison isolation

    Directory of Open Access Journals (Sweden)

    Karolina Grudzińska


    Full Text Available Long-term prisoner belongs to a particular category of people who are imprisoned in prisons. On the one hand in this group are often heavily demoralized people who committed the most serious crimes, on the other hand it is a group of prisoners, who should be well thought out and programmed the impact of rehabilitation. The situation of man trapped for years poses in a complicated situation not only the prisoners, but also the entire prison staff. They have to take care of the fact that the prison isolation did not cause the state in which convicts form itself in learned helplessness and lack of skills for self-planning and decision-making. In addition, planning the rehabilitation impact of long-term prisoners should not be forgotten that these prisoners in the short or the long term will return to the libertarian environment therefore, should prevent any negative effects of long-term imprisonment. This article presents the main issues related to the execution of imprisonment against long-term prisoners. It is an attempt to systematize the knowledge of this category of people living in prison isolation.

  17. Aspects of long - term intensive care


    Picková, Jana


    My thesis deals with aspects of long-term intensive care. The goal of my thesis is to determine the basic needs of patients and family preparedness aspects of intensive home care. Other stated goals is find out the possibility of returning patients to home care and also find out what is the use of basal stimulation in long-term intensive care department. In the theoretical part of my thesis are included the chapters about definition of intensive care and home intensive care, for the full comp...

  18. Long-term home care scheduling

    DEFF Research Database (Denmark)

    Gamst, Mette; Jensen, Thomas Sejr

    In several countries, home care is provided for certain citizens living at home. The long-term home care scheduling problem is to generate work plans spanning several days such that a high quality of service is maintained and the overall cost is kept as low as possible. A solution to the problem...... provides detailed information on visits and visit times for each employee on each of the covered days. We propose a branch-and-price algorithm for the long-term home care scheduling problem. The pricing problem generates one-day plans for an employee, and the master problem merges the plans with respect...

  19. A Long-term Plan for Kalk

    DEFF Research Database (Denmark)


    In this case, the author demonstrates together with the owner-manager of KALK A/S, Mr Rasmus Jorgensen, how to use the Family Business Map to frame a constructive discussion about long-term planning. The Family Business Map is a tool for long-term planning in family firms developed by Professor...... Morten Bennedsen, INSEAD and Professor Joseph Fan, Chinese University of Hong Kong. It consists of 40 questions regarding assets in the family and roadblocks facing the family firm. The Family Business Map determines that the level of family assets in KALK is high, while the level of roadblocks is severe...

  20. Marketing in the long-term care continuum. (United States)

    Laurence, J Nathan; Kash, Bita A


    Today, long-term care facilities are composed of independent, assisted living, and skilled nursing facilities along with many variations of those themes in between. The clientele for these various types of facilities differ because of the level of care the facility provides as well as the amenities long-term care consumers are looking for. However, there many similarities and common approaches to how reaching the target audience through effective marketing activities. Knowing who the target audience is, how to reach them, and how to communicate with them will serve any facility well in this competitive market. Developing marketing strategies for long-term care settings is as important as understanding what elements of care can be marketed individually as a niche market. Determining the market base for a facility is equally crucial since the target populations differ among the three types of facilities. By reviewing current marketing articles and applying marketing practices, we have crafted some general principles for which each facility type can learn from. Finally, we will discuss the types of marketing and how they related to the spectrum of long-term care facilities.

  1. [Safety of long-term nicotine use: An ongoing debate]. (United States)

    Dupont, P; Benyamina, A; Aubin, H-J


    Long-term nicotine use has been proposed as a risk-reduction strategy in smokers unwilling or unable to quit. However, its safety remains debated. Analysis of publications identified in PubMed, Toxibase, Google Scholar and in the Food and Drug Administration, and French National Authority for Health websites. Nicotine seems to be implicated in the genesis of atherosclerosis. It could be a cancer precursor, could be implicated in cancer proliferation and angiogenesis, in apoptosis reduction, and may be genotoxic. New studies are warranted for more complete assessment of the risk-benefit balance. It is difficult to affirm the safety of long term nicotine use. The risk-benefit balance should be assessed in terms of a risk-reduction strategy, as in other domains, notably illicit drug use. Copyright © 2016 SPLF. Published by Elsevier Masson SAS. All rights reserved.

  2. The long term effects of legalizing divorce on children


    Libertad González Luna; Tarja Viitanen


    We estimate the effect of divorce legalization on the long-term well-being of children. Our identification strategy relies on exploiting the different timing of divorce legalization across European countries. Using European Community Household Panel data, we compare the adult outcomes of cohorts who were raised in an environment where divorce was banned with cohorts raised after divorce was legalized in the same country. We also have “control” countries where all cohorts were exposed (or not ...

  3. The long term effects of legalizing divorce on children


    González Luna, Libertad; Viitanen, Tarja


    We estimate the effect of divorce legalization on the long-term well-being of children. Our identification strategy relies on exploiting the different timing of divorce legalization across European countries. Using European Community Household Panel data, we compare the adult outcomes of cohorts who were raised in an environment where divorce was banned with cohorts raised after divorce was legalized in the same country. We also have control countries where all cohorts were e...

  4. Long-term effects of directed forgetting. (United States)

    Hupbach, Almut


    The intention to forget reduces the accessibility of information in memory, which is commonly explained with temporary retrieval difficulties. Long-term effects have rarely been studied, and results are inconsistent. The present study re-assessed the long-term effects of directed forgetting (DF). Participants encoded a first list of items (L1), and were then instructed to forget or to remember this list. Immediately afterwards, all participants were presented with a second list to remember. In Experiment 1, memory for L1 and L2 was assessed after a 24-h delay. The forget cue reduced the number of items that were recalled from L1. Experiment 2 implemented a 12-h delay between encoding and test that was either filled with day-time wakefulness or night-time sleep. Replicating the findings of Exp. 1, recall of L1 was reduced in the forget in comparison to the remember condition. Sleep in comparison to wakefulness significantly strengthened L1 memory in the remember group only. Taken together, the present study shows that the intention to forget can have long-lasting consequences. This suggests that different mechanisms underlie the short- and long-term effects of DF, with long-term effects potentially reflecting the preferential consolidation of information that has been identified as important during encoding.

  5. Professionalism in Long-Term Care Settings (United States)

    Lubinski, Rosemary


    Speech-language pathologists who serve elders in a variety of long-term care settings have a variety of professional skills and responsibilities. Fundamental to quality service is knowledge of aging and communication changes and disorders associated with this process, institutional alternatives, and the changing nature of today's elders in…

  6. Long-term maintenance needs planning. (United States)


    This research contributes to Kentucky's knowledge base of long-term maintenance needs in two parts. Part I presents an estimate of the average revenue needed to maintain four categories of highway in the first fifteen years after each is built or res...

  7. Timber joints under long-term loading

    DEFF Research Database (Denmark)

    Feldborg, T.; Johansen, M.

    This report describes tests and results from stiffness and strength testing of splice joints under long-term loading. During two years of loading the spicimens were exposed to cyclically changing relative humidity. After the loading period the specimens were short-term tested. The connectors were...

  8. Long-Term Memory and Learning (United States)

    Crossland, John


    The English National Curriculum Programmes of Study emphasise the importance of knowledge, understanding and skills, and teachers are well versed in structuring learning in those terms. Research outcomes into how long-term memory is stored and retrieved provide support for structuring learning in this way. Four further messages are added to the…

  9. Long term consequences of early childhood malnutrition

    NARCIS (Netherlands)

    Kinsey, B.H.; Hoddinott, J; Alderman, H.


    This paper examines the impact of pre-school malnutrition on subsequent human capital formation in rural Zimbabwe using a maternal fixed effects - instrumental variables (MFE-IV) estimator with a long term panel data set. Representations of civil war and drought shocks are used to identify

  10. Long-Term Care Services for Veterans (United States)


    palliative care ,  adult day health care ,  homemaker/home health aide care ,  respite care , Long-Term Care Services for...8111A; §1785. 2 The VHA also provides dementia care ; transitional care ; health care workforce development; Geriatric Research Education, and...text (bold) = both VA and purchased community care . In addition, the VHA provides dementia care ; transitional care ; health care

  11. Long-term disability in anxiety disorders. (United States)

    Hendriks, Sanne M; Spijker, Jan; Licht, Carmilla M M; Hardeveld, Florian; de Graaf, Ron; Batelaan, Neeltje M; Penninx, Brenda W J H; Beekman, Aartjan T F


    This longitudinal study aims to investigate differences in long-term disability between social anxiety disorder (SAD), panic disorder with agoraphobia (PDA), panic disorder without agoraphobia (PD), generalized anxiety disorder (GAD) and multiple anxiety disorders (multiple AD), focusing on the effects of different course trajectories (remission, recurrence and chronic course) and specific symptom dimensions (anxiety arousal and avoidance behaviour). Data were used from participants with no psychiatric diagnosis (healthy controls, n = 647) or with a current anxiety disorder (SAD, n = 191; PDA, n = 90; PD, n = 84; GAD, n = 110; multiple AD, n = 480). Severity of anxiety arousal and avoidance behaviour symptoms was measured using the Beck Anxiety Inventory and the Fear Questionnaire. The World Health Organization Disability Assessment Schedule II was used to measure disability. Long-term disability was most prevalent in participants with SAD and multiple AD, and lowest in PDA and PD. GAD had an intermediate position. Anxiety arousal and avoidance behaviour were associated with more long-term disability in anxiety disorders than course trajectories. Various anxiety disorders have different disability levels over 4 years of time, therefore diagnostic distinction is important for treatment focus. Anxiety arousal and avoidance behaviour are major predictors for long-term disability in anxiety disorders.

  12. Long-term survival of human faecal microorganisms on the Antarctic Peninsula


    Hughes, Kevin A.; Nobbs, Simon J.


    Human faecal waste has been discarded at inland Antarctic sites for over 100 years, but little is known about the long-term survival of faecal microorganisms in the Antarctic terrestrial environment or the environmental impact. This study identified viable faecal microorganisms in 30-40 year old human faeces sampled from the waste dump at Fossil Bluff Field Station, Alexander Island, Antarctic Peninsula. Viable aerobic and anaerobic bacteria were predominantly spore-forming varieties (Bacillu...

  13. Assessment of Long-Term Mate Preferences in Iran

    Directory of Open Access Journals (Sweden)

    Mohammad Atari


    Full Text Available Previous research suggests that assessment of mate preferences has received relatively little psychometric attention from researchers, particularly in non-Western cultures. The current research was designed to (1 extend previous findings on long-term mate preferences by using a qualitative strategy, (2 develop a psychometrically sound scale for assessment of long-term mate preferences in men, and (3 develop a sex-neutral scale for assessment of long-term mate preferences. Six dimensions of mate preferences emerged for men: F = family/domesticity, A = attractiveness/sexuality, K = kindness/dependability, E = education/intelligence, R = religiosity/chastity, and S = status/resources. These male-specific dimensions of mate preferences showed satisfactory concurrent and convergent validity as well as high internal consistency coefficients. We mixed the female- and male-specific measures of mate preferences and arrived at 20 characteristics without culture- or sex-specific content. We further hypothesized that the 20-item scale of mate preferences would have a five-factor structure (i.e., kindness/dependability, attractiveness/sexuality, status/resources, education/intelligence, religiosity/chastity [KASER] in men and women and that this model would replicate sex differences cited in the evolutionary psychological literature. Measurement invariance was evidenced across sexes and sex differences accorded with those in the literature. Therefore, the five-factor model of long-term mate preferences (i.e., KASER model as measured by the Iranian Mate Preferences Scale-20 may be used to evaluate long-term mate preferences in men and women in Iran. Limitations are noted and future directions are discussed in the light of evolutionary perspective on human mating psychology.

  14. Assessment of Long-Term Mate Preferences in Iran. (United States)

    Atari, Mohammad


    Previous research suggests that assessment of mate preferences has received relatively little psychometric attention from researchers, particularly in non-Western cultures. The current research was designed to (1) extend previous findings on long-term mate preferences by using a qualitative strategy, (2) develop a psychometrically sound scale for assessment of long-term mate preferences in men, and (3) develop a sex-neutral scale for assessment of long-term mate preferences. Six dimensions of mate preferences emerged for men: F = family/domesticity, A = attractiveness/sexuality, K = kindness/dependability, E = education/intelligence, R = religiosity/chastity, and S = status/resources. These male-specific dimensions of mate preferences showed satisfactory concurrent and convergent validity as well as high internal consistency coefficients. We mixed the female- and male-specific measures of mate preferences and arrived at 20 characteristics without culture- or sex-specific content. We further hypothesized that the 20-item scale of mate preferences would have a five-factor structure (i.e., kindness/dependability, attractiveness/sexuality, status/resources, education/intelligence, religiosity/chastity [KASER]) in men and women and that this model would replicate sex differences cited in the evolutionary psychological literature. Measurement invariance was evidenced across sexes and sex differences accorded with those in the literature. Therefore, the five-factor model of long-term mate preferences (i.e., KASER model) as measured by the Iranian Mate Preferences Scale-20 may be used to evaluate long-term mate preferences in men and women in Iran. Limitations are noted and future directions are discussed in the light of evolutionary perspective on human mating psychology.

  15. Are Biofuels an Effective and Viable Energy Strategy for Industrialized Societies? A Reasoned Overview of Potentials and Limits


    Gomiero, Tiziano


    In this paper, I analyze the constraints that limit biomass from becoming an alternative, sustainable and efficient energy source, at least in relation to the current metabolism of developed countries. In order to be termed sustainable, the use of an energy source should be technically feasible, economically affordable and environmentally and socially viable, considering society as a whole. Above all, it should meet society’s “metabolic needs,” a fundamental issue that is overlooked in the ma...

  16. Long-term maintenance of fungal cultures on perlite in cryovials - an alternative for agar slants. (United States)

    Homolka, L; Lisá, L


    Cultures of 33 basidiomycete strains out of 35 tested were viable with unchanged characteristics after four years of maintenance on perlite in cryovials. These cultures can be a good substitute for agar cultures in long-term maintenance of fungi. For comparison, the storage under oil was evaluated but it turned out to be unsuitable for the majority of our cultures.

  17. Short- and Long-Term Quality of Life and Bowel Function in Patients With MRI-Defined, High-Risk, Locally Advanced Rectal Cancer Treated With an Intensified Neoadjuvant Strategy in the Randomized Phase 2 EXPERT-C Trial

    Energy Technology Data Exchange (ETDEWEB)

    Sclafani, Francesco; Peckitt, Clare [The Royal Marsden NHS Foundation Trust, London (United Kingdom); Cunningham, David, E-mail: [The Royal Marsden NHS Foundation Trust, London (United Kingdom); Tait, Diana [The Royal Marsden NHS Foundation Trust, London (United Kingdom); Giralt, Jordi [Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Department of Medical Oncology, Barcelona (Spain); Glimelius, Bengt [University of Uppsala, Uppsala (Sweden); Keränen, Susana Roselló [Biomedical Research Institute INCLIVA, Department of Hematology and Medical Oncology, University of Valencia (Spain); Bateman, Andrew [Southampton General Hospital, Cancer Sciences Unit, University of Southampton (United Kingdom); Hickish, Tamas [Poole Hospital NHS Foundation Trust, Department of Medical Oncology, Bournemouth University (United Kingdom); Tabernero, Josep [Vall d' Hebron University Hospital, Universitat Autònoma de Barcelona, Department of Medical Oncology, Barcelona (Spain); Thomas, Janet; Brown, Gina; Oates, Jacqueline; Chau, Ian [The Royal Marsden NHS Foundation Trust, London (United Kingdom)


    Objective: Intensified preoperative treatments have been increasingly investigated in locally advanced rectal cancer (LARC), but limited data are available for the impact of these regimens on quality of life (QoL) and bowel function (BF). We assessed these outcome measures in EXPERT-C, a randomized phase 2 trial of neoadjuvant capecitabine combined with oxaliplatin (CAPOX), followed by chemoradiation therapy (CRT), total mesorectal excision, and adjuvant CAPOX with or without cetuximab in magnetic resonance imaging-defined, high-risk LARC. Methods and Materials: QoL was assessed using the European Organization for Research and Treatment of Cancer QLQ-C30 and QLQ-CR29 questionnaires. Bowel incontinence was assessed using the modified Fecal Incontinence Severity Index questionnaire. Results: Compared to baseline, QoL scores during preoperative treatment were better for symptoms associated with the primary tumor in the rectum (blood and mucus in stool, constipation, diarrhea, stool frequency, buttock pain) but worse for global health status, role functioning, and symptoms related to the specific safety profile of each treatment modality. During follow-up, improved emotional functioning and lessened anxiety and insomnia were observed, but deterioration of body image, increased urinary incontinence, less sexual interest (men), and increased impotence and dyspareunia were observed. Cetuximab was associated with a deterioration of global health status during neoadjuvant chemotherapy but did not have any long-term detrimental effect. An improvement in bowel continence was observed after preoperative treatment and 3 years after sphincter-sparing surgery. Conclusions: Intensifying neoadjuvant treatment by administering induction systemic chemotherapy before chemoradiation therapy improves tumor-related symptoms and does not appear to have a significantly detrimental effect on QoL and BF, in both the short and the long term.

  18. Methods for Long-Term Stable Storage of Colletotrichum Species. (United States)

    Hiruma, Kei; Saijo, Yusuke


    In this chapter we describe methods for long-term preservation of ascomycete genus Colletotrichum species. Colletotrichum species employ a hemibiotrophic infection strategy and cause clear anthracnose diseases on various host plants including the model plant Arabidopsis thaliana. Their infection proceeds in a highly synchronized manner, which is helpful for the dissection of the fungus-plant interactions at the molecular level. Gene engineering methods, including efficient protocols for targeted gene disruption, and whole-genome sequences are available for several Colletotrichum species. Thus, these pathogens provide us with model systems to address the molecular mechanisms underlying hemibiotrophic fungal pathogenicity.We describe how to prepare glycerol stocks or filter paper fungal stocks for long-term preservation of Colletotrichum species. These two methods are easily handled, and provide a stable preservation for at least a few years.

  19. Long-term time series prediction using OP-ELM. (United States)

    Grigorievskiy, Alexander; Miche, Yoan; Ventelä, Anne-Mari; Séverin, Eric; Lendasse, Amaury


    In this paper, an Optimally Pruned Extreme Learning Machine (OP-ELM) is applied to the problem of long-term time series prediction. Three known strategies for the long-term time series prediction i.e. Recursive, Direct and DirRec are considered in combination with OP-ELM and compared with a baseline linear least squares model and Least-Squares Support Vector Machines (LS-SVM). Among these three strategies DirRec is the most time consuming and its usage with nonlinear models like LS-SVM, where several hyperparameters need to be adjusted, leads to relatively heavy computations. It is shown that OP-ELM, being also a nonlinear model, allows reasonable computational time for the DirRec strategy. In all our experiments, except one, OP-ELM with DirRec strategy outperforms the linear model with any strategy. In contrast to the proposed algorithm, LS-SVM behaves unstably without variable selection. It is also shown that there is no superior strategy for OP-ELM: any of three can be the best. In addition, the prediction accuracy of an ensemble of OP-ELM is studied and it is shown that averaging predictions of the ensemble can improve the accuracy (Mean Square Error) dramatically. Copyright © 2013 Elsevier Ltd. All rights reserved.

  20. Long-term prevention of diabetic nephropathy

    DEFF Research Database (Denmark)

    Schjoedt, K J; Hansen, H P; Tarnow, L


    . Glycaemic control and blood pressure remained nearly unchanged. CONCLUSIONS/INTERPRETATION: In our outpatient clinic, the implementation of RAAS-blocking treatment in type 1 diabetic patients with microalbuminuria successfully reduced long-term progression to overt DN to a rate similar to those previously......AIMS/HYPOTHESIS: In type 1 diabetic patients with microalbuminuria not receiving antihypertensive treatment, an increase in urinary AER (UAER) of 6-14%/year and a risk of developing diabetic nephropathy (DN) of 3-30%/year have been reported. We audited the long-term effect of blocking the renin......-angiotensin-aldosterone system (RAAS) with an ACE inhibitor (ACEI) or angiotensin II receptor blocker (ARB) in microalbuminuric type 1 diabetic patients on progression of microalbuminuria and development of DN. METHODS: All patients with type 1 diabetes and persistent microalbuminuria (30-300 mg/24 h) were identified (n=227...

  1. Long-term opioid therapy in Denmark

    DEFF Research Database (Denmark)

    Birke, H; Ekholm, Ola; Sjøgren, P


    BACKGROUND: Longitudinal population-based studies of long-term opioid therapy (L-TOT) in chronic non-cancer pain (CNCP) patients are sparse. Our study investigated incidence and predictors for initiating L-TOT and changes in self-rated health, pain interference and physical activities in long......-term opioid users. METHODS: Data were obtained from the national representative Danish Health and Morbidity Surveys and The Danish National Prescription Registry. Respondents with no dispensed opioids the year before the survey were followed from 2000 and from 2005 until the end of 2012 (n = 12...... defined as those who were dispensed at least one opioid prescription in six separate months within a year. RESULTS: The incidence of L-TOT was substantially higher in CNCP patients at baseline than in others (9/1000 vs. 2/1000 person-years). Smoking behaviour and dispensed benzodiazepines were...

  2. Learning A Physical Long-term Predictor


    Ehrhardt, Sebastien; Monszpart, Aron; Mitra, Niloy J.; Vedaldi, Andrea


    Evolution has resulted in highly developed abilities in many natural intelligences to quickly and accurately predict mechanical phenomena. Humans have successfully developed laws of physics to abstract and model such mechanical phenomena. In the context of artificial intelligence, a recent line of work has focused on estimating physical parameters based on sensory data and use them in physical simulators to make long-term predictions. In contrast, we investigate the effectiveness of a single ...

  3. Long-term course of opioid addiction. (United States)

    Hser, Yih-Ing; Evans, Elizabeth; Grella, Christine; Ling, Walter; Anglin, Douglas


    Opioid addiction is associated with excess mortality, morbidities, and other adverse conditions. Guided by a life-course framework, we review the literature on the long-term course of opioid addiction in terms of use trajectories, transitions, and turning points, as well as other factors that facilitate recovery from addiction. Most long-term follow-up studies are based on heroin addicts recruited from treatment settings (mostly methadone maintenance treatment), many of whom are referred by the criminal justice system. Cumulative evidence indicates that opioid addiction is a chronic disorder with frequent relapses. Longer treatment retention is associated with a greater likelihood of abstinence, whereas incarceration is negatively related to subsequent abstinence. Over the long term, the mortality rate of opioid addicts (overdose being the most common cause) is about 6 to 20 times greater than that of the general population; among those who remain alive, the prevalence of stable abstinence from opioid use is low (less than 30% after 10-30 years of observation), and many continue to use alcohol and other drugs after ceasing to use opioids. Histories of sexual or physical abuse and comorbid mental disorders are associated with the persistence of opioid use, whereas family and social support, as well as employment, facilitates recovery. Maintaining opioid abstinence for at least five years substantially increases the likelihood of future stable abstinence. Recent advances in pharmacological treatment options (buprenorphine and naltrexone) include depot formulations offering longer duration of medication; their impact on the long-term course of opioid addiction remains to be assessed.

  4. Long term evolution 4G and beyond

    CERN Document Server

    Yacoub, Michel; Figueiredo, Fabrício; Tronco, Tania


    This book focus on Long Term Evolution (LTE) and beyond. The chapters describe different aspects of research and development in LTE, LTE-Advanced (4G systems) and LTE-450 MHz such as telecommunications regulatory framework, voice over LTE, link adaptation, power control, interference mitigation mechanisms, performance evaluation for different types of antennas, cognitive mesh network, integration of LTE network and satellite, test environment, power amplifiers and so on. It is useful for researchers in the field of mobile communications.

  5. Long-Term Hearing Results After Ossiculoplasty. (United States)

    Cox, Matthew D; Trinidade, Aaron; Russell, James Shep; Dornhoffer, John L


    To determine if the OOPS index is predictive of long-term hearing results after ossiculoplasty. Case series with retrospective chart review. Tertiary care otology practice. Adult and pediatric patients (3-88 years of age). Ossiculoplasty with cartilage tympanoplasty, with or without mastoidectomy. Primary outcome measures included short-term hearing results (pure-tone average air-bone gap [PTA-ABG] measured between 60 days and 1 year after surgery), long-term hearing results (PTA-ABG measured ≥5 years after surgery), and the rate of successful ABG closure to ≤20 dB. Secondary measures included the need for revision surgery, delayed tympanic membrane graft failure, worsening conductive hearing loss (after an initially satisfactory hearing result), and recurrence of cholesteatoma. There was no significant difference between adults and children for short-term hearing results (average post-op PTA-ABG was 18.9 dB vs. 19.8 dB, respectively; p = 0.544), long-term hearing results (average final PTA-ABG was 19.3 dB vs. 19.4 dB, respectively; p = 0.922), or rate of ABG closure to less than 20 dB (63.1% vs. 58.0%, p = 0.282). Spearman's rank-order correlation (ρ) identified a strong positive correlation between OOPS index score and average post-operative PTA-ABG (ρ = 0.983; p hearing outcomes in adult and pediatric patients undergoing ossiculoplasty in both the short term and the long term.

  6. Timber joints under long-term loading

    DEFF Research Database (Denmark)

    Feldborg, T.; Johansen, M.

    This report describes tests and results from stiffness and strength testing of splice joints under long-term loading. During two years of loading the spicimens were exposed to cyclically changing relative humidity. After the loading period the specimens were short-term tested. The connectors were...... integral nail-plates and nailed steel and plywood gussets. The report is intended for designers and researchers in timber engineering....

  7. Long-Term Trends in World Politics

    Directory of Open Access Journals (Sweden)

    George Modelski


    Full Text Available A revisit, and an extension, of the paper “From Leadership to Organization: The Evolution of Global Politics,” originally presented at the University of Zurich in 1993. Three long-term processes: the evolution of global politics (or political globalization; the rise and decline of world powers (the long cycle of global politics; and the emergence of the world system, have been reviewed and updated.

  8. Orlistat for the long-term treatment of obesity. (United States)

    Harp, J B


    Orlistat, a potent gastrointestinal lipase inhibitor, is a member of a new class of drugs designed for the long-term treatment of obesity. When given with a fat-containing meal, orlistat reduces dietary fat absorption by approximately 30%, which equates to a decrease in caloric absorption of approximately 200 kilocalories per day. A 2-year European study found a mean decrease in body weight of 10.2% (10.3 kg) in the orlistat group compared to 6.1% (6.1 kg) in the placebo group at 1 year. Additionally, 9.3% of the orlistat group versus 2.1% of the placebo group lost >20% of their initial weight. Serum lipids and diabetes control are also improved by orlistat. Related to orlistat's mechanism of action, side effects include oily spotting, flatulence and frequent loose stools, but not frank diarrhea or intestinal malabsorption. Vitamin D and beta-carotene levels decreased, but remained within the normal range. In summary, orlistat is the first example of a new class of antiobesity drugs that enhances weight loss and weight maintenance by interfering with dietary fat absorption. Orlistat has tolerable gastrointestinal side effects and no major drug toxicity. Orlistat is a viable adjunct to lifestyle interventions used in the long-term management of obesity. (c) 1999 Prous Science. All rights reserved.

  9. Strategies for Stabilizing Nitrogenous Compounds in ECLSS Wastewater: Top-Down System Design and Unit Operation Selection with Focus on Bio-Regenerative Processes for Short and Long Term Scenarios (United States)

    Lunn, Griffin M.


    Water recycling and eventual nutrient recovery is crucial for surviving in or past low earth orbit. New approaches and syste.m architecture considerations need to be addressed to meet current and future system requirements. This paper proposes a flexible system architecture that breaks down pretreatment , steps into discrete areas where multiple unit operations can be considered. An overview focusing on the urea and ammonia conversion steps allows an analysis on each process's strengths and weaknesses and synergy with upstream and downstream processing. Process technologies to be covered include chemical pretreatment, biological urea hydrolysis, chemical urea hydrolysis, combined nitrification-denitrification, nitrate nitrification, anammox denitrification, and regenerative ammonia absorption through struvite formation. Biological processes are considered mainly for their ability to both maximize water recovery and to produce nutrients for future plant systems. Unit operations can be considered for traditional equivalent system mass requirements in the near term or what they can provide downstream in the form of usable chemicals or nutrients for the long term closed-loop ecological control and life support system. Optimally this would allow a system to meet the former but to support the latter without major modification.

  10. Unconjugated bilirubin exposure impairs hippocampal long-term synaptic plasticity.

    Directory of Open Access Journals (Sweden)

    Fang-Yu Chang

    Full Text Available BACKGROUND: Jaundice is one of the most common problems encountered in newborn infants, due to immaturity of hepatic conjugation and transport processes for bilirubin. Although the majority of neonatal jaundice is benign, some neonates with severe hyperbilirubinemia develop bilirubin encephalopathy or kernicterus. Accumulation of unconjugated bilirubin (UCB in selected brain regions may result in temporary or permanent impairments of auditory, motor, or cognitive function; however, the molecular mechanisms by which UCB elicits such neurotoxicity are still poorly understood. The present study is undertaken to investigate whether prolonged exposure of rat organotypic hippocampal slice cultures to UCB alters the induction of long-term synaptic plasticity. METHODOLOGY/PRINCIPAL FINDINGS: Using electrophysiological recording techniques, we find that exposure of hippocampal slice cultures to clinically relevant concentrations of UCB for 24 or 48 h results in an impairment of CA1 long-term potentiation (LTP and long-term depression (LTD induction in a time- and concentration-dependent manner. Hippocampal slice cultures stimulated with UCB show no changes in the secretion profiles of the pro-inflammatory cytokines, interleukin-1beta and tumor necrosis factor-alpha, or the propidium ioide uptake. UCB treatment produced a significant decrease in the levels of NR1, NR2A and NR2B subunits of N-methyl-D-aspartate (NMDA receptors through a calpain-mediated proteolytic cleavage mechanism. Pretreatment of the hippocampal slice cultures with NMDA receptor antagonist or calpain inhibitors effectively prevented the UCB-induced impairment of LTP and LTD. CONCLUSION/SIGNIFICANCE: Our results indicate that the proteolytic cleavage of NMDA receptor subunits by calpain may play a critical role in mediating the UCB-induced impairment of long-term synaptic plasticity in the hippocampus. These observations provide new insights into the molecular mechanisms underlying UCB

  11. Memory Reactivation Enables Long-Term Prevention of Interference. (United States)

    Herszage, Jasmine; Censor, Nitzan


    The ability of the human brain to successively learn or perform two competing tasks constitutes a major challenge in daily function. Indeed, exposing the brain to two different competing memories within a short temporal offset can induce interference, resulting in deteriorated performance in at least one of the learned memories [1-4]. Although previous studies have investigated online interference and its effects on performance [5-13], whether the human brain can enable long-term prevention of future interference is unknown. To address this question, we utilized the memory reactivation-reconsolidation framework [2, 12] stemming from studies at the synaptic level [14-17], according to which reactivation of a memory enables its update. In a set of experiments, using the motor sequence learning task [18] we report that a unique pairing of reactivating the original memory (right hand) in synchrony with novel memory trials (left hand) prevented future interference between the two memories. Strikingly, these effects were long-term and observed a month following reactivation. Further experiments showed that preventing future interference was not due to practice per se, but rather specifically depended on a limited time window induced by reactivation of the original memory. These results suggest a mechanism according to which memory reactivation enables long-term prevention of interference, possibly by creating an updated memory trace integrating original and novel memories during the reconsolidation time window. The opportunity to induce a long-term preventive effect on memories may enable the utilization of strategies optimizing normal human learning, as well as recovery following neurological insults. Copyright © 2017 Elsevier Ltd. All rights reserved.

  12. 47 CFR 54.303 - Long term support. (United States)


    ... 47 Telecommunication 3 2010-10-01 2010-10-01 false Long term support. 54.303 Section 54.303... SERVICE Universal Service Support for High Cost Areas § 54.303 Long term support. (a) Beginning January 1... shall receive Long Term Support. Beginning July 1, 2004, no carrier shall receive Long Term Support. (b...

  13. Health in the long-term unemployed. (United States)

    Herbig, Britta; Dragano, Nico; Angerer, Peter


    Although the unemployment rate in Germany is currently low, more than a million persons in the country have been out of work for more than a year. In this review article, we address these persons' state of health, the effect of unemployment on health, and the influence of macroeconomic factors and social policy. This article is based on a selective review of pertinent literature in the PubMed database. Large-scale meta-analyses and systematic reviews have shown that the long-term unemployed have an at least twofold risk of mental illness, particularly depression and anxiety disorders, compared to employed persons. Their mortality is 1.6-fold higher. Unemployment seems to be not only an effect of illness, but also a cause of it (i.e., there is evidence for both selection and causality). Learned helplessness is an important psychological explanatory model. Limited evidence indicates that the long-term unemployed have a moderately elevated prevalence of alcoholism; unemployment can be both an effect and a cause of alcoholism. Unemployment also seems to be associated with higher risks of heart attack and stroke. Cancer can lead to loss of employment. The link between unemployment and poorer health is strengthened by macroeconomic crises and weakened by governmental social interventions. The long-term unemployed carry a markedly higher burden of disease, particularly mental illness, than employed persons and those who are unemployed only for a short time. The burden of disease increases with the duration of unemployment. The vicious circle of unemployment and disease can be broken only by the combined effects of generally available health care, special health-promoting measures among the unemployed, and social interventions.

  14. Long-term EARLINET dust observations (United States)

    Mona, Lucia; Amiridis, Vassilis; Amodeo, Aldo; Binietoglou, Ioannis; D'Amico, Giuseppe; Schwarz, Anja; Papagiannopoulos, Nikolaos; Papayannis, Alexandros; Sicard, Michael; Comeron, Adolfo; Pappalardo, Gelsomina


    Systematic observations of Saharan dust events over Europe are performed from May 2000 by EARLINET, the European Aerosol Research LIdar NETwork. EARLINET is a coordinated network of stations that make use of advanced lidar methods for the vertical profiling of aerosols. The backbone of EARLINET network is a common schedule for performing the measurements and the quality assurance of instruments/data. Particular attention is paid to monitoring the Saharan dust intrusions over the European continent. The geographical distribution of the EARLINET stations is particularly appealing for the dust observation, with stations located all around the Mediterranean and in the center of the Mediterranean (Italian stations) where dust intrusions are frequent, and with several stations in the central Europe where dust penetrates occasionally. All aerosol backscatter and extinction profiles related to observations collected during these alerts are grouped in the devoted "Saharan dust" category of the EARLINET database. This category consists of about 4700 files (as of December 2013). Case studies involving several stations around Europe selected from this long-term database have been provided the opportunity to investigate dust modification processes during transport over the continent. More important, the long term EARLINET dust monitoring allows the investigation of the horizontal and vertical extent of dust outbreaks over Europe and the climatological analysis of dust optical intensive and extensive properties at continental scale. This long-term database is also a unique tool for a systematic comparison with dust model outputs and satellite-derived dust products. Because of the relevance for both dust modeling and satellite retrievals improvement, results about desert dust layers extensive properties as a function of season and source regions are investigated and will be presented at the conference. First comparisons with models outputs and CALIPSO dust products will be

  15. Long-Term Recency in Anterograde Amnesia (United States)

    Talmi, Deborah; Caplan, Jeremy B.; Richards, Brian; Moscovitch, Morris


    Amnesia is usually described as an impairment of a long-term memory (LTM) despite an intact short-term memory (STM). The intact recency effect in amnesia had supported this view. Although dual-store models of memory have been challenged by single-store models based on interference theory, this had relatively little influence on our understanding and treatment of amnesia, perhaps because the debate has centred on experiments in the neurologically intact population. Here we tested a key prediction of single-store models for free recall in amnesia: that people with amnesia will exhibit a memory advantage for the most recent items even when all items are stored in and retrieved from LTM, an effect called long-term recency. People with amnesia and matched controls studied, and then free-recalled, word lists with a distractor task following each word, including the last (continual distractor task, CDFR). This condition was compared to an Immediate Free Recall (IFR, no distractors) and a Delayed Free Recall (DFR, end-of-list distractor only) condition. People with amnesia demonstrated the full long-term recency pattern: the recency effect was attenuated in DFR and returned in CDFR. The advantage of recency over midlist items in CDFR was comparable to that of controls, confirming a key prediction of single-store models. Memory deficits appeared only after the first word recalled in each list, suggesting the impairment in amnesia may emerge only as the participant’s recall sequence develops, perhaps due to increased susceptibility to output interference. Our findings suggest that interference mechanisms are preserved in amnesia despite the overall impairment to LTM, and challenge strict dual-store models of memory and their dominance in explaining amnesia. We discuss the implication of our findings for rehabilitation. PMID:26046770

  16. Long-term EEG in children. (United States)

    Montavont, A; Kaminska, A; Soufflet, C; Taussig, D


    Long-term video-EEG corresponds to a recording ranging from 1 to 24 h or even longer. It is indicated in the following situations: diagnosis of epileptic syndromes or unclassified epilepsy, pre-surgical evaluation for drug-resistant epilepsy, follow-up of epilepsy or in cases of paroxysmal symptoms whose etiology remains uncertain. There are some specificities related to paediatric care: a dedicated pediatric unit; continuous monitoring covering at least a full 24-hour period, especially in the context of pre-surgical evaluation; the requirement of presence by the parents, technician or nurse; and stronger attachment of electrodes (cup electrodes), the number of which is adapted to the age of the child. The chosen duration of the monitoring also depends on the frequency of seizures or paroxysmal events. The polygraphy must be adapted to the type and topography of movements. It is essential to have at least an electrocardiography (ECG) channel, respiratory sensor and electromyography (EMG) on both deltoids. There is no age limit for performing long-term video-EEG even in newborns and infants; nevertheless because of scalp fragility, strict surveillance of the baby's skin condition is required. In the specific context of pre-surgical evaluation, long-term video-EEG must record all types of seizures observed in the child. This monitoring is essential in order to develop hypotheses regarding the seizure onset zone, based on electroclinical correlations, which should be adapted to the child's age and the psychomotor development. Copyright © 2015. Published by Elsevier SAS.

  17. The long term stability of lidar calibrations

    DEFF Research Database (Denmark)

    Courtney, Michael; Gayle Nygaard, Nicolai

    Wind lidars are now used extensively for wind resource measurements. One of the requirements for the data to be accepted in support of project financing (so-called ‘banka-bility’) is to demonstrate the long-term stability of lidar cali-brations. Calibration results for six Leosphere WindCube li-dars......-ters pertaining in the different calibration periods. This is supported by sliding-window analyses of one lidar at one location where the same order of variation is observed as between pre-service and post-service calibrations....

  18. Transverse dimension and long-term stability. (United States)

    Vanarsdall, R L


    This article emphasizes the critical importance of the skeletal differential between the width of the maxilla and the width of the mandible. Undiagnosed transverse discrepancy leads to adverse periodontal response, unstable dental camouflage, and less than optimal dentofacial esthetics. Hundreds of adult retreatment patients corrected for significant maxillary transverse deficiency using surgically assisted maxillary expansion (similar to osseous distraction) has produced excellent stability. Eliciting tooth movement for children (orthopedics, lip bumper, Cetlin plate) in all three planes of space by muscles, eruption, and growth, develops the broader arch form (without the mechanical forces of fixed or removable appliances) and has also demonstrated impressive long term stability.

  19. Long-term population studies of seabirds. (United States)

    Wooller, R D; Bradley, J S; Croxall, J P


    Long-term studies of seabirds, some now 30-40 years old, have begun to reveal significant age-related changes in the survival and reproduction o f these long-lived animals. Evidence for density-dependent regulation of seabird numbers, however, remains sparse whereas unpredictable, disastrous breeding years may be an important influence. Critical evaluation will require better data on (1) the extent of movements of seabirds between colonies, (2) the characteristics of those individuals that contribute disproportionately to the next generation, and (3) the importance of year and/or cohort effects on population processes. Copyright © 1992. Published by Elsevier Ltd.

  20. Terminating a long-term clinical trial. (United States)

    Klimt, C R


    Long-term clinical trials often include more than one active treatment group. These may be discontinued independently if found to be ineffective or possibly harmful. Certain subgroups of patients may be discovered, in the course of a clinical trial, who do not respond satisfactorily and are, therefore, excluded during the course of a trial. Yet another kind of termination comes when we have a therapeutic breakthrough or when hope has to be abandoned for demonstrating beneficial effects for one, several, or all treatments included in a trial. Examples from the authors' experience are presented, as are successful and unsuccessful techniques in managing terminations of various types.

  1. Long term testing of PSI-membranes

    Energy Technology Data Exchange (ETDEWEB)

    Huslage, J.; Brack, H.P.; Geiger, F.; Buechi, F.N.; Tsukada, A.; Scherer, G.G. [Paul Scherrer Inst. (PSI), Villigen (Switzerland)


    Long term tests of PSI membranes based on radiation-grafted FEP and ETFE films were carried out and FEP-based membranes were evaluated by monitoring the in-situ membrane area resistance measured by a current pulse method. By modifying our irradiation procedure and using the double crosslinking concept we obtain reproducible membrane cell lifetimes (in term of in-situ membrane resistance) of greater than 5000 hours at 60-65{sup o}C. Preliminary tests at 80-85{sup o}C with lifetimes of greater than 2500 demonstrate the potential long term stability of PSI proton exchange membranes based on FEP over the whole operating temperature range of low-temperature polymer electrolyte fuel cells. Radiation grafted PSI membranes based on ETFE have better mechanical properties than those of the FEP membranes. Mechanical properties are particularly important in large area cells and fuel cell stacks. ETFE membranes have been tested successfully for approximately 1000 h in a 2-cell stack (100 cm{sup 2} active area each cell). (author) 4 figs., 4 refs.

  2. Institutionalization and Organizational Long-term Success

    Directory of Open Access Journals (Sweden)

    Denise L. Fleck


    Full Text Available Institutionalization processes have an ambivalent effect on organizational long-term success. Even though they foster organizational stability and permanence, they also bring about rigidity and resistance to change. As a result, successful organizations are likely to lose their competitive advantage over time. The paper addresses this issue through the investigation of the institutionalization processes of two long-lived companies: General Electric, a firm that has been a long-term success and its rival, Westinghouse, which was broken up after eleven decades of existence. The longitudinal, multilevel analysis of firms and industry has identified two different modes of organizational institutionalization. The reactive mode gives rise to rigidity and change resistance, much like institutional theory predicts; the proactive mode, on the other hand, neutralizes those negative effects of institutionalization processes. In the reactive mode, structure predominates. In the proactive mode, agency plays a major role in organizational institutionalization, and in managing the organization’s relations with the environment, clearly contributing to environmental institutionalization.

  3. Sleep facilitates long-term face adaptation. (United States)

    Ditye, Thomas; Javadi, Amir Homayoun; Carbon, Claus-Christian; Walsh, Vincent


    Adaptation is an automatic neural mechanism supporting the optimization of visual processing on the basis of previous experiences. While the short-term effects of adaptation on behaviour and physiology have been studied extensively, perceptual long-term changes associated with adaptation are still poorly understood. Here, we show that the integration of adaptation-dependent long-term shifts in neural function is facilitated by sleep. Perceptual shifts induced by adaptation to a distorted image of a famous person were larger in a group of participants who had slept (experiment 1) or merely napped for 90 min (experiment 2) during the interval between adaptation and test compared with controls who stayed awake. Participants' individual rapid eye movement sleep duration predicted the size of post-sleep behavioural adaptation effects. Our data suggest that sleep prevented decay of adaptation in a way that is qualitatively different from the effects of reduced visual interference known as 'storage'. In the light of the well-established link between sleep and memory consolidation, our findings link the perceptual mechanisms of sensory adaptation--which are usually not considered to play a relevant role in mnemonic processes--with learning and memory, and at the same time reveal a new function of sleep in cognition.

  4. Long-term environmental behaviour of radionuclides

    Energy Technology Data Exchange (ETDEWEB)

    Brechignac, F.; Moberg, L.; Suomela, M


    The radioactive pollution of the environment results from the atmospheric nuclear weapons testing (during the mid-years of twentieth century), from the development of the civilian nuclear industry and from accidents such as Chernobyl. Assessing the resulting radiation that humans might receive requires a good understanding of the long-term behaviour of radionuclides in the environment. This document reports on a joint European effort to advance this understanding, 3 multinational projects have been coordinated: PEACE, EPORA and LANDSCAPE. This report proposes an overview of the results obtained and they are presented in 6 different themes: (i) redistribution in the soil-plant system, (ii) modelling, (iii) countermeasures, (iv) runoff (v) spatial variations, and (vi) dose assessment. The long term behaviour of the radionuclides {sup 137}Cs, {sup 90}Sr and {sup 239-240}Pu is studied through various approaches, these approaches range from in-situ experiments designed to exploit past contamination events to laboratory simulations. A broad scope of different ecosystems ranging from arctic and boreal regions down to mediterranean ones has been considered. (A.C.)

  5. Long-term motor cortex stimulation for phantom limb pain. (United States)

    Pereira, Erlick A C; Moore, Tom; Moir, Liz; Aziz, Tipu Z


    We present the long-term course of motor cortex stimulation to relieve a case of severe burning phantom arm pain after brachial plexus injury and amputation. During 16-year follow-up the device continued to provide efficacious analgesia. However, several adjustments of stimulation parameters were required, as were multiple pulse generator changes, antibiotics for infection and one electrode revision due to lead migration. Steady increases in stimulation parameters over time were required. One of the longest follow-ups of motor cortex stimulation is described; the case illustrates challenges and pitfalls in neuromodulation for chronic pain, demonstrating strategies for maintaining analgesia and overcoming tolerance.

  6. Long-term outcome after an early invasive versus selective invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome and elevated cardiac troponin T (the ICTUS trial): a follow-up study

    NARCIS (Netherlands)

    Hirsch, Alexander; Windhausen, Fons; Tijssen, Jan G. P.; Verheugt, Freek W. A.; Hein Cornel, Jan; de Winter, Robbert J.


    BACKGROUND: The ICTUS trial was a study that compared an early invasive with a selective invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome (nSTE-ACS). The study reported no difference between the strategies for frequency of death, myocardial infarction, or

  7. Long-term outcome after an early invasive versus selective invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome and elevated cardiac troponin T (the ICTUS trial): a follow-up study.

    NARCIS (Netherlands)

    Hirsch, A.; Windhausen, F.; Tijssen, J.G.P.; Verheugt, F.W.A.; Cornel, J.H.; Winter, R.J. de


    BACKGROUND: The ICTUS trial was a study that compared an early invasive with a selective invasive treatment strategy in patients with non-ST-elevation acute coronary syndrome (nSTE-ACS). The study reported no difference between the strategies for frequency of death, myocardial infarction, or

  8. Are Biofuels an Effective and Viable Energy Strategy for Industrialized Societies? A Reasoned Overview of Potentials and Limits

    Directory of Open Access Journals (Sweden)

    Tiziano Gomiero


    Full Text Available In this paper, I analyze the constraints that limit biomass from becoming an alternative, sustainable and efficient energy source, at least in relation to the current metabolism of developed countries. In order to be termed sustainable, the use of an energy source should be technically feasible, economically affordable and environmentally and socially viable, considering society as a whole. Above all, it should meet society’s “metabolic needs,” a fundamental issue that is overlooked in the mainstream biofuels narrative. The EROI (Energy Return on Investment of biofuels reaches a few units, while the EROI of fossil fuels is 20–30 or higher and has a power density (W/m2 thousands of times higher than the best biofuels, such as sugarcane in Brazil. When metabolic approaches are used it becomes clear that biomass cannot represent an energy carrier able to meet the metabolism of industrialized societies. For our industrial society to rely on “sustainable biofuels” for an important fraction of its energy, most of the agricultural and non-agricultural land would need to be used for crops, and at the same time a radical cut to our pattern of energy consumption would need to be implemented, whilst also achieving a significant population reduction.

  9. Anticipatory eye movements and long-term memory in early infancy. (United States)

    Wong-Kee-You, Audrey M B; Adler, Scott A


    Advances in our understanding of long-term memory in early infancy have been made possible by studies that have used the Rovee-Collier's mobile conjugate reinforcement paradigm and its variants. One function that has been attributed to long-term memory is the formation of expectations (Rovee-Collier & Hayne, 1987); consequently, a long-term memory representation should be established during expectation formation. To examine this prediction and potentially open the door on a new paradigm for exploring infants' long-term memory, using the Visual Expectation Paradigm (Haith, Hazan, & Goodman, 1988), 3-month-old infants were trained to form an expectation for predictable color and spatial information of picture events and emit anticipatory eye movements to those events. One day later, infants' anticipatory eye movements decreased in number relative to the end of training when the predictable colors were changed but not when the spatial location of the predictable color events was changed. These findings confirm that information encoded during expectation formation are stored in long-term memory, as hypothesized by Rovee-Collier and colleagues. Further, this research suggests that eye movements are potentially viable measures of long-term memory in infancy, providing confirmatory evidence for early mnemonic processes. © 2016 Wiley Periodicals, Inc.

  10. Towards a Long-Term Strategy for Voluntary-Based Internal Radiation Contamination Monitoring: A Population-Level Analysis of Monitoring Prevalence and Factors Associated with Monitoring Participation Behavior in Fukushima, Japan

    National Research Council Canada - National Science Library

    Shuhei Nomura; Masaharu Tsubokura; Akihiko Ozaki; Michio Murakami; Susan Hodgson; Marta Blangiardo; Yoshitaka Nishikawa; Tomohiro Morita; Tomoyoshi Oikawa


    Following Japan’s 2011 Fukushima nuclear incident, we assessed voluntary-based monitoring behavior in Minamisoma City-located 10-40 km from the Fukushima nuclear plant-to inform future monitoring strategies...

  11. Long-term Strategic Planning for a Resilient Metro Colombo: An Economic Case for Wetland Conservation and Management (United States)

    Rozenberg, J.


    Colombo faces recurrent floods that threaten its long-term economic development. Its urban wetlands have been identified by local agencies as a critical component of its flood reduction system, but they have declined rapidly in recent years due to continuous infilling, unmanaged land development and dredging to create lakes. In collaboration with government agencies, NGOs and local universities, the World Bank has carried out a Robust Decision Making analysis to examine the value of Colombo urban wetlands, both in the short-term and long-term, and identify what are the most viable strategies available to increase the city's flood resilience in an unclear future (in terms of climate change and patterns of urban development). This has involved the use of numerous hydrological and socio-economic scenarios as well as the evaluation of some wetlands benefits, like ecosystem services, wastewater treatment, or recreational services. The analysis has determined that if all urban wetlands across the Colombo catchment were lost, in some scenarios the metropolitan area would have to cope with an annual average flood loss of approximately 1% of Colombo GDP in the near future. For long-term strategies, trade-offs between urban development, lake creation and wetland conservation were analyzed and it was concluded that an active management of urban wetlands was the lowest regret option. Finally, the analysis also revealed that in the future, with climate change and fast urban development, wetlands will not be sufficient to protect Colombo against severe floods. Pro-active urban planning and land-use management are therefore necessary, both to protect existing wetlands and to reduce future exposure. The use of many different scenarios, the consideration of several policy options, and the open participatory process ensured policy-makers' buy-in and lead to the decision to actively protect urban wetlands in Colombo.

  12. Long-term opioid therapy in Denmark

    DEFF Research Database (Denmark)

    Birke, H; Ekholm, O; Sjøgren, P


    BACKGROUND: Longitudinal population-based studies of long-term opioid therapy (L-TOT) in chronic non-cancer pain (CNCP) patients are sparse. Our study investigated incidence and predictors for initiating L-TOT and changes in self-rated health, pain interference and physical activities in long...... defined as those who were dispensed at least one opioid prescription in six separate months within a year. RESULTS: The incidence of L-TOT was substantially higher in CNCP patients at baseline than in others (9/1000 vs. 2/1000 person-years). Smoking behaviour and dispensed benzodiazepines were...... individuals indicated a dose-response relationship between longer treatment duration and the risk of experiencing negative changes. CONCLUSIONS: Individuals on L-TOT seemed not to achieve the key goals of opioid therapy: pain relief, improved quality of life and functional capacity. SIGNIFICANCE: Long...

  13. [Enteral nutrition through long-term jejunostomy]. (United States)

    Fernández, T; Neira, P; Enríquez, C


    We present the case of a female patient suffering a peritonitis episode after subtotal gastrectomy due to gastric neoplasm in relation to lesser curvature necrosis extending to the anterior esophageal wall. This an uncommon andsevere complication that made mandatory further aggressive surgery: transection of the abdominal esophagus, transection of the gastric stump, and cervical esophagostomy with creation of a jejunostomy with a needle catheter for feeding. This digestive tube access technique is generally used during major abdominal post-surgery until oral intake is reestablished. Our patient has been 187 days with this therapy since reconstruction of the GI tract was ruled out due to tumoral infiltration of the colon and tumor recurrence at the gastrohepatic omentum. To date, there has been no complication from permanence and/or long-term use of this technique.

  14. Rising Long-term Interest Rates

    DEFF Research Database (Denmark)

    Hallett, Andrew Hughes

    Rather than chronicle recent developments in European long-term interest rates as such, this paper assesses the impact of increases in those interest rates on economic performance and inflation. That puts us in a position to evaluate the economic pressures for further rises in those rates......, the first question posed in this assignment, and the scope for overshooting (the second question), and then make some illustrative predictions of future interest rates in the euro area. We find a wide range of effects from rising interest rates, mostly small and mostly negative, focused on investment...... till the emerging European recovery is on a firmer basis and capable of overcoming increases in the cost of borrowing and shrinking fiscal space. There is also an implication that worries about rising/overshooting interest rates often reflect the fact that inflation risks are unequally distributed...

  15. Long-term stability of salivary cortisol

    DEFF Research Database (Denmark)

    Garde, A H; Hansen, Åse Marie


    The measurement of salivary cortisol provides a simple, non-invasive, and stress-free measure frequently used in studies of the hypothalamic-pituitary-adrenal axis activity. In research projects, samples are often required to be stored for longer periods of time either because of the protocol...... of the project or because of lack of funding for analysis. The aim of the present study was to explore the effects of long-term storage of samples on the amounts of measurable cortisol. Ten pools of saliva were collected on polyester Salivette tampons from five subjects. After centrifugation the samples were...... either stored in small vials or spiked to polyester Salivette tampons before analysis for cortisol using Spectria RIA kits. The effects of storage were evaluated by a linear regression model (mixed procedure) on a logarithmic scale. No effects on cortisol concentrations were found after storage of saliva...

  16. Autobiographical reasoning in long-term fandom

    Directory of Open Access Journals (Sweden)

    C. Lee Harrington


    Full Text Available We explore the social psychological processes through which fan-based experiences become situated in fans' larger life narratives. Drawing on original survey data with long-term U.S. soap opera fans, we examine how the psychological mechanism of autobiographical reasoning functions in fans' construction of self-narratives over time. The case study presented here is a subset of a larger investigation into the age-related structure of fans' activities, identities, and interpretive capacities. Situated at the intersections of gerontological (life span/life course theory and contemporary fan studies, our project mines relatively uninvestigated theoretical terrain. We conclude with a brief discussion of implications for future fan studies.

  17. Globalization: a long-term view. (United States)

    Suter, Keith


    The process of globalization is now the most important development in world affairs. It is the end of the world order dominated by nation states (or countries) and the beginning of an era in which national governments have to share their power with other entities, most notably transnational corporations (TNCs), inter-governmental organizations (IGOs) and non-governmental organizations (NGOs). The process has to be viewed in its long-term historical evolution. Unfortunately, the process was seen as a technical international law issue by most people so there was a lack of attention to ensuring that the process worked for the benefit of all of humanity. The current (belated) controversy, such as the 1999 Battle of Seattle, could be a window of opportunity for NGOs to encourage a more informed public debate on how to create proposals for a better world.

  18. Dynamics of long-term genomic selection

    Directory of Open Access Journals (Sweden)

    Jannink Jean-Luc


    Full Text Available Abstract Background Simulation and empirical studies of genomic selection (GS show accuracies sufficient to generate rapid gains in early selection cycles. Beyond those cycles, allele frequency changes, recombination, and inbreeding make analytical prediction of gain impossible. The impacts of GS on long-term gain should be studied prior to its implementation. Methods A simulation case-study of this issue was done for barley, an inbred crop. On the basis of marker data on 192 breeding lines from an elite six-row spring barley program, stochastic simulation was used to explore the effects of large or small initial training populations with heritabilities of 0.2 or 0.5, applying GS before or after phenotyping, and applying additional weight on low-frequency favorable marker alleles. Genomic predictions were from ridge regression or a Bayesian analysis. Results Assuming that applying GS prior to phenotyping shortened breeding cycle time by 50%, this practice strongly increased early selection gains but also caused the loss of many favorable QTL alleles, leading to loss of genetic variance, loss of GS accuracy, and a low selection plateau. Placing additional weight on low-frequency favorable marker alleles, however, allowed GS to increase their frequency earlier on, causing an initial increase in genetic variance. This dynamic led to higher long-term gain while mitigating losses in short-term gain. Weighted GS also increased the maintenance of marker polymorphism, ensuring that QTL-marker linkage disequilibrium was higher than in unweighted GS. Conclusions Losing favorable alleles that are in weak linkage disequilibrium with markers is perhaps inevitable when using GS. Placing additional weight on low-frequency favorable alleles, however, may reduce the rate of loss of such alleles to below that of phenotypic selection. Applying such weights at the beginning of GS implementation is important.

  19. Long-term reductions in tinnitus severity

    Directory of Open Access Journals (Sweden)

    Folmer Robert L


    Full Text Available Abstract Background This study was undertaken to assess long-term changes in tinnitus severity exhibited by patients who completed a comprehensive tinnitus management program; to identify factors that contributed to changes in tinnitus severity within this population; to contribute to the development and refinement of effective assessment and management procedures for tinnitus. Methods Detailed questionnaires were mailed to 300 consecutive patients prior to their initial appointment at the Oregon Health & Science University Tinnitus Clinic. All patients were then evaluated and treated within a comprehensive tinnitus management program. Follow-up questionnaires were mailed to the same 300 patients 6 to 36 months after their initial tinnitus clinic appointment. Results One hundred ninety patients (133 males, 57 females; mean age 57 years returned follow-up questionnaires 6 to 36 months (mean = 22 months after their initial tinnitus clinic appointment. This group of patients exhibited significant long-term reductions in self-rated tinnitus loudness, Tinnitus Severity Index scores, tinnitus-related anxiety and prevalence of current depression. Patients who improved their sleep patterns or Beck Depression Inventory scores exhibited greater reductions of tinnitus severity scores than patients who continued to experience insomnia and depression at follow-up. Conclusions Individualized tinnitus management programs that were designed for each patient contributed to overall reductions in tinnitus severity exhibited on follow-up questionnaires. Identification and treatment of patients experiencing anxiety, insomnia or depression are vital components of an effective tinnitus management program. Utilization of acoustic therapy also contributed to improvements exhibited by these patients.

  20. Microfluidic culture chamber for the long-term perfusion and precise chemical stimulation of organotypic brain tissue slices

    DEFF Research Database (Denmark)

    Caicedo, H. H.; Vignes, M.; Brugg, B.


    We have developed a microfluidic perfusion-based culture system to study long-term in-vitro responses of organo-typic brain slices exposed to localized neurochemical stimulation. Using this microperfusion chamber we show that hip-pocampal organotypic brain slices cultures grown on nitrocellulose......-vitro micro environment, long-term culture of viable brain slices, and delivery of fluids to selected brain regions in a multiplexed and spatially defined manner....

  1. Long-term potentiation and long-term depression: a clinical perspective

    Directory of Open Access Journals (Sweden)

    Timothy V.P. Bliss


    Full Text Available Long-term potentiation and long-term depression are enduring changes in synaptic strength, induced by specific patterns of synaptic activity, that have received much attention as cellular models of information storage in the central nervous system. Work in a number of brain regions, from the spinal cord to the cerebral cortex, and in many animal species, ranging from invertebrates to humans, has demonstrated a reliable capacity for chemical synapses to undergo lasting changes in efficacy in response to a variety of induction protocols. In addition to their physiological relevance, long-term potentiation and depression may have important clinical applications. A growing insight into the molecular mechanisms underlying these processes, and technological advances in non-invasive manipulation of brain activity, now puts us at the threshold of harnessing long-term potentiation and depression and other forms of synaptic, cellular and circuit plasticity to manipulate synaptic strength in the human nervous system. Drugs may be used to erase or treat pathological synaptic states and non-invasive stimulation devices may be used to artificially induce synaptic plasticity to ameliorate conditions arising from disrupted synaptic drive. These approaches hold promise for the treatment of a variety of neurological conditions, including neuropathic pain, epilepsy, depression, amblyopia, tinnitus and stroke.

  2. Creating a viable financial structure for electricity generation projects in Quebec : latest techniques and strategies; Creer une structure financiere viable pour les projets de production d'electricite au Quebec : dernieres techniques et strategies

    Energy Technology Data Exchange (ETDEWEB)

    Dorion, M. [McCarthy Tetrault, Quebec City, PQ (Canada)


    Several factors, such as the rapid rise in electricity demand, the increase in electricity prices, technological progress, and environmental concerns have prompted the Quebec government to develop strategies and measures to restructure its electricity industry. Independent electricity producers in Quebec rely primarily on water, natural gas, biomass, and wind power to generate electricity. Calls for tender were made by Hydro-Quebec Production and Hydro-Quebec Distribution in order to meet the expected increased electricity demand in the province in the next few years. Financial markets in Quebec are also following developments in the electricity market. Financing for electric power generation projects is available from a variety of sources including debt financing, conventional corporate financing, leasing, security, equity investment, strategic partners, and institutional investors. The author discussed risk management associated with a private production project, with reference to general risks, specific risks, and financial risks. The basic principles in terms of risk allocation were examined along with the specific risks related to the source of energy production (hydroelectricity, combined cycle natural gas and cogeneration, biomass, and wind power) and the possible management solutions.

  3. Long-term strategic asset allocation: An out-of-sample evaluation

    NARCIS (Netherlands)

    Diris, B.F.; Palm, F.C.; Schotman, P.C.

    We evaluate the out-of-sample performance of a long-term investor who follows an optimized dynamic trading strategy. Although the dynamic strategy is able to benefit from predictability out-of-sample, a short-term investor using a single-period market timing strategy would have realized an almost

  4. Improving students' long-term knowledge retention through personalized review. (United States)

    Lindsey, Robert V; Shroyer, Jeffery D; Pashler, Harold; Mozer, Michael C


    Human memory is imperfect; thus, periodic review is required for the long-term preservation of knowledge and skills. However, students at every educational level are challenged by an ever-growing amount of material to review and an ongoing imperative to master new material. We developed a method for efficient, systematic, personalized review that combines statistical techniques for inferring individual differences with a psychological theory of memory. The method was integrated into a semester-long middle-school foreign-language course via retrieval-practice software. Using a cumulative exam administered after the semester's end, we compared time-matched review strategies and found that personalized review yielded a 16.5% boost in course retention over current educational practice (massed study) and a 10.0% improvement over a one-size-fits-all strategy for spaced study.

  5. Elevated rheumatoid factor and long term risk of rheumatoid arthritis

    DEFF Research Database (Denmark)

    Nielsen, Sune F; Bojesen, Stig E; Schnohr, Peter


    To test whether elevated concentration of rheumatoid factor is associated with long term development of rheumatoid arthritis.......To test whether elevated concentration of rheumatoid factor is associated with long term development of rheumatoid arthritis....

  6. Patent Citations and Financial Analysts’ Long-Term Growth Forecasts

    National Research Council Canada - National Science Library

    Jincheol Bae; Wonchang Hur; Jaehong Lee; Jaimin Goh


    ...’ innovation outputs, on financial analysts’ long-term growth forecasts for firms. We find that financial analysts are more likely to issue long-term forecasts for firms with higher patent citations...

  7. In-hospital outcomes and long-term mortality according to sex and management strategy in acute myocardial infarction. Insights from the French ST-elevation and non-ST-elevation Myocardial Infarction (FAST-MI) 2005 Registry. (United States)

    Donataccio, Maria Pia; Puymirat, Etienne; Parapid, Biljana; Steg, Philippe Gabriel; Eltchaninoff, Hélène; Weber, Simon; Ferrari, Emile; Vilarem, Didier; Charpentier, Sandrine; Manzo-Silberman, Stéphane; Ferrières, Jean; Danchin, Nicolas; Simon, Tabassome


    The early mortality of acute myocardial infarction (AMI) has dramatically decreased in the recent past. Whether the previously reported sex disparities in use of invasive strategies (IS) persist and translate into differences in outcomes deserves to be examined. We used the data from a nationwide French prospective multicentre registry from 3,670 AMI patients (1155 women (31.5%), 2515 men (68.5%)) recruited in 223 centres in 2005 and followed-up for 5 years. We examined in-hospital outcomes and 5-year mortality in patients categorized according to sex and use of IS (i.e. coronary angiography during the hospitalisation with a view to revascularisation). IS was less frequently used in women than in men (adjusted OR=0.66; 95% CI: 0.52-0.85), regardless of the type of AMI, age group or risk category, while use of recommended medications was similar at 48 hours and discharge. In-hospital mortality did not differ according to sex, whatever the age group and use of an IS. At 5 years, overall and post-discharge mortality were similar in men and women. However, IS was associated with lower 5-year mortality in women (HR=0.66; 95% CI: 0.51-0.86) as in men (HR=0.48; 95% CI: 0.38-0.60) and there was no sex-strategy interaction. Invasive strategy remains less frequently used in women than in men, yet is associated with improved five-year survival irrespective of sex. Whether reducing the sex gap in its use would translate into a higher survival in women remains an open question. NCT 00673036. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  8. A device for long-term perfusion, imaging, and electrical interfacing of brain tissue in vitro

    Directory of Open Access Journals (Sweden)

    Nathaniel J Killian


    Full Text Available Distributed microelectrode array (MEA recordings from consistent, viable, ≥ 500 µm thick tissue preparations over time periods from days to weeks may aid in studying a wide range of problems in neurobiology that require in vivo-like organotypic morphology. Existing tools for electrically interfacing with organotypic slices do not address necrosis that inevitably occurs within thick slices with limited diffusion of nutrients and gas, and limited removal of waste. We developed an integrated device that enables long-term maintenance of thick, functionally active, brain tissue models using interstitial perfusion and distributed recordings from thick sections of explanted tissue on a perforated multi-electrode array. This novel device allows for automated culturing, in situ imaging, and extracellular multi-electrode interfacing with brain slices, 3 D cell cultures, and potentially other tissue culture models. The device is economical, easy to assemble, and integrable with standard electrophysiology tools. We found that convective perfusion through the culture thickness provided a functional benefit to the preparations as firing rates were generally higher in perfused cultures compared to their respective unperfused controls. This work is a step towards the development of integrated tools for days-long experiments with more consistent, healthier, thicker, and functionally more active tissue cultures with built-in distributed electrophysiological recording and stimulation functionality. The results may be useful for the study of normal processes, pathological conditions, and drug screening strategies currently hindered by the limitations of acute (a few hours long brain slice preparations.

  9. [Long-term outcome after hemispheric disconnection]. (United States)

    Bulteau, C; Dorfmüller, G; Fohlen, M; Jalin, C; Oliver, M-V; Delalande, O


    Hemispheric disconnection has been largely proposed for patients with severe epilepsy associated with a congenital or acquired hemispheric cerebral pathology. The classical procedure of anatomical hemispherectomy was progressively abandoned by neurosurgeons in order to avoid postoperative complications since then hemispherotomy techniques have been developed. Globally, with hemispheric disconnection, the rate of patients becoming seizure-free has been between 50 and 80%. The factors affecting seizure control have not been completely elucidated, but several authors suggested that differences in etiology as well as the hemispheric disconnection technique used may partially explain this variability. The percentage of seizure-free patients is higher with hemispherotomy techniques and in the group of patients with Rasmussen encephalitis, Sturge-Weber syndrome, and vascular insults. Depending on overall long-term progression, there is an improvement compared to preoperative status even if children exhibit heterogenous abilities. The lowest scores are observed for motor skills but communication and socialization are relatively well-preserved and strongly related to the duration of epilepsy: the longer the duration, the lower the scores were. Neuropsychological outcome following hemispheric disconnection makes it possible to study the development of hemispheric specialization during infancy and to provide information on cognitive recovery. Cerebral reorganization has been proved to exist in motor and language recovery. Ipsilateral corticospinal pathways seem to be involved in the movement of hemiplegic limbs. Everyday language can be supported by both hemispheres, but there is an early hemispheric specialization of the left hemisphere according to metaphonologic abilities.

  10. Long-Term Soft Denture Lining Materials (United States)

    Chladek, Grzegorz; Żmudzki, Jarosław; Kasperski, Jacek


    Long-term soft denture lining (LTSDL) materials are used to alleviate the trauma associated with wearing complete dentures. Despite their established clinical efficacy, the use of LTSDLs has been limited due to the unfavorable effects of the oral environment on some of their mechanical and performance characteristics. The unresolved issue of LTSDL colonization by Candida albicans is particularly problematic. Silicone-based LTSDL (SLTSDL) materials, which are characterized by more stable hardness, sorption and solubility than acrylic-based LTSDLs (ALTSDLs), are currently the most commonly used LTSDLs. However, SLTSDLs are more prone to debonding from the denture base. Moreover, due to their limitations, the available methods for determining bond strength do not fully reflect the actual stability of these materials under clinical conditions. SLTSDL materials exhibit favorable viscoelastic properties compared with ALTSDLs. Furthermore, all of the lining materials exhibit an aging solution-specific tendency toward discoloration, and the available cleansers are not fully effective and can alter the mechanical properties of LTSDLs. Future studies are needed to improve the microbiological resistance of LTSDLs, as well as some of their performance characteristics. PMID:28788163

  11. Alpine Soils as long-term Bioindicators (United States)

    Nestroy, O.


    Alpine soils as long-term bioindicators The introductory words concern the definitions and peculiarities of alpine soils and their position in the Austrian Soil Classification 2000 in comparison with the World Reference Base for Soil Resources 2006. The important parameters for genesis and threats for these soils in steep and high positions are discussed. It must be emphasized that the main threats are the very different kinds of erosion e.g. by water, wind and snow, and also by skiing (end of season) as well as and mountain-biking (mainly summer-sport). Due the very slow regeneration and - in this connection - due to the very slow changes of the soil entities, these soils give an utmost importance as a long-time bioindicator. With regard to the climate change one can assume an increase in the content of organic matter on site, but also an increase of erosion and mass movement on the other site, e. g. in kind of "plaiken" (soil slide) as result of an increasing intensity of rainfall. It lies partly in our hands to diminish the number and the intensity of the threats, we can influence the soil development, but the result to reach a new ecological equilibrium is very long - in case of alpine soil more than two generations.

  12. Long-term predictions using natural analogues

    Energy Technology Data Exchange (ETDEWEB)

    Ewing, R.C. [Univ. of New Mexico, Albuquerque, NM (United States)


    One of the unique and scientifically most challenging aspects of nuclear waste isolation is the extrapolation of short-term laboratory data (hours to years) to the long time periods (10{sup 3}-10{sup 5} years) required by regulatory agencies for performance assessment. The direct validation of these extrapolations is not possible, but methods must be developed to demonstrate compliance with government regulations and to satisfy the lay public that there is a demonstrable and reasonable basis for accepting the long-term extrapolations. Natural systems (e.g., {open_quotes}natural analogues{close_quotes}) provide perhaps the only means of partial {open_quotes}validation,{close_quotes} as well as data that may be used directly in the models that are used in the extrapolation. Natural systems provide data on very large spatial (nm to km) and temporal (10{sup 3}-10{sup 8} years) scales and in highly complex terranes in which unknown synergisms may affect radionuclide migration. This paper reviews the application (and most importantly, the limitations) of data from natural analogue systems to the {open_quotes}validation{close_quotes} of performance assessments.

  13. CERN Services for Long Term Data Preservation

    CERN Document Server

    Shiers, Jamie; Blomer, Jakob; Ganis, Gerardo; Dallmeier-Tiessen, Sunje; Simko, Tibor; Cancio Melia, German; CERN. Geneva. IT Department


    In this paper we describe the services that are offered by CERN for Long Term preservation of High Energy Physics (HEP) data, with the Large Hadron Collider (LHC) as a key use case. Data preservation is a strategic goal for European High Energy Physics (HEP), as well as for the HEP community worldwide and we position our work in this global content. Specifically, we target the preservation of the scientific data, together with the software, documentation and computing environment needed to process, (re-)analyse or otherwise (re-)use the data. The target data volumes range from hundreds of petabytes (PB – 10^15 bytes) to hundreds of exabytes (EB – 10^18 bytes) for a target duration of several decades. The Use Cases driving data preservation are presented together with metrics that allow us to measure how close we are to meeting our goals, including the possibility for formal certification for at least part of this work. Almost all of the services that we describe are fully generic – the exception being A...

  14. Model of long-term seismogenesis

    Directory of Open Access Journals (Sweden)

    D. Rhoades


    Full Text Available A three-stage faulting model explains the observed quantitative relations between long-term precursory seismicity, mainshocks and aftershocks. Seismogenesis starts with the formation of a major crack, culminates in the corresponding major fracture and earthquake, and ends with healing. Crack formation is a self-organised critical phenomenon, and shear fracture is a delayed sequel to crack formation. It is postulated that the major crack generates a set of minor cracks, just as, later, the major fracture generates a set of minor fractures. Fracturing of the minor cracks raises the average seismicity level. By Mogi’s uniformity criterion, the major earthquake is delayed until the minor fractures have healed and the stress-field has regained relative uniformity. In accord with the scaling principle, the model applies at all magnitude levels. The size of any given initial crack determines the scale of the ensuing seismogenic process. A graphical technique of cumulative magnitude analysis gives a quantitative representation of the seismicity aspects of the model. Examples are given for large earthquakes in a region of continental collision and a subduction region. The principle of hierarchy is exemplified by the seismogenesis of a M 5.9 mainshock occurring entirely within the precursory stage of a M 7.0 mainshock. The model is capable of accommodating a variety of proposed shorter-term precursory phenomena.

  15. Long-term outcome of neuroparacoccidioidomycosis treatment

    Directory of Open Access Journals (Sweden)

    Fabio Francesconi


    Full Text Available INTRODUCTION: Neuroparacoccidioidomycosis (NPCM is a term used to describe the invasion of the central nervous system by the pathogenic fungus Paracoccidioides brasiliensis. NPCM has been described sporadically in some case reports and small case series, with little or no focus on treatment outcome and long-term follow-up. METHODS: All patients with NPCM from January 1991 to December 2006 were analyzed and were followed until December 2009. RESULTS: Fourteen (3.8% cases of NPCM were identified out of 367 patients with paracoccidioidomycosis (PCM. A combination of oral fluconazole and sulfamethoxazole/trimethoprim (SMZ/TMP was the regimen of choice, with no documented death due to Paracoccidioides brasiliensis infection. Residual neurological deficits were observed in 8 patients. Residual calcification was a common finding in neuroimaging follow-up. CONCLUSIONS: All the patients in this study responded positively to the association of oral fluconazole and sulfamethoxazole/trimethoprim, a regimen that should be considered a treatment option in cases of NPCM. Neurological sequela was a relatively common finding. For proper management of these patients, anticonvulsant treatment and physical therapy support were also needed.

  16. Long term results of mandibular distraction

    Directory of Open Access Journals (Sweden)

    Batra Puneet


    Full Text Available Mandibular distraction osteogenesis has become a popular surgical modality due to its many advantages over conventional orthognathic surgical procedures. However, in spite of the technique having been used for over 15 years, no concrete long term results are available regarding the stability of results. We discuss the various studies which have reported either in favour or against the stablility of results after distraction. We report a series of 6 cases (3 unilateral and 3 bilateral distraction where distraction was carried out before puberty and followed them up to seven years after removal of distractors. This case series shows that results achieved by distraction osteogenesis are unstable or best unpredictable with respect to producing a permanent size increase in the mandible. The role of the distraction osteogenesis in overcoming the pterygomassetric sling is questionable. We suggest a multicenter study with adequate patient numbers treated with a similar protocol and documented after growth cessation to have meaningful conclusions on the debate of distraction osteogenesis versus orthognathic surgery.

  17. Long term results of childhood dysphonia treatment. (United States)

    Mackiewicz-Nartowicz, Hanna; Sinkiewicz, Anna; Bielecka, Arleta; Owczarzak, Hanna; Mackiewicz-Milewska, Magdalena; Winiarski, Piotr


    The aim of this study was to assess the long term results of treatment and rehabilitation of childhood dysphonia. This study included a group of adolescents (n=29) aged from 15 to 20 who were treated due to pediatric hyperfunctional dysphonia and soft vocal fold nodules during their pre-mutational period (i.e. between 5 and 12 years of age). The pre-mutational therapy was comprised of proper breathing pattern training, voice exercises and psychological counseling. Laryngostroboscopic examination and perceptual analysis of voice were performed in each patient before treatment and one to four years after mutation was complete. The laryngostroboscopic findings, i.e. symmetry, amplitude, mucosal wave and vocal fold closure, were graded with NAPZ scale, and the GRBAS scale was used for the perceptual voice analysis. Complete regression of the childhood dysphonia was observed in all male patients (n=14). Voice disorders regressed completely also in 8 out of 15 girls, but symptoms of dysphonia documented on perceptual scale persisted in the remaining seven patients. Complex voice therapy implemented in adolescence should be considered as either the treatment or preventive measure of persistent voice strain, especially in girls. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  18. Long term prediction of flood occurrence

    Directory of Open Access Journals (Sweden)

    C. Aguilar


    Full Text Available How long a river remembers its past is still an open question. Perturbations occurring in large catchments may impact the flow regime for several weeks and months, therefore providing a physical explanation for the occasional tendency of floods to occur in clusters. The research question explored in this paper may be stated as follows: can higher than usual river discharges in the low flow season be associated to a higher probability of floods in the subsequent high flow season? The physical explanation for such association may be related to the presence of higher soil moisture storage at the beginning of the high flow season, which may induce lower infiltration rates and therefore higher river runoff. Another possible explanation is persistence of climate, due to presence of long-term properties in atmospheric circulation. We focus on the Po River at Pontelagoscuro, whose catchment area amounts to 71 000 km2. We look at the stochastic connection between average river flows in the pre-flood season and the peak flows in the flood season by using a bivariate probability distribution. We found that the shape of the flood frequency distribution is significantly impacted by the river flow regime in the low flow season. The proposed technique, which can be classified as a data assimilation approach, may allow one to reduce the uncertainty associated to the estimation of the flood probability.

  19. Long term results of mandibular distraction. (United States)

    Batra, Puneet; Ryan, F S; Witherow, H; Calvert, M L


    Mandibular distraction osteogenesis has become a popular surgical modality due to its many advantages over conventional orthognathic surgical procedures. However, in spite of the technique having been used for over 15 years, no concrete long term results are available regarding the stability of results. We discuss the various studies which have reported either in favour or against the stablility of results after distraction. We report a series of 6 cases (3 unilateral and 3 bilateral distraction) where distraction was carried out before puberty and followed them up to seven years after removal of distractors. This case series shows that results achieved by distraction osteogenesis are unstable or best unpredictable with respect to producing a permanent size increase in the mandible. The role of the distraction osteogenesis in overcoming the pterygomassetric sling is questionable. We suggest a multicenter study with adequate patient numbers treated with a similar protocol and documented after growth cessation to have meaningful conclusions on the debate of distraction osteogenesis versus orthognathic surgery.

  20. TIA and Stroke: the long-term perspective

    NARCIS (Netherlands)

    Wijk, I. van


    Background Survival after stroke has improved, but little is known about the long-term risk of new vascular events and the functioning of long-term survivors. The main objective of this thesis was to evaluate the long-term perspective of these patients. Methods Two longitudinal studies were carried

  1. The long-term consequences of anaesthetic management | Sessler ...

    African Journals Online (AJOL)

    The long-term consequences of anaesthesia were not seriously considered until relatively recently. There is increasing evidence that some intraoperative anaesthetic management decisions have long-term consequences, and that others might as well. Keywords: long-term consequences; anaesthetic management ...

  2. Advances toward regenerative medicine in the central nervous system: challenges in making stem cell therapy a viable clinical strategy. (United States)

    Stoll, Elizabeth A


    Over recent years, there has been a great deal of interest in the prospects of stem cell-based therapies for the treatment of nervous system disorders. The eagerness of scientists, clinicians, and spin-out companies to develop new therapies led to premature clinical trials in human patients, and now the initial excitement has largely turned to skepticism. Rather than embracing a defeatist attitude or pressing blindly ahead, I argue it is time to evaluate the challenges encountered by regenerative medicine in the central nervous system and the progress that is being made to solve these problems. In the twenty years since the adult brain was discovered to have an endogenous regenerative capacity, much basic research has been done to elucidate mechanisms controlling proliferation and cellular identity; how stem cells may be directed into neuronal lineages; genetic, pharmacological, and behavioral interventions that modulate neurogenic activity; and the exact nature of limitations to regeneration in the adult, aged, diseased and injured CNS. These findings should prove valuable in designing realistic clinical strategies to improve the prospects of stem cell-based therapies. In this review, I discuss how basic research continues to play a critical role in identifying both barriers and potential routes to regenerative therapy in the CNS.

  3. Imaging windows for long-term intravital imaging (United States)

    Alieva, Maria; Ritsma, Laila; Giedt, Randy J; Weissleder, Ralph; van Rheenen, Jacco


    Intravital microscopy is increasingly used to visualize and quantitate dynamic biological processes at the (sub)cellular level in live animals. By visualizing tissues through imaging windows, individual cells (e.g., cancer, host, or stem cells) can be tracked and studied over a time-span of days to months. Several imaging windows have been developed to access tissues including the brain, superficial fascia, mammary glands, liver, kidney, pancreas, and small intestine among others. Here, we review the development of imaging windows and compare the most commonly used long-term imaging windows for cancer biology: the cranial imaging window, the dorsal skin fold chamber, the mammary imaging window, and the abdominal imaging window. Moreover, we provide technical details, considerations, and trouble-shooting tips on the surgical procedures and microscopy setups for each imaging window and explain different strategies to assure imaging of the same area over multiple imaging sessions. This review aims to be a useful resource for establishing the long-term intravital imaging procedure. PMID:28243510

  4. Facilitating change among nursing assistants in long term care. (United States)

    Aubry, Francois; Etheridge, Francis; Couturier, Yves


    In this article, the authors consider the implementation of change in long term care organizations (LTCOs) and present their study describing the process by which new nursing assistants are informally integrated into LTCOs in Quebec, Canada. The study method included 23 in-depth interviews with nursing assistants in two long term care centres. The findings enabled the authors to describe the informal process by which new nursing assistants are integrated into LTCOs and the manner in which informal work strategies enhance the work of nursing care, thus enabling the nursing assistants to manage heavy workloads. The authors discuss whether this teamwork is a deterrent to change or a lever for change and address issues regarding the collective structure of nursing assistant teams. Implications for practice include a Five-Step Innovation Plan. In conclusion, the authors propose that organizational change among nursing assistants in a LTCO is best accomplished when the leaders consider the nursing assistants' strong sense of community to be a change engine rather than a change obstacle.

  5. Problems of long-term preservation of web pages

    Directory of Open Access Journals (Sweden)

    Mitja Dečman


    Full Text Available The World Wide Web is a distributed collection of web sites available on the Internet anywhere in the world. Its content is constantly changing: old data are being replaced which causes constant loss of a huge amount of information and consequently the loss of scientific, cultural and other heritage. Often, unnoticeably even legal certainty is questioned. In what way the data on the web can be stored and how to preserve them for the long term is a great challenge. Even though some good practices have been developed, the question of final solution on the national level still remains. The paper presents the problems of long-term preservation of web pages from technical and organizational point of view. It includes phases such as capturing and preserving web pages, focusing on good solutions, world practices and strategies to find solutions in this area developed by different countries. The paper suggests some conceptual steps that have to be defined in Slovenia which would serve as a framework for all document creators in the web environment and therefore contributes to the consciousness in this field, mitigating problems of all dealing with these issues today and in the future.

  6. Reconciling change blindness with long-term memory for objects. (United States)

    Wood, Katherine; Simons, Daniel J


    How can we reconcile remarkably precise long-term memory for thousands of images with failures to detect changes to similar images? We explored whether people can use detailed, long-term memory to improve change detection performance. Subjects studied a set of images of objects and then performed recognition and change detection tasks with those images. Recognition memory performance exceeded change detection performance, even when a single familiar object in the postchange display consistently indicated the change location. In fact, participants were no better when a familiar object predicted the change location than when the displays consisted of unfamiliar objects. When given an explicit strategy to search for a familiar object as a way to improve performance on the change detection task, they performed no better than in a 6-alternative recognition memory task. Subjects only benefited from the presence of familiar objects in the change detection task when they had more time to view the prechange array before it switched. Once the cost to using the change detection information decreased, subjects made use of it in conjunction with memory to boost performance on the familiar-item change detection task. This suggests that even useful information will go unused if it is sufficiently difficult to extract.

  7. Scientific Understanding from Long Term Observations: Insights from the Long Term Ecological Research (LTER) Program (United States)

    Gosz, J.


    The network dedicated to Long Term Ecological Research (LTER) in the United States has grown to 24 sites since it was formed in 1980. Long-term research and monitoring are performed on parameters thatare basic to all ecosystems and are required to understand patterns, processes, and relationship to change. Collectively, the sites in the LTER Network provide opportunities to contrast marine, coastal, and continental regions, the full range of climatic gradients existing in North America, and aquatic and terrestrial habitats in a range of ecosystem types. The combination of common core areas and long-term research and monitoring in many habitats have allowed unprecedented abilities to understand and compare complex temporal and spatial dynamics associated with issues like climate change, effects of pollution, biodiversity and landuse. For example, McMurdo Dry Valley in the Antarctic has demonstrated an increase in glacier mass since 1993 which coincides with a period of cooler than normal summers and more than average snowfall. In contrast, the Bonanza Creek and Toolik Lake sites in Alaska have recorded a warming period unprecedented in the past 200 years. Nitrogen deposition effects have been identified through long-term watershed studies on biogeochemical cycles, especially at Coweeta Hydrological Lab, Harvard Forest, and the Hubbard Brook Experimental Forest. In aquatic systems, such as the Northern Temperate Lakes site, long-term data revealed time lags in effects of invaders and disturbance on lake communities. Biological recovery from an effect such as lake acidification was shown to lag behind chemical recovery. The long-term changes documented over 2 decades have been instrumental in influencing management practices in many of the LTER areas. In Puerto Rico, the Luquillo LTER demonstrated that dams obstruct migrations of fish and freshwater shrimp and water abstraction at low flows can completely obliterate downstream migration of juveniles and damage

  8. Long term benefits of hypnotherapy for irritable bowel syndrome. (United States)

    Gonsalkorale, W M; Miller, V; Afzal, A; Whorwell, P J


    There is now good evidence from several sources that hypnotherapy can relieve the symptoms of irritable bowel syndrome in the short term. However, there is no long term data on its benefits and this information is essential before the technique can be widely recommended. This study aimed to answer this question. 204 patients prospectively completed questionnaires scoring symptoms, quality of life, anxiety, and depression before, immediately after, and up to six years following hypnotherapy. All subjects also subjectively assessed the effects of hypnotherapy retrospectively in order to define their "responder status". 71% of patients initially responded to therapy. Of these, 81% maintained their improvement over time while the majority of the remaining 19% claimed that deterioration of symptoms had only been slight. With respect to symptom scores, all items at follow up were significantly improved on pre-hypnotherapy levels (phypnotherapy values. There were no significant differences in the symptom scores between patients assessed at 1, 2, 3, 4, or 5+ years following treatment. Quality of life and anxiety or depression scores were similarly still significantly improved at follow up (phypnotherapy. This study demonstrates that the beneficial effects of hypnotherapy appear to last at least five years. Thus it is a viable therapeutic option for the treatment of irritable bowel syndrome.

  9. Energy in 2010 - 2020. Long term challenges; Energie 2010-2020. Les defis du long terme

    Energy Technology Data Exchange (ETDEWEB)

    Dessus, Benjamin [ed.] [Centre National de la Recherche Scientifique (CNRS), 75 - Paris (France)


    This report presents the results of a workshop intending to anticipate the long term challenges, to guide better the short term power options, to understand the available political, economical and technical assumptions for the prospective world situation, to give some strategic hints on the necessary transition. Indeed, the difficult issue which the workshop tried to tackle was how should we prepare to reveal the energetic challenge of the development of the eight to ten billion inhabitants of our Planet in the next century without jeopardizing its existence. The energetic problems, a hardcore of the international preoccupation of both growth and environment, as it was recently evidenced by the climatic conference in Kyoto, have ever been the object of a particular attention on the part of General Commissariat of Plan. Thus, the commission 'Energy in 2010 - 2020' has been instituted in April 1996 in order to update the works done in 1990 - 1991 by the commission 'Energy 2010'. Soon it occurred to this new commission the task of illuminating its works by a long term (2050 - 2100) world prospective analysis of the challenges and problems linked to energy, growth and environment. In conclusion, this document tried to find answers to questions like: - which are the risks the energy consumption augmentation entail? - can we control them by appropriate urbanism and transport policies or technological innovation?. Four options for immediate action are suggested: - the energy efficiency should become a priority objective of policies; -coping with the long term challenges requires acting at present; - building the transition between governmental leadership and market; - taking profit of all the possible synergies between short and long term planning.

  10. Ecological carbon sequestration via wood harvest and storage (WHS): Can it be a viable climate and energy strategy? (United States)

    Zeng, N.; Zaitchik, B. F.; King, A. W.; Wullschleger, S. D.


    A carbon sequestration strategy is proposed in which forests are sustainably managed to optimal carbon productivity, and a fraction of the wood is selectively harvested and stored to prevent decomposition under anaerobic, dry or cold conditions. Because a large flux of CO2 is constantly assimilated into the world's forests via photosynthesis, cutting off its return pathway to the atmosphere forms an effective carbon sink. The live trees serve as a `carbon scrubber' or `carbon remover' that provides continuous sequestration (negative emissions). The stored wood is a semi-permanent carbon sink, but also serves as a `biomass/bioenergy reserve' that could be utilized in the future.Based on forest coarse wood production rate, land availability, bioconservation and other practical constraints, we estimate a carbon sequestration potential for wood harvest and storage (WHS) 1-3 GtC y-1. The implementation of such a scheme at our estimated lower value of 1 GtC y-1 would imply a doubling of the current world wood harvest rate. This can be achieved by harvesting wood at a modest harvesting intensity of 1.2 tC ha-1 y-1, over a forest area of 8 Mkm2 (800 Mha). To achieve the higher value of 3 GtC y-1, forests need to be managed this way on half of the world's forested land, or on a smaller area but with higher harvest intensity. However, the actual implementation may face challenges that vary regionally. We propose `carbon sequestration and biomass farms' in the tropical deforestation frontiers with mixed land use for carbon, energy, agriculture, as well as conservation. In another example, the forests damaged by insect infestation could be thinned to reduce fire and harvested for carbon sequestration.We estimate a cost of $10-50/tCO2 for harvest and storage around the landing site. The technique is low tech, distributed and reversible. We compare the potential of WHS with a number of other carbon sequestration methods. We will also show its impact on future land carbon sink

  11. Glioblastoma multiforme with long term survival. (United States)

    Deb, Prabal; Sharma, Mehar Chand; Mahapatra, Ashok Kumar; Agarwal, Deepak; Sarkar, Chitra


    Glioblastoma multiforme (GBM) Patients generally have a dismal prognosis, with median survival of 10-12 months. GBM with long-term survival (LTS) of (3) > or = 5 years is rare, and no definite markers indicating better prognosis have been identified till date. The present study was undertaken to evaluate GBMs with LTS in order to identify additional correlates associated with favourable outcome. The cases were evaluated for relevant clinicopathological data, proliferation index and expression of tumortumour suppressor gene (p53 ), cyclin-dependant kinase-inhibitors (p27 and p16 ) and epidermal growth factor receptor (EGFR) proteins. Six cases of GBM with LTS with an average survival of 9 years (range 5-15 years) were identified. All were young patients with mean age of 27 years (range 8-45 years). Histology of three cases was consistent with conventional GBM, while two showed prominent oligodendroglial component admixed with GBM areas. One was a giant cell GBM, which progressed to gliosarcoma on recurrence. The mean MIB-1LI was 12% (range 6-20%). p53 was immunopositive in 4 out of 5 cases. EGFR and p27 were immunonegative in all, whereas p16 was immunonegative in 3 out of 5 cases. Currently, in the absence of specific molecular and genetic markers, GBM in young patients should be meticulously evaluated for foci of oligodendroglial component and/or giant cell elements, in addition to proliferative index and p53 expression, since these probably have prognostic connotations, as evident in this study. The role of p16 and p27 however needs better definition with study of more number of cases.

  12. Long term observations of Saturn's northern auroras (United States)

    Nichols, Jonathan


    Auroral emissions are a vital tool in diagnosing the dynamics of planetary magnetospheres. While SaturnA?s southern UV auroras have been observed with high-sensitivity cameras onboard the Hubble Space Telescope {HST}, the northern auroras have only been observed at very oblique angles. Our understanding of SaturnA?s auroral emissions is thus only half complete. However, Saturn has now passed equinox and is moving toward summer in the northern hemisphere, such that the northern auroras are now visible from Earth, and recent results from HST have indicated that SaturnA?s northern auroras are not simply mirror images of the southern. The changing seasons are also expected to result in significant changes in magnetospheric phenomena related to the auroras. Observing these changes is a specific goal of the Cassini Solstice Mission {CSM} and, since joint HST-Cassini observations have repeatedly proved to be invaluable, CSM operations are currently being planned specifically with joint HST observations in mind. The observations proposed here will thus execute over Cycles 18-20, and will address the following science questions:What is the morphology of SaturnA?s northern auroras? Do SaturnA?s auroras change with the planetA?s season? How are the auroral emissions of different wavelengths related?The importance of long term HST observations of SaturnA?s northern auroras are highlighted by the fact that recent key discoveries would have been missed without the multiyear archive of observations of the planetA?s southern auroras. The opportunity to obtain HST images while Cassini makes specifically-tailored supporting observations is an extremely valuable opportunity, and HST is the only instrument capable of providing sustained, high time resolution observations of Saturns auroral emission.

  13. Long term stability of atomic time scales (United States)

    Petit, Gérard; Arias, Elisa Felicitas


    International Atomic Time TAI gets its stability from some 400 atomic clocks worldwide that generate the free atomic scale EA L and its accuracy from a small number of primary frequency standards (PFS) which frequency measurements are used to steer the EAL frequency. Because TAI is computed in "real - time" (every month) and has operational constraints, it is not optimal and the BIPM computes in deferred time another time scale TT(BIPM), which is based on a weighted average of the evaluations of TAI frequency by the PFS. We show that a point has been reached where the stability of atomic time scales, the accuracy of primary frequency standards, and the capabilities of frequency transfer are approximately at a similar level, in the low 10 - 16 in relative frequency. The goal is now to reach and surpass 1x10 - 16 and the three fields are in various stages of advancement towards this aim. We review the stability and accuracy recently achieved by frequency standards, focusing on primary frequency standards on one hand, and on new secondary realizations e.g. based on optical transitions on the other hand. We study how these performances can translate to the performance of atomic time scales, and the possible implications of the availability of new high - accuracy frequency standards operating on a regular basis. Finally we show how time transfer is trying to keep up with the progresses of frequency standards. Time transfer is presently the limiting factor at short averaging time (e.g. 1 - 2 weeks) but it should not be limiting the long term stability of atomic time scales, which is the main need of many applications in astronomy.

  14. Perinatal respiratory infections and long term consequences

    Directory of Open Access Journals (Sweden)

    Luciana Indinnimeo


    Full Text Available Respiratory syncytial virus (RSV is the most important pathogen in the etiology of respiratory infections in early life. 50% of children are affected by RSV within the first year of age, and almost all children become infected within two years. Numerous retrospective and prospective studies linking RSV and chronic respiratory morbidity show that RSV bronchiolitis in infancy is followed by recurrent wheezing after the acute episod. According to some authors a greater risk of wheezing in children with a history of RSV bronchiolitis would be limited to childhood, while according to others this risk would be extended into adolescence and adulthood. To explain the relationship between RSV infection and the development of bronchial asthma or the clinical pathogenetic patterns related to a state of bronchial hyperreactivity, it has been suggested that RSV may cause alterations in the response of the immune system (immunogenic hypothesis, activating directly mast cells and basophils and changing the pattern of differentiation of immune cells present in the bronchial tree as receptors and inflammatory cytokines. It was also suggested that RSV infection can cause bronchial hyperreactivity altering nervous airway modulation, acting on nerve fibers present in the airways (neurogenic hypothesis.The benefits of passive immunoprophylaxis with palivizumab, which seems to represent an effective approach in reducing the sequelae of RSV infection in the short- and long-term period, strengthen the implementation of prevention programs with this drug, as recommended by the national guidelines of the Italian Society of Neonatology. Proceedings of the 11th International Workshop on Neonatology and Satellite Meetings · Cagliari (Italy · October 26th-31st, 2015 · From the womb to the adultGuest Editors: Vassilios Fanos (Cagliari, Italy, Michele Mussap (Genoa, Italy, Antonio Del Vecchio (Bari, Italy, Bo Sun (Shanghai, China, Dorret I. Boomsma (Amsterdam, the

  15. Long-Term Nuclear Industry Outlook - 2004

    Energy Technology Data Exchange (ETDEWEB)

    Reichmuth, Barbara A.; Wood, Thomas W.; Johnson, Wayne L.


    The nuclear industry has become increasingly efficient and global in nature, but may now be poised at a crossroads between graceful decline and profound growth as a viable provider of electrical energy. Predicted population and energy-demand growth, an increased interest in global climate change, the desire to reduce the international dependence on oil as an energy source, the potential for hydrogen co-generation using nuclear power reactors, and the improved performance in the nuclear power industry have raised the prospect of a “nuclear renaissance” in which nuclear power would play an increasingly more important role in both domestic and international energy market. This report provides an assessment of the role nuclear-generated power will plan in the global energy future and explores the impact of that role on export controls.

  16. Towards a Long-Term Strategy for Voluntary-Based Internal Radiation Contamination Monitoring: A Population-Level Analysis of Monitoring Prevalence and Factors Associated with Monitoring Participation Behavior in Fukushima, Japan. (United States)

    Nomura, Shuhei; Tsubokura, Masaharu; Ozaki, Akihiko; Murakami, Michio; Hodgson, Susan; Blangiardo, Marta; Nishikawa, Yoshitaka; Morita, Tomohiro; Oikawa, Tomoyoshi


    Following Japan's 2011 Fukushima nuclear incident, we assessed voluntary-based monitoring behavior in Minamisoma City-located 10-40 km from the Fukushima nuclear plant-to inform future monitoring strategies. The monitoring in Minamisoma included occasional free of charge internal-radiation-exposure measurements. Out of around 70,000 individuals residing in the city before the incident, a total of 45,788 residents (female: 52.1%) aged ≥21 were evaluated. The monitoring prevalence in 2011-2012 was only 30.2%, and this decreased to 17.9% in 2013-2014. Regression analyses were performed to estimate factors associated with the monitoring prevalence and participation behavior. The results show that, in comparison with the age cohort of 21-30 years, the cohort of 71-80 and ≥81 years demonstrated significantly lower monitoring prevalence; female residents had higher monitoring prevalence than male residents; those who were living in evacuation zones at the time of the incident had higher monitoring prevalence than those who lived outside any of the evacuation zones; for those living outside Fukushima and neighboring Prefectures post-incident monitoring prevalence decreased significantly in 2013-2014. Our findings inform the discussion on the concepts of radiation risk perception and accessibility to monitoring and societal decision-making regarding the maintenance of the monitoring program with low monitoring prevalence. We also stress the possibility that the monitoring can work both to check that internal contamination levels are within acceptable limits, and as a risk communication tool, alleviating individuals' concern and anxiety over radiation contamination.

  17. Genetic susceptibility to diabetes and long-term improvement of insulin resistance and β cell function during weight loss: the Preventing Overweight Using Novel Dietary Strategies (POUNDS LOST) trial. (United States)

    Huang, Tao; Ley, Sylvia H; Zheng, Yan; Wang, Tiange; Bray, George A; Sacks, Frank M; Qi, Lu


    Diet interventions have shown effectiveness in improving diabetes risk factors; however, little is known about whether the effects of diet intervention are different according to genetic susceptibility. We examined interactions between weight-loss diets and the genetic risk score (GRS) for diabetes on 2-y changes in markers of insulin resistance and β cell function in a randomized controlled trial. Data from the Preventing Overweight Using Novel Dietary Strategies (POUNDS LOST) trial were analyzed. A GRS was calculated on the basis of 31 diabetes-associated variants in 744 overweight or obese nondiabetic adults (80% white Americans). We assessed the changes in insulin resistance and β cell function over the 2-y intervention. Dietary protein significantly interacted with the diabetes GRS on fasting insulin, glycated hemoglobin (HbA1c), the homeostasis model assessment of β cell function (HOMA-B), and the homeostasis model assessment of insulin resistance (HOMA-IR) at 2 y in white Americans (P-interaction = 0.02, 0.04, 0.01, and 0.05, respectively). The lower GRS was associated with a greater decrease in fasting insulin (P = 0.04), HbA1c (P = 0.0001), and HOMA-IR (P = 0.02), and a lesser increase in HOMA-B (P = 0.004) in participants consuming a low-protein diet. Participants with a higher GRS might have a greater reduction in fasting insulin when consuming a high-protein diet (P = 0.03). Our data suggest that individuals with a lower genetic risk of diabetes may benefit more from consuming a low-protein weight-loss diet in improving insulin resistance and β cell function, whereas a high-protein diet may be more beneficial for white patients with a higher genetic risk. This trial was registered at as NCT00072995. © 2016 American Society for Nutrition.

  18. Potential food-drug interactions in long-term care. (United States)

    Anderson, Judy K; Fox, Jodie R


    Medication administration at mealtimes may result in food-drug interactions. Older adults are especially at risk of food-drug interactions leading to adverse drug effects and subtherapeutic responses. Research on potential food-drug interactions is limited and dated. This study examined the frequency of potential food-drug interactions in long-term care. Forty-nine percent of drugs administered at mealtimes had potential for interaction, with cardiovascular medications given most frequently. The frequency of potential interactions makes this phenomenon critically important to review. Collaboration between nurses and pharmacists may identify optimal medication scheduling. Nurses can enhance care by identifying strategies to limit interactions through knowledge and creative, collaborative administration schedules. Copyright 2012, SLACK Incorporated.

  19. [Long-term pediatric opioid based pain control. Case reports]. (United States)

    Zernikow, B; Schiessl, C; Wamsler, C; Griessinger, N; Sittl, R


    Based on 4 case reports we focus on the peculiarities of long-term pediatric opioid based pain control. Case report #1, emphasizing the importance of adequate opioid dosing with reference to body weight, illustrates that with adequate management oral sustained-release opioid therapy is safe even in infants less than one year old. Case report #2 is the first report on the usage of buccal fentanyl citrate for pediatric break-through pain control. Case report #3 focuses on the adverse effects of opioid pain control in an infant with neurological impairment. Case report #4 reports on the successful tumor pain control using transdermal buprenorphine. We conclude that proven therapeutic strategies for opioid pain control as applied in adults may be adopted for the usage on children in pediatrics. However, it is mandatory to take into account both the pharmacokinetic and pharmacodynamic peculiarities of childhood.

  20. Long-term functional outcome in patients with neurogenic dysphagia. (United States)

    Bartolome, G; Prosiegel, M; Yassouridis, A


    The purpose of this prospective cohort study was: (1) to document and investigate long-term post-treatment outcome focusing on swallowing disability; and (2) to reveal variables predicting successful functional follow-up results in 63 patients with neurogenic dysphagia. All patients were admitted to an inpatient neurologic rehabilitation unit. Information was gathered through chart review and questionnaires. Functional outcome was categorized according to the degree of feeding status: (1) total tube feeding; (2) oral and tube feeding combined; (3) oral feeding with compensation; and (4) total oral feeding. 'Improvement' was determined as a positive shift in the type of feeding, 'deterioration' as a negative shift and 'no change' was defined as remaining at the same nutritional level. The safety of feeding was assessed by tracking the occurrence of pneumonia. Seventy percent of the patients achieved an improved immediate outcome after therapy. During long-term follow-up examinations, 43% of all patients showed further improvement, 57% did not show any change in their feeding ability and no deterioration was reported for any patient. Comparisons of the relative frequencies of the feeding modalities before and after therapy revealed a significant reduction in tube feeders and a significant increase in oral feeders with compensation during inpatient-treatment. The outpatient-interval showed a significant shift in total oral feeders without compensations but no significant improvement within the tube feeders and within the partial oral feeders. The improvement in nutritional status was not associated with an increased risk of pneumonia. Additional comparisons of the relative frequencies of the compensatory strategies indicated a significant reduction in all treatment techniques at final follow-up. Using logistic regression, predictors of successful post-discharge outcome involved a decreasing pre-treatment interval and unexpectedly low Barthel-ADL mobility scores. As a

  1. Northern European long term climate archives

    Energy Technology Data Exchange (ETDEWEB)

    Hohl, Veronica [Stockholm Univ. (Sweden)


    The Swedish Nuclear Fuel and Waste Management Company is responsible for the management and disposal of Sweden's radioactive waste. It is intended to deposit the spent nuclear fuel in a deep geological repository. This repository shall keep the radiotoxic material separated from humans and the environment for extended periods, from decades to millennia and possibly to geological timescales. During this time perspective climate induced changes such as shore-level displacement and evolution of permafrost and ice sheets are expected to occur which may affect the repository. The possible occurrence, extent and duration of these long-term changes, are therefore of interest when considering the assessment of repository performance and safety. The main climate parameters determining both surface and subsurface conditions are temperature and precipitation. As a result of the last advance of the Weichselian ice sheet only few geological archives exist, which contain information on past climatic conditions in Sweden before c 16,000 years BP. The purpose of this literature review is to compile and evaluate available information from Scandinavian, Northern and Central European geological archives, which record climatic conditions during the Weichselian time period. The compilation provides paleotemperature data sets, which may be used to explore the possible evolution of periglacial permafrost in Sweden. This report is a synopsis of 22 publications detailing climatic and environmental changes during the Weichselian time period in Northwestern Europe based on quantified paleotemperature records. Some of the data is presented as temperature curves which were digitised specifically for this report. The time range covered by the different publications varies considerably. Only few authors dealt with the whole Weichselian period and the majority cover only a few thousand years. This however is not considered to influence the reliability of the archives. The reason for the

  2. Long-term Outcomes Following Syme's Amputation. (United States)

    Finkler, Elissa S; Marchwiany, Daniel A; Schiff, Adam P; Pinzur, Michael S


    The metabolic cost of walking after Syme's ankle disarticulation amputation is minimally more than that for nonamputation. The ability to end weightbearing makes prosthetic fitting relatively simple, and very few patients require extensive rehabilitation or placement in a skilled nursing or rehabilitation facility. In spite of these potential benefits, there is a paucity of objective information on the actual long-term outcomes. Fifty-one patients were identified who underwent single-stage Syme's ankle disarticulation amputation with excision of the lateral and medial malleoli by a single surgeon during a 23-year period. None of these patients had sufficient tissue to allow amputation at the transmetatarsal or tarsometatarsal levels. Thirty-three underwent amputation due to a diabetic forefoot infection, 11 secondary to a crush injury, 3 for a nondiabetic infection, 3 for a noncorrectable acquired deformity, and 1 for neoplasm. The average age at surgery for the diabetic patients was 62.1 years (range, 36-81 years), with an average follow-up of 6.8 years (range, 4.0-11.6 years). The nondiabetic patients had an average age of 37.8 years (range, 21-65 years), with an average follow-up of 9.3 years (range, 2.2-25.0 years). Patients who were alive and could be contacted were invited to complete the Short Musculoskeletal Function Assessment (SMFA) questionnaire that was scored for functional, mobility, and bothersome indices. Seventeen of the 33 diabetic patients died. Four (12.1%) were converted to transtibial amputation. One of the nondiabetic patients died, and 1 (5.5%) was converted to transtibial amputation. Eleven of the 33 patients who were contacted completed the SMFA. All of these patients demonstrated favorable outcome scores in the mobility, functional, and bothersome indices (average mobility index of 17.2, functional index of 14.7, and bothersome index of 16.7 for nondiabetic patients compared to 34.7, 29.9, and 30.6 for diabetic patients, respectively

  3. Long-Term Monitoring of Permeable Reactive Barriers - Progress Report

    Energy Technology Data Exchange (ETDEWEB)

    Liang, L.


    The purpose of this project is to conduct collaborative research to evaluate and maximize the effectiveness of permeable reactive barriers (PRBs) with a broad-based working group including representatives from the U.S. Department of Energy (DOE), U.S. Department of Defense (DoD), and the U.S. Environmental Protection Agency (EPA). The Naval Facilities Engineering Service Center (NFESC) and its project partner, Battelle, are leading the DoD effort with funding from DoD's Environmental Security Technology Certification Program (ESTCP) and Strategic Environmental Research and Development Program (SERDP). Oak Ridge National Laboratory (ORNL) is coordinating the DOE effort with support from Subsurface Contaminant Focus Area (SCFA), a research program under DOEs Office of Science and Technology. The National Risk Management Research Laboratory's Subsurface Protection and Remediation Division is leading EPA's effort. The combined effort of these three agencies allows the evaluation of a large number of sites. Documents generated by this joint project will be reviewed by the participating agencies' principal investigators, the Permeable Barriers Group of the Remediation Technologies Development Forum (RTDF), and the Interstate Technology and Regulatory Cooperation (ITRC). The technical objectives of this project are to collect and review existing field data at selected PRB sites, identify data gaps, conduct additional measurements, and provide recommendations to DOE users on suitable long-term monitoring strategies. The specific objectives are to (1) evaluate geochemical and hydraulic performance of PRBs, (2) develop guidelines for hydraulic and geochemical characterization/monitoring, and (3) devise and implement long-term monitoring strategies through the use of hydrological and geochemical models. Accomplishing these objectives will provide valuable information regarding the optimum configuration and lifetime of barriers at specific sites. It will

  4. What counts as evidence for the long-term realisation of whole-class scaffolding?

    NARCIS (Netherlands)

    Smit, J.; van Eerde, H.A.A.


    To promote whole-class scaffolding of mathematical language, a teacher was encouraged to employ a repertoire of seven strategies (e.g., reformulating) in a multilingual primary classroom (22 pupils; aged 10–12). This paper investigates whether the enactment of these strategies has led to long-term

  5. "Is political behavior a viable coping strategy to perceived organizational politics? Unveiling the underlying resource dynamics": Correction to Sun and Chen (2017). (United States)


    Reports an error in "Is Political Behavior a Viable Coping Strategy to Perceived Organizational Politics? Unveiling the Underlying Resource Dynamics" by Shuhua Sun and Huaizhong Chen (Journal of Applied Psychology, Advanced Online Publication, May 22, 2017, np). In the article, Table 1 contained a formatting error. Correlation coefficient values in the last four cells of column 6 were misplaced with correlation coefficient values in the last four cells of column 7. All versions of this article have been corrected. (The following abstract of the original article appeared in record 2017-22542-001.) We conduct a theory-driven empirical investigation on whether political behavior, as a coping strategy to perceived organizational politics, creates resource trade-offs in moderating the relationship between perceived organizational politics and task performance. Drawing on conservation of resources theory, we hypothesize that political behavior mitigates the adverse effect of perceived organizational politics on task performance via psychological empowerment, yet exacerbates its adverse effect on task performance via emotional exhaustion. Three-wave multisource data from a sample of 222 employees and their 75 supervisors were collected for hypothesis testing. Findings supported our hypotheses. Our study enhances understandings of the complex resource dynamics of using political behavior to cope with perceived organizational politics and highlights the need to move stress-coping research from a focus on the stress-buffering effect of coping on outcomes to a focus on the underlying competing resource dynamics. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

  6. Reforming long-term care financing through insurance (United States)

    Meiners, Mark R.


    Until recently, insurance for long-term care was not viewed as feasible. This perception has changed dramatically in the past few years. Several models of long-term care insurance have begun to be tested. Although the application of insurance principles to long-term care is still new, the emergence of private market interest in developing long-term care insurance has been a catalyst to renewed public-policy support for reforming the way we pay for long-term care. States, in particular, have become interested in developing public-private partnerships to support the emergence of long-term care insurance that could help relieve the mounting pressure on Medicaid budgets. PMID:10312962


    Directory of Open Access Journals (Sweden)

    G. D. Toloraya


    Full Text Available In the recent years, BRICS emerged as one of the most influential international fora. It includes five leading emerging powers of the current world and has the potential to become the principal venue for elaboration of future global order. BRICS has the capacities to formulate a reasonable alternative to the current neoliberal model, which becomes increasingly irrelevant. The future world system should be built on the principles of sustainable development, which will address the growing environmental challenges. Russia remains one of the drivers of the club and views it as an essential element of the emerging multipolar world. It actively pursues further expansion of BRICS agenda and it greater institutionalization.

  8. Alternative strategies for the long-term preservation of spermatozoa. (United States)

    Holt, W V


    A number of perceived future requirements for stored germplasm in agriculture, aquaculture, biotechnology and conservation are discussed in the present review. In the light of these broad demands, it is apparent that current approaches to gamete and embryo storage need considerable improvement, and that novel approaches to the technologies of germplasm preservation should be pursued if possible. The present article is presented in response to a request for novel future research ideas in this area. Early literature on desiccation, and later research into natural mechanisms of survival during desiccation, is considered in relation to the development of freeze-drying and vitrification methods. Developments in reproductive technologies themselves may mean that freeze-dried spermatozoa could realistically be used for direct intracytoplasmic microinjection of oocytes. Other radical methods that may achieve germplasm preservation are harvesting testicular cells in culture, cryopreserving immature or seasonally regressed testicular material, or a combination of both. Evidence from non-mammalian testicular culture systems, and recent success with the transmeiotic development of mouse spermatids in vitro, suggest that these approaches may eventually become feasible.

  9. Strategies for Long Term Economic Growth in Vietnam (United States)


    Report Vietnam," EBSCO Host, April 4, 2013, Accessed September 6, 2013, Global Insight. "Country Report Vietnam." EBSCO Host. April 4, 2013. Accessed September 6, 2013.

  10. Long-term care in Israel: challenges and reform options. (United States)

    Chernichovsky, Dov; Koreh, Michal; Soffer, Sharon; Avrami, Shirley


    This paper has two objectives. The first is to examine the Israeli long-term care (LTC) system that is marked by rapidly increasing demands, and a multitude of public and private LTC arrangements. The second is to propose a reform to improve the system's efficiency and equity. The paper studies the LTC services in Israel, and the private-public composition in funding, fund holding, and provision of LTC. It focuses on structural deficiencies in the organization of each of these functions separately, and in combination. In many countries LTC has evolved in a patchwork fashion that at some point in time needs rethinking and rationalization. Israel is a case in point. In spite of numerous LTC arrangements supported by the state, in the absence of a comprehensive strategy, these have not generated a coherent system that can deal efficiently and equitably with existing and fast growing LTC needs, on the one hand, and the resources available to it, on the other. The current system is fragmented. It provides limited coverage and insufficient benefits in a troublesome fashion to public. The findings suggest that Israel can achieve at least in the short term, universal entitlement to LTC at lower financial and social cost, than the current costs of the system. In the medium and long term, the country will need to consider the trade between the burden of direct care on households or the tax burden of publicly supported and organized care. To remedy the situation the paper suggests a two-planked reform. The first is integration of the current fragmented publicly supported system while deciding on LTC either as a "social endeavor" under a separate authority responsible for implementing the public LTC budget, or as a "medical endeavor", putting this responsibility under the Israeli sickness funds. The second plank, building on the first, comprises extension of universal entitlement to LTC. Such an extension would increase public spending in the long term; simultaneously, it

  11. Long-Term Mean Wind Profiles Based on Similarity Theory

    DEFF Research Database (Denmark)

    Kelly, Mark C.; Gryning, Sven-Erik


    in turn facilitates the derivation of a long-term mean wind profile based on Monin–Obukhov similarity theory. The modelled stability distributions exhibit good agreement with measurements from sites having different local conditions. The long-term wind profile formulation is further extended to include...... the influence of the depth of the atmospheric boundary layer (h), which becomes relevant for heights above h/3, and the resultant long-term ‘tall’ profile form also matches observations....

  12. Long term behaviour of singularly perturbed parabolic degenerated equation


    Faye, Ibrahima; Frenod, Emmanuel; Seck, Diaraf


    In this paper we consider models for short-term, mean-term and long-term morphodynamics of dunes and megariples. We give an existence and uniqueness result for long term dynamics of dunes. This result is based on a time-space periodic solution existence result for degenerated parabolic equation that we set out. Finally the mean-term and long-term models are homogenized.


    Directory of Open Access Journals (Sweden)

    Daniela-Emanuela Dănăcică


    Full Text Available The aim of this paper is to analyze characteristics of long-term unemployment spells in Romania and to estimate the effect of factors influencing long-term unemployment spells. The study period is in between January 1st 2008 and December 31st 2010. 468159 long-term spells registered in the specified period at the National Agency of Employment are analyzed.

  14. A cost of long-term memory in Drosophila


    Mery, Frederic; Kawecki, Tadeusz J.


    Two distinct forms of consolidated associative memory are known in Drosophila: long-term memory and so-called anesthesia-resistant memory. Long-term memory is more stable, but unlike anesthesia-resistant memory, its formation requires protein synthesis. We show that flies induced to form long-term memory become more susceptible to extreme stress (such as desiccation). In contrast, induction of anesthesia-resistant memory had no detectable effect on desiccation resistance. This finding may hel...

  15. Unemployment and Long-Term Unemployment of Immigrants in Croatia

    Directory of Open Access Journals (Sweden)

    Valerija Botrić


    share of immigrants without prior working experience decreased in the crisis year, also regardless of the duration of their unemployment. Both factors indicate more active search in the crisis period and suggest demand constraints on the labour market, which has affected both the domicile and immigrant population. In order to determine significant predictors of very long-term in comparison to short-term unemployment, the same empirical strategy has been applied. The analysis for the 2007 (pre-crisis year has identified the following significant predictors of long-term unemployment status for immigrants in Croatia, listed in the decreasing marginal effects order: positive predictors: lower secondary education (in comparison to upper-secondary education, persons older than 55 and persons in the 45‒54 age cohort (in comparison to the reference 35‒44 age cohort. The analysis for the 2012 (crisis year has identified the following significant predictors of long-term unemployment status for immigrants in Croatia, listed in the decreasing marginal effects order: positive predictors: persons without prior working experience and persons older than 55 (in comparison to the reference age cohort; negative predictors: age cohorts 15‒24 and 25‒34 (in comparison to the reference age cohort, being married or cohabitating, male persons. Comparing the results for 2007 and 2012 it seems obvious that the most important difference is related to first-time job seekers. The crisis has created a population without previous working experience that has become long-term unemployed. Since the long-term unemployed are, in general, considered by employers as persons with lower employability, this is a serious issue that deserves policy actions. When considering future policy actions related to immigration, results for the most recent year are more important. The analysis in the paper has shown that certain occupations (elementary occupations, services and sales workers, crafts and related

  16. Long-term visual object recognition memory in aged rats. (United States)

    Platano, Daniela; Fattoretti, Patrizia; Balietti, Marta; Bertoni-Freddari, Carlo; Aicardi, Giorgio


    Aging is associated with memory impairments, but the neural bases of this process need to be clarified. To this end, behavioral protocols for memory testing may be applied to aged animals to compare memory performances with functional and structural characteristics of specific brain regions. Visual object recognition memory can be investigated in the rat using a behavioral task based on its spontaneous preference for exploring novel rather than familiar objects. We found that a behavioral task able to elicit long-term visual object recognition memory in adult Long-Evans rats failed in aged (25-27 months old) Wistar rats. Since no tasks effective in aged rats are reported in the literature, we changed the experimental conditions to improve consolidation processes to assess whether this form of memory can still be maintained for long term at this age: the learning trials were performed in a smaller box, identical to the home cage, and the inter-trial delays were shortened. We observed a reduction in anxiety in this box (as indicated by the lower number of fecal boli produced during habituation), and we developed a learning protocol able to elicit a visual object recognition memory that was maintained after 24 h in these aged rats. When we applied the same protocol to adult rats, we obtained similar results. This experimental approach can be useful to study functional and structural changes associated with age-related memory impairments, and may help to identify new behavioral strategies and molecular targets that can be addressed to ameliorate memory performances during aging.

  17. Assessing the Feasibility of Global Long-Term Mitigation Scenarios

    Directory of Open Access Journals (Sweden)

    Ajay Gambhir


    Full Text Available This study explores the critical notion of how feasible it is to achieve long-term mitigation goals to limit global temperature change. It uses a model inter-comparison of three integrated assessment models (TIAM-Grantham, MESSAGE-GLOBIOM and WITCH harmonized for socio-economic growth drivers using one of the new shared socio-economic pathways (SSP2, to analyse multiple mitigation scenarios aimed at different temperature changes in 2100, in order to assess the model outputs against a range of indicators developed so as to systematically compare the feasibility across scenarios. These indicators include mitigation costs and carbon prices, rates of emissions reductions and energy efficiency improvements, rates of deployment of key low-carbon technologies, reliance on negative emissions, and stranding of power generation assets. The results highlight how much more challenging the 2 °C goal is, when compared to the 2.5–4 °C goals, across virtually all measures of feasibility. Any delay in mitigation or limitation in technology options also renders the 2 °C goal much less feasible across the economic and technical dimensions explored. Finally, a sensitivity analysis indicates that aiming for less than 2 °C is even less plausible, with significantly higher mitigation costs and faster carbon price increases, significantly faster decarbonization and zero-carbon technology deployment rates, earlier occurrence of very significant carbon capture and earlier onset of global net negative emissions. Such a systematic analysis allows a more in-depth consideration of what realistic level of long-term temperature changes can be achieved and what adaptation strategies are therefore required.

  18. The psychophysics of transition to long term care. (United States)

    Miles, Richard W


    More than a decade after the publication of To Err Is Human, cognitive error remains a mystery to physicians. Competent and conscientious physicians rarely recall making a single cognitive error, yet this must be central to the explanation for inappropriate physician nonadherence to evidence-based guidelines. Published information regarding cognitive error in the medical literature is scarce and widely scattered. We do know that cognitive error is induced by complexity, duress, and uncertainty, conditions that regularly confront long term care physicians when they assume care of a new patient at the skilled nursing facility. Negative attitudes and low expectations of care are common among new patients and families. This is compounded when care is assumed by an unfamiliar physician. The initial disquiet and negative misconceptions of patients and families regularly make the transition one of the most error-prone events in medical practice. On the brighter side, the transition provides an excellent opportunity to study cognitive error. Cognitive errors at transition typically begin with a decision to avoid mention of necessary changes to flawed treatment plans already in effect. This is done as a temporary measure to avoid further stressing the patient and family. But what appears to be an ideal compromise is a risky option and should be avoided. Evading the issue introduces long-term risk to the patient. In addition, although it is seldom acknowledged, evading change often has a negative impact on local standards of care. Five cognitive principles are presented as root causes of cognitive error. Six contextual factors are identified that are endemic to nursing home practice, making the physician even more error prone. Because mistrust is central to dysfunctional decision making at the transition, strategies are presented to expedite gaining trust. This article makes the case for adding training in the cognitive psychology of medical decision making to core

  19. Enhanced Polyhydroxybutyrate Production for Long-Term Spaceflight Applications (United States)

    Putman, Ryan J.; Rahman, Asif; Miller, Charles D.; Hadi, Masood Z.


    Synthetic biology holds the promise of advancing long term space fight by the production of medicine, food, materials, and energy. One such application of synthetic biology is the production of biomaterials, specifically polyhydroxyalkanoates (PHAs), using purposed organisms such as Escherichia coli. PHAs are a group of biodegradable bioplastics that are produced by a wide variety of naturally occurring microorganisms, mainly as an energy storage intermediate. PHAs have similar melting point to polypropylene and a Youngs modulus close to polystyrene. Due to limited resources and cost of transportation, large-scale extraction of biologically produced products in situ is extremely cumbersome during space flight. To that end, we are developing a secretion systems for exporting PHA from the cell in order to reduce unit operations. PHAs granules deposited inside bacteria are typically associated with proteins bound to the granule surface. Phasin, a granule bound protein, was targeted for type I secretion by fusion with HlyA signal peptide for indirect secretion of PHAs. In order to validate our secretion strategy, a green fluorescent protein (GFP) was tagged to the PHA polymerase enzyme (phaC), this three part gene cassette consists of phaA and phaB and are required for PHA production. Producing PHAs in situ during space flight or planet colonization will enable mission success by providing a valuable source of biomaterials that can have many potential applications thereby reducing resupply requirements. Biologically produced PHAs can be used in additive manufacturing such as three dimensional (3D) printing to create products that can be made on demand during space flight. After exceeding their lifetime, the PHAs could be melted and recycled back to 3D print other products. We will discuss some of our long term goals of this approach.

  20. Predicting patterns of long-term adaptation and extinction with population genetics. (United States)

    Bertram, J; Gomez, K; Masel, J


    Population genetics struggles to model extinction; standard models track the relative rather than absolute fitness of genotypes, while the exceptions describe only the short-term transition from imminent doom to evolutionary rescue. But extinction can result from failure to adapt not only to catastrophes, but also to a backlog of environmental challenges. We model long-term adaptation to long series of small challenges, where fitter populations reach higher population sizes. The population's long-term fitness dynamic is well approximated by a simple stochastic Markov chain model. Long-term persistence occurs when the rate of adaptation exceeds the rate of environmental deterioration for some genotypes. Long-term persistence times are consistent with typical fossil species persistence times of several million years. Immediately preceding extinction, fitness declines rapidly, appearing as though a catastrophe disrupted a stably established population, even though gradual evolutionary processes are responsible. New populations go through an establishment phase where, despite being demographically viable, their extinction risk is elevated. Should the population survive long enough, extinction risk later becomes constant over time. © 2016 The Author(s). Evolution © 2016 The Society for the Study of Evolution.

  1. Handbook on Long Term Defence Planning (Manuel sur la planification de defense a long terme) (United States)


    ses mécanismes. On aborde également, dans le cadre de ce processus, le contexte de la planification et la traduction des plans en mesures exécutives...La planification à long terme est essentielle pour les organisations confrontées à un double impact : incertitude quant à l’avenir et très peu...d’apprendre, de prévoir et de réagir de façon plus appropriée aux événements au fur et à mesure qu’ils se produisent, en temps réel, notamment

  2. [Outsourcing in long-term care: a risk management approach]. (United States)

    Guimarães, Cristina Machado; Carvalho, José Crespo de


    This article seeks to investigate outsourcing decisions in supply chain management of healthcare organizations, namely the motives and constraints behind the decision, the selection criteria for activities to be outsourced to third parties, the type of possible agreements, and the impact of this decision on the organization per se. A case study of the start-up phase of a Long-term Care unit with an innovative approach and high levels of customization was conducted to understand the outsourcing process in a start-up context (not in the standard context of organizational change) and a risk evaluation matrix was created for outsourcing activities in order to define and implement a performance monitoring process. This study seeks to understand how to evaluate and assess the risks of an outsourcing strategy and proposes a monitoring model using risk management tools. It was shown that the risk management approach can be a solution for monitoring outsourcing in the organizational start-up phase. Conclusions concerning dissatisfaction with the results of outsourcing strategies adopted are also presented.

  3. A Long-Term Mathematical Model for Mining Industries

    Energy Technology Data Exchange (ETDEWEB)

    Achdou, Yves, E-mail: [Univ. Paris Diderot, Sorbonne Paris Cité, Laboratoire Jacques-Louis Lions, UMR 7598, UPMC, CNRS (France); Giraud, Pierre-Noel [CERNA, Mines ParisTech (France); Lasry, Jean-Michel [Univ. Paris Dauphine (France); Lions, Pierre-Louis [Collège de France (France)


    A parcimonious long term model is proposed for a mining industry. Knowing the dynamics of the global reserve, the strategy of each production unit consists of an optimal control problem with two controls, first the flux invested into prospection and the building of new extraction facilities, second the production rate. In turn, the dynamics of the global reserve depends on the individual strategies of the producers, so the models leads to an equilibrium, which is described by low dimensional systems of partial differential equations. The dimensionality depends on the number of technologies that a mining producer can choose. In some cases, the systems may be reduced to a Hamilton–Jacobi equation which is degenerate at the boundary and whose right hand side may blow up at the boundary. A mathematical analysis is supplied. Then numerical simulations for models with one or two technologies are described. In particular, a numerical calibration of the model in order to fit the historical data is carried out.

  4. Long-term follow-up of obstetric studies

    NARCIS (Netherlands)

    Teune, M.J.


    This thesis focuses on long-term child follow-up after obstetric studies. Obstetric randomized controlled clinical trials (RCTs) are performed to evaluate the effectiveness of perinatal interventions. However, most often only short-term outcomes are reported, while long-term outcomes are just as

  5. Albumin: Creatinine Ratio during long term Diabetes Mellitus in the ...

    African Journals Online (AJOL)

    Albumin: Creatinine Ratio during long term Diabetes Mellitus in the Assessment of early Nephropathy in Sudanese Population. ... Further studies with 24 hour urine sample are recommended for assessment of Microalbuminuria in long term Diabetic patients, provided that the patients are on a normal diet with regular ...

  6. Immunostimulatory and Other Haematological Effects of Long Term ...

    African Journals Online (AJOL)

    Carica papaya Linn. (Caricaceae)is used traditionally to treat malaria, hypertension, sickle cell anemia and diabetes. Its long-term hypoglycaemic and anti-obesity effects in normal rabbits are documented. This study assessed the long term immunostimulatory and other haematological effects of aqueous C. papaya leaf ...

  7. Long-term forest ecosystem research: a programmatic view (United States)

    Wayne Swank; James Vose


    Long-term research provides the building blocks of knowledge needed to address natural resource and environmental issues. "Long-term" has frequently been considered to span decades with a time frame that usually encompasses at least one generation of scientists and frequently two or more generations. In the rich history of forest science, the origin of long-...

  8. Long-term aged care: expenditure trends and projections


    Alan Madge


    Discusses the factors that influence long-term aged care demand and provides projections of future expenditure. Long-term aged care in this context comprises mainly residential care (nursing homes and hostels) and community care services for the infirm aged.

  9. Detecting long-term growth trends using tree rings

    NARCIS (Netherlands)

    Peters, R.L.; Groenendijk, Peter; Vlam, Mart; Zuidema, P.A.


    Tree-ring analysis is often used to assess long-term trends in tree growth. A variety of growth-trend detection methods (GDMs) exist to disentangle age/size trends in growth from long-term growth changes. However, these detrending methods strongly differ in approach, with possible implications

  10. Long-term hearing preservation in vestibular schwannoma

    DEFF Research Database (Denmark)

    Stangerup, Sven-Eric; Thomsen, Jens; Tos, Mirko


    The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas.......The aim of the present study was to evaluate the long-term hearing during "wait and scan" management of vestibular schwannomas....

  11. Long-term effects of a preoperative smoking cessation programme

    DEFF Research Database (Denmark)

    Villebro, Nete Munk; Pedersen, Tom; Møller, Ann M


    Preoperative smoking intervention programmes reduce post-operative complications in smokers. Little is known about the long-term effect upon smoking cessation.......Preoperative smoking intervention programmes reduce post-operative complications in smokers. Little is known about the long-term effect upon smoking cessation....

  12. How Does Long-Term Finance Affect Economic Volatility?

    NARCIS (Netherlands)

    Demirgüç-Kunt, A.; Horváth, Bálint; Huizinga, Harry


    In an approach analogous to Rajan and Zingales (1998), we examine how the ability to access long-term debt affects firm-level growth volatility. We find that firms in industries with stronger preference to use long-term finance relative to short-term finance experience lower growth volatility in

  13. Long-Term Orientation and Educational Performance. Working Paper 174 (United States)

    Figlio, David; Giuliano, Paola; Özek, Umut; Sapienza, Paola


    We use remarkable population-level administrative education and birth records from Florida to study the role of Long-Term Orientation on the educational attainment of immigrant students living in the US. Controlling for the quality of schools and individual characteristics, students from countries with long-term oriented attitudes perform better…

  14. Quantification of long term emission potential from landfills

    NARCIS (Netherlands)

    Heimovaara, T.J.


    Novel approaches for the after-care of Municipal Solid Waste (MSW) landfills are based on technological measures to reduce the long term emission potential in a short time period. Biological degradation in landfills is a means to significantly reduce the long term emission potential. Leachate

  15. Esophageal atresia: long-term morbidities in adolescence and adulthood.

    NARCIS (Netherlands)

    Ijsselstijn, H.; Beelen, N.W. van; Wijnen, R.M.H.


    Survival rates in esophageal atresia (EA) patients have reached 90%. In long-term follow-up studies the focus has shifted from purely surgical or gastrointestinal evaluation to a multidisciplinary approach. We evaluated the long-term morbidity in adolescent and adult EA patients and discussed mainly

  16. Long-Term Follow Up of Superficial Bladder Tumors | Shelbaia ...

    African Journals Online (AJOL)

    Conclusion: The treatment of superficial TCC may be done by relatively minor endoscopic procedures, but the disease itself is a serious condition that merits close long-term follow-up. Key words: bladder tumors, transitional cell carcinoma (TCC), ND: YAG lasers, transurethral resection (TURT) Suivi à long terme des ...

  17. Long-Term Mortality of Emergency Medical Services Patients

    DEFF Research Database (Denmark)

    Bøtker, Morten T; Terkelsen, Christian J; Sørensen, Jan Nørtved


    STUDY OBJECTIVE: Emergency medical services (EMS) provides out-of-hospital care to patients with life-threatening conditions, but the long-term outcomes of EMS patients are unknown. We seek to determine the long-term mortality of EMS patients in Denmark. METHODS: We analyzed linked EMS, hospital...

  18. Developmental Dyslexia and Explicit Long-Term Memory (United States)

    Menghini, Deny; Carlesimo, Giovanni Augusto; Marotta, Luigi; Finzi, Alessandra; Vicari, Stefano


    The reduced verbal long-term memory capacities often reported in dyslexics are generally interpreted as a consequence of their deficit in phonological coding. The present study was aimed at evaluating whether the learning deficit exhibited by dyslexics was restricted only to the verbal component of the long-term memory abilities or also involved…

  19. [Long-term clinical effects of antidepressive agents]. (United States)

    Sechter, D


    According to long term studies with antidepressants versus placebo, the therapeutic efficacy is prolonged: a long term treatment in full dosage seems to reduce from almost half the risk of relapse and recurrence till five years, during recurrent major affective disorders. We should therefore be cautious and we should not have a systematic prescription for all types of depressions; antidepressants are efficacious but have side effects and we do not know well their abilities in long term use. During bipolar disorders the prescription of long term antidepressants, even in association with normothymics, does not give benefits and can induce rapid cycles. In dysthymias and depressions with personality disorders, a psychotherapy is indicated, and it is difficult to evaluate the efficacy of a long term antidepressant treatment. Tricyclics antidepressants, MAOI's and SSRI's have classical side effects, and they can also induce: modifications of the symptomatology, of cognitive functions, of sleep, eating and sexual behaviours; modifications of the course of depressive illness, induction of manic switches, and may be sometimes an exacerbation of suicidal ideation ... pharmacogenetic modifications with their action on hepatic metabolism, neuroendocrine alterations and long term effects on monoamines. We have also to take into account the long term treatment consequences on quality of life, on self esteem with the importance of psychodynamic and relationships modifications. The use of a long term antidepressant treatment should be adapted to each individual, being cautious of its potential benefits and risks.

  20. Environmental Management Long-Term Stewardship Transition Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Kristofferson, Keith


    Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after the completion of facility cleanup. Long-term stewardship is administered and overseen by the U.S. Department of Energy Environmental Management Office of Science and Technology. This report describes the background of long-term stewardship and gives general guidance about considerations when ownership and/or responsibility of a site should be transferred to a long-term stewardship program. This guidance document will assist the U.S. Department of Energy in: (a) ensuring that the long-term stewardship program leads transition planning with respect to facility and site areas, and (b) describing the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete.

  1. Long-Term Memory Performance in Adult ADHD. (United States)

    Skodzik, Timo; Holling, Heinz; Pedersen, Anya


    Memory problems are a frequently reported symptom in adult ADHD, and it is well-documented that adults with ADHD perform poorly on long-term memory tests. However, the cause of this effect is still controversial. The present meta-analysis examined underlying mechanisms that may lead to long-term memory impairments in adult ADHD. We performed separate meta-analyses of measures of memory acquisition and long-term memory using both verbal and visual memory tests. In addition, the influence of potential moderator variables was examined. Adults with ADHD performed significantly worse than controls on verbal but not on visual long-term memory and memory acquisition subtests. The long-term memory deficit was strongly statistically related to the memory acquisition deficit. In contrast, no retrieval problems were observable. Our results suggest that memory deficits in adult ADHD reflect a learning deficit induced at the stage of encoding. Implications for clinical and research settings are presented.

  2. Long-term maintenance of in vitro cultured honeybee (Apis mellifera embryonic cells

    Directory of Open Access Journals (Sweden)

    Aamodt Randi M


    Full Text Available Abstract Background In vitro cultivation of cells allows novel investigation of in vivo- mechanisms and is a helpful tool in developmental biology, biochemistry and functional genomics. Numerous cell lines of insect species, e.g., silkworm and mosquito, have been reported. However, this is not the case for successful long-term cultivation of cells in honeybees. Results Methods for cultivation of honeybee embryonic cells are discussed here. Pre-gastrula stage embryos were used to initiate cultures, and cells were reared on 96-wells microplates with Grace insect medium, supplemented with Fetal Bovine Serum. Cells proliferated in clusters, and maintained viable and mitotic for more than three months. Conclusion We report here, for the first time, long-term cultivation of honeybee cells. Results represent a highly useful in vitro-system for studying a model organism of increasing importance in areas such as aging, sociality and neurobiology.

  3. Exploring views on long term rehabilitation for people with stroke in a developing country: findings from focus group discussions (United States)


    Background The importance of long term rehabilitation for people with stroke is increasingly evident, yet it is not known whether such services can be materialised in countries with limited community resources. In this study, we explored the perception of rehabilitation professionals and people with stroke towards long term stroke rehabilitation services and potential approaches to enable provision of these services. Views from providers and users are important in ensuring whatever strategies developed for long term stroke rehabilitations are feasible and acceptable. Methods Focus group discussions were conducted involving 15 rehabilitation professionals and eight long term stroke survivors. All recorded conversations were transcribed verbatim and analysed using the principles of qualitative research. Results Both groups agreed that people with stroke may benefit from more rehabilitation compared to the amount of rehabilitation services presently provided. Views regarding the unavailability of long term rehabilitation services due to multi-factorial barriers were recognised. The groups also highlighted the urgent need for the establishment of community-based stroke rehabilitation centres. Family-assisted home therapy was viewed as a potential approach to continued rehabilitation for long term stroke survivors, given careful planning to overcome several family-related issues. Conclusions Barriers to the provision of long term stroke rehabilitation services are multi-factorial. Establishment of community-based stroke rehabilitation centres and training family members to conduct home-based therapy are two potential strategies to enable the continuation of rehabilitation for long term stroke survivors. PMID:24606911

  4. A Long-Term View on Perovskite Optoelectronics. (United States)

    Docampo, Pablo; Bein, Thomas


    Recently, metal halide perovskite materials have become an exciting topic of research for scientists of a wide variety of backgrounds. Perovskites have found application in many fields, starting from photovoltaics and now also making an impact in light-emitting applications. This new class of materials has proven so interesting since it can be easily solution processed while exhibiting materials properties approaching the best inorganic optoelectronic materials such as GaAs and Si. In photovoltaics, in only 3 years, efficiencies have rapidly increased from an initial value of 3.8% to over 20% in recent reports for the commonly employed methylammonium lead iodide (MAPI) perovskite. The first light emitting diodes and light-emitting electrochemical cells have been developed already exhibiting internal quantum efficiencies exceeding 15% for the former and tunable light emission spectra. Despite their processing advantages, perovskite optoelectronic materials suffer from several drawbacks that need to be overcome before the technology becomes industrially relevant and hence achieve long-term application. Chief among these are the sensitivity of the structure toward moisture and crystal phase transitions in the device operation regime, unreliable device performance dictated by the operation history of the device, that is, hysteresis, the inherent toxicity of the structure, and the high cost of the employed charge selective contacts. In this Account, we highlight recent advances toward the long-term viability of perovskite photovoltaics. We identify material decomposition routes and suggest strategies to prevent damage to the structure. In particular, we focus on the effect of moisture upon the structure and stabilization of the material to avoid phase transitions in the solar cell operating range. Furthermore, we show strategies to achieve low-cost chemistries for the development of hole transporters for perovskite solar cells, necessary to be able to compete with other

  5. Towards a practical Johnson noise thermometer for long-term measurements in harsh environments

    Energy Technology Data Exchange (ETDEWEB)

    Greenen, Adam; Pearce, Jonathan [National Physical Laboratory, Hampton Road, Teddington, TW11 0LW, (United Kingdom); Cruickshank, David; Bramley, Paul [Metrosol Limited, Plum Park Estate, Watling Street, Paulerspury, Northamptonshire, NN12 6LQ, (United Kingdom)


    The impact of mechanical and chemical changes in conventional sensors such as thermocouples and resistance thermometers can be avoided by instead using temperature sensors based on fundamental thermometry. A prime example of this is Johnson noise thermometry, which is based on measurement of the fluctuations in the voltage of a resistor arising from thermal motion of charge carriers - i.e. the 'Johnson noise'. A Johnson noise thermometer never needs calibration and is insensitive to the condition of the sensor material. It is therefore ideally suited to long-term temperature measurements in harsh environments, such as nuclear reactor coolant circuits, in-pile measurements, nuclear waste management and storage, and severe accident monitoring. There have been a number of previous attempts to develop a Johnson noise thermometer for the nuclear industry, but none have reached commercial exploitation because of technical problems in practical implementation. The main challenge is to extract the tiny Johnson noise signal from ambient electrical noise influences, both from the internal amplification electronics, and from external electrical noise sources. Recent advances in electronics technology and digital signal processing techniques have opened up new possibilities for developing a viable, practical Johnson noise thermometer. We describe a project funded by the UK Technology Strategy Board (now Innovate UK) 'Developing the nuclear supply chain' call, currently underway, to develop a practical Johnson noise thermometer that makes use of innovative electronics for ultralow noise amplification and signal processing. The new electronics technology has the potential to help overcome the problems encountered with previous attempts at constructing a practical Johnson noise thermometer. An outline of the new developments is presented, together with an overview of the current status of the project. (authors)

  6. Long-term changes in dysnatremia incidence in the ICU: a shift from hyponatremia to hypernatremia

    NARCIS (Netherlands)

    A. Oude Lansink-Hartgring (Annemieke); L. Hessels (Lara); J. Weigel (Joachim); A.M. de Smet (Anne Marie); D.A.M.P.J. Gommers (Diederik); P.V.N. Panday (Prashant V. Nannan); E.J. Hoorn (Ewout); M.W.N. Nijsten (Maarten)


    textabstractBackground: Dysnatremia is associated with adverse outcome in critically ill patients. Changes in patients or treatment strategies may have affected the incidence of dysnatremia over time. We investigated long-term changes in the incidence of dysnatremia and analyzed its association with

  7. Long-term changes in dysnatremia incidence in the ICU : a shift from hyponatremia to hypernatremia

    NARCIS (Netherlands)

    Lansink-Hartgring, Annemieke Oude; Hessels, Lara; Weigel, Joachim; de Smet, Anne Marie G. A.; Gommers, Diederik; Nannan Panday, Prashant V.; Hoorn, Ewout J.; Nijsten, Maarten W.


    Background: Dysnatremia is associated with adverse outcome in critically ill patients. Changes in patients or treatment strategies may have affected the incidence of dysnatremia over time. We investigated long-term changes in the incidence of dysnatremia and analyzed its association with mortality.

  8. Long-term sedimentation effects of different patterns of timber harvesting (United States)

    R. R. Ziemer; J. Lewis; T. E. Lisle; Rice. R. M.


    Abstract - It is impractical to address the long-term effect of forest management strategies on erosion, sedimentation, and the resultant damage to fish habitat experimentally because to do so would require studying large watersheds for a century or more. Monte Carlo simulations were conducted on three hypothetical 10 000 ha, fifth-order forested watersheds. One...

  9. Long-term histories of land use and rapid urbaniSation of rural areas ...

    African Journals Online (AJOL)

    The authors reflect on how consideration of the long-term history of a landscape can and should contribute to urban planning strategies that, through the incorporation of concepts such as historical urban landscapes and sustainable social and economic development, could lead to a more equitable management of land and ...

  10. Model-based workflows for optimal long-term reservoir mangement

    NARCIS (Netherlands)

    Leeuwenburgh, O.; Egberts, P.; Chitu, A.; Wilschut, F.


    Life-cycle optimization is the process of finding field operation strategies that aim to optimize recovery or economic value with a long-term (years to decades) horizon. A reservoir simulation model is therefore generally appropriate and sufficient to explore the impact of different recovery

  11. The long-term ecological research community metada standardisation project: a progress report (United States)

    Inigo San Gil; Karen Baker; John Campbell; Ellen G. Denny; Kristin Vanderbilt; Brian Riordan; Rebecca Koskela; Jason Downing; Sabine Grabner; Eda Melendez; Jonathan M. Walsh; Masib Kortz; James Conners; Lynn Yarmey; Nicole Kaplan; Emery R. Boose; Linda Powell; Corinna Gries; Robin Schroeder; Todd Ackerman; Ken Ramsey; Barbara Benson; Jonathan Chipman; James Laundre; Hap Garritt; Don Henshaw; Barrie Collins; Christopher Gardner; Sven Bohm; Margaret O' Brien; Jincheng Gao; Wade Sheldon; Stephanie Lyon; Dan Bahauddin; Mark Servilla; Duane Costa; James Brunt


    We describe the process by which the Long-Term Ecological Research (LTER) Network standardized their metadata through the adoption of the Ecological Metadata Language (EML). We describe the strategies developed to improve motivation and to complement the information technology resources available at the LTER sites. EML implementation is presented as a mapping process...

  12. The Long-Term Economic Impact of in Utero and Postnatal Exposure to Malaria (United States)

    Barreca, Alan I.


    I use an instrumental-variables identification strategy and historical data from the United States to estimate the long-term economic impact of in utero and postnatal exposure to malaria. My research design matches adults in the 1960 Decennial Census to the malaria death rate in their respective state and year of birth. To address potential…

  13. Long-term soil monitoring at U.S. Geological Survey reference watersheds (United States)

    McHale, Michael R.; Siemion, Jason; Lawrence, Gregory B.; Mast, M. Alisa


    Monitoring the environment by making repeated measurements through time is essential to evaluate and track the health of ecosystems (fig. 1). Long-term datasets produced by such monitoring are indispensable for evaluating the effectiveness of environmental legislation and for designing mitigation strategies to address environmental changes in an era when human activities are altering the environment locally and globally.

  14. Engineering and agronomy aspects of a long-term precision agriculture field experiment (United States)

    Much research has been conducted on specific precision agriculture tools and implementation strategies, but little has been reported on long-term evaluation of integrated precision agriculture field experiments. In 2004 our research team developed and initiated a multi-faceted “precision agriculture...

  15. Abstracts 1987. New Horizons in Long Term Care: A Report on the Long Term Care Research and Demonstration Projects. (United States)

    Illinois State Dept. of Public Aid, Springfield.

    This booklet provides a description of 14 projects which were awarded funds during fiscal year 1987 for collaborative research in long-term care to find new ways to treat long-term care patients in Illinois nursing homes. It includes the organization or institution receiving the award, an abstract of the research proposal, and the name of the…

  16. [Calcium pros and cons: long term use of bisphosphonates. Bisphosphonates should be used for postmenopausal osteoporosis for a long term]. (United States)

    Soen, Satoshi


    Only bisphosphonates have evidence that show to reduce the risk of vertebral, nonvertebral, and hip fractures in postmenopausal osteoporosis. From the viewpoint of risk benefit, it may be said that a utility is far superior to problems of the long-term use. Long-term use of bisphosphonates is necessary for the patients at elevated risk for the hip fracture.

  17. Long-term effects of invasive treatment in patients with a post-thrombolytic Q-wave myocardial infarction

    DEFF Research Database (Denmark)

    Kofoed, Klaus F; Madsen, Jan K; Grande, Peer


    The aim of the present study was to assess the effect of a deferred invasive treatment strategy on long-term outcome in patients with a post-thrombolytic Q-wave myocardial infarction and inducible myocardial ischemia.......The aim of the present study was to assess the effect of a deferred invasive treatment strategy on long-term outcome in patients with a post-thrombolytic Q-wave myocardial infarction and inducible myocardial ischemia....

  18. A Literature Review on the Experience of Long-Term Mental Illness. (United States)

    Collier, Elizabeth; Grant, Maria J


    To illuminate long-term experiences of mental illness from both research and autobiographical accounts. A literature review of English-language papers, 1950-2014, relating to the experience of long-term mental illness indexed in AgeInfo, AMED, ASSIA, British Nursing Index (BNI), CINAHL, MEDLINE, PsycEXTRA, and PsychINFO. Twenty-five research papers and nine autobiographic accounts met the review criteria. Thematic analysis revealed nine themes: fear, explanation seeking, stigma, disability, coping strategies, control, support, change and learning, and life history. Specific gaps of note relate to age differences, acknowledgement of longevity of mental illnesses, and different cultural perspectives. Research Implications: There is an absence of longitudinal studies focused on experiences of long-term mental illness. The considerable length-of-time implicated in the experiences suggests that more individual life experience rather than illness focused studies are needed, enabling a holistic understanding. This includes studies from cultures other than the Western world. Greater transparency is needed in justifying age inclusions or passive exclusion of older peoples' perspectives. Knowledge of long-term mental illness experiences is of great importance to mental health practitioners. Evidence-based services cannot be provided if we do not have an holistic understanding of long-term mental illness. Social Implications: This review questions our ability to provide effective support for those experiencing long-term mental illness, in particular older people and different cultural perspectives. There appear to be no literature reviews that focus on the individual experience of long-term mental illness. It highlights the surprisingly small number of research studies available to inform mental health practitioners.

  19. Quality of life, coping strategies and support needs of women seeking Traditional Chinese Medicine for infertility and viable pregnancy in Australia: a mixed methods approach. (United States)

    Ried, Karin; Alfred, Ann


    Infertility affects about 15% of couples in Western-societies with most progressing to fertility clinics for treatment. Despite being common, infertility is often experienced as a lonely road for affected couples. In this paper we expand on our previously published findings of women's experiences with infertility or difficulty of viable pregnancy who had sought Traditional Chinese Medicine (TCM) therapy in Australia, and focus on women's quality of life, coping strategies, and support needs. We applied mixed methods using the Tuebingen Quality of Life and the COPE questionnaires and in-depth interviews with 25 women with primary or secondary infertility, recurrent miscarriages or unexplained stillbirth, and who had consulted a TCM practitioner. We used a thematic approach to analyse the interviews, and descriptive statistics to evaluate questionnaire responses. Women reported through both questionnaires and interviews compromised quality of life due to the high level of distress, guilt, grief, and frustration caused by infertility. However, our women represented a highly motivated sample, actively seeking alternative support. While the TCM approach to infertility management increased women's sense of personal agency and control through education and continuity of care, the need for greater understanding and support on a societal level remains. In infertility, ongoing emotional and instrumental support is pivotal to the wellbeing and quality of life of the affected. Traditional Chinese Medicine addresses some support needs in infertility not routinely available in the Western model of care. More peer-led and professional-led support groups are greatly needed for women experiencing infertility to help break isolation and raise awareness of integrative approaches to fertility management.

  20. Effects of long-term use of fluoxetine on fertility parameters in adult male rats. (United States)

    Bataineh, Hameed N; Daradka, Tewfik


    The effects of long-term ingestion of fluoxetine on fertility were investigated in Sprague-Dawley male rats. Adult male rats were exposed to fluoxetine at a concentration of 200 mg/kg for 60 days. Long-term ingestion of fluoxetine for 60 days caused a great decrease in spermatogenesis in seminiferous tubules of the testes. Sperm motility and density were also significantly reduced in cauda epididymides and testes of the treated group. The weights of reproductive organs (testes, epididymides, ventral prostrate and seminal vesicle) were decreased considerably. The hormonal assay also showed significant decrease in testosterone levels and FSH levels. Testicular cell population dynamics also demonstrated a decrease in the number of both primary and secondary spermatocystes and spermatids in the treatment group. The number of female rats impregnated by male rats on long-term fluoxetine diet had decreased. The number of implantations and the number of viable fetuses were also notably decreased in female rats impregnated by male rats ingested fluoxetine. Fluoxetine caused a slight decrease in body weight, when initial and final body weights were compared in the experimental groups. Levels of ALT and AST were found to be significantly increased in the treated group when compared to the control. Histometery of reproductive organs confirmed these results. In conclusion, these results confirm that the long-term fluoxetine ingestion produce adverse effects on fertility and reproductive system in adult male rat. Thus, it would be of great interest to investigate the impact via long -term treatment with fluoxetine in male human fertility.

  1. Long-Term Stewardship Baseline Report and Transition Guidance

    Energy Technology Data Exchange (ETDEWEB)

    Kristofferson, Keith


    Long-term stewardship consists of those actions necessary to maintain and demonstrate continued protection of human health and the environment after facility cleanup is complete. As the Department of Energy’s (DOE) lead laboratory for environmental management programs, the Idaho National Engineering and Environmental Laboratory (INEEL) administers DOE’s long-term stewardship science and technology efforts. The INEEL provides DOE with technical, and scientific expertise needed to oversee its long-term environmental management obligations complexwide. Long-term stewardship is administered and overseen by the Environmental Management Office of Science and Technology. The INEEL Long-Term Stewardship Program is currently developing the management structures and plans to complete INEEL-specific, long-term stewardship obligations. This guidance document (1) assists in ensuring that the program leads transition planning for the INEEL with respect to facility and site areas and (2) describes the classes and types of criteria and data required to initiate transition for areas and sites where the facility mission has ended and cleanup is complete. Additionally, this document summarizes current information on INEEL facilities, structures, and release sites likely to enter long-term stewardship at the completion of DOE’s cleanup mission. This document is not intended to function as a discrete checklist or local procedure to determine readiness to transition. It is an overarching document meant as guidance in implementing specific transition procedures. Several documents formed the foundation upon which this guidance was developed. Principal among these documents was the Long-Term Stewardship Draft Technical Baseline; A Report to Congress on Long-Term Stewardship, Volumes I and II; Infrastructure Long-Range Plan; Comprehensive Facility Land Use Plan; INEEL End-State Plan; and INEEL Institutional Plan.

  2. Long-term correlations in the surface behavior of dolphins (United States)

    Cancho, R. Ferrer i.; Lusseau, D.


    Here we study the sequences of surface behavioral patterns of dolphins (Tursiops sp.) and find long-term correlations. We show that the long-term correlations are not of a trivial nature, i.e. they cannot be explained by the repetition of the same surface behavior many times in a row. Our findings suggest that dolphins have a long collective memory extending back at least to the 7-th past behavior. As far as we know, this is the first evidence of long-term correlations in the behavior of a non-human species.

  3. Being a long-term user of nicotine replacement therapy

    DEFF Research Database (Denmark)

    Borup, Gitte; Nørgaard, Lotte Stig; Tønnesen, Philip

    , regarding long-term NRT users’ experiences with continuing the use of NRT. Results from a survey study among long-term NRT-users, who had used NRT for 12 months or more, found that out of 92 former smokers 88 % wished to quit using NRT. The primary causes stated for wishing to quit were being tired...... of feeling addicted, cost of NRT products and fear of adverse health consequences. Aim of study • To get a thorough understanding of the lived experiences of nicotine dependent long-term NRT users. • To investigate what motivates or discourages quitting NRT. Method Semi-structured interviews with long...

  4. Long-term criticality concerns associated with disposition of weapons plutonium

    Energy Technology Data Exchange (ETDEWEB)

    Choi, J.S. [Lawrence Livermore National Lab., CA (United States)


    This paper presents a very brief description of criticality concerns resulting from dismantlement of nuclear weapons. Two plutonium disposal options, and associated criticality considerations, are described: (1) irradiating it into reactor-grade spent fuel, and (2) immobilization and burial, either in a geologic repository or in deep, sealed boreholes. Mixed oxide spent fuel could contain 3 to 4 wt% of reactor-grade plutonium. For the immobilization and the deep borehole options to be economically viable, a plutonium content of 3 to 7 wt% would be required. A study is proposed to evaluate the long-term criticality safety concerns for disposition of fissionable material in a geologic setting. 2 refs.

  5. Long-term stabilization of uranium mill tailings

    Energy Technology Data Exchange (ETDEWEB)

    Voorhees, L.D.; Sale, M.J.; Webb, J.W.; Mulholland, P.J.


    The primary hazard associated with uranium mill tailings is exposure to a radioactive gas, radon-222, the concentration of which has been correlated with the occurrence of lung cancer. Previous studies on radon attenuation conclude that the placement of earthen cover materials over the tailings is the most effective technique for reducing radioactive emissions and dispersal of tailings. The success of such a plan, however, is dependent on ensuring the long-term integrity of these cover materials. Soil erosion from water and wind is the major natural cause of destabilizing earthen cover materials. Field data related to the control of soil loss are limited and only indirectly apply to the problem of isolation of uranium mill tailings over very long time periods (up to 80,000 a). However, sufficient information is available to determine benefits that will result from the changes in specific design variables and to evaluate the need for different design strategies among potential disposal sites. The three major options available for stabilization of uranium mill tailings are: rock cover, soil and revegetation, or a combination of both on different portions of the tailings cover. The optimal choice among these alternatives depends on site-specific characteristics such as climate and local geomorphology and soils, and on design variables such as embankment, heights and slopes, modification of upstream drainage, and revegetation practices. Generally, geomorphic evidence suggests that use of soil and vegetation alone will not be adequate to reduce erosion on slopes greater than about 5 to 9%.

  6. Diagnosis, management, and long-term outcomes of rectovaginal endometriosis

    Directory of Open Access Journals (Sweden)

    Moawad NS


    Full Text Available Nash S Moawad,1 Andrea Caplin21Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, University of Florida, 2University of Florida College of Medicine, Gainesville, FL, USAAbstract: Rectovaginal endometriosis is the most severe form of endometriosis. Clinically, it presents with a number of symptoms including chronic pelvic pain, dysmenorrhea, deep dyspareunia, dyschezia, and rectal bleeding. The gold standard for diagnosis is laparoscopy with histological confirmation; however, there are a number of options for presurgical diagnosis, including clinical examination, transvaginal/transrectal ultrasound, magnetic resonance imagining, colonoscopy, and computed tomography colonography. Treatment can be medical or surgical. Medical therapies include birth control pills, oral progestins, gonadotropin-releasing hormone agonists, danazol, and injectable progestins. Analgesics are often used as well. Surgery improves up to 70% of symptoms. Surgery is either ablative or excisional, and is conducted via transvaginal, laparoscopic, laparotomy, or combined approaches. Common surgical techniques involve shaving of the superficial rectal lesion, laparoscopic anterior discoid resection, and low anterior bowel resection and reanastomosis. Outcomes are generally favorable, but postoperative complications may include intra-abdominal bleeding, anastomotic leaks, rectovaginal fistulas, strictures, chronic constipation, and the need for reoperation. Recurrence of rectal endometriosis is a possibility as well. Other outcomes are improved pain-related symptoms and fertility. Long-term outcomes vary according to the management strategy used. This review will provide the most recent approaches and techniques for the diagnosis and treatment of rectovaginal endometriosis.Keywords: pelvic pain, dyspareunia, bowel resection, endometriosis, rectovaginal

  7. Long-Term Albendazole Effectiveness for Hepatic Cystic Echinococcosis (United States)

    Salinas, Jorge Luis; Gonzales, Herman Vildozola; Astuvilca, Juan; Arce-Villavicencio, Yanet; Carbajal-Gonzalez, Danny; Talledo, Lety; Willig, James H.


    Little is known about the long-term effectiveness of albendazole in the medical therapy of non-complicated hepatic cystic echinococcosis (HCE) in resource-constrained settings. We performed a retrospective review of patients starting albendazole for HCE in Lima, Peru from January 1997 to December 2007. Patients successfully recontacted underwent chart abstraction and clinical and ultrasonographic reevaluation. Descriptive statistics were used to delineate patient characteristics and treatment effectiveness at the conclusion of albendazole and after reevaluation. Patients (N = 27) were primarily female, mean age was 51. Initial treatment success at albendazole conclusion was 26% (N = 7) per patient and 37.5% (N = 24) per cyst. After 3.8 ± 2.5 years, albendazole success was 34% (N = 9) per patient and 40% (N = 24) per cyst. We found a gap in the effectiveness of albendazole HCE therapy compared with the efficacy reported in clinical trials. This underscores the need for further investigation into alternate therapeutic strategies for this neglected disease. PMID:22144447

  8. Accumulation and long term behavior of radiocesium in tropical plants

    Energy Technology Data Exchange (ETDEWEB)

    Anjos, R.M.; Carvalho, C.; Mosquera, B.; Macario, K.; Veiga, R.; Sanches, N.; Bastos, J.; Saavedra, R.; Iguatemy, M. [Universidade Federal Fluminense, Niteroi (Brazil)


    Full text of publication follows: In recent years, there has been a growing interest in the evaluation of nutrient fluxes and radioactive contaminants in forest and agricultural ecosystems. Several studies on forest ecosystems have been carried out, mostly in Europe, after the Chernobyl accident. Japanese forest sites and native plant species of the Marshall Islands have also been extensively investigated. These studies have been used for various purposes, including the development of models for predicting plant concentrations from soil concentration measurements or the long term of dietary contamination by radiocesium following a fallout nuclear. Cesium is an alkali metal just like potassium and its behavior in nature, as well as in the human body, is similar to that of potassium. Uptake of 137 Cs from contaminated soil represents a significant pathway of human radiation exposure, either due to the direct consumption of cereals, fruits and vegetables or, indirectly, following consumption of milk and meat from animals fed on contaminated vegetable matter. The decline of 137 Cs levels as function of time of fruit trees is of interest given its long life in the field. Therefore, the cesium behavior is important in the design of management strategies to mitigate any negative health effects of radioactivity on the environment. It is also important to apply the current knowledge of the transport and distribution of salts derived from forest ecosystems in agricultural ecosystems, especially for tropical fruit trees. So far, in the South hemisphere there have been only a few studies on this subject, without conclusive results. With this aim, the Laboratory of Radioecology (L.A.R.A.) of the Universidade Federal Fluminense has been performing analyzes of 137 Cs and 40 K concentrations in several tropical plants (guava, mango, avocado, pomegranate, papaya, manioc and chili pepper trees) in order to determine the accumulation of these radionuclides throughout these trees and

  9. Long-term predictions of minewater geothermal systems heat resources (United States)

    Harcout-Menou, Virginie; de ridder, fjo; laenen, ben; ferket, helga


    Abandoned underground mines usually flood due to the natural rise of the water table. In most cases the process is relatively slow giving the mine water time to equilibrate thermally with the the surrounding rock massif. Typical mine water temperature is too low to be used for direct heating, but is well suited to be combined with heat pumps. For example, heat extracted from the mine can be used during winter for space heating, while the process could be reversed during summer to provide space cooling. Altough not yet widely spread, the use of low temperature geothermal energy from abandoned mines has already been implemented in the Netherlands, Spain, USA, Germany and the UK. Reliable reservoir modelling is crucial to predict how geothermal minewater systems will react to predefined exploitation schemes and to define the energy potential and development strategy of a large-scale geothermal - cold/heat storage mine water systems. However, most numerical reservoir modelling software are developed for typical environments, such as porous media (a.o. many codes developed for petroleum reservoirs or groundwater formations) and cannot be applied to mine systems. Indeed, mines are atypical environments that encompass different types of flow, namely porous media flow, fracture flow and open pipe flow usually described with different modelling codes. Ideally, 3D models accounting for the subsurface geometry, geology, hydrogeology, thermal aspects and flooding history of the mine as well as long-term effects of heat extraction should be used. A new modelling approach is proposed here to predict the long-term behaviour of Minewater geothermal systems in a reactive and reliable manner. The simulation method integrates concepts for heat and mass transport through various media (e.g., back-filled areas, fractured rock, fault zones). As a base, the standard software EPANET2 (Rossman 1999; 2000) was used. Additional equations for describing heat flow through the mine (both

  10. Long-term monitoring of marine gas leakage (United States)

    Spickenbom, Kai; Faber, Eckhard; Poggenburg, Jürgen; Seeger, Christian; Furche, Markus


    The sequestration of CO2 in sub-seabed geological formations is one of the Carbon Capture and Storage (CCS) strategies currently under study. Although offshore operations are significantly more expensive than comparable onshore operations, the growing public resistance against onshore CCS projects makes sub-seabed storage a promising option. Even after a thorough review of the geological setting, there is always the possibility of leakage from the reservoir. As part of the EU-financed project CO2ReMoVe (Research, Monitoring, Verification), which aims to develop innovative research and technologies for monitoring and verification of carbon dioxide geological storage, we are working on the development of submarine long-term gas flow monitoring systems. The basic design of the monitoring system builds on our experience in volcano monitoring. Early prototypes were composed of a raft floating on the surface of a mud volcano, carrying sensors for CO2 flux and concentration, data storage and transmission, and power supply by battery-buffered solar panels. The system was modified for installation in open sea by using a buoy instead of a raft and a funnel on the seafloor to collect the gas, connected by a flexible tube. This setup provides a cost-effective solution for shallow waters. However, a buoy interferes with ship traffic, and it is also difficult to adapt this design to greater water depths. These requirements can best be complied by a completely submersed system. A system for unattended long-term monitoring in a marine environment has to be extremely durable. Therefore, we focussed on developing a mechanically and electrically as simple setup as possible, which has the additional advantage of low cost. The system consists of a funnel-shaped gas collector, a sensor head and pressure housings for electronics and power supply. Since this setup is inexpensive, it can be deployed in numbers to cover larger areas. By addition of multi-channel data loggers, data


    Directory of Open Access Journals (Sweden)

    T. A. Britvin


    Full Text Available Background: Adrenocortical cancer (ACC is a rare adrenal neoplasm with aggressive clinical course and poor prognosis, and with many unresolved problems of diagnostics, treatment and predictive factors. Aim: To identify the most significant clinical and morphological predictors of the outcome based on assessment of long-term results of surgical treatment of ACC patients. Materials and methods: This retrospective study included data on diagnosis and results of treatment of 73 ACC patients from 1999 to 2015. Results: Radical surgery was performed in 59 patients, and long-term results assessed in 52 of them (maximal duration of the follow-up was 12 years. The most favorable treatment results were seen in stages I and II of the disease, with a 5-year survival rate of 87%. The 5-year overall survival in patients with ACC stage III was significantly (p=0.042, multiple comparisons lower (48%. Two patients who had been operated with ACC stage IV (adrenalectomy with excision of a solid liver metastasis and atypical lung resection died of progressive tumor within 13 months after surgery. The survival rates in patients with stage III of the tumor were evaluated depending on the main clinical characteristics of the tumor. It was shown that the 5-year overall survival in non-functioning adrenocortical carcinomas was 59%, being significantly (p<0.05 better than that in patients with functionally active malignancies (22%. In the group of patients without metastases in the regional lymphatic nodes, the 5-year overall survival was 56%, whereas all patients with regional lymphatic metastases by the time of the surgery died from progression within 4 years after the intervention. There was an association between 5-year overall survival and the size of primary tumor, with significantly (p<0.05 lower numbers of 5-year overall survivors (29% among those with tumors of more than 10 cm in diameter, compared with 65% survival rate in those with tumors of less than 10

  12. Innovative culture in long-term care settings: the influence of organizational characteristics. (United States)

    Nieboer, Anna P; Strating, Mathilde M H


    Innovative cultures have been reported to enhance the creation and implementation of new ideas and working methods in organizations. Although there is considerable research on the impact of organizational context on the innovativeness of organizations, the same is not the case for research on the organizational characteristics responsible for an innovative culture in (long-term) care settings. The aim of this study was to identify organizational characteristics that explain innovative culture in the (long-term) care sector. A large cross-sectional study in Dutch long-term care-nursing homes and/or elderly homes, care organizations for the handicapped, and long-term mental health care organizations-was conducted. A total of 432 managers and care professionals in 37 organizations participated. The Group Innovation Inventory was used to measure innovative culture in long-term care organizations. Structural characteristics of the organization were centralization and formalization, environmental dynamism and competitiveness, internal and external exchange of information, leadership style, commitment to quality improvement, and the organization's innovative strategy. The determinants of an innovative culture were estimated with a two-level random-intercepts and fixed-slopes model. Multilevel regression models were used to account for the organizational clustering of individuals within the 37 care organizations. Environmental dynamism, job codification, formal external exchange of information, transformational leadership, commitment to quality, and an exploratory and exploitative innovation strategy were all significantly correlated with an innovative culture in the multivariate multilevel analysis; the other characteristics were not. The explained organizational- and individual-level variance was 52.5% and 49.2%, respectively. The results point to substantial differences in innovative cultures between and within care organizations that can, in part, be explained by

  13. Timing of angiography with a routine invasive strategy and long-term outcomes in non-ST-segment elevation acute coronary syndrome: a collaborative analysis of individual patient data from the FRISC II (Fragmin and Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction) Trials. (United States)

    Damman, Peter; van Geloven, Nan; Wallentin, Lars; Lagerqvist, Bo; Fox, Keith A A; Clayton, Tim; Pocock, Stuart J; Hirsch, Alexander; Windhausen, Fons; Tijssen, Jan G P; de Winter, Robbert J


    This study sought to investigate long-term outcomes after early or delayed angiography in patients with non-ST-segment elevation acute coronary syndrome (nSTE-ACS) undergoing a routine invasive management. The optimal timing of angiography in patients with nSTE-ACS is currently a topic for debate. Long-term follow-up after early (within 2 days) angiography versus delayed (within 3 to 5 days) angiography was investigated in the FRISC-II (Fragmin and Fast Revascularization During Instability in Coronary Artery Disease), ICTUS (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes), and RITA-3 (Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction) (FIR) nSTE-ACS patient-pooled database. The main outcome was cardiovascular death or myocardial infarction up to 5-year follow-up. Hazard ratios (HR) were calculated with Cox regression models. Adjustments were made for the FIR risk score, study, and the propensity of receiving early angiography using inverse probability weighting. Of 2,721 patients originally randomized to the routine invasive arm, consisting of routine angiography and subsequent revascularization if suitable, 975 underwent early angiography and 1,141 delayed angiography. No difference was observed in 5-year cardiovascular death or myocardial infarction in unadjusted (HR: 1.06, 95% confidence interval [CI]: 0.79 to 1.42, p=0.61) and adjusted (HR: 0.93, 95% CI: 0.75 to 1.16, p=0.54) Cox regression models. In the FIR database of patients presenting with nSTE-ACS, the timing of angiography was not related to long-term cardiovascular mortality or myocardial infarction. (Invasive Versus Conservative Treatment in Unstable Coronary Syndromes [ICTUS]; ISRCTN82153174. Intervention Versus Conservative Treatment Strategy in Patients With Unstable Angina or Non-ST Elevation Myocardial Infarction [the Third Randomised Intervention Treatment of Angina Trials (RITA-3)]; ISRCTN

  14. Long-term intrathecal administration of midazolam and clonidine

    NARCIS (Netherlands)

    Borg, PAJ; Krijnen, HJ

    Objective: To determine the clinical usefulness of the long-term intrathecal administration of midazolam and clonidine in patients with refractory neurogenic and musculoskeletal pain. Setting: Pain Centre, Academic Hospital Groningen, Groningen, The Netherlands. Patients: Four patients with chronic

  15. Long Term 1 Enhanced Surface Water Treatment Rule Documents (United States)

    The Long Term 1 Enhanced Surface Water Treatment Rule (LT1ESWTR) builds on the requirements of the Surface Water Treatment Rule and specifies treatment requirements to address Cryptosporidium m and other microbial contaminants in public water systems.

  16. Long-term outcome after mastectomy with immediate breast reconstruction

    DEFF Research Database (Denmark)

    Stralman, K.; Mollerup, C.L.; Kristoffersen, U.S.


    INTRODUCTION: The purpose of this study was to investigate long term outcome for women who had undergone mastectomy and immediate breast reconstruction. MATERIAL AND METHODS: Patient files of 167 immediately reconstructed breast cancer patients were reviewed for late surgical complications...

  17. Surgery for ACL Tear Often Successful Over Long Term (United States)

    ... fullstory_167352.html Surgery for ACL Tear Often Successful Over Long Term Even 10 years after procedure, ... were scheduled for presentation Friday at the annual meeting of the AOSSM in Toronto. Findings presented at ...

  18. Advancing an ethical framework for long-term care. (United States)

    Carter, Mary Whelan


    This article represents an effort to formulate an ethical framework for long-term care with the explicit purpose of providing a catalyst to promote further discourse and expand consideration of what an ethic of long-term care might entail. Grounding the discussion, an introduction to traditional ethical philosophy is presented, focusing mainly on the fundamentals of deontological and teleological ethical theories. Attention then shifts to a review of the more frequently cited principles found in the long-term care ethics literature, followed by a critique of the current reliance upon principlism to resolve ethical dilemmas in long-term care. In response to this criticism, an agent-driven ethical framework stressing dignity and respect for personhood, drawn from the philosophy of Immanuel Kant, is advanced.

  19. Institutional repositories as infrastructures for long-term preservation

    National Research Council Canada - National Science Library

    Francke, Helena; Gamalielsson, Jonas; Lundell, Björn


    Introduction. The study describes the conditions for long-term preservation of the content of the institutional repositories of Swedish higher education institutions based on an investigation of how deposited...

  20. Long-term patient survival in ANCA-associated vasculitis

    NARCIS (Netherlands)

    Flossmann, Oliver; Berden, Annelies; de Groot, Kirsten; Hagen, Chris; Harper, Lorraine; Heijl, Caroline; Hoglund, Peter; Jayne, David; Luqmani, Raashid; Mahr, Alfred; Mukhtyar, Chetan; Pusey, Charles; Rasmussen, Niels; Stegeman, Coen; Walsh, Michael; Westman, Kerstin

    Background Wegener's granulomatosis and microscopic polyangiitis are antineutrophil cytoplasm antibodies (ANCA)-associated vasculitides with significant morbidity and mortality. The long-term survival of patients with ANCA associated vasculitis treated with current regimens is uncertain. Objective

  1. Political connections, media monitoring and long-term loans

    National Research Council Canada - National Science Library

    Deming Yang Zhengfei Lu Danglun Luo


    We analyze data on Chinese non-state-listed firms and find that it is easier for firms with political connections to obtain long-term loans with extended debt maturities than it is for firms without...

  2. Physiological characteristics of long-term Bikram yoga practitioners

    National Research Council Canada - National Science Library

    Abel, Allison N; Lloyd, Lisa K; Williams, James S; Miller, Brian K


    .... The primary purpose of this cross-sectional study was to describe the resting heart rate, blood pressure, lung function and aerobic fitness characteristics of long-term Bikram yoga practitioners...

  3. Long-term outcome of Tunisian children with primary ciliary ...

    African Journals Online (AJOL)

    Long-term outcome of Tunisian children with primary ciliary dyskinesia confirmed by transmission electron microscopy. Hamouda Samia, Boussetta Khadija, Hamzaoui Agnes, Khalsi Fatma, Trabelsi Ines, Jaafoura Hafedh, Tinsa Faten ...

  4. Monitoring land degradation with long-term satellite data

    CSIR Research Space (South Africa)

    Wessels, Konrad J


    Full Text Available need for a standardised, quantitative and spatially-explicit measures of ecosystem functions to map and monitor land degradation, especially in the light of land redistribution and restitution. The authors investigated the long-term vegetation...

  5. Long-Term Complications of Diabetes (For Parents) (United States)

    ... Is Too High Keeping Track of Your Blood Sugar Diabetes Control: Why It's Important Diabetes Center Diabetes: What's ... False? Diabetes Center Keeping Track of Your Blood Sugar Diabetes Control: Why It's Important Long-Term Complications of ...

  6. Long term combination treatment for severe idiopathic pulmonary arterial hypertension (United States)

    Affuso, Flora; Cirillo, Plinio; Ruvolo, Antonio; Carlomagno, Guido; Fazio, Serafino


    We report the long-term follow-up of 3 cases of severe idiopathic pulmonary arterial hypertension, in whom tadalafil plus sitaxentan combination therapy improved the clinical condition and exercise performance without any relevant adverse event. PMID:21160759

  7. Long-term Periodicities of Cataclysmic Variables with Synoptic Surveys (United States)

    Yang, Michael Ting-Chang; Chou, Yi; Ngeow, Chow-Choong; Hu, Chin-Ping; Su, Yi-Hao; Prince, Thomas A.; Kulkarni, Shrinivas R.; Levitan, David; Laher, Russ; Surace, Jason; Drake, Andrew J.; Djorgovski, Stanislav G.; Mahabal, Ashish A.; Graham, Matthew J.; Donalek, Ciro


    A systematic study on the long-term periodicities of known Galactic cataclysmic variables (CVs) was conducted. Among 1580 known CVs, 344 sources were matched and extracted from the Palomar Transient Factory (PTF) data repository. The PTF light curves were combined with the Catalina Real-Time Transient Survey (CRTS) light curves and analyzed. Ten targets were found to exhibit long-term periodic variability, which is not frequently observed in the CV systems. These long-term variations are possibly caused by various mechanisms, such as the precession of the accretion disk, hierarchical triple star system, magnetic field change of the companion star, and other possible mechanisms. We discuss the possible mechanisms in this study. If the long-term period is less than several tens of days, the disk precession period scenario is favored. However, the hierarchical triple star system or the variations in magnetic field strengths are most likely the predominant mechanisms for longer periods.

  8. Examining Long-Term Global Climate Change on the Web. (United States)

    Huntoon, Jacqueline E.; Ridky, Robert K.


    Describes a web-based, inquiry-oriented activity that enables students to examine long-term global climate change. Supports instruction in other topics such as population growth. (Contains 34 references.) (DDR)

  9. Long-term memory, sleep, and the spacing effect. (United States)

    Bell, Matthew C; Kawadri, Nader; Simone, Patricia M; Wiseheart, Melody


    Many studies have shown that memory is enhanced when study sessions are spaced apart rather than massed. This spacing effect has been shown to have a lasting benefit to long-term memory when the study phase session follows the encoding session by 24 hours. Using a spacing paradigm we examined the impact of sleep and spacing gaps on long-term declarative memory for Swahili-English word pairs by including four spacing delay gaps (massed, 12 hours same-day, 12 hours overnight, and 24 hours). Results showed that a 12-hour spacing gap that includes sleep promotes long-term memory retention similar to the 24-hour gap. The findings support the importance of sleep to the long-term benefit of the spacing effect.

  10. What Drives Long Term Real Interest Rates in Brazil?

    Directory of Open Access Journals (Sweden)

    Adonias Evaristo da Costa Filho


    Full Text Available This paper investigates the drivers of long term real interest rates in Brazil. It is shown that long term yield on inflation linked bonds are driven by yields on 10 year interest rates of United States (US government bonds and 10 year risk premium, as measured by the Credit Default Swap (CDS. Long term interest rates in Brazil were on a downward trend, following US real rates and stable risk premium, until the taper tantrum in the first half of 2013. From then onwards, real interest rates rose due to the increase in US real rates in anticipation of the beginning of monetary policy normalization and, more recently, due to a sharp increase in Brazilian risk premium. Policy interest rates do not significantly affect long term real interest rates.

  11. Long-Term Ecological Monitoring Field Sampling Plan for 2007

    Energy Technology Data Exchange (ETDEWEB)

    T. Haney


    This field sampling plan describes the field investigations planned for the Long-Term Ecological Monitoring Project at the Idaho National Laboratory Site in 2007. This plan and the Quality Assurance Project Plan for Waste Area Groups 1, 2, 3, 4, 5, 6, 7, 10, and Removal Actions constitute the sampling and analysis plan supporting long-term ecological monitoring sampling in 2007. The data collected under this plan will become part of the long-term ecological monitoring data set that is being collected annually. The data will be used t determine the requirements for the subsequent long-term ecological monitoring. This plan guides the 2007 investigations, including sampling, quality assurance, quality control, analytical procedures, and data management. As such, this plan will help to ensure that the resulting monitoring data will be scientifically valid, defensible, and of known and acceptable quality.


    National Research Council Canada - National Science Library

    P Selvam; N Punitavati


      A Fundamental study on Capital Budgeting has been viewed with the intention of providing fundamental knowledge to investors whose inclination is making a profit by investing in long term securities...

  13. Long-term consequences of pregnancy-related venous thrombosis


    Wik, Hilde Skuterud


    Background: Venous thrombosis (VT) is among the leading causes of maternal mortality in countries with high standards of perinatal care; however the long-term outcomes of pregnancy-related VT are unknown. Aims: To assess the long-term prevalence of post-thrombotic syndrome (PTS), a frequently occurring chronic complication after deep vein thrombosis (DVT), to identify possible predictors for PTS, and to evaluate disease specific quality of life (QOL) after pregnancy-related DVT as compare...

  14. Preclinical rodent toxicity studies for long term use of ceftriaxone

    Directory of Open Access Journals (Sweden)

    Elena Ratti


    Ceftriaxone showed rapid absorption with half-life values ranging between 1 and 1.5 h. Additionally, there was no evidence of accumulation and a virtually complete elimination by 16 h after the last dose. Overall there were no toxicologically meaningful drug-related animal findings associated with the long-term administration (6 months of ceftriaxone. These results support safety of long-term use of ceftriaxone in human clinical trials.

  15. Long-term patient survival in ANCA-associated vasculitis

    DEFF Research Database (Denmark)

    Flossmann, Oliver; Berden, Annelies; de Groot, Kirsten


    Wegener's granulomatosis and microscopic polyangiitis are antineutrophil cytoplasm antibodies (ANCA)-associated vasculitides with significant morbidity and mortality. The long-term survival of patients with ANCA associated vasculitis treated with current regimens is uncertain.......Wegener's granulomatosis and microscopic polyangiitis are antineutrophil cytoplasm antibodies (ANCA)-associated vasculitides with significant morbidity and mortality. The long-term survival of patients with ANCA associated vasculitis treated with current regimens is uncertain....

  16. Alzheimer's disease: our biggest long-term health challenge. (United States)

    Hassan, Fred


    As we grapple with reforming health care in America, the discussion often seems to gravitate to short-term issues while ignoring growing long-term threats. There is a health care tsunami approaching. It is Alzheimer's Disease. How we deal with this crisis will tell us a lot about how we are doing on health policies and actions for the long term--and about how we are doing as a society.

  17. Adverse event reporting in Czech long-term care facilities. (United States)

    Hěib, Zdenřk; Vychytil, Pavel; Marx, David


    To describe adverse event reporting processes in long-term care facilities in the Czech Republic. Prospective cohort study involving a written questionnaire followed by in-person structured interviews with selected respondents. Long-term care facilities located in the Czech Republic. Staff of 111 long-term care facilities (87% of long-term care facilities in the Czech Republic). None. Sixty-three percent of long-term health-care facilities in the Czech Republic have adverse event-reporting processes already established, but these were frequently very immature programs sometimes consisting only of paper recording of incidents. Compared to questionnaire responses, in-person interview responses only partially tended to confirm the results of the written survey. Twenty-one facilities (33%) had at most 1 unconfirmed response, 31 facilities (49%) had 2 or 3 unconfirmed responses and the remaining 11 facilities (17%) had 4 or more unconfirmed responses. In-person interviews suggest that use of a written questionnaire to assess the adverse event-reporting process may have limited validity. Staff of the facilities we studied expressed an understanding of the importance of adverse event reporting and prevention, but interviews also suggested a lack of knowledge necessary for establishing a good institutional reporting system in long-term care.

  18. Long-term survival and virulence of Mycobacterium leprae in amoebal cysts.

    Directory of Open Access Journals (Sweden)

    William H Wheat


    Full Text Available Leprosy is a curable neglected disease of humans caused by Mycobacterium leprae that affects the skin and peripheral nerves and manifests clinically in various forms ranging from self-resolving, tuberculoid leprosy to lepromatous leprosy having significant pathology with ensuing disfiguration disability and social stigma. Despite the global success of multi-drug therapy (MDT, incidences of clinical leprosy have been observed in individuals with no apparent exposure to other cases, suggestive of possible non-human sources of the bacteria. In this study we show that common free-living amoebae (FLA can phagocytose M. leprae, and allow the bacillus to remain viable for up to 8 months within amoebic cysts. Viable bacilli were extracted from separate encysted cocultures comprising three common Acanthamoeba spp.: A. lenticulata, A. castellanii, and A. polyphaga and two strains of Hartmannella vermiformis. Trophozoites of these common FLA take up M. leprae by phagocytosis. M. leprae from infected trophozoites induced to encyst for long-term storage of the bacilli emerged viable by assessment of membrane integrity. The majority (80% of mice that were injected with bacilli extracted from 35 day cocultures of encysted/excysted A. castellanii and A. polyphaga showed lesion development that was similar to mice challenged with fresh M. leprae from passage mice albeit at a slower initial rate. Mice challenged with coculture-extracted bacilli showed evidence of acid-fast bacteria and positive PCR signal for M. leprae. These data support the conclusion that M. leprae can remain viable long-term in environmentally ubiquitous FLA and retain virulence as assessed in the nu/nu mouse model. Additionally, this work supports the idea that M. leprae might be sustained in the environment between hosts in FLA and such residence in FLA may provide a macrophage-like niche contributing to the higher-than-expected rate of leprosy transmission despite a significant decrease in

  19. Environmental bonds and the challenge of long-term carbon sequestration. (United States)

    Gerard, David; Wilson, Elizabeth J


    The potential to capture carbon from industrial sources and dispose of it for the long-term, known as carbon capture and sequestration (CCS), is widely recognized as an important option to reduce atmospheric carbon dioxide emissions. Specifically, CCS has the potential to provide emissions cuts sufficient to stabilize greenhouse gas levels, while still allowing for the continued use of fossil fuels. In addition, CCS is both technologically-feasible and commercially viable compared with alternatives with the same emissions profile. Although the concept appears to be solid from a technical perspective, initial public perceptions of the technology are uncertain. Moreover, little attention has been paid to developing an understanding of the social and political institutional infrastructure necessary to implement CCS projects. In this paper we explore a particularly dicey issue--how to ensure adequate long-term monitoring and maintenance of the carbon sequestration sites. Bonding mechanisms have been suggested as a potential mechanism to reduce these problems (where bonding refers to financial instruments used to ensure regulatory or contractual commitments). Such mechanisms have been successfully applied in a number of settings (e.g., to ensure court appearances, completion of construction projects, and payment of taxes). The paper examines the use of bonding to address environmental problems and looks at its possible application to nascent CCS projects. We also present evidence on the use of bonding for other projects involving deep underground injection of materials for the purpose of long-term storage or disposal.

  20. Long term psychological effects of a no sedation protocol in critically ill Patients

    DEFF Research Database (Denmark)

    Stroem, Thomas; Stylsvig, Mette; Toft, Palle


    ABSTRACT: INTRODUCTION: A protocol of no sedation has been shown to reduce the time patients receive mechanical ventilation and reduce intensive care and total hospital length of stay. The long term psychological effects of this strategy have not yet been described. The purpose of the study...... was to test whether a strategy of no sedation alters long-term psychological outcome compared with a standard strategy with sedation. METHODS: During intensive care stay 140 patients requiring mechanical ventilation were randomized to either no sedation or sedation with daily interruption of sedation...... by the Impact of Events Scale both groups had low stress scores (1 in intervention group vs. 2 in the control group had scores above 32, P=0.50). State anxiety scores were also low (28 in the control group vs. 30 the intervention group, P=0.58). CONCLUSIONS: Our data suggest that a protocol of no sedation...

  1. Employee experience of workplace supervisor contact and support during long-term sickness absence. (United States)

    Buys, Nicholas J; Selander, John; Sun, Jing


    Workplace support is an important factor in promoting successful return to work. The purpose of this article is to examine relationships between supervisor contact, perceived workplace support and demographic variables among employees on long-term sickness absence. Data were collected from 204 public employees at a municipality in Sweden who had been on long term sickness absence (60 days or more) using a 23 question survey instrument that collected information on demographic variables, supervisor contact and perceived workplace support. Most injured employees (97%) reported having contact with their supervisors during their sickness absence, with a majority (56%) reporting high levels of support, including early (58.6%) and multiple (70.7%) contacts. Most were pleased with amount of contact (68.9%) and the majority had discussed workplace accommodations (68.1%). Employees who self-initiated contact, felt the amount of contact was appropriate, had a personal meeting with their supervisors and discussed workplace adjustments reported experiencing higher levels of support from supervisors. Employees on long-term sickness absence appreciate contact from their supervisors and this is associated with perceived workplace support. However, the amount and employee experience of this contact is important. It needs to be perceived by employees as supportive, which includes a focus on strategies (e.g., work adjustment) to facilitate a return to work. Supervisor training is required in this area to support the return to work process. Implications for Rehabilitation Contact and support from workplace supervisors is important to workers on long-term sickness absence. Employees appreciate frequent contact from supervisors during long-terms sickness absence. Employees appreciate a personal meeting with supervisors and the opportunity to discuss issues related to return to work such as work adjustment. Employers should provide training to supervisors on how to communicate and

  2. Long-term exercise in older adults: 4-year outcomes of music-based multitask training. (United States)

    Hars, Mélany; Herrmann, François R; Fielding, Roger A; Reid, Kieran F; Rizzoli, René; Trombetti, Andrea


    Prospective controlled evidence supporting the efficacy of long-term exercise to prevent physical decline and reduce falls in old age is lacking. The present study aimed to assess the effects of long-term music-based multitask exercise (i.e., Jaques-Dalcroze eurhythmics) on physical function and fall risk in older adults. A 3-year follow-up extension of a 1-year randomized controlled trial (NCT01107288) was conducted in Geneva (Switzerland), in which 134 community-dwellers aged ≥65 years at increased risk of falls received a 6-month music-based multitask exercise program. Four years following original trial enrolment, 52 subjects (baseline mean ± SD age, 75 ± 8 years) who (i) have maintained exercise program participation through the 4-year follow-up visit ("long-term intervention group", n = 23) or (ii) have discontinued participation following original trial completion ("control group", n = 29) were studied. They were reassessed in a blind fashion, using the same procedures as at baseline. At 4 years, linear mixed-effects models showed significant gait (gait speed, P = 0.006) and balance (one-legged stance time, P = 0.015) improvements in the long-term intervention group, compared with the control group. Also, long-term intervention subjects did better on Timed Up & Go, Five-Times-Sit-to-Stand and handgrip strength tests, than controls (P multitask exercise program is a promising strategy to prevent age-related physical decline in older adults. They also highlight the efficacy of sustained long-term adherence to exercise for falls prevention.

  3. Human Engineered Heart Muscles Engraft and Survive Long-Term in a Rodent Myocardial Infarction Model (United States)

    Riegler, Johannes; Tiburcy, Malte; Ebert, Antje; Tzatzalos, Evangeline; Raaz, Uwe; Abilez, Oscar J.; Shen, Qi; Kooreman, Nigel G.; Neofytou, Evgenios; Chen, Vincent C.; Wang, Mouer; Meyer, Tim; Tsao, Philip S.; Connolly, Andrew J.; Couture, Larry A.; Gold, Joseph D.; Zimmermann, Wolfram H.; Wu, Joseph C.


    Rational Tissue engineering approaches may improve survival and functional benefits from human embryonic stem cell-derived cardiomyocte (ESC-CM) transplantation, thereby potentially preventing dilative remodelling and progression to heart failure. Objective Assessment of transport stability, long term survival, structural organisation, functional benefits, and teratoma risk of engineered heart muscle (EHM) in a chronic myocardial infarction (MI) model. Methods and Results We constructed EHMs from ESC-CMs and released them for transatlantic shipping following predefined quality control criteria. Two days of shipment did not lead to adverse effects on cell viability or contractile performance of EHMs (n=3, P=0.83, P=0.87). After ischemia/reperfusion (I/R) injury, EHMs were implanted onto immunocompromised rat hearts at 1 month to simulate chronic ischemia. Bioluminescence imaging (BLI) showed stable engraftment with no significant cell loss between week 2 and 12 (n=6, P=0.67), preserving up to 25% of the transplanted cells. Despite high engraftment rates and attenuated disease progression (change in ejection fraction for EHMs −6.7±1.4% vs control −10.9±1.5%, n>12, P=0.05), we observed no difference between EHMs containing viable or non-viable human cardiomyocytes in this chronic xenotransplantation model (n>12, P=0.41). Grafted cardiomyocytes showed enhanced sarcomere alignment and increased connexin 43 expression at 220 days after transplantation. No teratomas or tumors were found in any of the animals (n=14) used for long-term monitoring. Conclusions EHM transplantation led to high engraftment rates, long term survival, and progressive maturation of human cardiomyocytes. However, cell engraftment was not correlated with functional improvements in this chronic MI model. Most importantly, the safety of this approach was demonstrated by the lack of tumor or teratoma formation. PMID:26291556

  4. Long-term Effectiveness of Intensive Therapy in Chronic Stroke. (United States)

    Wu, Xiaotian; Guarino, Peter; Lo, Albert C; Peduzzi, Peter; Wininger, Michael


    Background While recent clinical trials involving robot-assisted therapy have failed to show clinically significant improvement versus conventional therapy, it is possible that a broader strategy of intensive therapy-to include robot-assisted rehabilitation-may yield clinically meaningful outcomes. Objective To test the immediate and sustained effects of intensive therapy (robot-assisted therapy plus intensive conventional therapy) on outcomes in a chronic stroke population. Methods A multivariate mixed-effects model adjusted for important covariates was established to measure the effect of intensive therapy versus usual care. A total of 127 chronic stroke patients from 4 Veterans Affairs medical centers were randomized to either robot-assisted therapy (n = 49), intensive comparison therapy (n = 50), or usual care (n = 28), in the VA-ROBOTICS randomized clinical trial. Patients were at least 6 months poststroke, of moderate-to-severe upper limb impairment. The primary outcome measure was the Fugl-Meyer Assessment at 12 and 36 weeks. Results There was significant benefit of intensive therapy over usual care on the Fugl-Meyer Assessment at 12 weeks with a mean difference of 4.0 points (95% CI = 1.3-6.7); P = .005; however, by 36 weeks, the benefit was attenuated (mean difference 3.4; 95% CI = -0.02 to 6.9; P = .05). Subgroup analyses showed significant interactions between treatment and age, treatment and time since stroke. Conclusions Motor benefits from intensive therapy compared with usual care were observed at 12 and 36 weeks posttherapy; however, this difference was attenuated at 36 weeks. Subgroups analysis showed that younger age, and a shorter time since stroke were associated with greater immediate and long-term improvement of motor function. © The Author(s) 2015.

  5. Long-term endoscopic management for primary recurrent pyogenic cholangitis

    Directory of Open Access Journals (Sweden)

    James L Buxbaum


    Full Text Available Background: Primary recurrent pyogenic cholangitis (RPC is characterized by relentless suppurative cholangitis in those with a suspected parasitic injury of the biliary tree. Prior work has demonstrated that the infections recur following "definitive" biliary surgery and long-term percutaneous biliary catheters are poorly tolerated. The aim of this study was to assess whether scheduled surveillance endoscopic retrograde cholangiopancreatography (ERCP prevents cholangitis in those with RPC. Materials and Methods: Following initial biliary decompression and stone clearance, patients with RPC were offered serial ERCP every 3-6 months to remove accumulating stony debris and to dilate incipient strictures. Review of a large series managed using this approach at the University of California, San Francisco Medical Center was performed. The principle outcome was the development of acute cholangitis requiring hospitalization and whether the episode occurred, while the RPC patient was in compliance with endoscopic surveillance recommendations. Results: Over a period of 10 years, 66 patients with primary RPC were managed for RPC at the University of California, San Francisco. The patients were comprised primarily of first-generation immigrants from Asia though one-quarter had migrated from Latin America and Russia. Episodes of cholangitis were significantly less likely to occur in those undergoing surveillance biliary endoscopy than in those who were not (odds ratio 5.3; P = 0.005 . The mean follow-up was 36.1 months. Conclusions: Serial endoscopic treatment of RPC may be used to systematically clear biliary debris and decreases the risk of cholangitis requiring hospitalization. It represents a reasonable initial management strategy for these patients. Surgery and percutaneous management may also be required, but are best performed as part of a multidisciplinary approach.

  6. Diet and long-term health: an African Diaspora perspective. (United States)

    Solomons, Noel W


    The life-stage approach, which views the behaviours and exposures of an individual from the preconceptual situation of the parent through pregnancy, infancy, childhood and adolescence, and into the advancing years through adulthood, is the basis of analysis of strategies to improve long-term health. Among the behaviours of note is the dietary selection pattern, conditioning our exposure to nutrients and dietary constituents that influences growth, nutriture, cognitive and physical performance, and disease resistance and susceptibility. The African Diaspora created a population displaced from Africa to the Western Hemisphere as part of the African slave trade from the 16th to 18th centuries. It continues to manifest distinct dietary and lifestyle practices in the context of a health experience that is different both from the population in their African countries of origin and from the other ethnicities in their countries of displacement and current residence. Afro-Americans are more susceptible to a series of diseases and conditions including low birth weight, violence, and HIV/AIDS, as well as the non-communicable diseases: obesity, diabetes mellitus, cardiovascular disease, hypertension, stroke, renal failure, breast cancer, prostate cancer and lead poisoning. The differential nature of dietary practices are conditioned at times by the poverty and marginalisation of the populace, resulting in either disadvantageous or beneficial outcomes relative to others' eating habits. Serious consideration must be given to the possibility that ethnic difference give rise to different requirements and tolerances for essential nutrients and distinct protective or adverse responses to foods and dietary substances. The major challenges to health improvement for the African Diaspora is coming to grips with the policy and programmatic nuances of differential treatment and the effecting the behavioural changes that would be needed in a population skeptical of the motives of media and

  7. Long-term in vitro system for maintenance and amplification of root-knot nematodes in Cucumis sativus roots

    Directory of Open Access Journals (Sweden)

    Fernando E. eDíaz-Manzano


    Full Text Available Root-knot nematodes (RKN are polyphagous plant-parasitic roundworms that produce large crop losses, representing a relevant agricultural pest worldwide. After infection, they induce swollen root structures called galls containing giant cells (GCs indispensable for nematode development. Among efficient control methods are biotechnology-based strategies that require a deep knowledge of underlying molecular processes during the plant-nematode interaction. Methods of achieving this knowledge include the application of molecular biology techniques such as transcriptomics (massive sequencing or microarray hybridization, proteomics or metabolomics. These require aseptic experimental conditions, as undetected contamination with other microorganisms could compromise the interpretation of the results. Herein, we present a simple, efficient and long-term method for nematode amplification on cucumber roots grown in vitro. Amplification of juveniles (J2 from the starting inoculum is around 40-fold. The method was validated for three Meloidogyne species (M. javanica, M. incognita and M. arenaria, producing viable and robust freshly hatched J2s. These can be used for further in vitro infection of different plant species such as Arabidopsis, tobacco and tomato, as well as enough J2s to maintain the population. The method allowed maintenance of around 90 Meloidogyne spp. generations (one every two months from a single initial female over 15 years.

  8. Mesozoic long-term eustatic cycles and their uncertain hierarchy

    Directory of Open Access Journals (Sweden)

    Dmitry A. Ruban


    Full Text Available Global sea-level has changed in a cyclic manner through geologic history, but the regularities of these changes are yet to be fully understood. Despite certain (and sometimes significant differences, the available Mesozoic eustatic curves permit the outlining of long-term eustatic cycles, which are provisionally defined as cycles recognizable at the stage level and higher. Interpretation of the Triassic eustatic curves indicates two orders of long-term cycles and a 1st-order sea-level rise throughout the entire period. The Jurassic eustatic curves imply cyclicity of one or two orders, and a 1st-order eustatic rise during the entire period is also evident. Most challenges are interpretations for the Cretaceous; two to four orders of long-term eustatic cycles can be established for this period. Generally, the hierarchy of the long-term eustatic cycles might have changed through the Mesozoic. If so, and if one considers differences of cycles of the same order between the periods of this era, it is difficult to apply “standard” hierarchical classifications to the documented cycles. The hypothetical uncertainty of the hierarchy of the Mesozoic long-term eustatic cycles is an important challenge for modern researchers.

  9. Long-Term Retardation of Uranium in the KURT Environment

    Energy Technology Data Exchange (ETDEWEB)

    Baik, Min Hoon [KAERI, Daejeon (Korea, Republic of); Shin, Joo Do [KARA, Seoul (Korea, Republic of); Park, Tae Jin [KAERI, Daejeon (Korea, Republic of)


    One of possibilities resolving this issue is to study the migration and retardation processes of radionuclides in the subsurface environments by using naturally occurring radionuclides as analogues of radioactive waste. To date, however, the long-term behavior of radionuclides in a granitic groundwater system is not yet fully understood. The ubiquitous presence of uranium (U) in rocks makes it an ideal natural analogue for studying the behaviors of radionuclides in a deep geological repository for the final disposal of HLW. In this study, long-term retardation behavior of natural uranium was investigated using granite rock samples taken from the KURT (KAERI Underground Research Tunnel), located in Daejeon city. The distribution of uranium and its binding mechanism in granite samples were investigated using the sequential chemical extraction (SCE) technique combined with X-ray diffraction (XRD) and ICP-MS methods. In this study, the long-term retardation of uranium in the KURT environment was investigated using SCE and EPMA techniques combined with ICP-MS and XRD. Results showed that long-term interaction of rock with groundwater can change U species and mineralize dissolved U, which can consequently contribute to the retardation of U in the fractured granitic rock environment. This study will help us to understand the long-term behavior of radionuclides migrating through the fractured granite rock and then enhance the reliability of the safety assessment for a HLW repository.

  10. Long-Term Stewardship Program Science and Technology Requirements

    Energy Technology Data Exchange (ETDEWEB)

    Joan McDonald


    Many of the United States’ hazardous and radioactively contaminated waste sites will not be sufficiently remediated to allow unrestricted land use because funding and technology limitations preclude cleanup to pristine conditions. This means that after cleanup is completed, the Department of Energy will have long-term stewardship responsibilities to monitor and safeguard more than 100 sites that still contain residual contamination. Long-term stewardship encompasses all physical and institutional controls, institutions, information, and other mechanisms required to protect human health and the environment from the hazards remaining. The Department of Energy Long-Term Stewardship National Program is in the early stages of development, so considerable planning is still required to identify all the specific roles and responsibilities, policies, and activities needed over the next few years to support the program’s mission. The Idaho National Engineering and Environmental Laboratory was tasked with leading the development of Science and Technology within the Long-Term Stewardship National Program. As part of that role, a task was undertaken to identify the existing science and technology related requirements, identify gaps and conflicts that exist, and make recommendations to the Department of Energy for future requirements related to science and technology requirements for long-term stewardship. This work is summarized in this document.

  11. Long-term psychosocial consequences of surgical congenital malformations. (United States)

    Diseth, Trond H; Emblem, Ragnhild


    Surgical congenital malformations often represent years of treatment, large number of hospital stays, treatment procedures, and long-term functional sequels affecting patients' psychosocial functioning. Both functional defects and psychosocial difficulties that occur commonly in childhood may pass through adolescence on to adulthood. This overview presents reports published over the past 3 decades to elucidate the long-term psychosocial consequences of surgical congenital malformations. Literature searches conducted on PubMed database revealed that less than 1% of all the records of surgical congenital malformations described long-term psychosocial consequences, but with diverse findings. This inconsistency may be due to methodological differences or deficiencies; especially in study design, patient sampling, and methods. Most of the studies revealed that the functional deficits may have great impact on patients' mental health, psychosocial functioning, and QoL; both short- and long-term negative consequences. Factors other than functional problems, e.g., repeated anesthesia, multiple hospitalization, traumatic treatment procedures, and parental dysfunctioning, may also predict long-term mental health and psychosocial functioning. Through multidisciplinary approach, pediatric surgeons should also be aware of deficits in emotional and psychosocial functioning. To achieve overall optimal psychosocial functioning, the challenge is to find a compromise between physically optimal treatment procedures and procedures that are not psychologically detrimental. Copyright © 2017. Published by Elsevier Inc.

  12. Method for Water Management Considering Long-term Probabilistic Forecasts (United States)

    Hwang, J.; Kang, J.; Suh, A. S.


    This research is aimed at predicting the monthly inflow of the Andong-dam basin in South Korea using long-term probabilistic forecasts to apply long-term forecasts to water management. Forecasted Cumulative Distribution Functions (CDFs) of monthly precipitation are plotted by combining the range of monthly precipitation based on proper Probability Density Function (PDF) in past data with probabilistic forecasts in each category. Ensembles of inflow are estimated by entering generated ensembles of precipitation based on the CDFs into the 'abcd' water budget model. The bias and RMSE between averages in past data and observed inflow are compared to them in forecasted ensembles. In our results, the bias and RMSE of average precipitation in the forecasted ensemble are bigger than in past data, whereas the average inflow in the forecasted ensemble is smaller than in past data. This result could be used for reference data to apply long-term forecasts to water management, because of the limit in the number of forecasted data for verification and differences between the Andong-dam basin and the forecasted regions. This research has significance by suggesting a method of applying probabilistic information in climate variables from long-term forecasts to water management in Korea. Original data of a climate model, which produces long-term probabilistic forecasts should be verified directly as input data of a water budget model in the future, so that a more scientific response in water management against uncertainty of climate change could be reached.

  13. Dual-Function Au@Y2O3:Eu3+Smart Film for Enhanced Power Conversion Efficiency and Long-Term Stability of Perovskite Solar Cells. (United States)

    Kim, Chang Woo; Eom, Tae Young; Yang, In Seok; Kim, Byung Su; Lee, Wan In; Kang, Yong Soo; Kang, Young Soo


    In the present study, a dual-functional smart film combining the effects of wavelength conversion and amplification of the converted wave by the localized surface plasmon resonance has been investigated for a perovskite solar cell. This dual-functional film, composed of Au nanoparticles coated on the surface of Y 2 O 3 :Eu 3+ phosphor (Au@Y 2 O 3 :Eu 3+ ) nanoparticle monolayer, enhances the solar energy conversion efficiency to electrical energy and long-term stability of photovoltaic cells. Coupling between the Y 2 O 3 :Eu 3+ phosphor monolayer and ultraviolet solar light induces the latter to be converted into visible light with a quantum yield above 80%. Concurrently, the Au nanoparticle monolayer on the phosphor nanoparticle monolayer amplifies the converted visible light by up to 170%. This synergy leads to an increased solar light energy conversion efficiency of perovskite solar cells. Simultaneously, the dual-function film suppresses the photodegradation of perovskite by UV light, resulting in long-term stability. Introducing the hybrid smart Au@Y 2 O 3 :Eu 3+ film in perovskite solar cells increases their overall solar-to-electrical energy conversion efficiency to 16.1% and enhances long-term stability, as compared to the value of 15.2% for standard perovskite solar cells. The synergism between the wavelength conversion effect of the phosphor nanoparticle monolayer and the wave amplification by the localized surface plasmon resonance of the Au nanoparticle monolayer in a perovskite solar cell is comparatively investigated, providing a viable strategy of broadening the solar spectrum utilization.

  14. Long-term and ultra long-term blood pressure variability during follow-up and mortality in 14,522 patients with hypertension. (United States)

    Hastie, Claire E; Jeemon, Panniyammakal; Coleman, Holli; McCallum, Linsay; Patel, Rajan; Dawson, Jesse; Sloan, William; Meredith, Peter; Jones, Gregory C; Muir, Scott; Walters, Matthew; Dominiczak, Anna F; Morrison, David; McInnes, Gordon T; Padmanabhan, Sandosh


    Recent evidence indicates that long-term visit-to-visit blood pressure variability (BPV) may be an independent cardiovascular risk predictor. The implication of this variability in hypertension clinical practice is unclear. BPV as average real variability (ARV) was calculated in 14,522 treated patients with hypertension in 4 time frames: year 1 (Y1), years 2 to 5 (Y2-5), years 5 to 10 (Y5-10), and years >10 (Y10+) from first clinic visit. Cox proportional hazards models for cause-specific mortality were used in each time frame separately for long-term BPV, across time frames based on ultra long-term BPV, and within each time frame stratified by mean BP. ARV in systolic blood pressure (SBP), termed ARV(SBP), was higher in Y1 (21.3±11.9 mm Hg) in contrast to Y2-5 (17.7±9.9 mm Hg), Y5-10 (17.4±9.6 mm Hg), and Y10+ (16.8±8.5 mm Hg). In all time frames, ARV(SBP) was higher in women (Pclinical practice may facilitate risk reduction strategies by identifying treated hypertensive individuals at high risk, especially those with BP within the normal range.

  15. Patent Citations and Financial Analysts’ Long-Term Growth Forecasts

    Directory of Open Access Journals (Sweden)

    Jincheol Bae


    Full Text Available This paper examines the influence of patent citations, a proxy for the quality of firms’ innovation outputs, on financial analysts’ long-term growth forecasts for firms. We find that financial analysts are more likely to issue long-term forecasts for firms with higher patent citations. In addition, we find that financial analysts’ long-term forecasts are more positive for firms with high patent citations. These results imply that patent citations increase financial analysts’ coverage, and result in more positive forecasts for firms with impactful patents. Considering that financial analysts play important roles in allocating financial resources in capital markets, our findings suggest that patents are valuable assets for firms in securing capital from capital markets, and are thus essential for the sustainable growth of firms.

  16. Stirling engine - Approach for long-term durability assessment (United States)

    Tong, Michael T.; Bartolotta, Paul A.; Halford, Gary R.; Freed, Alan D.


    The approach employed by NASA Lewis for the long-term durability assessment of the Stirling engine hot-section components is summarized. The approach consists of: preliminary structural assessment; development of a viscoplastic constitutive model to accurately determine material behavior under high-temperature thermomechanical loads; an experimental program to characterize material constants for the viscoplastic constitutive model; finite-element thermal analysis and structural analysis using a viscoplastic constitutive model to obtain stress/strain/temperature at the critical location of the hot-section components for life assessment; and development of a life prediction model applicable for long-term durability assessment at high temperatures. The approach should aid in the provision of long-term structural durability and reliability of Stirling engines.

  17. Are long-term bisphosphonate users a reality?

    DEFF Research Database (Denmark)

    Abrahamsen, B


    The prevalence of long-term bisphosphonate use may be low due to low refill compliance and gaps in treatment. An analysis of the prescription history of 58,674 bisphosphonate users in Denmark found that only 2.8 % had received ten dose years of treatment or above. INTRODUCTION: This study aims...... to describe the demographics of present bisphosphonate (BP) users, to determine the prevalence of long-term BP use, and to establish if long-term use (a 10-year history of osteoporosis treatment) translated to ten dose years of bisphosphonate prescriptions filled, given the propensity for treatment gaps...... and low refill compliance with bisphosphonates. METHODS: The study population was all persons aged 35 and above, who had filled at least one prescription for an oral bisphosphonate in the year 2008. Past use of osteoporosis medications (bisphosphonates, raloxifene, strontium ranelate, or PTH analogs...

  18. How to improve long-term outcome after liver transplantation? (United States)

    Durand, François


    The outcome of liver transplantation has markedly improved in the last 3 decades. Although early post-transplantation outcomes have improved over time, this is not true of the long-term outcome. The majority of late deaths are not related to graft dysfunction, and with the advent of new antiviral agents, recurrence of hepatitis B and hepatitis C after transplantation may no longer represent a source of graft loss and patient's death in the long term. The complications of metabolic syndrome may represent an increasing source of morbidity and mortality after transplantation. This study discusses these modifiable factors associated with late mortality to improve the long-term results of transplantation. © 2018 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

  19. How long does it take to initiate a child on long-term invasive ventilation? Results from a Canadian pediatric home ventilation program


    Reshma Amin; Aarti Sayal; Faiza Syed; Cathy Daniels; Andrea Hoffman; Moraes, Theo J; Peter Cox


    OBJECTIVE: To assess the length of stay required to initiate long-term invasive ventilation at the authors’ institution, which would inform future interventional strategies to streamline the in-hospital stay for these families.METHODS: A retrospective chart review of children initiated on invasive long-term ventilation via tracheostomy at the authors’ acute care centre between January 2005 and December 2013 was performed.RESULTS: Thirty-five children were initiated on long-term invasive venti...

  20. Long-term Prescription of Opioids and/or Benzodiazepines and Mortality Among HIV-Infected and Uninfected Patients. (United States)

    Weisberg, Daniel F; Gordon, Kirsha S; Barry, Declan T; Becker, William C; Crystal, Stephen; Edelman, Eva J; Gaither, Julie; Gordon, Adam J; Goulet, Joseph; Kerns, Robert D; Moore, Brent A; Tate, Janet; Justice, Amy C; Fiellin, David A


    Increased long-term prescription of opioids and/or benzodiazepines necessitates evaluating risks associated with their receipt. We sought to evaluate the association between long-term opioids and/or benzodiazepines and mortality in HIV-infected patients receiving antiretroviral therapy and uninfected patients. Prospective analysis of all-cause mortality using multivariable methods and propensity score matching among HIV-infected patients receiving antiretroviral therapy and uninfected patients. Of 64,602 available patients (16,989 HIV-infected and 47,613 uninfected), 27,128 (exposed and unexposed to long-term opioids and/or benzodiazepines) were 1:1 matched by propensity score. The hazard ratio for death was 1.40 [95% confidence interval (CI): 1.22 to 1.61] for long-term opioid receipt, 1.26 (95% CI: 1.08 to 1.48) for long-term benzodiazepine receipt, and 1.56 (95% CI: 1.26 to 1.92) for long-term opioid and benzodiazepine receipt. There was an interaction (P = 0.01) between long-term opioid receipt and HIV status with mortality. For long-term opioid receipt, the hazard ratio was 1.46 (95% CI: 1.15 to 1.87) among HIV-infected patients, and 1.25 (95% CI: 1.05 to 1.49) among uninfected patients. Mortality risk was increased for patients receiving both long-term opioids and benzodiazepines when opioid doses were ≥ 20 mg morphine-equivalent daily dose and for patients receiving long-term opioids alone when doses were ≥ 50 mg morphine-equivalent daily dose. Long-term opioid receipt was associated with an increased risk of death; especially with long-term benzodiazepine receipt, higher opioid doses, and among HIV-infected patients. Long-term benzodiazepine receipt was associated with an increased risk of death regardless of opioid receipt. Strategies to mitigate risks associated with these medications, and caution when they are coprescribed, are needed particularly in HIV-infected populations.

  1. Long-term prescription opioids and/or benzodiazepines and mortality among HIV-infected and uninfected patients (United States)

    Weisberg, DF; Gordon, KS; Barry, DT; Becker, WC; Crystal, S; Edelman, EJ; Gaither, J; Gordon, AJ; Goulet, J; Kerns, RD; Moore, BA; Tate, J; Justice, AC; Fiellin, DA


    Background Increased long-term prescribing of opioids and/or benzodiazepines necessitates evaluating risks associated with their receipt. We sought to evaluate the association between long-term opioids and/or benzodiazepines and mortality in HIV-infected patients receiving antiretroviral therapy and uninfected patients. Methods Prospective analysis of all-cause mortality using multivariable methods and propensity score matching among HIV-infected patients receiving antiretroviral therapy and uninfected patients. Results From 64,602 available patients (16,989 HIV-infected and 47,613 uninfected), 27,128 (long-term opioids and/or benzodiazepines exposed and unexposed) were 1:1 matched by propensity score. The hazard ratio (HR) for death was 1.40 (95% confidence interval [CI] 1.22-1.61) for long-term opioid receipt, 1.26 (95% CI 1.08-1.48) for long-term benzodiazepine receipt, and 1.56 (95% CI 1.26-1.92) for long-term opioid and benzodiazepine receipt. There was an interaction (p= 0.01) between long-term opioid receipt and HIV status with mortality. For long-term opioid receipt, the HR was 1.46 (95% CI 1.15-1.87) among HIV-infected patients, and 1.25 (95% CI 1.05 – 1.49) among uninfected patients. Mortality risk was increased for patients receiving both long-term opioids and benzodiazepines when opioid doses were ≥20mg morphine equivalent daily dose (MEDD) and for patients receiving long-term opioids alone when doses were ≥50mg MEDD. Conclusions Long-term opioid receipt was associated with an increased risk of death; especially with long-term benzodiazepine receipt, higher opioid doses and among HIV-infected patients. Long-term benzodiazepine receipt was associated with an increased risk of death regardless of opioid receipt. Strategies to mitigate risks associated with these medications, and caution when they are co-prescribed, are needed particularly in HIV-infected populations. PMID:26009831

  2. Long-term flow monitoring of submarine gas emanations (United States)

    Spickenbom, K.; Faber, E.; Poggenburg, J.; Seeger, C.


    One of the Carbon Capture and Storage (CCS) strategies currently under study is the sequestration of CO2 in sub-seabed geological formations. Even after a thorough review of the geological setting, there is the possibility of leaks from the reservoirs. As part of the EU-financed project CO2ReMoVe (Research, Monitoring, Verification), which aims to develop innovative research and technologies for monitoring and verification of carbon dioxide geological storage, we are working on the development of submarine long-term gas flow monitoring systems. Technically, however, these systems are not limited to CO2 but can be used for monitoring of any free gas emission (bubbles) on the seafloor. The basic design of the gas flow sensor system was derived from former prototypes developed for monitoring CO2 and CH4 on mud volcanoes in Azerbaijan. This design was composed of a raft floating on the surface above the gas vent to collect the bubbles. Sensors for CO2 flux and concentration and electronics for data storage and transmission were mounted on the raft, together with battery-buffered solar panels for power supply. The system was modified for installation in open sea by using a buoy instead of a raft and a funnel on the seafloor to collect the gas, which is then guided above water level through a flexible tube. Besides some technical problems (condensed water in the tube, movement of the buoys due to waves leading to biased measurement of flow rates), this setup provides a cost-effective solution for shallow waters. However, a buoy interferes with ship traffic, and it is also difficult to adapt this design to greater water depths. These requirements can best be complied by a completely submersed system. To allow unattended long-term monitoring in a submarine environment, such a system has to be extremely durable. Therefore, we focussed on developing a mechanically and electrically as simple setup as possible, which has the additional advantage of low cost. The system

  3. 42 CFR 412.536 - Special payment provisions for long-term care hospitals and satellites of long-term care... (United States)


    ... Federal rate in effect at the time of the long-term care hospital discharge. (2) Operating inpatient... hospitals and satellites of long-term care hospitals that discharged Medicare patients admitted from a... payment provisions for long-term care hospitals and satellites of long-term care hospitals that discharged...

  4. Association Between Anemia, Bleeding, and Transfusion with Long-term Mortality Following Noncardiac Surgery. (United States)

    Smilowitz, Nathaniel R; Oberweis, Brandon S; Nukala, Swetha; Rosenberg, Andrew; Zhao, Sibo; Xu, Jinfeng; Stuchin, Steven; Iorio, Richard; Errico, Thomas; Radford, Martha J; Berger, Jeffrey S


    Preoperative anemia is a well-established risk factor for short-term mortality in patients undergoing noncardiac surgery, but appropriate thresholds for transfusion remain uncertain. The objective of this study was to determine long-term outcomes associated with anemia, hemorrhage, and red blood cell transfusion in patients undergoing noncardiac surgery. We performed a long-term follow-up study of consecutive subjects undergoing hip, knee, and spine surgery between November 1, 2008 and December 31, 2009. Clinical data were obtained from administrative and laboratory databases, and retrospective record review. Preoperative anemia was defined as baseline hemoglobin Classification of Diseases, Ninth Revision coding. Data on long-term survival were collected from the Social Security Death Index database. Logistic regression models were used to identify factors associated with long-term mortality. There were 3050 subjects who underwent orthopedic surgery. Preoperative anemia was present in 17.6% (537) of subjects, hemorrhage occurred in 33 (1%), and 766 (25%) received at least one red blood cell transfusion. Over 9015 patient-years of follow-up, 111 deaths occurred. Anemia (hazard ratio [HR] 3.91; confidence interval [CI], 2.49-6.15) and hemorrhage (HR 5.28; 95% CI, 2.20-12.67) were independently associated with long-term mortality after multivariable adjustment. Red blood cell transfusion during the surgical hospitalization was associated with long-term mortality (HR 3.96; 95% CI, 2.47-6.34), which was attenuated by severity of anemia (no anemia [HR 4.39], mild anemia [HR 2.27], and moderate/severe anemia [HR 0.81]; P for trend .0015). Preoperative anemia, perioperative bleeding, and red blood cell transfusion are associated with increased mortality at long-term follow-up after noncardiac surgery. Strategies to minimize anemia and bleeding should be considered for all patients, and restrictive transfusion strategies may be advisable. Further investigation into

  5. Strategic search from long-term memory: an examination of semantic and autobiographical recall. (United States)

    Unsworth, Nash; Brewer, Gene A; Spillers, Gregory J


    Searching long-term memory is theoretically driven by both directed (search strategies) and random components. In the current study we conducted four experiments evaluating strategic search in semantic and autobiographical memory. Participants were required to generate either exemplars from the category of animals or the names of their friends for several minutes. Self-reported strategies suggested that participants typically relied on visualization strategies for both tasks and were less likely to rely on ordered strategies (e.g., alphabetic search). When participants were instructed to use particular strategies, the visualization strategy resulted in the highest levels of performance and the most efficient search, whereas ordered strategies resulted in the lowest levels of performance and fairly inefficient search. These results are consistent with the notion that retrieval from long-term memory is driven, in part, by search strategies employed by the individual, and that one particularly efficient strategy is to visualize various situational contexts that one has experienced in the past in order to constrain the search and generate the desired information.


    Directory of Open Access Journals (Sweden)

    Manju Khanna


    Full Text Available With present stress, being laid on green energy worldwide, harnessing solar energy for commercial use has importance in sizing and long-term prediction of solar radiation. However, with continuous changing environment parameters, it is quite difficult for long-term prediction of solar radiation. In the past research scholars, have carried out solar prediction only for a few days, which is insufficient to exploit the radiation for sizing and harnessing the solar energy for commercial use. To overcome this gap, present work utilizes application of lifting wavelet transform along with ANFIS to predict the radiation for long duration.

  7. Long-Term Effects of School Size on Students' Outcomes

    DEFF Research Database (Denmark)

    Humlum, Maria Knoth; Smith, Nina

    We estimate the effect of school size on students' long-term outcomes such as high school completion, being out of the labor market, and earnings at the age of 30. We use rich register data on the entire population of Danish children attending grade 9 in the period 1986-2004. This allows us...... school size and alternative measures of long-term success in the educational system and the labor market. The positive impact of school size seems mainly to be driven by boys, students from families with a low educational level and students attending schools in urban areas....

  8. Long Term Incentives for Residential Customers Using Dynamic Tariff

    DEFF Research Database (Denmark)

    Huang, Shaojun; Wu, Qiuwei; Nielsen, Arne Hejde


    This paper reviews several grid tariff schemes, including flat tariff, time-of-use, time-varying tariff, demand charge and dynamic tariff (DT), from the perspective of the long term incentives. The long term incentives can motivate the owners of flexible demands to change their energy consumption...... behavior in such a way that the power system operation issues, such as system balance and congestion, can be alleviated. From the comparison study, including analysis and case study, the DT scheme outperforms the other tariff schemes in terms of cost saving and network operation condition improving....

  9. Long-term recurrence and death rates after acute pancreatitis

    DEFF Research Database (Denmark)

    Lund, Helle; Tønnesen, Hanne; Tønnesen, Maja Hanne


    The aim of this study was to compare long-term recurrence and death rates after a first episode of acute pancreatitis in patients with and without gallstones. Additionally, it was of interest to find out if there were factors predictive of readmission or death.......The aim of this study was to compare long-term recurrence and death rates after a first episode of acute pancreatitis in patients with and without gallstones. Additionally, it was of interest to find out if there were factors predictive of readmission or death....

  10. Factors associated with long-term mortality in acute pancreatitis

    DEFF Research Database (Denmark)

    Nøjgaard, Camilla; Matzen, Peter; Bendtsen, Flemming


    Abstract Background and aims. Knowledge of the long-term prognosis of acute pancreatitis (AP) is limited. The aims were to investigate: (1) prognostic factors associated with long-term mortality in patients with AP; (2) whether or not the level of serum (S-)amylase at admission had an impact...... on the prognosis; (3) causes of death in these patients. Methods. During 1977-1982, patients who were admitted to the five main hospitals in Copenhagen with a diagnosis of AP or chronic pancreatitis (CP) were included in a prospective cohort, the Copenhagen Pancreatitis Study (CPS); in 2008, they were followed up...

  11. Long-term treatment of chronic hepatitis B

    Directory of Open Access Journals (Sweden)

    Experts attending the discussion on long-treatment of chronic hepatitis B


    Full Text Available Nucleos(tide analogs (NAs have been successfully used for treatment of chronic hepatitis B. Hepatitis B virus (HBV replication is now recognized as the key driver of liver injury and disease progression, so the primary aim of treatment for chronic HBV infection is to maximize sustained suppression of HBV replication to undetectable levels. The long-term treatment has also been shown to achieve substantial histological improvement and regression of liver fibrosis or cirrhosis, and reduction of hepatocellular carcinoma. This paper has reviewed the necessity, clinical benefits, and the management of long-term treatment for chronic hepatitis B.

  12. Mapping long-term wetland response to climate (United States)

    Zhou, Q.; Gallant, A.; Rover, J.


    Wetlands provide unique feeding and breeding habitat for numerous waterfowl species. The distribution of wetlands has been considerably changed due to agricultural land conversion and hydrologic modification. Climate change may further impact wetlands through altered moisture regimes. This study characterized long-term variation in wetland conditions by using dense time series from all available Landsat data from 1985 to 2014. We extracted harmonic frequencies from 30 years to two years to delineate the long-term variation in all seven Landsat bands. A cluster analysis and unsupervised classification then enabled us to map different classes of wetland response. We demonstrated the method in the Prairie Pothole Region in North Dakota.

  13. Long-term stability scintillation tiles for LHCb detector

    CERN Document Server

    Grinyov, B V; Khlapova, N P; Lebedev, V N; Melnychuk, S V; Senchyshyn, V G


    Accelerated thermal aging tests of materials-UPS-923A, UPS-96G, UPS-96GM and their analogues, SCSN-81 (Kuraray) and BC-408 (Bicron)- were made. A forecast of tile lifetime was made for normal conditions of usage (20% reduction of light output and 50% reduction of the bulk attenuation length (BAL) and technical attenuation length (TAL). Scintillator UPS-96GM has the most long-term stability of parameters- more than 11 yr. BC-408 samples have the minimum lifetime ~7 yr. The long-term stability, calculated by light yield reduction, of UPS-96G, UPS-923A and SCSN-81 is 10, 9 and 8 yr, respectively.

  14. Long-term skeletal findings in Menkes disease

    Energy Technology Data Exchange (ETDEWEB)

    Amador, Eva [Son Dureta Children' s Hospital, Department of Paediatric Radiology, Palma de Mallorca (Spain); Domene, Ruth; Fuentes, Cristian; Carreno, Juan-Carlos; Enriquez, Goya [Vall d' Hebron Children' s Hospital, Department of Paediatric Radiology, Barcelona (Spain)


    Skeletal findings in infants with Menkes disease, the most characteristic of which are metaphyseal spurs, long-bone fractures and wormian bones, have been widely reported. However, the changes in skeletal features over time are not well known. The long-term findings differ completely from those initially observed and consist of undertubulation and metaphyseal flaring, similar to the findings seen in some types of bone dysplasia. The initial and long-term radiological features in an 8-year-old boy with Menkes disease are illustrated. (orig.)

  15. A Novel Unsupervised Adaptive Learning Method for Long-Term Electromyography (EMG) Pattern Recognition. (United States)

    Huang, Qi; Yang, Dapeng; Jiang, Li; Zhang, Huajie; Liu, Hong; Kotani, Kiyoshi


    Performance degradation will be caused by a variety of interfering factors for pattern recognition-based myoelectric control methods in the long term. This paper proposes an adaptive learning method with low computational cost to mitigate the effect in unsupervised adaptive learning scenarios. We presents a particle adaptive classifier (PAC), by constructing a particle adaptive learning strategy and universal incremental least square support vector classifier (LS-SVC). We compared PAC performance with incremental support vector classifier (ISVC) and non-adapting SVC (NSVC) in a long-term pattern recognition task in both unsupervised and supervised adaptive learning scenarios. Retraining time cost and recognition accuracy were compared by validating the classification performance on both simulated and realistic long-term EMG data. The classification results of realistic long-term EMG data showed that the PAC significantly decreased the performance degradation in unsupervised adaptive learning scenarios compared with NSVC (9.03% ± 2.23%, p < 0.05) and ISVC (13.38% ± 2.62%, p = 0.001), and reduced the retraining time cost compared with ISVC (2 ms per updating cycle vs. 50 ms per updating cycle).

  16. The Interval Slope Method for Long-Term Forecasting of Stock Price Trends

    Directory of Open Access Journals (Sweden)

    Chun-xue Nie


    Full Text Available A stock price is a typical but complex type of time series data. We used the effective prediction of long-term time series data to schedule an investment strategy and obtain higher profit. Due to economic, environmental, and other factors, it is very difficult to obtain a precise long-term stock price prediction. The exponentially segmented pattern (ESP is introduced here and used to predict the fluctuation of different stock data over five future prediction intervals. The new feature of stock pricing during the subinterval, named the interval slope, can characterize fluctuations in stock price over specific periods. The cumulative distribution function (CDF of MSE was compared to those of MMSE-BC and SVR. We concluded that the interval slope developed here can capture more complex dynamics of stock price trends. The mean stock price can then be predicted over specific time intervals relatively accurately, in which multiple mean values over time intervals are used to express the time series in the long term. In this way, the prediction of long-term stock price can be more precise and prevent the development of cumulative errors.

  17. Summary of the engineering analysis report for the long-term management of depleted uranium hexafluoride

    Energy Technology Data Exchange (ETDEWEB)

    Dubrin, J.W., Rahm-Crites, L.


    The Department of Energy (DOE) is reviewing ideas for the long-term management and use of its depleted uranium hexafluoride. DOE owns about 560,000 metric tons (over a billion pounds) of depleted uranium hexafluoride. This material is contained in steel cylinders located in storage yards near Paducah, Kentucky; Portsmouth, Ohio; and at the East Tennessee Technology Park (formerly the K-25 Site) in Oak Ridge, Tennessee. On November 10, 1994, DOE announced its new Depleted Uranium Hexafluoride Management Program by issuing a Request for Recommendations and an Advance Notice of Intent in the Federal Register (59 FR 56324 and 56325). The first part of this program consists of engineering, costs and environmental impact studies. Part one will conclude with the selection of a long-term management plan or strategy. Part two will carry out the selected strategy.

  18. Hedging Long-Term Exposures of a Well-Diversified Portfolio with Short-Term Stock Index Futures Contracts

    Directory of Open Access Journals (Sweden)

    Yufang Liu


    Full Text Available It is difficult for passive portfolio strategy to manage the long-term exposure of a well-diversified portfolio because stock index futures contracts have a finite life limited by their maturity. In this paper, we investigate the problem of the rollover hedge strategy for the long-term exposure of a well-diversified portfolio. First, we consider the rollover hedge strategy for the well-diversified portfolio when the portfolio is not adjusted during the period. In order to obtain the optimal solution of the proposed model, the auxiliary models are constructed using the equivalent transformation technique. Moreover, dynamic programming is employed to derive the optimal positions of stock index futures contracts for the long-term exposure of the well-diversified portfolio. In addition, we extend the result to the case of the rollover hedge strategy with transaction costs and derive the optimal number of stock index futures contracts.

  19. Intermittent catheterisation for long-term bladder management. (United States)

    Prieto, Jacqui; Murphy, Catherine L; Moore, Katherine N; Fader, Mandy


    , mean differences and 95% confidence intervals were calculated for each outcome. Because of trial heterogeneity, it was not always possible to combine data to give an overall estimate of treatment effect. Thirty-one trials met the inclusion criteria, including 13 RCTs and 18 cross-over trials. Most were small (less than 60 participants completed), although five trials had more than 100 participants. There was considerable variation in length of follow-up and definitions of UTI. Participant dropout was a problem for several trials, particularly where there was long-term follow-up to measure incidence of UTI. Fifteen trials were more than 10 years old and focused mainly on comparing different catheterisation techniques (e.g. single versus multiple-use) on clinical outcomes whereas, several more recent trials have focused on comparing different types of catheter designs or materials, especially coatings, and user preference. It was not possible to combine data from some trials owing to variations in the catheters tested and in particular the catheter coatings. Where there were data, confidence intervals around estimates were wide and hence clinically important differences in UTI and other outcomes could neither be identified nor reliably ruled out. No study assessed cost-effectiveness. Despite a total of 31 trials, there is still no convincing evidence that the incidence of UTI is affected by use of aseptic or clean technique, coated or uncoated catheters, single (sterile) or multiple-use (clean) catheters, self-catheterisation or catheterisation by others, or by any other strategy. Results from user-reported outcomes varied. The current research evidence is weak and design issues are significant. More well-designed trials are strongly recommended. Such trials should include analysis of cost-effectiveness because there are likely to be substantial differences associated with the use of different catheter designs, catheterisation techniques and strategies.

  20. WITHDRAWN: Intermittent catheterisation for long-term bladder management. (United States)

    Prieto, Jacqui; Murphy, Catherine L; Moore, Katherine N; Fader, Mandy


    , mean differences and 95% confidence intervals were calculated for each outcome. Because of trial heterogeneity, it was not always possible to combine data to give an overall estimate of treatment effect. Thirty-one trials met the inclusion criteria, including 13 RCTs and 18 cross-over trials. Most were small (less than 60 participants completed), although five trials had more than 100 participants. There was considerable variation in length of follow-up and definitions of UTI. Participant dropout was a problem for several trials, particularly where there was long-term follow-up to measure incidence of UTI. Fifteen trials were more than 10 years old and focused mainly on comparing different catheterisation techniques (e.g. single versus multiple-use) on clinical outcomes whereas, several more recent trials have focused on comparing different types of catheter designs or materials, especially coatings, and user preference. It was not possible to combine data from some trials owing to variations in the catheters tested and in particular the catheter coatings. Where there were data, confidence intervals around estimates were wide and hence clinically important differences in UTI and other outcomes could neither be identified nor reliably ruled out. No study assessed cost-effectiveness. Despite a total of 31 trials, there is still no convincing evidence that the incidence of UTI is affected by use of aseptic or clean technique, coated or uncoated catheters, single (sterile) or multiple-use (clean) catheters, self-catheterisation or catheterisation by others, or by any other strategy. Results from user-reported outcomes varied. The current research evidence is weak and design issues are significant. More well-designed trials are strongly recommended. Such trials should include analysis of cost-effectiveness because there are likely to be substantial differences associated with the use of different catheter designs, catheterisation techniques and strategies.

  1. Inner Asia: Making a Long-Term U.S. Commitment (United States)


    Asia is fertile ground for terrorism because of its porous borders, weak central governments and sympathetic population . International funding and...USAWC STRATEGY RESEARCH PROJECT INNER ASIA : MAKING A LONG-TERM U.S. COMMITMENT by Colonel Carol D. Clair U.S. Army Professor R. Craig Nation Project...person shall be subject to any penalty for failing to comply with a collection of information if it does not display a currently valid OMB control number

  2. Radiocaesium in grazing sheep. A statistical analysis of variability, survey methodology and long term behaviour

    Energy Technology Data Exchange (ETDEWEB)

    Mehli, H.


    Since 1987 sheep grazing in the areas of Norway that received Chernobyl-fallout have been monitored before slaughter. These monitoring data formed the basis for development of a model describing the long term behaviour of radiocesium in unimproved pasture showing that in years with good mushroom abundance 70-80% of the radiocesium concentration in sheep is due to fungi consumption. A study of sampling strategy and variability of radiocesium concentration within flocks was also performed. 55 refs., 31 figs., 15 tabs.

  3. Compliant flooring for fall injury prevention in long-term care


    Lachance, Chantelle


    A promising strategy for reducing the incidence and severity of fall-related injuries in long-term care (LTC) is to decrease the ground surface stiffness, and the subsequent forces applied to the body parts at impact, through installation of compliant flooring. Evidence about the feasibility of compliant flooring in LTC is extremely limited. My PhD research addresses this gap by conducting a comprehensive, multimethod evaluation of compliant flooring. Specifically, I investigate the feasibili...

  4. Hippocampal Focal Knockout of CBP Affects Specific Histone Modifications, Long-Term Potentiation, and Long-Term Memory (United States)

    Barrett, Ruth M; Malvaez, Melissa; Kramar, Eniko; Matheos, Dina P; Arrizon, Abraham; Cabrera, Sara M; Lynch, Gary; Greene, Robert W; Wood, Marcelo A


    To identify the role of the histone acetyltransferase (HAT) CREB-binding protein (CBP) in neurons of the CA1 region of the hippocampus during memory formation, we examine the effects of a focal homozygous knockout of CBP on histone modifications, gene expression, synaptic plasticity, and long-term memory. We show that CBP is critical for the in vivo acetylation of lysines on histones H2B, H3, and H4. CBP's homolog p300 was unable to compensate for the loss of CBP. Neurons lacking CBP maintained phosphorylation of the transcription factor CREB, yet failed to activate CREB:CBP-mediated gene expression. Loss of CBP in dorsal CA1 of the hippocampus resulted in selective impairments to long-term potentiation and long-term memory for contextual fear and object recognition. Together, these results suggest a necessary role for specific chromatin modifications, selectively mediated by CBP in the consolidation of memories. PMID:21508930

  5. A conceptual framework for a long-term economic model for the treatment of attention-deficit/hyperactivity disorder. (United States)

    Nagy, Balázs; Setyawan, Juliana; Coghill, David; Soroncz-Szabó, Tamás; Kaló, Zoltán; Doshi, Jalpa A


    Models incorporating long-term outcomes (LTOs) are not available to assess the health economic impact of attention-deficit/hyperactivity disorder (ADHD). Develop a conceptual modelling framework capable of assessing long-term economic impact of ADHD therapies. Literature was reviewed; a conceptual structure for the long-term model was outlined with attention to disease characteristics and potential impact of treatment strategies. The proposed model has four layers: i) multi-state short-term framework to differentiate between ADHD treatments; ii) multiple states being merged into three core health states associated with LTOs; iii) series of sub-models in which particular LTOs are depicted; iv) outcomes collected to be either used directly for economic analyses or translated into other relevant measures. This conceptual model provides a framework to assess relationships between short- and long-term outcomes of the disease and its treatment, and to estimate the economic impact of ADHD treatments throughout the course of the disease.

  6. [A Reflection on the Policy of Transcultural Long-Term Care for the Indigenous Peoples in Taiwan]. (United States)

    Subeq, Yi-Maun; Hsu, Mutsu


    Giving high-profile attention to socio-cultural and traditional beliefs in the promotion of long-term care policies enjoys strong, consensus support in the field of transcultural nursing. To protect the rights of indigenous people in Taiwan, the Ministry of Health and Welfare incorporated the concept of cultural care into the Long-term Care Services Act, which was approved by the Legislature in May 2014. However, the policies, resource strategies, manpower allocations, and staff educations and trainings related to this act are still await implementation in indigenous areas. Beyond the concept of professional healthcare, which considers cultural sensitivity, suitability, and ability, cultural care gives greater priority to crossing cultural barriers, integrating with the lifestyle of clients, and addressing their concerns in order to improve the well-being of target populations. The present article reviews current long-term care policy to highlight the importance of considering the cultural needs of the indigenous peoples of Taiwan in order to enhance the efficiency and impact of long-term care programs. Furthermore, the findings strongly recommend that additional resources be provided in order to meet the long-term care needs of indigenous communities. Finally, cultural-specific, long-term care service strategies should be promulgated in order to upgrade well-being in order to ease and comfort the feelings of indigenous people.

  7. Mixing induces long-term hyperthermia in growing pigs

    NARCIS (Netherlands)

    de Jong, IC; Lambooij, E; Korte, SM; Blokhuis, HJ; Koolhaas, JM


    The purpose of this experiment was to determine whether body temperature is a sensitive parameter to measure long-term effects of stress in pigs. Mixing of unacquainted pigs is a severe stressor that has detrimental effects on health, production and welfare. We measured deep body temperature after

  8. Long term water integration in interconnected ramets of ...

    African Journals Online (AJOL)

    Buffalograss (Buchloë dactyloides) is known for its drought resistant character. Natural resources are patchily distributed and resource sharing between interconnected ramets can enhance the performance of the whole genet. In order to examine whether there exists long term water integration between interconnected ...

  9. Suicidal Behavior in Long-Term Care Facilities. (United States)

    Osgood, Nancy J.; Brant, Barbara A.


    Surveyed administrators of 463 long-term care facilities concerning overt suicides and intentional life-threatening behaviors. Data revealed that White males were highest risk group. Refusal to eat, drink, or take medications were most common suicidal behaviors. Depression, loneliness, feelings of family rejection, and loss were significant…

  10. Modelling the Long-term Periglacial Imprint on Mountain Landscapes

    DEFF Research Database (Denmark)

    Andersen, Jane Lund; Egholm, David Lundbek; Knudsen, Mads Faurschou

    Studies of periglacial processes usually focus on small-scale, isolated phenomena, leaving less explored questions of how such processes shape vast areas of Earth’s surface. Here we use numerical surface process modelling to better understand how periglacial processes drive large-scale, long-term...

  11. Long-term outcome in patients with juvenile dermatomyositis

    DEFF Research Database (Denmark)

    Mathiesen, P; Hegaard, H; Herlin, Troels


    To evaluate a group of 53 patients with juvenile dermatomyositis (JDM), on average 13.9 years after disease onset, in order to describe the long-term disease outcome and to identify disease-related parameters associated with poor disease outcome....

  12. Long-Term Outcomes of an Urban Farming Internship Program (United States)

    Sonti, Nancy Falxa; Campbell, Lindsay K.; Johnson, Michelle L.; Daftary-Steel, Sarita


    Long-term impacts of an urban farming youth internship were evaluated in Brooklyn, New York. Alumni surveyed 1 to 9 years after program completion were enrolled in college or graduate school at higher rates than their peers and reported connections to the environment and healthy eating. Participants reported learning job skills through the…

  13. Long-term salt stress responsive growth, carbohydrate metabolism ...

    African Journals Online (AJOL)

    We investigated the long-term responses of tobacco tissues to salt stress, with a particular interest for growth parameters, proline (Pro) accumulation, and carbohydrate metabolism. Exposure of 17-day-old tobacco plants to 0.2 M NaCl was followed by a higher decrease in dry matter in roots than shoots with a decrease of ...

  14. Domestic resource mobilization and long term economic growth in ...

    African Journals Online (AJOL)

    The objective of this paper is to examine the long term effects of domestic resource mobilization (DRM) on economic growth. This study used macroeconomic data for a period of 20 years spanning 1996 to 2015. By estimating the Autoregressive distributed lag (ARDL) model, Error Correction Model (ECM) and Impulse ...

  15. Recent warming reverses long-term arctic cooling

    DEFF Research Database (Denmark)

    kaufman, D.S.; Vinther, Bo Møllesøe


    continued through the Middle Ages and into the Little Ice Age. A 2000-year transient climate simulation with the Community Climate System Model shows the same temperature sensitivity to changes in insolation as does our proxy reconstruction, supporting the inference that this long-term trend was caused...

  16. Long-Term Growth and Fiscal Development Policies: The Ghanaian ...

    African Journals Online (AJOL)

    The article aims at clarifying the relationship between long-term growth and fiscal policy variables. Growth equations are derived from a structural macroeconomic model. The model developed here postulates that the steady-growth rate of output becomes endogenous and is influenced by government policies.

  17. Long term stability of cannabis resin and cannabis extracts

    DEFF Research Database (Denmark)

    Lindholst, Christian


      The aim of the present study was to investigate the stability of cannabinoids in cannabis resin slabs and cannabis extracts upon long-term storage. The levels of tetrahydrocannabinol (THC), cannabinol (CBN), cannabidiol (CBD) and cannabigerol (CBG) on both neutral and acidic form were measured...

  18. Endothelial damage in long-term survivors of childhood cancer

    NARCIS (Netherlands)

    Brouwer, Cornelia A J; Postma, Aleida; Hooimeijer, H Louise H; Smit, Andries J; Vonk, Judith M; van Roon, A. M.; van den Berg, Maarten P; Dolsma, W.; Lefrandt, Johan; Bink - Boelkens, Margaretha; Zwart, Nynke; de Vries, Elisabeth G. E.; Tissing, Wim J E; Gietema, Jourik A


    PURPOSE: To evaluate the presence of vascular damage in long-term childhood cancer survivors (CCS) and sibling controls, and to evaluate the association between vascular damage parameters and cancer treatment and influence of cardiovascular risk factors. PATIENTS AND METHODS: Vascular assessment was

  19. Long term neurological complications of bacterial meningitis in ...

    African Journals Online (AJOL)


    Long term neurological complications of bacterial meningitis in Nigerian children. Accepted: 11th March 2013. Frank-Briggs AI ... illnesses, a person's memory, mo- tor and cognitive abilities, con- centration, speech, and physique ... follow up prospective study of children with meningitis at the. Paediatric neurology unit of the.

  20. Long-term neurodevelopmental outcome after fetal arrhythmia

    NARCIS (Netherlands)

    Lopriore, Enrico; Aziz, Muhammed I.; Nagel, Helene T.; Blom, Nico A.; Rozendaal, Lieke; Kanhai, Humphrey H. H.; Vandenbussche, Frank P. H. A.


    OBJECTIVE: The purpose of this study was to determine the long-term neurodevelopmental outcome in fetuses with severe tachy- or bradyarrhythmia. STUDY DESIGN: This was a follow-up study to assess the neurologic, mental, and psychomotor development in cases with fetal cardiac arrhythmia. RESULTS: A

  1. Autonomy and Acceptance of Long-Term Care (United States)

    Hsu, Hui-Chuan; Ting, Yu-Shan; Jiang, Ting-Wen; Chien, Ming-Chih; Chien, Chih-Hsin


    This study explored the relationship between four types of autonomy (health autonomy, informational autonomy, living autonomy, and financial autonomy) and the acceptance of five types of long-term care (adult day care, respite care, assisted living, unit care, and group home) for the elderly in Taiwan. Data were collected from 167 middle-aged and…

  2. Neural correlates of long-term intense romantic love (United States)

    Aron, Arthur; Fisher, Helen E.; Brown, Lucy L.


    The present study examined the neural correlates of long-term intense romantic love using functional magnetic resonance imaging (fMRI). Ten women and 7 men married an average of 21.4 years underwent fMRI while viewing facial images of their partner. Control images included a highly familiar acquaintance; a close, long-term friend; and a low-familiar person. Effects specific to the intensely loved, long-term partner were found in: (i) areas of the dopamine-rich reward and basal ganglia system, such as the ventral tegmental area (VTA) and dorsal striatum, consistent with results from early-stage romantic love studies; and (ii) several regions implicated in maternal attachment, such as the globus pallidus (GP), substantia nigra, Raphe nucleus, thalamus, insular cortex, anterior cingulate and posterior cingulate. Correlations of neural activity in regions of interest with widely used questionnaires showed: (i) VTA and caudate responses correlated with romantic love scores and inclusion of other in the self; (ii) GP responses correlated with friendship-based love scores; (iii) hypothalamus and posterior hippocampus responses correlated with sexual frequency; and (iv) caudate, septum/fornix, posterior cingulate and posterior hippocampus responses correlated with obsession. Overall, results suggest that for some individuals the reward-value associated with a long-term partner may be sustained, similar to new love, but also involves brain systems implicated in attachment and pair-bonding. PMID:21208991

  3. Long-Term English Learners Writing Their Stories (United States)

    Jacobs, C. Lynn


    High school teacher C. Lynn Jacobs noted that the long-term English language learners in her class had improved in reading comprehension but still lacked writing skills. Inspired by a state humanities project, she worked with the students to publish a collection of stories and poems. Writing about their lives provided the motivation, and writing…

  4. Long-term followup of hypospadias: functional and cosmetic results

    NARCIS (Netherlands)

    Rynja, Sybren P.; Wouters, Gerlof A.; van Schaijk, Maaike; Kok, Esther T.; de Jong, Tom P.; de Kort, Laetitia M.


    We assessed long-term results after hypospadias surgery with respect to urinary and sexual function, cosmetic appearance and intimate relationships. We contacted 116 patients who are now adults and who underwent surgery between 1987 and 1992. Participation included mailed questionnaires containing

  5. long-term hepatotoxicity and hypoglycaemic study of aqueous ...

    African Journals Online (AJOL)


    The use of Carica papaya extracts as an anti-diabetic remedy in Nigeria is well documented. Since these extracts are usually taken for long periods of time, it is important to assess their long term biochemical effects so as to ascertain their safety. In this study, the effects of aqueous extracts of C. papaya leaves, orally ...

  6. Long-term hepatotoxicity and hypoglycaemic study of Aqueous ...

    African Journals Online (AJOL)

    The use of Carica papaya extracts as an anti-diabetic remedy in Nigeria is well documented. Since these extracts are usually taken for long periods of time, it is important to assess their long term biochemical effects so as to ascertain their safety. In this study, the effects of aqueous extracts of C. papaya leaves, orally ...

  7. North American long-term soil productivity research program (United States)

    Allan E. Tiarks; Marilyn A. Buford; Robert F. Powers; Jerry F. Ragus; Deborah S. Page-Dumroese; Felix Ponder; Douglas M. Stone


    The National Long-term Soil Productivity research program was chartered to address National Forest Management Act concerns over possible losses n soil productivity on national forest lands. The program supports validation of soil quality monitoring standards and process-level productivity research. Summarized results are supplied to forests as collected. National...

  8. Long-term brain slice culturing in a microfluidic platform

    DEFF Research Database (Denmark)

    Vedarethinam, Indumathi; Avaliani, N.; Tønnesen, J.


    In this work, we present the development of a transparent poly(methyl methacrylate) (PMMA) based microfluidic culture system for handling long-term brain slice cultures independent of an incubator. The different stages of system development have been validated by culturing GFP producing brain...... brain slice culturing for 16 days....

  9. Long term evolution of coastal morphology and global change

    NARCIS (Netherlands)

    Capobianco, M.; De Vriend, H.J.; Nicholls, R.J.; Stive, M.J.F.


    Long-term prediction of sediment transport and of morphological behaviour in the coastal zone, in response to human interference or to change in environmental conditions (collectively global change) is an increasingly important issue in coastal zone management, especially in relation to the needs

  10. Article Title: Appraisal of Long Term Groundwater Quality of ...

    Indian Academy of Sciences (India)


    Article Title: Appraisal of Long Term Groundwater Quality of Peninsular India using Water Quality Index and. Fractal Dimension. Authors Names: 1. Dr(Er.). Kishan Singh Rawat#. Centre for Remote Sensing and Geo-Informatics,. Sthyabama University. Chennai-600119, India. E-mail: 2. Dr. Sudhir ...

  11. Long-term protection of hepatitis B vaccination among Egyptian ...

    African Journals Online (AJOL)

    Background: Hepatitis B Vaccination is the most effective way to prevent transmission of hepatitis B virus (HBV). Objective: to detect the long-term immunogenicity of the vaccine in Egyptian children after five and ten years of vaccination. Methods: Two hundreds healthy children were recruited. They were divided into two ...

  12. Long-term survival in small-cell lung cancer

    DEFF Research Database (Denmark)

    Lassen, U; Osterlind, K; Hansen, M


    PURPOSE: To describe in patients with small-cell lung cancer (SCLC) the characteristics of those who survive for > or = 5 years, to identify long-term prognostic factors, to analyze survival data of 5-year survivors, and to study 10-year survival in patients entered before 1981. PATIENTS......, especially tobacco-related cancers and other tobacco-related diseases....

  13. [The behavior of bioelements during long-term parenteral feeding]. (United States)

    Herold, G; Stephan, B; Menzel, T


    26 adult patients were investigated for 26--35 postoperative days while being fed parenterally. Serum levels and urine excretion of zinc, magnesium, calcium and phosphate were measured. From the results it can be assumed that only phosphate substitution is necessary during parenteral long-term nutrition.

  14. A cross cultural comparison of long-term supply relationships

    NARCIS (Netherlands)

    Jong, Gjalt de; Nooteboom, Bart


    This paper challenges the received view that long-term supply relationships are a typically Japanese feature, embedded and developed in a typically Japanese society characterized by high levels of trust and cooperation, and for that reason cannot be established in the typically a-cooperative,

  15. Temporary and long-term consequences of bereavement on happiness

    NARCIS (Netherlands)

    Moor, J.A.; de Graaf, P.M.

    In this article, we examine the temporary and long-term consequences of the death of a parent or child on happiness. According to set-point theory external conditions are expected to only have a short-term or limited influence on happiness. This directly contradicts the basic assumption of affective

  16. Long Term Toxicity of Cancer Treatment in Older Patients (United States)

    Shahrokni, Armin; Wu, Abraham; Carter, Jeanne; Lichtman, Stuart M.


    Synopsis With earlier cancer diagnosis among older cancer patients, the possibility of curing cancer increases. However, cancer treatment may have long lasting impact on older cancer survivors. It is vital to screen, diagnose and properly manage the long term toxicities of cancer treatment, in order to maintain quality of life of older cancer survivors PMID:26614861

  17. Long-Term Parental Illness and Children: Perils and Promises. (United States)

    Johnston, Mona; And Others


    Discusses effects of long-term parental illness, focusing on effects on children. Describes effects on family homeostasis and family coping mechanisms. Discusses school counselor's role in bringing about a more balanced viewpoint of power and sharing within the family. Recommends establishing a strong therapeutic bond, assessing what the child is…

  18. [Disappointing long-term experiences of patients with penile prosthesis

    NARCIS (Netherlands)

    Meuleman, E.J.H.; Deunk, L.; Schreuders-Bais, C.; Rabsztyn, P.


    OBJECTIVE: To describe the long-term experience with the implantation of a penile prosthesis as a last resort treatment for erectile dysfunction. DESIGN: Retrospective and descriptive. METHOD: During the period 1986-1996, 124 men received a penile prosthesis. Basic information was obtained from

  19. Long-Term Effects of Neurofeedback Treatment in Autism (United States)

    Kouijzer, Mirjam E. J.; de Moor, Jan M. H.; Gerrits, Berrie J. L.; Buitelaar, Jan K.; van Schie, Hein T.


    Previously we demonstrated significant improvement of executive functions and social behavior in children with autism spectrum disorders (ASD) treated with 40 sessions of EEG neurofeedback in a nonrandomized waiting list control group design. In this paper we extend these findings by reporting the long-term results of neurofeedback treatment in…

  20. Long-Term Effects of Adderall XR in ADHD

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available The long-term tolerability and effectiveness of extended release mixed amphetamine salts (Adderall XR in children with attention deficit hyperactivity disorder (ADHD were evaluated in a 24-month, multicenter, open-label extension of 2 placebo-controlled studies at UCLA, Massachusetts General Hospital, UC-Irvine, Maitland, FL, and Shire Pharmaceutical, Wayne, PA.

  1. Long-term Ecological Monitoring in Schools and Colleges. (United States)

    Doberski, Julian; Brodie, Iain D. S.


    The value and difficulties of long-term ecological monitoring studies undertaken in schools and colleges are reviewed. Rookeries, stream ecology, sand dune succession, fish population, and seed production and survival are presented as examples of successful studies. This is followed by a discussion of points to consider when setting up a long-term…

  2. Outcome of Long-Term Mechanical Ventilation Support in Children

    Directory of Open Access Journals (Sweden)

    Shao-Hsuan Hsia


    Conclusions: There are now more children on long-term MV support in Taiwan and most are in respiratory care wards in local hospitals. The shift in underlying diagnoses from pulmonary disease to neurogenic respiratory insufficiency affects hospitalization. The main cause of respiratory insufficiency is neurologic insult.

  3. Areas of Marital Dissatisfaction among Long-Term Couples (United States)

    Duba, Jill D.; Hughey, Aaron W.; Lara, Tracy; Burke, Monica G.


    To better understand relational dissatisfaction and duration of long-term married couples, this study surveyed 30 couples married at least 40 years with the Marital Satisfaction Inventory. Findings suggest various areas of dissatisfaction (e.g., affective communication, conflict over child rearing) and relationship among and link to other areas of…

  4. Long term ocular and neurological involvement in severe congenital toxoplasmosis

    NARCIS (Netherlands)

    Meenken, C.; Assies, J.; van Nieuwenhuizen, O.; Holwerda-van der Maat, W. G.; van Schooneveld, M. J.; Delleman, W. J.; Kinds, G.; Rothova, A.


    This study was set up to determine the long term ocular and systemic sequelae in patients with severe congenital toxoplasmosis. Cross sectional and retrospective study of 17 patients with severe congenital toxoplasmosis. In addition to chorioretinitis (100%), the most common abnormal ocular features

  5. Effects of Long-Term Kerosene Spillage on Heterotrophic ...

    African Journals Online (AJOL)

    Michael Horsfall

    This revealed that long-term kerosene slippage had a selecting effect on soil bacteria as opposed to soil ... The oil industry is the main stay of Nigerian economy ... using auger borer. Preparation and incubation of soil samples: The soil samples obtained for analysis were bulked, air dried and passed through a 2mm sieve to ...

  6. Long-term outcomes after upper limb arterial injuries

    NARCIS (Netherlands)

    vanderSluis, CK; Kucey, DS; Brenneman, FD; Hunter, GA; Maggisano, R; tenDuis, HJ

    OBJECTIVE: To assess long-term outcomes in multisystem trauma victims who have arterial injuries to upper limbs. DESIGN: A retrospective case series. SETTING: Tertiary care regional trauma centre in a university hospital. PATIENTS: All consecutive severely injured patients (Injury Severity Score

  7. Institutional Repositories as Infrastructures for Long-Term Preservation (United States)

    Francke, Helena; Gamalielsson, Jonas; Lundell, Björn


    Introduction: The study describes the conditions for long-term preservation of the content of the institutional repositories of Swedish higher education institutions based on an investigation of how deposited files are managed with regards to file format and how representatives of the repositories describe the functions of the repositories.…

  8. Long-term human-robot interaction with young users

    NARCIS (Netherlands)

    Baxter, P.; Belpaeme, T.; Canamero, L.; Cosi, P.; Demiris, Y.; Enescu, V.; Et al.


    Artificial companion agents have the potential to combine novel means for effective health communication with young patients support and entertainment. However, the theory and practice of long-term child-robot interaction is currently an underdeveloped area of research. This paper introduces an

  9. Species richness inside and outside long-term exclosures (United States)

    W. A. Laycock; D. L. Bartos; K. D. Klement


    Recent environmental literature contains claims that livestock grazing has caused reduction in species diversity on Western rangelands. Data of species richness (number of species) is presented from inside and outside 24 long-term exclosures in Montana, Utah, and Wyoming. For the average of all exclosures there was no difference between species richness inside and...

  10. Long-Term Outcome in Pyridoxine-Dependent Epilepsy (United States)

    Bok, Levinus A.; Halbertsma, Feico J..; Houterman, Saskia; Wevers, Ron A.; Vreeswijk, Charlotte; Jakobs, Cornelis; Struys, Eduard; van der Hoeven, Johan H.; Sival, Deborah A.; Willemsen, Michel A.


    Aim: The long-term outcome of the Dutch pyridoxine-dependent epilepsy cohort and correlations between patient characteristics and follow-up data were retrospectively studied. Method: Fourteen patients recruited from a national reference laboratory were included (four males, 10 females, from 11 families; median age at assessment 6y; range 2y…

  11. Structural composite panel performance under long-term load (United States)

    Theodore L. Laufenberg


    Information on the performance of wood-based structural composite panels under long-term load is currently needed to permit their use in engineered assemblies and systems. A broad assessment of the time-dependent properties of panels is critical for creating databases and models of the creep-rupture phenomenon that lead to reliability-based design procedures. This...

  12. Modeling Wettability Variation during Long-Term Water Flooding

    Directory of Open Access Journals (Sweden)

    Renyi Cao


    Full Text Available Surface property of rock affects oil recovery during water flooding. Oil-wet polar substances adsorbed on the surface of the rock will gradually be desorbed during water flooding, and original reservoir wettability will change towards water-wet, and the change will reduce the residual oil saturation and improve the oil displacement efficiency. However there is a lack of an accurate description of wettability alternation model during long-term water flooding and it will lead to difficulties in history match and unreliable forecasts using reservoir simulators. This paper summarizes the mechanism of wettability variation and characterizes the adsorption of polar substance during long-term water flooding from injecting water or aquifer and relates the residual oil saturation and relative permeability to the polar substance adsorbed on clay and pore volumes of flooding water. A mathematical model is presented to simulate the long-term water flooding and the model is validated with experimental results. The simulation results of long-term water flooding are also discussed.

  13. Long-term priming of the meanings of ambiguous words (United States)

    Rodd, Jennifer M.; Lopez Cutrin, Belen; Kirsch, Hannah; Millar, Allesandra; Davis, Matthew H.


    Comprehension of semantically ambiguous words (e.g., "bark") is strongly influenced by the relative frequencies of their meanings, such that listeners are biased towards retrieving the most frequent meaning. These biases are often assumed to reflect a highly stable property of an individual's long-term lexical-semantic representations. We present…

  14. The long-term financial consequences of breast cancer

    DEFF Research Database (Denmark)

    Jensen, Laura Schärfe; Overgaard, Charlotte; Bøggild, Henrik


    BACKGROUND: A breast cancer diagnosis affects an individual's affiliation to labour market, but the long-term consequences of breast cancer on income in a Danish setting have not been examined. The present study investigated whether breast cancer affected future income among Danish women that par...

  15. Long-term results of lower energy transurethral microwave thermotherapy

    NARCIS (Netherlands)

    Keijzers, G. B.; Francisca, E. A.; D'Ancona, F. C.; Kiemeney, L. A.; Debruyne, F. M.; de la Rosette, J. J.


    We evaluate long-term results of lower energy transurethral microwave thermotherapy (Prostasoft 2.0*) and identify pretreatment characteristics that predict a favorable outcome. Between December 1990 and December 1992, 231 patients with lower urinary tract symptoms were treated with lower energy

  16. Long-Term Impact of Service Learning in Environmental Studies (United States)

    MacFall, Janet


    Long-term impacts from a senior course in Environmental Studies were evaluated by a survey of program graduates (36 respondents, 50% response rate) who had participated in the course over an 8-year permiod. Each year, the Senior Seminar used a service-learning pedagogy with a different environmentally focused project ranging from web resource…

  17. Going Solar Yields Long-Term Economical, Educational Benefits (United States)

    von Moos, Brian


    Going solar is not an easy decision, but a long-term investment with a potentially substantial up-front cost. While some schools have enough capital in reserve, can raise bond money, or can solicit sufficient donations, many schools rely on creative financial programs to make a solar energy system economically feasible. Thinking about going solar…

  18. Nurses struggle to help pupils with long-term conditions. (United States)

    Longhurst, Chris


    Most school nurses are not confident they can give essential support to pupils with long-term health conditions. Research by the National Children's Bureau found that, due to heavy workloads and the need to work across several schools, nine out of ten school nurses were less confident they can help children with conditions such as diabetes and asthma.

  19. Archiving primary data : Solutions for long-term studies

    NARCIS (Netherlands)

    Mills, James A.; Teplitsky, Celine; Arroyo, Beatriz; Charmantier, Anne; Becker, Peter. H.; Birkhead, Tim R.; Bize, Pierre; Blumstein, Daniel T.; Bonenfant, Christophe; Boutin, Stan; Bushuev, Andrey; Cam, Emmanuelle; Cockburn, Andrew; Cote, Steeve D.; Coulson, John C.; Daunt, Francis; Dingemanse, Niels J.; Doligez, Blandine; Drummond, Hugh; Espie, Richard H. M.; Festa-Bianchet, Marco; Frentiu, Francesca; Fitzpatrick, John W.; Furness, Robert W.; Garant, Dany; Gauthier, Gilles; Grant, Peter R.; Griesser, Michael; Gustafsson, Lars; Hansson, Bengt; Harris, Michael P.; Jiguet, Frederic; Kjellander, Petter; Korpimaki, Erkki; Krebs, Charles J.; Lens, Luc; Linne, John D. C.; Low, Matthew; McAdam, Andrew; Margalida, Antoni; Merila, Juha; Moller, Anders P.; Nakagawa, Shinichi; Nilsson, Jan-Ake; Nisbet, Ian C. T.; van Noordwijk, Arie J.; Oro, Daniel; Part, Tomas; Pelletier, Fanie; Potti, Jaime; Pujol, Benoit; Reale, Denis; Rockwel, Robert F.; Ropert-Coudert, Yan; Roulin, Alexandre; Sedinger, James S.; Swenson, Jon E.; Thebaud, Christophe; Visser, Marcel E.; Wanless, Sarah; Westneat, David F.; Wilson, Alastair J.; Zedrosser, Andreas


    The recent trend for journals to require open access to primary data included in publications has been embraced by many biologists, but has caused apprehension amongst researchers engaged in long-term ecological and evolutionary studies. A worldwide survey of 73 principal investigators (PIs) with

  20. Histological effects of long term administration of piliostigma ...

    African Journals Online (AJOL)

    Histological effects of long term administration of piliostigma thonningii stem bark on the liver of adult Wistar rats. ... Anatomy Journal of Africa ... by cervical dislocation on the twenty nine day of the experiment and the liver was carefully dissected out and quickly fixed in 10% formal saline for further routine histological study.

  1. Uterine artery embolization: Long term follow-up and implementation

    NARCIS (Netherlands)

    van der Kooij, S.M.


    This thesis aims to determine the position of uterine artery embolization (UAE) in the spectrum of treatments for symptomatic uterine fibroids and to stimulate its implementation into daily practice. To do this, firstly the following aspects of UAE were investigated: the long-term clinical results

  2. The efficacy of long-term psychotherapy: Methodological research issues

    NARCIS (Netherlands)

    Maat, S.M.; Dekker, J.J.M.; Schoevers, R.A.; Jonghe, de F.


    In evidence-based medicine (EBM) hierarchy, randomized controlled trials (RCTs) are ranked higher than cohort studies. However, cohort intervention studies are frequently, and RCTs rarely, used to investigate long-term psychotherapy (LTP). The authors compare the two methods and provide critical

  3. Lake restoration: successes, failures and long-term effects

    NARCIS (Netherlands)

    Sondergaard, M.; Jeppesen, E.; Lauridsen, T.L.; Skov, C.; Nes, van E.H.; Roijackers, R.M.M.; Lammens, E.; Portielje, R.


    1. Eutrophication constitutes a serious threat to many European lakes and many approaches have been used during the past 20–30 years to improve lake water quality. Results from the various lake restoration initiatives are diverse and the long-term effects are not well described. 2. In this study we

  4. Microfinance and rural development: a long-term perspective

    NARCIS (Netherlands)

    Moll, H.A.J.


    The long-term perspective on microfinance starts with a discussion of three central issues: first, views and policies, with two opposing views: "credit for target group" and "pushing the financial frontier"; second, the performance of microfinance institutions measured via two objectives: outreach

  5. Long-term Periodicity Analysis of Polarization Variation for Radio ...

    Indian Academy of Sciences (India)

    Abstract. We use the database of University of Michigan Radio As- tronomy Observatory (UMRAO) at three radio bands (4.8, 8 and 14.5. GHz) to analyse the long-term polarization variation in search of the pos- sible periodicity. Using the power spectral analysis method (PSA), the. Jurkevich method and the discrete ...

  6. Subintimal angioplasty: predictors of long-term success.

    LENUS (Irish Health Repository)

    Keeling, Aoife N


    To determine the clinical outcomes and success rates after percutaneous subintimal angioplasty (SIA) in patients with lower-limb occlusive lesions causing intermittent claudication (IC) or critical limb ischemia (CLI) at midterm to long-term follow-up. The secondary aim was to elicit factors predictive of a successful outcome.

  7. Long-term smoking results in haemostatic dysfunction in chronic ...

    African Journals Online (AJOL)

    Background: Smoking has been known to cause endothelial dysfunction and bronchial carcinoma and duration of smoking has been implicated in the effects of smoking on regular smokers. This study evaluated the effects of long-term smoking on some coagulation markers in chronic smokers. Materials and Methods: A ...

  8. Long-Term Sequelae after Cerebellar Astrocytoma Surgery

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available The long-term effects on neurologic, neuropsychological, and behavioral functioning in a consecutive series of 23 children treated surgically for cerebellar pilocytic astrocytoma without additional radio- and chemotherapy are determined in a study at Sophia Children’s Hospital, Rotterdam, The Netherlands, and other medical centers.

  9. Semi-automatic long-term acoustic surveying

    DEFF Research Database (Denmark)

    Andreassen, Tórur; Surlykke, Annemarie; Hallam, John


    Increasing concern about decline in biodiversity has created a demand for population surveys. Acoustic monitoring is an efficient non-invasive method, which may be deployed for surveys of animals as diverse as insects, birds, and bats. Long-term unmanned automatic monitoring may provide unique...... to determine bat behavior and correct for the bias toward loud bats inherent in acoustic surveying....

  10. Mathematics Learning Development: The Role of Long-Term Retrieval (United States)

    Calderón-Tena, Carlos O.; Caterino, Linda C.


    This study assessed the relation between long-term memory retrieval and mathematics calculation and mathematics problem solving achievement among elementary, middle, and high school students in nationally representative sample of US students, when controlling for fluid and crystallized intelligence, short-term memory, and processing speed. As…

  11. Long term impacts of international outsourcing of manufacturing on sustainability

    DEFF Research Database (Denmark)

    Moosavirad, Seyed Hamed; Kara, Sami; Hauschild, Michael Zwicky


    International outsourcing seems to be a cost efficient way of production. However, there are serious concerns about its long term impacts on the environmental, social and economic sustainability. This paper aims to quantify these impacts by using input output analysis, linear programming and system...

  12. Long-term RNA persistence in postmortem contexts

    DEFF Research Database (Denmark)

    Fordyce, Sarah Louise; Kampmann, Marie-Louise; van Doorn, Nienke L.


    Ribonucleic acids (RNA) are generally considered fragile molecules that are readily degraded. However, there is growing documentation of long-term (from days to centuries) RNA persistence in a variety of contexts and tissue types, and as such a number of academic disciplines are beginning...

  13. Concept Formation Skills in Long-Term Cochlear Implant Users (United States)

    Castellanos, Irina; Kronenberger, William G.; Beer, Jessica; Colson, Bethany G.; Henning, Shirley C.; Ditmars, Allison; Pisoni, David B.


    This study investigated if a period of auditory sensory deprivation followed by degraded auditory input and related language delays affects visual concept formation skills in long-term prelingually deaf cochlear implant (CI) users. We also examined if concept formation skills are mediated or moderated by other neurocognitive domains (i.e.,…

  14. Drug taper during long-term video-EEG monitoring

    DEFF Research Database (Denmark)

    Guld, Asger Toke; Sabers, A; Kjaer, T W


    OBJECTIVES: Anti-epileptic drugs (AED) are often tapered to reduce the time needed to record a sufficient number of seizure during long-term video-EEG monitoring (LTM). Fast AED reduction is considered less safe, but few studies have examined this. Our goal is to examine whether the rate of AED r...

  15. Long-term efficacy of the pubovaginal Mersilene mesh sling. (United States)

    Young, Stephen B; Howard, Allison E; Illanes, Diego S; Weber LeBrun, Emily E; Hardy, Janet R; Kambiss, Scott M; O'Dell, Katharine K; Zhang, Yan


    The objective of the study was to determine the efficacy of the pubovaginal Mersilene mesh sling (PVMMS) for complicated urodynamic stress incontinence (USI). Between 1990 and 2008, patients with USI plus an at-risk diagnosis underwent a PVMMS by a single surgeon. They were followed up with urodynamics (UDE) and Pelvic Floor Distress Inventory-short form 20 (PFDI-20). Stratification was in an at-risk hierarchy: intrinsic sphincter deficiency (ISD) greater than recurrent USI (RUSI) greater than USI with chronically increased intraabdominal pressure (CI-IAP). A cough stress test determined objective cure. PFDI question 17 assessed subjective cure. Three hundred six patients with ISD (43.5%), RUSI (26.8%), and CI-IAP (29.7%) had objective cure rates of 89.2% in the short term, 86.7% in the intermediate term, and 91.2% in the long term. A group of 48 patients with both short- and long-term UDEs showed cures of 100% and 91.7%. Long-term objective cure rates were: ISD, 90.5% (n = 21); RUSI, 84.2%, (n = 19); CI-IAP, 100% (n = 17). The mean score of postoperative PFDI question 17 was 0.57 (n = 119). Mean symptom improvement was -2.98 (n = 52; P < .0001). We demonstrated PVMMS to be subjectively and objectively effective in long-term treatment of complicated forms of USI.

  16. Carpal Tunnel Syndrome in Patient on long Term Hemodialysis - a ...

    African Journals Online (AJOL)

    Pain in hands is a common complaint in patients of end-stage renal disease on long term hemodialysis. This pain can arise from various different etiological factors. We present one such case of 56 years old lady who suffered from pain in the hand due to carpal tunnel syndrome on the side with angioaccess. Carpal tunnel ...

  17. Long-Term Outcome in Guillain-Barre Syndrome

    Directory of Open Access Journals (Sweden)

    J Gordon Millichap


    Full Text Available The long-term sequelae and early predictors of sequelae were determined in a chart review of 47 children with Guillain-Barre syndrome (GBS of whom 30 had been treated with intravenous gammaglobulin (IVIG at The Hospital for Sick Children, Toronto, Canada.

  18. Gender-Based Violence in India: Long-Term Trends (United States)

    Simister, John; Mehta, Parnika S.


    This article examines long-term trends in Indian society regarding domestic violence between husband and wife, and attitudes to such violence. This article analyzes crime data and uses data from several Indian household surveys: "Work Attitudes and Spending" surveys (1992 to 2007); "World Values Survey" (1990, 1995, 2001, and…

  19. Evidence of long term benefit of morbidity reduction due to ...

    African Journals Online (AJOL)

    Evidence of long term benefit of morbidity reduction due to praziquantel treatment against Schistosoma mansoni in Kigungu fishing village in Entebbe, Uganda. ... a yearly administration of praziquantel to the community could be a regiment for mass drug administration (MAD) for this community to control schistosomiasis ...

  20. Factors influencing long-term and seasonal waterbird abundance ...

    African Journals Online (AJOL)

    The spatial and temporal structures of waterbird communities are dynamic and complex with many driving factors. We used long-term waterbird census data at two lakes in Zimbabwe to explore the ecological and anthropogenic drivers of waterbird community composition and abundance. Ecological drivers predicted to ...