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Sample records for viable therapeutic option

  1. Therapeutic options for lip augmentation.

    Science.gov (United States)

    Segall, Lorne; Ellis, David A F

    2007-11-01

    Aesthetic ideals vary with emerging fashion trends and within different cultures. However, over the past few decades, fuller lips have been considered a desirable trait. Many younger patients are presenting for lip augmentation to achieve the sought-after look commonly seen in many fashion magazines. In addition, as individuals age, they lose lip volume, with a thinning of the red lip, some effacement of the vermillion border, and elongation and flattening of the white portion of the lip. Rejuvenation of the lips plays a key role in restoring a more youthful appearance. As a result, lip augmentation appeals to a wide spectrum of patients who present with various different aesthetic goals and expectations. Numerous therapeutic options exist for aesthetic lip augmentation, ranging from temporary and permanent injectable fillers to implants and other surgical techniques.

  2. Vaccines against drugs of abuse: a viable treatment option?

    Science.gov (United States)

    Kantak, Kathleen M

    2003-01-01

    Drug addiction is a chronically relapsing brain disorder. There is an urgent need for new treatment options for this disease because the relapse rate among drug abusers seeking treatment is quite high. During the past decade, many groups have explored the feasibility of using vaccines directed against drugs of abuse as a means of eliminating illicit drug use as well as drug overdose and neurotoxicity. Vaccines work by inducing drug-specific antibodies in the bloodstream that bind to the drug of abuse and prevent its entry into the brain. The majority of work in this area has been conducted with vaccines and antibodies directed against cocaine and nicotine. On the basis of preclinical work, vaccines for cocaine and nicotine are now in clinical trials because they can offer long-term protection with minimal treatment compliance. In addition, vaccines and antibodies for phencyclidine, methamphetamine and heroin abuse are currently under development. An underlying theme in this research is the need for high concentrations of circulating drug-specific antibodies to reduce drug-seeking and drug-taking behaviour when the drug is repeatedly available, especially in high doses. Although vaccines against drugs of abuse may become a viable treatment option, there are several drawbacks that need to be considered. These include: a lack of protection against a structurally dissimilar drug that produces the same effects as the drug of choice;a lack of an effect on drug craving that predisposes an addict to relapse; and tremendous individual variability in antibody formation. Forced or coerced vaccination is not likely to work from a scientific perspective, and also carries serious legal and ethical concerns. All things considered, vaccination against a drug of abuse is likely to work best with individuals who are highly motivated to quit using drugs altogether and as part of a comprehensive treatment programme. As such, the medical treatment of drug abuse will not be radically

  3. Job sharing: a viable option for the clinical nurse specialist.

    Science.gov (United States)

    Haibeck, S V; Howard, J L

    1991-01-01

    NUMEROUS WORK TIME options have been developed to attract, retain and meet the various needs of nurses. Job sharing, a work option little known to nurses, can be a successful alternative for balancing professional and personal lifestyle. The business literature supports job sharing and other innovative work options as successful mechanisms in retaining quality employees in their respective professions. After exploring the literature in this area, a proposal for job sharing the oncology clinical nurse specialist (CNS) position was presented to the Personnel Director and Vice President of Nursing at our institution. The proposal addressed the advantages and disadvantages of the concept. These included: (1) scheduling flexibility, (2) reduced absenteeism and turnover, (3) increased productivity, (4) handling fringe benefits, and (5) job satisfaction. The proposal was accepted, and the job sharing position has been successfully implemented for more than 2 years now. This paper describes issues relevant to designing and implementing job sharing in a CNS position.

  4. Charter Schools: A Viable Public School Choice Option?

    Science.gov (United States)

    Geske, Terry G.; And Others

    1997-01-01

    Overviews the charter-school phenomenon and these schools' basic design. Discusses the government's role in education and identifies various school-choice options. Explores overall autonomy via legislative provisions and examines empirical evidence on charter schools' innovative features, teacher and student characteristics, and parental contracts…

  5. Social Media in Diabetes Education: A Viable Option?

    Science.gov (United States)

    Cooper, Julie; Cox, Jill N.; Corbin, Marilyn A.

    2012-01-01

    As Extension educators are encouraged to implement more cost-effective and efficient means of programming, the use of Web-based social media has become a popular option. Penn State Extension implemented a social media awareness survey among participants in its community-based diabetes education program to determine familiarity with this medium,…

  6. Designing viable cropping options for salt-affected lands

    Science.gov (United States)

    Shabala, Sergey; Meinke, Holger

    2017-04-01

    Salinity cost agricultural sector over 27Bln pa in lost opportunities and is an issue that crosses all spatial and temporal scales - from individual fields, farms, catchments, landscapes to national and global levels. Salinity manifests itself in many forms and often leads to further soil degradation such as erosion, nutrient and soil organic matter depletion, and a loss of (soil) biodiversity. Salinity may also cause major disturbance to ecosystems due to its impact on resources (e.g. pollution of aquifers). In extreme cases it can turn previously highly productive areas into wastelands. An increasing global population and unprecedented urban sprawls are now putting additional pressures on our soil and water resources, particularly in regions where urbanisation directly competes with agriculture for access to land and water. And although everyone agrees that avoiding soil salinity in the first instance would be the most effective way of combating it, reality is that the amount of saline land and water resources is rapidly increasing, and will continue to increase, especially in developing countries. Purposefully designing our cropping systems that can cope with various levels of salinity could be one answer to this increasing problem. In this work we review some of the key cropping options that can be deployed to either avoid, reduce or remediate salt-affected lands. We argue that for these measures to be most effective an ongoing science - policy - society dialogue is required to ensure that policy frameworks that govern land and water management are conducive to reducing salinity or even assist in restoring affected areas. We first consider several case studies highlighting the extent of the problem using ongoing salinity hotspots around the globe. We then look at halophytes as a possible biological tools to remediate already saline sols, and discuss prospects of mixed (halophytes and glycophytes) cropping solutions for various agricultural systems at different

  7. Telestroke a viable option to improve stroke care in India.

    Science.gov (United States)

    Srivastava, Padma V; Sudhan, Paulin; Khurana, Dheeraj; Bhatia, Rohit; Kaul, Subash; Sylaja, P N; Moonis, Majaz; Pandian, Jeyaraj Durai

    2014-10-01

    In India, stroke care services are not well developed. There is a need to explore alternative options to tackle the rising burden of stroke. Telemedicine has been used by the Indian Space Research Organization (ISRO) to meet the needs of remote hospitals in India. The telemedicine network implemented by ISRO in 2001 presently stretches to around 100 hospitals all over the country, with 78 remote/rural/district health centers connected to 22 specialty hospitals in major cities, thus providing treatment to more than 25 000 patients, which includes stroke patients. Telemedicine is currently used in India for diagnosing stroke patients, subtyping stroke as ischemic or hemorrhagic, and treating accordingly. However, a dedicated telestroke system for providing acute stroke care is needed. Keeping in mind India's flourishing technology sector and leading communication networks, the hub-and-spoke model could work out really well in the upcoming years. Until then, simpler alternatives like smartphones, online data transfer, and new mobile applications like WhatsApp could be used. Telestroke facilities could increase the pool of patients eligible for thrombolysis. But this primary aim of telestroke can be achieved in India only if thrombolysis and imaging techniques are made available at all levels of health care. © 2014 World Stroke Organization.

  8. Emergency total thyroidectomy for bleeding anaplastic thyroid carcinoma: A viable option for palliation

    Directory of Open Access Journals (Sweden)

    Sunil Kumar

    2011-01-01

    Full Text Available Anaplastic thyroid carcinoma (ATC is a rare and highly aggressive thyroid neoplasm. Bleeding from tumor is an uncommon, but potentially life-threatening complication requiring sophisticated intervention facilities which are not usually available at odd hours in emergency. We report the case of a 45-year-old woman who presented with exsanguinating hemorrhage from ATC and was treated by emergency total thyroidectomy. The patient is well three months postoperatively. Emergency total thyroidectomy is a viable option for palliation in ATC presenting with bleeding.

  9. Vermicomposting and anaerobic digestion – viable alternative options for terrestrial weed management – A review

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    Biswanath Saha

    2018-03-01

    Full Text Available The management of terrestrial weed is of great concern for the scientific community as these weeds cause adverse effect in different ecosystems like forest, agriculture and urban. The widespread of these weeds by their adaptive capability and morphological advancement is difficult to control. Parthenium hysterophorous, Lantana camara, Saccharum spontaneum, Ageratum conyzoides are the weeds that spread all over the world. There are various management practices employed for the control of this weeds. But all of these practices have some drawbacks those are neither environment friendly nor economical. In this paper a review has been done to evaluate various alternative management practices for these terrestrial weeds and to analyze their feasibility. Vermicomposting and anaerobic digestion can be viable alternative option which is cost effective as well. There are few studies regarding vermicomposting and anaerobic digestions of terrestrial weeds are done.

  10. Acupuncture as a therapeutic treatment option for threatened miscarriage

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    Betts Debra

    2012-03-01

    Full Text Available Abstract Background Threatened miscarriage involves vaginal bleeding in a pregnancy that remains viable. This is a common early pregnancy complication with increased risk factors for early pregnancy loss, preterm premature rupture of membranes (PPROM, preterm delivery, low birth weight babies and maternal antepartum haemorrhage. Currently there are no recommended medical treatment options, rather women receive advice that centres on a 'wait and see' approach. For women with a history of unexplained recurrent miscarriage providing supportive care in a subsequent pregnancy improves live birthing outcomes, but the provision of supportive care to women experiencing threatened miscarriage has to date not been examined. Discussion While it is known that 50-70% of miscarriages occur due to chromosomal abnormalities, the potential for therapeutic intervention amongst the remaining percentage of women remains unknown. Complementary and alternative medicine (CAM therapies have the potential to provide supportive care for women presenting with threatened miscarriage. Within fertility research, acupuncture demonstrates beneficial hormonal responses with decreased miscarriage rates, raising the possibility acupuncture may promote specific beneficial effects in early pregnancy. With the lack of current medical options for women presenting with threatened miscarriage it is timely to examine the possible treatment benefits of providing CAM therapies such as acupuncture. Summary Despite vaginal bleeding being a common complication of early pregnancy there is often reluctance from practitioners to discuss with women and medical personal how and why CAM may be beneficial. In this debate article, the physiological processes of early pregnancy together with the concept of providing supportive care and acupuncture are examined. The aim is to raise awareness and promote discussion as to the beneficial role CAM may have for women presenting with threatened miscarriage.

  11. Graves' disease. Manifestations and therapeutic options

    International Nuclear Information System (INIS)

    McFarland, K.F.; Saleeby, G.

    1988-01-01

    Graves' disease is the most common cause of hyperthyroidism. Clinical features include thyroid enlargement, eye signs, tachycardia, heat intolerance, emotional lability, weight loss, and hyperkinesis. Three modes of therapy are available. The preferences of the patient and physician are usually prime considerations in devising the therapeutic plan. Radioactive iodine is the most frequently used and safest method of treatment for adults. Antithyroid drugs are preferred for children and pregnant women. Surgery is usually reserved for patients in whom the other forms of treatment are not acceptable. Considerable patient education during the decision-making process enhances the success of the therapeutic plan

  12. automated (centrifugal) therapeutic plasma exchange option for ...

    African Journals Online (AJOL)

    Therapeutic plasma exchange (TPE) is performed frequently and effectively in developed countries, whereas the reverse is the case in developing countries. Guillain‑Barre syndrome (GBS), synonymous with acute inflammatory demyelinating polyneuropathy, is an important indication for TPE, but this is rarely administered ...

  13. Phytotherapy: emerging therapeutic option in urologic disease

    Science.gov (United States)

    2012-01-01

    Phytotherapy belongs to the area of complementary and alternative medicine (CAM) and the definition of phytotherapy is the use of plants or plant extracts for medicinal uses. Interest in phytotherapy is growing in both Asian and western countries for its use in the prevention and management of disease, improvement of general health and anti-aging. And also, there are several studies about the efficacy of phytotherapy in urologic diseases like benign prostatic hyperplasia (BPH), erectile dysfunction (ED), late-onset hypogonadism (LOH) and infertility in males. Phytotherapy for BPH including saw palmetto, pygeum, and nettles, is under vigorous research for the therapeutic effect. No solid evidence showing better effective treatment modality for ED than placebo has been found yet for phytotherapy. Recently, a potent NO donor, L-arginine is under research with promising results. Phytotherapy is used by a number of patients with urological disease, and urologists need to have accurate knowledge about phytotherapy as well as keep a cautious approach. The possible effects and side effects should be defined and related to urologic patients by urologists. PMID:26816707

  14. Polymyxins: Antimicrobial susceptibility concerns and therapeutic options

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    V Balaji

    2011-01-01

    Full Text Available The increasing prevalence of multidrug-resistant nosocomial pathogens such as Acinetobacter baumannii, Pseudomonas aeruginosa and Klebsiella pneumoniae poses a great challenge to the treating physicians. The paucity of newer effective antimicrobials has led to renewed interest in the polymyxin group of drugs, as a last resort for treatment of gram-negative bacterial infections. There is a dearth of information on the pharmacological properties of colistin, leading to difficulties in selecting the right dose, dosing interval, and route of administration for treatment, especially in critically-ill patients. The increasing use of colistin over the last few years necessitates the need for accurate and reliable in vitro susceptibility testing methods. Development of heteroresistant strains as a result of colistin monotherapy is also a growing concern. There is a compelling need from the clinicians to provide options for probable and possible colistin combination therapy for multidrug-resistant bacterial infections in the ICU setting. Newer combination drug synergy determination tests are being developed and reported. There are no standardized recommendations from antimicrobial susceptibility testing reference agencies for the testing and interpretation of these drug combinations. Comparison and analysis of these reported methodologies may help to understand and assist the microbiologist to choose the best method that produces accurate results at the earliest. This will help clinicians to select the appropriate combination therapy. In this era of multidrug resistance it is important for the microbiology laboratory to be prepared, by default, to provide timely synergistic susceptibility results in addition to routine susceptibility, if warranted. Not as a favour or at request, but as a responsibility.

  15. Metabolic syndrome: nature, therapeutic solutions and options.

    Science.gov (United States)

    Onat, Altan

    2011-08-01

    Metabolic syndrome (MetS) defines the clustering in an individual of multiple metabolic abnormalities, based on central obesity and insulin resistance. In addition to its five components, prothrombotic and proinflammatory states are essential features. The significance of MetS lies in its close association with the risk of type 2 diabetes and cardiovascular disease (CVD). This field being an evolving one necessitated the current review. The areas covered in this review include the so far unproven concept that enhanced low-grade inflammation often leads to dysfunction of the anti-inflammatory and atheroprotective properties of apolipoprotein A-I (apoA-I) and HDL particles, which further increases the risk of diabetes and CVD. It was emphasized that lifestyle modification is essential in the prevention and management of MetS, which includes maintenance of optimal weight by caloric restriction, adherence to a diet that minimizes postprandial glucose and triglyceride fluctuations, restricting alcohol consumption, smoking cessation and engaging in regular exercise. Drug therapy should target the dyslipoproteinemia and the often associated hypertension or dysglycemia.Statins are the drugs of first choice, to be initiated in patients with MetS at high 10-year cardiovascular risk. Such treatment is inadequate if fasting serum triglycerides remain at > 150 mg/dl, when niacin should be combined. Fibrates, omega 3 fatty acids, metformin, angiotensin-converting enzyme inhibitors and pioglitazone are additional options in drug therapy. Research on MetS in subpopulations prone to impaired glucose tolerance and insulin resistance has indicated that proinflammatory state and oxidative stress are often prominently involved in MetS, to the extent that evidence of impaired function of HDL and apo A-I particles is discernible by biological evidence of functional defectiveness via outcomes studies and/or correlations with inflammatory and anti-inflammatory biomarkers. A sex difference

  16. Bariatric surgery: a viable treatment option for patients with severe mental illness.

    Science.gov (United States)

    Shelby, Sarah R; Labott, Susan; Stout, Rebecca A

    2015-01-01

    Although bariatric surgery has become a recognized treatment for obesity, its utility among patients with severe psychiatric disorders has not been extensively studied. A few studies have reported similar weight loss outcomes in these patients, but psychiatric status after bariatric surgery has been studied only minimally, and it is unknown if exacerbation of the mental illness affects weight loss. The aim of this study was to shed greater light on the issue of serious mental illness and bariatric surgery. Specifically, do patients with a diagnosis of schizophrenia, bipolar I, and bipolar II have poorer weight loss outcomes postbariatric surgery than the general bariatric surgery population? Also, do patients with these diagnoses experience an exacerbation of psychiatric symptoms after bariatric surgery, and if so, is the exacerbation of these disorders linked to poorer weight loss results? Midwest university medical center. A medical record review of approximately 1500 bariatric patients in a Midwest university medical center was conducted to identify those patients with diagnoses of schizophrenia, bipolar I, and bipolar II. Information was gathered on bariatric surgery outcomes and changes in psychiatric status postsurgery. Eighteen patients were identified as undergoing bariatric surgery and having a diagnosis of schizophrenia, bipolar I, or bipolar II. Weight loss in this group was significant and comparable to expected outcomes of absolute weight lost, changes in body mass index, and percentage excess weight loss for patients in the typical bariatric population. Postsurgery psychiatric status was known on 10 patients. All 10 patients experienced some exacerbation of psychiatric problems yet weight loss outcomes were still as expected. Bariatric surgery is a viable obesity treatment option for patients with schizophrenia, bipolar I, and bipolar II disorders. Symptom exacerbations occurred postsurgery, although it is not clear if these were due to the surgery or

  17. Central venous catheters: detection of catheter complications and therapeutical options

    International Nuclear Information System (INIS)

    Gebauer, B.; Beck, A.; Wagner, H.J.; Vivantes-Kliniken, Hellersdorf und Prenzlauer Berg

    2008-01-01

    For modern medicine central venous catheters play an important role for diagnostic and therapeutic options. Catheter implantation, complication detection and therapy of catheter complications are an increasing demand for the radiologist. The review article provides an overview of different catheter types, their indications, advantages and disadvantages. Catheter malpositions are usually detectable in conventional X-ray. Most malpositions are correctable using interventional-radiological techniques. In addition therapeutical options for thrombotic complications (venous thrombosis, catheter occlusion, fibrin sheath) are discussed. In case of an infectious catheter complication, usually a catheter extraction and re-implantation is necessary

  18. Conceptualizing an economically, legally, and politically viable active debris removal option

    Science.gov (United States)

    Emanuelli, M.; Federico, G.; Loughman, J.; Prasad, D.; Chow, T.; Rathnasabapathy, M.

    2014-11-01

    challenges and propose an economically, politically, and legally viable ADR option. Much like waste management on Earth, cleaning up space junk will likely lie somewhere between a public good and a private sector service. An international, cooperative, public-private partnership concept can address many of these issues and be economically sustainable, while also driving the creation of a proper set of regulations, standards and best practices.

  19. Therapeutic Options in Idiopathic Burning Mouth Syndrome: Literature Review

    Science.gov (United States)

    Miziara, Ivan; Chagury, Azis; Vargas, Camila; Freitas, Ludmila; Mahmoud, Ali

    2014-01-01

    Introduction Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue, palate, lips, or gums of no well-defined etiology. The diagnosis and treatment for primary BMS are controversial. No specific laboratory tests or diagnostic criteria are well established, and the diagnosis is made by excluding all other possible disorders. Objective To review the literature on the main treatment options in idiopathic BMS and compare the best results of the main studies in 15 years. Data Synthesis We conducted a literature review on PubMed/MEDLINE, SciELO, and Cochrane-BIREME of work in the past 15 years, and only selected studies comparing different therapeutic options in idiopathic BMS, with preference for randomized and double-blind controlled studies. Final Comments Topical clonazepam showed good short-term results for the relief of pain, although this was not presented as a definitive cure. Similarly, α-lipoic acid showed good results, but there are few randomized controlled studies that showed the long-term results and complete remission of symptoms. On the other hand, cognitive therapy is reported as a good and lasting therapeutic option with the advantage of not having side effects, and it can be combined with pharmacologic therapy. PMID:25992157

  20. Therapeutic Options in Idiopathic Burning Mouth Syndrome: Literature Review

    Directory of Open Access Journals (Sweden)

    Miziara, Ivan

    2014-07-01

    Full Text Available Introduction Burning mouth syndrome (BMS is characterized by a burning sensation in the tongue, palate, lips, or gums of no well-defined etiology. The diagnosis and treatment for primary BMS are controversial. No specific laboratory tests or diagnostic criteria are well established, and the diagnosis is made by excluding all other possible disorders. Objective To review the literature on the main treatment options in idiopathic BMS and compare the best results of the main studies in 15 years. Data Synthesis We conducted a literature review on PubMed/MEDLINE, SciELO, and Cochrane-BIREME of work in the past 15 years, and only selected studies comparing different therapeutic options in idiopathic BMS, with preference for randomized and double-blind controlled studies. Final Comments Topical clonazepam showed good short-term results for the relief of pain, although this was not presented as a definitive cure. Similarly, α-lipoic acid showed good results, but there are few randomized controlled studies that showed the long-term results and complete remission of symptoms. On the other hand, cognitive therapy is reported as a good and lasting therapeutic option with the advantage of not having side effects, and it can be combined with pharmacologic therapy.

  1. A review of treatment options for Graves' disease: why total thyroidectomy is a viable option in selected patients.

    Science.gov (United States)

    Mohan, Vinuta; Lind, Robert

    2016-01-01

    Graves' disease is the most common cause of hyperthyroidism. If left untreated, patients may have multiple systemic complications such as cardiac, reproductive, and skeletal disease. Thionamides, such as methimazole and propylthiouracil, and I(131) iodine ablation are the most commonly prescribed treatment for Graves' disease. Total thyroidectomy is often overlooked for treatment and is usually only offered if the other options have failed. In our case, we discuss a patient who was admitted to our medical center with symptomatic hyperthyroidism secondary to long-standing Graves' disease. She had a history of non-compliance with medications and medical clinic follow-up. The risks and benefits of total thyroidectomy were explained and she consented to surgery. A few months after the procedure, she was biochemically and clinically euthyroid on levothyroxine. She had no further emergency room visits or admissions for uncontrolled thyroid disease. Here we review the advantages and disadvantages of the more typically prescribed treatments, thionamides and I(131)iodine ablation. We also review the importance of shared decision making and the benefits of total thyroidectomy for the management of Graves' disease. Given the improvement in surgical techniques over the past decade and a significant reduction of complications, we suggest total thyroidectomy be recommended more often for patients with Graves' disease.

  2. Municipal Bonds. A Viable Funding Option For Oradea Local Public Administration (Romania

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    Liliana Bunescu

    2010-10-01

    Full Text Available In a market economy government resources are often insufficient to cover all the public budget needs. Public capital collecting process presents a particular interest considering the need of getting them with lower costs. The options for collecting public resources are characterized by diversity and complexity. One of them is based on municipal bonds funds. This paper explores the potential of public bonds issued at a local level in raising capital for infrastructure investments in Romanian public administration. This paper is not meant to be an empirical study at national level because sub-sovereign bonds market in Romania is not very developed. This paper is limited to a case study of public financing methods for a Romanian local public administration. Local authorities from Oradea have no other possibility without one of borrowing to achieve the objectives proposed. Thus, it resorted to a set of internal and external loans. Our study contents a comparative cost analysis of public financing by loans. The analysis lead to the result that the cheapest source of financing is the loan offered by the European Investment Bank, followed by municipal bonds issuing.

  3. Studies on nonsense mediated decay reveal novel therapeutic options for genetic diseases.

    Science.gov (United States)

    Bashyam, Murali D

    2009-01-01

    Scientific breakthroughs have often led to commercially viable patents mainly in the field of engineering. Commercialization in the field of medicine has been restricted mostly to machinery and engineering on the one hand and therapeutic drugs for common chronic ailments such as cough, cold, headache, etc, on the other. Sequencing of the human genome has attracted the attention of pharmaceutical companies and now biotechnology has become a goldmine for commercialization of products and processes. Recent advances in our understanding of basic biological processes have resulted in the opening of new avenues for treatment of human genetic diseases, especially single gene disorders. A significant proportion of human genetic disorders have been shown to be caused due to degradation of transcripts for specific genes through a process called nonsense mediated decay (NMD). The modulation of NMD provides a viable therapeutic option for treatment of several genetic disorders and therefore has been a good prospect for patenting and commercialization. In this review the molecular basis for NMD and attempts to treat genetic diseases which result from NMD are discussed.

  4. Therapeutic Options for the Management of the Cardiorenal Syndrome

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    Katerina Koniari

    2011-01-01

    Full Text Available Patients with heart failure often present with impaired renal function, which is a predictor of poor outcome. The cardiorenal syndrome is the worsening of renal function, which is accelerated by worsening of heart failure or acute decompensated heart failure. Although it is a frequent clinical entity due to the improved survival of heart failure patients, still its pathophysiology is not well understood, and thus its therapeutic approach remains controversial and sometimes ineffective. Established therapeutic strategies, such as diuretics and inotropes, are often associated with resistance and limited clinical success. That leads to an increasing concern about novel options, such as the use of vasopressin antagonists, adenosine A1 receptor antagonists, and renal-protective dopamine. Initial clinical trials have shown quite encouraging results in some heart failure subpopulations but have failed to demonstrate a clear beneficial role of these agents. On the other hand, ultrafiltration appears to be a more promising therapeutic procedure that will improve volume regulation, while preserving renal and cardiac function. Further clinical studies are required in order to determine their net effect on renal function and potential cardiovascular outcomes. Until then, management of the cardiorenal syndrome remains quite empirical.

  5. Biceps tenodesis is a viable option for salvage of failed SLAP repair.

    Science.gov (United States)

    Werner, Brian C; Pehlivan, Hakan C; Hart, Joseph M; Lyons, Matthew L; Gilmore, C Jan; Garrett, Cara B; Carson, Eric W; Diduch, David R; Miller, Mark D; Brockmeier, Stephen F

    2014-08-01

    Outcomes of arthroscopic superior labral anterior-posterior (SLAP) repairs have been well reported with generally favorable outcomes. Unfortunately, a percentage of patients remain dissatisfied or suffer further injury after SLAP repair and may seek additional treatment. The purpose of this study was to evaluate the surgical outcomes of biceps tenodesis for failed SLAP repairs. A retrospective review of all patients undergoing biceps tenodesis was completed. Inclusion criteria were previous SLAP repair and subsequent revision biceps tenodesis. Exclusion criteria were additional shoulder procedures including rotator cuff repair, instability procedures, and preoperative frozen shoulder. Objective outcomes were postoperative assessments with Constant score, American Shoulder and Elbow Surgeons score, Single Assessment Numeric Evaluation, Simple Shoulder Test, and Veterans RAND 36-Item Health Survey. Physical examination was conducted to determine postoperative range of motion and strength compared with the nonoperative shoulder. A cohort of 24 patients was identified, and of these, 17 patients (71%) completed the study at 2 years' follow-up. The average postoperative Constant score was 84.4; American Shoulder and Elbow Surgeons score, 75.5; Single Assessment Numeric Evaluation score, 73.1%; Simple Shoulder Test score, 9.2; and Veterans RAND 36-Item Health Survey score, 76.1. Postoperative range of motion of the operative shoulder returned to near that of the asymptomatic nonoperative shoulder. Workers' compensation status led to inferior results. Options for patients with a failed prior SLAP repair are limited. As a salvage operation for failed SLAP repair, biceps tenodesis serves the majority of patients well, with favorable outcomes by validated measures and excellent shoulder range of motion and elbow strength at 2 years' follow-up. Workers' compensation status may predispose patients to poorer outcomes. Copyright © 2014 Journal of Shoulder and Elbow Surgery Board

  6. [Usher syndrome: clinical features, diagnostic options, and therapeutic prospects].

    Science.gov (United States)

    Seeliger, M W; Fischer, M D; Pfister, M

    2009-06-01

    Usher syndrome denotes a clinically and genetically heterogeneous combination of retinitis pigmentosa and sensorineural deafness. The division into subtypes I, II, and III is based on the degree of hearing loss: Type I is characterized by deafness from birth together with ataxia and retarded motor development, type II by a stationary deafness of a moderate degree, and type III by a progressive deafness with adult onset. In Germany, Usher syndrome currently bears particular relevance because in January 2009 a new compulsory screening of auditory function in newborn infants was introduced. Consequently, it can be expected that a higher number of patients with Usher syndrome will be identified in early childhood and referred to ophthalmologists. The focus of this work is to introduce the typical clinical picture of Usher syndrome, summarize diagnostic options, and give an overview of therapeutic strategies.

  7. Merkel Cell Carcinoma: Chemotherapy and Emerging New Therapeutic Options

    International Nuclear Information System (INIS)

    Desch, L.; Kunstfeld, R.

    2013-01-01

    Merkel cell carcinoma (MCC) is a rare neuroendocrine skin tumor that typically occurs in elderly, immunosuppressed patients. Infection with Merkel cell virus (MCV) and immunosuppression play an important role in the development of MCC. Different staging systems make it difficult to compare the existing clinical data. Furthermore, there predominantly exist single case reports and case series, but no randomized controlled trials. However, it is necessary to develop further therapy options because MCC tends to grow rapidly and metastasizes early. In the metastatic disease, therapeutic attempts were made with various chemotherapeutic combination regimens. Because of the high toxicity of these combinations, especially those established in SCLC, and regarding the unsatisfying results, the challenge is to balance the pros and cons of chemotherapy individually and carefully. Up to now, emerging new therapy options as molecular-targeted agents, for example, pipebuzone, imatinib, or somatostatin analogues as well as immunologic als, for example, imiquimod and interferons, also showed less success concerning the disease-free response rates. According to the literature, neither chemotherapy nor molecular-targeted agents or immunotherapeutic strategies have shown promising effects in the therapy of the metastatic disease of MCC so far. There is a great demand for randomized controlled studies and a need for an MCC registry and multicenter clinical trials due to the tumors curiosity.

  8. Skewed Epigenetics: An Alternative Therapeutic Option for Diabetes Complications

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    Gabriele Togliatto

    2015-01-01

    Full Text Available Vascular complications are major causes of morbidity and mortality in type 2 diabetes patients. Mitochondrial reactive oxygen species (ROS generation and a lack of efficient antioxidant machinery, a result of hyperglycaemia, mainly contribute to this problem. Although advances in therapy have significantly reduced both morbidity and mortality in diabetic individuals, diabetes-associated vascular complications are still one of the most challenging health problems worldwide. New healing options are urgently needed as current therapeutics are failing to improve long-term outcomes. Particular effort has recently been devoted to understanding the functional relationship between chromatin structure regulation and the persistent change in gene expression which is driven by hyperglycaemia and which accounts for long-lasting diabetic complications. A detailed investigation into epigenetic chromatin modifications in type 2 diabetes is underway. This will be particularly useful in the design of mechanism-based therapeutics which interfere with long-lasting activating epigenetics and improve patient outcomes. We herein provide an overview of the most relevant mechanisms that account for hyperglycaemia-induced changes in chromatin structure; the most relevant mechanism is called “metabolic memory.”

  9. Phytoestrogens: a viable option?

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    Russell, Lori; Hicks, G Swink; Low, Annette K; Shepherd, Jinna M; Brown, C Andrew

    2002-10-01

    Estrogen replacement therapy is one of the most commonly prescribed medicines in the United States by traditional medical professionals. Over the past decade, the market for complementary/ alternative therapies for hormone replacement has dramatically increased. Women are seeking more "natural" alternatives to treat menopausal symptoms. Well-designed randomized clinical trials are often lacking, as is the information on efficacy and safety. This article will review several popular herbal therapies for menopausal symptoms including phytoestrogens, black cohosh (Cimicifuga racemosa), dong quai (Angelica sinensis), chast tree (Vitex agnus-castus), and wild Mexican yam. Their use, mechanism of action, and adverse effects are outlined.

  10. Rectal cancer and Fournier's gangrene - current knowledge and therapeutic options.

    Science.gov (United States)

    Bruketa, Tomislav; Majerovic, Matea; Augustin, Goran

    2015-08-14

    Fournier's gangrene (FG) is a rapid progressive bacterial infection that involves the subcutaneous fascia and part of the deep fascia but spares the muscle in the scrotal, perianal and perineal region. The incidence has increased dramatically, while the reported incidence of rectal cancer-induced FG is unknown but is extremely low. Pathophysiology and clinical presentation of rectal cancer-induced FG per se does not differ from the other causes. Only rectal cancer-specific symptoms before presentation can lead to the diagnosis. The diagnosis of rectal cancer-induced FG should be excluded in every patient with blood on digital rectal examination, when urogenital and dermatological causes are excluded and when fever or sepsis of unknown origin is present with perianal symptomatology. Therapeutic options are more complex than for other forms of FG. First, the causative rectal tumor should be removed. The survival of patients with rectal cancer resection is reported as 100%, while with colostomy it is 80%. The preferred method of rectal resection has not been defined. Second, oncological treatment should be administered but the timing should be adjusted to the resolution of the FG and sometimes for the healing of plastic reconstructive procedures that are commonly needed for the reconstruction of large perineal, scrotal and lower abdominal wall defects.

  11. Current Nondopaminergic Therapeutic Options for Motor Symptoms of Parkinson's Disease

    Institute of Scientific and Technical Information of China (English)

    Juan-Juan Du; Sheng-Di Chen

    2017-01-01

    Objective:The aim of this study was to summarize recent studies on nondopaminergic options for the treatment of motor symptoms in Parkinson's disease (PD).Data Sources:Papers in English published in PubMed,Cochrane,and Ovid Nursing databases between January 1988 and November 2016 were searched using the following keywords:PD,nondopaminergic therapy,adenosine,glutamatergic,adrenergic,serotoninergic,histaminic,and iron chelator.We also reviewed the ongoing clinical trials in the website of clinicaltrials.gov.Study Selection:Articles related to the nondopaminergic treatment of motor symptoms in PD were selected for this review.Results:PD is conventionally treated with dopamine replacement strategies,which are effective in the early stages of PD.Long-term use oflevodopa could result in motor complications.Recent studies revealed that nondopaminergic systems such as adenosine,glutamatergic,adrenergic,serotoninergic,histaminic,and iron chelator pathways could include potential therapeutic targets for motor symptoms,including motor fluctuations,levodopa-induced dyskinesia,and gait disorders.Some nondopaminergic drugs,such as istradefylline and amantadine,are currently used clinically,while most such drugs are in preclinical testing stages.Transitioning of these agents into clinically beneficial strategies requires reliable evaluation since several agents have failed to show consistent results despite positive findings at the preclinical level.Conclusions:Targeting nondopaminergic transmission could improve some motor symptoms in PD,especially the discomfort ofdyskinesia.Although nondopaminergic treatments show great potential in PD treatment as an adjunct therapy to levodopa,further investigation is required to ensure their success.

  12. Graves' disease. Manifestations and therapeutic options

    Energy Technology Data Exchange (ETDEWEB)

    McFarland, K.F.; Saleeby, G.

    1988-03-01

    Graves' disease is the most common cause of hyperthyroidism. Clinical features include thyroid enlargement, eye signs, tachycardia, heat intolerance, emotional lability, weight loss, and hyperkinesis. Three modes of therapy are available. The preferences of the patient and physician are usually prime considerations in devising the therapeutic plan. Radioactive iodine is the most frequently used and safest method of treatment for adults. Antithyroid drugs are preferred for children and pregnant women. Surgery is usually reserved for patients in whom the other forms of treatment are not acceptable. Considerable patient education during the decision-making process enhances the success of the therapeutic plan.

  13. Therapeutic options in chronic heart failure. Findings on chest X-ray

    International Nuclear Information System (INIS)

    Granitz, M.R.; Meissnitzer, T.; Meissnitzer, M.W.; Hergan, K.; Altenberger, J.; Granitz, C.

    2016-01-01

    The contribution covers drugless therapeutic options for chronic heart failure: the implantable cardioverter/defibrillator (ICD), the cardiac resynchronization therapy (CRT), the interventional catheter treatment of functional mitral insufficiency, and mechanical heart supporting systems and heart transplantation.

  14. Therapeutic antibodies as a treatment option for dengue fever.

    Science.gov (United States)

    Chan, Kuan Rong; Ong, Eugenia Z; Ooi, Eng Eong

    2013-11-01

    Dengue fever is the most prevalent mosquito-borne viral disease globally with about 100 million cases of acute dengue annually. Severe dengue infection can result in a life-threatening illness. In the absence of either a licensed vaccine or antiviral drug against dengue, therapeutic antibodies that neutralize dengue virus (DENV) may serve as an effective medical countermeasure against severe dengue. However, therapeutic antibodies would need to effectively neutralize all four DENV serotypes. It must not induce antibody-dependent enhancement of DENV infection in monocytes/macrophages through Fc gamma receptor (FcγR)-mediated phagocytosis, which is hypothesized to increase the risk of severe dengue. Here, we review the strategies and technologies that can be adopted to develop antibodies for therapeutic applications. We also discuss the mechanism of antibody neutralization in the cells targeted by DENV that express Fc gamma receptor. These studies have provided significant insight toward the use of therapeutic antibodies as a potentially promising bulwark against dengue.

  15. Emerging therapeutic options for sporadic inclusion body myositis

    Directory of Open Access Journals (Sweden)

    Alfano LN

    2015-09-01

    Full Text Available Lindsay N Alfano, Linda P Lowes Nationwide Children’s Hospital, Center for Gene Therapy, Columbus, OH, USA Abstract: Sporadic inclusion body myositis is the most common inflammatory muscle disorder preferentially affecting males over the age of 40 years. Progressive muscle weakness of the finger flexors and quadriceps muscles results in loss of independence with activities of daily living and eventual wheelchair dependence. Initial signs of disease are often overlooked and can lead to mis- or delayed diagnosis. The underlying cause of disease is unknown, and disease progression appears refractory to available treatment options. This review discusses the clinical presentation of inclusion body myositis and the current efforts in diagnosis, and focuses on the current state of research for both nonpharmacological and pharmacological treatment options for this patient group. Keywords: myositis, inclusion body myositis, inflammatory myopathy, treatment, function, outcomes

  16. Therapeutic Options in Idiopathic Burning Mouth Syndrome: Literature Review

    OpenAIRE

    Miziara, Ivan; Chagury, Azis; Vargas, Camila; Freitas, Ludmila; Mahmoud, Ali

    2014-01-01

    Introduction Burning mouth syndrome (BMS) is characterized by a burning sensation in the tongue, palate, lips, or gums of no well-defined etiology. The diagnosis and treatment for primary BMS are controversial. No specific laboratory tests or diagnostic criteria are well established, and the diagnosis is made by excluding all other possible disorders.Objective To review the literature on the main treatment options in idiopathic BMS and compare the best results of the main studies in 15 years....

  17. [Female androgenetic alopecia, a survey of causes and therapeutic options].

    Science.gov (United States)

    Duchková, Hana; Hašková, Marta

    2015-01-01

    Mesotherapy is one of the options for the treatment of androgenetic alopecia. Testing 24 women with androgenetic alopecia has demonstrated a positive effect of mesotherapy on the hair growth, hair thickness, with only insignificant increase of hair density. It is known that androgenetic alopecia represents a localized aging of hair follicles. We therefore decided to examine the different effects of mesotherapy on hair density in younger and in elderly women. In younger women mesotherapy significantly increased hair density compared with older women. For mesotherapy we used a combination of micronutrients and antioxidants. Mesotherapy achievements were evident for 6-12 months. Treatment requires a long-term care.

  18. Is tetrahydrobiopterin a therapeutic option in diabetic hypertensive patients?

    Directory of Open Access Journals (Sweden)

    Alberto Francisco Rubio-Guerra

    2010-09-01

    Full Text Available Alberto Francisco Rubio-Guerra1, Hilda Vargas-Robles2, Luz Maria Ramos-Brizuela1, Bruno Alfonso Escalante-Acosta21Metabolic Clinic, Hospital General de Ticomán SS DF, Mexico; 2Department of Molecular Biomedicine, Centro de Investigacion y de Estudios Avanzados del IPN, MexicoAbstract: Nitric oxide (NO is an important regulator of vascular tone, and is also an antithrombotic, anti-inflammatory, antiproliferative, and antiatherogenic factor. Endothelial function is altered in patients with coronary artery disease, stroke, and peripheral artery disease, and endothelial dysfunction correlates with the risk factor profile for a patient. Hypertension and type 2 diabetes are risk factors for vascular disease, and are both pathologies characterized by loss of NO activity. Indeed, endothelial dysfunction is usually present in diabetic and/or hypertensive patients. Tetrahydrobiopterin is an essential cofactor for the NO synthase enzyme, and insufficiency of this cofactor leads to uncoupling of the enzyme, release of superoxide, endothelial dysfunction, progression of hypertension, and finally, proatherogenic effects. Tetrahydrobiopterin is also an important mediator of NO synthase regulation in type 2 diabetes and hypertension, and may be a rational therapeutic target to restore endothelial function and prevent vascular disease in these patients. The aim of this paper is to review the rationale for therapeutic strategies directed to biopterins as a target for vascular disease in type 2 diabetic hypertensive patients.Keywords: tetrahydrobiopterin, endothelial dysfunction, diabetes, hypertension, oxidative stress, nitric oxide, eNOS synthase uncoupling

  19. Novel therapeutic options for relapsed hairy cell leukemia.

    Science.gov (United States)

    Jain, Preetesh; Polliack, Aaron; Ravandi, Farhad

    2015-01-01

    The majority of patients with hairy cell leukemia (HCL) achieve a response to therapy with cladribine or pentostatin with or without rituximab. However, late relapses can occur. Treatment of relapsed HCL can be difficult due to a poor tolerance to chemotherapy, increased risk of infections and decreased responsiveness to chemotherapy. The identification of BRAFV600E mutations and the role of aberrant MEK kinase and Bruton's tyrosine kinase (BTK) pathways in the pathogenesis of HCL have helped to develop novel targeted therapies for these patients. Currently, the most promising therapeutic strategies for relapsed or refractory HCL include recombinant immunoconjugates targeting CD22 (e.g. moxetumomab pasudotox), BRAF inhibitors such as vemurafenib and B cell receptor signaling kinase inhibitors such as ibrutinib. Furthermore, the VH4-34 molecular variant of classic HCL has been identified to be less responsive to chemotherapy. Herein, we review the results of the ongoing clinical trials and potential future therapies for relapsed/refractory HCL.

  20. New therapeutic options for the metabolic syndrome: what's next?

    Science.gov (United States)

    Flordellis, Christodoulos S; Ilias, Ioannis; Papavassiliou, Athanasios G

    2005-08-01

    The metabolic syndrome (MSX), characterized by obesity, insulin resistance, dyslipidemia and hypertension, increases the risk of cardiovascular morbidity and mortality. It has recently been hypothesized that MSX and type 2 diabetes are caused by triglyceride and long-chain fatty acid accumulation in liver, muscle, pancreatic islets and selected brain areas. This lipocentric approach is integrated with analysis of inflammation associated with end-organ damage, including the vascular wall. Genes and proteins contributing to insulin resistance, beta cell dysfunction and vascular wall damage have been identified. Transcription factors and coactivators, including peroxisome proliferator-activated receptor gamma (PPARgamma) coactivator-1 are crucial in mediating insulin resistance and accelerating vascular wall inflammation, and represent promising therapeutic targets. New pharmacological strategies include dual PPARalpha/gamma agonists, drugs with pleiotropic effects or combination therapies.

  1. The potential for emerging therapeutic options for Clostridium difficile infection

    Science.gov (United States)

    Mathur, Harsh; Rea, Mary C; Cotter, Paul D; Ross, R Paul; Hill, Colin

    2014-01-01

    Clostridium difficile is mainly a nosocomial pathogen and is a significant cause of antibiotic-associated diarrhea. It is also implicated in the majority of cases of pseudomembranous colitis. Recently, advancements in next generation sequencing technology (NGS) have highlighted the extent of damage to the gut microbiota caused by broad-spectrum antibiotics, often resulting in C. difficile infection (CDI). Currently the treatment of choice for CDI involves the use of metronidazole and vancomycin. However, recurrence and relapse of CDI, even after rounds of metronidazole/vancomycin administration is a problem that must be addressed. The efficacy of alternative antibiotics such as fidaxomicin, rifaximin, nitazoxanide, ramoplanin and tigecycline, as well as faecal microbiota transplantation has been assessed and some have yielded positive outcomes against C. difficile. Some bacteriocins have also shown promising effects against C. difficile in recent years. In light of this, the potential for emerging treatment options and efficacy of anti-C. difficile vaccines are discussed in this review. PMID:25564777

  2. Distance Learning: A Viable Option for Professional Development for Teachers of Students with Autism Spectrum Disorder in China

    Science.gov (United States)

    Simpson, Lisa A.; Qi, Sharon; He, Kan; Tao, Qing Qing

    2015-01-01

    Identifying students with ASD in the People's Republic of China (PRC) has lagged behind western countries, particularly the United States. Families often have to travel long distances to obtain a diagnosis and then are faced with few treatment options once the diagnosis is made. Recent laws governing special education in the PRC do not…

  3. Therapeutic Options for Controlling Fluids in the Visual System

    Science.gov (United States)

    Curry, Kristina M.; Wotring, Virginia E.

    2014-01-01

    Visual Impairment/Intracranial Pressure (VIIP) is a newly recognized risk at NASA. The VIIP project examines the effect of long-term exposure to microgravity on vision of crewmembers before and after they return to Earth. Diamox (acetazolamide) is a medication which is used to decrease intraocular pressure; however, it carries a 3% risk of kidney stones. Astronauts are at a higher risk of kidney stones during spaceflight and the use Diamox would only increase the risk; therefore alternative therapies were investigated. Histamine 2 (H2) antagonist acid blockers such as cimetidine, ranitidine, famotidine and nizatidine are typically used to relieve the symptoms of gastroesophageal reflux disease (GERD). H2 receptors have been found in the human visual system, which has led to research on the use of H2 antagonist blockers to control fluid production in the human eye. Another potential therapeutic strategy is targeted at aquaporins, which are water channels that help maintain fluid homeostasis. Aquaporin antagonists are also known to affect intracranial pressure which can in turn alter intraocular pressure. Studies on aquaporin antagonists suggest high potential for effective treatment. The primary objective of this investigation is to review existing research on alternate medications or therapy to significantly reduce intracranial and intraocular pressure. A literature review was conducted. Even though we do not have all the answers quite yet, a considerable amount of information was discovered, and findings were narrowed, which should allow for more conclusive answers to be found in the near future.

  4. Breast cancer. Nuclear medicine in diagnosis and therapeutic options

    International Nuclear Information System (INIS)

    Bombardieri, E.; Bonadonna, G.; Gianni, L.

    2008-01-01

    Brings up-to-date nuclear medical knowledge in breast cancer. Includes vital information on advances in the field of diagnosis. Supplies data on the development of some new modalities. Offers a general overview of the available tools for breast cancer treatment. There can never be enough material in the public domain about cancers, and particularly breast cancer. This book adds much to the literature. It provides general information on breast cancer management and considers all new methods of diagnosis and therapy. It focuses on nuclear medicine modalities by comparing their results with other diagnostic and therapeutic approaches. The coverage provides readers with up-to-date knowledge on breast cancer as well as information on the advances in the field of diagnosis. It also details data on the development of some new modalities and provides a general overview of the available tools for breast cancer treatment. In sum, it is a hugely useful text that performs a dual function. Not only does it provide practitioners of all descriptions with a vital overview of the current state of play in breast cancer treatment, but it also lays out in a beautifully structured way the latest diagnostic methodologies. (orig.)

  5. Acquired thrombotic thrombocytopenic purpura: new therapeutic options and their optimal use.

    Science.gov (United States)

    Cataland, S R; Wu, H M

    2015-06-01

    Advances in our understanding of the pathophysiology of both congenital and acquired thrombotic thrombocytopenic purpura (TTP) have led to both an increased understanding of the disease and novel approaches to therapy. The efficacy of rituximab in acquired TTP has led to consideration of rituximab as a prophylactic therapy to prevent relapse of TTP. Novel therapies that target the A1 domain of von Willebrand factor (VWF) to block the formation of microthrombotic disease have also entered clinical study and have demonstrated promise as potential therapeutic options. Additionally, a recombinant ADAMTS13 protease has been developed which may be an important therapeutic option for both congenital and acquired TTP. The development of these new therapeutic options for patients diagnosed with TTP has increased the importance of conducting prospective, randomized studies with these agents to both confirm their efficacy and more importantly understand their most appropriate role in the treatment of patients with TTP. © 2015 International Society on Thrombosis and Haemostasis.

  6. Herbal Medicine Offered as an Initiative Therapeutic Option for the Management of Hepatocellular Carcinoma.

    Science.gov (United States)

    Chen, Shao-Ru; Qiu, Hong-Cong; Hu, Yang; Wang, Ying; Wang, Yi-Tao

    2016-06-01

    Hepatocellular carcinoma (HCC) is a common malignant cancer and is the third leading cause of death worldwide. Effective treatment of this disease is limited by the complicated molecular mechanism underlying HCC pathogenesis. Thus, therapeutic options for HCC management are urgently needed. Targeting the Wnt/β-catenin, Hedgehog, Notch, and Hippo-YAP signaling pathways in cancer stem cell development has been extensively investigated as an alternative treatment. Herbal medicine has emerged as an initiative therapeutic option for HCC management because of its multi-level, multi-target, and coordinated intervention effects. In this article, we summarized the recent progress and clinical benefits of targeting the above mentioned signaling pathways and using natural products such as herbal medicine formulas to treat HCC. Proving the clinical success of herbal medicine is expected to deepen the knowledge on herbal medicine efficiency and hasten the adoption of new therapies. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

  7. Therapeutic Success of the Ketogenic Diet as a Treatment Option for Epilepsy: a Meta-analysis

    Science.gov (United States)

    Li, Hai-feng; Zou, Yan; Ding, Gangqiang

    2013-01-01

    Objective To systematically evaluate therapeutic success of the ketogenic diet (KD) as a treatment option for epilepsy. Methods Using MEDLINE and Google Scholar search, we searched for studies investigating the therapeutic success of ketogenic diet for epilepsy. We estimated therapeutic success rate for ketogenic diet as a treatment option for epilepsy and its 95% CIs using generic inverse variance method. Findings A total of 38 studies met the inclusion criteria. In retrospective studies, the weighted success rate of the patients who take the KD as a treatment option for epilepsy was 58.4% (95% confidence interval (95%CI)=48.7% – 69.9%) at 3 months (n=336); 42.8% (95%CI =36.3% – 50.3%) at 6 months (n=492), and 30.1% (95%CI =24.3% – 37.2%) at 12 months (n=387); in prospective studies, weighted success rate was 53.9% (95%CI 45.5% – 63.8%) at 3 months (n=474); 53.2% (95%CI =44.0% – 64.2%) at 6 months (n=321), and 55.0% (95%CI =45.9% – 65.9%) at 12 months (n=347). Conclusion This meta-analysis provides formal statistical support for the efficacy of the ketogenic diet in the treatment of epileptic patients. PMID:24910737

  8. Therapeutic options in pediatric non alcoholic fatty liver disease: current status and future directions

    Directory of Open Access Journals (Sweden)

    Vajro Pietro

    2012-10-01

    Full Text Available Abstract The epidemics of overweight and obesity has resulted in a significant increase of non alcoholic fatty liver disease (NAFLD, a potentially progressive condition. Currently, obesity related hepatopathy represents therefore the main cause of pediatric chronic liver disease. The first choice treatment at all ages is weight loss and/or lifestyle changes, however compliance is very poor and a pharmacological approach has become necessary. In the present article we present a systematic literature review focusing on established pediatric NALFD drugs (ursodeoxycholic acid, insulin sensitizers, and antioxidants and on innovative therapeutic options as well. Regarding the former ones, a pediatric pilot study highlighted that ursodeoxycholic acid is not efficient on transaminases levels and bright liver. Similarly, a recent large scale, multicenter randomized clinical trial (TONIC study showed that also insulin sensitizers and antioxidant vitamin E have scarce effects on serum transaminase levels. Among a large series of novel therapeutic approaches acting on recently proposed different pathomechanisms, probiotics seem hitherto the most interesting and reasonable option for their safety and tolerability. Toll-like receptors modifiers, Pentoxifylline, and Farnesoid X receptors agonists have been still poorly investigated, and will need further studies before becoming possible promising innovative therapeutic strategies.

  9. Therapeutic options to manage bleeding in a dentist’s office

    Science.gov (United States)

    Rostetter, Claudio; Finkenstädt, Tim; Rücker, Martin; Lübbers, Heinz-Theo

    2018-06-18

    This manuscript provides an overview of therapeutic options for the problem of bleeding in a dentist’s office. Bleeding after tooth extraction is a very common finding in dental medicine and persistent blood in the mouth is obviously uncomfortable and sometimes terrifying for the patient. Most bleedings can be stopped simply with compression, in some cases a homeostatic therapy is necessary. For local compression, a swab with tranexamic acid is useful. If local compression is not sufficient, sutures are often an option. A very effective therapy would also be Tabotamp®, a local hemostypticum which is placed onto the bleeding and should increase the thrombocytic aggregation. In the worst case Floseal®, a human Thrombin, can be placed locally. It stops the bleeding very fast and sufficiently.

  10. [Epigenetic regulations and cerebral plasticity: towards new therapeutic options in neurodegenerative diseases?

    Science.gov (United States)

    Merienne, Karine; Boutillier, Anne-Laurence

    2016-01-01

    Although revealed in the 1950's, epigenetics is still a fast-growing field. Its delineations continuously evolve and become clarified. In particular, "neuroepigenetics", a notion that encompasses epigenetic regulations associated with neuronal processes, appears very promising. Indeed, the challenge to be undertaken in this sub-field is double. On the one hand, it should bring molecular comprehension of specific neuronal processes, some of them falling within the long term regulations, such as learning and memory. On the other hand, it could bring therapeutic options for brain diseases, e.g. neurodegenerative diseases such as Alzheimer's or Huntington's diseases. © Société de Biologie, 2017.

  11. Utilization of Cell-Transfer Technique for Molecular Testing on Hematoxylin-Eosin-Stained Sections: A Viable Option for Small Biopsies That Lack Tumor Tissues in Paraffin Block.

    Science.gov (United States)

    Wu, Howard H; Jovonovich, Stephen M; Randolph, Melissa; Post, Kristin M; Sen, Joyashree D; Curless, Kendra; Cheng, Liang

    2016-12-01

    - In some instances the standard method of doing molecular testing from formalin-fixed, paraffin-embedded block is not possible because of limited tissue. Tumor cell-enriched cell-transfer technique has been proven useful for performing immunocytochemistry and molecular testing on cytologic smears. - To establish the cell-transfer technique as a viable option for isolating tumor cells from hematoxylin-eosin (H&E)-stained slides. - Molecular testing was performed by using the cell-transfer technique on 97 archived H&E-stained slides from a variety of different tumors. Results were compared to the conventional method of molecular testing. - Polymerase chain reaction-based molecular testing via the cell-transfer technique was successfully performed on 82 of 97 samples (85%). This included 39 of 47 cases for EGFR, 10 of 11 cases for BRAF, and 33 of 39 cases for KRAS mutations. Eighty-one of 82 cell-transfer technique samples (99%) showed agreement with previous standard method results, including 4 mutations and 35 wild-type alleles for EGFR, 4 mutations and 6 wild-type alleles for BRAF, and 11 mutations and 21 wild-type alleles for KRAS. There was only 1 discrepancy: a cell-transfer technique with a false-negative >KRAS result (wild type versus G12C). - Molecular testing performed on H&E-stained sections via cell-transfer technique is useful when tissue from cell blocks and small surgical biopsy samples is exhausted and the only available material for testing is on H&E-stained slides.

  12. Hereditary angioedema as a metabolic liver disorder: novel therapeutic options and prospects for cure

    Directory of Open Access Journals (Sweden)

    Rohan Ameratuga

    2016-11-01

    Full Text Available Hereditary angioedema (HAE is a rare autosomal dominant disorder caused by mutations of the SERPING1 or the Factor 12 genes. It is potentially fatal, particularly if not identified at an early stage. Apart from androgens, which are contraindicated in children and in pregnant women, a range of effective, albeit very expensive treatments have recently become available for HAE patients. The cost of these new treatments is beyond the reach of most developing countries. At this time, there is no cure for the disorder. In spite of mutations of the SERPING1 gene, autoimmunity and infections are not prominent features of the condition. Here we present the argument that HAE should be viewed primarily as a metabolic liver disorder. This conceptual paradigm shift will stimulate basic research and may facilitate new therapeutic approaches to HAE outlined in this paper. We suggest several novel potential treatment options for HAE from the perspectives of clinical immunology, molecular biology and liver transplantation. Many of these offer the prospect of curing the disorder. The effectiveness of these options are rapidly improving in many cases and their risks are decreasing. Given the very high costs of treating HAE, some of these curative options may become feasible in the next decade.

  13. Buffer-free therapeutic antibody preparations provide a viable alternative to conventionally buffered solutions: from protein buffer capacity prediction to bioprocess applications.

    Science.gov (United States)

    Bahrenburg, Sven; Karow, Anne R; Garidel, Patrick

    2015-04-01

    Protein therapeutics, including monoclonal antibodies (mAbs), have significant buffering capacity, particularly at concentrations>50 mg/mL. This report addresses pH-related issues critical to adoption of self-buffered monoclonal antibody formulations. We evaluated solution conditions with protein concentrations ranging from 50 to 250 mg/mL. Samples were both buffer-free and conventionally buffered with citrate. Samples were non-isotonic or adjusted for isotonicity with NaCl or trehalose. Studies included accelerated temperature stability tests, shaking stability studies, and pH changes in infusion media as protein concentrate is added. We present averaged buffering slopes of capacity that can be applied to any mAb and present a general method for calculating buffering capacity of buffer-free, highly concentrated antibody liquid formulations. In temperature stability tests, neither buffer-free nor conventionally buffered solution conditions showed significant pH changes. Conventionally buffered solutions showed significantly higher opalescence than buffer-free ones. In general, buffer-free solution conditions showed less aggregation than conventionally buffered solutions. Shaking stability tests showed no differences between buffer-free and conventionally buffered solutions. "In-use" preparation experiments showed that pH in infusion bag medium can rapidly approximate that of self-buffered protein concentrate as concentrate is added. In summary, the buffer capacity of proteins can be predicted and buffer-free therapeutic antibody preparations provide a viable alternative to conventionally buffered solutions. Copyright © 2015 WILEY-VCH Verlag GmbH & Co. KGaA, Weinheim.

  14. Current Therapeutic Options for Esophageal Motor Disorders as Defined by the Chicago Classification.

    Science.gov (United States)

    Zerbib, Frank; Roman, Sabine

    2015-07-01

    With the development of high-resolution manometry and specific metrics to characterize esophageal motility, the Chicago Classification has become the gold standard for the diagnosis of esophageal motor disorders. Major and significant disorders, that is, never observed in healthy subjects, are achalasia, esophagogastric junction outflow obstruction, distal esophageal spasm, absent peristalsis, and hypercontractile (Jackhammer) esophagus. Achalasia subtyping is relevant to predict the response to endoscopic and surgical therapies as several studies suggest that, pneumatic dilation is less effective than Heller myotomy, in type III achalasia. Peroral endoscopic myotomy, initially developed in expert centers, is a promising technique for the treatment of achalasia. The medical therapeutic options for distal esophageal spasm and hypercontractile esophagus are smooth muscle relaxants and pain modulators. Intraesophageal injection of botulinum toxin might be an interesting option for treatment of these disorders but further studies are required to determine the optimal injection protocol and the best candidates based on manometric patterns. The treatment of hypotensive motility disorders is disappointing and relies mainly on dietary and lifestyle changes as no effective esophageal prokinetic is currently available.

  15. SGLT2 inhibitors: a promising new therapeutic option for treatment of type 2 diabetes mellitus.

    Science.gov (United States)

    Misra, Monika

    2013-03-01

    Hyperglycemia is an important pathogenic component in the development of microvascular and macrovascular complications in type 2 diabetes mellitus. Inhibition of renal tubular glucose reabsorption that leads to glycosuria has been proposed as a new mechanism to attain normoglycemia and thus prevent and diminish these complications. Sodium glucose cotransporter 2 (SGLT2) has a key role in reabsorption of glucose in kidney. Competitive inhibitors of SGLT2 have been discovered and a few of them have also been advanced in clinical trials for the treatment of diabetes. To discuss the therapeutic potential of SGLT2 inhibitors currently in clinical development. A number of preclinical and clinical studies of SGLT2 inhibitors have demonstrated a good safety profile and beneficial effects in lowering plasma glucose levels, diminishing glucotoxicity, improving glycemic control and reducing weight in diabetes. Of all the SGLT2 inhibitors, dapagliflozin is a relatively advanced compound with regards to clinical development. SGLT2 inhibitors are emerging as a promising therapeutic option for the treatment of diabetes. Their unique mechanism of action offers them the potential to be used in combination with other oral anti-diabetic drugs as well as with insulin. © 2012 The Author. JPP © 2012 Royal Pharmaceutical Society.

  16. Lumbar sympathectomy under CT guidance: therapeutic option in critical limb ischaemia

    International Nuclear Information System (INIS)

    Pieri, Stefano; Agresti, Paolo; Di Cesare, Fabio; Ricci, Guiseppe

    2005-01-01

    Purpose: Lumbar sympathectomy is a complementary therapeutic option for patients with severe peripheral vascular occlusive disease presenting rest pain or gangrene and not eligible for surgical revascularisation. Traditional surgical sympathectomy was widely used in the past. However, due to its invasive character, it has increasingly been replaced by percutaneous techniques and, in some recent cases, by laparoscopic procedures. Percutaneous lumbar sympathectomy is a safe, cost-effective and widely available treatment option. We report our experience on 19 patients subjected to percutaneous sympathectomy under CT guidance. Materials and methods: Between 1998 and 2000, 19 patients underwent percutaneous sympathectomy under CT guidance. All patients had severe vascular disease of the lower extremities (Fontaine stage IV), with rest pain and gangrene. They were not eligible for surgical revascularization. Phenol was injected at the level of L2 and L4 using two 22 G needles (15 cm long). Signs of interrupted sympathetic activity usually occur 2'-15' after the procedure with warmth and flushing and dryness of the lower extremities. Results: Percutaneous sympathectomy under CT guidance is a simple, safe and well-tolerated procedure with a low rate of complications. Of the 19 patients, 9 (47.3%) showed clinical improvement, whereas 5 experienced a worsening of ischaemia in the month immediately following the procedure. Discussion: Results suggest that percutaneous lumbar sympathectomy causes a sympathetic blockade in patients with advanced vascular disease of the limb. CT guidance ensures a high level of precision in drug dosing, thus lowering the risk of complications. Although the results are demoralizing. the impossibility of achieving surgical revascularisation in advanced peripheral arteriosclerosis enhances the role of Ct-guided percutaneous sympathectomy in relieving rest pain and healing ulcers in order to postpone the amputation [it

  17. Intermittent Massage as a Therapeutic Option for Compartment Syndrome after Embolectomy of the Lower Limbs

    Directory of Open Access Journals (Sweden)

    José Maria Pereira de Godoy

    2018-01-01

    Full Text Available The case of a 54-year-old cardiac patient is reported, who was admitted to hospital with a complaint of sudden pain in the legs associated with edema, paresthesia, and coldness. Arterial embolism of the lower limbs was diagnosed and the patient was submitted to bilateral embolectomy. The patient evolved with a burning sensation, hypersensitivity in the right leg, swelling, and difficulty bending and stretching the sole of the foot and the knee. A physical examination detected edema and increased tension in the anterior, lateral, and posterior compartments. Treatment using intermittent massage of the leg during the evaluation of the patient was chosen in an attempt to stimulate lymphatic and venous drainage. After a few minutes of stimulation, there was significant improvement in the pain and edema. In 40 minutes, there was total reduction of the pain in the posterior and lateral compartments and improvement of over 50% in the anterior compartment. After this, the patient started to bend the knee without pain and bend the sole of the foot with slight pain. On the following day, the patient was walking around the hospital ward without difficulty. It seems that intermittent massage is a therapeutic option in selected cases of compartment syndrome.

  18. Addressing Therapeutic Options for Ebola Virus Infection in Current and Future Outbreaks.

    Science.gov (United States)

    Haque, Azizul; Hober, Didier; Blondiaux, Joel

    2015-10-01

    Ebola virus can cause severe hemorrhagic disease with high fatality rates. Currently, no specific therapeutic agent or vaccine has been approved for treatment and prevention of Ebola virus infection of humans. Although the number of Ebola cases has fallen in the last few weeks, multiple outbreaks of Ebola virus infection and the likelihood of future exposure highlight the need for development and rapid evaluation of pre- and postexposure treatments. Here, we briefly review the existing and future options for anti-Ebola therapy, based on the data coming from rare clinical reports, studies on animals, and results from in vitro models. We also project the mechanistic hypotheses of several potential drugs against Ebola virus, including small-molecule-based drugs, which are under development and being tested in animal models or in vitro using various cell types. Our paper discusses strategies toward identifying and testing anti-Ebola virus properties of known and medically approved drugs, especially those that can limit the pathological inflammatory response in Ebola patients and thereby provide protection from mortality. We underline the importance of developing combinational therapy for better treatment outcomes for Ebola patients. Copyright © 2015, American Society for Microbiology. All Rights Reserved.

  19. Rectal cancer and Fournier’s gangrene - current knowledge and therapeutic options

    Science.gov (United States)

    Bruketa, Tomislav; Majerovic, Matea; Augustin, Goran

    2015-01-01

    Fournier’s gangrene (FG) is a rapid progressive bacterial infection that involves the subcutaneous fascia and part of the deep fascia but spares the muscle in the scrotal, perianal and perineal region. The incidence has increased dramatically, while the reported incidence of rectal cancer-induced FG is unknown but is extremely low. Pathophysiology and clinical presentation of rectal cancer-induced FG per se does not differ from the other causes. Only rectal cancer-specific symptoms before presentation can lead to the diagnosis. The diagnosis of rectal cancer-induced FG should be excluded in every patient with blood on digital rectal examination, when urogenital and dermatological causes are excluded and when fever or sepsis of unknown origin is present with perianal symptomatology. Therapeutic options are more complex than for other forms of FG. First, the causative rectal tumor should be removed. The survival of patients with rectal cancer resection is reported as 100%, while with colostomy it is 80%. The preferred method of rectal resection has not been defined. Second, oncological treatment should be administered but the timing should be adjusted to the resolution of the FG and sometimes for the healing of plastic reconstructive procedures that are commonly needed for the reconstruction of large perineal, scrotal and lower abdominal wall defects. PMID:26290629

  20. Autologous stem-cell transplantation in Hodgkin’s lymphoma: analysis of a therapeutic option

    Directory of Open Access Journals (Sweden)

    Adriano de Moraes Arantes

    2011-06-01

    Full Text Available Objective: To report the clinical progress of patients with Hodgkin’slymphoma treated with autologous transplantation after failure orrelapse of first-line treatment with chemotherapy and/or radiationtherapy. Methods: The results of a retrospective analysis of 31patients submitted to autologous transplantation as second-linetreatment, between April 2000 and December 2008, were analyzed.Fourteen men and seventeen women, with a median age of 27 years,were submitted to autologous transplantation for relapsed (n = 21or refractory (n = 10 Hodgkin’s lymphoma. Results: Mortalityrelated to treatment in the first 100 days after transplant was 3.2%.With a mean follow-up period of 18 months (range: 1 to 88 months,the probability of global survival and progression-free survival in18 months was 84 and 80%, respectively. The probability of globalsurvival and progression-free survival at 18 months for patients withchemosensitive relapses (n = 21 was 95 and 90%, respectively,versus 60 and 45% for patients with relapses resistant to chemotherapy(n = 10 (p = 0.001 for global survival; p = 0.003 for progressionfreesurvival. In the multivariate analysis, absence of disease or pretransplant disease < 5 cm were favorable factors for global survival (p= 0.02; RR: 0.072; 95%CI: 0.01-0.85 and progression-free survival (p= 0.01; RR: 0.040; 95%CI: 0.007-0.78. Conclusion: Autologous transplantation of stem-cells is a therapeutic option for Hodgkin’s lymphoma patients after the first relapse. Promising results were observed in patients with a low tumor burden at transplant.

  1. Intravaginal boric acid: is it an alternative therapeutic option for vaginal trichomoniasis?

    Science.gov (United States)

    Thorley, Nicola; Ross, Jonathan

    2017-12-09

    Trichomoniasis, caused by Trichomonas vaginalis (TV), is the most common curable sexually transmitted infection worldwide. Current guidance in the UK is to treat TV with a nitroimidazole antibiotic. The high prevalence of TV, high rate of antibiotic resistance and limited tolerability to nitroimidazoles suggest that alternative treatment regimens are needed. Intravaginal boric acid (BA) has been used safely for the treatment of candida vulvovaginitis and bacterial vaginosis, and in vitro studies suggest BA is active against TV. We review the evidence for the efficacy of BA in patients with TV. MEDLINE, EMBASE, CINAHL, AMED, HMIC and BNI and Grey literature databases, The Cochrane Library, Trial Registers, conference abstracts and proceedings were searched. Inclusion criteria were women aged 16 years or over with microbiological confirmation of TV infection and using BA as treatment. There were no restrictions on language, publication date or study design. The in vitro evidence for BA activity against TV was also reviewed. No randomised controlled trials or case series were found. Four case reports demonstrated TV clearance with BA using a variety of dose regimens (dose 600 mg alternate nights to 600 mg two times per day; duration 1-5 months). In vitro studies suggest that BA has activity against TV which is independent of its effect on pH. Further evaluation of BA for the treatment of uncomplicated TV is required, but it may be useful when therapeutic options are limited. If shown to be safe and effective, intravaginal BA might provide a well-tolerated alternative anti-infective treatment which reduces community exposure to systemic antibiotics. © Article author(s) (or their employer(s) unless otherwise stated in the text of the article) 2017. All rights reserved. No commercial use is permitted unless otherwise expressly granted.

  2. New therapeutic options for allergic rhinitis: back to the future with intranasal corticosteroid aerosols.

    Science.gov (United States)

    Carr, Warner W

    2013-01-01

    Under current guidelines, intranasal corticosteroids (INSs) are considered the most effective first-line therapy to improve allergic rhinitis (AR) symptoms and burden of disease. In the late 1980s-1990s, chlorofluorocarbon (CFC)-propelled corticosteroid aerosol nasal sprays formed the standard of care for the treatment of AR. Because of environmental concerns, CFC aerosols were gradually phased out, and aqueous INS formulations of nasal sprays became the standard of care. Although many aqueous INS sprays are available, specific product-related factors can reduce patient adherence to an INS and subsequently reduce treatment efficacy. The purpose of this paper was to review the evolution of AR therapeutics and drug devices and how it may have an effect on patient adherence/compliance and patient satisfaction with current available therapies and show the unmet need to improve INS delivery systems. Although aqueous INSs are effective and well tolerated, use in some patients may be compromised because of patient sensory perception and device preference. A historical review of the evolution of intranasal delivery of INSs was undertaken to provide further insight into improving treatment options for patients with AR. Although the various approved INSs appear to be equivalent in terms of reducing AR disease burden, the method in which an INS is delivered to a patient has significant bearing on the overall success of each specific drug product. Hydrofluoroalkane-propelled INS drug products offer a back-to-the-future delivery approach that may be further tailored to the individual patient's needs. Past experiences and the development of new devices are paving the way toward further therapy choices, ultimately affording health care providers access to the most effective treatments for patients with AR.

  3. IFN-αα induced psoriatic arthritis and HCV-related liver cirrhosis. Therapeutic options and patient’s opinion

    Directory of Open Access Journals (Sweden)

    M. Piga

    2011-09-01

    Full Text Available Hepatitis C virus (HCV infection in the setting of Psoriatic Arthritis is an additional variable to be considered in the therapeutic approach to the disease because of the complications of an immunosuppressive treatment in the course of a chronic infection and the possible hepatotoxicity of many drugs conventionally used to treat psoriatic arthritis. The case reported explores the therapeutic options in a patient with IFN-α induced psoriatic arthritis, characterised by severe arthritis and psoriasis but also the concomitant presence of HCV chronic hepatitis, in light of the patient’s concerns

  4. Peroral endoscopic myotomy is a viable option for failed surgical esophagocardiomyotomy instead of redo surgical Heller myotomy: a single center prospective study.

    Science.gov (United States)

    Onimaru, Manabu; Inoue, Haruhiro; Ikeda, Haruo; Yoshida, Akira; Santi, Esperanza Grace; Sato, Hiroki; Ito, Hiroaki; Maselli, Roberta; Kudo, Shin-ei

    2013-10-01

    Surgical Heller myotomy has high rates of successful long-term results, but failed cases still remain. Moreover, the treatment strategy in patients with surgical myotomy failure is controversial. Recently, peroral endscopic myotomy (POEM) was reported to be efficient and safe in primary treatment of achalasia. In this study, we aimed to evaluate the efficacy and safety of POEM for surgical myotomy failure as a rescue second-line treatment, and we discuss the treatment options adapted in achalasia recurrence. A total of 315 consecutive achalasia patients received POEM from September 2008 to December 2012 in our hospital. Eleven (3.5%) patients who had persistent or recurrent achalasia and had received surgical myotomy as a first-line treatment from other hospitals were included in this study. Patient background, barium swallow studies, esophagogastroduodenoscopy (EGD), manometry, and symptom scores were prospectively evaluated. In principle, all patients in whom surgical myotomy failed received pneumatic balloon dilatation (PBD) as the first line "rescue" treatment, and only if PBD failed were patients considered for rescue POEM. The PBD alone was effective in 1 patient, and in the remaining 10 patients, rescue POEM was performed successfully without complications. Three months after rescue POEM, significant reduction in lower esophageal sphincter (LES) resting pressures (22.1 ± 6.6 mmHg vs 10.9 ± 4.5 mmHg, p myotomy were excellent. Long-term results are awaited. Copyright © 2013 American College of Surgeons. Published by Elsevier Inc. All rights reserved.

  5. Biofeedback as complementary treatment in patients with epilepsy – an underestimated therapeutic option? Review, results, discussion

    Directory of Open Access Journals (Sweden)

    Uhlmann Carmen

    2016-12-01

    Full Text Available Background. Biofeedback methods represent side effect free complementary options in the treatment of epilepsy. In this paper we review the current status of these methods in terms of clinical study results and their evaluation by systematic review papers. Possible mechanisms of action in biofeedback methods are discussed.

  6. [Are therapeutics decisions homogeneous in multidisciplinary onco-urology staff meeting? Comparison of therapeutic options taken in four departments from Paris].

    Science.gov (United States)

    Audenet, F; Lejay, V; Mejean, A; De La Taille, A; Abbou, C-C; Lebret, T; Botto, H; Bitker, M-O; Roupret, M

    2012-06-01

    One of the priorities of the "Plan against the Cancer" in France is to ensure the discussion of all cancer cases in a multidisciplinary meeting staff (RCP). The multidisciplinary collaboration is proposed to guarantee a discussion between specialists in every cases, particularly in complex cases. The aim of this study was to compare the therapeutic decision taken in four RCP in Paris Île-de-France academic centres for three identical cases. Three cases of urological oncology (prostate cancer [PCa], renal cell carcinoma [RCC] and bladder tumour) were selected by a single urologist, not involved in further discussion. These cases were blindly presented in four academic urology department from Paris: Pitié-Salpêtrière Hospital, Mondor Hospital, the Georges-Pompidou European Hospital and Foch Hospital. The four centres met the criteria of quality of RCP in terms of multidisciplinarity, frequency and standardization. The therapeutic suggestions were similar in the RCC cases, there were differences in the surgical approaches and preoperative work-up in the PCa case and, lastly, the proposals were different for the bladder cancer case. The decisions relies on clinical data and preoperative work-up but also on the experience and habits of the centre of excellence. For complex cases that does not fit with current guidelines, the panel discussion can lead to different therapeutic options from a centre to another and is largely influenced by the local organisation of the RCP. Copyright © 2012 Elsevier Masson SAS. All rights reserved.

  7. Comparison of different options for harvest of a therapeutic protein product from high cell density yeast fermentation broth.

    Science.gov (United States)

    Wang, Alice; Lewus, Rachael; Rathore, Anurag S

    2006-05-05

    Recovery of therapeutic protein from high cell density yeast fermentations at commercial scale is a challenging task. In this study, we investigate and compare three different harvest approaches, namely centrifugation followed by depth filtration, centrifugation followed by filter-aid enhanced depth filtration, and microfiltration. This is achieved by presenting a case study involving recovery of a therapeutic protein from Pichia pastoris fermentation broth. The focus of this study is on performance of the depth filtration and the microfiltration steps. The experimental data has been fitted to the conventional models for cake filtration to evaluate specific cake resistance and cake compressibility. In the case of microfiltration, the experimental data agrees well with flux predicted by shear induced diffusion model. It is shown that, under optimal conditions, all three options can deliver the desired product recovery ( >80%), harvest time ( making a final decision on a harvesting approach.

  8. Therapeutic options in chronic heart failure. Findings on chest X-ray; Nicht medikamentoese Therapieoptionen der chronischen Herzinsuffizienz. Befunde in der Projektionsradiografie des Thorax

    Energy Technology Data Exchange (ETDEWEB)

    Granitz, M.R.; Meissnitzer, T.; Meissnitzer, M.W.; Hergan, K.; Altenberger, J.; Granitz, C. [Uniklinikum Salzburg - Landeskrankenhaus (Austria)

    2016-05-15

    The contribution covers drugless therapeutic options for chronic heart failure: the implantable cardioverter/defibrillator (ICD), the cardiac resynchronization therapy (CRT), the interventional catheter treatment of functional mitral insufficiency, and mechanical heart supporting systems and heart transplantation.

  9. Intuition, subjectivity, and Le bricoleur: cancer patients' accounts of negotiating a plurality of therapeutic options.

    Science.gov (United States)

    Broom, Alex

    2009-08-01

    Cancer patients are now combining complementary and alternative medicine (CAM) with biomedical cancer treatments, reflecting an increasingly pluralistic health care environment. However, there has been little research done on the ways in which cancer patients juggle multiplicity in claims to expertise, models of disease, and therapeutic practice. Drawing on the accounts of cancer patients who use CAM, in this article I develop a conceptualization of therapeutic decision making, utilizing the notion of bricolage as a key point of departure. The patient accounts illustrate the "piecing together" (or bricolage) of therapeutic trajectories, drawing on intuitive, embodied knowledge, as well as formalized "objective" scientific expertise. Le bricoleur, as characterized here, actively mediates, rather than accepts or rejects CAM or biomedicine, and utilizes a combination of scientific expertise, embodied physicality, and social knowledge to make decisions and assess therapeutic effectiveness. Although these "border crossings" are potentially subversive of established biomedical expertise, the analysis also illustrates the structural constraints (and penalties) associated with bricolage, and furthermore, the interplay of a repositioning of responsibility with neoliberal forms of self-governance.

  10. Therapeutic options to treat sulfur mustard poisoning--the road ahead.

    Science.gov (United States)

    Smith, William J

    2009-09-01

    For the past 15 years the international research community has conducted a basic and applied research program aimed at identifying a medical countermeasure against chemical threat vesicant, or blistering, agents. The primary emphasis of this program has been the development of therapeutic protection against sulfur mustard and its cutaneous pathology-blister formation. In addition to the work on a medical countermeasures, significant research has been conducted on the development of topical skin protectants and medical strategies for wound healing. This review will focus on the pharmacological strategies investigated, novel therapeutic targets currently under investigation and therapeutic approaches being considered for transition to advanced development. Additionally, we will review the expansion of our understanding of the pathophysiological mechanisms of mustard injury that has come from this research. While great strides have been made through these investigations, the complexity of the mustard insult demands that further studies extend the inroads made and point the way toward better understanding of cellular and tissue disruptions caused by sulfur mustard.

  11. Tadalafil - a therapeutic option in the management of BPH-LUTS.

    Science.gov (United States)

    Carson, C C; Rosenberg, M; Kissel, J; Wong, D G

    2014-01-01

    Men with signs of benign prostatic hyperplasia (BPH) may experience lower urinary tract symptoms (LUTS) such as urinary frequency, urgency, intermittence, nocturia, straining, incomplete emptying or a weak urinary stream. The effective management of LUTS suggestive of BPH (BPH-LUTS) requires careful consideration of several factors, including the severity of a patient's symptoms, concurrent or other coexisting medical conditions, the ability to improve symptoms and impact quality of life (QOL), as well as the potential side effects of available treatment options. Several clinical studies have assessed phosphodiesterase type 5 (PDE5) inhibitors in reducing LUTS; however, tadalafil is the only PDE5 inhibitor approved for the treatment of signs and symptoms of BPH, as well as in men with both erectile dysfunction (ED) and the signs and symptoms of BPH. This review examined articles that assessed tadalafil in patients with signs and symptoms of BPH, with or without erectile dysfunction (ED), which led to regulatory approval in the United States and Europe. In dose-ranging and confirmatory studies, results demonstrate that tadalafil significantly improved total International Prostate Symptom Score (IPSS) following 12 weeks of treatment with once daily tadalafil 5 mg. Statistically significant improvements in Benign Prostatic Hyperplasia Impact Index (BII), IPSS subscores, IPSS QOL and International Index of Erectile Function (IIEF) were also observed. Improvement in urinary symptoms occurred regardless of age, previous treatment with an α1 -adrenergic blocker, BPH-LUTS severity at baseline or ED status. While tadalafil is most frequently recognised as a standard treatment option for men with ED, it also represents a well-tolerated and effective treatment option in men with moderate to severe BPH-LUTS. © 2013 John Wiley & Sons Ltd.

  12. Automated (Centrifugal) therapeutic plasma exchange option for guillain-barre syndrome: A report from Calabar, Nigeria.

    Science.gov (United States)

    Iheanacho, O E; Chimeziem, C; Sachais, B S; Shi, P A

    2017-10-01

    Therapeutic plasma exchange (TPE) is performed frequently and effectively in developed countries, whereas the reverse is the case in developing countries. Guillain-Barre syndrome (GBS), synonymous with acute inflammatory demyelinating polyneuropathy, is an important indication for TPE, but this is rarely administered in the treatment of such patients in Nigeria due to lack of such automated facility, limited expertise, and high cost. This report therefore presents an uncommon case of GBS in which automated TPE was utilized in the management, with the aims of highlighting the current status and challenges of therapeutic apheresis services in Nigeria. A 42-year-old male presented with rapidly progressive (in an ascending fashion) paralysis of all four limbs within 24 h without any preceding history of fever or other symptoms. Clinical examination revealed a young man, afebrile, not pale, and also not dehydrated. Central nervous system examination showed a conscious man, alert, and oriented in time, person, and place. There were no signs of meningeal irritation and the cranial nerves were grossly intact. There was no power in the limbs: global hypotonia and areflexia were noted on examination. However, he had intact sensory perceptions to touch and pain. Following a diagnosis of GBS, he was treated with four sessions of plasmapheresis and TPE. The TPE session was done using a discontinuous flow apheresis machine which exchanged one plasma volume (3 L of plasma) and 5% albumin used for replacement. The patient made gradual but steady recovery as return of power to the upper limbs and trunk started by the 2nd week of treatment. TPE is an important treatment modality in the management of GBS as well as several other conditions, and it is becoming increasingly available in Nigeria. However, it is still grossly underutilized, thus the need for more therapeutic apheresis facilities and trained personnel, in addition to concerted efforts to subsidize the cost of accessing

  13. Acquired hemophilia A: a review of recent data and new therapeutic options.

    Science.gov (United States)

    Franchini, Massimo; Vaglio, Stefania; Marano, Giuseppe; Mengoli, Carlo; Gentili, Sara; Pupella, Simonetta; Liumbruno, Giancarlo Maria

    2017-10-01

    Acquired hemophilia A (AHA) is a rare, but potentially life-threatening, bleeding disorder caused by an autoantibody against factor VIII that interferes with its coagulant function. We performed a narrative review focusing on the diagnostic aspects of AHA and on the current treatment strategies with particular regard to new data and therapeutic developments. The management of this severe hemorrhagic disorder is based on the control of bleeding with the use of bypassing agents and on the utilization of a variety of immunosuppressant agents with the goal of eliminating the autoantibody permanently. The optimal management of AHA should be multidisciplinary and requires a close collaboration between physicians from various specialties.

  14. Therapeutic options for lymphangioleiomyomatosis (LAM): where we are and where we are going

    Science.gov (United States)

    Steagall, Wendy K; Moss, Joel

    2009-01-01

    Lymphangioleiomyomatosis (LAM), a multisystem disease affecting predominantly premenopausal and middle-aged women, causes progressive respiratory failure due to cystic lung destruction and is associated with lymphatic and kidney tumors. In the past, the treatment of LAM comprised exclusively anti-estrogen and related hormonal therapies. These treatments, however, have not been proven effective. In this article, we discuss new findings regarding the molecular mechanisms involved in the regulation of LAM cell growth, which may offer opportunities to develop effective and targeted therapeutic agents. PMID:20948684

  15. Extracellular vesicles derived from mesenchymal stromal cells: a therapeutic option in respiratory diseases?

    Science.gov (United States)

    Abreu, Soraia C; Weiss, Daniel J; Rocco, Patricia R M

    2016-04-14

    Extracellular vesicles (EVs) are plasma membrane-bound fragments released from several cell types, including mesenchymal stromal cells (MSCs), constitutively or under stimulation. EVs derived from MSCs and other cell types transfer molecules (such as DNA, proteins/peptides, mRNA, microRNA, and lipids) and/or organelles with reparative and anti-inflammatory properties to recipient cells. The paracrine anti-inflammatory effects promoted by MSC-derived EVs have attracted significant interest in the regenerative medicine field, including for potential use in lung injuries. In the present review, we describe the characteristics, biological activities, and mechanisms of action of MSC-derived EVs. We also review the therapeutic potential of EVs as reported in relevant preclinical models of acute and chronic respiratory diseases, such as pneumonia, acute respiratory distress syndrome, asthma, and pulmonary arterial hypertension. Finally, we discuss possible approaches for potentiating the therapeutic effects of MSC-derived EVs so as to enable use of this therapy in clinical practice.

  16. GROUNEWATER PROTECTION AS VIABLE OPTION FOR

    African Journals Online (AJOL)

    for groundwater protection before there is serious contamination is clear and powerlul. ... KEYWORDS: Groundwater protection,contamination, pollution, sustainable water supply, Nigeria. ... the increase owing to increases in the emerging.

  17. Salix: A viable option for phytoremediation

    African Journals Online (AJOL)

    user

    Many animals depend on willows for food. (mostly leaf ... tolerant to deposition and resistant to moderate salinity .... mechanism may enable stabilization of toxic metals ... 'Phytoremediation of Lead, Nickel, and Copper by Salix acmophylla.

  18. SGLT2 inhibitors provide an effective therapeutic option for diabetes complicated with insulin antibodies.

    Science.gov (United States)

    Hayashi, Akinori; Takano, Koji; Kawai, Sayuki; Shichiri, Masayoshi

    2016-01-01

    Diabetes mellitus complicated with insulin antibodies is rare in clinical practice but usually difficult to control. A high amount of insulin antibodies, especially with low affinity and high binding capacity, leads to unstable glycemic control characterized by hyperglycemia unresponsive to large volume of insulin and unanticipated hypoglycemia. There are several treatment options, such as changing insulin preparation, immunosupression with glucocorticoids, and plasmapheresis, most of which are of limited efficacy. Sodium-glucose cotransporter 2 (SGLT2) inhibitors are a novel class of drug which decrease renal glucose reabsorption and lowers plasma glucose level independent of insulin action. We report here a case with diabetes complicated with insulin antibodies who was effectively controlled by an SGLT2 inhibitor. A 47-year-old man with type 2 diabetes treated with insulin had very poor glycemic control characterized by postprandial hyperglycemia unresponsive to insulin therapy and repetitive hypoglycemia due to insulin antibodies. Treatment with ipragliflozin, an SGLT2 inhibitor, improved HbA1c from 8.4% to 6.0% and glycated albumin from 29.4% to 17.9%. Continuous glucose monitoring revealed improvement of glycemic profile (average glucose level from 212 mg/dL to 99 mg/dL and glycemic standard deviation from 92 mg/dL to 14 mg/dL) with disappearance of hypoglycemic events. This treatment further ameliorated the characteristics of insulin antibodies and resulted in reduced insulin requirement. SGLT2 inhibitors may offer an effective treatment option for managing the poor glycemic control in diabetes complicated with insulin antibodies.

  19. Therapeutic Options for the Treatment of Hypertension in Children and Adolescents

    Directory of Open Access Journals (Sweden)

    Mary M. Stephens MD, MPH

    2012-01-01

    Full Text Available Primary hypertension in children is increasing in prevalence with many cases likely going undiagnosed. The prevalence is currently estimated at between 3%-5% in the United States and may be higher in certain ethnic groups. Primary hypertension, once felt to be rare in children, is now considered to be about five times more common than secondary hypertension. This review provides information to guide physicians through an organized approach to: 1 screening children and adolescents for hypertension during routine visits; 2 using normative percentile data for diagnosis and classification; 3 performing a clinical evaluation to identify the presence of co-morbidities; 4 initiating a plan of care including subsequent follow-up blood pressure measurements, therapeutic lifestyle changes and pharmacologic therapies.

  20. Date Palm Tree (Phoenix dactylifera L.: Natural Products and Therapeutic Options

    Directory of Open Access Journals (Sweden)

    Reem A. Al-Alawi

    2017-05-01

    Full Text Available Many plants, including some of the commonly consumed herbs and spices in our daily food, can be safely and effectively used to prevent and/or treat some health concerns. For example, caffeine the active ingredient found in coffee beans (Coffea, shows biological activity in the treatment of the central nervous system (CNS disorders, indole-3-carbinol, and 3,3′-diindolylmethane are both broccoli (Brassica oleracea derived phytochemicals with potential anti-cancer activity, and resveratrol, isolated from grape (Vitis vinifera, is reported to extend lifespan and provide cardio-neuro-protective, anti-diabetic, and anti-cancer effects. Date palm fruits possess high nutritional and therapeutic value with significant antioxidant, antibacterial, antifungal, and anti-proliferative properties. This review focuses on the date fruit extracts and their benefits in individual health promoting conditions and highlights their applications as useful to the pharmaceutical and nutraceutical industries in the development of natural compound-based industrial products.

  1. Novel strategies and therapeutic options for the management of primary biliary cholangitis.

    Science.gov (United States)

    Khanna, Amardeep; Jones, David E

    2017-10-01

    Primary biliary cholangitis (PBC) is a chronic autoimmune liver disease. It has a varied course of progression ranging from being completely asymptomatic to aggressive disease leading to cirrhosis and resulting in liver transplantation. In addition, symptoms can be debilitating and can have a major impact on quality of life. For decades, there was only one anti-cholestatic agent available to target this disease and that was only effective in around half of patients, with little or no effect on symptoms. With increasing understanding of the pathogenic mechanisms of PBC and potential targets for drug treatment, pharmaceutical companies have shown a greater interest in this rare disease. A large number of novel therapeutic molecules have been developed and are currently being evaluated. In this review article all the novel molecules in use and in trials targeting cholestasis and symptoms in PBC are discussed.

  2. Predictive Biomarkers in Colorectal Cancer: From the Single Therapeutic Target to a Plethora of Options

    Directory of Open Access Journals (Sweden)

    Daniela Rodrigues

    2016-01-01

    Full Text Available Colorectal cancer (CRC is one of the most frequent cancers and is a leading cause of cancer death worldwide. Treatments used for CRC may include some combination of surgery, radiation therapy, chemotherapy, and targeted therapy. The current standard drugs used in chemotherapy are 5-fluorouracil and leucovorin in combination with irinotecan and/or oxaliplatin. Most recently, biologic agents have been proven to have therapeutic benefits in metastatic CRC alone or in association with standard chemotherapy. However, patients present different treatment responses, in terms of efficacy and toxicity; therefore, it is important to identify biological markers that can predict the response to therapy and help select patients that would benefit from specific regimens. In this paper, authors review CRC genetic markers that could be useful in predicting the sensitivity/resistance to chemotherapy.

  3. Agreement between clinicians' and care givers' assessment of intelligence in Nigerian children with intellectual disability: 'ratio IQ' as a viable option in the absence of standardized 'deviance IQ' tests in sub-Saharan Africa

    Directory of Open Access Journals (Sweden)

    Aguocha Chinyere M

    2009-09-01

    Full Text Available Abstract Background There may be need to assess intelligent quotient (IQ scores in sub-Saharan African children with intellectual disability, either for the purpose of educational needs assessment or research. However, modern intelligence scales developed in the western parts of the world suffer limitation of widespread use because of the influence of socio-cultural variations across the world. This study examined the agreement between IQ scores estimation among Nigerian children with intellectual disability using clinicians' judgment based on International Classification of Diseases, tenth Edition (ICD - 10 criteria for mental retardation and caregivers judgment based on 'ratio IQ' scores calculated from estimated mental age in the context of socio-cultural milieu of the children. It proposed a viable option of IQ score assessment among sub-Saharan African children with intellectual disability, using a ratio of culture-specific estimated mental age and chronological age of the child in the absence of standardized alternatives, borne out of great diversity in socio-cultural context of sub-Saharan Africa. Methods Clinicians and care-givers independently assessed the children in relation to their socio-cultural background. Clinicians assessed the IQ scores of the children based on the ICD - 10 diagnostic criteria for mental retardation. 'Ratio IQ' scores were calculated from the ratio of estimated mental age and chronological age of each child. The IQ scores as assessed by the clinicians were then compared with the 'ratio IQ' scores using correlation statistics. Results A total of forty-four (44 children with intellectual disability were assessed. There was a significant correlation between clinicians' assessed IQ scores and the 'ratio IQ' scores employing zero order correlation without controlling for the chronological age of the children (r = 0.47, df = 42, p = 0.001. First order correlation controlling for the chronological age of the children

  4. Agreement between clinicians' and care givers' assessment of intelligence in Nigerian children with intellectual disability: 'ratio IQ' as a viable option in the absence of standardized 'deviance IQ' tests in sub-Saharan Africa.

    Science.gov (United States)

    Bakare, Muideen O; Ubochi, Vincent N; Okoroikpa, Ifeoma N; Aguocha, Chinyere M; Ebigbo, Peter O

    2009-09-15

    There may be need to assess intelligent quotient (IQ) scores in sub-Saharan African children with intellectual disability, either for the purpose of educational needs assessment or research. However, modern intelligence scales developed in the western parts of the world suffer limitation of widespread use because of the influence of socio-cultural variations across the world. This study examined the agreement between IQ scores estimation among Nigerian children with intellectual disability using clinicians' judgment based on International Classification of Diseases, tenth Edition(ICD - 10) criteria for mental retardation and caregivers judgment based on 'ratio IQ' scores calculated from estimated mental age in the context of socio-cultural milieu of the children. It proposed a viable option of IQ score assessment among sub-Saharan African children with intellectual disability, using a ratio of culture-specific estimated mental age and chronological age of the child in the absence of standardized alternatives, borne out of great diversity in socio-cultural context of sub-Saharan Africa. Clinicians and care-givers independently assessed the children in relation to their socio-cultural background. Clinicians assessed the IQ scores of the children based on the ICD - 10 diagnostic criteria for mental retardation. 'Ratio IQ' scores were calculated from the ratio of estimated mental age and chronological age of each child. The IQ scores as assessed by the clinicians were then compared with the 'ratio IQ' scores using correlation statistics. A total of forty-four (44) children with intellectual disability were assessed. There was a significant correlation between clinicians' assessed IQ scores and the 'ratio IQ' scores employing zero order correlation without controlling for the chronological age of the children (r = 0.47, df = 42, p = 0.001). First order correlation controlling for the chronological age of the children showed higher correlation score between clinicians

  5. Mediterranean diet and non-alcoholic fatty liver disease: New therapeutic option around the corner?

    Science.gov (United States)

    Sofi, Francesco; Casini, Alessandro

    2014-01-01

    Non-alcoholic fatty liver disease (NAFLD) represents the most common chronic liver disease in Western countries, being considered as the hepatic manifestation of metabolic syndrome. NAFLD has a common pathogenic background to that of metabolic syndrome, and shares many risk factors such as obesity, hypertension, insulin resistance and dyslipidemia. Although there is no currently available evidence-based established treatment for NAFLD, all the recommendations from the medical associations indicate that the most effective treatment is to reduce weight through lifestyle modifications. Diet, indeed, plays a key role in the management of NAFLD patients, as both the quantity and quality of the diet have been reported to have a beneficial role in the onset and severity of the liver disease. Among all the diets that have been proposed, a Mediterranean diet was the most effective dietary option for inducing weight loss together with beneficial effects on all the risk factors associated with metabolic syndrome and NAFLD. Over the last few years, research has demonstrated a beneficial effect of a Mediterranean diet in NAFLD. In this review, we will examine all the available data on the association between diet, nutrients and the Mediterranean diet in association with onset and severity of NAFLD. PMID:24966604

  6. Therapeutic options for chronic myeloid leukemia: focus on imatinib (Glivec®, Gleevec™

    Directory of Open Access Journals (Sweden)

    Martin Henkes

    2008-03-01

    Full Text Available 1Martin Henkes, 2Heiko van der Kuip, 1Walter E Aulitzky12nd Department of Internal Medicine, Oncology and Hematology, Robert Bosch Hospital, Auerbachstr. 110, Stuttgart, Germany; 2Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Auerbachstr. 112, Stuttgart, and University of Tuebingen, GermanyAbstract: Treatment options for chronic myeloid leukemia (CML have changed dramatically during the last decades. Interferon-α treatment and stem cell transplantation (SCT clearly improved survival over conventional chemotherapy and offered the possibility of complete and durable responses. With the advent of the small molecule inhibitor imatinib mesylate (Glivec®, GleevecTM targeting the causative Bcr-Abl oncoprotein, the era of molecular cancer therapy began with remarkable success especially in chronic phase patients. Today, imatinib is the first-line treatment for CML. However, imatinib does not appear to be capable to eliminate all leukemia cells in the patients and pre-existing as well as acquired resistance to the drug has been increasingly recognized. To overcome these problems, several strategies involving dose escalation, combinations with other agents, and novel Bcr-Abl inhibitors have been developed.Keywords: CML therapy, imatinib, SCT, novel kinase inhibitors

  7. Exergaming as a Viable Therapeutic Tool to Improve Static and Dynamic Balance among Older Adults and People with Idiopathic Parkinson's Disease: A Systematic Review and Meta-Analysis.

    Science.gov (United States)

    Harris, Dale M; Rantalainen, Timo; Muthalib, Makii; Johnson, Liam; Teo, Wei-Peng

    2015-01-01

    The use of virtual reality games (known as "exergaming") as a neurorehabilitation tool is gaining interest. Therefore, we aim to collate evidence for the effects of exergaming on the balance and postural control of older adults and people with idiopathic Parkinson's disease (IPD). Six electronic databases were searched, from inception to April 2015, to identify relevant studies. Standardized mean differences (SMDs) and 95% confidence intervals (CI) were used to calculate effect sizes between experimental and control groups. I (2) statistics were used to determine levels of heterogeneity. 325 older adults and 56 people with IPD who were assessed across 11 -studies. The results showed that exergaming improved static balance (SMD 1.069, 95% CI 0.563-1.576), postural control (SMD 0.826, 95% CI 0.481-1.170), and dynamic balance (SMD -0.808, 95% CI -1.192 to -0.424) in healthy older adults. Two IPD studies showed an improvement in static balance (SMD 0.124, 95% CI -0.581 to 0.828) and postural control (SMD 2.576, 95% CI 1.534-3.599). Our findings suggest that exergaming might be an appropriate therapeutic tool for improving balance and postural control in older adults, but more -large-scale trials are needed to determine if the same is true for people with IPD.

  8. Hematopoietic stem cells transplant in patients with common variable immunodeficiency. Is a therapeutic option?

    Directory of Open Access Journals (Sweden)

    Julio César Cambray-Gutiérrez

    2017-02-01

    Full Text Available Background: Patients with common variable immunodeficiency show higher incidence of sinopulmonary and gastrointestinal infections, as well as lymphoproliferative and autoimmune diseases. The treatment of choice is replacement therapy with human gamma-globulin. Hematopoietic stem cell transplantation is a non-conventional therapeutic modality. Clinical case: Twenty-six-year old woman with no family or hereditary history of primary immune deficiencies or consanguinity, with repeated episodes of otitis, sinusitis, gastroenteritis and bronchitis since childhood. At adolescence, she was diagnosed with common variable immunodeficiency; she was prescribed intravenous gamma-globulin, broad-spectrum antimicrobials and macrolides. At 22 years of age, she underwent hematopoietic stem cell transplantation owing to continued severe infections. At 4 months, post-transplantation she was diagnosed with hypothyroidism and ovarian insufficiency. During the following 3 years, she had no infections, but at 25 years of age she had immune thrombocytopenic purpura diagnosed, which persists together with Raynaud’s disease and upper respiratory tract persistent infections. At the moment of this report she is being treated with intravenous gamma-globulin and receiving prophylaxis with clarithromycin, without steroids or danazol. Conclusions: Given the high rate of morbidity and mortality associated and immune reconstitution failure, hematopoietic stem cell transplantation should be carefully evaluated in patients with treatment-unresponsive infections or lymphoproliferative disorders.

  9. [Advanced luminal breast cancer (hormone receptor-positive, HER2 negative): New therapeutic options in 2015].

    Science.gov (United States)

    Vanacker, Hélène; Bally, Olivia; Kassem, Loay; Tredan, Olivier; Heudel, Pierre; Bachelot, Thomas

    2015-06-01

    Despite improvements in early detection, surgery and systemic therapy, metastatic breast cancer remains a major cause of death. Luminal type breast cancers expressing hormone estrogen receptor (ER) or progesterone (PR) and without HER2 overexpression are generally sensitive to endocrine therapy, but raise the issue of the occurrence of resistance to treatment, particularly at metastatic stage. A better understanding of hormone resistance may guide the development of new therapeutics. New strategies aim at enhancing and prolonging of endocrine sensitivity, by optimizing existing schemes, or by combining an endocrine therapy with a targeted therapies specific to hormone resistance pathways: ER signaling, PI3K/AKT/mTOR and Cyclin Dependent Kinase (CDK). Key corners of 2014 include confirmation of benefit of high dose fulvestrant, and commercialization of everolimus as the first mTOR inhibitor in this indication. Other strategies are being tested dealing with new endocrine therapies or new molecular targets such as PI3K inhibitors, insulin-like growth factor receptor (IGF-R) and histone deacetylase (HDAC) inhibitors. Coming years may be fruitful and might radically change our way to treat these patients. Copyright © 2015 Société Françise du Cancer. Publié par Elsevier Masson SAS. Tous droits réservés. Published by Elsevier Masson SAS. All rights reserved.

  10. Gentamicin-intercalated smectite as a new therapeutic option for Helicobacter pylori eradication.

    Science.gov (United States)

    Jeong, Su Jin; Kim, Jie-Hyun; Jung, Da Hyun; Lee, Kyoung Hwa; Park, Soon Young; Song, Yungoo; Kang, Il-Mo; Song, Young Goo

    2018-02-12

    Novel antibacterial strategies against Helicobacter pylori are needed because H. pylori strains are acquiring resistance to antibiotics. We evaluated the efficacy of gentamicin-intercalated smectite hybrid (S-GEN)-based treatment regimens in a murine model of H. pylori infection. Two groups of 10 rats were administered either smectite or S-GEN to measure coverage of the gastric mucosa. To evaluate anti-H. pylori efficacy, mice were divided into eight groups of 10 mice each given different treatments, and H. pylori eradication was assessed by a Campylobacter-like organism (CLO) test and H. pylori PCR of the gastric mucosa, and H. pylori antigen and H. pylori PCR analysis of mouse faeces. The levels of proinflammatory cytokines were examined. S-GEN was retained in the gastric mucosal layer with a >60% distribution ratio for up to 1 h, and the S-GEN-based triple regimen decreased bacterial burden in vivo compared with that of untreated mice or mice treated with other regimens. The cure rates in the CLO test and H. pylori PCR from gastric mucosa were 70%, 60%, 80%, 50%, 60% and 60% in Groups III-VIII, respectively. Those for H. pylori PCR in the faeces of mice were 90% and 100% in Group III with standard therapy and Group V with triple therapy including S-GEN, respectively. S-GEN triple therapy also reduced the levels of proinflammatory cytokines. These results suggest that S-GEN is a promising and effective therapeutic agent for the treatment of H. pylori infection. © The Author(s) 2018. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

  11. [Cell-based therapies - an innovative therapeutic option in ophthalmology: Treating corneal diseases with stem cells].

    Science.gov (United States)

    Bakker, Ann-Christin; Langer, Barbara

    2015-11-01

    Pathological changes and disorders of the cornea are a major cause of severe visual impairment and blindness. Replacement of a pathologically altered cornea with healthy corneal tissue from the eye of a suitable donor is among the most common and successful transplantation procedures in medicine. In Germany, approximately 5000-6000 corneal transplantations are performed each year, but the total demand per year is estimated to be twice as high. With a success rate of 90%, the outcome of cornea transplantation is very favourable. However, long-term maintenance and regeneration of a healthy new cornea requires tissue-specific corneal stem cells residing at the basal layer of the limbus, which is the annular transition zone between the cornea and sclera. When this important limbal stem cell population is destroyed or dysfunctional, a pathological condition known as limbal stem cell deficiency (LSCD) manifests. Limbal stem cell deficiency describes conditions associated with impaired corneal wound healing and regeneration. In this situation, transplantation of healthy limbal stem cells is the only curative treatment approach for restoration of an intact and functional ocular surface. To date, treatment of LSCD presents a great challenge for ophthalmologists. However, innovative, cell-therapeutic approaches may open new, promising treatment perspectives. In February 2015, the European Commission granted marketing authorization to the first stem cell-based treatment in the European Union. The product named Holoclar® is an advanced therapy medicinal product (ATMP) for the treatment of moderate to severe LSCD due to physical and chemical burns in adults. Further cell-based treatment approaches are in clinical development.

  12. Mycoplasma genitalium infection: current treatment options, therapeutic failure, and resistance-associated mutations

    Directory of Open Access Journals (Sweden)

    Couldwell DL

    2015-05-01

    failure, due to bacteria with coexistent macrolide-associated and fluoroquinolone-associated resistance mutations, were recently published by Australian investigators. Pristinamycin and solithromycin may be of clinical benefit for such multidrug-resistant infections. Further clinical studies are required to determine the optimal therapeutic dosing schedules for both agents to effect clinical cure and minimize the risk of emergent antimicrobial resistance. Continual inappropriate M. genitalium treatments will likely lead to untreatable infections in the future. Keywords: Mycoplasma genitalium, non-gonococcal urethritis, macrolide, fluoroquinolone, resistance, treatment failure

  13. Sexuality issues in gynaecological oncology patients: post treatment symptoms and therapeutic options.

    Science.gov (United States)

    Iavazzo, C; Johnson, K; Savage, H; Gallagher, S; Datta, M; Winter-Roach, B A

    2015-03-01

    According to recent studies up to 80% of patients would like to receive more information about how cancer treatments can affect their sexual functioning. Moreover, 75 % of them would not feel comfortable being the first to bring up the subject. Our Gynaecological Advice Clinic was established in 2006 at the Christie Hospital and offers support to cancer patients who face sexuality issues. A previous evaluation established that the service sees approximately, 200 patients per year. The aims of this study are to evaluate the service by collecting data relating to levels of attendance, type and amount of clinical activity and to explore further patients' experiences and management. This is a retrospective study which was carried out in 2012-2013. Different models are used to evaluate our patients including history taking integrated therapy model, consultations to understand the normal anatomy and physiology with the use of diagrams and photographs, psycho-education and the international classification "Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition" (DSMV). The treatment options advised include medications such as hormone replacement treatment, testosterone, antidepressant, local oestrogen, tibolone, aqueous cream, lubrication to introitus, diprobase, dermal cream and advice for massage to areas of discomfort. Moreover, the use of vaginal dilators, the role of pelvic floor exercises, vulval care and self examination are explained. The team works closely with the psycho-oncology department. The most frequently discussed topics that were covered during the consultation are analysed. 41 outpatient clinics were held between 2012 and 2013. 194 patients attended those clinics during the study period. Single and not group therapy was offered to all the participants. 216 patients were offered appointments while 194 patients actually attended (90%). Patients' age ranged from 24 to 91 years with a mean age of 59 years. 45% had endometrial and 32% cervical

  14. Open-to-Air Is a Viable Option for Initial Wound Care in Necrotizing Soft Tissue Infection that Allows Early Detection of Recurrence without Need for Painful Dressing Changes or Return to Operating Room.

    Science.gov (United States)

    Yang, Derek; Davies, April; Burge, Bailey; Watkins, Phillip; Dissanaike, Sharmila

    2018-01-01

    The standard treatment of necrotizing soft tissue infection (NSTI) includes extensive surgical debridement. Care of these debridements is challenging because of the size of the wound and associated pain. A potential solution is to leave the wounds open-to-air in the period after the initial debridement, allowing for regular inspection at bedside while reducing pain associated with frequent dressing changes. We evaluated the feasibility of this approach from a pain control standpoint. An audit of wound care modalities used on adult patients with NSTI admitted to a regional burn center between January 2009 and May 2014 was performed. Patients with at least one operation were included. Those opting for palliative care were excluded. Wound care was divided into four categories: open-to-air (OTA), negative-pressure wound therapy (NPWT), packing, and ointment. Wound care, pain score, pain medication use, and number of operations were collected for the first seven days after initial debridement. Pain management was assessed by pain scores. Analgesic use was measured and compared using conversion to morphine milligram equivalents (MME). Ninety-six patients were included; 67% were men with average age of 50 years, resulting in a total of 672 days of wound care evaluated: 69 days of OTA, 127 days of NPWT, 200 days of packing, and 126 days of ointment (150 days were undocumented). Average daily pain score from all wound care modalities was 2.00. Negative pressure wound therapy had the highest reported daily pain score (2.18, p = 0.034), whereas OTA had the lowest pain score (1.63, p < 0.05). Mortality was lower in the OTA cohort but was not statistically significant; there were no other differences in long-term outcome. Leaving wounds OTA is a safe and viable option in the immediate post-debridement period of NSTI to reduce pain, while permitting frequent re-evaluation for quick recognition of disease progression and repeat operative debridement if necessary.

  15. Aquatic Therapy: A Viable Therapeutic Recreation Intervention.

    Science.gov (United States)

    Broach, Ellen; Dattilo, John

    1996-01-01

    Reviews literature on the effects of aquatic therapy (swimming and exercise) to improve function. Research shows that aquatic therapy has numerous psychological and physical benefits, and it supports the belief that participation can provide a realistic solution to maintaining physical fitness and rehabilitation goals while engaging in enjoyable…

  16. Threaded biliary inside stents are a safe and effective therapeutic option in cases of malignant hilar obstruction.

    Science.gov (United States)

    Inatomi, Osamu; Bamba, Shigeki; Shioya, Makoto; Mochizuki, Yosuke; Ban, Hiromitsu; Tsujikawa, Tomoyuki; Saito, Yasuharu; Andoh, Akira; Fujiyama, Yoshihide

    2013-02-14

    Although endoscopic biliary stents have been accepted as part of palliative therapy for cases of malignant hilar obstruction, the optimal endoscopic management regime remains controversial. In this study, we evaluated the safety and efficacy of placing a threaded stent above the sphincter of Oddi (threaded inside plastic stents, threaded PS) and compared the results with those of other stent types. Patients with malignant hilar obstruction, including those requiring biliary drainage for stent occlusion, were selected. Patients received either one of the following endoscopic indwelling stents: threaded PS, conventional plastic stents (conventional PS), or metallic stents (MS). Duration of stent patency and the incident of complication were compared in these patients. Forty-two patients underwent placement of endoscopic indwelling stents (threaded PS = 12, conventional PS = 17, MS = 13). The median duration of threaded PS patency was significantly longer than that of conventional PS patency (142 vs. 32 days; P = 0.04, logrank test). The median duration of threaded PS and MS patency was not significantly different (142 vs. 150 days, P = 0.83). Stent migration did not occur in any group. Among patients who underwent threaded PS placement as a salvage therapy after MS obstruction due to tumor ingrowth, the median duration of MS patency was significantly shorter than that of threaded PS patency (123 vs. 240 days). Threaded PS are safe and effective in cases of malignant hilar obstruction; moreover, it is a suitable therapeutic option not only for initial drainage but also for salvage therapy.

  17. [Extracorporeal shockwave therapy (ESWT) as therapeutic option in supraspinatus tendon syndrome? One year results of a placebo controlled study].

    Science.gov (United States)

    Schmitt, J; Tosch, A; Hünerkopf, M; Haake, M

    2002-07-01

    Extracorporeal shock wave therapy (ESWT) is seen as a therapeutic option in the treatment of chronic supraspinatus tendinitis by some authors. To test whether ESWT comprising 3 x 2000 pulses with the positive energy flux density ED+ of 0.33 mJ/mm2 is clinically superior to a sham ESWT treatment, a prospective, randomized, single-blinded, placebo-controlled study with an independent observer was performed. Forty patients were treated either by verum ESWT or sham ESWT under local anesthesia. Target criteria were the age-corrected Constant score, pain at rest and during activity on a visual analogue scale, and subjective improvement. Patients who reported no subjective improvement after 12 weeks were deblinded and received verum ESWT if they had belonged to the placebo group (partial crossover). The results of the verum group lie within the range of results for ESWT published by other authors. Patients in the placebo group with local anesthetic showed equally good results. At 12 weeks, and 1 year after intervention, no difference could be found between the verum and placebo groups regarding Constant score, pain, shoulder function, or subjective improvement. The nonresponders to the placebo ESWT continued to show no improvement after receiving verum ESWT. This contradicts a specific ESWT effect. Based on the results of this placebo-controlled study, ESWT appears to have no clinically relevant effect on supraspinatus tendinitis. The study underlines the importance of a control group in evaluating new treatment methods for diseases with unknown natural history.

  18. The use of radiotherapy as a therapeutic option in the juvenile nasopharyngeal angiofibroma: An update of results in 11 patients

    International Nuclear Information System (INIS)

    Alert Silva, Jose; Perez Penna, Lourdes; Caballero Aguirrechu, Iraida; Reno Cespedes, Jesus; Garcia Socarras, Debora; Perez Trejo, Migdalia

    2009-01-01

    The juvenile nasopharyngeal angiofibroma is a rare benign tumor composed of fibrous connective tissue and abundant vascular spaces lined with endothelium, almost exclusively male and adolescence. The recommended treatment of choice is surgical excision of the tumor after embolization, however, in patients with bulky tumors, in which no surgical treatment is possible or it is refused, or where excision was incomplete, or the case of recurrence, radiation therapy (RT) is a therapeutic option. Results are presented in a series of 11 patients suffering from juvenile nasopharyngeal angiofibroma, all male, between 9 and 16 years of age, treated at INOR from 1990 to 2005. Nine patients were used as initial therapy irradiated and 2 relapse treated. The radiation treatment was applied in the irradiation of the entire tumor volume with a margin of safety, dose between 40 and 60 Gy, 1.8 Gy per session, associated with RT, was used postirradiation interferon from 3 to 6 months in 10 poly chemotherapy patients and in 1 patient. They keep 10 of the 11 patients with sustained complete remission (90.9%) without recurrence. In one patient only partial remission was achieved, using then surgical treatment. Early complications were all patients, and late in some. In the management of juvenile nasopharyngeal angiofibroma, RT is a treatment that maintains its usefulness, with their specific indications. (Author)

  19. Micro - Focused Phototherapy Associated To Janus Kinase Inhibitor: A Promising Valid Therapeutic Option for Patients with Localized Vitiligo

    Directory of Open Access Journals (Sweden)

    Serena Gianfaldoni

    2018-01-01

    Full Text Available BACKGROUND: Vitiligo is an acquired pigmentary cutaneous disease, characterised by the progressive loss of melanocytes, resulting in hypopigmented skin areas which progressively become amelanotic. Classically, vitiligo treatments are unsatisfactory and challenging. Despite the continuous introduction of new therapies, phototherapy is still the mainstay for vitiligo repigmentation. AIM: The aim of this multicenter observational retrospective study was to evaluate the efficacy and safety of the nb - UVB micro - phototherapy (BIOSKIN EVOLUTION®, used alone or in associations with an oral Janus kinase inhibitor (Tofacitinib citrate, in the treatment of stable or active forms of localised vitiligo. MATERIAL AND METHODS: Fifty eight patients had been treated with n-UVB micro-photootherapy (Group A; 9 patients had been treated with phototherapy plus Tofacitinb citrate (Group B. RESULTS: Among Group A, 42 patients (72% obtained a re-pigmentation rate higher than 75%, with a medium value of 77%. 11 patients (19% achieved a marked improvement of the clinical findings with a repigmentation rate between 50-75%; 4 patients (8% showed a moderate response with a lesional repigmentation of 25-50%. Only one patient (1% had a poor response to the phototherapeutic treatment CONCLUSION: Nb - UVB micro-focused phototherapy is one of the most effective therapeutic options for vitiligo treatment. The association of micro-focused phototherapy to Tofacitinib citrate seems to provide better clinical results in term of repigmentation rate.

  20. Splenomegaly in myelofibrosis—new options for therapy and the therapeutic potential of Janus kinase 2 inhibitors

    Directory of Open Access Journals (Sweden)

    Randhawa Jasleen

    2012-08-01

    Full Text Available Abstract Splenomegaly is a common sign of primary myelofibrosis (PMF, post-polycythemia vera myelofibrosis (post-PV MF, and post-essential thrombocythemia myelofibrosis (post-ET MF that is associated with bothersome symptoms, which have a significant negative impact on patients’ quality of life. It may also be present in patients with advanced polycythemia vera (PV or essential thrombocythemia (ET. Until recently, none of the therapies used to treat MF were particularly effective in reducing splenomegaly. The discovery of an activating Janus kinase 2 (JAK2 activating mutation (JAK2V617F that is present in almost all patients with PV and in about 50-60 % of patients with ET and PMF led to the initiation of several trials investigating the clinical effectiveness of various JAK2 (or JAK1/JAK2 inhibitors for the treatment of patients with ET, PV, and MF. Some of these trials have documented significant clinical benefit of JAK inhibitors, particularly in terms of regression of splenomegaly. In November 2011, the US Food and Drug Administration approved the use of the JAK1- and JAK2-selective inhibitor ruxolitinib for the treatment of patients with intermediate or high-risk myelofibrosis, including PMF, post-PV MF, and post-ET MF. This review discusses current therapeutic options for splenomegaly associated with primary or secondary MF and the treatment potential of the JAK inhibitors in this setting.

  1. Inhibition of mTOR's Catalytic Site by PKI-587 Is a Promising Therapeutic Option for Gastroenteropancreatic Neuroendocrine Tumor Disease.

    Science.gov (United States)

    Freitag, Helma; Christen, Friederike; Lewens, Florentine; Grass, Irina; Briest, Franziska; Iwaszkiewicz, Sara; Siegmund, Britta; Grabowski, Patricia

    2017-01-01

    The characteristic clinical heterogeneity and mostly slow-growing behavior of gastroenteropancreatic neuroendocrine neoplasms (GEP-NENs) cause problems in finding appropriate treatments. Thus, the current therapy options are not satisfactory. PKI-587 is a highly potent, novel dual inhibitor of PI3K and mTORC1/C2. We assessed the effects of PKI-587 in different GEP-NEN tumor models, including the poorly differentiated cell line LCC-18, and compared them with those of the established mTORC1 inhibitor everolimus. We treated BON, QGP-1, KRJ-I, and LCC-18 cell lines with increasing concentrations of the inhibitor PKI-587, and compared the results with those of everolimus and DMSO. We assessed the impact of the treatments on viability (WST-1 assay), on apoptotic processes (caspase 3/7 assay, JC-1), and on cell cycle regulation (flow cytometry). We determined alterations in signaling mediators by phosphor-specific Western blot analysis and conducted multiplexed gene expression analysis (nCounter® technology). In all cell lines, PKI-587 dose-dependently inhibited proliferation, whereas everolimus was less effective. Treatment with PKI-587 led to cell cycle arrest and induction of apoptosis and successfully suppressed activity of the direct mTORC1 target 4E-BP1, a crucial factor for tumor genesis only partially inhibited by everolimus. Gene expression analyses revealed relevant changes of RAS, MAPK, STAT, and PI3K pathway genes after treatment. Treatment-dependent and cell line-characteristic effects on AKT/Rb/E2F signaling regarding cell cycle control and apoptosis are extensively discussed in this paper. PI3K/mTOR dual targeting is a promising new therapeutic approach in neuroendocrine tumor disease that should be evaluated in further clinical trials. © 2016 The Author(s) Published by S. Karger AG, Basel.

  2. Managing Viable Knowledge

    NARCIS (Netherlands)

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

    2002-01-01

    In this paper, Beer's Viable System Model (VSM) is applied to knowledge management. Based on the VSM, domains of knowledge are identified that an organization should possess to maintain its viability. The logic of the VSM is also used to support the diagnosis, design and implementation of the

  3. Lumbar sympathectomy under CT guidance: therapeutic option in critical limb ischaemia; la simpaticolisi TC guidata: alternativa terapeutica delle ischemie critiche

    Energy Technology Data Exchange (ETDEWEB)

    Pieri, Stefano; Agresti, Paolo [Az. Osp. S. Camillo-Forlanini, Roma (Italy). U.O. di radiologia vascolare ed interventistica; Ialongo, Pasquale; Fedeli, Stefano [Radiologia diagnostica Busi, Roma (Italy); Di Cesare, Fabio; Ricci, Guiseppe [Az. Osp. S. Camillo-Forlanini, Roma (Italy). Chirurgia vascolare

    2005-04-01

    Purpose: Lumbar sympathectomy is a complementary therapeutic option for patients with severe peripheral vascular occlusive disease presenting rest pain or gangrene and not eligible for surgical revascularisation. Traditional surgical sympathectomy was widely used in the past. However, due to its invasive character, it has increasingly been replaced by percutaneous techniques and, in some recent cases, by laparoscopic procedures. Percutaneous lumbar sympathectomy is a safe, cost-effective and widely available treatment option. We report our experience on 19 patients subjected to percutaneous sympathectomy under CT guidance. Materials and methods: Between 1998 and 2000, 19 patients underwent percutaneous sympathectomy under CT guidance. All patients had severe vascular disease of the lower extremities (Fontaine stage IV), with rest pain and gangrene. They were not eligible for surgical revascularization. Phenol was injected at the level of L2 and L4 using two 22 G needles (15 cm long). Signs of interrupted sympathetic activity usually occur 2'-15' after the procedure with warmth and flushing and dryness of the lower extremities. Results: Percutaneous sympathectomy under CT guidance is a simple, safe and well-tolerated procedure with a low rate of complications. Of the 19 patients, 9 (47.3%) showed clinical improvement, whereas 5 experienced a worsening of ischaemia in the month immediately following the procedure. Discussion: Results suggest that percutaneous lumbar sympathectomy causes a sympathetic blockade in patients with advanced vascular disease of the limb. CT guidance ensures a high level of precision in drug dosing, thus lowering the risk of complications. Although the results are demoralizing. the impossibility of achieving surgical revascularisation in advanced peripheral arteriosclerosis enhances the role of Ct-guided percutaneous sympathectomy in relieving rest pain and healing ulcers in order to postpone the amputation. [Italian] Scopo: La

  4. Total recall: Reconsolidation theory unifies cognitive psychology and neuroscience and creates new therapeutic options for memory-related disorders

    OpenAIRE

    Hunter, Philip

    2011-01-01

    New research reveals that long-term memory is not entirely stable and can be modified or potentially erased. These insights open new therapeutic possibilities for a range of memory-related diseases and disorders.

  5. Coal liquefaction becomes viable

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2005-11-15

    In 2003 the May/June issue of CoalTrans International speculated that coal liquefaction would become viable due to falling coal prices. This has not proved the case but the sustained high oil price is sparking new interest. A survey by Energy Intelligence and Marketing Research during November 2005 revealed a growth in the number of projects under development or at the feasibility stage. The article reports projects in China, the USA, Australia, New Zealand, the Philippines and India. China is commissioning the first wave of large liquefaction plants. The key question is whether other countries, particularly the USA, will follow.

  6. Androgen receptor status is a prognostic marker in non-basal triple negative breast cancers and determines novel therapeutic options.

    Directory of Open Access Journals (Sweden)

    Pierluigi Gasparini

    Full Text Available Triple negative breast cancers are a heterogeneous group of tumors characterized by poor patient survival and lack of targeted therapeutics. Androgen receptor has been associated with triple negative breast cancer pathogenesis, but its role in the different subtypes has not been clearly defined. We examined androgen receptor protein expression by immunohistochemical analysis in 678 breast cancers, including 396 triple negative cancers. Fifty matched lymph node metastases were also examined. Association of expression status with clinical (race, survival and pathological (basal, non-basal subtype, stage, grade features was also evaluated. In 160 triple negative breast cancers, mRNA microarray expression profiling was performed, and differences according to androgen receptor status were analyzed. In triple negative cancers the percentage of androgen receptor positive cases was lower (24.8% vs 81.6% of non-triple negative cases, especially in African American women (16.7% vs 25.5% of cancers of white women. No significant difference in androgen receptor expression was observed in primary tumors vs matched metastatic lesions. Positive androgen receptor immunoreactivity was inversely correlated with tumor grade (p<0.01 and associated with better overall patient survival (p = 0.032 in the non-basal triple negative cancer group. In the microarray study, expression of three genes (HER4, TNFSF10, CDK6 showed significant deregulation in association with androgen receptor status; eg CDK6, a novel therapeutic target in triple negative cancers, showed significantly higher expression level in androgen receptor negative cases (p<0.01. These findings confirm the prognostic impact of androgen receptor expression in non-basal triple negative breast cancers, and suggest targeting of new androgen receptor-related molecular pathways in patients with these cancers.

  7. The role of stress and beta-adrenergic system in melanoma: current knowledge and possible therapeutic options.

    Science.gov (United States)

    Colucci, Roberta; Moretti, Silvia

    2016-05-01

    The aim of the present review was to discuss recent findings on the role of beta-adrenergic system in melanoma, in order to provide information on the biological responses elicited by its activation and its potential application for melanoma treatment. A literature search was performed, and evidences regarding the involvement of stress and beta-adrenergic system in cancer and melanoma were found and discussed. Our search pointed out that beta-adrenergic system is a key regulator of important biological processes involved in the onset and progression of some solid tumors. In the last decade, functional beta-adrenoceptors have been also identified on melanoma cells, as well as on their microenvironment cells. Similarly to other common cancers too, the activation of such adrenoceptors by catecholamines, usually released under stress conditions, has been found to trigger pro-tumorigenic pathways contributing to cell proliferation and motility, immune system regulation, apoptosis, epithelial-mesenchymal transition, invasion and neoangiogenesis. The biological evidences we found clarify and sustain the clinical evidences reporting the involvement of chronic stress in melanoma onset and progression. In such scenario, it is conceivable that a therapeutic approach targeting beta-adrenergic system could constitute a novel and promising strategy for melanoma treatment.

  8. Evaluation of MYBPC3 trans-Splicing and Gene Replacement as Therapeutic Options in Human iPSC-Derived Cardiomyocytes

    Directory of Open Access Journals (Sweden)

    Maksymilian Prondzynski

    2017-06-01

    Full Text Available Gene therapy is a promising option for severe forms of genetic diseases. We previously provided evidence for the feasibility of trans-splicing, exon skipping, and gene replacement in a mouse model of hypertrophic cardiomyopathy (HCM carrying a mutation in MYBPC3, encoding cardiac myosin-binding protein C (cMyBP-C. Here we used human induced pluripotent stem cell-derived cardiomyocytes (hiPSC-CMs from an HCM patient carrying a heterozygous c.1358-1359insC MYBPC3 mutation and from a healthy donor. HCM hiPSC-CMs exhibited ∼50% lower MYBPC3 mRNA and cMyBP-C protein levels than control, no truncated cMyBP-C, larger cell size, and altered gene expression, thus reproducing human HCM features. We evaluated RNA trans-splicing and gene replacement after transducing hiPSC-CMs with adeno-associated virus. trans-splicing with 5′ or 3′ pre-trans-splicing molecules represented ∼1% of total MYBPC3 transcripts in healthy hiPSC-CMs. In contrast, gene replacement with the full-length MYBPC3 cDNA resulted in ∼2.5-fold higher MYBPC3 mRNA levels in HCM and control hiPSC-CMs. This restored the cMyBP-C level to 81% of the control level, suppressed hypertrophy, and partially restored gene expression to control level in HCM cells. This study provides evidence for (1 the feasibility of trans-splicing, although with low efficiency, and (2 efficient gene replacement in hiPSC-CMs with a MYBPC3 mutation.

  9. Medicinal plants--prophylactic and therapeutic options for gastrointestinal and respiratory diseases in calves and piglets? A systematic review.

    Science.gov (United States)

    Ayrle, Hannah; Mevissen, Meike; Kaske, Martin; Nathues, Heiko; Gruetzner, Niels; Melzig, Matthias; Walkenhorst, Michael

    2016-06-06

    Gastrointestinal and respiratory diseases in calves and piglets lead to significant economic losses in livestock husbandry. A high morbidity has been reported for diarrhea (calves ≤ 35%; piglets ≤ 50%) and for respiratory diseases (calves ≤ 80%; piglets ≤ 40%). Despite a highly diverse etiology and pathophysiology of these diseases, treatment with antimicrobials is often the first-line therapy. Multi-antimicrobial resistance in pathogens results in international accordance to strengthen the research in novel treatment options. Medicinal plants bear a potential as alternative or additional treatment. Based on the versatile effects of their plant specific multi-component-compositions, medicinal plants can potentially act as 'multi-target drugs'. Regarding the plurality of medicinal plants, the aim of this systematic review was to identify potential medicinal plant species for prevention and treatment of gastrointestinal and respiratory diseases and for modulation of the immune system and inflammation in calves and piglets. Based on nine initial sources including standard textbooks and European ethnoveterinary studies, a total of 223 medicinal plant species related to the treatment of gastrointestinal and respiratory diseases was identified. A defined search strategy was established using the PRISMA statement to evaluate 30 medicinal plant species starting from 20'000 peer-reviewed articles published in the last 20 years (1994-2014). This strategy led to 418 references (257 in vitro, 84 in vivo and 77 clinical trials, thereof 48 clinical trials in veterinary medicine) to evaluate effects of medicinal plants and their efficacy in detail. The findings indicate that the most promising candidates for gastrointestinal diseases are Allium sativum L., Mentha x piperita L. and Salvia officinalis L.; for diseases of the respiratory tract Echinacea purpurea (L.) MOENCH, Thymus vulgaris L. and Althea officinalis L. were found most promising, and Echinacea purpurea (L

  10. Successful Isolation of Viable Adipose-Derived Stem Cells from Human Adipose Tissue Subject to Long-Term Cryopreservation: Positive Implications for Adult Stem Cell-Based Therapeutics in Patients of Advanced Age

    Directory of Open Access Journals (Sweden)

    Sean M. Devitt

    2015-01-01

    Full Text Available We examined cell isolation, viability, and growth in adipose-derived stem cells harvested from whole adipose tissue subject to different cryopreservation lengths (2–1159 days from patients of varying ages (26–62 years. Subcutaneous abdominal adipose tissue was excised during abdominoplasties and was cryopreserved. The viability and number of adipose-derived stem cells isolated were measured after initial isolation and after 9, 18, and 28 days of growth. Data were analyzed with respect to cryopreservation duration and patient age. Significantly more viable cells were initially isolated from tissue cryopreserved 2 years, irrespective of patient age. However, this difference did not persist with continued growth and there were no significant differences in cell viability or growth at subsequent time points with respect to cryopreservation duration or patient age. Mesenchymal stem cell markers were maintained in all cohorts tested throughout the duration of the study. Consequently, longer cryopreservation negatively impacts initial live adipose-derived stem cell isolation; however, this effect is neutralized with continued cell growth. Patient age does not significantly impact stem cell isolation, viability, or growth. Cryopreservation of adipose tissue is an effective long-term banking method for isolation of adipose-derived stem cells in patients of varying ages.

  11. THERAPEUTIC OPTIONS FOR BREAST CANCER

    Directory of Open Access Journals (Sweden)

    Milena Georgescu

    2011-12-01

    Full Text Available Breast cancer remains a major public health problem, being the second cause of cancer death in women. There is a marked tendency to restrict the extension of surgical gesture, which directly leads to two different attitudes: radical surgery and conservative surgery, to which, at least in our country, there are still some delays. Prospective and retrospective studies have shown that, in 20 years, conservative and radical therapy had about the same rate of survival and disease-free interval, at least for stage I and II breast cancer, the only real counterargument against conservative surgery being that, in principle, the higher rate of recurrence local constraint can be solved by postoperative radiotherapy. Finally, the survival rate is the main parameter of evaluation, assessing the effectiveness of the treatment in breast cancer, and in all its other forms.

  12. Radiation caries: a therapeutical option

    International Nuclear Information System (INIS)

    Biazolla, E.R.; Miziara, T.C.

    1988-01-01

    It is showed a clinical report about radiation caries. As the tooth destruction was, mainly, of the majority of the teeth, was made a therapy where, besides avoiding the osteoradiomielite, also is possible to reability the patient. (author)

  13. CDK4/6 dual inhibitor abemaciclib demonstrates compelling preclinical activity against esophageal adenocarcinoma: a novel therapeutic option for a deadly disease.

    Science.gov (United States)

    Kosovec, Juliann E; Zaidi, Ali H; Omstead, Ashten N; Matsui, Daisuke; Biedka, Mark J; Cox, Erin J; Campbell, Patrick T; Biederman, Robert W W; Kelly, Ronan J; Jobe, Blair A

    2017-11-21

    Esophageal adenocarcinoma (EAC) is a deadly disease with limited therapeutic options. In the present study, we determined the preclinical efficacy of CDK4/6 inhibitor abemaciclib for treatment of EAC. In vitro , apoptosis, proliferation, and pathway regulation were evaluated in OE19, OE33, and FLO1 EAC cell lines. In vivo , esophagojejunostomy was performed on rats to induce EAC. At 36 weeks post-surgery, MRI and endoscopic biopsy established baseline tumor volume and molecular correlates, respectively. Next, the study animals were randomized to 26mg/kg intraperitoneal abemaciclib treatment or vehicle control for 28 days. Pre and post treatment MRIs, histopathology, and qRT-PCR were utilized to determine response. Our results demonstrated treatment with abemaciclib lead to increased apoptosis, and decreased proliferation in OE19 (p=0.185), OE33 (p=0.048), and FLO1 (p=0.043) with anticipated downstream molecular inhibition. In vivo , 78.9% of treatment animals demonstrated >20% tumor volume decrease (placebo 0%). Mean tumor volume changed in the treatment arm by -65.5% (placebo +133.5%) (p<0.01), and prevalence changed by -37.5% (placebo +16.7%) (p<0.01). Pre vs post treatment qRT-PCR demonstrated significant inhibition of all downstream molecular correlates. Overall our findings suggest potent antitumor efficacy of abemaciclib against EAC with evident molecular pathway inhibition and reasonable safety, establishing the rationale for future clinical development.

  14. Membrana amniótica como alternativa de tratamiento en superficie ocular Amniotic membrane as a therapeutic option for the ocular surface

    Directory of Open Access Journals (Sweden)

    Keyly Fernández García

    2012-12-01

    Full Text Available Se realizó una revisión bibliográfica con el objetivo de conocer la utilidad de la membrana amniótica como alternativa de tratamiento en la superficie ocular. Son abordados tópicos como las diferentes formas de obtención, preparación y conservación de la misma, sus mecanismos de acción y aplicaciones. Se consultó una bibliografía que abarca un periodo de varios años para conocer los resultados publicados sobre el trasplante de membrana amniótica humana en la superficie ocular.A literature review was made to learn about the usefulness of the amniotic membrane as a therapeutic option for the ocular surface. The different ways for obtaining, preparing, and conserving this membrane, its mechanism of action and its applications were also addressed. Literature covering several years was reviewed in order to be acquainted with the published results of the human amniotic membrane transplantation on the ocular surface.

  15. Finding a Comparison Group: Is Online Crowdsourcing a Viable Option?

    Science.gov (United States)

    Azzam, Tarek; Jacobson, Miriam R.

    2013-01-01

    This article explores the viability of online crowdsourcing for creating matched-comparison groups. This exploratory study compares survey results from a randomized control group to survey results from a matched-comparison group created from Amazon.com's MTurk crowdsourcing service to determine their comparability. Study findings indicate…

  16. Judicial review of Shaik's medical parole a viable option

    African Journals Online (AJOL)

    Dr. Loammi Wolf

    This section will focus on pre-trial equal treatment in criminal justice. ..... (state) level with the bulk of criminal offences falling under the jurisdiction of the ...... January 2007 he was hospitalised for dental surgery, this time under a false ... See "Crooked patient, crooked docs" News24 ..... and may create legal uncertainty in.

  17. Judicial review of Shaik's medical parole a viable option

    African Journals Online (AJOL)

    Dr. Loammi Wolf

    The normative quality of pre-conviction equality is therefore much ..... not signal a relationship of subordination typical of an internal executive hierarchy. .... The Judicial Service Commission in South Africa usually consists of ...... he was sighted at an upmarket French restaurant where a lunch party was held to celebrate his.

  18. Is Leaving the Middle East a Viable Option

    Science.gov (United States)

    2008-01-01

    overran the South. The plight of the South Vietnamese boat people, the Cambodian killing fields, or the fall of eleven countries to communist forces in...their causes, whether American Zionists or Christian humanitarian groups, which opposed the slaughter of their brethren or the Turkish genocide of...large numbers during the 1920s to the eastern Mediterranean enclave. The rise of the Nazis and their genocidal polices during the 1930s and 1940s

  19. Trend of extensively drug-resistant Acinetobacter baumannii and the remaining therapeutic options: a multicenter study in Tehran, Iran over a 3-year period.

    Science.gov (United States)

    Jasemi, S; Douraghi, M; Adibhesami, H; Zeraati, H; Rahbar, M; Boroumand, M A; Aliramezani, A; Ghourchian, S; Mohammadzadeh, M

    2016-12-01

    Comprehensive data on drug-resistant patterns of Acinetobacter baumannii isolates in developing countries is limited. We conducted a multihospital study to assess the rate and trend of drug-resistant phenotypes in Ac. baumannii using standardized definitions and to determine the remaining therapeutic options against resistant phenotypes. The 401 nonduplicate isolates were collected from six hospitals which are geographically distributed across Tehran, Iran over a 3-year period. Following PCR of bla OXA -51-like gene, susceptibility testing was performed against nine antimicrobial agent categories. Three hundred and ninety (97%) isolates were resistant to least two carbapenems; carbapenem-resistant Ac. baumannii. The majority of isolates (366, 91·3%) were extensively drug resistant (XDR) and the rest of the isolates were classified as multidrug resistant (26, 6·8%) and susceptible (9, 2·2%). The rate of XDR-AB slightly decreased from 93·8% in 2011 to 89·8% in 2013. A considerable decrease in resistance to doxycycline, minocycline and tigecycline was demonstrated. The XDR-AB isolates showed susceptibility to gentamicin (10·4%), tobramycin (23%), ampicilin-sulbactam (30·1%), minocycline (32·8%), tigecycline (10·7%), doxycycline (21·6%), colistin (100%) and polymixin B (100%). We demonstrated the rising trend of resistance to all antibiotic categories except tetracyclines and folate pathway inhibitors. We found that the treatment options against XDR-AB are extremely limited and each treatment alternative including even old, but safe, antibiotics might be considered. The high frequency of drug-resistant phenotypes including carbapenem-resistant Acinetobacter baumannii, multidrug-resistant, and extensively resistant has been demonstrated in Ac. baumannii isolates tested here. As the antibiotic resistance pattern of isolates varies in different geographical regions, this study can provide comprehensive information about the antibiotic resistance profile of Ac

  20. Exergaming as a viable therapeutic tool to improve static and dynamic balance among older adults and people with idiopathic Parkinson’s disease: a systematic review and meta-analysis

    Directory of Open Access Journals (Sweden)

    Dale Michael Harris

    2015-09-01

    Full Text Available The use of virtual reality games (known as ‘exergaming’ as a neurorehabilitation tool is gaining interest. Therefore, we aim to collate evidence for the effects of exergaming on the balance and postural control of older adults and people with idiopathic Parkinson’s disease (IPD. Six electronic databases were searched, from inception to April 2015, to identify relevant studies. Standardised mean differences (SMD and 95% confidence intervals (CI were used to calculate effect sizes between experimental and control groups. I2 statistics were used to determine levels of heterogeneity. 309 older adults and 74 people with IPD were assessed across eleven studies. The results showed that exergaming improved static balance (SMD 1.069, 95% CI 0.563 to 1.576, postural control (SMD 0.826, 95% CI 0.481 to 1.170 and dynamic balance (SMD -0.808, 95% CI -1.192 to -0.424 in healthy older adults. Two PD studies showed an improvement in static balance (SMD 0.124, 95% CI -0.581 to 0.828 and postural control (SMD 2.576, 95% CI 1.534 to 3.599. Our findings suggest that exergaming might be an appropriate therapeutic tool for improving balance and postural control in older adults, but more large-scale trials are needed to determine if the same is true for people with IPD.

  1. Exergaming as a Viable Therapeutic Tool to Improve Static and Dynamic Balance among Older Adults and People with Idiopathic Parkinson’s Disease: A Systematic Review and Meta-Analysis

    Science.gov (United States)

    Harris, Dale M.; Rantalainen, Timo; Muthalib, Makii; Johnson, Liam; Teo, Wei-Peng

    2015-01-01

    The use of virtual reality games (known as “exergaming”) as a neurorehabilitation tool is gaining interest. Therefore, we aim to collate evidence for the effects of exergaming on the balance and postural control of older adults and people with idiopathic Parkinson’s disease (IPD). Six electronic databases were searched, from inception to April 2015, to identify relevant studies. Standardized mean differences (SMDs) and 95% confidence intervals (CI) were used to calculate effect sizes between experimental and control groups. I2 statistics were used to determine levels of heterogeneity. 325 older adults and 56 people with IPD who were assessed across 11 ­studies. The results showed that exergaming improved static balance (SMD 1.069, 95% CI 0.563–1.576), postural control (SMD 0.826, 95% CI 0.481–1.170), and dynamic balance (SMD −0.808, 95% CI −1.192 to −0.424) in healthy older adults. Two IPD studies showed an improvement in static balance (SMD 0.124, 95% CI −0.581 to 0.828) and postural control (SMD 2.576, 95% CI 1.534–3.599). Our findings suggest that exergaming might be an appropriate therapeutic tool for improving balance and postural control in older adults, but more ­large-scale trials are needed to determine if the same is true for people with IPD. PMID:26441634

  2. Morphoproteomics, E6/E7 in-situ hybridization, and biomedical analytics define the etiopathogenesis of HPV-associated oropharyngeal carcinoma and provide targeted therapeutic options.

    Science.gov (United States)

    Brown, Robert E; Naqvi, Syed; McGuire, Mary F; Buryanek, Jamie; Karni, Ron J

    2017-08-17

    biomedical analytics as consistent with published literature. This is significant because the biology lends itself to targeted therapeutic options using metformin, curcumin, celecoxib and sulforaphane as therapeutic strategies to prevent progression or recurrence of disease.

  3. Combination of hydroxyapatite, platelet rich fibrin and amnion membrane as a novel therapeutic option in regenerative periapical endodontic surgery: Case series

    Directory of Open Access Journals (Sweden)

    Uday Kiran Uppada

    2017-01-01

    Conclusion: The results of this case seriessubstantiatesthe credibility of using a combination ofamnion membrane with a bone graft and PRF to enhance radiographic healing outcome with decreased post-operative discomfort and present a viable regenerative treatment modality in periapical surgery.

  4. Left atrial appendage occlusion with Amplatzer Cardio Plug is an acceptable therapeutic option for prevention of stroke recurrence in patients with non-valvular atrial fibrillation and contraindication or failure of oral anticoagulation with acenocumarol

    OpenAIRE

    Hawkes, Maximiliano A.; Pertierra, Lucía; Rodriguez-Lucci, Federico; Pujol-Lereis, Virginia A.; Ameriso, Sebastián F.

    2016-01-01

    ABSTRACT Left atrial appendage occlusion (LAAO) appears as a therapeutic option for some atrial fibrillation patients not suitable for oral anticoagulation because an increased hemorrhagic risk or recurrent ischemic events despite anticoagulant treatment. Methods Report of consecutive atrial fibrillation patients treated with LAAO with Amplatzer Cardio Plug because contraindication or failure of oral anticoagulation with acenocumarol. CHA2DS2VASC, HAS-BLED, NIHSS, mRS, procedural complicati...

  5. Immediate natural tooth pontic: A viable yet temporary prosthetic solution: A patient reported outcome

    Directory of Open Access Journals (Sweden)

    Sudhir Bhandari

    2012-01-01

    Conclusion: The concept of immediate pontic placement is surely a viable treatment option and promises an excellent transient esthetic solution for a lost tooth as well as enables good preparation of the extraction site for future prosthetic replacement.

  6. Wind energy: A viable alternative

    International Nuclear Information System (INIS)

    Soin, R.S.

    1991-01-01

    This article examines the economic feasibility of wind energy in the current economic and political environment. The article specifically addresses the wind farm application to India, with asides to Europe and the US. Topics discussed include cost of energy generation for a 10 MW wind farm, cost comparison for captive energy options (diesel, coal, wind), environmental impacts, and social benefits

  7. Energy options

    International Nuclear Information System (INIS)

    Hampton, Michael

    1999-01-01

    This chapter focuses on energy options as a means of managing exposure to energy prices. An intuitive approach to energy options is presented, and traditional definitions of call and put options are given. The relationship between options and swaps, option value and option exercises, commodity options, and option pricing are described. An end-user's guide to energy option strategy is outlined, and straight options, collars, participating swaps and collars, bull and bear spreads, and swaption are examined. Panels explaining the defining of basis risk, and discussing option pricing and the Greeks, delta hedging, managing oil options using the Black-Scholes model, caps, floors and collars, and guidelines on hedging versus speculation with options are included in the paper

  8. Avian Diagnostic and Therapeutic Antibodies

    Energy Technology Data Exchange (ETDEWEB)

    Bradley, David Sherman [UND SMHS

    2012-12-31

    A number of infectious agents have the potential of causing significant clinical symptomology and even death, but dispite this, the number of incidence remain below the level that supports producing a vaccine. Therapeutic antibodies provide a viable treatment option for many of these diseases. We proposed that antibodies derived from West Nile Virus (WNV) immunized geese would be able to treat WNV infection in mammals and potential humans. We demonstrated that WNV specific goose antibodies are indeed successful in treating WNV infection both prophylactically and therapeutically in a golden hamster model. We demonstrated that the goose derived antibodies are non-reactogenic, i.e. do not cause an inflammatory response with multiple exposures in mammals. We also developed both a specific pathogen free facility to house the geese during the antibody production phase and a patent-pending purification process to purify the antibodies to greater than 99% purity. Therefore, the success of these study will allow a cost effective rapidly producible therapeutic toward clinical testing with the necessary infrastructure and processes developed and in place.

  9. Viable Syntax: Rethinking Minimalist Architecture

    Directory of Open Access Journals (Sweden)

    Ken Safir

    2010-03-01

    Full Text Available Hauser et al. (2002 suggest that the human language faculty emerged as a genetic innovation in the form of what is called here a ‘keystone factor’—a single, simple, formal mental capability that, interacting with the pre-existing faculties of hominid ancestors, caused a cascade of effects resulting in the language faculty in modern humans. They take Merge to be the keystone factor, but instead it is posited here that Merge is the pre-existing mechanism of thought made viable by a principle that permits relations interpretable at the interfaces to be mapped onto c-command. The simplified minimalist architecture proposed here respects the keystone factor as closely as possible, but is justified on the basis of linguistic analyses it makes available, including a relativized intervention theory applicable across Case, scope, agreement, selection and linearization, a derivation of the A/A’-distinction from Case theory, and predictions such as why in situ wh-interpretation is island-insensitive, but susceptible to intervention effects.

  10. Therapeutic options to enhance coma arousal after traumatic brain injury: state of the art of current treatments to improve coma recovery.

    Science.gov (United States)

    Cossu, Giulia

    2014-04-01

    Traumatic brain injury is a leading cause of death and disability. Optimizing the recovery from coma is a priority in seeking to improve patients' functional outcomes. Standards of care have not been established: pharmacological interventions, right median nerve and sensory stimulation, dorsal column stimulation (DCS), deep brain stimulation, transcranial magnetic stimulation, hyperbaric oxygen therapy and cell transplantation have all been utilized with contrasting results. The aim of this review is to clarify the indications for the various techniques and to guide the clinical practice towards an earlier coma arousal. A systematic bibliographic search was undertaken using the principal search engines (Pubmed, Embase, Ovid and Cochrane databases) to locate the most pertinent studies. Traumatic injury is a highly individualized process, and subsequent impairments are dependent on multiple factors: this heterogeneity influences and determines therapeutic responses to the various interventions.

  11. Modulation of the activity of N-methyl-D-aspartate receptors as a novel treatment option for depression: current clinical evidence and therapeutic potential of rapastinel (GLYX-13

    Directory of Open Access Journals (Sweden)

    Vasilescu AN

    2017-03-01

    Full Text Available Andrei-Nicolae Vasilescu,1,* Nina Schweinfurth,2,* Stefan Borgwardt,2,* Peter Gass,1 Undine E Lang,2,* Dragos Inta,1,2,* Sarah Eckart2,* 1Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Heidelberg, Germany; 2Department of Psychiatry (Universitäre Psychiatrische Kliniken, University of Basel, Basel, Switzerland *These authors contributed equally to this work Abstract: Classical monoaminergic antidepressants show several disadvantages, such as protracted onset of therapeutic action. Conversely, the fast and sustained antidepressant effect of the N-methyl-d-aspartate receptor (NMDAR antagonist ketamine raises vast interest in understanding the role of the glutamate system in mood disorders. Indeed, numerous data support the existence of glutamatergic dysfunction in major depressive disorder (MDD. Drawback to this short-latency therapy is its side effect profile, especially the psychotomimetic action, which seriously hampers the common and widespread clinical use of ketamine. Therefore, there is a substantial need for alternative glutamatergic antidepressants with milder side effects. In this article, we review evidence that implicates NMDARs in the prospective treatment of MDD with focus on rapastinel (formerly known as GLYX-13, a novel synthetic NMDAR modulator with fast antidepressant effect, which acts by enhancing NMDAR function as opposed to blocking it. We summarize and discuss current clinical and animal studies regarding the therapeutic potential of rapastinel not only in MDD but also in other psychiatric disorders, such as obsessive–compulsive disorder and posttraumatic stress disorder. Additionally, we discuss current data concerning the molecular mechanisms underlying the antidepressant effect of rapastinel, highlighting common aspects as well as differences to ketamine. In 2016, rapastinel received the Breakthrough Therapy designation for the treatment

  12. The use of the rhTSH (thyrogen-genzyme) as adjuvant to the radioiodine (131I) in multi nodular goiter treatment : comparison among 2 therapeutic options

    International Nuclear Information System (INIS)

    Albino, Claudio C.; Gaviolli, Aroldo; Mesa, Cleo; Graf, Hans

    2005-01-01

    Full text: Introduction: In our experience and of the recent literature, the association of the recombinant TSH (rh TSH) in low doses, previously to 131 I has been value in MNG treatment. However we don't have an ideal approach on this disease. Objective: To compare two different options with rh TSH previously to fixed dose of 131 I (30 mCi) in BMN treatment. Patients and Methods: We have 18 patients in group 1 and 14 in group 2. The patients had similar age and volume goiter in both groups. They were submitted to the same diagnosis protocol: TSH, FT 4 , T 3 , Tg on days 0, 1, 2, 3, 5, 10, 30, 90, 180 and TPO ab, Tg ab and TRAB on days 0, 30, 90 and 180. The goiter was measured by helicoidal CT on days 0 and 180.The RAIU on 24 h after rh TSH was measured in both groups. The G 1 used rh TSH in two consecutive doses of 0,1 mg and the G 2 used an unique dose of 0,1 mg. Both groups were submitted to 30 mCi of 131 I 24 h after the last injection of rh TSH. Results: The increment of TSH level was bigger in group 1 than group 2 (33 times in G1 and 13 times in G2). Similar results were found on FT 4 ,T 3 and Tg levels. The hormones returned to base levels after 30 d on G1 and 90 d on G2. The RAIU 24 h peak was bigger on G1 than G2 (12% to 52% on G1 and 10,2% to 35% on G2). 39% patients on G1 and 21% on G2 had clinic thyrotoxicosis and actinic thyroiditis were prevalent in 33 % on G1 and 14% on G2. After six months 65% of patients on G1 were in hypothyroidism and 28% on G2. The reduction on goiter volume was similar in both groups: 40% on G1 and 45% on G2. Conclusion: The option with 1 injection of 0,1 mg rh TSH plus 131 I had similar efficiency on reduction of volume goiter however was safer than 2 injections of 0,1 rh TSH plus 131 I in MNG treatment. (author)

  13. Is photodynamic therapy a relevant therapeutic option in refractory benign familial pemphigus (Hailey-Hailey disease)? A series of eight patients.

    Science.gov (United States)

    Alsahli, Maha; Debu, Anca; Girard, Celine; Bessis, Didier; Du Thanh, Aurélie; Guillot, Bernard; Dereure, Olivier

    2017-11-01

    Treatment of benign familial pemphigus or Hailey-Hailey disease (HHD), a rare inherited condition associated with a significant impairment of quality of life, is often challenging and disappointing with frequent relapses and infectious complications. Topical photodynamic therapy (PDT) may offer new perspectives in this difficult setting. Eight patients with long-lasting HHD lesions refractory to multiple treatments were treated on at least one involved site with PDT using methyl-amino levulinate with a standardized protocol of three sessions of irradiation separated by 3-week intervals. A complete or partial clearing was achieved in all treated areas, and the result was satisfactorily maintained in all cases after a follow-up period ranging from 3 to 36 months. Results were of higher quality in non-inguinal areas. Tolerance was overall acceptable with local pain during and shortly after irradiation being the main limiting factor. Our series, although limited in size, emphasizes the interest of PDT in this difficult condition even though results may be incomplete. Treatment-related pain can be adequately managed by prior analgesics, cooling with sprayed water and local tumescent anesthesia. Overall, PDT appears as a relevant option in refractory HHD management with a favorable benefit/risk ratio.

  14. PO-38 - Young women with breast cancer and inferior vena cava thrombosis. Which is the best therapeutic option? And for how long?

    Science.gov (United States)

    Vilaseca, A B; Capmany, C L; Sabsay, F

    2016-04-01

    Thromboembolic disease (TED) is frequent, and, thromboembolic events are the second cause of death in active cancer patients Today we have knowledge of a lot of risk and predictor factors of thrombosis in cancer, although some mechanisms underlying this increased thromboembolic risk, still remains unclear. Knowing that cancer is today curable, we want to remark that not only old people but also young should be investigated about their personal burden of thromboembolic disease to improve prognosis, and at the same time remark the need to establish different therapeutic strategies in each stage of the disease to prevent or treat TED. We present the case of a young 28 old, female, with breast nodule and axillaries lymphadenopathies, highly suspicious of breast cancer. She has an acute Inferior Vena Cava Thrombosis in her Scan Tomography with a 40% occlusion clinically asymptomatic. Personal history: 2008 splenectomy by a refractory autoimmune hemolytic anemia Directed Coombs Positive (DC) to corticosteroids, 2010 hypothyroidism, 2011 anti lupus antibodies(LA) during traditional pre surgical coagulation test, that persist along time. Family history positive for breast cancer, mother and grandmother and negative for thromboembolic disease In this scenario we decide to put her in low molecular weight heparin 1mg/kg bid a day until we have the oncology diagnosis and then re evaluate our therapeutic anticoagulant decision. After breast cancer diagnosis with the axillaries biopsy she continued with LMWH at full doses to perform the surgery and complete treatment. The diagnosis after surgery was high grade intraductal carcinoma N1 Pos of 21. She performs chemotherapy with cyclophosphamide, doxorubicin and taxol and then radiotherapy. She has been controlled with doppler ultrasonography every three months, at month six shows vena cava recanalization. When she finished radiotherapy we stop HBPM one day and reevaluated for LA that persist positive. At this time we decided to

  15. A semifluorinated alkane (F4H5) as novel carrier for cyclosporine A: a promising therapeutic and prophylactic option for topical treatment of dry eye.

    Science.gov (United States)

    Gehlsen, Uta; Braun, Tobias; Notara, Maria; Krösser, Sonja; Steven, Philipp

    2017-04-01

    Cyclosporine A (Cs) has been used as effective topical therapy for inflammatory dry eye disease since more than a decade. However, due to its lipophilic character, Cs is formulated as emulsions or oily solutions for topical application. This experimental study aimed to test if the use of semifluorinated alkanes (SFAs) as a preservative-free, well-tolerated non-stinging or burning vehicle maintains or even improves the benefits of Cs in the topical therapy of dry-eye disease. Desiccating stress was applied to C57BL/6 mice for 14 consecutive days to induce experimental dry-eye. Cs dissolved in SFA (perfluorobutylpentane = F4H5with 0.5% Ethanol), F4H5 with 0.5% ethanol only, 0.05% Cs (Restasis®), and dexamethasone (Monodex®) were applied three times daily beginning either at day 4 or day 11 of desiccating stress for up to 3 weeks after end of dry-eye induction. In comparison to other groups, Cs/F4H5 demonstrated high efficacy and earlier reduction of corneal staining. In this study, Cs/F4H5 had the ability to maintain conjunctival goblet cell density once applied on day 4. Flow cytometry analysis from cervical lymphnodes demonstrated a significantly lower CD4+ and CD8+ T-cells in the Cs/F4H5 group following 3 weeks of therapy than at baseline, but no difference in regulatory T cells from regional lymphnodes were seen. Overall, compared to a commercially available Cs formulation (Restasis®) and dexamethasone, Cs/F4H5 was shown to be equally effective but with a significantly faster therapeutic response in reducing signs of dry-eye disease in an experimental mouse model.

  16. Rehabilitation Options

    Science.gov (United States)

    ... Speech Pathology Occupational Therapy Art Therapy Recreational therapy Neuropsychology Home Care Options Advanced Care Planning Palliative Care ... Speech Pathology Occupational Therapy Art Therapy Recreational therapy Neuropsychology Home Care Options Advanced Care Planning Palliative Care ...

  17. On-Chip Dielectrophoretic Separation and Concentration of Viable, Non-Viable and Viable but Not Culturable (VBNC) Escherichia coli

    Energy Technology Data Exchange (ETDEWEB)

    Packard, M M; Shusteff, M; Alocilja, E C

    2012-04-12

    Although bacterial culture remains the gold standard for detection of viable bacteria in environmental specimens, the typical time requirement of twenty-four hours can delay and even jeopardize appropriate public health intervention. In addition, culture is incapable of detecting viable but not culturable (VBNC) species. Conversely, nucleic acid and antibody-based methods greatly decrease time to detection but rarely characterize viability of the bacteria detected. Through selection by membrane permeability, the method described in this work employs positive dielectrophoresis (pDEP) for separation and purification of viable and VBNC species from water and allows concentration of bacteria for downstream applications.

  18. Strengthening Agricultural Research Capacity for Viable Extension ...

    African Journals Online (AJOL)

    Strengthening Agricultural Research Capacity for Viable Extension Policies in Nigeria: An Exploration of Ricoeur's Hermeneutic Theory for Analysing Extension Research. ... Progressively more, researchers use hermeneutic philosophy to inform the conduct of interpretive research. Analogy between the philosophical ...

  19. Automated (Centrifugal) Therapeutic Plasma Exchange Option for ...

    African Journals Online (AJOL)

    Central nervous system examination showed a conscious man, alert, and oriented in time, person, and place. There were no signs of meningeal irritation and the cranial nerves were grossly intact. There was no power in the limbs: global hypotonia and areflexia were noted on examination. However, he had intact sensory ...

  20. Sporotrichosis: An Overview and Therapeutic Options

    Science.gov (United States)

    Mahajan, Vikram K.

    2014-01-01

    Sporotrichosis is a chronic granulomatous mycotic infection caused by Sporothrix schenckii, a common saprophyte of soil, decaying wood, hay, and sphagnum moss, that is endemic in tropical/subtropical areas. The recent phylogenetic studies have delineated the geographic distribution of multiple distinct Sporothrix species causing sporotrichosis. It characteristically involves the skin and subcutaneous tissue following traumatic inoculation of the pathogen. After a variable incubation period, progressively enlarging papulo-nodule at the inoculation site develops that may ulcerate (fixed cutaneous sporotrichosis) or multiple nodules appear proximally along lymphatics (lymphocutaneous sporotrichosis). Osteoarticular sporotrichosis or primary pulmonary sporotrichosis are rare and occur from direct inoculation or inhalation of conidia, respectively. Disseminated cutaneous sporotrichosis or involvement of multiple visceral organs, particularly the central nervous system, occurs most commonly in persons with immunosuppression. Saturated solution of potassium iodide remains a first line treatment choice for uncomplicated cutaneous sporotrichosis in resource poor countries but itraconazole is currently used/recommended for the treatment of all forms of sporotrichosis. Terbinafine has been observed to be effective in the treatment of cutaneous sporotrichosis. Amphotericin B is used initially for the treatment of severe, systemic disease, during pregnancy and in immunosuppressed patients until recovery, then followed by itraconazole for the rest of the therapy. PMID:25614735

  1. Sporotrichosis: An Overview and Therapeutic Options

    OpenAIRE

    Mahajan, Vikram K.

    2014-01-01

    Sporotrichosis is a chronic granulomatous mycotic infection caused by Sporothrix schenckii, a common saprophyte of soil, decaying wood, hay, and sphagnum moss, that is endemic in tropical/subtropical areas. The recent phylogenetic studies have delineated the geographic distribution of multiple distinct Sporothrix species causing sporotrichosis. It characteristically involves the skin and subcutaneous tissue following traumatic inoculation of the pathogen. After a variable incubation period, p...

  2. Natural Therapeutic Options in Endodontics - A Review

    Science.gov (United States)

    Venkateshbabu, Nagendrababu; Anand, Suresh; Abarajithan, Mohan; Sheriff, Sultan O.; Jacob, Pulikkotil S.; Sonia, Nath

    2016-01-01

    Complete eradication of microbial biofilms and elimination of the smear layer are the key factors during endodontic treatment. Various chemical irrigants have been proposed in the literature for the same. The major setback with these chemical irrigants is that they are not bio-friendly to the dental and peri-radicular tissues. In the recent years, research to use natural products for root canal disinfection has gained importance. The aim of this article is to compile various herbal products that have been used as an irrigants and intracanal medicaments in the field of Endodontics to eradicate the biofilm and remove smear layer. PMID:27386007

  3. Therapeutic options in peripheral T cell lymphoma

    Directory of Open Access Journals (Sweden)

    Yaping Zhang

    2016-04-01

    Full Text Available Abstract Peripheral T cell lymphoma (PTCL is a rare and heterogeneous group of non-Hodgkin lymphomas with a very poor prognosis. The standard first-line treatments have resulted in unsatisfactory patient outcomes. With the exception of low-risk anaplastic lymphoma kinase (ALK-positive anaplastic large cell lymphoma (ALCL, the majority of patients relapse rapidly; the current 5-year overall survival rates are only 10–30 %. Novel targeted therapies and combination chemotherapies are required for the treatment of patients with PTCL. In recent years, some retrospective and prospective studies have been performed concerning PTCL. Consequently, a number of novel agents and their relevant combination therapies have been identified, including histone deacetylase inhibitors, immunoconjugates, antifolates, monoclonal antibodies, immunomodulatory agents, nucleoside analogs, proteasome inhibitors, kinase inhibitors, bendamustine, l-asparaginase, and other targeted agents. It is hoped that these innovative approaches will finally improve outcomes in patients with PTCL. This review summarizes the currently available approaches for the treatment of PTCL with an emphasis on potential new agents, including the role of stem cell transplantation.

  4. New therapeutic options in meconium aspiration syndrome

    OpenAIRE

    Colvero, Mauricio Obal; Colvero, Aline Pieruccini; Fiori, Renato Machado; Garcia, Pedro Celiny Ramos

    2006-01-01

    OBJETIVOS: revisar a literatura sobre a síndrome de aspiração de mecônio (SAM), enfocando aspectos clínicos, fisiopatológicos e abordagem terapêutica, com destaque ao uso do surfactante e lavado broncoalveolar. MÉTODOS: revisão baseada em artigos publicados na MEDLINE, SCIELO e resumos de congressos internacionais de 1988 a 2004, incluindo ensaios randomizados ou quasi-randomizados, estudos caso-controle e metanálises. RESULTADOS: devido à comprovação da inibição do surfactante na SAM, houve ...

  5. Budget Options

    National Research Council Canada - National Science Library

    2000-01-01

    This volume-part of the Congressional Budget Office's (CBO's) annual report to the House and Senate Committees on the Budget-is intended to help inform policymakers about options for the federal budget...

  6. Sycamore produces viable seed after six years

    Science.gov (United States)

    A. F. Ike

    1966-01-01

    In the early stages of any tree improvement program it is desirable to know how soon progenies of selected parents can themselves be included in a breeding program. How soon will they produce viable pollen and seed? In the case of sycamore (Platanus occidentalis L.), the information is meager: the Woody- Plant Seed Manual lists the minimum commercial seedbearing age...

  7. Monotone viable trajectories for functional differential inclusions

    Science.gov (United States)

    Haddad, Georges

    This paper is a study on functional differential inclusions with memory which represent the multivalued version of retarded functional differential equations. The main result gives a necessary and sufficient equations. The main result gives a necessary and sufficient condition ensuring the existence of viable trajectories; that means trajectories remaining in a given nonempty closed convex set defined by given constraints the system must satisfy to be viable. Some motivations for this paper can be found in control theory where F( t, φ) = { f( t, φ, u)} uɛU is the set of possible velocities of the system at time t, depending on the past history represented by the function φ and on a control u ranging over a set U of controls. Other motivations can be found in planning procedures in microeconomics and in biological evolutions where problems with memory do effectively appear in a multivalued version. All these models require viability constraints represented by a closed convex set.

  8. Regulation of Viable and Optimal Cohorts

    Energy Technology Data Exchange (ETDEWEB)

    Aubin, Jean-Pierre, E-mail: aubin.jp@gmail.com [VIMADES (Viabilité, Marchés, Automatique, Décisions) (France)

    2015-10-15

    This study deals with the evolution of (scalar) attributes (resources or income in evolutionary demography or economics, position in traffic management, etc.) of a population of “mobiles” (economic agents, vehicles, etc.). The set of mobiles sharing the same attributes is regarded as an instantaneous cohort described by the number of its elements. The union of instantaneous cohorts during a mobile window between two attributes is a cohort. Given a measure defining the number of instantaneous cohorts, the accumulation of the mobile attributes on a evolving mobile window is the measure of the cohort on this temporal mobile window. Imposing accumulation constraints and departure conditions, this study is devoted to the regulation of the evolutions of the attributes which are1.viable in the sense that the accumulations constraints are satisfied at each instant;2.and, among them, optimal, in the sense that both the duration of the temporal mobile window is maximum and that the accumulation on this temporal mobile window is the largest viable one. This value is the “accumulation valuation” function. Viable and optimal evolutions under accumulation constraints are regulated by an “implicit Volterra integro-differential inclusion” built from the accumulation valuation function, solution to an Hamilton–Jacobi–Bellman partial differential equation under constraints which is constructed for this purpose.

  9. Technical note An investigation of the franchising option for water ...

    African Journals Online (AJOL)

    Technical note An investigation of the franchising option for water services operation ... of water services, and outlines the need to formulate a franchise model that ... made available to emerging entrepreneurs as the basis of a viable business.

  10. Axenic isolation of viable Giardia muris trophozoites.

    Science.gov (United States)

    Tillotson, K D; Buret, A; Olson, M E

    1991-06-01

    Large numbers of viable Giardia muris trophozoites were isolated from the duodenum of experimentally infected mice 6 days after inoculation with 1,000 G. muris cysts. A series of shaking, incubation, and washing steps in the presence of the broad-spectrum antibiotic piperacillin readily provided 4.9 +/- 1.5 x 10(5) G. muris trophozoites per mouse, free of detectable contaminant organisms. Anaerobic and microaerophilic culturing and scanning electron microscopy demonstrated axenic status and high purity of the isolates. The viability of trophozoites was 98 +/- 2%. Application of this technique should permit novel immunological and epidemiological analyses of G. muris infection and biochemical investigations of this protozoan parasite.

  11. New options in the management of tendinopathy

    Science.gov (United States)

    Maffulli, Nicola; Longo, Umile Giuseppe; Loppini, Mattia; Spiezia, Filippo; Denaro, Vincenzo

    2010-01-01

    Tendon injuries can be acute or chronic, and caused by intrinsic or extrinsic factors, either alone or in combination. Tendinopathies are a common cause of disability in occupational medicine and account for a substantial proportion of overuse injuries in sports. Tendinopathy is essentially a failed healing response, with haphazard proliferation of tenocytes, abnormalities in tenocytes, with disruption of collagen fibres and subsequent increase in noncollagenous matrix. The scientific evidence base for managing tendinopathies is limited. What may appear clinically as an “acute tendinopathy” is actually a well advanced failure of a chronic healing response in which there is neither histologic nor biochemical evidence of inflammation. In this review we report the new options for the management of tendinopathy, including eccentric exercises, extracorporeal shockwave therapy, injections (intratendinous injections of corticosteroids, aprotinin, polidocanol platelet-rich plasma, autologous blood injection, high-volume injections) and surgery. Open surgery aims to excise fibrotic adhesions, remove areas of failed healing and make multiple longitudinal incisions in the tendon to detect intratendinous lesions, and to restore vascularity and possibly stimulate the remaining viable cells to initiate cell matrix response and healing. New surgical techniques aim to disrupt the abnormal neoinnervation to interfere with the pain sensation caused by tendinopathy. These procedures are intrinsically different from the classical ones in present use, because they do not attempt to address directly the pathologic lesion, but act only to denervate them. They include endoscopy, electrocoagulation, and minimally invasive stripping. Further randomized controlled trials are necessary to clarify better the best therapeutic options for the management of tendinopathy. PMID:24198540

  12. New options in the management of tendinopathy

    Directory of Open Access Journals (Sweden)

    Nicola Maffulli

    2010-03-01

    Full Text Available Nicola Maffulli1, Umile Giuseppe Longo2, Mattia Loppini2, Filippo Spiezia2, Vincenzo Denaro21Centre for Sports and Exercise Medicine, Queen Mary University of London, Barts and The London School of Medicine and Dentistry, Mile End Hospital, London, England; 2Department of Orthopedic and Trauma Surgery, Campus Biomedico University, Rome, ItalyAbstract: Tendon injuries can be acute or chronic, and caused by intrinsic or extrinsic factors, either alone or in combination. Tendinopathies are a common cause of disability in occupational medicine and account for a substantial proportion of overuse injuries in sports. Tendinopathy is essentially a failed healing response, with haphazard proliferation of tenocytes, abnormalities in tenocytes, with disruption of collagen fibres and subsequent increase in noncollagenous matrix. The scientific evidence base for managing tendinopathies is limited. What may appear clinically as an “acute tendinopathy” is actually a well advanced failure of a chronic healing response in which there is neither histologic nor biochemical evidence of inflammation. In this review we report the new options for the management of tendinopathy, including eccentric exercises, extracorporeal shockwave therapy, injections (intratendinous injections of corticosteroids, aprotinin, polidocanol platelet-rich plasma, autologous blood injection, high-volume injections and surgery. Open surgery aims to excise fibrotic adhesions, remove areas of failed healing and make multiple longitudinal incisions in the tendon to detect intratendinous lesions, and to restore vascularity and possibly stimulate the remaining viable cells to initiate cell matrix response and healing. New surgical techniques aim to disrupt the abnormal neoinnervation to interfere with the pain sensation caused by tendinopathy. These procedures are intrinsically different from the classical ones in present use, because they do not attempt to address directly the pathologic

  13. Energy exotic options

    International Nuclear Information System (INIS)

    Kaminski, V.; Gibner, S.; Pinnamaneni, K.

    1999-01-01

    This chapter with 88 references focuses on the use of exotic options to control exposure to energy prices. Exotic options are defined, and the conversion of a standard option into an exotic option and pricing models are examined. Pricing and hedging exotic options, path-dependent options, multi-commodity options, options on the minimum-or-maximum of two commodities, compound options, digital options, hybrid and complex structures, and natural gas daily options are described. Formulas for option pricing for vanilla, barrier, compound, options on minimum or maximum of two assets, and look back options are given in an appendix

  14. Options theory

    International Nuclear Information System (INIS)

    Markland, J.T.

    1992-01-01

    Techniques used in conventional project appraisal are mathematically very simple in comparison to those used in reservoir modelling, and in the geosciences. Clearly it would be possible to value assets in mathematically more sophisticated ways if it were meaningful and worthwhile so to do. The DCf approach in common use has recognized limitations; the inability to select a meaningful discount rate being particularly significant. Financial Theory has advanced enormously over the last few years, along with computational techniques, and methods are beginning to appear which may change the way we do project evaluations in practice. The starting point for all of this was a paper by Black and Scholes, which asserts that almost all corporate liabilities can be viewed as options of varying degrees of complexity. Although the financial presentation may be unfamiliar to engineers and geoscientists, some of the concepts used will not be. This paper outlines, in plain English, the basis of option pricing theory for assessing the market value of a project. it also attempts to assess the future role of this type of approach in practical Petroleum Exploration and Engineering economics. Reference is made to relevant published Natural Resource literature

  15. Senior health clinics: are they financially viable?

    Science.gov (United States)

    McAtee, Robin E; Crandall, Debra; Wright, Larry D; Beverly, Claudia J

    2009-07-01

    Are hospital-based outpatient interdisciplinary clinics a financially viable alternative for caring for our burgeoning population of older adults in America? Although highly popular, with high patient satisfaction rates among older adults and their families, senior health clinics (SHCs) can be expensive to operate, with limited quantifiable health outcomes. This study analyzed three geriatric hospital-based interdisciplinary clinics in rural Arkansas by examining their patient profiles, revenues, and expenses. It closely examined the effects of the downstream revenue using the multiplier effect and acknowledged other factors that weigh heavily on the success of SHCs and the care of older adults. The findings highlight the similarities and differences in the three clinics' operating and financial structures in addition to the clinics' and providers' productivity. The analysis presents an evidence-based illustration that SHCs can break even or lose large amounts of money.

  16. Roots of success: cultivating viable community forestry

    Energy Technology Data Exchange (ETDEWEB)

    MacQueen, Duncan

    2009-05-15

    Is community forestry emerging from the shadows? The evidence shows that locally controlled enterprises can be economically viable, and often build on stronger social and environmental foundations than the big private-sector players. Certainly this is an industry in need of a shakeup. Many forests have become flashpoints where agro-industry, large-scale logging concerns and conservation interests clash, while forest-dependent communities are left out in the cold. Meanwhile, governments – driven by concerns over the climate impacts of deforestation – are having to gear up for legal, sustainable forestry production. Community forestry could be crucial to solving many of these challenges. By building on local core capabilities and developing strategic partnerships, they are forging key new business models that could transform the sector.

  17. Introduce of Viable But Nonculturable Bacteria

    Directory of Open Access Journals (Sweden)

    Mehdi Hassanshahian

    2008-03-01

    Full Text Available Viable-But-Nonculturable-State (VBNC is the condition in which bacteria fail to grow on their routine bacteriological media where they would normally grow and develop into colonies, but are still alive and capable of renewed metabolic activity. VBNC state is useful for evaluating public health and for ascertaining the sterility of drinking water, pharmaceuticals, and foodstuff. A number of bacteria, mostly pathogenic to humans, have been proved to enter into this state in response to natural stresses such as starvation, incubation out of optimum growth temperature, increased osmotic pressure, etc. Once in the VBNC state, they undergo various physiological, structural, and genetic alterations. These alterations result in reduced cell size, conversion from bacilli to coccid, thickened cell walls, and peptidoglycan gaining many cross links. Metabolic changes also occur that include reductions in growth, nutrient transport, and respiratory rate; biosynthesis of new protein, and ATP remaining at a constant level. It has been shown that in the VBNC state, some pathogens conserve their virulence properties. Gene expression continues in the VBNC cell. Nucleic acids remain intact in the early VBNC phase but they gradually undergo degradation with prolonged VBNC. Cytological methods such as direct viable count and reduction of tetrazolium salts, and molecular methods such as reverse transcription polymerase chain reaction and green fluorescent protein have been used for the study of VBNC. Resuscitation from VBNC state starts when the inducing factor(s is/are lifted. Factors that help the resuscitation of VBNC bacteria include addition of certain nutrients and chemicals, introduction of a few culturable cells into the VBNC cell population, and passage through the animal host. As virulence properties are sustained during the VBNC phase, special care must be paid when evaluating sterility of drinking water.

  18. Novas opções terapêuticas na síndrome de aspiração de mecônio New therapeutic options in meconium aspiration syndrome

    Directory of Open Access Journals (Sweden)

    Mauricio Obal Colvero

    2006-01-01

    ensued new therapeutic options availability. MAS management is initiated with airway aspiration in the delivery room, followed by the ventilatory management required to maintain optimal arterial oxygenation, as well as complications treatment. Considering evidences showing that meconium mechanical airway obstruction and its inhibitory effect on the surfactant system, the use of surfactant replacement and bronchoalveolar lavage with surfactant suspension are under study. CONCLUSIONS: experimental studies and studies focused on newborn using different surfactant suspensions have demonstrated controversial results. Therefore, it is very important to identify new ventilatory strategies and evaluate whether there are advantages in using surfactant and bronchoalveolar lavage with surfactant suspension in MAS.

  19. Achalasia: Treatment Options Revisited

    Directory of Open Access Journals (Sweden)

    Willemijntje A Hoogerwerf

    2000-01-01

    Full Text Available The aim of all current forms of treatment of achalasia is to enable the patient to eat without disabling symptoms such as dysphagia, regurgitation, coughing or choking. Historically, this has been accomplished by mechanical disruption of the lower esophageal sphincter fibres, either by means of pneumatic dilation (PD or by open surgical myotomy. The addition of laparoscopic myotomy and botulinum toxin (BTX injection to the therapeutic armamentarium has triggered a recent series of reviews to determine the optimal therapeutic approach. Both PD and BTX have excellent short term (less than three months efficacy in the majority of patients. New data have been published that suggest that PD and BTX (with repeat injections can potentially obtain long term efficacy. PD is still considered the first-line treatment by most physicians; its main disadvantage is risk of perforation. BTX injection is evolving as an excellent, safe option for patients who are considered high risk for more invasive procedures. Laparoscopic myotomy with combined antireflux surgery is an increasingly attractive option in younger patients with achalasia, but long term follow-up studies are required to establish its efficacy and the potential for reflux-related sequelae.

  20. Polymerase chain reaction-based discrimination of viable from non-viable Mycoplasma gallisepticum

    Directory of Open Access Journals (Sweden)

    Ching Giap Tan

    2014-09-01

    Full Text Available The present study was based on the reverse transcription polymerase chain reaction (RT-PCR of the 16S ribosomal nucleic acid (rRNA of Mycoplasma for detection of viable Mycoplasma gallisepticum. To determine the stability of M. gallisepticum 16S rRNA in vitro, three inactivation methods were used and the suspensions were stored at different temperatures. The 16S rRNA of M. gallisepticum was detected up to approximately 20–25 h at 37 °C, 22–25 h at 16 °C, and 23–27 h at 4 °C. The test, therefore, could detect viable or recently dead M. gallisepticum (< 20 h. The RT-PCR method was applied during an in vivo study of drug efficacy under experimental conditions, where commercial broiler-breeder eggs were inoculated with M. gallisepticum into the yolk. Hatched chicks that had been inoculated in ovo were treated with Macrolide 1. The method was then applied in a flock of day 0 chicks with naturally acquired vertical transmission of M. gallisepticum, treated with Macrolide 2. Swabs of the respiratory tract were obtained for PCR and RT-PCR evaluations to determine the viability of M. gallisepticum. This study proved that the combination of both PCR and RT-PCR enables detection and differentiation of viable from non-viable M. gallisepticum.

  1. Enumeration of viable and non-viable larvated Ascaris eggs with quantitative PCR

    Science.gov (United States)

    Aims: The goal of the study was to further develop an incubation-qPCR method for quantifying viable Ascaris eggs. The specific objectives were to characterize the detection limit and number of template copies per egg, determine the specificity of the method, and test the method w...

  2. An economically viable alternative to coastal discharge of produced water

    International Nuclear Information System (INIS)

    D'Unger, C.V.; Carr, R.S.; Chapman, D.C.

    1993-01-01

    The discharge of produced waters to coastal estuaries has been common practice on the Texas coast for many years as these discharges are currently exempt from NPDES permitting. A study of the active produced water discharges in Nueces Bay, Texas revealed that all eight effluents were highly toxic as determined by the sea urchin (Arbacia punctulata) fertilization and embryological development assays. An alternative to discharging produced water into coastal estuaries is the use of disposal wells. Inactive wells can be converted to produced water disposal wells. Production records for the Nueces Bay, Texas area reveal that 52% of the gas wells produce less than 100 mcf/d and 50% of the oil wells produce less than 10 b/d. Using conservative estimates, the cost of converting an inactive well to a disposal well was calculated to be $31,500 which could be paid out by a gas well producing as little as 100 mcf/d in 26 months using only 50% of the well's profit. Combining multiple leases to a single disposal well would reduce proportionately the cost to each operation. This study has demonstrated that economically viable disposal options could be achieved in the Nueces Bay area through the imaginative and cooperative formation of produced water disposal ventures. This same model could be applied to produced water discharges in other coastal areas

  3. Living with less water: development of viable adaptation options for Riverina irrigators

    NARCIS (Netherlands)

    Gaydon, D.S.

    2012-01-01

    In Australia, the best use of limited national water resources continues to be a major political and scientific issue. Average water allocations for rice-cereal irrigation farmers in the Riverina region have been drastically reduced since 1998 as a consequence of high rainfall variability and

  4. Alternative Pathways into University: Are Tertiary Preparation Programs a Viable Option?

    Science.gov (United States)

    Chesters, Jenny; Rutter, Kerry; Nelson, Karen; Watson, Louis

    2018-01-01

    During the past three decades, the student populations of Australian universities have become more heterogeneous as the higher education sector expanded and new alternative entry pathways were established. Broadening access to university study and, therefore, to professional and semi-professional occupations, provides avenues for social mobility.…

  5. Small-scale automated biomass energy heating systems: a viable option for remote Canadian communities?

    Energy Technology Data Exchange (ETDEWEB)

    McCallum, B. [Canadian Forest Service, Ottawa, ON (Canada). Industry, Economics and Programs Branch

    1997-12-31

    The potential benefits of wood energy (forest biomass) for space heating in Canada`s remote communities was discussed. Diesel fuel and heating oil must be transported into these communities to produce electricity and to heat large public buildings. Below the treeline, roundwood is often used to heat private homes. The move toward environmentally sustainable development has focussed much attention on renewable energy technologies such as biomass energy, (i.e. any form of energy derived from plant or animal materials). Wood is the most readily available biomass fuel in remote communities. Woodchips and sawmill waste can be burned in automated biomass heating systems which provide a convenient way to use low-grade wood to heat large buildings or groups of buildings which would not be feasible to heat with roundwood. It was shown that one cord of spruce can produce 1.5 tonnes of woodchips to ultimately displace 300 litres of heating oil. A description of a small-commercial and small-industrial biomass system was presented. The benefits of biomass were described as: (1) direct savings compared to high-cost oil heat, (2) increased circulation of energy dollars inside the community, and (3) employment opportunities in harvesting, processing and operating biomass systems. A steady supply of good quality woodchips to the heating plant must be ensured. 1 ref., 3 figs.

  6. Pyrolysis Of Saudi Arabian Date Palm Waste: A Viable Option For Converting Waste Into Wealth

    KAUST Repository

    Hussain, Ahmad; Farooq, Aamir; Bassyouni, Mohammad Ismail; Sait, Hani Hussain; El-Wafa, Mahmoud Abo; Hasan, Syed Waheedul; Ani, Farid Nasir

    2014-01-01

    Saudi Arabia has about 23 million palm trees and it is the second largest producer of dates. The biomass from the trimmed branches of palm trees amount to more than 200,000 tons/year. This biomass waste can be used to produce many commercial

  7. Pyrolysis Of Saudi Arabian Date Palm Waste: A Viable Option For Converting Waste Into Wealth

    KAUST Repository

    Hussain, Ahmad

    2014-11-01

    Saudi Arabia has about 23 million palm trees and it is the second largest producer of dates. The biomass from the trimmed branches of palm trees amount to more than 200,000 tons/year. This biomass waste can be used to produce many commercial products. There are several relevant technologies for conversion of biomass and solid wastes into higher value products. The starting point of the project is the pretreatment of palm solid wastes. Thermogravimetric analysis has been done to understand the pyrolysis behavior of palm date wastes. A fluidized bed (FB) has been designed and to study hydrodynamics and develop optimum conditions for the pyrolysis of palm wastes. A novel fluidized bed test rig has been designed and fabricated to carry out the pyrolysis of palm wastes. The pyrolysis is used to produce activated carbon and the waste can also be readily converted to liquid phenolic products. Liquid products are particularly interesting because they have a higher energy density and can be used to produce adhesives as well as biofuels for use in power generation and transport sector. Experimental results have indicated potential opportunities of using the date biomass waste as a potential fuel in the Kingdom of Saudi Arabia.

  8. Revisiting colostomy irrigation: a viable option for persons with permanent descending and sigmoid colostomies.

    Science.gov (United States)

    Kent, Dea J; Arnold Long, Mary; Bauer, Carole

    2015-01-01

    Colostomy irrigation (CI) is the regular irrigation of the bowel for persons with a permanent colostomy of the descending or sigmoid colon. Although this technique was first described in the 1920s, a recent study of 985 WOC nurses found that almost half (47%) do not routinely teach CI to persons with colostomies. In a systematic review (Evidence-Based Report Card) published in this issue of the Journal, we summarized current best evidence concerning the effect of CI on bowel function and found that irrigation reduces the frequency of bowel elimination episodes and allows some patients to reduce or eliminate ongoing use of a pouching system. This article describes techniques for teaching CI and discussed additional findings associated with CI.

  9. The unipolar ASR : Viable option in unsalvageable femoral head conditions in the young patient

    Directory of Open Access Journals (Sweden)

    Marya SKS

    2006-01-01

    Full Text Available Background: The management of unsalvageable femoral head conditions in the young patient has remained an unresolved dilemma. Articular surface replacement of the hip has recently made some headway in terms of providing near-normal hip joint mechanics and function. However, this surgery has been limited to early stages of arthritis only with reasonable maintenance of head-neck congruity and morphology. Femoral neck fractures, osteonecrosis with large segment collapse, advanced arthritis with femoral incongruity, etc are traditional contraindications to the resurfacing technique. Methods: We present here a report on our series of 20 cases of unsalvageable femoral heads in young patients (age range, 27 to 52yrs, over a twelve month period (Aug 2004 to Jul 2005, treated with the unipolar ASR prosthesis. Fifteen patients (two had bilateral hip pathology had primary or secondary arthritis (degenerative, post-traumatic, ankylosing spondylitis and post-avascular necrosis while three had old operated femoral neck fractures. All patients underwent hip replacement surgery using the Unipolar ASR prosthesis. Results: Clinical and radiological results at 6-month follow up have been very encouraging and warrant further study. At an average of 4 months post-operatively, patients were able to squat, sit on the ground and perform light sporting activities. Conclusions: The Unipolar ASR prosthesis is an extension of the articular resurfacing technique employing similar principles (large size bearings, metal-on-metal interfaces, and has incorporated the advantages of the uncemented technique. We propose that this technique be more frequently used so as to brighten the prognosis of the young active patient with unsalvageable hip conditions, especially in the Asian scenario.

  10. A critical assessment of asphalt batching as a viable remedial option for hydrocarbon contaminated soils

    International Nuclear Information System (INIS)

    Elliott, E.J.; Brashears, D.F.

    1991-01-01

    Hot mix asphalt production equipment has been successfully utilized in the remediation of soils contaminated with petroleum hydrocarbons. This paper reports that there are two major ways in which this equipment can be used to remediate the petroleum contaminated soils; by incorporating the contaminated soil in the hot mix asphalt product or by using the equipment to clean the soil thermally of the contaminant, leaving a clean soil material. Both of these processes have limitations encompassing technical, political, and certainly liability problems. The remediation of contaminated soil in hot mix asphalt facilities is primarily a physical phenomenon relying on laws of heat and mass transfer. Although chemical changes do occur, the primary function of the process is to cause a physical separation of the contaminant from the soils

  11. Accelerator breeder: a viable option for the production of nuclear fuels

    International Nuclear Information System (INIS)

    Grand, P.

    1983-01-01

    Despite the growing pains of the US nuclear power industry, our dependence on nuclear energy for the production of electricity and possibly process heat is likely to increase dramatically over the next few deacades. This statement dismisses fusion as being entirely too speculative to be practical within that time frame. Sometime, between the years 2000 and 2050, fissile material will be in short supply whether it is to fuel existing LWR's or to provide initial fuel inventory for FBR's. The accelerator breeder could produce the fuel shortfall predicted to occur during the first half of the 21st century. The accelerator breeder offers the only practical means today of producing, or breeding, large quantities of fissile fuel from fertile materials, albeit at high cost. Studies performed over the last few years at Chalk River Laboratory and at Brookhaven National Laboratory have demonstrated that the accelerator breeder is practical, technically feasible with state-of-the-art technology, and is economically competitive with any other proposed synthetic means of fissile fuel production. This paper gives the parameters of a nearly optimized accelerator-breeder system, then discusses the development needs, and the economics and institutional problems that this breeding concept faces

  12. Freezing the biological clock: a viable fertility preservation option for young Singapore women?

    Science.gov (United States)

    Blyth, Eric; Yee, Samantha; Lee, Geok Ling

    2013-09-01

    In March 2012, an article in The Straits Times entitled 'Freezing eggs could reverse falling birth rate' suggested that employing the latest oocyte cryopreservation techniques could both foster individual women's reproductive autonomy and impact Singapore's fertility rate, which in recent years has consistently been among the world's lowest. The article cited both local and international fertility specialists' approval of elective oocyte cryopreservation for young women wishing to protect their reproductive potential against ageing and as a potential antidote to the contemporary 'delay and defer' model of family-building. Later in 2012, the Ministry of Health announced a review of oocyte cryopreservation policy taking into account related medical, scientific and ethical issues, while the Singapore College of Obstetricians and Gynaecologists endorsed oocyte cryopreservation as an "important, safe and efficient technology". This paper outlines and analyses the arguments and empirical evidence used both to support and oppose offering elective oocyte cryopreservation as a routine fertility service, before concluding that this remains unjustifiable on the basis of insufficient evidence of its clinical efficacy and safety as regards either pregnancy rates or birth outcomes. If it is to be made available at all for these reasons in Singapore, it should be subjected to rigorous clinic-specific evaluation in accordance with accepted clinical and ethical norms.

  13. Wastewater re-use for peri-urban agriculture: a viable option for adaptive water management?

    NARCIS (Netherlands)

    Kurian, M.; Reddy, V.R.; Dietz, T.; Brdjanovic, D.

    2013-01-01

    Urbanization is known to spur land modification in the form of conversion of common land to human settlements. This factor, combined with climate variability, can alter the duration, frequency and intensity of storm drain overflows in urban areas and lead to public health risks. In peri-urban

  14. Wastewater re-use for peri-urban agriculture : a viable option for adaptive water management?

    NARCIS (Netherlands)

    Kurian, M.; Ratna, Reddy V.; Dietz, A.J.; Brdjanovic, D.

    2013-01-01

    Urbanization is known to spur land modification in the form of conversion of common land to human settlements. This factor, combined with climate variability, can alter the duration, frequency and intensity of storm drain overflows in urban areas and lead to public health risks. In peri-urban

  15. The Adjoint Monte Carlo - a viable option for efficient radiotherapy treatment planning

    Energy Technology Data Exchange (ETDEWEB)

    Goldstein, M [Israel Atomic Energy Commission, Beersheba (Israel). Nuclear Research Center-Negev

    1996-12-01

    In cancer therapy using collimated beams of photons, the radiation oncologist must determine a set of beams that delivers the required dose to each point in the tumor and minimizes the risk of damage to the healthy tissue and vital organs. Currently, the oncologist determines these beams iteratively, by using a sequence of dose calculations using approximate numerical methods. In this paper, a more accurate and potentially faster approach, based on the Adjoint Monte Carlo method, is presented (authors).

  16. Aromatase inhibitors - a viable option for recurrent granulosa cell tumour of ovary: overview and case report

    International Nuclear Information System (INIS)

    Munem, A.A.; Bahrani, B.A.; Mehdi, I.

    2012-01-01

    Granulosa cell tumour of the ovary in adults is a rare tumour of low malignant potential affecting middle aged peri or post menopausal patients. These tumours are often diagnosed at an early stage, due to their hormonally active nature. They, however, have unique distinguishing histologic features and behaviour of frequent and late local or systemic relapses. The diagnosis can be challenging with unusual presentations. There is high association of endometrial carcinoma. Surgery is the mainstay of management in early low risk disease, while radiotherapy and systemic platinum based chemotherapy are employed in higher stage with poor prognostic indices. Survival is good in early stage disease. Recurrent, progressive, and treatment refractory disease is not infrequent and poses management challenge. Endocrine manipulation and hormone treatment are employed in few cases with equivocal results, as reported in literature. We present a case of recurrent and treatment refractory GCT in a postmenopausal patient, managed by aromatase inhibitor Anastrozole with reasonable efficacy. (author)

  17. Laparoscopically assisted colonoscopic polypectomy - viable option for curative surgery in elderly patients.

    Science.gov (United States)

    Račkauskas, Rokas; Mikalauskas, Saulius; Petrulionis, Marius; Poškus, Tomas; Jotautas, Valdemaras; Stanaitis, Juozas; Poškus, Eligijus; Strupas, Kęstutis

    2017-06-01

    Colorectal cancer (CRC) is the third most common cancer worldwide and the fourth most frequent cause of cancer-related death in the world. CRC screening programs have been widely introduced worldwide, allowing for early detection and removal of precancerous lesions and avoiding major surgical intervention. However, not all polyps are suitable for conventional and advanced colonoscopic polypectomy. Thus, laparoscopically assisted colonoscopic polypectomy (LACP) was introduced to clinical practice as a method of choice for these polyps and adenomas. To overlook our experience in laparoscopically assisted colonoscopic polypectomies and evaluate effectiveness and quality of the procedure. A retrospective analysis of a prospectively maintained database was performed. using the Vilnius University Hospital Santariskiu Klinikos patient database for the period from 2010 to 2016, resulting in 21 cases in which LACP was performed. All procedures were performed using combined laparoscopy and videocolonoscopy techniques. Morphology of adenomas was classified according to the Paris classification during the procedure. Creation of the database was approved by the Lithuanian Bioethics committee. Twenty-two adenomas were removed from 21 patients, aged 65.33 ±8.9. There was no difference between male and female age, but occurrence of adenomas in females was 2-fold higher. The majority of removed lesions were localized in the cecum and mean size was 27.2 ±11.1 mm. The morphology of adenomas was distributed equally between 0-Is, 0-Ip, and 0-IIa, except one, which belonged to 0-III. Histological analysis revealed that tubulovillous adenoma occurrence was 1.4 times higher than tubulous adenoma. There was only one postoperative complication - bleeding from the adenoma resection site, which was managed by conservative means. One patient developed G2 adenocarcinoma at the polyp resection site and was referred for radical surgery. The LACP is a safe procedure with minimal risk to the elderly patient. Patient follow-up is essential for detection of recurrence.

  18. The Conceptual Mechanism for Viable Organizational Learning Based on Complex System Theory and the Viable System Model

    Science.gov (United States)

    Sung, Dia; You, Yeongmahn; Song, Ji Hoon

    2008-01-01

    The purpose of this research is to explore the possibility of viable learning organizations based on identifying viable organizational learning mechanisms. Two theoretical foundations, complex system theory and viable system theory, have been integrated to provide the rationale for building the sustainable organizational learning mechanism. The…

  19. An economically viable space power relay system

    Science.gov (United States)

    Bekey, Ivan; Boudreault, Richard

    1999-09-01

    This paper describes and analyzes the economics of a power relay system that takes advantage of recent technological advances to implement a system that is economically viable. A series of power relay systems are described and analyzed which transport power ranging from 1,250 megawatts to 5,000 megawatts, and distribute it to receiving sites at transcontinental distances. Two classes of systems are discussed—those with a single reflector and delivering all the power to a single rectenna, and a second type which has multiple reflectors and distributes it to 10 rectenna sites, sharing power among them. It is shown that when offering electricity at prices competitive to those prevalent in developed cities in the US that a low IRR is inevitable, and economic feasibility of a business is unlikely. However, when the target market is Japan where the prevalent electricity prices are much greater, that an IRR exceeding 65% is readily attainable. This is extremely attractive to potential investors, making capitalization of a venture likely. The paper shows that the capital investment required for the system can be less than 1 per installed watt, contributing less than 0.02 /KW-hr to the cost of energy provision. Since selling prices in feasible regions range from 0.18 to over 030 $/kW-hr, these costs are but a small fraction of the operating expenses. Thus a very large IRR is possible for such a business.

  20. Deletion of ultraconserved elements yields viable mice

    Energy Technology Data Exchange (ETDEWEB)

    Ahituv, Nadav; Zhu, Yiwen; Visel, Axel; Holt, Amy; Afzal, Veena; Pennacchio, Len A.; Rubin, Edward M.

    2007-07-15

    Ultraconserved elements have been suggested to retainextended perfect sequence identity between the human, mouse, and ratgenomes due to essential functional properties. To investigate thenecessities of these elements in vivo, we removed four non-codingultraconserved elements (ranging in length from 222 to 731 base pairs)from the mouse genome. To maximize the likelihood of observing aphenotype, we chose to delete elements that function as enhancers in amouse transgenic assay and that are near genes that exhibit markedphenotypes both when completely inactivated in the mouse as well as whentheir expression is altered due to other genomic modifications.Remarkably, all four resulting lines of mice lacking these ultraconservedelements were viable and fertile, and failed to reveal any criticalabnormalities when assayed for a variety of phenotypes including growth,longevity, pathology and metabolism. In addition more targeted screens,informed by the abnormalities observed in mice where genes in proximityto the investigated elements had been altered, also failed to revealnotable abnormalities. These results, while not inclusive of all thepossible phenotypic impact of the deleted sequences, indicate thatextreme sequence constraint does not necessarily reflect crucialfunctions required for viability.

  1. Developing Viable Financing Models for Space Tourism

    Science.gov (United States)

    Eilingsfeld, F.; Schaetzler, D.

    2002-01-01

    Increasing commercialization of space services and the impending release of government's control of space access promise to make space ventures more attractive. Still, many investors shy away from going into the space tourism market as long as they do not feel secure that their return expectations will be met. First and foremost, attracting investors from the capital markets requires qualifying financing models. Based on earlier research on the cost of capital for space tourism, this paper gives a brief run-through of commercial, technical and financial due diligence aspects. After that, a closer look is taken at different valuation techniques as well as alternative ways of streamlining financials. Experience from earlier ventures has shown that the high cost of capital represents a significant challenge. Thus, the sophistication and professionalism of business plans and financial models needs to be very high. Special emphasis is given to the optimization of the debt-to-equity ratio over time. The different roles of equity and debt over a venture's life cycle are explained. Based on the latter, guidelines for the design of an optimized loan structure are given. These are then applied to simulating the financial performance of a typical space tourism venture over time, including the calculation of Weighted Average Cost of Capital (WACC) and Net Present Value (NPV). Based on a concluding sensitivity analysis, the lessons learned are presented. If applied properly, these will help to make space tourism economically viable.

  2. Economically viable large-scale hydrogen liquefaction

    Science.gov (United States)

    Cardella, U.; Decker, L.; Klein, H.

    2017-02-01

    The liquid hydrogen demand, particularly driven by clean energy applications, will rise in the near future. As industrial large scale liquefiers will play a major role within the hydrogen supply chain, production capacity will have to increase by a multiple of today’s typical sizes. The main goal is to reduce the total cost of ownership for these plants by increasing energy efficiency with innovative and simple process designs, optimized in capital expenditure. New concepts must ensure a manageable plant complexity and flexible operability. In the phase of process development and selection, a dimensioning of key equipment for large scale liquefiers, such as turbines and compressors as well as heat exchangers, must be performed iteratively to ensure technological feasibility and maturity. Further critical aspects related to hydrogen liquefaction, e.g. fluid properties, ortho-para hydrogen conversion, and coldbox configuration, must be analysed in detail. This paper provides an overview on the approach, challenges and preliminary results in the development of efficient as well as economically viable concepts for large-scale hydrogen liquefaction.

  3. Parejas viables que perduran en el tiempo

    Directory of Open Access Journals (Sweden)

    Juan José Cuervo Rodríguez

    2013-01-01

    Full Text Available El presente artículo científico presenta resultados del proceso llevado a cabo en el proyecto de investigación docente "Mecanismos de autorregulación en parejas viables que perduran en el tiempo". Se soporta en una mirada compleja de la psicología basada en una epistemología de la construcción. En el ámbito metodológico, se inscribe en los estudios de terapia familiar desde una perspectiva de la comunicación humana como un todo integrado. Participaron nueve parejas. Los criterios de inclusión fueron: cinco o más años de convivencia, participación voluntaria, no presentar (ni haber presentado problemáticas especiales que ameriten intervención psicoterapéutica y la obtención de un porcentaje significativo en el uso de estrategias de comunicación asertiva en la resolución de conflictos. El método general utilizado fue el análisis de la comunicación en tarea de conversación. Los principales hallazgos señalan una estrecha relación entre el contexto de desarrollo de las parejas, la emergencia de códigos comunicacionales propios y la posibilidad de perdurar en el tiempo; también, se resalta el tipo de comunicación asertiva o constructiva, la construcción de valores como el respeto y la aceptación de las diferencias, y el deseo por vivir y construir bienestar común, como elementos constitutivos de su identidad como pareja.

  4. Separation of viable and non-viable tomato (Solanum lycopersicum L.) seeds using single seed near-infrared spectroscopy

    DEFF Research Database (Denmark)

    Shrestha, Santosh; Deleuran, Lise Christina; Gislum, René

    2017-01-01

    Single seed near-infrared (NIR) spectroscopy is a non-destructive technology commonly used for predicting lipids, proteins, carbohydrates and water content of agricultural products. The aim of the current study is to investigate the prospects of NIR spectroscopy in classifying viable and non...... identified as important for classification of viable and non-viable tomato seeds by iPLS-DA. The sensitivity i.e. ability to correctly identify the positive samples and specificity i.e. ability to reject the negative samples of the (iPLS-DA) model on identified spectral regions for prediction of viable......-viable tomato seeds of two cultivars using chemometrics. The data exploration were performed by principal component analysis (PCA). Subsequently, viable and non-viable seeds were classified by partial least squares-discriminant analysis (PLS-DA) and interval PLS-DA (iPLS-DA). The indication of clustering...

  5. Mapping In Vivo Tumor Oxygenation within Viable Tumor by 19F-MRI and Multispectral Analysis

    Directory of Open Access Journals (Sweden)

    Yunzhou Shi

    2013-11-01

    Full Text Available Quantifying oxygenation in viable tumor remains a major obstacle toward a better understanding of the tumor microenvironment and improving treatment strategies. Current techniques are often complicated by tumor heterogeneity. Herein, a novel in vivo approach that combines 19F magnetic resonance imaging (19F-MRIR1 mapping with diffusionbased multispectral (MS analysis is introduced. This approach restricts the partial pressure of oxygen (pO2 measurements to viable tumor, the tissue of therapeutic interest. The technique exhibited sufficient sensitivity to detect a breathing gas challenge in a xenograft tumor model, and the hypoxic region measured by MS 19F-MRI was strongly correlated with histologic estimates of hypoxia. This approach was then applied to address the effects of antivascular agents on tumor oxygenation, which is a research question that is still under debate. The technique was used to monitor longitudinal pO2 changes in response to an antibody to vascular endothelial growth factor (B20.4.1.1 and a selective dual phosphoinositide 3-kinase/mammalian target of rapamycin inhibitor (GDC-0980. GDC-0980 reduced viable tumor pO2 during a 3-day treatment period, and a significant reduction was also produced by B20.4.1.1. Overall, this method provides an unprecedented view of viable tumor pO2 and contributes to a greater understanding of the effects of antivascular therapies on the tumor's microenvironment.

  6. Therapeutic Effects of Horseback Riding Interventions: A Systematic Review and Meta-analysis.

    Science.gov (United States)

    Stergiou, Alexandra; Tzoufi, Meropi; Ntzani, Evangelia; Varvarousis, Dimitrios; Beris, Alexandros; Ploumis, Avraam

    2017-10-01

    Equine-assisted therapies, such as therapeutic riding and hippotherapy, are believed to have positive physical and emotional effects in individuals with neuromotor, developmental, and physical disabilities. The purpose of this review was to determine whether therapeutic riding and hippotherapy improve balance, motor function, gait, muscle symmetry, pelvic movement, psychosocial parameters, and the patients' overall quality of life. In this study, a literature search was conducted on MEDLINE, CINAHL, MBASE, SportDiscus, Cochrane Database of Systematic Reviews, Cochrane Controlled Trials Register, PEDro, DARE, Google Scholar, and Dissertation Abstracts. Only studies with a control/comparison group or self-controlled studies performing preintervention and postintervention assessment were included. Excluded were (1) studies not providing data on baseline score or end-point outcome, (2) single-subject studies, (3) studies providing only qualitative data, and (4) studies that used a mechanical horse. Sixteen trials were included. The methodologic quality of each study was evaluated using Downs and Black quality assessment tool. Most of the studies showed a trend toward a beneficial effect of therapeutic riding and hippotherapy on balance and gross motor function. The meta-analysis showed improvement in both the Berg Balance Scale and the Gross Motor Function Measure in therapeutic riding and hippotherapy programs. Programs such as therapeutic riding and hippotherapy are a viable intervention option for patients with balance, gait, and psychomotor disorders.

  7. Comprehensive risk reduction in patients with atrial fibrillation: emerging diagnostic and therapeutic options--a report from the 3rd Atrial Fibrillation Competence NETwork/European Heart Rhythm Association consensus conference

    DEFF Research Database (Denmark)

    Kirchhof, Paulus; Lip, Gregory Y H; Van Gelder, Isabelle C

    2012-01-01

    While management of atrial fibrillation (AF) patients is improved by guideline-conform application of anticoagulant therapy, rate control, rhythm control, and therapy of accompanying heart disease, the morbidity and mortality associated with AF remain unacceptably high. This paper describes...... the proceedings of the 3rd Atrial Fibrillation NETwork (AFNET)/European Heart Rhythm Association (EHRA) consensus conference that convened over 60 scientists and representatives from industry to jointly discuss emerging therapeutic and diagnostic improvements to achieve better management of AF patients. The paper...

  8. Asouzu's Complementary Ontology as a Foundation for a Viable ...

    African Journals Online (AJOL)

    This paper on “Asouzu's Complementary Ontology as a foundation for a viable Ethic of the Environment”, posits that an ethic of the environment can be seen as viable if it considers the whole of reality as ontologically relevant. This point of view would free environmental ethics of anthropocentric bias and its attendant ...

  9. Treatment Options for Retinoblastoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other places in the body. Treatment Option Overview Key Points There are different types of ...

  10. Therapeutic hypothermia for acute stroke

    DEFF Research Database (Denmark)

    Olsen, Tom Skyhøj; Weber, Uno Jakob; Kammersgaard, Lars Peter

    2003-01-01

    Experimental evidence and clinical experience show that hypothermia protects the brain from damage during ischaemia. There is a growing hope that the prevention of fever in stroke will improve outcome and that hypothermia may be a therapeutic option for the treatment of stroke. Body temperature...... obvious therapeutic potential, hypothermia as a form of neuroprotection for stroke has been investigated in only a few very small studies. Therapeutic hypothermia is feasible in acute stroke but owing to serious side-effects--such as hypotension, cardiac arrhythmia, and pneumonia--it is still thought...

  11. Quantitative Analysis of Therapeutic Drugs in Dried Blood Spot Samples by Paper Spray Mass Spectrometry: An Avenue to Therapeutic Drug Monitoring

    Science.gov (United States)

    Manicke, Nicholas Edward; Abu-Rabie, Paul; Spooner, Neil; Ouyang, Zheng; Cooks, R. Graham

    2011-09-01

    A method is presented for the direct quantitative analysis of therapeutic drugs from dried blood spot samples by mass spectrometry. The method, paper spray mass spectrometry, generates gas phase ions directly from the blood card paper used to store dried blood samples without the need for complex sample preparation and separation; the entire time for preparation and analysis of blood samples is around 30 s. Limits of detection were investigated for a chemically diverse set of some 15 therapeutic drugs; hydrophobic and weakly basic drugs, such as sunitinib, citalopram, and verapamil, were found to be routinely detectable at approximately 1 ng/mL. Samples were prepared by addition of the drug to whole blood. Drug concentrations were measured quantitatively over several orders of magnitude, with accuracies within 10% of the expected value and relative standard deviation (RSD) of around 10% by prespotting an internal standard solution onto the paper prior to application of the blood sample. We have demonstrated that paper spray mass spectrometry can be used to quantitatively measure drug concentrations over the entire therapeutic range for a wide variety of drugs. The high quality analytical data obtained indicate that the technique may be a viable option for therapeutic drug monitoring.

  12. Management options for recycling radioactive scrap metals

    Energy Technology Data Exchange (ETDEWEB)

    Dehmel, J.C.; MacKinney, J.; Bartlett, J.

    1997-02-01

    The feasibility and advantages of recycling radioactive scrap metals (RSM) have yet to be assessed, given the unique technical, regulatory, safety, and cost-benefit issues that have already been raised by a concerned recycling industry. As is known, this industry has been repeatedly involved with the accidental recycling of radioactive sources and, in some cases, with costly consequences. If recycling were deemed to be a viable option, it might have to be implemented with regulatory monitoring and controls. Its implementation may have to consider various and complex issues and address the requirements and concerns of distinctly different industries. There are three basic options for the recycling of such scraps. They are: (1) recycling through the existing network of metal-scrap dealers and brokers, (2) recycling directly and only with specific steelmills, or (3) recycling through regional processing centers. Under the first option, scrap dealers and brokers would receive material from RSM generators and determine at which steelmills such scraps would be recycled. For the second option, RSM generators would deal directly with selected steelmills under specific agreements. For the third option, generators would ship scraps only to regional centers for processing and shipment to participating steelmills. This paper addresses the potential advantages of each option, identifies the types of arrangements that would need to be secured among all parties, and attempts to assess the receptivity of the recycling industry to each option.

  13. Australian Asian Options

    OpenAIRE

    Manuel Moreno; Javier F. Navas

    2003-01-01

    We study European options on the ratio of the stock price to its average and viceversa. Some of these options are traded in the Australian Stock Exchange since 1992, thus we call them Australian Asian options. For geometric averages, we obtain closed-form expressions for option prices. For arithmetic means, we use different approximations that produce very similar results.

  14. Options with Extreme Strikes

    Directory of Open Access Journals (Sweden)

    Lingjiong Zhu

    2015-07-01

    Full Text Available In this short paper, we study the asymptotics for the price of call options for very large strikes and put options for very small strikes. The stock price is assumed to follow the Black–Scholes models. We analyze European, Asian, American, Parisian and perpetual options and conclude that the tail asymptotics for these option types fall into four scenarios.

  15. Macromolecular therapeutics.

    Science.gov (United States)

    Yang, Jiyuan; Kopeček, Jindřich

    2014-09-28

    This review covers water-soluble polymer-drug conjugates and macromolecules that possess biological activity without attached low molecular weight drugs. The main design principles of traditional and backbone degradable polymer-drug conjugates as well as the development of a new paradigm in nanomedicines - (low molecular weight) drug-free macromolecular therapeutics are discussed. To address the biological features of cancer, macromolecular therapeutics directed to stem/progenitor cells and the tumor microenvironment are deliberated. Finally, the future perspectives of the field are briefly debated. Copyright © 2014 Elsevier B.V. All rights reserved.

  16. Talons and beaks are viable but underutilized samples for detecting ...

    African Journals Online (AJOL)

    Talons and beaks are viable but underutilized samples for detecting organophosphorus and carbamate pesticide poisoning in raptors. Ngaio Richards, Irene Zorrilla, Joseph Lalah, Peter Otieno, Isabel Fernandez, Monica Calvino, Joaquin Garcia ...

  17. Promoting Women Participation in Aquaculture as a Viable Tool for ...

    African Journals Online (AJOL)

    Promoting Women Participation in Aquaculture as a Viable Tool for Poverty Alleviation in the Rural Areas of Nigeria. ... Open Access DOWNLOAD FULL TEXT ... a source of income, also the paper focus on the roles of women in aquaculture, ...

  18. Therapeutic Nanodevices

    Science.gov (United States)

    Lee, Stephen; Ruegsegger, Mark; Barnes, Philip; Smith, Bryan; Ferrari, Mauro

    Therapeutic nanotechnology offers minimally invasive therapies with high densities of function concentrated in small volumes, features that may reduce patient morbidity and mortality. Unlike other areas of nanotechnology, novel physical properties associated with nanoscale dimensionality are not the raison d'être of therapeutic nanotechnology, whereas the aggregation of multiple biochemical (or comparably precise) functions into controlled nanoarchitectures is. Multifunctionality is a hallmark of emerging nanotherapeutic devices, and multifunctionality can allow nanotherapeutic devices to perform multistep work processes, with each functional component contributing to one or more nanodevice subroutine such that, in aggregate, subroutines sum to a cogent work process. Cannonical nanotherapeutic subroutines include tethering (targeting) to sites of disease, dispensing measured doses of drug (or bioactive compound), detection of residual disease after therapy and communication with an external clinician/operator. Emerging nanotherapeutics thus blur the boundaries between medical devices and traditional pharmaceuticals. Assembly of therapeutic nanodevices generally exploits either (bio)material self-assembly properties or chemoselective bioconjugation techniques, or both. Given the complexity, composition, and the necessity for their tight chemical and structural definition inherent in the nature of nanotherapeutics, their cost of goods (COGs) might exceed that of (already expensive) biologics. Early therapeutic nanodevices will likely be applied to disease states which exhibit significant unmet patient need (cancer and cardiovascular disease), while application to other disease states well-served by conventional therapy may await perfection of nanotherapeutic design and assembly protocols.

  19. Precision cut lung slices as test system for candidate therapeutics in organophosphate poisoning.

    Science.gov (United States)

    Herbert, Julia; Thiermann, Horst; Worek, Franz; Wille, Timo

    2017-08-15

    Standard therapeutic options in organophosphate (OP) poisoning are limited to the administration of atropine and oximes, a regimen often lacking in efficacy and applicability. Treatment alternatives are needed, preferably covering a broad spectrum of OP intoxications. Although recent research yielded several promising compounds, e.g. bioscavengers, modulators of the muscarinic acetylcholine (ACh) receptor or bispyridinium non-oximes, these substances still need further evaluation, especially regarding effects on the potentially lethal respiratory symptoms of OP poisoning. Aim of this study was the development of an applicable and easy method to test the therapeutic efficiency of such substances. For this purpose, airway responsiveness in viable precision cut lung slices (PCLS) from rats was analysed. We showed that ACh-induced airway contractions were spontaneously reversible in non-poisoned PCLS, whereas in OP poisoned PCLS, contractions were irreversible. This effect could be antagonized by addition of the standard therapeutic atropine, thereby presenting a clear indication for treatment efficiency. Now, candidate therapeutic compounds can be evaluated, based on their ability to counteract the irreversible airway contraction in OP poisoned PCLS. Copyright © 2017 Elsevier B.V. All rights reserved.

  20. Treatment options for hepatocellular carcinoma.

    Science.gov (United States)

    Sandhu, Dalbir S; Tharayil, Vivek S; Lai, Jin-Ping; Roberts, Lewis R

    2008-02-01

    Hepatocellular carcinoma (HCC) is frequently diagnosed at advanced stages and has a high mortality rate. With improved survival of patients with cirrhotic liver disease and increased prevalence of chronic hepatitis C viral infections, a rise in the number of HCC cases is being reported worldwide. Early diagnosis and treatment can significantly improve the prognosis of patients with HCC. Although surgical resection is an important potentially curative therapy for liver tumors, in appropriately selected patients, liver transplantation has been shown to achieve excellent survival rates for a solid tumor. Locally ablative and locoregional therapies in the form of percutaneous ethanol injection, radiofrequency ablation, transcatheter arterial chemoembolization and transcatheter arterial radioembolization (TheraSphere) are viable options in patients with unresectable HCC. Unfortunately, the role of systemic therapy has been very limited in the treatment of these patients. Novel treatment options based on an improved understanding of the molecular pathogenesis of HCC are being explored. These targeted molecular therapies are aimed at growth factors and their receptors, intracellular signal transduction and cell cycle control. A substantial improvement in outcomes of intermediate and advanced stage HCC is expected with the advent of these targeted therapies, used in combination with surgical or locoregional therapies. Recent positive results from a large Phase III study of the receptor tyrosine kinase inhibitor, sorafenib, hold great promise in the treatment of HCC.

  1. Teratoma cervical congênito gigante: relato de caso e revisão quanto às opções terapêuticas Giant congenital cervical teratoma: case report and review about therapeutic options

    Directory of Open Access Journals (Sweden)

    Camila Ferro Miele

    2011-12-01

    Full Text Available OBJETIVO: Relatar um caso de teratoma cervical congênito, destacando a gravidade e as dificuldades terapêuticas associadas. DESCRIÇÃO DO CASO: Mãe de 30 anos, com gestação por fertilização assistida. Com 23 semanas, diagnosticada malformação cervical fetal à direita. Parto cesáreo por indicação fetal com 31 semanas. Recém-nascido masculino, peso ao nascer de 1800g, Apgar 4 e 9, com volumoso processo expansivo à direita, ocupando toda a região cervical, comprometendo a mandíbula e estendendo-se para o terço superior do tórax. Com 40 horas de vida, apresentou insuficiência cardíaca congestiva de alto débito por roubo de fluxo pelo tumor. A partir de 54 horas de vida, houve progressiva deterioração hemodinâmica e respiratória, com hipotensão, anúria e labilidade de oxigenação, refratárias às aminas vasoativas, reposição de volume e aumento do suporte ventilatório. Indicada abordagem cirúrgica para ressecção tumoral, todavia o paciente não apresentou estabilidade clínica que permitisse seu transporte ao centro cirúrgico e faleceu com 70 horas de vida. COMENTÁRIOS: O caso demonstra as dificuldades relacionadas à abordagem pós-natal dos teratomas cervicais volumosos. Apesar do diagnóstico pré-natal, o paciente evoluiu com obstrução de vias aéreas, complicada por um choque cardiogênico refratário, que culminou no óbito. A abordagem intraparto é fundamental nesses pacientes, consistindo em exérese tumoral, enquanto a manutenção da circulação materno-fetal permite a oxigenação fetal contínua. A evolução neonatal no caso descrito é condizente com a literatura que mostra prognóstico reservado quando não é realizada a abordagem cirúrgica intraparto.OBJECTIVE: To report a case of congenital cervical teratoma, highlighting the severity and the therapeutic difficulties associated. CASE DESCRIPTION: A 30-year old mother, with pregnancy by assisted fertilization. At 23 weeks, a cervical fetal

  2. Polyzystisches Ovarsyndrom – ein aktueller Überblick über therapeutische Ansätze bei Kinderwunsch und metabolischen Komorbiditäten // PCOS – A Current Overview of Therapeutic Options for Infertility and Metabolic Co-Morbidities

    Directory of Open Access Journals (Sweden)

    Lunger F

    2017-01-01

    Full Text Available The diagnosis of the polycystic ovary syndrome continues to be made based on the 2003 Rotterdam criteria which include oligo- or anovulation, hyperandrogenemia and/ or clinical signs of androgen excess, and polycystic ovaries on ultrasound. Nonetheless, the diagnosis is not always clear. In cases where one is unsure whether a woman ovulates, a progesterone level in the mid-luteal phase of the cycle can confirm ovulation. Clinical signs of hyperandrogenemia are strongly influenced by ethnicity, which should be considered during the assessment, although no ethnicity- related norms have been published. Recent studies have shown that AMH in combination with LH can aid in differentiating sonographically observed PCO morphology (a common entity in younger women from true PCOS. For women desiring pregnancy, the first therapeutic step is weight reduction as part of a lifestyle modification. Ovulation induction in these anovulatory women can be accomplished with clomiphene or low-dose gonadotropins, and may be combined with metformin. Clomiphene continues to be the first-line treatment because of its ease of administration, low costs and success rates. Low-dose gonadotropins may have an even higher success rate of ovulation and pregnancy, especially in clomipheneresistant women, but are much more expensive. Metabolic co-morbidities are very common in women with PCOS and should be diagnosed and treated in order to prevent or reduce future consequences. International recommendations include screening women with PCOS for dia betes with fasting glucose and oral glucose tolerance test, especially those with adiposity, anovulation and positive family history. Fasting insulin or HOMA Index can be used to assess for IR. Targeted thera pies for the metabolic aspects of PCOS include diet and exercise as part of lifestyle modification, treatment of hypertension and hypercholesterolemia with appropriate medications, and the use of insulin sensitizers for insulin

  3. Pawnee Nation Energy Option Analyses

    Energy Technology Data Exchange (ETDEWEB)

    Matlock, M.; Kersey, K.; Riding In, C.

    2009-07-21

    Pawnee Nation of Oklahoma Energy Option Analyses In 2003, the Pawnee Nation leadership identified the need for the tribe to comprehensively address its energy issues. During a strategic energy planning workshop a general framework was laid out and the Pawnee Nation Energy Task Force was created to work toward further development of the tribe’s energy vision. The overarching goals of the “first steps” project were to identify the most appropriate focus for its strategic energy initiatives going forward, and to provide information necessary to take the next steps in pursuit of the “best fit” energy options. Description of Activities Performed The research team reviewed existing data pertaining to the availability of biomass (focusing on woody biomass, agricultural biomass/bio-energy crops, and methane capture), solar, wind and hydropower resources on the Pawnee-owned lands. Using these data, combined with assumptions about costs and revenue streams, the research team performed preliminary feasibility assessments for each resource category. The research team also reviewed available funding resources and made recommendations to Pawnee Nation highlighting those resources with the greatest potential for financially-viable development, both in the near-term and over a longer time horizon. Findings and Recommendations Due to a lack of financial incentives for renewable energy, particularly at the state level, combined mediocre renewable energy resources, renewable energy development opportunities are limited for Pawnee Nation. However, near-term potential exists for development of solar hot water at the gym, and an exterior wood-fired boiler system at the tribe’s main administrative building. Pawnee Nation should also explore options for developing LFGTE resources in collaboration with the City of Pawnee. Significant potential may also exist for development of bio-energy resources within the next decade. Pawnee Nation representatives should closely monitor

  4. Traditional preventive treatment options

    DEFF Research Database (Denmark)

    Longbottom, C; Ekstrand, K; Zero, D

    2009-01-01

    Preventive treatment options can be divided into primary, secondary and tertiary prevention techniques, which can involve patient- or professionally applied methods. These include: oral hygiene (instruction), pit and fissure sealants ('temporary' or 'permanent'), fluoride applications (patient...... options....

  5. Breast Cancer: Treatment Options

    Science.gov (United States)

    ... Breast Cancer > Breast Cancer: Treatment Options Request Permissions Breast Cancer: Treatment Options Approved by the Cancer.Net Editorial ... can be addressed as quickly as possible. Recurrent breast cancer If the cancer does return after treatment for ...

  6. Pawnee Nation Energy Option Analyses

    Energy Technology Data Exchange (ETDEWEB)

    Matlock, M.; Kersey, K.; Riding In, C.

    2009-07-31

    In 2003, the Pawnee Nation leadership identified the need for the tribe to comprehensively address its energy issues. During a strategic energy planning workshop a general framework was laid out and the Pawnee Nation Energy Task Force was created to work toward further development of the tribe’s energy vision. The overarching goals of the “first steps” project were to identify the most appropriate focus for its strategic energy initiatives going forward, and to provide information necessary to take the next steps in pursuit of the “best fit” energy options. Based on the request of Pawnee Nation’s Energy Task Force the research team, consisting Tribal personnel and Summit Blue Consulting, focused on a review of renewable energy resource development potential, funding sources and utility organizational along with energy savings options. Elements of the energy demand forecasting and characterization and demand side options review remained in the scope of work, but were only addressed at a high level. Description of Activities Performed Renewable Energy Resource Development Potential The research team reviewed existing data pertaining to the availability of biomass (focusing on woody biomass, agricultural biomass/bio-energy crops, and methane capture), solar, wind and hydropower resources on the Pawnee-owned lands. Using these data, combined with assumptions about costs and revenue streams, the research team performed preliminary feasibility assessments for each resource category. The research team also reviewed available funding resources and made recommendations to Pawnee Nation highlighting those resources with the greatest potential for financially-viable development, both in the near-term and over a longer time horizon. Energy Efficiency Options While this was not a major focus of the project, the research team highlighted common strategies for reducing energy use in buildings. The team also discussed the benefits of adopting a building energy code and

  7. Distributed Energy Implementation Options

    Energy Technology Data Exchange (ETDEWEB)

    Shah, Chandralata N [National Renewable Energy Laboratory (NREL), Golden, CO (United States)

    2017-09-13

    This presentation covers the options for implementing distributed energy projects. It distinguishes between options available for distributed energy that is government owned versus privately owned, with a focus on the privately owned options including Energy Savings Performance Contract Energy Sales Agreements (ESPC ESAs). The presentation covers the new ESPC ESA Toolkit and other Federal Energy Management Program resources.

  8. Analyzing the Risks Embedded in Option Prices with rndfittool

    DEFF Research Database (Denmark)

    Barletta, Andrea; Santucci de Magistris, Paolo

    2018-01-01

    This paper introduces a new computational tool for the analysis of the risks embedded in a set of prices of European-style options. The software enables the estimation of the risk-neutral density (RND) from the observed option prices by means of orthogonal polynomial expansions. Orthogonal...... polynomials offer a viable alternative to more standard techniques based on interpolation and estimation of the second-order derivatives of option prices. The app rndfittool is available on GitHub and its usage is illustrated with examples based on real data....

  9. TANK SPACE OPTIONS REPORT

    International Nuclear Information System (INIS)

    Willis, W.L.; Ahrendt, M.R.

    2009-01-01

    Since this report was originally issued in 2001, several options proposed for increasing double-shell tank (DST) storage space were implemented or are in the process of implementation. Changes to the single-shell tank (SST) waste retrieval schedule, completion of DST space saving options, and the DST space saving options in progress have delayed the projected shortfall of DST storage space from the 2007-2011 to the 2018-2025 timeframe (ORP-11242, River Protection Project System Plan). This report reevaluates options from Rev. 0 and includes evaluations of new options for alleviating projected restrictions on SST waste retrieval beginning in 2018 because of the lack of DST storage space.

  10. Comparison of options for distributed generation in India

    International Nuclear Information System (INIS)

    Banerjee, Rangan

    2006-01-01

    There is renewed interest in distributed generation (DG). This paper reviews the different technological options available for DG, their current status and evaluates them based on the cost of generation and future potential in India. The non-renewable options considered are internal combustion engines fuelled by diesel, natural gas and microturbines and fuel cells fired by natural gas. The renewable technologies considered are wind, solar photovoltaic, biomass gasification and bagasse cogeneration. The cost of generation is dependent on the load factor and the discount rate. Gas engines and Bagasse based cogeneration are found to be the most cost effective DG options while wind and biomass gasifier fired engines are viable under certain conditions. PEM Fuel cells and micro turbines based on natural gas need a few demonstrations projects and cost reductions before becoming viable. A strategy involving pilot projects, tracking of costs and dissemination of information is likely to result in DG meeting 10% of India's power needs by 2012

  11. Therapeutic ultrasound

    International Nuclear Information System (INIS)

    Crum, Lawrence A

    2004-01-01

    The use of ultrasound in medicine is now quite commonplace, especially with the recent introduction of small, portable and relatively inexpensive, hand-held diagnostic imaging devices. Moreover, ultrasound has expanded beyond the imaging realm, with methods and applications extending to novel therapeutic and surgical uses. These applications broadly include: tissue ablation, acoustocautery, lipoplasty, site-specific and ultrasound mediated drug activity, extracorporeal lithotripsy, and the enhancement of natural physiological functions such as wound healing and tissue regeneration. A particularly attractive aspect of this technology is that diagnostic and therapeutic systems can be combined to produce totally non-invasive, imageguided therapy. This general lecture will review a number of these exciting new applications of ultrasound and address some of the basic scientific questions and future challenges in developing these methods and technologies for general use in our society. We shall particularly emphasize the use of High Intensity Focused Ultrasound (HIFU) in the treatment of benign and malignant tumors as well as the introduction of acoustic hemostasis, especially in organs which are difficult to treat using conventional medical and surgical techniques. (amum lecture)

  12. Surgical therapeutic management of perforated peptic ulcer

    OpenAIRE

    Ana Karla de Sousa Almeida; Clara Rafael Silva Xavier; Lucas de Faria Barros Medeiros; Joanna de Andrade Cordeiro; Amália Cínthia Menezes Rêgo; Irami Araújo-Filho

    2016-01-01

    Perforated peptic ulcer is an emergency should be readily corrected by surgical approach to reduce potential damage and the risk of mortality associated with the extension frame. The option of handling most commonly used by surgeons is laparotomy, however, there is evidence pointing to approach laparoscopically like a viable, safe and with good results for their treatment. Therefore, it is appropriate to evaluate the data about each management and minimally invasive procedure, lap...

  13. The search for viable local government system in Nigeria: an ...

    African Journals Online (AJOL)

    The history of the Nigerian local government system has been one long episode of trails and errors aimed at achieving viable local government institution without much success. Local government in the country began its long series of reforms from the colonial period when the colonial government attempted to ...

  14. Skills training workshops as a viable strategy for improving ...

    African Journals Online (AJOL)

    Skills training workshops as a viable strategy for improving smallholder and cooperative agribusiness management: A case study of Vhembe District, Limpopo Province, South Africa. ... South African Journal of Agricultural Extension ... Empirical evidence from this study shows that six months after attending the workshops, ...

  15. A viable real estate economy with disruption and blockchain

    NARCIS (Netherlands)

    Veuger, Jan

    2017-01-01

    Two titles in one cover. On page 56-112 there's the English version of the book: 'A viable real estate economy with disruption and blockchain. Does real estate still have the value that it had, or is the valuation of real estate going to change due to surprising products and services, innovative

  16. Microneedle physical contact as a therapeutic for abnormal scars.

    Science.gov (United States)

    Yeo, David C; Balmayor, Elizabeth R; Schantz, Jan-Thorsten; Xu, Chenjie

    2017-08-14

    Abnormal (keloid and hypertrophic) scars are a significant affliction with no satisfactory single modality therapy to-date. Available options are often ineffective, painful, potentially hazardous, and require healthcare personnel involvement. Herein a self-administered microneedle device based on drug-free physical contact for inhibiting abnormal scars is reported. Its therapeutic activity through microneedle contact eliminates hazards associated with toxic anti-scarring drugs while self-treatment enables administration flexibility. The microneedle patch was fabricated with FDA-approved liquid crystalline polymer under good manufacturing practice. It was first tested to ascertain its ability to inhibit (keloid) fibroblast proliferation. Later the microneedle patch was examined on the rabbit ear hypertrophic scar model to explore its potential in inhibiting the generation of abnormal scars post-injury. Finally, the microneedle patch was applied to the caudal region of a hypertrophic scar located on a female patient's dorsum to verify clinical efficacy. On untreated control cultures, barely any non-viable fibroblasts could be seen. After 12-h treatment with the microneedle patch, the non-viable proportion increased to 83.8 ± 11.96%. In rabbit ear hypertrophic scar model, 100% of the control wounds without the presence of patches on rabbit ears generated regions of raised dermis originating from the wound site (3/3), whereas microneedle treatment prevented dermis tissue thickening in 83.33% of the wounds (15/18). In the clinical test, the microneedle patch was well tolerated by the patient. Compared to the untreated region, microneedle treatment decreased the number of infiltrated inflammatory cells, with less disrupted dermis tissue architecture and more flattened appearance. A self-administered, drug-free microneedle patch appears highly promising in reducing abnormal scarring as observed from in vitro, in vivo and clinical experiments. Larger cohort clinical

  17. Papaya Extract to Treat Dengue: A Novel Therapeutic Option?

    African Journals Online (AJOL)

    review of available literature regarding the use of the papaya leaf extract for the treatment of ... there are no effective antiviral agents available to treat dengue complications. .... A study in the journal of Medicinal and Aromatic Plants reported an ...

  18. Eribulin Mesylate: A New Therapeutic Option for Metastatic Breast ...

    African Journals Online (AJOL)

    Asthenia, fatigue, neutropenia, alopecia, nausea, anorexia, and neuropathy are the most frequent adverse effects associated with this drug. The aim of this review was to highlight the importance of this drug in the management of breast cancer. Medline, Excerpta Medica database, cochrane database, medscape, Elsevier ...

  19. Lysosomal storage diseases: current diagnostic and therapeutic options

    International Nuclear Information System (INIS)

    Malinova, V.; Honzik, T.

    2013-01-01

    Lysosomal storage diseases are rare genetic diseases caused by insufficient activity of some of the lysosomal enzymes and/or transport proteins. Initial symptoms may appear any time from the neonatal period to late adulthood; early forms tend to have a severe course with rapid progression and unfavorable prognosis. There is multisystem involvement with continuous progression of symptoms and involvement of metabolically active organs or tissues – the bone marrow, liver, bones, skeletal muscles, myocardium, or CNS. The diagnosis is definitively confirmed by demonstration of reduced activity of the particular enzyme and by mutation analysis. Some of the storage diseases can be effectively treated by intravenous administration of recombinant enzymes or by limiting the amount of the substrate stored. In a small number of lysosomal storage diseases, bone marrow transplantation is successful. Multidisciplinary collaboration, including genetic counselling and prenatal diagnosis in patient families, is required. The first part of the paper deals with general characteristics of lysosomal storage diseases and the most common diseases that are currently treatable in the Czech Republic (Gaucher’s disease, Pompe disease, Fabry disease, Niemann–Pick disease, cholesterol ester storage disease). The second part of the paper deals with mucopolysaccharidase, another group of rare lysosomal storage diseases. (author)

  20. SGLT2 Inhibitors as a Therapeutic Option for Diabetic Nephropathy

    Directory of Open Access Journals (Sweden)

    Daiji Kawanami

    2017-05-01

    Full Text Available Diabetic nephropathy (DN is a major cause of end-stage renal disease (ESRD worldwide. Glycemic and blood pressure (BP control are important but not sufficient to attenuate the incidence and progression of DN. Sodium–glucose cotransporter (SGLT 2 inhibitors are a new class of glucose-lowering agent suggested to exert renoprotective effects in glucose lowering-dependent and independent fashions. Experimental studies have shown that SGLT2 inhibitors attenuate DN in animal models of both type 1 diabetes (T1D and type 2 diabetes (T2D, indicating a potential renoprotective effect beyond glucose reduction. Renoprotection by SGLT2 inhibitors has been demonstrated in T2D patients with a high cardiovascular risk in randomized controlled trials (RCTs. These favorable effects of SGLT2 inhibitors are explained by several potential mechanisms, including the attenuation of glomerular hyperfiltration, inflammation and oxidative stress. In this review article, we discuss the renoprotective effects of SGLT2 inhibitors by integrating experimental findings with the available clinical data.

  1. SGLT2 Inhibitors as a Therapeutic Option for Diabetic Nephropathy.

    Science.gov (United States)

    Kawanami, Daiji; Matoba, Keiichiro; Takeda, Yusuke; Nagai, Yosuke; Akamine, Tomoyo; Yokota, Tamotsu; Sango, Kazunori; Utsunomiya, Kazunori

    2017-05-18

    Diabetic nephropathy (DN) is a major cause of end-stage renal disease (ESRD) worldwide. Glycemic and blood pressure (BP) control are important but not sufficient to attenuate the incidence and progression of DN. Sodium-glucose cotransporter (SGLT) 2 inhibitors are a new class of glucose-lowering agent suggested to exert renoprotective effects in glucose lowering-dependent and independent fashions. Experimental studies have shown that SGLT2 inhibitors attenuate DN in animal models of both type 1 diabetes (T1D) and type 2 diabetes (T2D), indicating a potential renoprotective effect beyond glucose reduction. Renoprotection by SGLT2 inhibitors has been demonstrated in T2D patients with a high cardiovascular risk in randomized controlled trials (RCTs). These favorable effects of SGLT2 inhibitors are explained by several potential mechanisms, including the attenuation of glomerular hyperfiltration, inflammation and oxidative stress. In this review article, we discuss the renoprotective effects of SGLT2 inhibitors by integrating experimental findings with the available clinical data.

  2. Blunt traumatic cardiac rupture: therapeutic options and outcomes.

    Science.gov (United States)

    Nan, Yu-Yun; Lu, Ming-Shian; Liu, Kuo-Sheng; Huang, Yao-Kuang; Tsai, Feng-Chun; Chu, Jaw-Ji; Lin, Pyng Jing

    2009-09-01

    Cardiac rupture following blunt thoracic trauma is rarely encountered by clinicians, since it commonly causes death at the scene. With advances in traumatology, blunt cardiac rupture had been increasingly disclosed in various ways. This study reviews our experience of patients with suspected blunt traumatic cardiac rupture and proposes treatment protocols for the same. This is a 5-year retrospective study of trauma patients confirmed with blunt traumatic cardiac rupture admitted to a university-affiliated tertiary trauma referral centre. The following information was collected from the patients: age, sex, mechanism of injury, initial effective diagnostic tool used for diagnosing blunt cardiac rupture, location and size of the cardiac injury, associated injury and injury severity score (ISS), reversed trauma score (RTS), survival probability of trauma and injury severity scoring (TRISS), vital signs and biochemical lab data on arrival at the trauma centre, time elapsed from injury to diagnosis and surgery, surgical details, hospital course and final outcome. The study comprised 8 men and 3 women with a median age of 39 years (range: 24-73 years) and the median follow-up was 5.5 months (range: 1-35 months). The ISS, RTS, and TRISS scores of the patients were 32.18+/-5.7 (range: 25-43), 6.267+/-1.684 (range: 2.628-7.841), and 72.4+/-25.6% (range: 28.6-95.5%), respectively. Cardiac injuries were first detected using focused assessment with sonography for trauma (FAST) in 4 (36.3%) patients, using transthoracic echocardiography in 3 (27.3%) patients, chest CT in 1 (9%) patient, and intra-operatively in 3 (27.3%) patients. The sites of cardiac injury comprised the superior vena cava/right atrium junction (n=4), right atrial auricle (n=1), right ventricle (n=4), left ventricular contusion (n=1), and diffuse endomyocardial dissection over the right and left ventricles (n=1). Notably, 2 had pericardial lacerations presenting as a massive haemothorax, which initially masked the cardiac rupture. The in-hospital mortality was 27.3% (3/11) with 1 intra-operative death, 1 multiple organ failure, and 1 death while waiting for cardiac transplantation. Another patient with morbid neurological defects died on the thirty-third postoperative day; the overall survival was 63.6% (7/11). Compared with the surviving patients, the fatalities had higher RTS and TRISS scores, serum creatinine levels, had received greater blood transfusions, and had a worse preoperative conscious state. We proposed a protocol combining various diagnostic tools, including FAST, CT, transthoracic echocardiography, and TEE, to manage suspected blunt traumatic cardiac rupture. Pericardial defects can mask the cardiac lesion and complicate definite cardiac repair. Comorbid trauma, particularly neurological injury, may have an impact on the survival of such patients, despite timely repair of the cardiac lesions.

  3. A less aggressive therapeutic option for electrical storm.

    Science.gov (United States)

    Bertero, G; Agosti, S; Brunelli, C

    2013-01-01

    Electrical storm (ES) describes the rapidly clustering ventricular fibrillation (VF) that requires multiple cardioversions. Emerging evidence suggests that Purkinje arborization and sympathetic nerve regeneration play a major role in initiating malignant arrhythmias. We report the case of two patients who, after having survived an acute myocardial infarction (MI), developed repetitive episodes of polymorphic ventricular tachycardia and VF one week after percutaneous revascularization, triggered by monomorphic premature ventricular contractions (PVCs). Owing to repetitive and drug-refractory VF episodes, temporary atrial overdrive pacing was attempted with complete suppression of VF. In the following month, recurrence of ventricular arrhythmia was inversely related to the atrial pacing rate. Although antiarrhythmic drugs other than beta-blockers had been discontinued, neither PVCs nor ventricular arrhythmias recurred at one-month follow-up when the lower pacing rate was set at 60 bpm. In conclusion in these patients, ES was likely related to nerve sprouting after ischemic injury. This chaotic phenomenon occurs early after tissue damage and shows a peak seven days after acute MI with degeneration of superfluous axon branches. High pacing rates can reduce early after depolarizations and suppress PVCs, thus preventing ES. On these grounds, ES patients may be treated with temporary overdrive pacing rather than early radiofrequency ablation.

  4. Aromatase inhibitors in men: effects and therapeutic options

    Directory of Open Access Journals (Sweden)

    de Jong Frank H

    2011-06-01

    Full Text Available Abstract Aromatase inhibitors effectively delay epiphysial maturation in boys and improve testosterone levels in adult men Therefore, aromatase inhibitors may be used to increase adult height in boys with gonadotropin-independent precocious puberty, idiopathic short stature and constitutional delay of puberty. Long-term efficacy and safety of the use of aromatase inhibitors has not yet been established in males, however, and their routine use is therefore not yet recommended.

  5. Papaya extract to treat dengue: a novel therapeutic option? | Sarala ...

    African Journals Online (AJOL)

    Dengue is a viral disease that today affects a vast number of people in over 125 countries and is responsible for a sizable number of deaths. In the absence of an effective antiviral drug to treat the disease, various treatments are being investigated. Studies have indicated that the juice of the leaves of the Carica papaya plant ...

  6. In vivo evaluation of therapeutic options in atopic dermatitis

    NARCIS (Netherlands)

    Oldhoff, Jantje Maria

    2006-01-01

    Atopic dermatitis (AD, or atopic eczema) is an inflammatory itchy skin disease. AD patients often have high serum immunoglobulin E (IgE) levels, T-cell activation and eosinophilia in peripheral blood. The dermal infiltrate of AD contains mainly T-cells, eosinophils and dendritic cells. Epicutaneous

  7. Polyphenolic acetates: A newer anti-Mycobacterial therapeutic option

    African Journals Online (AJOL)

    Anti acetyl lysine polyclonal antibody was purchased from Cell Signaling. ... acetyl group from various polyphenolic peracetate (PA) to certain receptor proteins such as cytochromes P-450, NADPH cytochrome reductase, nitric oxide synthase (NOS) has been established in various eukaryotic as well as prokaryotic sources.

  8. Diagnosis and therapeutic options for peripheral vasculitic neuropathy

    Science.gov (United States)

    2015-01-01

    Vasculitis can affect the peripheral nervous system alone (nonsystemic vasculitic neuropathy) or can be a part of primary or secondary systemic vasculitis. In cases of pre-existing systemic vasculitis, the diagnosis can easily be made, whereas suspected vasculitic neuropathy as initial or only manifestation of vasculitis requires careful clinical, neurophysiological, laboratory and histopathological workout. The typical clinical syndrome is mononeuropathia multiplex or asymmetric neuropathy, but distal-symmetric neuropathy can frequently be seen. Standard treatments include steroids, azathioprine, methotrexate and cyclophosphamide. More recently the B-cell antibody rituximab and intravenous immunoglobulins have shown to be effective in some vasculitic neuropathy types. PMID:25829955

  9. Therapeutical options for the treatment of Cheyne-Stokes respiration.

    Science.gov (United States)

    Randerath, Winfried J

    2009-03-07

    The awareness of Cheyne-Stokes respiration (CSR) and of the co-existence of the obstructive sleep apnoea syndrome and central breathing disturbances has rapidly grown in recent years. CSR is defined by a waxing and waning pattern of the breathing amplitude. Sleep related breathing disorders in patients with heart failure are associated with impaired clinical outcome and survival. While continuous positive airway pressure treatment (CPAP) is widely used to treat CSR, it has failed to improve overall survival of heart failure patients. Nevertheless, it has been shown that CPAP reduces mortality if breathing disturbances were sufficiently eliminated. Therefore, optimal suppression of CSR is critical. While CPAP reduces CSR by 50% on average, adaptive servoventilation (ASV) normalises CSR in most patients. ASV devices apply different levels of pressure support: during periods of hypoventilation the inspiratory pressure is increased while it is reduced to the lowest possible level during hyperventilation. The devices deliver an expiratory pressure to overcome upper airways obstruction. Pressure support is defined by the difference between expiratory and inspiratory pressure. Thus, while pressure support is fixed in bilevel devices, it varies under ASV. However, the hypothesis that ASV might improve survival in CSR patients has to be proved in prospective studies in CPAP nonresponders. There is a lack of evidence on the use of bilevel devices in CSR. However, ASV has proven both to effectively treat CSR and to be superior to CPAP in respiratory and sleep parameters in short term and medium term studies. Nevertheless, data on the long term use and the influence on cardiac parameters are necessary.

  10. Topical kanamycin: an effective therapeutic option in aerobic vaginitis.

    Science.gov (United States)

    Tempera, G; Abbadessa, G; Bonfiglio, G; Cammarata, E; Cianci, A; Corsello, S; Raimondi, A; Ettore, G; Nicolosi, D; Furneri, P M

    2006-08-01

    Eighty-one patients with clinical diagnosis of aerobic vaginitis (AV) were included in the study. The patients were randomized for treatment, 45 with kanamycin (100 mg vaginal ovules for 6 days, consecutively) and 36 with meclocycline (35 mg vaginal ovules for 6 days, consecutively). The patients were examined before starting the study, 1-2 days after treatment and 30 days after the end of the study. At the first follow-up the patients showed different levels of symptom reduction. Reduction in the presence of leukocytes, vaginal mucosa burning and itching were statistically significant in the group treated with kanamycin with respect to the group treated with meclocycline. Moreover, there was also reduced isolation of Enterobacteriaeae (97%) in the group treated with kanamycin versus those treated with meclocycline (76%). At the second follow-up, vaginal homeostasis (normalization of pH and presence of lactobacilli) was more evident in the kanamycin-treated group. In conclusion, our data suggest that the topical use of kanamycin could be considered a specific antibiotic for the therapy of this new pathology.

  11. Follicular unit extraction as a therapeutic option for Vitiligo

    Directory of Open Access Journals (Sweden)

    S Sacchidanand

    2013-01-01

    Full Text Available Follicular unit extraction (FUE is a surgical procedure, which can be used to transplant follicular units into vitiliginous areas. Such follicular unit transplant has been recently used to repigment stable vitiligo patches. FUE was done for a 12-year-old female with a stable vitiligo patch with leukotrichia on the eyebrow. Repigmentation was noted in 6 weeks and complete pigmentation seen at 12 weeks. Leukotrichia resolved over a period of 6 months. No recurrence was noted at the end of 6 months follow-up with excellent colour match. This case is presented to highlight the simplicity, safety and effectiveness of FUE in stable vitiligo patches with leukotrichia.

  12. Insomnia during menopause and perimenopause: clinical characteristics and therapeutic options

    OpenAIRE

    Soares, Claudio N.

    2006-01-01

    Transtornos do sono e insônia são mais freqüentemente observados entre as mulheres do que entre os homens durante a vida adulta. Entre outros fatores, especula-se que alta comorbidade psiquiátrica para transtornos afetivos e ansiosos entre as mulheres contribua para maior ocorrência de insônia. Além disso, períodos de intensa variabilidade hormonal (por exemplo, gestação e puerpério, perimenopausa) parecem estar relacionados com maior incidência de insônia e de transtornos respiratórios do so...

  13. Radiologic diagnostic and therapeutic options in patients with pulsatile tinnitus

    International Nuclear Information System (INIS)

    Wanke, Isabel; Universitaetsklinikum Essen; Forsting, Michael

    2010-01-01

    A pulse synchronous tinnitus is characterized by a rhythmic sound that is in sync with the patient heartbeat or respiration and can be perceived by the patient as a bruit. Different from the more common classic and continuous ear sound, with pulse synchronous tinnitus one may often discover a pathological neovascular condition that can be diagnosed with medical imaging. This review covers the different conditions leading to pulse synchronous tinnitus and provides indications requiring preventive and active treatment to avoid potential but serious sequela for the patient. (orig.)

  14. Therapeutic Plasma Exchange Option for Guillain-Barre Syndrome

    African Journals Online (AJOL)

    2018-02-07

    Feb 7, 2018 ... [1] It is an immune-mediated inflammatory disease affecting the myelin and .... blood pressure (140/100 mmHg), and respiratory rate ... Renal function test and serum protein results showed no significant abnormality. Certain other ..... cell exchange (Erythrocytapheresis) in Nigeria for a sickle cell anaemia ...

  15. Therapeutic options in the management of autonomously functioning thyroid adenomas

    International Nuclear Information System (INIS)

    Barrenechea, E.A.; Ong, A.

    2005-01-01

    Full text: Autonomously functioning thyroid nodules or adenomas (AFTN or AFTA) was established as a clinical entity in 1918 by Goetsch correlating cellular mitochondrial content with nodular function and showing the inverse correlation between AFTN function and extra nodular tissue function. They are almost always benign and degeneration, which is common in AFTN, can result in the development of hyperthyroidism. It is therefore important to know the function of these nodules by requesting for the thyroid function tests namely T3, T4, and TSH. They are diagnosed by thyroid scans using I-131 or Tc 99m as a hot solitary nodule in one lobe with the other lobe not appearing on scan or suppressed. The frequency of AFTA worldwide is quite variable depending on geography. It ranges from 1% in North America to 10 % in some areas in Europe and Asia or in areas of iodine deficiency. The traditional methods of treatment of these nodules have been surgery and radioactive iodine ablation. Surgical treatment as a rule is indicated in young patients with nodules larger than 3 cm and those with local compressive symptoms. RAI is used in elderly patients and those who are poor surgical risks. The usual dose ranges from 20 to 30 mCi and is definitely larger that when treating Graves' disease. Others have resorted to PEI or percutaneous ethanol injection with reported success. There has been no definite management of these AFTA due to the variable natural history and some would only recommend observation for asymptomatic small adenomas, which are euthyroid. Therefore this paper studied the results of treatment using RAI ablation, surgery or plain observation for AFTA. Percutaneous ethanol injection is not being done in our center. In the local setting, where thyroid disease is still endemic, the incidence of AFTA is not so high. Graves' disease is still the predominating cause of hyperthyroidism followed by multinodular goiter. Toxic AFTA occurs in 3% of the total hyperthyroid patients. In a ten-year review of the course of the disease after treatment with any of the three modalities of surgery, RAI and purely observation, there still seem to be no common consensus, which the best treatment modality is. Forty-eight patients were included in the study. Among these patients were 43 females and 5 males. Majority were over fifty years old. Among the 48 patients, thirty-nine were toxic and 9 were non-toxic. Of the toxic patients, twelve patients underwent surgery of the affected lobe, undergoing lobectomy or nodulectomy, while 19 patients were given radioactive iodine with a dose range of 20 to 30 mCi. Eight patients just had antithyroid drugs and were just observed. Among the nine patients who were euthyroid, five were just observed but requiring periodic followup while four underwent surgery. Two of the total population, one hyperthyroid and one euthyroid patient while being observed after 6 months and three months respectively developed rapid growth of the nodules. FNAB was done which showed well differentiated CA (papillary and follicular) hence underwent total thyroidectomy or near total thyroidectomy, RAI ablation and lifetime thyroid hormone suppression. The results of the 3 modalities were compared and the best results were seen in the group given RAI in terms of cost effectiveness, diminished size of the nodules to disappearance of nodules and relief of symptoms. Hypothyroidism was not a problem as only two patients developed such. Those who were observed only still had the nodules, which became bigger in size with the antithyroids while the incidence of hypothyroidism secondary to surgery was higher in this study as seen in 4 patients. In conclusion, the three modes of treatment has its own weaknesses and strengths and treatment should be individualized depending on which age group the patient belongs (very important consideration) as well as patients choice, size of the nodule and function of the nodule. I-131 may still be the treatment of choice especially in the elderly since they have concomitant cardiac problems. However in the younger age group and for bigger nodules, surgery may be preferred for aesthetic reasons and since they are good surgical risks. Pure antithyroid treatment usually is not recommended. (author)

  16. What are the current therapeutic options for haemorrhagic strokes

    International Nuclear Information System (INIS)

    Khan, M.; Kamal, A.K.

    2010-01-01

    The Factor Seven for Acute Haemorrhagic Stroke Trial (FAST) and Intensive Blood Pressure Reduction in Acute Cerebral Haemorrhage trial (INTERACT). Intracerebral haemorrhage (ICH) is the most devastating form of stroke carrying a mortality of up to 40% at one month. In our part of the world the levels of uncontrolled hypertension pose a greater risk of ICH for our population where ICH is about 30% of all strokes compared to 14% in developed countries. There is evidence to suggest that haematoma expansion occurs in as many as 70% of patients. This expansion translates into increased disability and death. Most of this expansion is within the initial three hours. Also early elevation of blood pressure (BP) is very common after ICH and many studies have highlighted an association between elevated BP post ICH and poor outcomes. The reason for this is postulated to be an increase in both the size of the haematoma and perilesional oedema. (author)

  17. Viable tumor in salvage neck dissections in head and neck cancer : Relation with initial treatment, change of lymph node size and human papillomavirus

    NARCIS (Netherlands)

    van den Bovenkamp, Karlijn; Dorgelo, Bart; Noordhuis, Maartje G; van der Laan, Bernard F A M; van der Vegt, Bert; Bijl, Hendrik P; Roodenburg, Jan L; van Dijk, Boukje A C; Oosting, Sjoukje F; Schuuring, Ed M D; Langendijk, Johannes A; Halmos, Gyorgy B; Plaat, Boudewijn E C

    Objectives: To identify predictive factors for the presence of viable tumor and outcome in head and neck cancer patients who undergo therapeutic salvage neck dissections. Materials and Methods: Retrospective analysis of 76 salvage neck dissections after radiotherapy alone (n = 22), radiotherapy in

  18. Viable group A streptococci in macrophages during acute soft tissue infection.

    Directory of Open Access Journals (Sweden)

    Pontus Thulin

    2006-03-01

    Full Text Available Group A streptococcal severe soft tissue infections, such as necrotizing fasciitis, are rapidly progressive infections associated with high mortality. Group A streptococcus is typically considered an extracellular pathogen, but has been shown to reside intracellularly in host cells.We characterized in vivo interactions between group A streptococci (GAS and cells involved in innate immune responses, using human biopsies (n = 70 collected from 17 patients with soft tissue infections. Immunostaining and in situ image analysis revealed high amounts of bacteria in the biopsies, even in those collected after prolonged antibiotic therapy. Viability of the streptococci was assessed by use of a bacterial viability stain, which demonstrated viable bacteria in 74% of the biopsies. GAS were present both extracellularly and intracellularly within phagocytic cells, primarily within macrophages. Intracellular GAS were predominantly noted in biopsies from newly involved tissue characterized by lower inflammation and bacterial load, whereas purely extracellular GAS or a combination of intra- and extracellular GAS dominated in severely inflamed tissue. The latter tissue was also associated with a significantly increased amount of the cysteine protease streptococcal pyrogenic exotoxin SpeB. In vitro studies confirmed that macrophages serve as reservoirs for viable GAS, and infection with a speB-deletion mutant produced significantly lower frequencies of cells with viable GAS following infection as compared to the wild-type bacteria.This is the first study to demonstrate that GAS survive intracellularly in macrophages during acute invasive infections. This intracellular presence may have evolved as a mechanism to avoid antibiotic eradication, which may explain our finding that high bacterial load is present even in tissue collected after prolonged intravenous antibiotic therapy. This new insight into the pathogenesis of streptococcal soft tissue infections

  19. Viable Group A Streptococci in Macrophages during Acute Soft Tissue Infection.

    Directory of Open Access Journals (Sweden)

    2006-01-01

    Full Text Available BACKGROUND: Group A streptococcal severe soft tissue infections, such as necrotizing fasciitis, are rapidly progressive infections associated with high mortality. Group A streptococcus is typically considered an extracellular pathogen, but has been shown to reside intracellularly in host cells. METHODS AND FINDINGS: We characterized in vivo interactions between group A streptococci (GAS and cells involved in innate immune responses, using human biopsies (n = 70 collected from 17 patients with soft tissue infections. Immunostaining and in situ image analysis revealed high amounts of bacteria in the biopsies, even in those collected after prolonged antibiotic therapy. Viability of the streptococci was assessed by use of a bacterial viability stain, which demonstrated viable bacteria in 74% of the biopsies. GAS were present both extracellularly and intracellularly within phagocytic cells, primarily within macrophages. Intracellular GAS were predominantly noted in biopsies from newly involved tissue characterized by lower inflammation and bacterial load, whereas purely extracellular GAS or a combination of intra- and extracellular GAS dominated in severely inflamed tissue. The latter tissue was also associated with a significantly increased amount of the cysteine protease streptococcal pyrogenic exotoxin SpeB. In vitro studies confirmed that macrophages serve as reservoirs for viable GAS, and infection with a speB-deletion mutant produced significantly lower frequencies of cells with viable GAS following infection as compared to the wild-type bacteria. CONCLUSIONS: This is the first study to demonstrate that GAS survive intracellularly in macrophages during acute invasive infections. This intracellular presence may have evolved as a mechanism to avoid antibiotic eradication, which may explain our finding that high bacterial load is present even in tissue collected after prolonged intravenous antibiotic therapy. This new insight into the pathogenesis

  20. Value of an option to purchase electric power. The case of uncertain consumption

    International Nuclear Information System (INIS)

    Bhanot, Karan

    2002-01-01

    Large manufacturers and corporations often purchase options on power to protect themselves against unanticipated price increases. This paper analyzes the impact of uncertainty in power consumption by a corporation on the value of an option to purchase electric power. Because there is no economically viable method to store power, these options are exercised to satisfy immediate consumption needs only. The amount exercised may differ from the maximum amount contracted, which in turn alters the payoffs that accrue to the option contract. We apply a Monte Carlo methodology to show that 'consumption uncertainty' may substantively lower the price of an option contract under different conditions

  1. The origins of options.

    Science.gov (United States)

    Smaldino, Paul E; Richerson, Peter J

    2012-01-01

    Most research on decision making has focused on how human or animal decision makers choose between two or more options, posed in advance by the researchers. The mechanisms by which options are generated for most decisions, however, are not well understood. Models of sequential search have examined the trade-off between continued exploration and choosing one's current best option, but still cannot explain the processes by which new options are generated. We argue that understanding the origins of options is a crucial but untapped area for decision making research. We explore a number of factors which influence the generation of options, which fall broadly into two categories: psycho-biological and socio-cultural. The former category includes factors such as perceptual biases and associative memory networks. The latter category relies on the incredible human capacity for culture and social learning, which doubtless shape not only our choices but the options available for choice. Our intention is to start a discussion that brings us closer toward understanding the origins of options.

  2. Americal options analyzed differently

    NARCIS (Netherlands)

    Nieuwenhuis, J.W.

    2003-01-01

    In this note we analyze in a discrete-time context and with a finite outcome space American options starting with the idea that every tradable should be a martingale under a certain measure. We believe that in this way American options become more understandable to people with a good working

  3. Conservative therapeutic management of carpal tunnel syndrome

    Directory of Open Access Journals (Sweden)

    Roberto Sérgio Martins

    Full Text Available ABSTRACT Carpal tunnel syndrome is the most prevalent nerve compression and can be clinically or surgically treated. In most cases, the first therapeutic alternative is conservative treatment but there is still much controversy regarding the most effective modality of this treatment. In this study, we critically evaluated the options of conservative treatment for carpal tunnel syndrome, aiming to guide the reader through the conventional options used in this therapy.

  4. Acupuntura un tratamiento viable para las adicciones en Colombia

    Directory of Open Access Journals (Sweden)

    Hernán López Seuscún

    2013-07-01

    Los tratamientos con auriculoterapia, como el protocolo NADA (National Acupuncture Detoxification Association, son los métodos más usados para las adicciones en el mundo, y aunque no se ha logrado evidenciar su efectividad, por su costo, facilidad y el poco riesgo de efectos adversos se hace viable en un país con pocos recursos económicos como Colombia.

  5. Traffic Light Options

    DEFF Research Database (Denmark)

    Jørgensen, Peter Løchte

    This paper introduces, prices, and analyzes traffic light options. The traffic light option is an innovative structured OTC derivative developed independently by several London-based investment banks to suit the needs of Danish life and pension (L&P) companies, which must comply with the traffic...... 2006, and supervisory authorities in many other European countries have implemented similar regulation. Traffic light options are therefore likely to attract the attention of a wider audience of pension fund managers in the future. Focusing on the valuation of the traffic light option we set up a Black...... light scenarios. These stress scenarios entail drops in interest rates as well as in stock prices, and traffic light options are thus designed to pay off and preserve sufficient capital when interest rates and stock prices fall simultaneously. Sweden's FSA implemented a traffic light system in January...

  6. Traffic Light Options

    DEFF Research Database (Denmark)

    Jørgensen, Peter Løchte

    2007-01-01

    This paper introduces, prices, and analyzes traffic light options. The traffic light option is an innovative structured OTC derivative developed independently by several London-based investment banks to suit the needs of Danish life and pension (L&P) companies, which must comply with the traffic...... 2006, and supervisory authorities in many other European countries have implemented similar regulation. Traffic light options are therefore likely to attract the attention of a wider audience of pension fund managers in the future. Focusing on the valuation of the traffic light option we set up a Black...... light scenarios. These stress scenarios entail drops in interest rates as well as in stock prices, and traffic light options are thus designed to pay off and preserve sufficient capital when interest rates and stock prices fall simultaneously. Sweden's FSA implemented a traffic light system in January...

  7. Spent fuel storage options: a critical appraisal

    International Nuclear Information System (INIS)

    Singh, K.P.; Bale, M.G.

    1990-01-01

    The delayed decisions on nuclear fuel reprocessing strategies in the USA and other countries have forced the development of new long-term irradiated fuel storage techniques, to allow a larger volume of fuel to be held on the nuclear station site after removal from the reactor. The nuclear power industry has responded to the challenge by developing several viable options for long-term onsite storage, which can be employed individually or in tandem. They are: densification of storage in the existing spent fuel pool; building another fuel pool facility at the plant site; onsite cask park, and on site vault clusters. Desirable attributes of a storage option are: Safety: minimise the number of fuel handling steps; Economy: minimise total installed, and O and M cost; Security: protection from anti-nuclear protesters; Site adaptability: available site space, earthquake characteristics of the region and so on; Non-intrusiveness: minimise required modifications to existing plant systems; Modularisation: afford the option to adapt a modular approach for staged capital outlays; and Maturity: extent of industry experience with the technology. A critical appraisal is made of each of the four aforementioned storage options in the light of these criteria. (2 figures, 1 table, 4 references) (Author)

  8. Viable Mycobacterium avium ssp. paratuberculosis isolated from calf milk replacer.

    Science.gov (United States)

    Grant, Irene R; Foddai, Antonio C G; Tarrant, James C; Kunkel, Brenna; Hartmann, Faye A; McGuirk, Sheila; Hansen, Chungyi; Talaat, Adel M; Collins, Michael T

    2017-12-01

    When advising farmers on how to control Johne's disease in an infected herd, one of the main recommendations is to avoid feeding waste milk to calves and instead feed calf milk replacer (CMR). This advice is based on the assumption that CMR is free of viable Mycobacterium avium ssp. paratuberculosis (MAP) cells, an assumption that has not previously been challenged. We tested commercial CMR products (n = 83) obtained from dairy farms around the United States by the peptide-mediated magnetic separation (PMS)-phage assay, PMS followed by liquid culture (PMS-culture), and direct IS900 quantitative PCR (qPCR). Conventional microbiological analyses for total mesophilic bacterial counts, coliforms, Salmonella, coagulase-negative staphylococci, streptococci, nonhemolytic Corynebacterium spp., and Bacillus spp. were also performed to assess the overall microbiological quality of the CMR. Twenty-six (31.3%) of the 83 CMR samples showed evidence of the presence of MAP. Seventeen (20.5%) tested positive for viable MAP by the PMS-phage assay, with plaque counts ranging from 6 to 1,212 pfu/50 mL of reconstituted CMR (average 248.5 pfu/50 mL). Twelve (14.5%) CMR samples tested positive for viable MAP by PMS-culture; isolates from all 12 of these samples were subsequently confirmed by whole-genome sequencing to be different cattle strains of MAP. Seven (8.4%) CMR samples tested positive for MAP DNA by IS900 qPCR. Four CMR samples tested positive by both PMS-based tests and 5 CMR samples tested positive by IS900 qPCR plus one or other of the PMS-based tests, but only one CMR sample tested positive by all 3 MAP detection tests applied. All conventional microbiology results were within current standards for whole milk powders. A significant association existed between higher total bacterial counts and presence of viable MAP indicated by either of the PMS-based assays. This represents the first published report of the isolation of viable MAP from CMR. Our findings raise concerns

  9. Changing Profiles of Diagnostic and Treatment Options in Subclavian Artery Aneurysms

    NARCIS (Netherlands)

    Vierhout, B. P.; Zeebregts, C. J.; van den Dungen, J. J. A. M.; Reijnen, M. M. P. J.

    Background: Subclavian artery aneurysms (SAAs) are rare and may cause life- and limb-threatening complications. Therapeutic options greatly differ as do access alternatives. The aim of the study was to assess its clinical presentation, diagnostics and therapeutic options as reported in the

  10. Polish Toxic Currency Options

    Directory of Open Access Journals (Sweden)

    Waldemar Gontarski

    2009-06-01

    Full Text Available Toxic currency options are defined on the basis of the opposition to the nature (essence of an option contract, which is justified in terms of norms founded on the general law clause of characteristics (nature of a relation (which represents an independent premise for imposing restrictions on the freedom of contracts. So-understood toxic currency options are unlawful. Indeed they contravene iuris cogentis regulations. These include for instance option contracts, which are concluded with a bank, if the bank has not informed about option risk before concluding the contract; or the barrier options, which focus only on the protection of bank’s interests. Therefore, such options may appear to be invalid. Therefore, performing contracts for toxic currency options may be qualified as a criminal mismanagement. For the sake of security, the manager should then take into consideration filing a claim for stating invalidity (which can be made in a court verdict. At the same time, if the supervisory board member in a commercial company, who can also be a subject to mismanagement offences, commits an omission involving lack of reaction (for example, if he/she fails to notify of the suspected offence committed by the management board members acting to the company’s detriment when the management board makes the company conclude option contracts which are charged with absolute invalidity the supervisory board member so acting may be considered to act to the company’s detriment. In the most recent Polish jurisprudence and judicature the standard of a “good host” is treated to be the last resort for determining whether the manager’s powers resulting from criminal regulations were performed. The manager of the exporter should not, as a rule, issue any options. Issuing options always means assuming an obligation. In the case of currency put options it is an absolute obligation to purchase a given amount in euro at exchange rate set in advance. On the

  11. 2005 resource options report

    International Nuclear Information System (INIS)

    Morris, T.

    2005-01-01

    This resource options report (ROR) fulfils regulatory requirements in British Columbia's two-year resource planning process. It identifies a wide range of resources and technologies that could be used to meet BC Hydro's future electricity demand. As such, it facilitates a transparent public review of resource options which include both supply-side and demand-side options. The resource options that will be used in the 2005 integrated electricity plan (IEP) were characterized. This ROR also documents where there is a general agreement or disagreement on the resource type characterization, based on the First Nations and Stakeholder engagement. BC Hydro used current information to provide realistic ranges on volume and cost to characterize environmental and social attributes. The BC Hydro system was modelled to assess the benefit and cost of various resource options. The information resulting from this ROR and IEP will help in making decisions on how to structure competitive acquisition calls and to determine the level of transmission services needed to advance certain BC Hydro projects. The IEP forecasts the nature and quantity of domestic resources required over the next 20 years. A strategic direction on how those needs will be met has been created to guide the management of BC Hydro's energy resources. Supply-side options include near-commercial technologies such as energy storage, ocean waves, tidal, fuel cells and integrated coal gasification combined cycle technology. Supply-side options also include natural gas, coal, biomass, geothermal, wind, and hydro. 120 refs., 39 tabs., 21 figs., 6 appendices

  12. Expensing options solves nothing.

    Science.gov (United States)

    Sahlman, William A

    2002-12-01

    The use of stock options for executive compensation has become a lightning rod for public anger, and it's easy to see why. Many top executives grew hugely rich on the back of the gains they made on their options, profits they've been able to keep even as the value they were supposed to create disappeared. The supposed scam works like this: Current accounting regulations let companies ignore the cost of option grants on their income statements, so they can award valuable option packages without affecting reported earnings. Not charging the cost of the grants supposedly leads to overstated earnings, which purportedly translate into unrealistically high share prices, permitting top executives to realize big gains when they exercise their options. If an accounting anomaly is the problem, then the solution seems obvious: Write off executive share options against the current year's revenues. The trouble is, Sahlman writes, expensing option grants won't give us a more accurate view of earnings, won't add any information not already included in the financial statements, and won't even lead to equal treatment of different forms of executive pay. Far worse, expensing evades the real issue, which is whether compensation (options and other-wise) does what it's supposed to do--namely, help a company recruit, retain, and provide the right people with appropriate performance incentives. Any performance-based compensation system has the potential to encourage cheating. Only ethical management, sensible governance, adequate internal control systems, and comprehensive disclosure will save the investor from disaster. If, Sahlman warns, we pass laws that require the expensing of options, thinking that's fixed the fundamental flaws in corporate America's accounting, we will have missed a golden opportunity to focus on the much more extensive defects in the present system.

  13. Early Option Exercise

    DEFF Research Database (Denmark)

    Heje Pedersen, Lasse; Jensen, Mads Vestergaard

    A classic result by Merton (1973) is that, except just before expiration or dividend payments, one should never exercise a call option and never convert a convertible bond. We show theoretically that this result is overturned when investors face frictions. Early option exercise can be optimal when...... it reduces short-sale costs, transaction costs, or funding costs. We provide consistent empirical evidence, documenting billions of dollars of early exercise for options and convertible bonds using unique data on actual exercise decisions and frictions. Our model can explain as much as 98% of early exercises...

  14. Early Option Exercise

    DEFF Research Database (Denmark)

    Jensen, Mads Vestergaard; Heje Pedersen, Lasse

    2016-01-01

    A classic result by Merton (1973) is that, except just before expiration or dividend payments, one should never exercise a call option and never convert a convertible bond. We show theoretically that this result is overturned when investors face frictions. Early option exercise can be optimal when...... it reduces short-sale costs, transaction costs, or funding costs. We provide consistent empirical evidence, documenting billions of dollars of early exercise for options and convertible bonds using unique data on actual exercise decisions and frictions. Our model can explain as much as 98% of early exercises...

  15. Thermometers: Understand the Options

    Science.gov (United States)

    ... the options Thermometers come in a variety of styles. Understand the different types of thermometers and how ... MA. Fever in infants and children: Pathophysiology and management. http://www.uptodate.com/home. Accessed July 23, ...

  16. Options for human intrusion

    International Nuclear Information System (INIS)

    Bauser, M.; Williams, R.

    1993-01-01

    This paper addresses options for dealing with human intrusion in terms of performance requirements and repository siting and design requirements. Options are presented, along with the advantages and disadvantages of certain approaches. At the conclusion, a conceptual approach is offered emphasizing both the minimization of subjective judgements concerning future human activity, and specification of repository requirements to minimize the likelihood of human intrusion and any resulting, harmful effects should intrusion occur

  17. Anterior greater trochanteric muscle pedicle bone grafting: a viable graft option adjunct to hip osteotomy or fracture surgery.

    Science.gov (United States)

    Limpaphayom, Noppachart; Osateerakun, Phatcharapa; Wilairatana, Vajara; Prasongchin, Pairatch

    2017-05-12

    The objectives were to evaluate a technique, outcome and complications following anterior greater trochanteric with gluteus medius muscle pedicle bone graft (AMG) procedure in the treatment of adolescent and active adult hip disorders. 20 patients (20 hips) with a mean age of 22.7 ± 15.6 (range 10.0-63.5) years who had undergone AMG and been followed up more than 12 months postoperative were retrospectively enrolled in our study. The AMG procedure was performed in conjunction with subcapital osteotomy for slipped capital femoral epiphysis in 12 and open reduction for fracture/dislocation in 8 hips. At the most recent evaluation, patient functional status was rated by the Harris Hip Score (HHS) and radiographic changes were graded according to Tönnis criteria. Complications were defined as Tönnis grade >2 or hip requiring further surgery. Univariate analysis was used to explore factors associated with complications. Spearman's rank correlation coefficient was calculated between HHS and Tönnis grading. At mean follow-up of 4.4 ± 2.6 (range 1.1-9.5) years, mean HHS was 87.4. Tönnis grading was rated as 0 in 10 hips, 1 in 5 hips, 2 in 2 hips, and 3 in 3 hips. Avascular necrosis of the femoral head as a complication developed in 3 hips (15%). Clinical parameters including age at surgery, duration of follow-up and diagnosis were not significantly associated with postoperative complications. A negative correlation between HHS and Tönnis grade was shown by Spearman's rank correlation (rs = -0.49, p = 0.03). The AMG can be safely recommended as an adjunct bone graft procedure when performing anterior open reduction of adolescent and active adult hip disorders.

  18. Is CAPD a viable option among ADPKD with end stage renal disease population in India? Its outcomes and economics.

    Science.gov (United States)

    Kaul, Anupma; Dharshan, R; Bhadhuaria, Dharmendra; Prasad, Narayan; Gupta, Amit; Sharma, R K

    2015-09-01

    Autosomal dominant polycystic kidney disease (ADPKD) is the most common inherited renal disease, with 50-75% of these patients requiring renal replacement therapy (RRT). The outcome of peritoneal dialysis (PD) in ADPKD with end-disease renal disease (ESRD) is not clearly defined, more so in developing countries. We conducted a retrospective analysis of the outcomes and economics of PD in these ESRD patients and compared them with other causes of ESRD on PD. Data were reviewed of all the PD patients who were followed-up at our institute from January 2007 to December 2011. The inclusion criteria were ADPKD patients who chose PD as the dialysis modality (Group 1), while age and gender-matched ESRD (other than ADPKD) patients who were started on PD during the same period were considered as the other group (Group 2). A total of 26 ADPKD patients underwent PD with an average size of kidneys among ADPKD ESRD patients of 15.2 + 2.1 cm. The overall peritonitis rates were similar among the compared groups. The median survival for the first peritonitis episodes were 1.2 and 1.8 years (95% confidence interval 0.82-1.91) for the control and ADPKD groups, respectively. The overall patient survival was 22 among PKD while five patients died among the control group. Among PKD, one patient died due to intra-cerebral bleed while one patient had severe cyst hemorrhage and infection, while three others had peritonitis and sepsis. Hernia was observed in four ADPKD patients, once on PD that was surgically corrected and PD was resumed in all. Two patients lost the catheter due to peritonitis while one patient had membrane failure while one underwent surgical exploration due to diverticulosis. PD treatment was not prevented by voluminous kidneys in any of these patients and no patient ceased PD treatment due to insufficient peritoneal space. Besides this, the cost on PD was much less as compared with that on hemodialysis (HD). PD is a reasonable mode of RRT among ADPKD, where HD is not possible or contraindicated with lesser risks to bleeding and infections, and the cost benefit favoring PD in general.

  19. Illegal Immigration: Is the Use of Military Force in Policing the United states' Border with Mexico a Viable Option?

    National Research Council Canada - National Science Library

    Lopez, David

    2001-01-01

    Illegal immigration across the United States' borders, in particular the Southern Border with Mexico, has been a continual problem confronting our local, state and national political decision makers...

  20. Command and Control of Private Security Contractors: Are They a Viable Force Option for the Combatant Commander?

    National Research Council Canada - National Science Library

    Sherard, Scott H

    2008-01-01

    If a Combatant Commander (CCDR) or Joint Force Commander (JFC) were to take command of the approximately 25,000 security contractors in Iraq, a force of such size and capability would prove to be a valuable operational asset...

  1. Mobile phones are a viable option for surveying young Australian women: a comparison of two telephone survey methods

    Directory of Open Access Journals (Sweden)

    Liu Bette

    2011-11-01

    Full Text Available Abstract Background Households with fixed-line telephones have decreased while mobile (cell phone ownership has increased. We therefore sought to examine the feasibility of recruiting young women for a national health survey through random digit dialling mobile phones. Methods Two samples of women aged 18 to 39 years were surveyed by random digit dialling fixed and mobile numbers. We compared participation rates and responses to a questionnaire between women surveyed by each contact method. Results After dialling 5,390 fixed-lines and 3,697 mobile numbers, 140 and 128 women were recruited respectively. Among women contacted and found to be eligible, participation rates were 74% for fixed-lines and 88% for mobiles. Taking into account calls to numbers where eligibility was unknown (e.g. unanswered calls the estimated response rates were 54% and 45% respectively. Of women contacted by fixed-line, 97% reported having a mobile while 61% of those contacted by mobile reported having a fixed-line at home. After adjusting for age, there were no significant differences between mobile-only and fixed-line responders with respect to education, residence, and various health behaviours; however compared to those with fixed-lines, mobile-only women were more likely to identify as Indigenous (OR 4.99, 95%CI 1.52-16.34 and less likely to live at home with their parents (OR 0.09, 95%CI 0.03-0.29. Conclusions Random digit dialling mobile phones to conduct a health survey in young Australian women is feasible, gives a comparable response rate and a more representative sample than dialling fixed-lines only. Telephone surveys of young women should include mobile dialling.

  2. Chemical modification with phthalic anhydride and chitosan: Viable options for the stabilization of raw starch digesting amylase from Aspergillus carbonarius.

    Science.gov (United States)

    Nwagu, Tochukwu Nwamaka; Okolo, Bartholomew; Aoyagi, Hideki; Yoshida, Shigeki

    2017-06-01

    The raw starch digesting type of amylase (RSDA) presents greater opportunities for process efficiency at cheaper cost and shorter time compared to regular amylases. Chemical modification is a simple and rapid method toward their stabilization for a wider application. RSDA from Aspergillus carbonarius was modified with either phthalic anhydride (PA) or chitosan. Activity retention was 87.3% for PA-modified and 80.9% for chitosan-modified RSDA. Optimum pH shifted from 5 to 7 after PA-modification. Optimum temperature changed from 30°C (native) to 30-40°C and 60°C for PA-modified and chitosan-modified, respectively. Activation energy (kJmol -1 ) for hydrolysis was 13.5, 12.7, and 10.2 while the activation energy for thermal denaturation was 32.8, 80.3, 81.9 for free, PA-modified and chitosan-modified, respectively. The specificity constants (V max /K m ) were 73.2 for PA-modified, 63.1 for chitosan-modified and 77.1 for native RSDA. The half-life (h) of the RSDA at 80°C was increased from 6.1 to 25.7 for the PA-modified and 138.6 for the chitosan derivative. Modification also led to increase in D value, activation enthalpy and Gibbs free energy of enzyme deactivation. Fluorescence spectra showed that center of spectral mass decreased for the PA-modified RSDA but increased for chitosan modified RSDA. Copyright © 2017 Elsevier B.V. All rights reserved.

  3. Developing a global health diplomacy supply chain--a viable option for the United States to curb extremism.

    Science.gov (United States)

    Kumar, Sameer; Honkanen, Erik J; Karl, Chad C

    2009-01-01

    This study examines the idea of developing a global health diplomacy supply chain as an important foreign policy approach with the aim of improving the lives of vulnerable populations and serving the best interests of the United States. The study was based on the review of academic literature, news events, and military communiques, and historical writings were studied to determine the feasibility of the idea and the extent of costs and benefits of such an endeavor. An integrated strategic business model, supported by a medical care delivery process, was developed to create a framework for a feasible global health diplomacy supply chain. The findings indicate that extremism can be contained by creating and efficiently executing an effective supply chain to get medical care units to those that need them. The limitations are the potential exit strategies required, the tactical abilities, and diplomatic techniques needed in order to create positive diplomatic change in aid distribution. Managers must consider how supply chains will affect other organizations giving aid and the potential public response. Moreover, determining the level of care necessary to achieve the greatest positive health diplomacy continues to require vigilant scrutiny over the potential cost/benefit analysis. The analysis is valuable to policymakers considering the impacts of health diplomacy by utilizing supply chain management.

  4. Contracting of energy services: often a viable alternative

    International Nuclear Information System (INIS)

    Milic, M.; Bruendler, M.

    2001-01-01

    This article discusses the outsourcing of energy services as a viable alternative to the operation of own energy facilities. The advantages of contracting for enterprises wanting to focus on their core competencies and have their energy infrastructure financed, built, maintained and operated by a third party are discussed. Financial aspects are looked at and examples in connection with the calculation of actual energy costs are given. The article is concluded with tips on the evaluation of offers for contracting services and on the definition of ownership aspects and property boundaries

  5. Identification and evaluation of alternative radioactive waste categorisation options

    International Nuclear Information System (INIS)

    Maul, P.R.; Smith, G.M.; Stenhouse, M.J.; Watkins, B.M.

    1996-09-01

    The purpose of the research described in this report was to consider the options for future UK radioactive waste categorisation, to evaluate the advantages and disadvantages of each option and, as a result, to identify any which might be viable practical alternatives to the current arrangements. The review process included meetings with large and small waste producers, a wider consultation exercise using a questionnaire, a presentation to RWMAC, and discussion with representatives of the UK regulators. These consultations provided the basis for the formulation and evaluation of a number of alternative waste categorisation schemes. (UK)

  6. Nevada Transportation Options Study

    International Nuclear Information System (INIS)

    P. GEHNER; E.M. WEAVER; L. FOSSUM

    2006-01-01

    This study performs a cost and schedule analysis of three Nevada Transportation options that support waste receipt at the repository. Based on the U.S. Department of Energy preference for rail transportation in Nevada (given in the Final Environmental Impact Statement), it has been assumed that a branch rail line would be constructed to support waste receipt at the repository. However, due to potential funding constraints, it is uncertain when rail will be available. The three Nevada Transportation options have been developed to meet a varying degree of requirements for transportation and to provide cost variations used in meeting the funding constraints given in the Technical Direction Letter guidelines for this study. The options include combinations of legal-weight truck, heavy-haul truck, and rail. Option 1 uses a branch rail line that would support initial waste receipt at the repository in 2010. Rail transportation would be the primary mode, supplemented by legal weight trucks. This option provides the highest level of confidence in cost and schedule, lowest public visibility, greatest public acceptability, lowest public dose, and is the recommended option for support of waste receipt. The completion of rail by 2010 will require spending approximately $800 million prior to 2010. Option 2 uses a phased rail approach to address a constrained funding scenario. To meet funding constraints, Option 2 uses a phased approach to delay high cost activities (final design and construction) until after initial waste receipt in 2010. By doing this, approximately 95 percent of the cost associated with completion of a branch rail line is deferred until after 2010. To support waste receipt until a branch rail line is constructed in Nevada, additional legal-weight truck shipments and heavy-haul truck shipments (on a limited basis for naval spent nuclear fuel) would be used to meet the same initial waste receipt rates as in Option 1. Use of heavy-haul shipments in the absence

  7. Options Study - Phase II

    Energy Technology Data Exchange (ETDEWEB)

    R. Wigeland; T. Taiwo; M. Todosow; W. Halsey; J. Gehin

    2010-09-01

    The Options Study has been conducted for the purpose of evaluating the potential of alternative integrated nuclear fuel cycle options to favorably address the issues associated with a continuing or expanding use of nuclear power in the United States. The study produced information that can be used to inform decisions identifying potential directions for research and development on such fuel cycle options. An integrated nuclear fuel cycle option is defined in this study as including all aspects of the entire nuclear fuel cycle, from obtaining natural resources for fuel to the ultimate disposal of used nuclear fuel (UNF) or radioactive wastes. Issues such as nuclear waste management, especially the increasing inventory of used nuclear fuel, the current uncertainty about used fuel disposal, and the risk of nuclear weapons proliferation have contributed to the reluctance to expand the use of nuclear power, even though it is recognized that nuclear power is a safe and reliable method of producing electricity. In this Options Study, current, evolutionary, and revolutionary nuclear energy options were all considered, including the use of uranium and thorium, and both once-through and recycle approaches. Available information has been collected and reviewed in order to evaluate the ability of an option to clearly address the challenges associated with the current implementation and potential expansion of commercial nuclear power in the United States. This Options Study is a comprehensive consideration and review of fuel cycle and technology options, including those for disposal, and is not constrained by any limitations that may be imposed by economics, technical maturity, past policy, or speculated future conditions. This Phase II report is intended to be used in conjunction with the Phase I report, and much information in that report is not repeated here, although some information has been updated to reflect recent developments. The focus in this Options Study was to

  8. Cost allocation policy review: options and preferred alternatives

    Energy Technology Data Exchange (ETDEWEB)

    NONE

    2010-10-15

    This policy review of the consultation process on the electricity cost allocation issue is presented with specific cost allocation policy issues addressed herein, such as: the new microFIT rate, accounting changes and the transition to IFRS, and review of allocating costs to load displacement generation. This report gave the current situation for all these issues, previous work, issues, viable options for dealing with these issues and the preferred alternatives.

  9. Monitoring of viable airborne SARS virus in ambient air

    Science.gov (United States)

    Agranovski, Igor E.; Safatov, Alexander S.; Pyankov, Oleg V.; Sergeev, Alexander N.; Agafonov, Alexander P.; Ignatiev, Georgy M.; Ryabchikova, Elena I.; Borodulin, Alexander I.; Sergeev, Artemii A.; Doerr, Hans W.; Rabenau, Holger F.; Agranovski, Victoria

    Due to recent SARS related issues (Science 300 (5624) 1394; Nature 423 (2003) 240; Science 300 (5627) 1966), the development of reliable airborne virus monitoring procedures has become galvanized by an exceptional sense of urgency and is presently in a high demand (In: Cox, C.S., Wathers, C.M. (Eds.), Bioaerosols Handbook, Lewis Publishers, Boca Raton, FL, 1995, pp. 247-267). Based on engineering control method (Aerosol Science and Technology 31 (1999) 249; 35 (2001) 852), which was previously applied to the removal of particles from gas carriers, a new personal bioaerosol sampler has been developed. Contaminated air is bubbled through porous medium submerged into liquid and subsequently split into multitude of very small bubbles. The particulates are scavenged by these bubbles, and, thus, effectively removed. The current study explores its feasibility for monitoring of viable airborne SARS virus. It was found that the natural decay of such virus in the collection fluid was around 0.75 and 1.76 lg during 2 and 4 h of continuous operation, respectively. Theoretical microbial recovery rates of higher than 55 and 19% were calculated for 1 and 2 h of operation, respectively. Thus, the new sampling method of direct non-violent collection of viable airborne SARS virus into the appropriate liquid environment was found suitable for monitoring of such stress sensitive virus.

  10. Formas cocoides de Helicobacter pylori: viables o degenerativas

    Directory of Open Access Journals (Sweden)

    Felipe Cava

    2003-06-01

    Full Text Available De los trabajos presentados acerca de las formas cocoides de Helicobacter pylori se deduce una controversia mucho mayor que la resultante del mero estudio clínico de este microorganismo. Parece claro que existe una conversión tanto in vivo como in vitro de las formas espirales a las formas cocoides inducida por varios motivos, como cultivos prolongados, estrés físico y químico, y agentes antimicrobianos. En esta revisión repasamos los puntos de vista que han dividido a investigadores de esta área en dos grupos bien definidos: Los que consideran a estas formas cocoides como un producto no viable de degeneración celular y los que piensan que estas formas son estructuras viables,durmientes o de resistencia frente a condiciones ambientales adversas. Esta discrepancia conlleva a que interrogantes sobre la relación entre la transmisión de la enfermedad y estas formas cocoides permanezcan sin respuesta todavía.

  11. Separation of viable lactic acid bacteria from fermented milk

    Directory of Open Access Journals (Sweden)

    Tomohiko Nishino

    2018-04-01

    Full Text Available Probiotics are live microorganisms that provide health benefits to humans. Some lactic acid bacteria (LAB are probiotic organisms used in the production of fermented foods, such as yogurt, cheese, and pickles. Given their widespread consumption, it is important to understand the physiological state of LAB in foods such as yogurt. However, this analysis is complicated, as it is difficult to separate the LAB from milk components such as solid curds, which prevent cell separation by dilution or centrifugation. In this study, we successfully separated viable LAB from yogurt by density gradient centrifugation. The recovery rate was >90 %, and separation was performed until the stationary phase. Recovered cells were observable by microscopy, meaning that morphological changes and cell viability could be directly detected at the single-cell level. The results indicate that viable LAB can be easily purified from fermented milk. We expect that this method will be a useful tool for the analysis of various aspects of probiotic cells, including their enzyme activity and protein expression. Keywords: Food analysis, Microbiology

  12. Druthers! A Collection of Viable Ideas from Rural Schools.

    Science.gov (United States)

    Elliott, Richard D., Comp.

    An individualized junior high school, a youth resources program that interweaves high school with supervised work experiences, multi-aged elementary family groupings that mainstream EMR (educable mentally retarded) children, and a single library room transformed into seven optional learning stations using a multi-channel audio system are real…

  13. Treatment Options for Wilms Tumor

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... come back) after it has been treated. Treatment Option Overview Key Points There are different types of ...

  14. Treatment Options for Myelodysplastic Syndromes

    Science.gov (United States)

    ... special light. Certain factors affect prognosis and treatment options. The prognosis (chance of recovery) and treatment options ... age and general health of the patient. Treatment Option Overview Key Points There are different types of ...

  15. Treatment Option Overview (Prostate Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  16. Treatment Option Overview (Myelodysplastic Syndromes)

    Science.gov (United States)

    ... special light. Certain factors affect prognosis and treatment options. The prognosis (chance of recovery) and treatment options ... age and general health of the patient. Treatment Option Overview Key Points There are different types of ...

  17. Treatment Option Overview (Esophageal Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  18. Treatment Option Overview (Childhood Rhabdomyosarcoma)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  19. Treatment Option Overview (Penile Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  20. Treatment Option Overview (Vulvar Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  1. Treatment Option Overview (Pancreatic Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  2. Treatment Option Overview (Adrenocortical Carcinoma)

    Science.gov (United States)

    ... affect the prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  3. Treatment Options for Childhood Rhabdomyosarcoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  4. Treatment Options for Kaposi Sarcoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  5. Treatment Options for Childhood Craniopharyngioma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... the brain where it was first found. Treatment Option Overview Key Points There are different types of ...

  6. THERAPEUTIC DECISION-MAKING OF PHYSICIANS

    NARCIS (Netherlands)

    DENIG, P; HAAIJER-RUSKAMP, FM

    1992-01-01

    In this review the therapeutic decision-making process of physicians is described. This process is divided into two steps: the generation of a limited set of possible options (the 'evoked set') and the selection from this evoked set of a treatment for a specific patient. Factors that are important

  7. Stem cell therapeutic possibilities: future therapeutic options for male-factor and female-factor infertility?

    Science.gov (United States)

    Easley, Charles A; Simerly, Calvin R; Schatten, Gerald

    2013-07-01

    Recent advances in assisted reproduction treatment have enabled some couples with severe infertility issues to conceive, but the methods are not successful in all cases. Notwithstanding the significant financial burden of assisted reproduction treatment, the emotional scars from an inability to conceive a child enacts a greater toll on affected couples. While methods have circumvented some root causes for male and female infertility, often the underlying causes cannot be treated, thus true cures for restoring a patient's fertility are limited. Furthermore, the procedures are only available if the affected patients are able to produce gametes. Patients rendered sterile by medical interventions, exposure to toxicants or genetic causes are unable to utilize assisted reproduction to conceive a child - and often resort to donors, where permitted. Stem cells represent a future potential avenue for allowing these sterile patients to produce offspring. Advances in stem cell biology indicate that stem cell replacement therapies or in-vitro differentiation may be on the horizon to treat and could cure male and female infertility, although significant challenges need to be met before this technology can reach clinical practice. This article discusses these advances and describes the impact that these advances may have on treating infertility. Copyright © 2013 Reproductive Healthcare Ltd. Published by Elsevier Ltd. All rights reserved.

  8. On-Farm, Almond Orchard Flooding as a Viable Aquifer Recharge Alternative

    Science.gov (United States)

    Ulrich, C.; Nico, P. S.; Wu, Y.; Newman, G. A.; Conrad, M. E.; Dahlke, H. E.

    2017-12-01

    In 2014, California legislators passed the Sustainable Groundwater Management Act (SGMA), which requires groundwater sustainability agencies (areas) to identify/prioritize water basins, develop current and projected water use/needs, develop a groundwater management plan, develop fees, etc. One of the challenges for implementing SGMA is the lack of data that can support alternative groundwater recharge methods such as on-farm flooding. Prior to anthropogenic river control, river floodplains captured excess water during overbank flow in the rainy season in the CA central valley. Today levees and canals strategically route rainy season high flows to the delta/ocean when irrigation water is not needed. Utilizing farmland once again as infiltration basins for groundwater banking and aquifer recharge could be a viable answer to California's depleted central valley aquifers. Prior to 2017, U.C. Davis had partnered with the Almond Board of California (ABC) and local growers to study the efficacy of agricultural flooding and the effects on annual almond crops (. LBNL joined this team to help understand the conveyance of recharge water, using electrical resistivity tomography (ERT), into the subsurface (i.e. localized fast paths, depth of infiltration, etc.) during flooding events. The fate of the recharge water is what is significant to understanding the viability of on-farm flooding as an aquifer recharge option. In this study two orchards (in Delhi and Modesto, CA), each approximately 2 acres, were flooded during the almond tree dormant period (January), to recharge 2 acre/ft of water into the local aquifers. ERT was used to characterize (soil structure) and monitor water infiltration over a single flooding event to investigate the fate of applied water. Data were collected every hour prior to flooding (baseline), during, and after all flood water had infiltrated (about 5 days total). Our time-lapse ERT results show a heterogeneous soil structure that leads to non

  9. Pelvic floor muscle rehabilitation for patients with lifelong premature ejaculation: a novel therapeutic approach.

    Science.gov (United States)

    Pastore, Antonio L; Palleschi, Giovanni; Fuschi, Andrea; Maggioni, Cristina; Rago, Rocco; Zucchi, Alessandro; Costantini, Elisabetta; Carbone, Antonio

    2014-06-01

    Premature ejaculation is the most common male sexual disorder. The aim of the study was to evaluate the possible therapeutic role of pelvic floor muscle rehabilitation in patients affected by lifelong premature ejaculation. We treated 40 men with lifelong premature ejaculation, reporting, a baseline intravaginal ejaculatory latency time (IELT) ≤ 1 min, with 12-week pelvic floor muscle rehabilitation. At the end of the rehabilitation, mean IELTs were calculated to evaluate the effectiveness of the therapy. At the end of the treatment, 33 (82.5%) of the 40 patients gained control of their ejaculatory reflex, with a mean IELT of 146.2 s (range: 123.6-152.4 s). A total of 13 out of 33 (39%) patients were evaluated at 6 months follow up, and they maintained a significant IELT (112.6 s) compared with their initial IELT (mean 39.8 s). The results obtained in our subjects treated with pelvic floor rehabilitation are promising. This therapy represents an important cost reduction compared with the standard treatment (selective serotonin reuptake inhibitors). Based on the present data, we propose pelvic floor muscle rehabilitation as a new, viable therapeutic option for the treatment of premature ejaculation.

  10. Therapeutic fasting as a potential effective treatment for type 2 diabetes: A 4-month case study

    Directory of Open Access Journals (Sweden)

    Michael Ku

    2017-12-01

    Full Text Available Lifestyle therapy is an integral part of type 2 diabetes (T2D management, but there remains no consensus on an optimal diet. The objective of this study is to evaluate the efficacy of therapeutic fasting as a treatment for T2D. This case follows a male T2D patient treated at the Intensive Dietary Management Clinic in Scarborough, Ontario, over a 4-month period. The patient’s initial fasting regimen consisted of a 24-h fast, three times a week. Over the course of treatment, the patient gradually extended his fasting period, eventually fasting for 42 h, two to three times a week. By the end of treatment, the patient’s weight was reduced by 17.8% and his waist circumference was reduced by 11.0%. In addition, the patient’s glycated haemoglobin levels decreased from 7.7% to 7.2%, and he was able to completely discontinue his insulin treatment, despite over a decade of insulin usage. The patient did not find it difficult to adhere to the fasting schedule and did not experience any hypoglycaemic episodes or other significant adverse effects. These observations suggest that therapeutic fasting may be a viable treatment option for T2D patients.

  11. 20 CFR 416.2035 - Optional supplementation: Additional State options.

    Science.gov (United States)

    2010-04-01

    ... 20 Employees' Benefits 2 2010-04-01 2010-04-01 false Optional supplementation: Additional State options. 416.2035 Section 416.2035 Employees' Benefits SOCIAL SECURITY ADMINISTRATION SUPPLEMENTAL... § 416.2035 Optional supplementation: Additional State options. (a) Residency requirement. A State or...

  12. Novel preventive treatment options

    DEFF Research Database (Denmark)

    Longbottom, C; Ekstrand, K; Zero, D

    2009-01-01

    A number of novel preventive treatment options which, as with traditional methods, can be differentiated into 3 categories of prevention (primary, secondary and tertiary), have been and are being currently investigated. Those reviewed are either commercially available or appear relatively close...... of these techniques show considerable promise and dentists should be aware of these developments and follow their progress, the evidence for each of these novel preventive treatment options is currently insufficient to make widespread recommendations. Changes in dental practice should be explored to see how oral...

  13. Tank Space Options Report

    International Nuclear Information System (INIS)

    BOYLES, V.C.

    2001-01-01

    A risk-based priority for the retrieval of Hanford Site waste from the 149 single-shell tanks (SSTs) has been adopted as a result of changes to the Hanford Federal Facility Agreement and Consent Order (HFFACO) (Ecology et al. 1997) negotiated in 2000. Retrieval of the first three tanks in the retrieval sequence fills available capacity in the double-shell tanks (DSTs) by 2007. As a result, the HFFACO change established a milestone (M-45-12-TO1) requiring the determination of options that could increase waste storage capacity for single-shell tank waste retrieval. The information will be considered in future negotiations. This document fulfills the milestone requirement. This study presents options that were reviewed for the purpose of increasing waste storage capacity. Eight options are identified that have the potential for increasing capacity from 5 to 10 million gallons, thus allowing uninterrupted single-shell tank retrieval until the planned Waste Treatment Plant begins processing substantial volumes of waste from the double-shell tanks in 2009. The cost of implementing these options is estimated to range from less than $1 per gallon to more than $14 per gallon. Construction of new double-shell tanks is estimated to cost about $63 per gallon. Providing 5 to 10 million gallons of available double-shell tank space could enable early retrieval of 5 to 9 high-risk single-shell tanks beyond those identified for retrieval by 2007. These tanks are A-101, AX-101, AX-103, BY-102, C-107, S-105, S-106, S-108, and S-109 (Garfield et al. 2000). This represents a potential to retrieve approximately 14 million total curies, including 3,200 curies of long-lived mobile radionuclides. The results of the study reflect qualitative analyses conducted to identify promising options. The estimated costs are rough-order-of magnitude and, therefore, subject to change. Implementing some of the options would represent a departure from the current baseline and may adversely impact the

  14. Alternative energy options

    International Nuclear Information System (INIS)

    Bennett, K.F.

    1983-01-01

    It is accepted that coal will continue to play the major role in the supply of energy to the country for the remainder of the century. In this paper, however, emphasis has been directed to those options which could supplement coal in an economic and technically sound manner. The general conclusion is that certain forms of solar energy hold the most promise and it is in this direction that research, development and implementation programmes should be directed. Tidal energy, fusion energy, geothermal energy, hydrogen energy and fuel cells are also discussed as alternative energy options

  15. Thermal test options

    International Nuclear Information System (INIS)

    Koski, J.A.; Keltner, N.R.; Sobolik, K.B.

    1993-02-01

    Shipping containers for radioactive materials must be qualified to meet a thermal accident environment specified in regulations, such at Title 10, Code of Federal Regulations, Part 71. Aimed primarily at the shipping container design, this report discusses the thermal testing options available for meeting the regulatory requirements, and states the advantages and disadvantages of each approach. The principal options considered are testing with radiant heat, furnaces, and open pool fires. The report also identifies some of the facilities available and current contacts. Finally, the report makes some recommendations on the appropriate use of these different testing methods

  16. Lighting Options for Homes.

    Energy Technology Data Exchange (ETDEWEB)

    Baker, W.S.

    1991-04-01

    This report covers many aspects of various lighting options for homes. Types of light sources described include natural light, artificial light, incandescent lamps, fluorescent lamps, and high intensity discharge lamps. A light source selection guide gives the physical characteristics of these, design considerations, and common applications. Color, strategies for efficient lighting, and types of lighting are discussed. There is one section giving tips for various situations in specific rooms. Rooms and types of fixtures are shown on a matrix with watts saved by using the recommended type lighting for that room and room location. A major emphasis of this report is saving energy by utilizing the most suitable, recommended lighting option. (BN)

  17. Social Networking and Smart Technology: Viable Environmental Communication Tools…?

    Science.gov (United States)

    Montain, J.; Byrne, J. M.

    2010-12-01

    To what extent do popular social networking channels represent a viable means for disseminating information regarding environmental change to the general public? Are new forms of communication such as YouTube™, Facebook™, MySpace™ and Twitter™ and smart devices such as iPhone™ and BlackBerry™ useful and effective in terms motivating people into social action and behavioural modification; or do they simply pay ‘lip service’ to these pressing environmental issues? This project will explore the background connections between social networking and environmental communication and education; and outline why such tools might be an appropriate way to connect to a broad audience in an efficient and unconventional manner. Further, research will survey the current prevalence of reliable environmental change information on social networking Internet-based media; and finally, suggestions for improved strategies and new directions will be provided.

  18. Dissolvable tattoo sensors: from science fiction to a viable technology

    Science.gov (United States)

    Cheng, Huanyu; Yi, Ning

    2017-01-01

    Early surrealistic painting and science fiction movies have envisioned dissolvable tattoo electronic devices. In this paper, we will review the recent advances that transform that vision into a viable technology, with extended capabilities even beyond the early vision. Specifically, we focus on the discussion of a stretchable design for tattoo sensors and degradable materials for dissolvable sensors, in the form of inorganic devices with a performance comparable to modern electronics. Integration of these two technologies as well as the future developments of bio-integrated devices is also discussed. Many of the appealing ideas behind developments of these devices are drawn from nature and especially biological systems. Thus, bio-inspiration is believed to continue playing a key role in future devices for bio-integration and beyond.

  19. Selection of viable cell subpopulations from murine tumours using FACS

    International Nuclear Information System (INIS)

    Chaplin, D.J.; Durand, R.E.; Olive, P.L.

    1985-01-01

    The authors developed a technique which enables isolation of viable tumour cells subpopulation as a function of their distance from the blood supply. The basis for this separation procedure is that the fluorochrome, Hoechst 33342, as a result of its high avidity for cellular DNA, exhibits a marked diffusion/consumption gradient when it has to pass through several cell layers. As a result intravenous injection of Hoechst 33342 into tumour bearing animals, results in a heterogeneous straining pattern within the tumour with cells close to blood vessels being brightly fluorescent while those more distant are less intensely stained. Since these differences in staining intensity persist after tumour disaggregation, cells can be sorted into subpopulations on the basis of their fluorescence intensity using a fluorescence activated cell sorter. This technique offers the unique possibility of identifying the location of those cell subpopulations resistant to treatment with either radiation or chemotherapeutic drugs

  20. Dye Sensitized Solar Cells for Economically Viable Photovoltaic Systems.

    Science.gov (United States)

    Jung, Hyun Suk; Lee, Jung-Kun

    2013-05-16

    TiO2 nanoparticle-based dye sensitized solar cells (DSSCs) have attracted a significant level of scientific and technological interest for their potential as economically viable photovoltaic devices. While DSSCs have multiple benefits such as material abundance, a short energy payback period, constant power output, and compatibility with flexible applications, there are still several challenges that hold back large scale commercialization. Critical factors determining the future of DSSCs involve energy conversion efficiency, long-term stability, and production cost. Continuous advancement of their long-term stability suggests that state-of-the-art DSSCs will operate for over 20 years without a significant decrease in performance. Nevertheless, key questions remain in regards to energy conversion efficiency improvements and material cost reduction. In this Perspective, the present state of the field and the ongoing efforts to address the requirements of DSSCs are summarized with views on the future of DSSCs.

  1. Cummins L10G in Kenworth truck 'viable today'

    International Nuclear Information System (INIS)

    Anon.

    1996-01-01

    As the culmination of five years of developmental work by Cummins Engines, BC Research Inc., and BC Gas Utility Ltd., a T800 Kenworth truck was outfitted with a new Cummins L10G natural gas engine, and two lightweight fully -wrapped Dynetek cylinders; it was pronounced to be 'a viable clean truck today'. The L10G spark-ignited engine operates at a relatively high peak efficiency of 37 per cent and is commercially available to meet the current California Air Resources Board heavy duty vehicle emission standards without the use of a catalytic converter. The L10G engine produces no particulate emissions, a very significant advantage, in view of the fact that particulate emissions have been identified as major contributors to respiratory ailments

  2. Dissolvable tattoo sensors: from science fiction to a viable technology

    International Nuclear Information System (INIS)

    Cheng, Huanyu; Yi, Ning

    2017-01-01

    Early surrealistic painting and science fiction movies have envisioned dissolvable tattoo electronic devices. In this paper, we will review the recent advances that transform that vision into a viable technology, with extended capabilities even beyond the early vision. Specifically, we focus on the discussion of a stretchable design for tattoo sensors and degradable materials for dissolvable sensors, in the form of inorganic devices with a performance comparable to modern electronics. Integration of these two technologies as well as the future developments of bio-integrated devices is also discussed. Many of the appealing ideas behind developments of these devices are drawn from nature and especially biological systems. Thus, bio-inspiration is believed to continue playing a key role in future devices for bio-integration and beyond. (invited comment)

  3. A viable logarithmic f(R) model for inflation

    Energy Technology Data Exchange (ETDEWEB)

    Amin, M.; Khalil, S. [Center for Fundamental Physics, Zewail City of Science and Technology,6 October City, Giza (Egypt); Salah, M. [Center for Fundamental Physics, Zewail City of Science and Technology,6 October City, Giza (Egypt); Department of Mathematics, Faculty of Science, Cairo University,Giza (Egypt)

    2016-08-18

    Inflation in the framework of f(R) modified gravity is revisited. We study the conditions that f(R) should satisfy in order to lead to a viable inflationary model in the original form and in the Einstein frame. Based on these criteria we propose a new logarithmic model as a potential candidate for f(R) theories aiming to describe inflation consistent with observations from Planck satellite (2015). The model predicts scalar spectral index 0.9615

  4. Biocatalytically active silCoat-composites entrapping viable Escherichia coli.

    Science.gov (United States)

    Findeisen, A; Thum, O; Ansorge-Schumacher, M B

    2014-02-01

    Application of whole cells in industrial processes requires high catalytic activity, manageability, and viability under technical conditions, which can in principle be accomplished by appropriate immobilization. Here, we report the identification of carrier material allowing exceptionally efficient adsorptive binding of Escherichia coli whole cells hosting catalytically active carbonyl reductase from Candida parapsilosis (CPCR2). With the immobilizates, composite formation with both hydrophobic and hydrophilized silicone was achieved, yielding advanced silCoat-material and HYsilCoat-material, respectively. HYsilCoat-whole cells were viable preparations with a cell loading up to 400 mg(E. coli) · g(-1)(carrier) and considerably lower leaching than native immobilizates. SilCoat-whole cells performed particularly well in neat substrate exhibiting distinctly increased catalytic activity.

  5. Mixed waste management options

    International Nuclear Information System (INIS)

    Owens, C.B.; Kirner, N.P.

    1992-01-01

    Currently, limited storage and treatment capacity exists for commercial mixed waste streams. No commercial mixed waste disposal is available, and it has been estimated that if and when commercial mixed waste disposal becomes available, the costs will be high. If high disposal fees are imposed, generators may be willing to apply extraordinary treatment or regulatory approaches to properly dispose of their mixed waste. This paper explores the feasibility of several waste management scenarios and management options. Existing data on commercially generated mixed waste streams are used to identify the realm of mixed waste known to be generated. Each waste stream is evaluated from both a regulatory and technical perspective in order to convert the waste into a strictly low-level radioactive or a hazardous waste. Alternative regulatory approaches evaluated in this paper include a delisting petition) no migration petition) and a treatability variance. For each waste stream, potentially available treatment options are identified that could lead to these variances. Waste minimization methodology and storage for decay are also considered. Economic feasibility of each option is discussed broadly. Another option for mixed waste management that is being explored is the feasibility of Department of Energy (DOE) accepting commercial mixed waste for treatment, storage, and disposal. A study has been completed that analyzes DOE treatment capacity in comparison with commercial mixed waste streams. (author)

  6. Strategic growth options

    NARCIS (Netherlands)

    Kulatilaka, N.; Perotti, E.C.

    1998-01-01

    We provide a strategic rationale for growth options under uncertainty and imperfect corn-petition. In a market with strategic competition, investment confers a greater capability to take advantage of future growth opportunities. This strategic advantage leads to the capture of a greater share of the

  7. New Options, Old Concerns.

    Science.gov (United States)

    O'Neil, John

    1996-01-01

    Will greater school choice result in more responsive, higher quality schools and happier parents? Or will proliferating options further sort students and families by race, social class, and special interest? Increasingly, education is viewed as a private good. If parents become autonomous, self-interested consumers, erosion of common purposes and…

  8. Heterogeneity and option pricing

    NARCIS (Netherlands)

    Benninga, Simon; Mayshar, Joram

    2000-01-01

    An economy with agents having constant yet heterogeneous degrees of relative risk aversion prices assets as though there were a single decreasing relative risk aversion pricing representative agent. The pricing kernel has fat tails and option prices do not conform to the Black-Scholes formula.

  9. Option Pricing and Momentum

    NARCIS (Netherlands)

    Rodriguez, J.C.

    2007-01-01

    If managers are reluctant to fully adjust dividends to changes in earnings, stock returns and changes in the dividend yield will tend to be negatively correlated. When this is the case, stock returns will exhibit positive autocorrelation, or mo- mentum. This paper studies the pricing of options in

  10. Idaho's Energy Options

    Energy Technology Data Exchange (ETDEWEB)

    Robert M. Neilson

    2006-03-01

    This report, developed by the Idaho National Laboratory, is provided as an introduction to and an update of the status of technologies for the generation and use of energy. Its purpose is to provide information useful for identifying and evaluating Idaho’s energy options, and for developing and implementing Idaho’s energy direction and policies.

  11. Photovoltaic power - An important new energy option

    Science.gov (United States)

    Ferber, R. R.

    1983-01-01

    A review of photovoltaic (PV) power technology is presented with an emphasis of PV as an economical and technically feasible alternative source of energy. The successful completion of the development and transfer of emerging low-cost technologies into a fully commercialized status are identified as the means to the realization of this option's full potential. The DOE National Photovoltaics Program, a significant sponsor of PV R&D, expects both flat-plate and concentrator collectors to meet established cost targets. Citing the DOE large flat-plate grid-connected system project of the Sacramento Municipal Utility District, current technology modules priced at near $5/Wp (1983 dollars) are steadily reducing costs. A recent DOE study suggests that PV-generated electricity produced at a 30-year levelized cost of 15 cents per kWh would represent a viable energy supply alternative for the nation.

  12. Surgical therapeutic management of perforated peptic ulcer

    Directory of Open Access Journals (Sweden)

    Ana Karla de Sousa Almeida

    2016-03-01

    Full Text Available Perforated peptic ulcer is an emergency should be readily corrected by surgical approach to reduce potential damage and the risk of mortality associated with the extension frame. The option of handling most commonly used by surgeons is laparotomy, however, there is evidence pointing to approach laparoscopically like a viable, safe and with good results for their treatment. Therefore, it is appropriate to evaluate the data about each management and minimally invasive procedure, laparoscopy if overcomes the open surgical approach regarding the laparotomy regarding the treatment of patients with this condition.

  13. 9 CFR 113.26 - Detection of viable bacteria and fungi except in live vaccine.

    Science.gov (United States)

    2010-01-01

    ... 9 Animals and Animal Products 1 2010-01-01 2010-01-01 false Detection of viable bacteria and fungi... VECTORS STANDARD REQUIREMENTS Standard Procedures § 113.26 Detection of viable bacteria and fungi except... required to be free of viable bacteria and fungi, they shall also be tested as prescribed in this section...

  14. Making decentralised systems viable: a guide to managing decentralised assets and risks.

    Science.gov (United States)

    Willetts, J; Fane, S; Mitchell, C

    2007-01-01

    Decentralised systems have the potential to provide a viable option for long term sustainable management of household wastewater. Yet, at present, such systems hold an uncertain status and are frequently omitted from consideration. Their potential can only be realised with improved approaches to their management, and improved methods to decision-making in planning of wastewater systems. The aim of this paper is to demonstrate the value of a novel framework to guide the planning of decentralised systems so that asset management and risk management are explicitly considered. The framework was developed through a detailed synthesis of literature and practice in the area of asset management of centralised water and wastewater systems, and risk management in the context of decentralised systems. Key aspects of the framework are attention to socio-economic risks as well as engineering, public health and ecological risks, the central place of communication with multiple stakeholders and establishing a shared asset information system. A case study is used to demonstrate how the framework can guide a different approach and lead to different, more sustainable outcomes, by explicitly considering the needs and perspectives of homeowners, water authorities, relevant government agencies and society as a whole.

  15. Inactivation of viable Ascaris eggs by reagents during enumeration.

    Science.gov (United States)

    Nelson, K L; Darby, J L

    2001-12-01

    Various reagents commonly used to enumerate viable helminth eggs from wastewater and sludge were evaluated for their potential to inactivate Ascaris eggs under typical laboratory conditions. Two methods were used to enumerate indigenous Ascaris eggs from sludge samples. All steps in the methods were the same except that in method I a phase extraction step with acid-alcohol (35% ethanol in 0.1 N H(2)SO(4)) and diethyl ether was used whereas in method II the extraction step was avoided by pouring the sample through a 38-microm-mesh stainless steel sieve that retained the eggs. The concentration of eggs and their viability were lower in the samples processed by method I than in the samples processed by method II by an average of 48 and 70%, respectively. A second set of experiments was performed using pure solutions of Ascaris suum eggs to elucidate the effect of the individual reagents and relevant combination of reagents on the eggs. The percentages of viable eggs in samples treated with acid-alcohol alone and in combination with diethyl ether or ethyl acetate were 52, 27, and 4%, respectively, whereas in the rest of the samples the viability was about 80%. Neither the acid nor the diethyl ether alone caused any decrease in egg viability. Thus, the observed inactivation was attributed primarily to the 35% ethanol content of the acid-alcohol solution. Inactivation of the eggs was prevented by limiting the direct exposure to the extraction reagents to 30 min and diluting the residual concentration of acid-alcohol in the sample by a factor of 100 before incubation. Also, the viability of the eggs was maintained if the acid-alcohol solution was replaced with an acetoacetic buffer. None of the reagents used for the flotation step of the sample cleaning procedure (ZnSO(4), MgSO(4), and NaCl) or during incubation (0.1 N H(2)SO(4) and 0.5% formalin) inactivated the Ascaris eggs under the conditions studied.

  16. Indications and interventional options for non-resectable tracheal stenosis

    Science.gov (United States)

    Bacon, Jenny Louise; Patterson, Caroline Marie

    2014-01-01

    Non-specific presentation and normal examination findings in early disease often result in tracheal obstruction being overlooked as a diagnosis until patients present acutely. Once diagnosed, surgical options should be considered, but often patient co-morbidity necessitates other interventional options. Non-resectable tracheal stenosis can be successfully managed by interventional bronchoscopy, with therapeutic options including airway dilatation, local tissue destruction and airway stenting. There are common aspects to the management of tracheal obstruction, tracheomalacia and tracheal fistulae. This paper reviews the pathogenesis, presentation, investigation and management of tracheal disease, with a focus on tracheal obstruction and the role of endotracheal intervention in management. PMID:24624290

  17. Management options of varicoceles

    Directory of Open Access Journals (Sweden)

    Peter Chan

    2011-01-01

    Full Text Available Varicocele is one of the most common causes of male infertility. Treatment options for varicoceles includes open varicocelectomy performed at various anatomical levels. Laparoscopic varicocelectomy has been established to be a safe and effective treatment for varicoceles. Robotic surgery has been introduced recently as an alternative surgical option for varicocelectomy. Microsurgical varicocelectomy has gained increasing popularity among experts in male reproductive medicine as the treatment of choice for varicocele because of its superior surgical outcomes. There is a growing volume of literature in the recent years on minimal invasive varicocele treatment with percutaneous retrograde and anterograde venous embolization/sclerotherapy. In this review, we will discuss the advantages and limitations associated with each treatment modality for varicoceles. Employment of these advanced techniques of varicocelectomy can provide a safe and effective approach aiming to eliminate varicocele, preserve testicular function and, in a substantial number of men, increase semen quality and the likelihood of pregnancy.

  18. Energy options?; Energie opties?

    Energy Technology Data Exchange (ETDEWEB)

    Van Sark, W. (ed.)

    2006-05-15

    March 2006 the so-called Options Document was published by the Energy research Centre of the Netherlands (ECN) and the Netherlands Environmental Assessment Agency (MNP). The document is an overview of technical options to reduce energy consumption and emission of greenhouse gases up to 2020. Next to a brief summary of the document a few reactions and comments on the contents of the document are given. [Dutch] Maart 2006 publiceerde het Energieonderzoek Centrum Nederland (ECN) en het Milieu- en Natuurplanbureau (MNP) het zogenaamde Optiedocument energie en emissies 2010-2020. Daarin wordt een overzicht gegeven van de technische mogelijkheden voor vermindering van het energieverbruik en de uitstoot van broeikasgassen en luchtverontreinigende stoffen tot 2020. Naast een korte samenvatting van het document worden enkele reacties gegeven op de inhoud.

  19. Evaluating technology service options.

    Science.gov (United States)

    Blumberg, D F

    1997-05-01

    Four service and support options are available to healthcare organizations for maintaining their growth arsenals of medical and information technology. These options include maintaining and servicing all equipment using a facility-based biomedical engineering and MIS service department; using a combination of facility-based service and subcontracted service; expanding facility-based biomedical and MIS service departments to provide service to other healthcare organizations to achieve economies of scale; and outsourcing all maintenance, repair, and technical support services. Independent service companies and original equipment manufacturers (OEMs) are offering healthcare organizations a wider array of service and support capabilities than ever before. However, some health systems have successfully developed their own independent service organizations to take care of their own--and other healthcare organizations'--service and support needs.

  20. Optioner eller betingede aktier?

    DEFF Research Database (Denmark)

    Bechmann, Ken L.; Thorsell, Christopher

    2016-01-01

    Incitamentsaflønning – og herunder især aktieaflønning – fortsætter med at tiltrække sig stor opmærksomhed fra en lang række sider. Et spørgsmål, der ofte diskuteres, er selskabernes anvendelse af aktieaflønning, dvs. aflønning med optioner, betingede aktier o. lign. Diskussionerne har blandt andet...

  1. Radiation disinfestation: A viable technology for developing countries

    International Nuclear Information System (INIS)

    Loaharanu, P.

    1985-01-01

    Increasing food production in many countries is often offset by spoilage losses that occur at different stages after harvesting, slaughtering, or catching. The situation becomes critical in developing countries as more food is needed to feed the ever-increasing population. One of the major problems of losses of food and agricultural products during storage is insect infestation. This paper reviews some insect infestation problems of valuable crops in developing countries such as cereals, pulses, dried fish and meat, fresh and dried fruits, coffee and cocoa beans, spices, and cured tobacco leaves. Present practices of chemical fumigation to eliminate insect problems in these crops give rise to concern from the points of view of both public health and occupational safety. Irradiation technology has been shown to be as effective as other insect disinfestation methods and could provide a viable alternative for this purpose. Insects do not develop resistance to physical techniques such as heat or irradiation as they do to chemical treatments. Applications of radiation for disinfestation of food and agricultural products of importance to developing countries are discussed. The economics of radiation disinfestation of cereals and pulses, dried fish, and fresh fruits are also discussed

  2. Keeping checkpoint/restart viable for exascale systems.

    Energy Technology Data Exchange (ETDEWEB)

    Riesen, Rolf E.; Bridges, Patrick G. (IBM Research, Ireland, Mulhuddart, Dublin); Stearley, Jon R.; Laros, James H., III; Oldfield, Ron A.; Arnold, Dorian (University of New Mexico, Albuquerque, NM); Pedretti, Kevin Thomas Tauke; Ferreira, Kurt Brian; Brightwell, Ronald Brian

    2011-09-01

    Next-generation exascale systems, those capable of performing a quintillion (10{sup 18}) operations per second, are expected to be delivered in the next 8-10 years. These systems, which will be 1,000 times faster than current systems, will be of unprecedented scale. As these systems continue to grow in size, faults will become increasingly common, even over the course of small calculations. Therefore, issues such as fault tolerance and reliability will limit application scalability. Current techniques to ensure progress across faults like checkpoint/restart, the dominant fault tolerance mechanism for the last 25 years, are increasingly problematic at the scales of future systems due to their excessive overheads. In this work, we evaluate a number of techniques to decrease the overhead of checkpoint/restart and keep this method viable for future exascale systems. More specifically, this work evaluates state-machine replication to dramatically increase the checkpoint interval (the time between successive checkpoint) and hash-based, probabilistic incremental checkpointing using graphics processing units to decrease the checkpoint commit time (the time to save one checkpoint). Using a combination of empirical analysis, modeling, and simulation, we study the costs and benefits of these approaches on a wide range of parameters. These results, which cover of number of high-performance computing capability workloads, different failure distributions, hardware mean time to failures, and I/O bandwidths, show the potential benefits of these techniques for meeting the reliability demands of future exascale platforms.

  3. Physiology limits commercially viable photoautotrophic production of microalgal biofuels.

    Science.gov (United States)

    Kenny, Philip; Flynn, Kevin J

    2017-01-01

    Algal biofuels have been offered as an alternative to fossil fuels, based on claims that microalgae can provide a highly productive source of compounds as feedstocks for sustainable transport fuels. Life cycle analyses identify algal productivity as a critical factor affecting commercial and environmental viability. Here, we use mechanistic modelling of the biological processes driving microalgal growth to explore optimal production scenarios in an industrial setting, enabling us to quantify limits to algal biofuels potential. We demonstrate how physiological and operational trade-offs combine to restrict the potential for solar-powered algal-biodiesel production in open ponds to a ceiling of ca. 8000 L ha -1 year -1 . For industrial-scale operations, practical considerations limit production to ca. 6000 L ha -1 year -1 . According to published economic models and life cycle analyses, such production rates cannot support long-term viable commercialisation of solar-powered cultivation of natural microalgae strains exclusively as feedstock for biofuels. The commercial viability of microalgal biofuels depends critically upon limitations in microalgal physiology (primarily in rates of C-fixation); we discuss the scope for addressing this bottleneck concluding that even deployment of genetically modified microalgae with radically enhanced characteristics would leave a very significant logistical if not financial burden.

  4. Towards a viable and just global nursing ethics.

    Science.gov (United States)

    Crigger, Nancy J

    2008-01-01

    Globalization, an outgrowth of technology, while informing us about people throughout the world, also raises our awareness of the extreme economic and social disparities that exist among nations. As part of a global discipline, nurses are vitally interested in reducing and eliminating disparities so that better health is achieved for all people. Recent literature in nursing encourages our discipline to engage more actively with social justice issues. Justice in health care is a major commitment of nursing; thus questions in the larger sphere of globalization, justice and ethics, are our discipline's questions also. Global justice, or fairness, is not an issue for some groups or institutions, but a deeper human rights issue that is a responsibility for everyone. What can we do to help reduce or eliminate the social and economic disparities that are so evident? What kind of ethical milieu is needed to address the threat that globalization imposes on justice and fairness? This article enriches the conceptualization of globalization by investigating recent work by Schweiker and Twiss. In addition, I discuss five qualities or characteristics that will facilitate the development of a viable and just global ethic. A global ethic guides all people in their response to human rights and poverty. Technology and business, two major forces in globalization that are generally considered beneficial, are critiqued as barriers to social justice and the common good.

  5. Shungnak Energy Configuration Options.

    Energy Technology Data Exchange (ETDEWEB)

    Rosewater, David Martin [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States); Eddy, John P. [Sandia National Lab. (SNL-NM), Albuquerque, NM (United States)

    2017-10-01

    Power systems in rural Alaska villages face a unique combination of challenges that can increase the cost of energy and lowers energy supply reliability. In the case of the remote village of Shungnak, diesel and heating fuel is either shipped in by barge or flown in by aircraft. This report presents a technical analysis of several energy infrastructure upgrade and modification options to reduce the amount of fuel consumed by the community of Shungnak. Reducing fuel usage saves money and makes the village more resilient to disruptions in fuel supply. The analysis considers demand side options, such as energy efficiency, alongside the installation of wind and solar power generation options. Some novel approaches are also considered including battery energy storage and the use of electrical home heating stoves powered by renewable generation that would otherwise be spilled and wasted. This report concludes with specific recommendations for Shungnak based on economic factors, and fuel price sensitivity. General conclusions are also included to support future work analyzing similar energy challenges in remote arctic regions.

  6. The safeguards options study

    Energy Technology Data Exchange (ETDEWEB)

    Hakkila, E.A.; Mullen, M.F.; Olinger, C.T.; Stanbro, W.D. [Los Alamos National Lab., NM (United States); Olsen, A.P.; Roche, C.T.; Rudolph, R.R. [Argonne National Lab., IL (United States); Bieber, A.M.; Lemley, J. [Brookhaven National Lab., Upton, NY (United States); Filby, E. [Idaho National Engineering Lab., Idaho Falls, ID (United States)] [and others

    1995-04-01

    The Safeguards Options Study was initiated to aid the International Safeguards Division (ISD) of the DOE Office of Arms Control and Nonproliferation in developing its programs in enhanced international safeguards. The goal was to provide a technical basis for the ISD program in this area. The Safeguards Options Study has been a cooperative effort among ten organizations. These are Argonne National Laboratory, Brookhaven National Laboratory, Idaho National Engineering Laboratory, Lawrence Livermore National Laboratory, Los Alamos National Laboratory, Mound Laboratory, Oak Ridge National Laboratory, Pacific Northwest Laboratories, Sandia National Laboratories, and Special Technologies Laboratory. Much of the Motivation for the Safeguards Options Study is the recognition after the Iraq experience that there are deficiencies in the present approach to international safeguards. While under International Atomic Energy Agency (IAEA) safeguards at their declared facilities, Iraq was able to develop a significant weapons program without being noticed. This is because negotiated safeguards only applied at declared sites. Even so, their nuclear weapons program clearly conflicted with Iraq`s obligations under the Nuclear Nonproliferation Treaty (NPT) as a nonnuclear weapon state.

  7. The safeguards options study

    International Nuclear Information System (INIS)

    Hakkila, E.A.; Mullen, M.F.; Olinger, C.T.; Stanbro, W.D.; Olsen, A.P.; Roche, C.T.; Rudolph, R.R.; Bieber, A.M.; Lemley, J.; Filby, E.

    1995-04-01

    The Safeguards Options Study was initiated to aid the International Safeguards Division (ISD) of the DOE Office of Arms Control and Nonproliferation in developing its programs in enhanced international safeguards. The goal was to provide a technical basis for the ISD program in this area. The Safeguards Options Study has been a cooperative effort among ten organizations. These are Argonne National Laboratory, Brookhaven National Laboratory, Idaho National Engineering Laboratory, Lawrence Livermore National Laboratory, Los Alamos National Laboratory, Mound Laboratory, Oak Ridge National Laboratory, Pacific Northwest Laboratories, Sandia National Laboratories, and Special Technologies Laboratory. Much of the Motivation for the Safeguards Options Study is the recognition after the Iraq experience that there are deficiencies in the present approach to international safeguards. While under International Atomic Energy Agency (IAEA) safeguards at their declared facilities, Iraq was able to develop a significant weapons program without being noticed. This is because negotiated safeguards only applied at declared sites. Even so, their nuclear weapons program clearly conflicted with Iraq's obligations under the Nuclear Nonproliferation Treaty (NPT) as a nonnuclear weapon state

  8. Spent fuel reprocessing options

    International Nuclear Information System (INIS)

    2008-08-01

    The objective of this publication is to provide an update on the latest developments in nuclear reprocessing technologies in the light of new developments on the global nuclear scene. The background information on spent fuel reprocessing is provided in Section One. Substantial global growth of nuclear electricity generation is expected to occur during this century, in response to environmental issues and to assure the sustainability of the electrical energy supply in both industrial and less-developed countries. This growth carries with it an increasing responsibility to ensure that nuclear fuel cycle technologies are used only for peaceful purposes. In Section Two, an overview of the options for spent fuel reprocessing and their level of development are provided. A number of options exist for the treatment of spent fuel. Some, including those that avoid separation of a pure plutonium stream, are at an advanced level of technological maturity. These could be deployed in the next generation of industrial-scale reprocessing plants, while others (such as dry methods) are at a pilot scale, laboratory scale or conceptual stage of development. In Section Three, research and development in support of advanced reprocessing options is described. Next-generation spent fuel reprocessing plants are likely to be based on aqueous extraction processes that can be designed to a country specific set of spent fuel partitioning criteria for recycling of fissile materials to advanced light water reactors or fast spectrum reactors. The physical design of these plants must incorporate effective means for materials accountancy, safeguards and physical protection. Section four deals with issues and challenges related to spent fuel reprocessing. The spent fuel reprocessing options assessment of economics, proliferation resistance, and environmental impact are discussed. The importance of public acceptance for a reprocessing strategy is discussed. A review of modelling tools to support the

  9. Deliberating emission reduction options

    Energy Technology Data Exchange (ETDEWEB)

    Dowd, A. M.; Rodriguez, M.; Jeanneret, T. [Commonwealth Scientific and Industrial Research Organisation CSIRO, 37 Graham Rd, Highett VIC 3190 (Australia); De Best-Waldhober, M.; Straver, K.; Mastop, J.; Paukovic, M. [Energy research Centre of the Netherlands ECN, Policy Studies, Amsterdam (Netherlands)

    2012-06-15

    For more than 20 years there has been a concerted international effort toward addressing climate change. International conventions, such as the United Nations Foreign Convention on Climate Change (UNFCCC; ratified in 1994), have been established by committed nations seeking to address global climate change through the reduction of greenhouse gases emitted into the Earth's atmosphere (Global CCS Institute, 2011). Long recognised as the most crucial of the greenhouse gases to impact global warming, the majority of carbon dioxide's anthropogenic global emissions are directly related to fuel combustion of which both Australia and the Netherlands' energy production is significantly reliant. Both these nations will need to consider many opinions and make hard decisions if alternative energy options are to be implemented at the scale that is required to meet international emission targets. The decisions that are required not only need to consider the many options available but also their consequences. Along with politicians, policy developers and industry, the general public also need to be active participants in deciding which energy options, and their subsequent consequences, are acceptable for implementation at the national level. Access to balanced and factual information is essential in establishing informed opinions on the many policy options available. Past research has used several methods to measure public perceptions and opinions yet for complex issues, such as emission reduction, some of these methods have shown to be problematic. For example, semi structured interviews can provide data that is flexible and context rich yet is does also come with the limitations such as it seldom provides a practical assessment that can be utilised from researcher to researcher, across disciplines and public participation techniques. Surveys on the other hand usually address these limitations but surveys that do not encourage comparison of information or ask participants to

  10. Deliberating emission reduction options

    Energy Technology Data Exchange (ETDEWEB)

    Dowd, A.M.; Rodriguez, M.; Jeanneret, T. [Commonwealth Scientific and Industrial Research Organisation CSIRO, 37 Graham Rd, Highett VIC 3190 (Australia); De Best-Waldhober, M.; Straver, K.; Mastop, J.; Paukovic, M. [Energy research Centre of the Netherlands ECN, Policy Studies, Amsterdam (Netherlands)

    2012-06-15

    For more than 20 years there has been a concerted international effort toward addressing climate change. International conventions, such as the United Nations Foreign Convention on Climate Change (UNFCCC; ratified in 1994), have been established by committed nations seeking to address global climate change through the reduction of greenhouse gases emitted into the Earth's atmosphere (Global CCS Institute, 2011). Long recognised as the most crucial of the greenhouse gases to impact global warming, the majority of carbon dioxide's anthropogenic global emissions are directly related to fuel combustion of which both Australia and the Netherlands' energy production is significantly reliant. Both these nations will need to consider many opinions and make hard decisions if alternative energy options are to be implemented at the scale that is required to meet international emission targets. The decisions that are required not only need to consider the many options available but also their consequences. Along with politicians, policy developers and industry, the general public also need to be active participants in deciding which energy options, and their subsequent consequences, are acceptable for implementation at the national level. Access to balanced and factual information is essential in establishing informed opinions on the many policy options available. Past research has used several methods to measure public perceptions and opinions yet for complex issues, such as emission reduction, some of these methods have shown to be problematic. For example, semi structured interviews can provide data that is flexible and context rich yet is does also come with the limitations such as it seldom provides a practical assessment that can be utilised from researcher to researcher, across disciplines and public participation techniques. Surveys on the other hand usually address these limitations but surveys that do not encourage comparison of information or ask

  11. Novel treatment options for portal hypertension

    Science.gov (United States)

    Laleman, Wim

    2017-01-01

    Abstract Portal hypertension is most frequently associated with cirrhosis and is a major driver for associated complications, such as variceal bleeding, ascites or hepatic encephalopathy. As such, clinically significant portal hypertension forms the prelude to decompensation and impacts significantly on the prognosis of patients with liver cirrhosis. At present, non-selective β-blockers, vasopressin analogues and somatostatin analogues are the mainstay of treatment but these strategies are far from satisfactory and only target splanchnic hyperemia. In contrast, safe and reliable strategies to reduce the increased intrahepatic resistance in cirrhotic patients still represent a pending issue. In recent years, several preclinical and clinical trials have focused on this latter component and other therapeutic avenues. In this review, we highlight novel data in this context and address potentially interesting therapeutic options for the future. PMID:28533907

  12. Climate targets for all countries: the options

    International Nuclear Information System (INIS)

    Philibert, C.; Pershing, J.

    2001-01-01

    This paper assesses five options for targets that could be taken by all countries to meet the ultimate objective of the Climate Change Convention: fixed, binding targets, dynamic targets; non-binding targets; sectoral targets, policies and measures. Each is evaluated according to criteria of environmental effectiveness, cost-effectiveness, contribution to economic growth and sustainable development, and equity. While fixed, binding targets continue to be viable for industrialized countries, they do not seem suitable for many developing countries in the near future. Dynamic targets could alleviate developing countries' concerns about constraining their development as well as broader concerns about possible introduction of 'hot air' in a world trading regime; they could also be considered for some or all industrialized countries. Non-binding targets could be politically appealing to developing counties, alleviate fears about development and/or hot air, but might only allow conditional participation in emissions trading by developing countries. Sectoral targets could offer a pragmatic first step - although their cost-effectiveness might be questioned. Finally, targets based on commitments to implement specific policies and measures might drive mitigation action and be part of negotiated packages including financial and technological cooperation. All these options may coexist in the future. (authors)

  13. The future of the nuclear option

    International Nuclear Information System (INIS)

    Frost, B.R.T.

    1992-01-01

    This paper reports on the future of the nuclear option. No nuclear power reactors have been ordered in the U.S.A. since 1975, but the number of operating reactors has increased to the 115 operating today. The demand for electric power continues to grow. At this time, concern over the environmental effects of fossil fuels has grown; global warming and acid rain effects are major determinants of energy policy. In these circumstances nuclear power may be the only viable option to meet the growing demand for electricity. In the past decade the nuclear power industry has addressed its major critics by standardizing designs, improving operator training, and developing safe methods of disposing of waste products. Fast breeder reactors have taken a new lease on life through the American Integral Fast Reactor (IFR) design which is inherently safe, proliferation resistant, and helps the waste-disposal problem. It will probably not be commercially available until well into the next century. The extension of reactor life raises questions of long-term thermal and radiation effects

  14. A combination of direct viable count and fluorescence in situ hybridization for specific enumeration of viable Lactobacillus delbrueckii subsp.bulgaricus and Streptococcus thermophilus.

    Science.gov (United States)

    García-Hernández, J; Moreno, Y; Amorocho, C M; Hernández, M

    2012-03-01

    We have developed a direct viable count (DVC)-FISH procedure for quickly and easily discriminating between viable and nonviable cells of Lactobacillus delbrueckii subsp. bulgaricus and Streptococcus thermophilus strains, the traditional yogurt bacteria. direct viable count method has been modified and adapted for Lact. delbrueckii subsp. bulgaricus and Strep. thermophilus analysis by testing different times of incubation and concentrations of DNA-gyrase inhibitors. DVC procedure has been combined with fluorescent in situ hybridization (FISH) for the specific detection of viable cells of both bacteria with specific rRNA oligonucleotide probes (DVC-FISH). Of the four antibiotics tested (novobiocin, nalidixic acid, pipemidic acid and ciprofloxacin), novobiocin was the most effective for DVC method and the optimum incubation time was 7 h for both bacteria. The number of viable cells was obtained by the enumeration of specific hybridized cells that were elongated at least twice their original length for Lactobacillus and twice their original size for Streptococcus. This technique was successfully applied to detect viable cells in inoculated faeces. Results showed that this DVC-FISH procedure is a quick and culture-independent useful method to specifically detect viable Lact. delbrueckii subsp. bulgaricus and Strep. thermophilus in different samples, being applied for the first time to lactic acid bacteria. © 2011 The Authors. Letters in Applied Microbiology © 2011 The Society for Applied Microbiology.

  15. Coronectomy - A viable alternative to prevent inferior alveolar nerve injury

    Directory of Open Access Journals (Sweden)

    Alok Sagtani

    2015-12-01

    Full Text Available Background and Objectives: Coronectomy is a relatively new method to prevent the risk of Inferior Alveolar Nerve (IAN injury during removal of lower third molars with limited scientific literature among Nepalese patients. Thus, a study was designed to evaluate coronectomy regarding its use, outcomes and complications.Materials and Methods: A descriptive study was conducted from December 2012 to December 2013 among patients attending Department of Oral and Maxillofacial Surgery, College of Dental Sciences, BP Koirala Institute of Health Sciences, Dharan, Nepal for removal of mandibular third molars. After reviewing the radiograph for proximity of third molar to the IAN, coronectomy was advised. A written informed consent was obtained from the patients and coronectomy was performed. Patients were recalled after one week. The outcome measures in the follow-up visit were primary healing, pain, infection, dry socket, root exposure and IAN injury. The prevalence of IAN proximity of lower third molars and incidence of complications were calculated.Results: A total 300 mandibular third molars were extracted in 278 patients during the study period. Out of 300 impacted mandibular third molar, 41 (13.7% showed close proximity to inferior alveolar nerve . The incidence of complications and failed procedure was 7.4% among the patients who underwent coronectomy. During the follow up visit, persistent pain and root exposure was reported while other complications like inferior alveolar nerve injury, dry socket and infection was not experienced by the study patients.Conclusion: With a success rate of 92.6% among the 41 patients, coronectomy is a viable alternative to conventional total extraction for mandibular third molars who have a higher risk for damage to the inferior alveolar nerve.JCMS Nepal. 2015;11(3:1-5.

  16. Oclusão da artéria umbilical como opção terapêutica em gestações com gêmeo acárdio Umbilical artery occlusion as a therapeutic option in pregnancy with acardiac twin

    Directory of Open Access Journals (Sweden)

    Júlio César de Faria Couto

    2004-07-01

    Full Text Available Gestação gemelar com gêmeo acárdio é um evento raro que se caracteriza pela presença de uma anastomose placentária entre o gêmeo doador, morfologicamente normal, e o gêmeo acárdio, levando à perfusão contra-corrente de um dos gêmeos. As principais complicações encontram-se associadas à prematuridade e insuficiência cardíaca do gêmeo normal secundária à sobrecarga circulatória. Várias modalidades terapêuticas têm sido propostas, mas não há consenso em relação aos resultados observados. A oclusão intra-fetal da artéria umbilical do gêmeo acárdio tem se mostrado um método de baixo custo, fácil execução e alta eficácia no controle da sobrecarga circulatória. Apresentamos dois casos com ablação intra-fetal e boa evolução. Uma gestação trigemelar na qual se realizou a ablação intra-fetal com 29 semanas, evoluindo com parto prematuro e nascimento de um recém-nascido em boas condições. Uma gestação gemelar cuja ablação foi realizada com 31 semanas e que evoluiu com rotura prematura de membranas e parto prematuro com nascimento de uma criança saudável.Twin pregnancy with an acardiac twin is a rare event characterized by the presence of a placentary arterial anastomosis between the pump twin, morfologically normal, and the acardiac twin, causing a reverse circulation in one of the twins. The major complications are associated with cardiac failure in the normal twin, which is due to circulatory overload and prematurity. Many therapeutic options have been proposed, but there is no consensus about which one is the best therapy. However, intrafetal ablation of the umbilical artery of the acardiac fetus proved to be an inexpensive method that is easy to perform and highly efficient in controlling circulatory overload. We presented two cases of intra-fetal ablation and good evolution. A triplet pregnancy in which the intra-fetal ablation was done in a 29-week-old fetus that evolved to premature delivery of

  17. Options for modulation of drug resistance in ovarian cancer

    NARCIS (Netherlands)

    Arts, HJG; Van der Zee, AGJ; De Jong, S; De Vries, EGE

    2000-01-01

    The objective of this paper is to present an update of mechanisms responsible for drug resistance in ovarian cancer and the possible therapeutic options to modulate this resistance using literature review with emphasis on data acquired in studies comprising ovarian tumor samples. The classic

  18. Treatment Options for Actinic Keratosis

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends mostly on ... helped by lip balm or petroleum jelly . Treatment Option Overview Key Points There are different types of ...

  19. Treatment Option Overview (Vaginal Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on the ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  20. Treatment Option Overview (Anal Cancer)

    Science.gov (United States)

    ... affect the prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) depends on the ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  1. Pricing American and Asian Options

    OpenAIRE

    Pat Muldowney

    2015-01-01

    An analytic method for pricing American call options is provided; followed by an empirical method for pricing Asian call options. The methodology is the pricing theory presented in "A Modern Theory of Random Variation", by Patrick Muldowney, 2012.

  2. The information content of options

    OpenAIRE

    Navon, Yonatan

    2017-01-01

    The objective of this thesis is to examine the information content of stock options in financial markets. A key question in financial economics is how information diffuses across markets and how quickly it is reflected in security prices. This thesis aims at exploring this question by investigating the informational role that options play in financial markets. This is achieved by exploring the joint cross section of option and bond prices, the informational role of options in seasoned equity ...

  3. Enhanced Delivery of Gold Nanoparticles with Therapeutic Potential for Targeting Human Brain Tumors

    Science.gov (United States)

    Etame, Arnold B.

    The blood brain barrier (BBB) remains a major challenge to the advancement and application of systemic anti-cancer therapeutics into the central nervous system. The structural and physiological delivery constraints of the BBB significantly limit the effectiveness of conventional chemotherapy, thereby making systemic administration a non-viable option for the vast majority of chemotherapy agents. Furthermore, the lack of specificity of conventional systemic chemotherapy when applied towards malignant brain tumors remains a major shortcoming. Hence novel therapeutic strategies that focus both on targeted and enhanced delivery across the BBB are warranted. In recent years nanoparticles (NPs) have emerged as attractive vehicles for efficient delivery of targeted anti-cancer therapeutics. In particular, gold nanoparticles (AuNPs) have gained prominence in several targeting applications involving systemic cancers. Their enhanced permeation and retention within permissive tumor microvasculature provide a selective advantage for targeting. Malignant brain tumors also exhibit transport-permissive microvasculature secondary to blood brain barrier disruption. Hence AuNPs may have potential relevance for brain tumor targeting. However, the permeation of AuNPs across the BBB has not been well characterized, and hence is a potential limitation for successful application of AuNP-based therapeutics within the central nervous system (CNS). In this dissertation, we designed and characterized AuNPs and assessed the role of polyethylene glycol (PEG) on the physical and biological properties of AuNPs. We established a size-dependent permeation profile with respect to core size as well as PEG length when AuNPs were assessed through a transport-permissive in-vitro BBB. This study was the first of its kind to systematically examine the influence of design on permeation of AuNPs through transport-permissive BBB. Given the significant delivery limitations through the non

  4. Balancing of solar heating options

    NARCIS (Netherlands)

    Veltkamp, W.B.; van Koppen, C.W.J.; Ouden, den C.

    1984-01-01

    In the field of energy conservation many options are presently competing. This study aims at providing more rational criteria for selection between these options.The options considered are; insulation of the walls, regeneration of the heat in the waste air, double glazing, attached sunspace at the

  5. Stock option repricing in Europe

    NARCIS (Netherlands)

    Sauer, M.; Sautner, Z.

    2008-01-01

    This paper investigates the link between option repricing, firm performance and corporate governance in Europe. Our sample consists of 77 European firms that repriced their stock option between 1987 and 2003. We document that option repricing is mainly a phenomenon for young and fast growing firms

  6. Contemplating future energy options

    International Nuclear Information System (INIS)

    Pooley, D.

    2005-01-01

    All political parties in the UK accept that we should move away from our reliance on fossil fuels towards a much greater use of alternative energy technologies. Nuclear power is one of these but finds minimal support in the political spectrum. The article reviews the European Commission's Advisory Group on Energy submission to the EC's report entitled 'Key Tasks for European Energy R and D'. The 'strength and weaknesses' of the various 'alternative energy' systems (including nuclear power) are summarised and then the key R and D tasks which, if they are carried out successfully, should make the eight selected technologies significantly more attractive. However, the message here is clear enough: there are no easy options, only a range of very imperfect possibilities, despite what enthusiastic proponents of each may say. Nuclear fission is certainly one of the most attractive options available, but the industry needs to continue to strive to eliminate the possibility of significant off-site releases, whether caused by plant failure or by human error or intention, and to prove beyond reasonable doubt the safety of high-level radioactive waste disposal. (author)

  7. Retrieval options study

    Energy Technology Data Exchange (ETDEWEB)

    1980-03-01

    This Retrieval Options Study is part of the systems analysis activities of the Office of Nuclear Waste Isolation to develop the scientific and technological bases for radioactive waste repositories in various geologic media. The study considers two waste forms, high level waste and spent fuel, and defines various classes of waste retrieval and recovery. A methodology and data base are developed which allow the relative evaluation of retrieval and recovery costs and the following technical criteria: safety; technical feasibility; ease of retrieval; probable intact retrieval time; safeguards; monitoring; criticality; and licensability. A total of 505 repository options are defined and the cost and technical criteria evaluated utilizing a combination of facts and engineering judgments. The repositories evaluated are selected combinations of the following parameters: Geologic Media (salt, granite, basalt, shale); Retrieval Time after Emplacement (5 and 25 years); Emplacement Design (nominal hole, large hole, carbon steel canister, corrosion resistant canister, backfill in hole, nominal sleeves, thick wall sleeves); Emplacement Configuration (single vertical, multiple vertical, single horizontal, multiple horizontal, vaults; Thermal Considerations; (normal design, reduced density, once-through ventilation, recirculated ventilation); Room Backfill; (none, run-of-mine, early, 5 year delay, 25 year delay, decommissioned); and Rate of Retrieval; (same as emplacement, variably slower depending on repository/canister condition).

  8. Retrieval options study

    International Nuclear Information System (INIS)

    1980-03-01

    This Retrieval Options Study is part of the systems analysis activities of the Office of Nuclear Waste Isolation to develop the scientific and technological bases for radioactive waste repositories in various geologic media. The study considers two waste forms, high level waste and spent fuel, and defines various classes of waste retrieval and recovery. A methodology and data base are developed which allow the relative evaluation of retrieval and recovery costs and the following technical criteria: safety; technical feasibility; ease of retrieval; probable intact retrieval time; safeguards; monitoring; criticality; and licensability. A total of 505 repository options are defined and the cost and technical criteria evaluated utilizing a combination of facts and engineering judgments. The repositories evaluated are selected combinations of the following parameters: Geologic Media (salt, granite, basalt, shale); Retrieval Time after Emplacement (5 and 25 years); Emplacement Design (nominal hole, large hole, carbon steel canister, corrosion resistant canister, backfill in hole, nominal sleeves, thick wall sleeves); Emplacement Configuration (single vertical, multiple vertical, single horizontal, multiple horizontal, vaults; Thermal Considerations; (normal design, reduced density, once-through ventilation, recirculated ventilation); Room Backfill; (none, run-of-mine, early, 5 year delay, 25 year delay, decommissioned); and Rate of Retrieval;

  9. Kaluza-Klein models: Can we construct a viable example?

    International Nuclear Information System (INIS)

    Eingorn, Maxim; Zhuk, Alexander

    2011-01-01

    candidates for a viable model of astrophysical objects (e.g., Sun) if we can provide a satisfactory explanation of negative tension for particles constituting these objects.

  10. A homotopy analysis method for the option pricing PDE in illiquid markets

    Science.gov (United States)

    E-Khatib, Youssef

    2012-09-01

    One of the shortcomings of the Black and Scholes model on option pricing is the assumption that trading the underlying asset does not affect the underlying asset price. This can happen in perfectly liquid markets and it is evidently not viable in markets with imperfect liquidity (illiquid markets). It is well-known that markets with imperfect liquidity are more realistic. Thus, the presence of price impact while studying options is very important. This paper investigates a solution for the option pricing PDE in illiquid markets using the homotopy analysis method.

  11. Predictors of viable germ cell tumor in postchemotherapeutic residual retroperitoneal masses

    Directory of Open Access Journals (Sweden)

    Khalid Al Othman

    2014-01-01

    Full Text Available Objective: The aim of this study was to identify predictors of viable germ cell tumor (GCT in postchemotherapeutic residual retroperitoneal masses. Materials and Methods: The pertinent clinical and pathologic data of 16 male patients who underwent postchemotherapeutic retroperitoneal lymph node dissection (PC-RPLND at King Faisal Specialist Hospital and Research Centre between 1994 and 2005 were reviewed retrospectively. It was found that all patients received cisplatin-based chemotherapy for advanced testicular GCT. Results: Out of the 16 male patients, 2 (13%, 8 (50%, and 6 (37% had viable GCT, fibrosis, and teratoma, respectively. Ten (10 of the patients with prechemotherapeutic S1 tumor markers did not have viable GCT, and two of the six patients who had prechemotherapeutic S2 tumor markers have viable GCT. All tumor marker levels normalized after chemotherapy even in patients with viable GCT. Four patients had vascular invasion without viable GCT. Furthermore, four patients had more than 60% embryonal elements in the original pathology, but only 1 had viable GCT at PC-RPLND. Four of the five patients with immature teratoma had teratoma at PC-RPLND but no viable GCT; however, out of the four patients with mature teratoma, one had viable GCT and two had teratoma at PC-RPLND. Of the two patients with viable GCT, one had 100% embryonal cancer in the original pathology, prechemotherapeutic S2 tumor markers, history of orchiopexy, and no vascular invasion; the other patient had yolk sac tumor with 25% embryonal elements and 40% teratoma in the original pathology, and prechemotherapeutic S2 tumor markers. Conclusion: None of the clinical or pathological parameters showed a strong correlation with the presence of viable GCT in PC-RPLND. However, patients with ≥S2 may be at higher risk to have viable GCT. Further studies are needed to clarify this.

  12. VAMOS: The verification and monitoring options study: Current research options for in-situ monitoring and verification of contaminant remediation and containment within the vadose zone

    International Nuclear Information System (INIS)

    Betsill, J.D.; Gruebel, R.D.

    1995-09-01

    The Verification and Monitoring Options Study Project (VAMOS) was established to identify high-priority options for future vadose-zone environmental research in the areas of in-situ remediation monitoring, post-closure monitoring, and containment emplacement and verification monitoring. VAMOS examined projected needs not currently being met with applied technology in order to develop viable monitoring and verification research options. The study emphasized a compatible systems approach to reinforce the need for utilizing compatible components to provide user friendly site monitoring systems. To identify the needs and research options related to vadose-zone environmental monitoring and verification, a literature search and expert panel forums were conducted. The search included present drivers for environmental monitoring technology, technology applications, and research efforts. The forums included scientific, academic, industry, and regulatory environmental professionals as well as end users of environmental technology. The experts evaluated current and future monitoring and verification needs, methods for meeting these needs, and viable research options and directions. A variety of high-priority technology development, user facility, and technology guidance research options were developed and presented as an outcome of the literature search and expert panel forums

  13. Novel therapeutic approaches in chondrosarcoma.

    Science.gov (United States)

    Polychronidou, Genovefa; Karavasilis, Vasilios; Pollack, Seth M; Huang, Paul H; Lee, Alex; Jones, Robin L

    2017-03-01

    Chondrosarcoma is a malignant tumor of bones, characterized by the production of cartilage matrix. Due to lack of effective treatment for advanced disease, the clinical management of chondrosarcomas is exceptionally challenging. Current research focuses on elucidating the molecular events underlying the pathogenesis of this rare bone malignancy, with the goal of developing new molecularly targeted therapies. Signaling pathways suggested to have a role in chondrosarcoma include Hedgehog, Src, PI3k-Akt-mTOR and angiogenesis. Mutations in IDH1/2, present in more than 50% of primary conventional chondrosarcomas, make the development of IDH inhibitors a promising treatment option. The present review discusses the preclinical and early clinical data on novel targeted therapeutic approaches in chondrosarcoma.

  14. Koranic Education Centres: A viable educational alternative for the disadvantaged learner in Sahel Africa?

    Science.gov (United States)

    Bah-Lalya, Ibrahima

    2015-08-01

    Within the international momentum for achieving Education for All (EFA) and the Millennium Development Goals (MDGs), many African countries have made considerable progress during the last decade in terms of access to basic education. However, a significant number of children enrolled in the early grades of primary schools either repeat classes or drop out and never graduate. Moreover, there are currently about 30 million school-age children in sub-Saharan Africa who have never attended any form of schooling. In view of this situation, sub-Saharan African countries have been looking for alternative options to educate those who have not been accounted for in the formal school system. This note considers informal Koranic Education Centres (KECs) which are trying to fill the gap of schooling in the Sahel-Saharan strip. The author looks at the challenges this form of schooling faces and at how to meet them efficiently. He sounds out the possibility of using KECs to cater for those who have been left aside by formal schooling. Based on existing studies, data compiled by educational systems and a study conducted by the Working Group on Non-Formal Education (WGNFE) of the Association for the Development of Education in Africa (ADEA) in four West African countries (Burkina Faso, Mali, Mauritania and Senegal) in 2013, the author of this research note came to the conclusion that a holistic approach, where the two systems (the Koranic and the formal) collaborate and support one another, could effectively contribute to alleviating the dropout predicament and to reducing the number of unschooled children. It could offer a second-chance opportunity to dropout and unschooled children in the Sahel and Saharan zone. However, before this can become a viable alternative, a number of major challenges need to be addressed. Through its WGNFE, ADEA intends to further investigate the holistic approach of combining formal "modern" and informal "Koranic" schooling to come up with tangible

  15. Optional Defaultable Markets

    Directory of Open Access Journals (Sweden)

    Mohamed N. Abdelghani

    2017-10-01

    Full Text Available The paper deals with defaultable markets, one of the main research areas of mathematical finance. It proposes a new approach to the theory of such markets using techniques from the calculus of optional stochastic processes on unusual probability spaces, which was not presented before. The paper is a foundation paper and contains a number of fundamental results on modeling of defaultable markets, pricing and hedging of defaultable claims and results on the probability of default under such conditions. Moreover, several important examples are presented: a new pricing formula for a defaultable bond and a new pricing formula for credit default swap. Furthermore, some results on the absence of arbitrage for markets on unusual probability spaces and markets with default are also provided.

  16. Automotive turbogenerator design options

    Energy Technology Data Exchange (ETDEWEB)

    Rodgers, C. [ITC, San Diego, CA (United States); McDonald, C. [McDonald Thermal Engineering, La Jolla, CA (United States)

    1998-12-31

    For the small turbogenerator to find reception in the hybrid electric automotive market its major features must be dominated by the following considerations, low cost, high performance, low emissions, compact size and high reliability. Not meeting the first two criteria has been the nemesis of earlier attempts to introduce the small gas turbine for automotive service. With emphasis on the design for low cost and high performance, this paper presents several turbogenerator design flowpath configuration options for the major engine components. The projected evolution from today`s state-of-the-art all metallic engines, to advanced technology ceramic units for service in the early decade of the 21st century, is the major topic of this paper. (author)

  17. The Gel Generator option

    International Nuclear Information System (INIS)

    Boyd, R.E.

    1999-01-01

    The development of a national policy for guaranteeing an ample supply of 99m Tc to nuclear medicine, involves issues which go beyond the means by which radioactivation is achieved. Indeed, in such an exercise the pragmatic dictates of business and the sensitivities of politics must also be taken into account. Furthermore where a preference towards the nuclear reactor or the potential of cyclotrons is being questioned, the debate is incomplete if the only options that are considered are the fission-based 99 Mo generator versus the direct cyclotron production of 99m Tc. There is a third option (also neutron γ-based), an alternative to the fission 99 Mo generator, which ought not be overlooked. The application of low specific activity (n,γ) 99 Mo to a new type of generator, the Gel Generator, has been the focus of much research, particularly in Australia and more recently in China. After the initial concept had been established in the laboratory, the Australian researchers then undertook a comprehensive program of tests on the Gel Generator to assess its potential, either in the clinical laboratory or the centralised radiopharmacy, for supplying 99m Tc suitable for nuclear medicine. The outcome of this program was a clear indication that the Gel Generator innovation had the capability to provide both technical and economic advantages to the nuclear medicine industry. These advantages are described. Since that time the Gel Generator has been selected for routine use in China where it now satisfies more than 30% of the 99m Tc demand. (author)

  18. Transportation Options | Climate Neutral Research Campuses | NREL

    Science.gov (United States)

    Transportation Options Transportation Options Transportation to, from, and within a research campus from business travel often enlarge the footprint more than expected. To understand options for climate

  19. Grazing of particle-associated bacteria-an elimination of the non-viable fraction.

    Science.gov (United States)

    Gonsalves, Maria-Judith; Fernandes, Sheryl Oliveira; Priya, Madasamy Lakshmi; LokaBharathi, Ponnapakkam Adikesavan

    Quantification of bacteria being grazed by microzooplankton is gaining importance since they serve as energy subsidies for higher trophic levels which consequently influence fish production. Hence, grazing pressure on viable and non-viable fraction of free and particle-associated bacteria in a tropical estuary controlled mainly by protist grazers was estimated using the seawater dilution technique. In vitro incubations over a period of 42h showed that at the end of 24h, growth coefficient (k) of particle-associated bacteria was 9 times higher at 0.546 than that of free forms. Further, 'k' value of viable cells on particles was double that of free forms at 0.016 and 0.007, respectively. While bacteria associated with particles were grazed (coefficient of removal (g)=0.564), the free forms were relatively less grazed indicating that particle-associated bacteria were exposed to grazers in these waters. Among the viable and non-viable forms, 'g' of non-viable fraction (particle-associated bacteria=0.615, Free=0.0086) was much greater than the viable fraction (particle-associated bacteria=0.056, Free=0.068). Thus, grazing on viable cells was relatively low in both the free and attached states. These observations suggest that non-viable forms of particle-associated bacteria were more prone to grazing and were weeded out leaving the viable cells to replenish the bacterial standing stock. Particle colonization could thus be a temporary refuge for the "persistent variants" where the viable fraction multiply and release their progeny. Copyright © 2016 Sociedade Brasileira de Microbiologia. Published by Elsevier Editora Ltda. All rights reserved.

  20. Grazing of particle-associated bacteria-an elimination of the non-viable fraction

    Directory of Open Access Journals (Sweden)

    Maria-Judith Gonsalves

    Full Text Available Abstract Quantification of bacteria being grazed by microzooplankton is gaining importance since they serve as energy subsidies for higher trophic levels which consequently influence fish production. Hence, grazing pressure on viable and non-viable fraction of free and particle-associated bacteria in a tropical estuary controlled mainly by protist grazers was estimated using the seawater dilution technique. In vitro incubations over a period of 42 h showed that at the end of 24 h, growth coefficient (k of particle-associated bacteria was 9 times higher at 0.546 than that of free forms. Further, ‘k’ value of viable cells on particles was double that of free forms at 0.016 and 0.007, respectively. While bacteria associated with particles were grazed (coefficient of removal (g = 0.564, the free forms were relatively less grazed indicating that particle-associated bacteria were exposed to grazers in these waters. Among the viable and non-viable forms, ‘g’ of non-viable fraction (particle-associated bacteria = 0.615, Free = 0.0086 was much greater than the viable fraction (particle-associated bacteria = 0.056, Free = 0.068. Thus, grazing on viable cells was relatively low in both the free and attached states. These observations suggest that non-viable forms of particle-associated bacteria were more prone to grazing and were weeded out leaving the viable cells to replenish the bacterial standing stock. Particle colonization could thus be a temporary refuge for the “persistent variants” where the viable fraction multiply and release their progeny.

  1. Alopecia areata: Treatment options

    Directory of Open Access Journals (Sweden)

    E. Kasumagić-Halilović

    2006-02-01

    Full Text Available Alopecia areata (AA is a common cause of reversible hair loss afflictingapproximately1-2%ofthegeneralpopulation. It commonly present as round patches of hair loss which can be the firstmanifestationofamoreseverealopecia totalis or universalis. The cause of AA is unknown although most evidence supports the hypothesis that AA is an immunologically mediated disease. Treatment of AA may be divided into four different categories of widely accepted therapeutic modalities: immune inhibitors (steroid or psoralen and UVA light- PUVA, topicalsensitizers (squaric acid dibutylester and diphenylcyclopropenone, non-specificirritants(anthralinandthevasodilatator minoxidil. Improved future treatments may be immunosuppressive or immunomodulatory or they may otherwise protect hair follicles from the injurious effects of inflammation.Theaimofthisarticleistoreviewavailable data on current and potential agents for the treatment of AA.

  2. Free space optics: a viable last-mile alternative

    Science.gov (United States)

    Willebrand, Heinz A.; Clark, Gerald R.

    2001-10-01

    This paper explores Free Space Optics (FSO) as an access technology in the last mile of metropolitan area networks (MANs). These networks are based in part on fiber-optic telecommunications infrastructure, including network architectures of Synchronous Optical Network (commonly referred to as SONET), the North American standard for synchronous data transmission; and Synchronous Digital Hierarchy (commonly referred to as SDH), the international standard and equivalent of SONET. Several converging forces have moved FSO beyond a niche technology for use only in local area networks (LANs) as a bridge connecting two facilities. FSO now allows service providers to cost effectively provide optical bandwidth for access networks and accelerate the extension of metro optical networks bridging what has been termed by industry experts as the optical dead zone. The optical dead zone refers to both the slowdown in capital investment in the short-term future and the actual connectivity gap that exists today between core metro optical networks and the access optical networks. Service providers have built extensive core and minimal metro networks but have not yet provided optical bandwidth to the access market largely due to the non-compelling economics to bridge the dead zone with fiber. Historically, such infrastructure build-out slowdowns have been blamed on a combination of economics, time-to-market constraints and limited technology options. However, new technology developments and market acceptance of FSO give service providers a new cost-effective alternative to provide high-bandwidth services with optical bandwidth in the access networks. Merrill Lynch predicts FSO will grow into a $2 billion market by 2005. The drivers for this market are a mere 5%- 6% penetration of fiber to business buildings; cost effective solution versus RF or fiber; and significant capacity which can only be matched by a physical fiber link, Merrill Lynch reports. This paper will describe FSO

  3. Cybernetically sound organizational structures II: Relating de Sitter's design theory to Beer's viable system model

    NARCIS (Netherlands)

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

    2011-01-01

    - Purpose – The purpose of this paper is to show how the viable system model (VSM) and de Sitter's design theory can complement each other in the context of the diagnosis and design of viable organizations. - Design/methodology/approach – Key concepts from Beer's model and de Sitter's design theory

  4. Option-implied term structures

    OpenAIRE

    Vogt, Erik

    2014-01-01

    The illiquidity of long-maturity options has made it difficult to study the term structures of option spanning portfolios. This paper proposes a new estimation and inference framework for these option-implied term structures that addresses long-maturity illiquidity. By building a sieve estimator around the risk-neutral valuation equation, the framework theoretically justifies (fat-tailed) extrapolations beyond truncated strikes and between observed maturities while remaining nonparametric. Ne...

  5. Portfolio insurance using traded options

    OpenAIRE

    Machado-Santos, Carlos

    2001-01-01

    Literature concerning the institutional use of options indicates that the main purpose of option trading is to provide investors with the opportunity to create return distributions previously unavailable, considering that options provide the means to manipulate portfolio returns. In such a context, this study intends to analyse the returns of insured portfolios generated by hedging strategies on underlying stock portfolios. Because dynamic hedging is too expensive, we have hedged the stock po...

  6. Synroc processing options

    International Nuclear Information System (INIS)

    Rozsa, R.B.; Hoenig, C.L.

    1981-01-01

    Synroc is a titanate-based ceramic material currently being developed for immobilizing high-level nuclear reactor wastes in solid form. Synroc D is a unique variation of Synroc. It can contain the high-level defense wastes, particularly those in storage at the Savannah River Plant. In this report, we review the early development of the initial Synroc process, discuss modification and other options that simplify it overall, and recommend the future direction of research and development in the processing area. A reference Synroc process is described briefly and contrasted with the Savannah River Laboratory glass-based reference case. Preliminary engineering layouts show Synroc to be a more complex processing operation and, thus, more expensive than the glass-based process. However, we believe that simplifications, which will significantly reduce the cost difference, are possible. Further research and development will continue in the areas of slurry processing, fluidized bed calcination, and mineralization. This last will use sintering, hot uniaxial pressing, or hot isostatic pressing

  7. Nuclear technology options

    International Nuclear Information System (INIS)

    Salvatores, Massimo

    2013-01-01

    Different strategies and motivations in different countries have led to diverse options. In Europe the SNETP (Sustainable Nuclear Energy Technology Platform) has the objective of developing R&D supporting GEN-II (present) and GEN-III nuclear systems under development; allowing sustainability and minimisation of waste burden, promoting advanced Gen-IV Fast Reactors; and accounting for a Nuclear Cogeneration Industrial Initiative. A remarkable initiative in the USA has been the promotion of small modular reactors (SMRs) – at less than 300 MWe in capacity, much smaller than typical reactors – which can be an ideal choice for (remote) areas which cannot support a larger reactor. Compact scalable design offers a host of potential safety, construction and economic benefits. More “upbeat” strategies are expected in other areas of the world where significant increase in nuclear energy demand is predicted in the next decades. If this growth materialises, future fuel cycles characteristics, feasibility and acceptability will be crucial. This paper will discuss different scenarios for future fuel cycles, resources optimisation and/or waste minimization, the range from full fast reactor deployment to phase-out, management of spent nuclear fuel and the significant potential benefits of advanced cycles. The next 45 years will be dominated by deployment of standard large or medium size plants operating for 60 years. Available resources do allow it. However, fuel cycle will be a growing and most challenging issue and early assessments will be needed for public acceptance and policy decisions.

  8. Optional carbon capture

    Energy Technology Data Exchange (ETDEWEB)

    Alderson, T.; Scott, S.; Griffiths, J. [Jacobs Engineering, London (United Kingdom)

    2007-07-01

    In the case of IGCC power plants, carbon capture can be carried out before combustion. The carbon monoxide in the syngas is catalytically shifted to carbon dioxide and then captured in a standard gas absorption system. However, the insertion of a shift converter into an existing IGCC plant with no shift would mean a near total rebuild of the gasification waste heat recovery, gas treatment system and HRSG, with only the gasifier and gas turbine retaining most of their original features. To reduce the extent, cost and time taken for the revamping, the original plant could incorporate the shift, and the plant would then be operated without capture to advantage, and converted to capture mode of operation when commercially appropriate. This paper examines this concept of placing a shift converter into an IGCC plant before capture is required, and operating the same plant first without and then later with CO{sub 2} capture in a European context. The advantages and disadvantages of this 'capture ready' option are discussed. 6 refs., 2 figs., 4 tabs.

  9. Treatment Options for Narcolepsy.

    Science.gov (United States)

    Barateau, Lucie; Lopez, Régis; Dauvilliers, Yves

    2016-05-01

    Narcolepsy type 1 and narcolepsy type 2 are central disorders of hypersomnolence. Narcolepsy type 1 is characterized by excessive daytime sleepiness and cataplexy and is associated with hypocretin-1 deficiency. On the other hand, in narcolepsy type 2, cerebrospinal fluid hypocretin-1 levels are normal and cataplexy absent. Despite major advances in our understanding of narcolepsy mechanisms, its current management is only symptomatic. Treatment options may vary from a single drug that targets several symptoms, or multiple medications that each treats a specific symptom. In recent years, narcolepsy treatment has changed with the widespread use of modafinil/armodafinil for daytime sleepiness, antidepressants (selective serotonin and dual serotonin and noradrenalin reuptake inhibitors) for cataplexy, and sodium oxybate for both symptoms. Other psychostimulants can also be used, such as methylphenidate, pitolisant and rarely amphetamines, as third-line therapy. Importantly, clinically relevant subjective and objective measures of daytime sleepiness are required to monitor the treatment efficacy and to provide guidance on whether the treatment goals are met. Associated symptoms and comorbid conditions, such as hypnagogic/hypnopompic hallucinations, sleep paralysis, disturbed nighttime sleep, unpleasant dreams, REM- and non REM-related parasomnias, depressive symptoms, overweight/obesity, and obstructive sleep apnea, should also be taken into account and managed, if required. In the near future, the efficacy of new wake-promoting drugs, anticataplectic agents, hypocretin replacement therapy and immunotherapy at the early stages of the disease should also be evaluated.

  10. Perpetual Cancellable American Call Option

    OpenAIRE

    Emmerling, Thomas J.

    2010-01-01

    This paper examines the valuation of a generalized American-style option known as a Game-style call option in an infinite time horizon setting. The specifications of this contract allow the writer to terminate the call option at any point in time for a fixed penalty amount paid directly to the holder. Valuation of a perpetual Game-style put option was addressed by Kyprianou (2004) in a Black-Scholes setting on a non-dividend paying asset. Here, we undertake a similar analysis for the perpetua...

  11. Option price and market instability

    Science.gov (United States)

    Baaquie, Belal E.; Yu, Miao

    2017-04-01

    An option pricing formula, for which the price of an option depends on both the value of the underlying security as well as the velocity of the security, has been proposed in Baaquie and Yang (2014). The FX (foreign exchange) options price was empirically studied in Baaquie et al., (2014), and it was found that the model in general provides an excellent fit for all strike prices with a fixed model parameters-unlike the Black-Scholes option price Hull and White (1987) that requires the empirically determined implied volatility surface to fit the option data. The option price proposed in Baaquie and Cao Yang (2014) did not fit the data during the crisis of 2007-2008. We make a hypothesis that the failure of the option price to fit data is an indication of the market's large deviation from its near equilibrium behavior due to the market's instability. Furthermore, our indicator of market's instability is shown to be more accurate than the option's observed volatility. The market prices of the FX option for various currencies are studied in the light of our hypothesis.

  12. Treatment Option Overview (Myelodysplastic/Myeloproliferative Neoplasms)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ...

  13. Probabilistic methods in exotic option pricing

    NARCIS (Netherlands)

    Anderluh, J.H.M.

    2007-01-01

    The thesis presents three ways of calculating the Parisian option price as an illustration of probabilistic methods in exotic option pricing. Moreover options on commidities are considered and double-sided barrier options in a compound Poisson framework.

  14. Can Malin's gravitational-field equations be modified to obtain a viable theory of gravity to obtain a viable theory of gravity to obtain a viable theory of gravity

    International Nuclear Information System (INIS)

    Smalley, L.L.; Prestage, J.

    1976-01-01

    Malin's gravitational theory, which was recently shown by Lindblom and Nester to be incorrect, is modified by means of a recently proposed method for obtaining viable gravitational theories. The resulting self-consistent theory, which is in effect a Rastall-type modification of the Einstein theory, exhibits nonconservation of momentum, yet agrees with all experimental limits known to date within the PPN framework

  15. Treatment Options in Kleptomania

    Directory of Open Access Journals (Sweden)

    Lut Tamam

    2009-06-01

    Full Text Available Kleptomania is a rare disorder with inability or great difficulty in resisting impulses of stealing. People with this disorder are compelled to steal things, generally things of little or no value. This disorder usually begins during puberty and usually last until late adulthood; in some cases lasts throughout the person's life. People with this disorder are likely to have a comorbid conditions like mood disorders. Individuals with the disorder are usually referred for treatment due to the comorbid psychiatric complaints rather than kleptomanic behaviour per se. On the other hand literature lacks of studies about the treatment of kleptomania. A wide variety of therapeutic strategies have been proposed for its treatment, among them psychoanalytic oriented psychotherapy, behavioral therapy and pharmacotherapy. Some medications that are used for people diagnosed with kleptomania are selective serotonin reuptake inhibitors, mood stabilizers and opioid antagonists. There is evidence from numerous case studies that a variety of cognitive behavioral therapy techniques are effective in the treatment of kleptomania and it is favored over other approaches such as psychodynamic and psychoanalytic therapies. Studies to date suggest that cognitive behavioral therapy when used in combination with medication, is more effective than medication alone.

  16. Separating the agony from ecstasy: R(-)-3,4-methylenedioxymethamphetamine has prosocial and therapeutic-like effects without signs of neurotoxicity in mice.

    Science.gov (United States)

    Curry, Daniel W; Young, Matthew B; Tran, Andrew N; Daoud, Georges E; Howell, Leonard L

    2018-01-01

    S,R(+/-)-3,4-methylenedioxymethamphetamine (SR-MDMA) is an amphetamine derivative with prosocial and putative therapeutic effects. Ongoing clinical trials are investigating it as a treatment for post-traumatic stress disorder (PTSD) and other conditions. However, its potential for adverse effects such as hyperthermia and neurotoxicity may limit its clinical viability. We investigated the hypothesis that one of the two enantiomers of SR-MDMA, R-MDMA, would retain the prosocial and therapeutic effects but with fewer adverse effects. Using male Swiss Webster and C57BL/6 mice, the prosocial effects of R-MDMA were measured using a social interaction test, and the therapeutic-like effects were assessed using a Pavlovian fear conditioning and extinction paradigm relevant to PTSD. Locomotor activity and body temperature were tracked after administration, and neurotoxicity was evaluated post-mortem. R-MDMA significantly increased murine social interaction and facilitated extinction of conditioned freezing. Yet, unlike racemic MDMA, it did not increase locomotor activity, produce signs of neurotoxicity, or increase body temperature. A key pharmacological difference between R-MDMA and racemic MDMA is that R-MDMA has much lower potency as a dopamine releaser. Pretreatment with a selective dopamine D1 receptor antagonist prevented SR-MDMA-induced hyperthermia, suggesting that differential dopamine signaling may explain some of the observed differences between the treatments. Together, these results indicate that the prosocial and therapeutic effects of SR-MDMA may be separable from the stimulant, thermogenic, and potential neurotoxic effects. To what extent these findings translate to humans will require further investigation, but these data suggest that R-MDMA could be a more viable therapeutic option for the treatment of PTSD and other disorders for which SR-MDMA is currently being investigated. Copyright © 2017 Elsevier Ltd. All rights reserved.

  17. Analysis of Options Contract, Option Pricing in Agricultural Products

    Directory of Open Access Journals (Sweden)

    H. Tamidy

    2016-03-01

    Full Text Available Introduction: Risk is an essential component in the production and sale of agricultural products. Due to the nature of agricultural products, the people who act in this area including farmers and businesspersons encounter unpredictable fluctuations of prices. On the other hand, the firms that process agricultural products also face fluctuation of price of agricultural inputs. Given that the Canola is considered as one of the inputs of product processing factories, control of unpredictable fluctuations of the price of this product would increase the possibility of correct decision making for farmers and managers of food processing industries. The best available tool for control and management of the price risk is the use of future markets and options. It is evident that the pricing is the main pillar in every trade. Therefore, offering a fair price for the options will be very important. In fact, options trading in the options market create cost insurance stopped. In this way, which can reduce the risks of deflation created in the future, if the person entitled to the benefits of the price increase occurs in the future. Unlike the futures, market where the seller had to deliver the product on time, in the options market, there is no such compulsion. In addition, this is one of the strengths of this option contract, because if there is not enough product for delivery to the futures market as result of chilling, in due course, the farmers suffer, but in the options market there will be a loss. In this study, the setup options of rape, as a product, as well as inputs has been paid for industry. Materials and Methods: In this section. The selection criteria of the disposal of asset base for valuation of European put options and call option is been introduced. That for obtain this purpose, some characteristics of the goods must considered: 1-Unpredictable fluctuations price of underlying asset 2 -large underlying asset cash market 3- The possibility

  18. Bounds for Asian basket options

    Science.gov (United States)

    Deelstra, Griselda; Diallo, Ibrahima; Vanmaele, Michèle

    2008-09-01

    In this paper we propose pricing bounds for European-style discrete arithmetic Asian basket options in a Black and Scholes framework. We start from methods used for basket options and Asian options. First, we use the general approach for deriving upper and lower bounds for stop-loss premia of sums of non-independent random variables as in Kaas et al. [Upper and lower bounds for sums of random variables, Insurance Math. Econom. 27 (2000) 151-168] or Dhaene et al. [The concept of comonotonicity in actuarial science and finance: theory, Insurance Math. Econom. 31(1) (2002) 3-33]. We generalize the methods in Deelstra et al. [Pricing of arithmetic basket options by conditioning, Insurance Math. Econom. 34 (2004) 55-57] and Vanmaele et al. [Bounds for the price of discrete sampled arithmetic Asian options, J. Comput. Appl. Math. 185(1) (2006) 51-90]. Afterwards we show how to derive an analytical closed-form expression for a lower bound in the non-comonotonic case. Finally, we derive upper bounds for Asian basket options by applying techniques as in Thompson [Fast narrow bounds on the value of Asian options, Working Paper, University of Cambridge, 1999] and Lord [Partially exact and bounded approximations for arithmetic Asian options, J. Comput. Finance 10 (2) (2006) 1-52]. Numerical results are included and on the basis of our numerical tests, we explain which method we recommend depending on moneyness and time-to-maturity.

  19. A case for reviving the nuclear option

    International Nuclear Information System (INIS)

    Smith, S.H. Jr.

    1991-01-01

    The US simply cannot afford to ignore an energy source that provides the economic, environmental, and strategic benefits that nuclear power has provided over the past three decades. Compared to the mix of coal, oil, and gas that would have been used to generate electricity in its absence, nuclear power has saved American consumers almost $5 billion in electricity charges since 1973; has cut annual SO 2 emissions by 5 million tons, NO x emissions by 2 million tons, and CO 2 emissions by 128 million tons; and has reduced annual oil imports by 270 million barrels. Indications are that the new advanced design reactors presently under development will be able to provide consumers with competitively priced electricity for decades to come. However, political issues, not technical ones, stand in the way. The industry is doing its part to make nuclear energy a viable option. But the industry cannot do it alone. Universities, environmental groups, political organizations, and others also have important roles to play

  20. Evaluation of the confinement option for LMRs

    International Nuclear Information System (INIS)

    Himes, D.A.; Stepnewski, D.D.; Franz, G.R.

    1985-12-01

    The coolant in liquid metal cooled reactors operates at low pressures and therefore contains relatively little stored energy compared to LWR systems. This presents the possibility of using a more conventional building for containment coupled with a confinement system which vents the internal volume of the building through a filter/scrubber. The confinement system would be designed to keep the internal pressure in the containment near atmospheric thereby minimizing unfiltered leakage. The principal benefits of such an arrangement would be lower capital cost and less stringent leaktightness requirements permitting simpler and less disruptive testing. In conclusion, the confinement system assumed here would reduce consequences to the public of an LMR HCDA to acceptable levels. However control room doses are unacceptable due to the noble gas concentration inside the control room. A confinement system is therefore a viable design option for LMR's provided means are included for keeping noble gases out of the control room. Such means are readily available including, for example, selectable remote air intakes, an exhaust stack, or a noble gas filter. Probably the most satisfactory alternative would be a large cryogenic filter on the confinement system exhaust

  1. Nuclear Option in Korea

    International Nuclear Information System (INIS)

    Han, K. I.

    2002-01-01

    With sixteen(16) operating nuclear units in Korea, the share of nuclear power generation reached 41% of the total electric power generation as of December 2000. A prediction is that it would further increase to 44.5% by year 2015 according to the national long term power development plan. Four units are currently under construction with 6 more units in order. With little domestic energy resource and increasing energy demand to support national economic growth, Korea has chosen nuclear power as one of the major energy sources to ensure stable power supply and to promote energy self-sufficiency. It has been recognized that nuclear power in Korea is not a selective option but rather a necessity. The Korean nuclear power development started with construction of a 600 MWe size reactor that was designed and constructed by foreign vendors. As the national grid capacity became larger, the size of nuclear units increased to 1000 MWe class. In the mean time, the need for nuclear technology self-reliance grew not only in operation and maintenance but also in construction, manufacturing and design. For this, a nuclear technology self-reliance program has been embarked with the support of the Government and utility, and the 1000 MWe class KSNP(Korean Standard Nuclear Power Plant) has been developed. The KSNPs are currently being designed, manufactured, constructed and operated by relevant Korean entities themselves. To fit into a larger capacity national grid and also to improve nuclear economic competitiveness, the 1400 MWe class KNGR(Korean Next Generation Reactor) design has been developed uprating the 1000 MWe KSNP design. Its construction project is currently under contract negotiation, and is planned to be finished by 2010. In the mean time, to be ready for future electric power market deregulation, the 600 MWe class small KSNP design is being developed downsizing the KSNP. A modular small size reactor, SMART(System Integrated Modular Advanced Reactor) is also being

  2. Aluminum industry options paper

    International Nuclear Information System (INIS)

    1999-10-01

    In 1990, Canada's producers of aluminum (third largest in the world) emitted 10 million tonnes of carbon dioxide and equivalent, corresponding to 6.4 tonnes of greenhouse gas intensity per tonne of aluminum. In 2000, the projection is that on a business-as-usual (BAU) basis Canadian producers now producing 60 per cent more aluminum than in 1990, will emit 10.7 million tonnes of carbon dioxide and equivalent, corresponding to a GHG intensity of 4.2 tonnes per tonne of aluminum. This improvement is due to production being based largely on hydro-electricity, and partly because in general, Canadian plants are modern, with technology that is relatively GHG-friendly. The Aluminum Association of Canada estimates that based on anticipated production, and under a BAU scenario, GHG emissions from aluminum production will rise by 18 per cent by 2010 and by 30 per cent by 2020. GHG emissions could be reduced below the BAU forecast first, by new control and monitoring systems at some operations at a cost of $4.5 to 7.5 million per smelter. These systems could reduce carbon dioxide equivalent emissions by 0.8 million tonnes per year. A second alternative would require installation of breaker feeders which would further reduce perfluorocarbon (PFC) emissions by 0.9 million tonnes of carbon dioxide equivalent. Cost of the breakers feeders would be in the order of $200 million per smelter. The third option calls for the the shutting down of some of the smelters with older technology by 2015. In this scenario GHG emissions would be reduced by 2010 by 0.8 million tonnes per year of carbon dioxide equivalent. However, the cost in this case would be about $1.36 billion. The industry would support measures that would encourage the first two sets of actions, which would produce GHG emissions from aluminum production in Canada of about 10.2 million tonnes per year of carbon dioxide equivalent, or about two per cent above 1990 levels with double the aluminum production of 1990. Credit for

  3. Therapeutic Vaccination for HPV Induced Cervical Cancers

    Directory of Open Access Journals (Sweden)

    Joeli A. Brinkman

    2007-01-01

    Full Text Available Cervical Cancer is the second leading cause of cancer–related deaths in women worldwide and is associated with Human Papillomavirus (HPV infection, creating a unique opportunity to treat cervical cancer through anti-viral vaccination. Although a prophylactic vaccine may be available within a year, millions of women, already infected, will continue to suffer from HPV-related disease, emphasizing the need to develop therapeutic vaccination strategies. A majority of clinical trials examining therapeutic vaccination have shown limited efficacy due to examining patients with more advanced-stage cancer who tend to have decreased immune function. Current trends in clinical trials with therapeutic agents examine patients with pre-invasive lesions in order to prevent invasive cervical cancer. However, longer follow-up is necessary to correlate immune responses to lesion regression. Meanwhile, preclinical studies in this field include further exploration of peptide or protein vaccination, and the delivery of HPV antigens in DNA-based vaccines or in viral vectors. As long as pre-clinical studies continue to advance, the prospect of therapeutic vaccination to treat existing lesions seem good in the near future. Positive consequences of therapeutic vaccination would include less disfiguring treatment options and fewer instances of recurrent or progressive lesions leading to a reduction in cervical cancer incidence.

  4. [Psychological aspects of pruritus and therapy options].

    Science.gov (United States)

    Stumpf, A; Schut, C; Schneider, G

    2016-08-01

    Besides biological factors, which cause or influence chronic pruritus, more and more attention has recently also been paid to psychological and psychoneuroimmunological factors which uphold the symptom. This review article gives an overview of the state of research regarding psychological and psychoneuroimmunological factors and the resulting therapeutic options. The article is based on a literature search in the PubMed database. Under experimental conditions, pruritus can be induced by verbal instructions and modulated by placebo and nocebo effects. Stressful life events can also induce pruritus or its exacerbation. This can also be demonstrated on a cellular level. The knowledge that pruritus intensity is modulated by cognitions, behavioral factors, and stress is important for the development and application of psychological interventions. More research should be done regarding psychological interventions in the treatment of chronic itch and they should be applied clinically more often.

  5. The current treatment options for epilepsy

    International Nuclear Information System (INIS)

    Sykora, P.; Svecova, L.

    2014-01-01

    Epilepsy is the most prevalent chronic brain disease manifesting with epileptic seizures. Epilepsy itself is not one nosological entity, it rather includes several diseases with various etiology, clinics, course and therapy. Antiepileptic therapy aims seizure freedom without affecting psychical and physical functions. The therapy is in first line pharmacological. The choice of antiepileptic drug depends not only on the seizure phenomenology, but also on the respective type of epilepsy syndrome. Most patients achieve seizure freedom or at least significant seizure frequency reduction. In 20-30% of the patients is the pharmacotherapy ineffective. In these cases of refractory epilepsy therapeutical options include epilepsy surgery, vagal stimulation or ketogenic diet. Despite recent advances in the diagnostics and therapy, epilepsy remains a serious medical and social issue. (author)

  6. Non-viable antagonist cells are associated with reduced biocontrol performance by viable cells of the yeast Papiliotrema flavescens against Fusarium head blight of wheat.

    Science.gov (United States)

    Microbially-based plant disease control products have achieved commercial market success, but the efficacy of such biocontrol products is sometimes deemed inconsistent. Improper processing of harvested microbial biomass or long-term storage can reduce the proportion of viable cells and necessitate t...

  7. Pain and endometriosis: Etiology, impact, and therapeutics

    Directory of Open Access Journals (Sweden)

    Robert N. Taylor

    2012-12-01

    Full Text Available The association of pain and endometriosis was recognized with the first definitive published reports of this disorder. Unfortunately, the precise etiologies and pathways leading to nociception and pain symptoms in endometriosis remain poorly understood, and as a result, effective therapeutic interventions are lacking with consequent profound effects on affected women’s quality of life. In this opinion paper we summarize selected proceedings presented at the 28th Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE in Istanbul, Turkey, and review the clinical and translational evidence of chronic pain, neurogenesis, and the pernicious impact of dyspareunia on women with symptomatic endometriosis. The effectiveness of medical treatments is critically assessed and the findings indicate that good therapeutic options are available with extant medications effective in some sub-groups of women with endometriosis, many of which are affordable globally. Nevertheless, new management strategies and drugs need to be developed to increase the options of all afflicted women to minimize and ideally eradicate painful symptoms of endometriosis. However, only by elucidating distinctions among sub-groups with specific symptoms, suggesting different mechanisms, are we likely to derive truly successful therapeutic strategies.

  8. The Amnesiac Lookback Option: Selectively Monitored Lookback Options and Cryptocurrencies

    Directory of Open Access Journals (Sweden)

    Ho-Chun Herbert Chang

    2018-05-01

    Full Text Available This study proposes a strategy to make the lookback option cheaper and more practical, and suggests the use of its properties to reduce risk exposure in cryptocurrency markets through blockchain enforced smart contracts and correct for informational inefficiencies surrounding prices and volatility. This paper generalizes partial, discretely-monitored lookback options that dilute premiums by selecting a subset of specified periods to determine payoff, which we call amnesiac lookback options. Prior literature on discretely-monitored lookback options considers the number of periods and assumes equidistant lookback periods in pricing partial lookback options. This study by contrast considers random sampling of lookback periods and compares resulting payoff of the call, put and spread options under floating and fixed strikes. Amnesiac lookbacks are priced with Monte Carlo simulations of Gaussian random walks under equidistant and random periods. Results are compared to analytic and binomial pricing models for the same derivatives. Simulations show diminishing marginal increases to the fair price as the number of selected periods is increased. The returns correspond to a Hill curve whose parameters are set by interest rate and volatility. We demonstrate over-pricing under equidistant monitoring assumptions with error increasing as the lookback periods decrease. An example of a direct implication for event trading is when shock is forecasted but its timing uncertain, equidistant sampling produces a lower error on the true maximum than random choice. We conclude that the instrument provides an ideal space for investors to balance their risk, and as a prime candidate to hedge extreme volatility. We discuss the application of the amnesiac lookback option and path-dependent options to cryptocurrencies and blockchain commodities in the context of smart contracts.

  9. Current and future treatment options in osteoporosis.

    LENUS (Irish Health Repository)

    Brewer, Linda

    2012-02-01

    PURPOSE: The incidence of osteoporosis-related fractures will increase substantially over the coming decades as the population ages globally. This has important economic and public health implications, contributing substantially to morbidity and excess mortality in this population. METHODS: When prescribing for older patients the effectiveness profile of drugs needs to be balanced against their tolerability in individual patients. RESULTS: Currently we have good anti-fracture data to support the use of many available anti-resorptive and anabolic drugs including bisphosphonates, strontium ranelate and recombinant human parathyroid hormone. We also have evidence to demonstrate the importance of calcium and vitamin D repletion in these patients. However, in recent years our understanding of normal bone physiology and the mechanisms underlying the development of osteoporosis has significantly advanced and this has led to the development of new therapies. Novel agents, particularly denosumab, but also inhibitors of cathepsin K and anabolic agents that act on Wnt signalling, will increase the therapeutic options for clinicians in the coming years. CONCLUSION: This review discusses the evidence supporting the use of currently available treatment options for osteoporosis and potential future advances in drug therapy. Particular consideration should be given when prescribing for certain older patients who have issues with compliance or tolerance and also in those with co-morbidities or levels of frailty that may restrict the choice of therapy. Understanding the evidence for the benefit and possible harm of osteoporosis treatments is critical to appropriate management of this patient population.

  10. Progressive Supranuclear Palsy and Corticobasal Degeneration: Pathophysiology and Treatment Options

    OpenAIRE

    Lamb, Ruth; Rohrer, Jonathan D.; Lees, Andrew J.; Morris, Huw R.

    2016-01-01

    Opinion statement There are currently no disease-modifying treatments for progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD), and no approved pharmacological or therapeutic treatments that are effective in controlling their symptoms. The use of most pharmacological treatment options are based on experience in other disorders or from non-randomized historical controls, case series, or expert opinion. Levodopa may provide some improvement in symptoms of Parkinsonism (specif...

  11. Progressive Supranuclear Palsy and Corticobasal Degeneration: Pathophysiology and Treatment Options

    OpenAIRE

    Lamb, R.; Rohrer, J. D.; Lees, A. J.; Morris, H. R.

    2016-01-01

    There are currently no disease-modifying treatments for progressive supranuclear palsy (PSP) or corticobasal degeneration (CBD), and no approved pharmacological or therapeutic treatments that are effective in controlling their symptoms. The use of most pharmacological treatment options are based on experience in other disorders or from non-randomized historical controls, case series, or expert opinion. Levodopa may provide some improvement in symptoms of Parkinsonism (specifically bradykinesi...

  12. Exotic Options: a Chooser Option and its Pricing

    Directory of Open Access Journals (Sweden)

    Raimonda Martinkutė-Kaulienė

    2012-12-01

    Full Text Available Financial instruments traded in the markets and investors’ situation in such markets are getting more and more complex. This leads to more complex derivative structures used for hedging that are harder to analyze and which risk is harder managed. Because of the complexity of these instruments, the basic characteristics of many exotic options may sometimes be not clearly understood. Most scientific studies have been focused on developing models for pricing various types of exotic options, but it is important to study their unique characteristics and to understand them correctly in order to use them in proper market situations. The paper examines main aspects of options, emphasizing the variety of exotic options and their place in financial markets and risk management process. As the exact valuation of exotic options is quite difficult, the article deals with the theoretical and practical aspects of pricing of chooser options that suggest a broad range of usage and application in different market conditions. The calculations made in the article showed that the price of the chooser is closely correlated with the choice time and low correlated with its strike price. So the first mentioned factor should be taken into consideration when making appropriate hedging and investing decisions.

  13. Mathematical modelling of the viable epidermis: impact of cell shape and vertical arrangement

    KAUST Repository

    Wittum, Rebecca; Naegel, Arne; Heisig, Michael; Wittum, Gabriel

    2017-01-01

    In-silico methods are valuable tools for understanding the barrier function of the skin. The key benefit is that mathematical modelling allows the interplay between cell shape and function to be elucidated. This study focuses on the viable (living

  14. Solar System constraints on a cosmologically viable f(R) theory

    Energy Technology Data Exchange (ETDEWEB)

    Bisabr, Yousef, E-mail: y-bisabr@srttu.ed [Department of Physics, Shahid Rajaee Teacher Training University, Lavizan, Tehran 16788 (Iran, Islamic Republic of)

    2010-01-18

    Recently, a model f(R) theory is proposed (Miranda et al. (2009)) which is cosmologically viable and distinguishable from LAMBDACDM. We use chameleon mechanism to investigate viability of the model in terms of Solar System experiments.

  15. Establishment of a Viable Population of Red-Cockaded Woodpeckers at the Savannah River Site

    International Nuclear Information System (INIS)

    Johnston, P.A.

    2002-01-01

    Report on program's objective to restore viable population of Red-cockaded woodpecker at SRS. Several management strategies were used to promote population expansion of Red-cockaded woodpecker and reduction of interspecific competition with Red-Cockaded woodpecker

  16. Solar System constraints on a cosmologically viable f(R) theory

    International Nuclear Information System (INIS)

    Bisabr, Yousef

    2010-01-01

    Recently, a model f(R) theory is proposed (Miranda et al. (2009)) which is cosmologically viable and distinguishable from ΛCDM. We use chameleon mechanism to investigate viability of the model in terms of Solar System experiments.

  17. Entry of Vibrio harveyi and Vibrio fischeri into the viable but nonculturable state

    Digital Repository Service at National Institute of Oceanography (India)

    Ramaiah, Neelam; Ravel, J.; Straube, W.L.; Hill, R.T.; Colwell, R.R.

    , direct viable counts, actively respiring cell counts, nucleoid-containing cell counts, and total counts were determined. V. harveyi incubated at 22 degrees C nutrient-limited artificial seawater (ASW) became nonculturable after approximately 62 and 45 d...

  18. Improved identification of viable myocardium using second harmonic imaging during dobutamine stress echocardiography

    NARCIS (Netherlands)

    F. Sozzi (Fabiola); D. Poldermans (Don); J.J. Bax (Jeroen); A. Elhendy (Abdou); E.C. Vourvouri (Eleni); R. Valkema (Roelf); J. de Sutter; A.F.L. Schinkel (Arend); A. Borghetti; J.R.T.C. Roelandt (Jos)

    2001-01-01

    textabstractOBJECTIVE: To determine whether, compared with fundamental imaging, second harmonic imaging can improve the accuracy of dobutamine stress echocardiography for identifying viable myocardium, using nuclear imaging as a reference. PATIENTS: 30 patients with chronic left

  19. Social and Business Entrepreneurship as Career Options for University Students in the United Arab Emirates: The Drive-Preparedness Gap

    Science.gov (United States)

    Ashour, Sanaa

    2016-01-01

    With limited employment opportunities, entrepreneurship is becoming a viable option to combat unemployment. This study explores undergraduate students' attitudes towards business and social entrepreneurship in the United Arab Emirates (UAE), assuming that the lack of awareness among students regarding social entrepreneurship and the lack of…

  20. Novel treatment options in depression and psychosis

    Directory of Open Access Journals (Sweden)

    Ceskova E

    2018-03-01

    Full Text Available Eva Ceskova, Petr Silhan Department of Psychiatry, University Hospital Ostrava, Ostrava, Czech Republic Abstract: In spite of tremendous development in central nervous system research, current treatment is suboptimal, especially in severe mental disorders. In medicine, there are two main methods of improving the health care provided: seeking new treatment procedures and perfecting (optimizing the existing ones. Optimization of treatment includes not only practical tools such as therapeutic drug monitoring but also implementation of general trends in the clinical practice. New pharmacological options include new more sophisticated forms of monoaminergic drugs, old drugs rediscovered on the base of a better understanding of pathophysiology of mental illnesses, and drugs aimed at new treatment targets. In depression, treatment resistance to antidepressive pharmacotherapy represents one of the most important clinical challenges. Switching to monotherapy with new multimodal/multifunctional antidepressants and augmentation with new atypical antipsychotics (aripiprazole and brexpiprazole may be promising options. Further, current evidence supports utility and safety of adjunctive treatment of nutraceuticals. Novel approaches being studied include ketamine and opioids. Recent advances in technology and emerging knowledge about dysfunctional brain circuits and neuroplasticity have led to the development of different new neuromodulation techniques usually used as add-on therapy. Antipsychotics are still the cornerstone of the current treatment of schizophrenia. Two new partial dopamine agonists, brexpiprazole and cariprazine, are now available in addition to aripiprazole. Although the mechanisms of action are similar, the two agents differ in terms of their pharmacodynamic profiles. Further, two new formulations of long-acting injections of second-generation antipsychotics (aripiprazole lauroxil and 3-month paliperidone palmitate were introduced into

  1. 48 CFR 552.217-71 - Notice Regarding Option(s).

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Notice Regarding Option(s... Notice Regarding Option(s). As prescribed in 517.208(b), insert the following provision: Notice Regarding Option(s) (NOV 1992) The General Services Administration (GSA) has included an option to [Insert...

  2. Treatment options for diabetic foot osteomyelitis.

    Science.gov (United States)

    Senneville, Eric; Robineau, Olivier

    2017-06-01

    Diabetic foot osteomyelitis therapeutical options are based on antibiotic therapy and surgical resection of the infected bone(s). Surgical and medical approaches of patients suffering from a diabetic foot osteomyelitis do not oppose but are complementary and need to be discussed as a tailored manner. Areas covered: The aim of the present article is to discuss data issued from the most recent guidelines of the Infectious Diseases Society of America and the International Working Group on the Diabetic Foot on the management of the diabetic foot infection and from a search in the current literature using the terms diabetic foot osteomyelitis and treatment/therapy/therapeutical in both PubMed and Medline, restricted to the last five years. Expert opinion: Surgical removal of the entire infected bone(s) has been considered in the past as the standard treatment but medical approach of these patients has now proven efficacy in selected situations. The current emergence of bacteria, especially among Gram negative rods, resistant to almost all the available antibiotics gradually augments the complexity of the management of these patients and is likely to decrease the place of the medical approach and to worsen the outcome of these infections in the next future.

  3. Pelvic radiation disease: Updates on treatment options

    Science.gov (United States)

    Frazzoni, Leonardo; La Marca, Marina; Guido, Alessandra; Morganti, Alessio Giuseppe; Bazzoli, Franco; Fuccio, Lorenzo

    2015-01-01

    Pelvic cancers are among the most frequently diagnosed neoplasms and radiotherapy represents one of the main treatment options. The irradiation field usually encompasses healthy intestinal tissue, especially of distal large bowel, thus inducing gastrointestinal (GI) radiation-induced toxicity. Indeed, up to half of radiation-treated patients say that their quality of life is affected by GI symptoms (e.g., rectal bleeding, diarrhoea). The constellation of GI symptoms - from transient to long-term, from mild to very severe - experienced by patients who underwent radiation treatment for a pelvic tumor have been comprised in the definition of pelvic radiation disease (PRD). A correct and evidence-based therapeutic approach of patients experiencing GI radiation-induced toxicity is mandatory. Therapeutic non-surgical strategies for PRD can be summarized in two broad categories, i.e., medical and endoscopic. Of note, most of the studies have investigated the management of radiation-induced rectal bleeding. Patients with clinically significant bleeding (i.e., causing chronic anemia) should firstly be considered for medical management (i.e., sucralfate enemas, metronidazole and hyperbaric oxygen); in case of failure, endoscopic treatment should be implemented. This latter should be considered the first choice in case of acute, transfusion requiring, bleeding. More well-performed, high quality studies should be performed, especially the role of medical treatments should be better investigated as well as the comparative studies between endoscopic and hyperbaric oxygen treatments. PMID:26677440

  4. Advancing treatment options for chronic idiopathic constipation.

    Science.gov (United States)

    Quigley, Eamonn M M; Neshatian, Leila

    2016-01-01

    Chronic constipation is a global problem affecting all ages and associated with considerable morbidity and significant financial burden for society. Though formerly defined on the basis of a single symptom, infrequent defecation; constipation is now viewed as a syndrome encompassing several complaints such as difficulty with defecation, a sense of incomplete evacuation, hard stools, abdominal discomfort and bloating. The expanded concept of constipation has inevitably led to a significant change in outcomes in clinical trials, as well as in patient expectations from new therapeutic interventions. The past decades have also witnessed a proliferation in therapeutic targets for new agents. Foremost among these have been novel prokinetics, a new category, prosecretory agents and innovative approaches such as inhibitors of bile salt transport. In contrast, relatively few effective therapies exist for the management of those anorectal and pelvic floor problems that result in difficult defecation. Though constipation is a common and often troublesome disorder, many of those affected can resolve their symptoms with relatively simple measures. For those with more resistant symptoms a number of novel, effective and safe options now exist. Those with defecatory difficulty (anismus, pelvic floor dysfunction) continue to represent a significant management challenge.

  5. Quantitative assessment of viable Cryptosporidium parvum load in commercial oysters (Crassostrea virginica) in the Chesapeake Bay.

    Science.gov (United States)

    Graczyk, Thaddeus K; Lewis, Earl J; Glass, Gregory; Dasilva, Alexandre J; Tamang, Leena; Girouard, Autumn S; Curriero, Frank C

    2007-01-01

    The epidemiological importance of increasing reports worldwide on Cryptosporidium contamination of oysters remains unknown in relation to foodborne cryptosporidiosis. Thirty market-size oysters (Crassostrea virginica), collected from each of 53 commercial harvesting sites in Chesapeake Bay, MD, were quantitatively tested in groups of six for Cryptosporidium sp. oocysts by immunofluorescent antibody (IFA). After IFA analysis, the samples were retrospectively retested for viable Cryptosporidium parvum oocysts by combined fluorescent in situ hybridization (FISH) and IFA. The mean cumulative numbers of Cryptosporidium sp. oocysts in six oysters (overall, 42.1+/-4.1) were significantly higher than in the numbers of viable C. parvum oocysts (overall, 28.0+/-2.9). Of 265 oyster groups, 221 (83.4%) contained viable C. parvum oocysts, and overall, from 10-32% (mean, 23%) of the total viable oocysts were identified in the hemolymph as distinct from gill washings. The amount of viable C. parvum oocysts was not related to oyster size or to the level of fecal coliforms at the sampling site. This study demonstrated that, although oysters are frequently contaminated with oocysts, the levels of viable oocysts may be too low to cause infection in healthy individuals. FISH assay for identification can be retrospectively applied to properly stored samples.

  6. Spatiotemporal Dynamics of Total Viable Vibrio spp. in a NW Mediterranean Coastal Area.

    Science.gov (United States)

    Girard, Léa; Peuchet, Sébastien; Servais, Pierre; Henry, Annabelle; Charni-Ben-Tabassi, Nadine; Baudart, Julia

    2017-09-27

    A cellular approach combining Direct Viable Counting and Fluorescent In Situ Hybridization using a one-step multiple-probe technique and Solid Phase Cytometry (DVC-FISH-SPC) was developed to monitor total viable vibrios and cover the detection of a large diversity of vibrios. FISH combined three probes in the same assay and targeted sequences located at different positions on the 16S rRNA of Vibrio and Aliivibrio members. We performed a 10-month in situ study to investigate the weekly dynamics of viable vibrios relative to culturable counts at two northwestern Mediterranean coastal sites, and identified the key physicochemical factors for their occurrence in water using a multivariate analysis. Total viable and culturable cell counts showed the same temporal pattern during the warmer season, whereas the ratios between both methods were inverted during the colder seasons (<15°C), indicating that some of the vibrio community had entered into a viable but non-culturable (VBNC) state. We confirmed that Seawater Surface Temperature explained 51-62% of the total variance in culturable counts, and also showed that the occurrence of viable vibrios is controlled by two variables, pheopigment (15%) and phosphate (12%) concentrations, suggesting that other unidentified factors play a role in maintaining viability.

  7. Option Pricing using Realized Volatility

    DEFF Research Database (Denmark)

    Stentoft, Lars Peter

    dynamics to be used for option pricing purposes in this framework, and we show that our model explains some of the mispricings found when using traditional option pricing models based on interdaily data. We then show explicitly that a Generalized Autoregressive Conditional Heteroskedastic model with Normal...... Inverse Gaussian distributed innovations is the corresponding benchmark model when only daily data is used. Finally, we perform an empirical analysis using stock options for three large American companies, and we show that in all cases our model performs significantly better than the corresponding...... benchmark model estimated on return data alone. Hence the paper provides evidence on the value of using high frequency data for option pricing purposes....

  8. Treatment Option Overview (Ewing Sarcoma)

    Science.gov (United States)

    ... Ewing Sarcoma Treatment Osteosarcoma Treatment Research Ewing Sarcoma Treatment (PDQ®)–Patient Version General Information About Ewing Sarcoma ... started or in another part of the body. Treatment Option Overview Key Points There are different types ...

  9. Treatment Option Overview (Kaposi Sarcoma)

    Science.gov (United States)

    ... Treatment Childhood Vascular Tumors Treatment Research Kaposi Sarcoma Treatment (PDQ®)–Patient Version General Information About Kaposi Sarcoma ... Certain factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment ...

  10. 77 FR 25319 - Commodity Options

    Science.gov (United States)

    2012-04-27

    ..., merchants, SDs, commodity funds, futures industry organizations, academics and think tanks, a U.S... particular (i.e., optionality in a contract settling by physical delivery that is used to meet varying demand...

  11. Antihistamines: Understanding Your OTC Options

    Science.gov (United States)

    ... CorrectlyPain Relievers: Understanding Your OTC OptionsAntacids and Acid Reducers: OTC Relief for Heartburn and Acid RefluxOTC Cough ... Loss and Diet Plans Nutrients and Nutritional Info Sugar and Sugar Substitutes Exercise and Fitness Exercise Basics ...

  12. FS65 Disposition Option Report

    Energy Technology Data Exchange (ETDEWEB)

    Wenz, Tracy R. [Los Alamos National Lab. (LANL), Los Alamos, NM (United States)

    2015-09-25

    This report outlines the options for dispositioning the MOX fuel stored in FS65 containers at LANL. Additional discussion regarding the support equipment for loading and unloading the FS65 transport containers is included at the end of the report.

  13. Essential Tremor (ET): Surgical Options

    Science.gov (United States)

    ... option for severe depression, epilepsy, Tourette’s syndrome, stroke, addiction, and dementia. Top Focused Ultrasound Thalamotomy The FDA ... ultrasound but in a very different way. This technology uses multiple beams of sound focused in on ...

  14. Perpetual American options within CTRWs

    Science.gov (United States)

    Montero, Miquel

    2008-06-01

    Continuous-time random walks are a well suited tool for the description of market behaviour at the smallest scale: the tick-to-tick evolution. We will apply this kind of market model to the valuation of perpetual American options: derivatives with no maturity that can be exercised at any time. Our approach leads to option prices that fulfill financial formulas when canonical assumptions on the dynamics governing the process are made, but it is still suitable for more exotic market conditions.

  15. Perpetual American options within CTRW's

    OpenAIRE

    Montero, Miquel

    2007-01-01

    Continuous-time random walks are a well suited tool for the description of market behaviour at the smallest scale: the tick-to-tick evolution. We will apply this kind of market model to the valuation of perpetual American options: derivatives with no maturity that can be exercised at any time. Our approach leads to option prices that fulfil financial formulas when canonical assumptions on the dynamics governing the process are made, but it is still suitable for more exotic market conditions.

  16. 48 CFR 570.401 - Renewal options.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 4 2010-10-01 2010-10-01 false Renewal options. 570.401... Requirements 570.401 Renewal options. (a) Exercise of options. Before exercising an option to renew, follow the... survey. Before exercising an option to renew a lease, review current market information to ensure the...

  17. Option Derivatives in Electricity Hedging

    Directory of Open Access Journals (Sweden)

    P. Pavlátka

    2010-01-01

    Full Text Available Despite the high volatility of electricity prices, there is still little demand for electricity power options, and the liquidity on the power exchanges of these power derivatives is quite low. One of the reasons is the uncertainty about how to evaluate these electricity options and about finding the right fair value of this product. Hedging of electricity is associated mainly with products such as futures and forwards. However, due to new trends in electricity trading and hedging, it is also useful to think more about options and the principles for working with them in hedging various portfolio positions and counterparties. We can quite often encounter a situation when we need to have a perfect hedge for our customer’s (end user consuming electricity portfolio, or we have to evaluate the volumetric risk (inability of a customer to predict consumption, which is very similar to selling options. Now comes the moment to compare the effects of using options or futures to hedge these open positions. From a practical viewpoint, the Black-Scholes prices appear to be the best available and the simplest method for evaluating option premiums, but there are some limitations that we have to consider.

  18. [Recurrent vulvovaginitis: diagnostic assessment and therapeutic management].

    Science.gov (United States)

    Ramírez-Santos, A; Pereiro, M; Toribio, J

    2008-04-01

    Recurrent vulvovaginitis is a common problem in clinical practice. Management is often complicated by a long history of inappropriate treatments based on tentative diagnoses after an incomplete diagnostic workup. We review the most common causes of recurrent vulvovaginitis; the appropriate steps with which to establish a diagnosis, from the medical history through to the additional tests needed; and, finally, the best therapeutic options. We will focus on infectious, irritant, allergic, and hormonal causes as the ones of most interest to the dermatologist. Given that infection is the most frequent cause of these processes and also a common reason for inopportune treatment, we will pay particular attention to infectious etiologies and their differential diagnosis.

  19. Dry eye syndrome. Etiological and therapeutic aspects.

    Science.gov (United States)

    Apostol, Silvia; Filip, M; Dragne, Carmen; Filip, A

    2003-01-01

    "Dry eye syndrome" is a common disorder of the tear film that results from inadequate tear production, excessive tear evaporation or abnormality in mucin or lipid components of the tear film. A number of 53 patients suffering from dry eye syndrome were followed up for a period of 18 months. The study group was heterogeneous, including a lot of conditions accompanied by dry eye syndrome: Syogren's syndrome, lupus erythematous, ocular rosacea, patients with systemic treatments with antidepressants, betablockers, diuretics, oral contraceptives, glaucomatous patients with topical beta-blockers, postmenopausal women, aging people, computer users and long-term contact lens wearers. The therapeutical options were dictated by the severity of the syndrome: substitution therapy, treatment of the underlying eyelid diseases, modifying of the environmental conditions and treatment of the complications in the most severe cases. The new pathological approach is innovative and it may provide a real therapeutical measure for this condition: topical A Cyclosporine and androgen drops.

  20. Meeting world energy needs. The economic and environmental aspects of the nuclear option

    International Nuclear Information System (INIS)

    Ward, D.P.; Chalpin, D.M.

    1994-01-01

    Tabulated capital, operating, and overall production costs for nuclear, coal, and gas-fuelled power show that nuclear power is a viable option for meeting the world's energy needs. The advantage of nuclear, otherwise limited to certain markets, is seen to be much greater when credit is taken for environmental factors, namely emissions of carbon dioxide and acidic gases by fossil-fuelled plants. 5 figs

  1. Expression of proposed implantation marker genes CDX2 and HOXB7 in the blastocyst does not distinguish viable from non-viable human embryos

    DEFF Research Database (Denmark)

    Kirkegaard, Kirstine; Hindkjær, Johnny Juhl; Ingerslev, Hans Jakob

    2012-01-01

    expression differs between viable and non-viable embryos in both human and non-humans, suggesting transcriptome analysis of trophectoderm (TE) as a novel method of improving embryo selection. Potential candidate marker genes have been identified with array studies on animal blastocysts. The aim of this study...... was to investigate the expression of selected genes in human blastocysts in relation to the outcome of implantation. Materials and methods: Embryos from 10 oatients undergoing in vitro fertilization treatment were included in the project. A single blastocyst was chosen for biopsy on the morning of day 5 after oocyte...... of 15 key genes associated with developmental competence in animals were evaluated in high quality human embryos with monogenic or chromosomal disorders from a pre-implantation genetic disorder program. Triplicate cDNA amplifications for quantitative (q) RT-PCR were performed using pre-designed gene...

  2. Imaging enabled platforms for development of therapeutics

    Science.gov (United States)

    Celli, Jonathan; Rizvi, Imran; Blanden, Adam R.; Evans, Conor L.; Abu-Yousif, Adnan O.; Spring, Bryan Q.; Muzikansky, Alona; Pogue, Brian W.; Finkelstein, Dianne M.; Hasan, Tayyaba

    2011-03-01

    Advances in imaging and spectroscopic technologies have enabled the optimization of many therapeutic modalities in cancer and noncancer pathologies either by earlier disease detection or by allowing therapy monitoring. Amongst the therapeutic options benefiting from developments in imaging technologies, photodynamic therapy (PDT) is exceptional. PDT is a photochemistry-based therapeutic approach where a light-sensitive molecule (photosensitizer) is activated with light of appropriate energy (wavelength) to produce reactive molecular species such as free radicals and singlet oxygen. These molecular entities then react with biological targets such as DNA, membranes and other cellular components to impair their function and lead to eventual cell and tissue death. Development of PDT-based imaging also provides a platform for rapid screening of new therapeutics in novel in vitro models prior to expensive and labor-intensive animal studies. In this study we demonstrate how an imaging platform can be used for strategizing a novel combination treatment strategy for multifocal ovarian cancer. Using an in vitro 3D model for micrometastatic ovarian cancer in conjunction with quantitative imaging we examine dose and scheduling strategies for PDT in combination with carboplatin, a chemotherapeutic agent presently in clinical use for management of this deadly form of cancer.

  3. Treatment Options by Stage (Pancreatic Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  4. Treatment Options by Stage (Esophageal Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  5. Treatment Options by Stage (Vulvar Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  6. Treatment Options by Stage (Penile Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  7. Treatment Options for Non-Hodgkin Lymphoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... lymphoma may come back as indolent lymphoma. Treatment Option Overview Key Points There are different types of ...

  8. Treatment Options for Adult Soft Tissue Sarcoma

    Science.gov (United States)

    ... reacts to the light. Certain factors affect treatment options and prognosis (chance of recovery). The treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  9. Treatment Options by Stage (Merkel Cell Carcinoma)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... common for Merkel cell carcinoma to recur. Treatment Option Overview Key Points There are different types of ...

  10. Treatment Options by Stage (Prostate Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  11. Treatment Options by Stage (Adrenocortical Carcinoma)

    Science.gov (United States)

    ... affect the prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  12. Treatment Options for Childhood Hodgkin Lymphoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... the lungs , liver , bones, or bone marrow . Treatment Option Overview Key Points There are different types of ...

  13. Treatment Options by Stage (Chronic Lymphocytic Leukemia)

    Science.gov (United States)

    ... examination under a microscope. Certain factors affect treatment options and prognosis (chance of recovery). Treatment options depend ... that does not get better with treatment. Treatment Option Overview Key Points There are different types of ...

  14. Treatment Options for Adult Hodgkin Lymphoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  15. Treatment Options for Hodgkin Lymphoma during Pregnancy

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  16. Treatment Option Overview (Chronic Lymphocytic Leukemia)

    Science.gov (United States)

    ... examination under a microscope. Certain factors affect treatment options and prognosis (chance of recovery). Treatment options depend ... that does not get better with treatment. Treatment Option Overview Key Points There are different types of ...

  17. Treatment Option Overview (Adult Soft Tissue Sarcoma)

    Science.gov (United States)

    ... reacts to the light. Certain factors affect treatment options and prognosis (chance of recovery). The treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  18. Hairy Cell Leukemia Treatment Option Overview

    Science.gov (United States)

    ... or a swollen spleen. Certain factors affect treatment options and prognosis (chance of recovery). The treatment options ... cell leukemia has not responded to treatment. Treatment Option Overview Key Points There are different types of ...

  19. Treatment Option Overview (Small Intestine Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  20. Treatment Option Overview (Adult Hodgkin Lymphoma)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  1. Treatment Option Overview (Merkel Cell Carcinoma)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... common for Merkel cell carcinoma to recur. Treatment Option Overview Key Points There are different types of ...

  2. Treatment Option Overview (Childhood Hodgkin Lymphoma)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... the lungs , liver , bones, or bone marrow . Treatment Option Overview Key Points There are different types of ...

  3. Treatment Option Overview (Small Cell Lung Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  4. Treatment Option Overview (Adult Acute Lymphoblastic Leukemia)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... marrow , or other parts of the body. Treatment Option Overview Key Points There are different types of ...

  5. Treatment Options for AIDS-Related Lymphoma

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... nervous system is not primary CNS lymphoma. Treatment Option Overview Key Points There are different types of ...

  6. Treatment Options for Adult Acute Lymphoblastic Leukemia

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... marrow , or other parts of the body. Treatment Option Overview Key Points There are different types of ...

  7. Treatment Options for Renal Cell Cancer

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  8. Treatment Options for Gastrointestinal Carcinoid Tumors

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... body. Has not gotten better with treatment. Treatment Option Overview Key Points There are different types of ...

  9. Treatment Options by Stage (Gastric Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... such as the liver or lymph nodes . Treatment Option Overview Key Points There are different types of ...

  10. Treatment Options by Stage (Thyroid Cancer)

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... or in other parts of the body. Treatment Option Overview Key Points There are different types of ...

  11. Treatment Options for Chronic Myelogenous Leukemia

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... of blast cells increases after a remission . Treatment Option Overview Key Points There are different types of ...

  12. Treatment Options for Adult Acute Myeloid Leukemia

    Science.gov (United States)

    ... factors affect prognosis (chance of recovery) and treatment options. The prognosis (chance of recovery ) and treatment options ... back in the blood or bone marrow . Treatment Option Overview Key Points There are different types of ...

  13. Therapeutic HIV Peptide Vaccine

    DEFF Research Database (Denmark)

    Fomsgaard, Anders

    2015-01-01

    Therapeutic vaccines aim to control chronic HIV infection and eliminate the need for lifelong antiretroviral therapy (ART). Therapeutic HIV vaccine is being pursued as part of a functional cure for HIV/AIDS. We have outlined a basic protocol for inducing new T cell immunity during chronic HIV-1...... infection directed to subdominant conserved HIV-1 epitopes restricted to frequent HLA supertypes. The rationale for selecting HIV peptides and adjuvants are provided. Peptide subunit vaccines are regarded as safe due to the simplicity, quality, purity, and low toxicity. The caveat is reduced immunogenicity...

  14. Efficient option valuation of single and double barrier options

    Science.gov (United States)

    Kabaivanov, Stanimir; Milev, Mariyan; Koleva-Petkova, Dessislava; Vladev, Veselin

    2017-12-01

    In this paper we present an implementation of pricing algorithm for single and double barrier options using Mellin transformation with Maximum Entropy Inversion and its suitability for real-world applications. A detailed analysis of the applied algorithm is accompanied by implementation in C++ that is then compared to existing solutions in terms of efficiency and computational power. We then compare the applied method with existing closed-form solutions and well known methods of pricing barrier options that are based on finite differences.

  15. PMA-Linked Fluorescence for Rapid Detection of Viable Bacterial Endospores

    Science.gov (United States)

    LaDuc, Myron T.; Venkateswaran, Kasthuri; Mohapatra, Bidyut

    2012-01-01

    The most common approach for assessing the abundance of viable bacterial endospores is the culture-based plating method. However, culture-based approaches are heavily biased and oftentimes incompatible with upstream sample processing strategies, which make viable cells/spores uncultivable. This shortcoming highlights the need for rapid molecular diagnostic tools to assess more accurately the abundance of viable spacecraft-associated microbiota, perhaps most importantly bacterial endospores. Propidium monoazide (PMA) has received a great deal of attention due to its ability to differentiate live, viable bacterial cells from dead ones. PMA gains access to the DNA of dead cells through compromised membranes. Once inside the cell, it intercalates and eventually covalently bonds with the double-helix structures upon photoactivation with visible light. The covalently bound DNA is significantly altered, and unavailable to downstream molecular-based manipulations and analyses. Microbiological samples can be treated with appropriate concentrations of PMA and exposed to visible light prior to undergoing total genomic DNA extraction, resulting in an extract comprised solely of DNA arising from viable cells. This ability to extract DNA selectively from living cells is extremely powerful, and bears great relevance to many microbiological arenas.

  16. Investigation of Removal Capacities of Biofilters for Airborne Viable Micro-Organisms

    Science.gov (United States)

    Soret, Rémi; Fanlo, Jean-Louis; Malhautier, Luc; Geiger, Philippe; Bayle, Sandrine

    2018-01-01

    New emerging issues appears regarding the possible aerosolization of micro-organisms from biofilters to the ambient air. Traditional bioaerosol sampling and cultural methods used in literature offer relative efficiencies. In this study, a new method revolving around a particle counter capable of detecting total and viable particles in real time was used. This counter (BioTrak 9510-BD) uses laser-induced fluorescence (LIF) technology to determine the biological nature of the particle. The concentration of viable particles was measured on two semi-industrial pilot scale biofilters in order to estimate the Removal Efficiency in viable particles (REvp) in stable conditions and to examine the influence of pollutant feeding and relative humidification of the gaseous effluent on the REvp. The REvp of biofilters reached near 80% and highlighted both the stability of that removal and the statistical equivalence between two identical biofilters. Pollutant deprivation periods of 12 h, 48 h and 30 days were shown to have no influence on the biofilters’ removal capacity, demonstrating the robustness and adaptation capacities of the flora. In contrast, a 90-day famine period turned the biofilters into emitters of viable particles. Finally, the humidification of the effluent was shown to negatively influence the removal capacity for viable particles, as drying off the air was shown to increase the REvp from 60 to 85%. PMID:29562709

  17. Lunar Cube Transfer Trajectory Options

    Science.gov (United States)

    Folta, David; Dichmann, Donald James; Clark, Pamela E.; Haapala, Amanda; Howell, Kathleen

    2015-01-01

    Numerous Earth-Moon trajectory and lunar orbit options are available for Cubesat missions. Given the limited Cubesat injection infrastructure, transfer trajectories are contingent upon the modification of an initial condition of the injected or deployed orbit. Additionally, these transfers can be restricted by the selection or designs of Cubesat subsystems such as propulsion or communication. Nonetheless, many trajectory options can b e considered which have a wide range of transfer duration, fuel requirements, and final destinations. Our investigation of potential trajectories highlights several options including deployment from low Earth orbit (LEO) geostationary transfer orbits (GTO) and higher energy direct lunar transfer and the use of longer duration Earth-Moon dynamical systems. For missions with an intended lunar orbit, much of the design process is spent optimizing a ballistic capture while other science locations such as Sun-Earth libration or heliocentric orbits may simply require a reduced Delta-V imparted at a convenient location along the trajectory.

  18. Option valuation for energy issues

    International Nuclear Information System (INIS)

    Ostertag, K.; Llerena, P.; Richard, A.

    2004-01-01

    In many industrial and economic situations, decision processes, both individual and collective, have to simultaneously face uncertainty and irreversibility of some kind. This is particularly valid for energy choices if they are linked to technological alternatives. The purpose of this book is to highlight specific aspects of these situations. This is done from the particular perspective of option valuation. The contributions to this book grew out of an international workshop on ''Option valuation in energy and environmental issues'' held at the Fraunhofer ISI in February 2003. This workshop brought together reseachers from energy economics, but also researchers working on option valuation in other empirical fields or with a more theoretical perspective. This is reflected in the organisation of the book, which starts with some theory-oriented contributions and subsequently presents more applied contributions in the field of energy economics with an extension to water infrastructure in the annex. (orig.)

  19. Accounting treatment of currency options

    Directory of Open Access Journals (Sweden)

    Prošić Danica

    2016-01-01

    Full Text Available Currency options are often used to mitigate currency risk resulting from corporate activities. Their implementation can be complex, and there could be problems if the essential elements and principles are not fully understood. Although they are not the simplest financial products, currency options are interesting and useful to those who are trying to make a step forward in the area of currency risk management. This paper aims to present the general principles and specifics of accounting records and valuation of currency options used for hedging against risk. It is a complex process which, in addition to numerous conditions, also involves the implementation of accounting rules that deviate from the generally accepted accounting principles.

  20. Marketing therapeutic recreation services.

    Science.gov (United States)

    Thorn, B E

    1984-01-01

    The use of marketing strategies can enhance the delivery of therapeutic recreation services. This article discusses how agencies can adapt marketing techniques and use them to identify potential markets, improve image, evaluate external pressures, and maximize internal strengths. Four variables that can be controlled and manipulated in a proposed marketing plan are product, price, place and promotion.

  1. Therapeutic Recombinant Monoclonal Antibodies

    Science.gov (United States)

    Bakhtiar, Ray

    2012-01-01

    During the last two decades, the rapid growth of biotechnology-derived techniques has led to a myriad of therapeutic recombinant monoclonal antibodies with significant clinical benefits. Recombinant monoclonal antibodies can be obtained from a number of natural sources such as animal cell cultures using recombinant DNA engineering. In contrast to…

  2. Therapeutic applications of radiopharmaceuticals

    International Nuclear Information System (INIS)

    Baker, W.J.; Datz, F.L.; Beightol, R.W.

    1987-01-01

    Whether a radiopharmaceutical has diagnostic or therapeutic application depends on both the isotope and pharmaceutical used. For diagnostic applications, the isotope should undergo only γ-decay, since usually only γ-radiation is detected by nuclear medicine cameras. The half-life should be just long enough to allow the procedure to be performed. In contrast, the isotope needed for therapeutic purposes should have particulate radiation, such as a β-particle (electron), since these are locally absorbed an increase the local radiation dose. γ-Radiation, which penetrates the tissues, produces less radiation dose than do Β-particles. Several references dealing with radioactive decay, particulate interactions, and diagnostic and therapeutic applications of radiopharmaceuticals are available. Radiopharmaceuticals can legally be used only by physicians who are qualified by specific training in the safe handling of radionuclides. The experience and training of these physicians must be approved by the Nuclear Regulatory Commission or Agreement State Agency authorized to license the use of radiopharmaceuticals. A list of all byproduct material and procedures is available in the Code of Federal Regulations. Of the many radiopharmaceuticals available for diagnostic and therapeutic use, only those commonly used are discussed in this chapter

  3. Efficient Trajectory Options Allocation for the Collaborative Trajectory Options Program

    Science.gov (United States)

    Rodionova, Olga; Arneson, Heather; Sridhar, Banavar; Evans, Antony

    2017-01-01

    The Collaborative Trajectory Options Program (CTOP) is a Traffic Management Initiative (TMI) intended to control the air traffic flow rates at multiple specified Flow Constrained Areas (FCAs), where demand exceeds capacity. CTOP allows flight operators to submit the desired Trajectory Options Set (TOS) for each affected flight with associated Relative Trajectory Cost (RTC) for each option. CTOP then creates a feasible schedule that complies with capacity constraints by assigning affected flights with routes and departure delays in such a way as to minimize the total cost while maintaining equity across flight operators. The current version of CTOP implements a Ration-by-Schedule (RBS) scheme, which assigns the best available options to flights based on a First-Scheduled-First-Served heuristic. In the present study, an alternative flight scheduling approach is developed based on linear optimization. Results suggest that such an approach can significantly reduce flight delays, in the deterministic case, while maintaining equity as defined using a Max-Min fairness scheme.

  4. Disposition Options for Uranium-233

    International Nuclear Information System (INIS)

    Beahm, E.C.; Dole, L.R.; Forsberg, C.W.; Icenhour, A.S.; Storch, S.N.

    1999-01-01

    The U.S. Department of Energy (DOE) Fissile Materials Disposition Program (MD), in support of the U.S. arms-control and nonproliferation policies, has initiated a program to disposition surplus weapons-usable fissile material by making it inaccessible and unattractive for use in nuclear weapons. Weapons-usable fissile materials include plutonium, high-enriched uranium (HEU), and uranium-233 (sup 233)U. In support of this program, Oak Ridge National Laboratory led DOE's contractor efforts to identify and characterize options for the long-term storage and disposal of excess (sup 233)U. Five storage and 17 disposal options were identified and are described herein

  5. TMI abnormal wastes disposal options

    International Nuclear Information System (INIS)

    Ayers, A.L. Jr.

    1984-03-01

    A substantial quantity of high beta-gamma/high-TRU contaminated wastes are expected from cleanup activities of Unit 2 of the Three Mile Island Nuclear Power Station. Those wastes are not disposable because of present regulatory constraints. Therefore, they must be stored temporarily. This paper discusses three options for storage of those wastes at the Idaho National Engineering Laboratory: (1) storage in temporary storage casks; (2) underground storage in vaults; and (3) storage in silos at a hot shop. Each option is analyzed and evaluated. Also included is a discussion of future disposal strategies, which might be pursued when a suitable federal or commercial repository is built

  6. Design Evolution Study - Aging Options

    International Nuclear Information System (INIS)

    McDaniel, P.

    2002-01-01

    The purpose of this study is to identify options and issues for aging commercial spent nuclear fuel received for disposal at the Yucca Mountain Mined Geologic Repository. Some early shipments of commercial spent nuclear fuel to the repository may be received with high-heat-output (younger) fuel assemblies that will need to be managed to meet thermal goals for emplacement. The capability to age as much as 40,000 metric tons of heavy metal of commercial spent nuclear he1 would provide more flexibility in the design to manage this younger fuel and to decouple waste receipt and waste emplacement. The following potential aging location options are evaluated: (1) Surface aging at four locations near the North Portal; (2) Subsurface aging in the permanent emplacement drifts; and (3) Subsurface aging in a new subsurface area. The following aging container options are evaluated: (1) Complete Waste Package; (2) Stainless Steel inner liner of the waste package; (3) Dual Purpose Canisters; (4) Multi-Purpose Canisters; and (5) New disposable canister for uncanistered commercial spent nuclear fuel. Each option is compared to a ''Base Case,'' which is the expected normal waste packaging process without aging. A Value Engineering approach is used to score each option against nine technical criteria and rank the options. Open issues with each of the options and suggested future actions are also presented. Costs for aging containers and aging locations are evaluated separately. Capital costs are developed for direct costs and distributable field costs. To the extent practical, unit costs are presented. Indirect costs, operating costs, and total system life cycle costs will be evaluated outside of this study. Three recommendations for aging commercial spent nuclear fuel--subsurface, surface, and combined surface and subsurface are presented for further review in the overall design re-evaluation effort. Options that were evaluated but not recommended are: subsurface aging in a new

  7. Technetium removal: preliminary flowsheet options

    International Nuclear Information System (INIS)

    Eager, K.M.

    1995-01-01

    This document presents the results of a preliminary investigation into options for preliminary flowsheets for 99Tc removal from Hanford Site tank waste. A model is created to show the path of 99Tc through pretreatment to disposal. The Tank Waste Remediation (TWRS) flowsheet (Orme 1995) is used as a baseline. Ranges of important inputs to the model are developed, such as 99Tc inventory in the tanks and important splits through the TWRS flowsheet. Several technetium removal options are discussed along with sensitivities of the removal schemes to important model parameters

  8. Issues of organizational cybernetics and viability beyond Beer's viable systems model

    Science.gov (United States)

    Nechansky, Helmut

    2013-11-01

    The paper starts summarizing the claims of Beer's viable systems model to identify five issues any viable organizations has to deal with in an unequivocal hierarchical structure of five interrelated systems. Then the evidence is introduced for additional issues and related viable structures of organizations, which deviate from Beer's model. These issues are: (1) the establishment and (2) evolution of an organization; (3) systems for independent top-down control (like "Six Sigma"); (4) systems for independent bottom-up correction of performance problems (like "Kaizen"), both working outside a hierarchical structure; (5) pull production systems ("Just in Time") and (6) systems for checks and balances of top-level power (like boards and shareholder meetings). Based on that an evolutionary approach to organizational cybernetics is outlined, addressing the establishment of organizations and possible courses of developments, including recent developments in quality and production engineering, as well as problems of setting and changing goal values determining organizational policies.

  9. A multicenter study of viable PCR using propidium monoazide to detect Legionella in water samples.

    Science.gov (United States)

    Scaturro, Maria; Fontana, Stefano; Dell'eva, Italo; Helfer, Fabrizia; Marchio, Michele; Stefanetti, Maria Vittoria; Cavallaro, Mario; Miglietta, Marilena; Montagna, Maria Teresa; De Giglio, Osvalda; Cuna, Teresa; Chetti, Leonarda; Sabattini, Maria Antonietta Bucci; Carlotti, Michela; Viggiani, Mariagabriella; Stenico, Alberta; Romanin, Elisa; Bonanni, Emma; Ottaviano, Claudio; Franzin, Laura; Avanzini, Claudio; Demarie, Valerio; Corbella, Marta; Cambieri, Patrizia; Marone, Piero; Rota, Maria Cristina; Bella, Antonino; Ricci, Maria Luisa

    2016-07-01

    Legionella quantification in environmental samples is overestimated by qPCR. Combination with a viable dye, such as Propidium monoazide (PMA), could make qPCR (named then vPCR) very reliable. In this multicentre study 717 artificial water samples, spiked with fixed concentrations of Legionella and interfering bacterial flora, were analysed by qPCR, vPCR and culture and data were compared by statistical analysis. A heat-treatment at 55 °C for 10 minutes was also performed to obtain viable and not-viable bacteria. When data of vPCR were compared with those of culture and qPCR, statistical analysis showed significant differences (P 0.05). Overall this study provided a good experimental reproducibility of vPCR but also highlighted limits of PMA in the discriminating capability of dead and live bacteria, making vPCR not completely reliable. Copyright © 2016 Elsevier Inc. All rights reserved.

  10. Association of viable Mycobacterium leprae with Type 1 reaction in leprosy.

    Science.gov (United States)

    Save, Mrudula Prakash; Dighe, Anju Rajaram; Natrajan, Mohan; Shetty, Vanaja Prabhakaran

    2016-03-01

    The working hypothesis is that, viable Mycobacterium leprae (M. leprae) play a crucial role in the precipitation of Type 1 reaction (T1R) in leprosy. A total of 165 new multibacillary patients were studied. To demonstrate presence of viable M. leprae in reactional lesion (T1R+), three tests were used concurrently viz. growth in the mouse foot pad (MFP), immunohistochemical detection of M. leprae secretory protein Ag85, and 16s rRNA--using in situ RT-PCR. Mirror biopsies and non reactional lesions served as controls (T1R-). A significantly higher proportion of lesion biopsy homogenates obtained at onset, from T1R(+) cases have shown unequivocal growth in MFP, proving the presence of viable bacteria, as compared to T1R(-) (P leprae is a component/prerequisite and the secretory protein Ag 85, might be the trigger for precipitation of T1R.

  11. Comparison between three option, four option and five option multiple choice question tests for quality parameters: A randomized study.

    Science.gov (United States)

    Vegada, Bhavisha; Shukla, Apexa; Khilnani, Ajeetkumar; Charan, Jaykaran; Desai, Chetna

    2016-01-01

    Most of the academic teachers use four or five options per item of multiple choice question (MCQ) test as formative and summative assessment. Optimal number of options in MCQ item is a matter of considerable debate among academic teachers of various educational fields. There is a scarcity of the published literature regarding the optimum number of option in each item of MCQ in the field of medical education. To compare three options, four options, and five options MCQs test for the quality parameters - reliability, validity, item analysis, distracter analysis, and time analysis. Participants were 3 rd semester M.B.B.S. students. Students were divided randomly into three groups. Each group was given one set of MCQ test out of three options, four options, and five option randomly. Following the marking of the multiple choice tests, the participants' option selections were analyzed and comparisons were conducted of the mean marks, mean time, validity, reliability and facility value, discrimination index, point biserial value, distracter analysis of three different option formats. Students score more ( P = 0.000) and took less time ( P = 0.009) for the completion of three options as compared to four options and five options groups. Facility value was more ( P = 0.004) in three options group as compared to four and five options groups. There was no significant difference between three groups for the validity, reliability, and item discrimination. Nonfunctioning distracters were more in the four and five options group as compared to three option group. Assessment based on three option MCQs is can be preferred over four option and five option MCQs.

  12. Homeopathy in the Age of Antimicrobial Resistance: Is It a Viable Treatment for Upper Respiratory Tract Infections?

    Science.gov (United States)

    Fixsen, Alison

    2018-05-01

     Acute upper respiratory tract infections (URTIs) and their complications are the most frequent cause of antibiotic prescribing in primary care. With multi-resistant organisms proliferating, appropriate alternative treatments to these conditions are urgently required. Homeopathy presents one solution; however, there are many methods of homeopathic prescribing. This review of the literature considers firstly whether homeopathy offers a viable alternative therapeutic solution for acute URTIs and their complications, and secondly how such homeopathic intervention might take place.  Critical review of post 1994 clinical studies featuring homeopathic treatment of acute URTIs and their complications. Study design, treatment intervention, cohort group, measurement and outcome were considered. Discussion focused on the extent to which homeopathy is used to treat URTIs, rate of improvement and tolerability of the treatment, complications of URTIs, prophylactic and long-term effects, and the use of combination versus single homeopathic remedies.  Multiple peer-reviewed studies were found in which homeopathy had been used to treat URTIs and associated symptoms (cough, pharyngitis, tonsillitis, otitis media, acute sinusitis, etc.). Nine randomised controlled trials (RCTs) and 8 observational/cohort studies were analysed, 7 of which were paediatric studies. Seven RCTs used combination remedies with multiple constituents. Results for homeopathy treatment were positive overall, with faster resolution, reduced use of antibiotics and possible prophylactic and longer-term benefits.  Variations in size, location, cohort and outcome measures make comparisons and generalisations concerning homeopathic clinical trials for URTIs problematic. Nevertheless, study findings suggest at least equivalence between homeopathy and conventional treatment for uncomplicated URTI cases, with fewer adverse events and potentially broader therapeutic outcomes. The use of non

  13. Osteodistrofias do Osso Temporal: Revisão dos Conceitos Atuais, Manifestações Clínicas e Opções Terapêuticas Osteodysplasia of the Temporal Bone: Up-date Concepts, Clinical Presentations and Therapeutic Options

    Directory of Open Access Journals (Sweden)

    Oswaldo Laércio M. Cruz

    Full Text Available Sob a designação de osteodistrofias do osso temporal, podemos encontrar uma série de doenças que apresentam em comum a desorganização da arquitetura ou da composição do tecido ósseo. A otospongiose é, com larga margem, a osteodistrofia mais comum nessa localização e suas alterações, repercussões clínicas e tratamentos são amplamente discutidos na literatura. Entretanto, formas menos freqüentes, como a displasia fibrosa e a osteogênese imperfeita, não são entidades raras e merecem atenção. Este artigo tem como objetivo discutir essas formas menos comuns de osteodistrofia do temporal através de uma revisão sobre os conceitos atuais dessas entidades, da apresentação de três exemplos clínicos e a discussão sobre opções de tratamento.Osteodysplasia of the temporal bone included a significant amount of osseous diseases sharing bone matrix structural and composition damage. Otospongiosis is, by far, the most frequent form of this involvement in the temporal bone. Nevertheless, fibrous dysplasia and osteogenesis imperfecta are not rare and deserve attention. In this article, the authors present a discussion about the recent concepts of those less frequent forms of osteodysplasia of temporal bone, its options of treatment, illustrated with three clinical cases.

  14. El modelo de sistema viable: un instrumento para la organización efectiva

    Directory of Open Access Journals (Sweden)

    Norlando Sánchez Rueda

    2015-05-01

    Full Text Available RESUMEN En este ensayo se presenta una interpretación teórica del denominado Modelo de Sistema Viable (MSV, de Stafford Beer y su Potencial Aplicación en Tareas de Diagnóstico  y diseño empresarial, al igual que para Mejorar las capacidades Organizacionales de Auto- Regulación  y Auto- Organización. Se explica como el Modelo del Sistema Viable permite conocer e interpretar  los mecanismos de estabilidad y adaptabilidad de las organizaciones, pilares para el crecimiento de una verdadera organización Efectiva.

  15. Therapeutic inertia amongst general practitioners with interest in diabetes.

    Science.gov (United States)

    Seidu, Samuel; Than, Tun; Kar, Deb; Lamba, Amrit; Brown, Pam; Zafar, Azhar; Hussain, Rizwan; Amjad, Ahmed; Capehorn, Mathew; Martin, Elizabeth; Fernando, Kevin; McMoran, Jim; Millar-Jones, David; Kahn, Shahzada; Campbell, Nigel; Brice, Richard; Mohan, Rahul; Mistry, Mukesh; Kanumilli, Naresh; St John, Joan; Quigley, Richard; Kenny, Colin; Khunti, Kamlesh

    2018-02-01

    As the therapeutic options in the management of type 2 diabetes increase, there is an increase confusion among health care professionals, thus leading to the phenomenon of therapeutic inertia. This is the failure to escalate or de-escalate treatment when the clinical need for this is required. It has been studied extensively in various settings, however, it has never been reported in any studies focusing solely on primary care physicians with an interest in diabetes. This group is increasingly becoming the focus of managing complex diabetes care in the community, albeit with the support from specialists. In this retrospective audit, we assessed the prevalence of the phenomenon of therapeutic inertia amongst primary care physicians with an interest in diabetes in UK. We also assessed the predictive abilities of various patient level characteristics on therapeutic inertia amongst this group of clinicians. Out of the 240 patients reported on, therapeutic inertia was judged to have occurred in 53 (22.1%) of patients. The full model containing all the selected variables was not statistically significant, p=0.59. So the model was not able to distinguish between situations in which therapeutic inertia occurred and when it did not occur. None of the patient level characteristics on its own was predictive of therapeutic inertia. Therapeutic inertia was present only in about a fifth of patient patients with diabetes being managed by primary care physicians with an interest in diabetes. Copyright © 2017 Primary Care Diabetes Europe. Published by Elsevier Ltd. All rights reserved.

  16. Document Delivery: Evaluating the Options.

    Science.gov (United States)

    Ward, Suzanne M.

    1997-01-01

    Discusses options available to libraries for document delivery. Topics include users' needs; cost; copyright compliance; traditional interlibrary loan; types of suppliers; selection criteria, including customer service; new developments in interlibrary loan, including outsourcing arrangements; and the need to evaluate suppliers. (LRW)

  17. Exploring Higher Education Financing Options

    Science.gov (United States)

    Nkrumah-Young, Kofi K.; Powell, Philip

    2011-01-01

    Higher education can be financed privately, financed by governments, or shared. Given that the benefits of education accrue to the individual and the state, many governments opt for shared financing. This article examines the underpinnings of different options for financing higher education and develops a model to compare conditions to choices and…

  18. New options for purchasing electricity

    International Nuclear Information System (INIS)

    2003-10-01

    This guide is intended for small to medium commercial customers in Alberta and explains new options for purchasing electricity. Small to medium customers include corner stores, community centres, schools, small office buildings, and light industrial businesses. In the 1990s, private power producers in Alberta built 3,000 megawatts of new generation, adding 30 per cent more supply to the power grid in the province. Prices in the deregulated electricity market have fluctuated with natural gas prices, changing weather and changing power demands. The competitive electricity market was opened on January 1, 2001 in Alberta, offering consumers purchasing choices such as green power, multi-year contracts, or electricity rates under the Regulated Rate Option (RRO). The RRO was a transition mechanism that will end by December 31, 2003 at which time, small to medium commercial customers will have the option to shop around for competitive electricity contracts that provide a fixed price of power over time, or they can opt to stay with their current supplier and receive a regulated flow-through of market prices. Under the flow-through option, risk of future deferral charges is reduced, but electricity prices will probably change between billing periods. 1 fig

  19. LHC challenges and upgrade options

    Energy Technology Data Exchange (ETDEWEB)

    Bruning, O [CERN AB/ABP, Y03600, 1211 Geneva 23 (Switzerland)], E-mail: Oliver.Bruning@cern.ch

    2008-05-15

    The presentation summarizes the key parameters of the LHC collider. Following a discussion of the main challenges for reaching the nominal machine performance the presentation identifies options for increasing the operation tolerances and the potential performance reach of the LHC by means of future hardware upgrades of the LHC and its injector complex.

  20. LHC challenges and upgrade options

    International Nuclear Information System (INIS)

    Bruning, O

    2008-01-01

    The presentation summarizes the key parameters of the LHC collider. Following a discussion of the main challenges for reaching the nominal machine performance the presentation identifies options for increasing the operation tolerances and the potential performance reach of the LHC by means of future hardware upgrades of the LHC and its injector complex

  1. American options under stochastic volatility

    NARCIS (Netherlands)

    Chockalingam, A.; Muthuraman, K.

    2011-01-01

    The problem of pricing an American option written on an underlying asset with constant price volatility has been studied extensively in literature. Real-world data, however, demonstrate that volatility is not constant, and stochastic volatility models are used to account for dynamic volatility

  2. Greenhouse gas emissions reduction from fossil fuels: options and prospects

    International Nuclear Information System (INIS)

    McDonald, M.M.

    1999-01-01

    If levels of carbon dioxide in the atmosphere are to be stabilized over the next 50 years, net emissions from the use of fossil fuels have to be reduced. One concept worth exploring is the removal of carbon dioxide from plant flue gases and disposing of it in a manner that sequesters it from the atmosphere. A number of technologies, which are either commercially available or under development, promise to make this concept viable. The question of where to dispose of the carbon dioxide removed is not the limiting factor, given the potential for use in enhanced hydrocarbon production as well as other geological disposal options. In the longer term, fossil fuel use will significantly decline, but these extraction and sequestration technologies can provide the time for the transition to take place in a manner which causes least impact to the economies of the world. (author)

  3. Alternative Fuels Data Center: Biodiesel Equipment Options

    Science.gov (United States)

    Equipment Options to someone by E-mail Share Alternative Fuels Data Center: Biodiesel Equipment Options on Facebook Tweet about Alternative Fuels Data Center: Biodiesel Equipment Options on Twitter Bookmark Alternative Fuels Data Center: Biodiesel Equipment Options on Google Bookmark Alternative Fuels

  4. 26 CFR 1.544-4 - Options.

    Science.gov (United States)

    2010-04-01

    ... 26 Internal Revenue 7 2010-04-01 2010-04-01 true Options. 1.544-4 Section 1.544-4 Internal Revenue... (CONTINUED) Personal Holding Companies § 1.544-4 Options. The shares of stock which may be acquired by reason of an option shall be considered to be constructively owned by the individual having the option to...

  5. 24 CFR 206.19 - Payment options.

    Science.gov (United States)

    2010-04-01

    ... 24 Housing and Urban Development 2 2010-04-01 2010-04-01 false Payment options. 206.19 Section 206... CONVERSION MORTGAGE INSURANCE Eligibility; Endorsement Eligible Mortgages § 206.19 Payment options. (a) Term payment option. Under the term payment option, equal monthly payments are made by the mortgagee to the...

  6. 48 CFR 2917.207 - Exercising options.

    Science.gov (United States)

    2010-10-01

    ... 48 Federal Acquisition Regulations System 7 2010-10-01 2010-10-01 false Exercising options. 2917... AND CONTRACT TYPES SPECIAL CONTRACTING METHODS Options 2917.207 Exercising options. The contracting officer must use a standardized determination and finding before exercising an option in accordance with...

  7. Stata 8 Graphics: Options, sub-options and sub-sub-options

    OpenAIRE

    Tim Collier

    2005-01-01

    Stata 8 graphics have changed out of all recognition from that available in earlier versions. It was not just that a whole new array of options and sub-options were introduced, but the graph syntax itself completely changed. Just trying to produce a simple plot of x against y using Stata 7 syntax (graph x y) produced bewildering error messages e.g. xgraph_g.new y: class member function not found r(4023) and the like. If you did succeed in working out the new syntax (graph twoway scatter x y) ...

  8. PYTHIOSIS: A THERAPEUTIC APPROACH

    Directory of Open Access Journals (Sweden)

    C. M. C. Falcão

    2015-10-01

    Full Text Available Pythiosis, a disease caused by the oomycete Pythium insidiosum, often presents inefficient response to chemotherapy. It is a consensus that, in spite the several therapeutic protocols, a combination of surgery, chemotherapy and immunotherapy should be used. Surgical excision requires the removal of the entire affected area, with a wide margin of safety. The use of antifungal drugs has resulted in variable results, both in vitro and in vivo, and presents low therapeutic efficiency due to differences in the agent characteristics, which differ from true fungi. Immunotherapy is a non-invasive alternative for the treatment of pythiosis, which aims at modifying the immune response of the host, thereby producing an effective response to the agent. Photodynamic therapy has emerged as a promising technique, with good activity against P. insidiosum in vitro and in vivo. However, more studies are necessary to increase the efficiency of the current treatment protocols and consequently improve the cure rates. This paper aims to conduct a review covering the conventional and recent therapeutic methods against P. insidiosum infections

  9. Assessments of Total and Viable Escherichia coli O157:H7 on Field and Laboratory Grown Lettuce

    Science.gov (United States)

    Moyne, Anne-Laure; Harris, Linda J.; Marco, Maria L.

    2013-01-01

    Leafy green produce has been associated with numerous outbreaks of foodborne illness caused by strains of Escherichia coli O157:H7. While the amounts of culturable E. coli O157:H7 rapidly decline after introduction onto lettuce in the field, it remains to be determined whether the reduction in cell numbers is due to losses in cell viability, cell injury and a subsequent inability to be detected by standard laboratory culturing methods, or a lack of adherence and hence rapid removal of the organism from the plants during application. To assess which of these options is most relevant for E. coli O157:H7 on leafy green produce, we developed and applied a propidium monoazide (PMA) real-time PCR assay to quantify viable (with PMA) and total (without PMA) E. coli O157:H7 cells on growth chamber and field-grown lettuce. E. coli O157:H7, suspended in 0.1% peptone, was inoculated onto 4-week-old lettuce plants at a level of approximately 106 CFU/plant. In the growth chamber at low relative humidity (30%), culturable amounts of the nontoxigenic E. coli O157:H7 strain ATCC 700728 and the virulent strain EC4045 declined 100 to 1000-fold in 24 h. Fewer E. coli O157:H7 cells survived when applied onto plants in droplets with a pipette compared with a fine spray inoculation. Total cells for both strains were equivalent to inoculum levels for 7 days after application, and viable cell quantities determined by PMA real-time PCR were approximately 104 greater than found by colony enumeration. Within 2 h after application onto plants in the field, the number of culturable E. coli ATCC 700728 was reduced by up to 1000-fold, whereas PCR-based assessments showed that total cell amounts were equivalent to inoculum levels. These findings show that shortly after inoculation onto plants, the majority of E. coli O157:H7 cells either die or are no longer culturable. PMID:23936235

  10. Equity Portfolio Management Using Option Price Information

    DEFF Research Database (Denmark)

    Christoffersen, Peter; Pan, Xuhui (Nick)

    We survey the recent academic literature that uses option-implied information to construct equity portfolios. Studies show that equity managers can earn a positive alpha by using information in individual equity options, by using stocks' exposure to information in market index options, and by using...... stocks' exposure to crude oil option information. Option-implied information can also help construct better mean-variance portfolios and better estimates of market beta....

  11. The Pricing of Foreign Currency Futures Options

    OpenAIRE

    Chang Mo Ahn

    1996-01-01

    We derive semi-closed form solutions for the forward and futures exchange rates, European foreign currency options, currency forward options, and currency futures options when the domestic and foreign interest rate movements follow mean reverting diffusion processes. These solutions are consistent with the Black-Scholes option formula so that they can be easily applied. The impact of interest rate uncertainty on theoretical prices of currency futures options is too significant to be neglected.

  12. In search of viable business models for development: sustainable energy in developing countries

    NARCIS (Netherlands)

    Kolk, A.; van den Buuse, D.

    2012-01-01

    Purpose - Although the crucial role of business, and of business-based approaches, in development is increasingly emphasised by academics and practitioners, insight is lacking into the "whether and how" of viable business models, in environmental, social and economical terms. This article analyses

  13. Modelling the number of viable vegetative cells of Bacillus cereus passing through the stomach

    NARCIS (Netherlands)

    Wijnands, L.M.; Pielaat, A.; Dufrenne, J.B.; Zwietering, M.H.; Leusden, van F.M.

    2009-01-01

    Aims: Model the number of viable vegetative cells of B. cereus surviving the gastric passage after experiments in simulated gastric conditions. Materials and Methods: The inactivation of stationary and exponential phase vegetative cells of twelve different strains of Bacillus cereus, both mesophilic

  14. 9 CFR 113.27 - Detection of extraneous viable bacteria and fungi in live vaccines.

    Science.gov (United States)

    2010-01-01

    ... bacteria and fungi in live vaccines. 113.27 Section 113.27 Animals and Animal Products ANIMAL AND PLANT... bacteria and fungi in live vaccines. Unless otherwise specified by the Administrator or elsewhere exempted... Seed Bacteria shall be tested for extraneous viable bacteria and fungi as prescribed in this section. A...

  15. 40 CFR 180.1011 - Viable spores of the microorganism Bacillus thuringiensis Berliner; exemption from the...

    Science.gov (United States)

    2010-07-01

    ... EXEMPTIONS FOR PESTICIDE CHEMICAL RESIDUES IN FOOD Exemptions From Tolerances § 180.1011 Viable spores of the... characteristics of the parent strain or contamination by other microorganisms. (3) Each lot of spore preparation... production is a Bacillus thuringiensis strain which does not produce β-exotoxin under standard manufacturing...

  16. Economically viable biochemical processes for the advanced rural biorefinery and downstream recovery operations

    Science.gov (United States)

    Rural biorefineries offer an alternative to traditional ethanol production by providing the opportunity to produce fuel on site to reduce costs associated with biomass transportation thus making the fuel economically viable. Widespread installation of rural biorefineries could lead to increased upt...

  17. The ghost of extinction: Preservation values and minimum viable population in wildlife models

    NARCIS (Netherlands)

    Eiswerth, M.E.; Kooten, van G.C.

    2009-01-01

    The inclusion of a minimum viable population in bioeconomic modeling creates at least two complications that are not resolved by using a modified logistic growth function. The first complication can be dealt with by choosing a different depensational growth function. The second complication relates

  18. Viable Techniques, Leontief’s Closed Model, and Sraffa’s Subsistence Economies

    Directory of Open Access Journals (Sweden)

    Alberto Benítez

    2014-11-01

    Full Text Available This paper studies the production techniques employed in economies that reproduce themselves. Special attention is paid to the distinction usually made between those that do not produce a surplus and those that do, which are referred to as first and second class economies, respectively. Based on this, we present a new definition of viable economies and show that every viable economy of the second class can be represented as a viable economy of the first class under two different forms, Leontief‘s closed model and Sraffa’s subsistence economies. This allows us to present some remarks concerning the economic interpretation of the two models. On the one hand, we argue that the participation of each good in the production of every good can be considered as a normal characteristic of the first model and, on the other hand, we provide a justification for the same condition to be considered a characteristic of the second model. Furthermore, we discuss three definitions of viable techniques advanced by other authors and show that they differ from ours because they admit economies that do not reproduce themselves completely.

  19. Entry of Vibrio harveyi and Vibrio fischeri into the viable but nonculturable state.

    Science.gov (United States)

    Ramaiah, N; Ravel, J; Straube, W L; Hill, R T; Colwell, R R

    2002-01-01

    Physiological responses of marine luminous bacteria, Vibrio harveyi (ATCC 14216) and V. fischeri (UM1373) to nutrient-limited normal strength (35 ppt iso-osmolarity) and low (10 ppt hypo-osmolarity) salinity conditions were determined. Plate counts, direct viable counts, actively respiring cell counts, nucleoid-containing cell counts, and total counts were determined. Vibrio harveyi incubated at 22 degrees C in nutrient-limited artificial seawater (ASW) became nonculturable after approximately 62 and 45 d in microcosms of 35 ppt and 10 ppt ASW, respectively. In contrast, V. fischeri became nonculturable at approximately 55 and 31 d in similar microcosms. Recovery of both culturability and luminescence of cells in the viable but nonculturable state was achieved by addition of nutrient broth or nutrient broth supplemented with a carbon source, including luminescence-stimulating compounds. Temperature upshift from 22 degrees C to 30 degrees C or 37 degrees C did not result in recovery from nonculturability. The study confirms entry of V. harveyi and V. fischeri into the viable but nonculturable state under low-nutrient conditions and demonstrates nutrient-dependent resuscitation from this state. This study confirms loss of luminescence of V. harveyi and V. fischeri on entry into the viable but nonculturable state and suggests that enumeration of luminescent cells in water samples may be a rapid method to deduce the nutrient status of a water sample.

  20. Is a HIV vaccine a viable option and at what price? An economic evaluation of adding HIV vaccination into existing prevention programs in Thailand

    OpenAIRE

    Leelahavarong, Pattara; Teerawattananon, Yot; Werayingyong, Pitsaphun; Akaleephan, Chutima; Premsri, Nakorn; Namwat, Chawetsan; Peerapatanapokin, Wiwat; Tangcharoensathien, Viroj

    2011-01-01

    Abstract Background This study aims to determine the maximum price at which HIV vaccination is cost-effective in the Thai healthcare setting. It also aims to identify the relative importance of vaccine characteristics and risk behavior changes among vaccine recipients to determine how they affect this cost-effectiveness. Methods A semi-Markov model was developed to estimate the costs and health outcomes of HIV prevention programs combined with HIV vaccination in comparison to the existing HIV...